Criminal Liability of Legal Entities in Health Care Abstract The submitted diploma thesis deals with the institute of criminal liability of legal entities in health care. The main objective of this thesis is to define all the requirements and essential elements of criminal responsibility of legal persons, especially healthcare providers. We also look into the most critical aspects of providing healthcare services in which a criminal offense may be committed. Concepts of criminal law are considered in the context of medical law. Thesis is divided into five main chapters. The first chapter focuses on conditions of criminal liability taking into account the specifics of the topic. Attention will also be paid to attributability of a crime to a legal person as well as to legal regulation in United Kingdom and France. In the second chapter we describe the most common circumstances excluding illegality in medicine. We particularly focus on medical intervention, research and experiment. These are not only accepted but also beneficial. The third chapter deals with the main concepts of medical law. If healthcare providers comply with related legal provisions, they significantly reduce the risk of committing an act against the law. Special emphasis is placed on lege artis procedure as an objective measurement of...

The Criminal Offence of Failure to Provide Assistance in the Context of Healthcare Abstract The diploma thesis deals with the specifics of the criminal offence of failure to provide assistance which arise when the perpetrator is a healthcare worker. The thesis analyses the conditions under which the obligation to provide assistance arises from affiliation to a healthcare profession applies, and the content of this obligation. Given that the exercise of a healthcare profession is an activity significantly regulated by non-criminal regulations, the obligation in question is interpreted in the context of the entire legal order. The initial proposition is that the obligation in question is narrower than literal interpretation of criminal law provisions may imply, if interpreted in isolation. Contrary to the general assumption, both the range of persons to whom the provision applies, as well as the conditions under which the obligation arises, and quality of the required level of the assistance, are limited. In its first part, the paper first deals with the definition of key terms (with focus on the concept of a healthcare worker) and defines the basic obligations that the legal system imposes on healthcare workers. The subsequent part is devoted to explications of the criminal offence of failure to provide...

<p dir="ltr">This study aims to predict the environmental, organizational, and managerial factors that determine the adoption of cloud computing in U.S. healthcare delivery systems. The premise of the analysis is that several internal and external factors determine a health provider’s transition to cloud computing. The U.S. government has funded healthcare providers through HITECH <a href="" target="_blank">(Health Information Technology for Economic and Clinical Health) </a>to implement electronic health records (EHR) which is considered as an important first step in transitioning to cloud computing. This study investigated whether there is a significant difference between hospitals and providers that received HITECH funding to enhance their EHR infrastructure and those that did not in terms of their external environmental complexities, internal organizational structure, and quality of healthcare services they provide. A stratified random sample was applied to select a cohort of 3,385 hospitals from the American Hospital Association (AHA) 2022 roster for the period 2018- 2021 to test the study hypothesis. The sampled hospitals were linked with claim, administrative, cost, and ICD-10 clinical data files to capture variables of interest repeatedly over the study period. The analysis modeled for selected external (location, market concentration as measured by Herfindahl Index), internal (number and composition of staff – physicians, nurses, technicians, etc.) demographic, clinical and financial factors. Quantitative methods such as generalized estimating equations (GEE), logistic regression, and generalized linear mixed model (GLMM) were applied within the framework of unified technology acceptance theory (UTAT), accounting for both discrete and continuous response variables while modeling for possible between-subject heterogeneity and within-subject correlations. The analysis is based on publicly available data sources that are systematically linked to address the research questions. The portion of the HITECH funding that is applied for cloud computing is calculated from the hospital’s EHR funding. This is one of the very few longitudinal time series studies of cloud computing in healthcare since almost all previous studies on American hospitals are cross-sectional. The findings of this study show statistically significant differences between hospitals that received government funding in terms of internal organizational structure, environmental complexity, and quality of healthcare provided. The analysis identified management and quality metrics that help to gauge continuously changing organizational needs and identify emerging trends. This study proposes specific topics that future researchers can consider promoting a successful implementation of cloud computing.</p>

