Source: Masters Abstracts International, Volume: 46-01, page: 0343. Adviser: Nuria Homedes. Includes bibliographical references.

Thesis (M.S.)--University of North Carolina at Wilmington, 2005. / Includes bibliographical references (leaves: [25]-33)

Thesis--University of Wisconsin--Madison. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 317-332).

This thesis examines the impact of disease and mortality on the Royal Navy in the West Indies from 1770 to 1806. It also investigates the navy’s medical branch which was established to manage the care of sick seamen. Using an interdisciplinary approach, this thesis produces a cohesive understanding of how disease and mortality affected the navy’s presence in the West Indies and the ways in which the navy attempted to mitigate their impact. This thesis explores various aspects of naval medicine including the history of the Sick and Hurt Board, the diseases which distressed seamen, the medicines distributed by the navy, the key personnel who were integral in generating changes to the medical system and the development of hospital facilities. Largely based on Admiralty records including correspondence and minutes from the Sick and Hurt Board, ships’ muster books and surgeons’ journals, this thesis investigates the most prevalent diseases in the West Indies and the prescribed treatments advocated by the navy. It then examines how these diseases and treatments affected seamen on board ships in that region through a quantitative analysis; then focuses on a number of the integral naval personnel who ushered in sweeping changes to naval medicine; and explores the navy’s increasing desire to transition from hired sick quarters to purpose-built naval hospitals on various West Indies islands. It concludes with a case study of the development of Antigua naval hospital which demonstrates the effectiveness of these facilities in convalescing sick seamen. Through a quantitative analysis of ships’ muster books, this thesis argues that the levels of sickness and mortality in the navy in the West Indies during the late eighteenth century are largely exaggerated in historical studies while also discrediting the myth that those islands were the ‘white man’s graveyard’ for many naval personnel. By surveying over 100,000 seamen on board ships in that region, sickness and mortality figures emerge which indicate that, on average, less than 4 per cent of seamen were on the sick list at any given time and only a small percentage died, meaning that the majority remained on active duty. This thesis then argues that many of the changes to the navy’s medical system that facilitated such low percentages were primarily instigated by surgeons, physicians and captains who identified beneficial medicines and championed their general distribution among the entire fleet. By looking at these aspects of naval medicine through a multidisciplinary lens rather than a purely administrative one, it is possible to understand the true state of health of British seamen in the West Indies during the last quarter of the eighteenth century.

Made available in DSpace on 2018-06-04T19:14:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-10-06 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Este trabalho tem como objetivo analisar, na perspectiva de médicos e enfermeiros, as condições e a organização do trabalho em dois hospitais sob diferentes formas de gestão - Administração Direta (ADM) e Organização social (OS) - ambos componentes do sistema público de saúde de um município de grande porte da região metropolitana de São Paulo. Como passo metodológico procedeu-se à validação do Questionário sobre Condições de Trabalho – qCT, em sua dimensão quantitativa, como instrumento de avaliação da organização e das condições de trabalho. Em um segundo momento, em estudo de cunho quantitativo, foi aplicado o qCT, objetivando identificar e discutir as condições de trabalho dos enfermeiros e médicos em relação às diferentes formas de gestão. Na validação foram utilizados 689 questionários respondidos por profissionais dos serviços públicos de diferentes níveis de atenção sob gestão da Secretaria de Saúde do município estudado. A análise dos principais componentes evidenciou a existência de seis fatores agrupados em três pares de escalas, mostrando todas elas uma alta consistência interna, com alfas de Cronbach de 0.96 e Análise Fatorial Confirmatória ≥ 90, sendo aceitos valores acima de 90.Os dados indicam que o qCT reproduz fielmente a estrutura do modelo teórico assumido e reúne as propriedades técnicas necessárias para avaliar as condições de trabalho em serviços de saúde. Na segunda etapa, a amostra estudada foi composta por 181 questionários distribuídos do seguinte modo: 88 no hospital ADM e 93 no hospital OS. No hospital ADM, 54 eram médicos e 39 enfermeiros. No hospital OS 57 eram médicos e 31 enfermeiros. Os dados categóricos foram apresentados por frequências e proporções, enquanto os dados numéricos foram descritos por médias e desvios-padrão. Analisando as respostas obtidas, delineia-se uma tendência, notadamente entre os médicos, de aceitação e naturalização de vínculos empregatícios privados, e mesmo valorização do setor privado. Entre os enfermeiros destacam-se a ambiguidade em relação às condições de trabalho e respostas matizadas por atitudes de aquiescência com as normas da organização. Esses posicionamentos são analisados à luz de referencial teórico que situa a assistência hospitalar sob gestão das OS como empreendimento tornado vantajoso em um contexto de apropriação do fundo público por empresas médicas em crise, com a imposição de instabilidade de vínculos empregatícios e colonização da esfera pública por valores neoliberais, tais como o empreendedorismo, maciçamente propagandeado pelos meios de comunicação e aceito pela classe “média” a qual pertence a maior parte dos médicos e enfermeiros que participaram dessa pesquisa. / This study aims to capture and analyze, from the perspective of physicians and nurses, the working organization and conditions in two hospitals under different management forms -- direct administration- Adm and social organization – OS- both components of the public health system of a large municipality of greater São Paulo. As a major methodological step, the Questionnaire on Working Conditions (qCT) was validated in its quantitative dimension as an instrument for evaluating the working organization and conditions. In a second moment, in a quantitative study, the qCT was applied, objectifying to identify and discuss the working organization and conditions of nurses and physicians in two hospitals under different management forms. The sample of the first phase consisted of 689 health professionals working