This research studies the phenomena of hospital groups expanding beyond their home country by setting up operations in less developed countries, and patients travelling out of their country for healthcare services, by looking at the internationalisation of private healthcare firms from Singapore. The research helps to address a gap in the literature as there is a lack of firm-level research on internationalisation of healthcare firms, and even more so for firms from Southeast Asia. For practitioners, the research offers a better understanding of the internationalisation strategies and choices adopted by healthcare firms, and more generally, service firms. With the region which Singapore is part of undergoing rapid integration, the study also offers useful insights on the impact of regional integration on internationalisation of healthcare firms. Using a multiple-case study of four private healthcare firms from Singapore, the research examines the where (market selection), how (entry modes) and when (timing) of their internationalisation, as well as their response to regional integration, in the context of existing literature on internationalisation of firms. The study shows that the internationalisation strategies of healthcare firms from Singapore, in relation to market selection, entry modes and timing of entry, were well-explained by existing theories on internationalisation of firms. Family ownership was identified as a reason for the deviation from theory for one of the cases. Specifically on the internationalisation of healthcare firms, the study shows that healthcare services in Singapore is undergoing commodification, with increasing use of and emphasis on 'marketing' to procure patients-customers; increasing emphasis on quality; and the creation of customers and consumers. This has made healthcare services increasingly 'exportable' in the sense that they can be 'sold' overseas away from the point of 'production', via representative offices, instead of having to rely on higher commitment non-export entry modes as indicated in the literature. Another deviation from literature was the case firms' stated preference to make market entry using management contract instead of joint venture. This can be attributed to their strategic need to internationalise quickly and the high cost of building new healthcare facilities. Using the findings from the analysis, the thesis proposed a characterization of the internationalisation strategies of a healthcare firm from Singapore, in terms of market selection, entry modes and timing of entry. A conceptual model on the internationalisation of healthcare firms was also developed, identifying the factors which may influence the internationalisation of healthcare firms. Besides, the study identified that the healthcare firms went through four phases of internationalisation process, namely, learning, opportunistic, de-internationalisation and maturisation, with each presenting some unique patterns of internationalisation by the firms. Further analysis showed that the four phases tied in well with the 'Link-Leverage-Learn' framework of Mathews (2006) for emerging/second wave multinational enterprises (MNEs), hence offering a new perspective for evaluating the internationalisation of such firms in future. On impact of regional integration, a possible 'ideal' model for a healthcare MNE in an economically integrated region was proposed. Applying the model, it is proposed that internationalisation by healthcare MNEs will increase as the region integrates, and there will be further consolidation within the industry. Healthcare MNEs from small countries like Singapore are likely to compete particularly strongly, as they are under even greater pressure to secure the foreign markets given the constraint of their small domestic population.

MPH / Department of Public Health / See the attached abstract below

The current study explores the experiences of mental health care professionals in Sweden who conduct therapy with the assistance of an interpreter. Seven participants took part in semi-structured interviews that were analyzed using interpretative phenomenological analysis (Smith, 1996). Three main themes emerged from the analysis of the interview transcripts: (1) communication and translation - highlighting the communicative challenges and benefits that arise when using an interpreter, (2) the interpreter as a person and as a professional - describing the variation of interpreters in terms of behavior, personality, roles, and professionalism, and their impact on psychological treatment, and (3) dynamics and relations - featuring the interpreter’s impact on the dynamics and the process of building a patient-therapist alliance. The results show that all participants find it difficult to determine the accuracy of the translation, and several techniques used by the clinician to ensure a correct translation were pointed out. Moreover, findings highlight the essentiality of non-verbal cues and body language in communication and that the role and the behavior, in addition to several personal factors of the interpreter has an impact on the patient-therapist alliance and therapy dynamics. In addition, the study illuminates the patient’s impact on the interpreter as many interpreters themselves have been through traumatic experiences, which in turn may affect the therapeutic process. The findings of the current study show how important it is for clinicians, mental health services, and interpreting services to take the interpreters’ impact on the clinician, the patient, and the therapeutic outcome  into account. The study aims to contribute to a better understanding of clinicians’ experiences of working with interpreters to improve the use of - and collaboration with - interpreters and thereby raise the standard of psychological treatment for refugees and asylum seekers.

Healthcare systems need to adjust services and methods to accommodate the needs, desires, and capabilities of people. Experience-Based Co-Design (EBCD) is the state of the art in participatory service design within the UK National Health Service (NHS), that draws upon design tools and ways of thinking in order to bring healthcare staff and patients together to improve the quality of care. The Co-design process that is integral to the EBCD approach is powerful but also challenging, as it requires active collaboration among multidisciplinary teams, including organizational stakeholders (e.g., investors, managers, advocates, etc.), end-users (e.g., staff, patients, carers, etc.), designers/researchers, and developers. Over the last decade, given the evaluation of the EBCD approach, there has been a gap between theory and practice resulting in limited outcomes in healthcare service improvements. Systematic reviews suggest this low success results from the lack of a systematic elaboration of Co-Design methods, limited tools and insufficient guidance on the ideation process, the tendency to develop a solution without enough divergent thinking, and a poor structure of participation. In order to improve health care services and address the gaps mentioned, we propose a methodology called Double Hexagon, that includes principles of Co-Design, Human-Centred Design, and Design Thinking. This framework is a Human-Centred Design framework that seeks to assist designers and non-designers in moving from designing “product” categories to designing for “people” by providing a concrete and step-by-step realization for “Designing for People”. / Thesis / Master of Science (MSc)

Darbo tikslas. Įvertinti sergančiųjų reumatoidiniu artritu darbingo amžiaus žmonių gyvenimo kokybės sąsajas su sveikatos paslaugų prieinamumu Prienų rajone. Uždaviniai. Įvertinti sergančiųjų reumatoidiniu artritu darbingo amžiaus žmonių klinikinę charakteristiką ir sąsajas su socialiniais – ekonominiais veiksniais. Ištirti sergančiųjų reumatoidiniu artritu darbingo amžiaus žmonių savarankiško judėjimo ir apsitarnavimo galimybes. Įvertinti sergančiųjų reumatoidiniu artritu darbingo amžiaus žmonių gydymo įstaigos pasiekiamumo ir aptarnavimo galimybes. Įvertinti sergančiųjų reumatoidiniu artritu gyvenimo kokybės ir skausmo intensyvumo sąsajas su aptarnavimu ir sveikatos priežiūros paslaugų prieinamumo galimybėmis. Tyrimo metodika. Kiekybinis momentinis tyrimas. Anketinė apklausa, naudota SF – 36, DAS 28 ir paruoštas bendrojo pobūdžio klausimynas. Analizuojamosios imties dydis – 67 reumatoidiniu artritu sergantys asmenys. Atsako dažnis – 74,4 proc. Gautiems duomenims apdoroti naudota SPSS 22.0. Rezultatai. Tyrime dalyvavo 61,2 proc. moterų ir 38,8 proc. vyrų. Patenkinamai savo sveikatos būklę dažniau vertino dirbantys respondentai, gyvenantys santuokoje, kaime. Nustatyta, kad sąnarių skausmas dažnai vargina 50,7 proc. respondentų, sąnarių sutinimas – 40,3 proc. tiriamųjų, rytinis sąnarių sustingimas – 34,3 proc. apklaustųjų, sąnarių judesių ribotumas – 52,2 proc. Nedirbantys, gaunantys mažas pajamas respondentai dažniau teigė turintys daugiau sutinusių ir skausmingų sąnarių... [toliau žr. visą tekstą] / Aim of the study. To evaluate the quality of life and its links with accessibility to healthcare services for working age patients with rheumatoid arthritis in Prienai region. Objectives. To evaluate the clinical characteristics and their links to the social - economic factors for working age patients with rheumatoid arthritis. To analize the self-movement and the self-service capabilities for working age patients with rheumatoid arthritis. To evaluate the reach of medical institutions and the service capabilities for working age patients with rheumatoid arthritis. To evaluate the quality of life, the intensity of pain and their links with accessibility to healthcare services for working age patients with rheumatoid arthritis. Methods. Quantitative cross sectional research. The size of the sample under analysis – 67 patients with rheumatoid arthritis. The frequency of the response is 74,4 %. The statistical analysis of data was performed using statistical package SPSS Statistics 22.0. Results. 61,2% women and 38,8% man participated in the study. Working in, living in marriage, living in the village respondents their health evaluated satisfactory more often. The pain of joints more often suffer 50,7% of respondents, the swelling of joints – 40,3%, morning stiffness – 34,3%, limitation of joint movement – 52,2%. The unemployed, with low incomes respondents affirmed about the swollen and the painful joints more often. Respondents living in the village and the employed... [to full text]

Abstract This thesis describes the development of a personal machine-to-machine (M2M) healthcare system that is both flexible and scalable. Based on the IPv6 protocol, the system can be used over a low-power wireless personal area network (6LoWPAN). Since a hierarchical network structure offers excellent accessibility, the system is applicable both to local and international healthcare services. To further enhance scalability and reliability, the proposed system combines 6LoWPAN with mobile techniques, depending on whether the sensor is located inside or outside the range of a wireless sensor network (WSN). Employing wearable low-power sensors, the system measures health parameters dynamically. For wireless transmission, these sensors are connected to an M2M node either through the internet or through an external IPv4/IPv6-enabled network. The applicability of the IEEE 802.15.4 and 6LoWPAN protocols to wide area networks were verified in practical tests using an M2M gateway. To assess the physical health of an individual, the system uses heart rate variability analysis in time and frequency domains. Acquired data are first stored on a server for analysis. Results of the analysis are then automatically sent to Android-based mobile devices carried by the individual or appointed healthcare providers. In this way, mobile techniques are used to support remote health monitoring services. This personal M2M healthcare system has the capacity to accurately process a large amount of biomedical signals. Moreover, due to its ability to use mobile technology, the system allows patients to conveniently monitor their own health status, regardless of location. / Tiivistelmä Tutkimuksessa kehitetään henkilökohtainen mobiililaitteden välillä toimiva (M2M) terveydenhoitojärjestelmä, joka mahdollistaa joustavan ja skaalautuvan potilaan terveyden monitoroinnin. Perustuen IPv6-protokollaan, sovellusta voidaan käyttää matalatehoisen langattoman 6LowPAN-verkon yli. Koska hierarkkinen verkkorakenne tarjoaa erinomaisen saavutettavuuden, järjestelmän kapasiteetti riittää paitsi kaupungin sisäisten myös kansainvälisten terveyspalvelujen järjestämiseen. Skaalattavuuden ja luotettavuuden vuoksi ehdotettu järjestelmä yhdistelee 6LowPAN-tekniikkaa mobiiliteknologiaan riippuen siitä onko sensori langattoman sensoriverkon kuuluvuusalueella vai sen ulkopuolella. Puettavia matalatehoisia sensoreita käyttävä järjestelmä kykenee mittaamaan terveysparametreja dynaamisesti. Langatonta siirtoa varten nämä sensorit on kytketty M2M-solmuun joko internetin tai ulkoisen IPv4/IPv6-verkon kautta. Käytännön testeissä IEEE802.15.4- ja 6LowPAN-protokollien soveltaminen laajaverkossa mahdollistettiin tähän soveltuvalla M2M-yhdyskäytävällä. Yksilöiden fyysisen terveyden arvioinnissa järjestelmä käyttää sydämen sykevaihtelun analysointia aika- ja taajuustasossa. Data tallennetaan palvelimelle analysointia varten. Analyysin tulokset lähetetään automaattisesti henkilöiden omiin tai heidän lääkäriensä mobiililaitteisiin. Näin mobiiliteknologiaa käytetään tukemaan terveyden etämonitorointipalveluja. Tämä henkilökohtainen M2M-kommunikointiin perustuva terveydenhoitojärjestelmä kykenee käsittelemään tarkkaan suuriakin määriä 6LowPAN-verkon ja internetin kautta tulevia biolääketieteellisiä signaaleja. Lisäksi kyky käyttää mobiiliteknologiaa tekee järjestelmästä potilaille miellyttävän tavan monitoroida omaa terveydentilaansa sijaintipaikasta riippumatta.

This study aimed at identifying the socio-demographic and service related factors influencing intra uterine contraceptive device (IUD) utilization among family planning clients in Addis Ababa. With a quantitative, cross sectional descriptive design approach, data was collected using structured questionnaires administered by healthcare supervisors. A total of 366 family planning clients and 35 family planning service providers were interviewed. The findings indicated that the level of education, occupation, parity and fertility plan have significant (p<0.05) association with utilization of IUD. Healthcare service provider’s knowledge and skills for provision of intra uterine contraceptive device services were low. Community members lack awareness and knowledge of the benefit and side effects of the device. Therefore, community members need education to promote adherence and effective use of IUD. Similarly, healthcare service providers need skill training and education to ensure quality provision of IUD service / Health Studies / M.A. (Public Health)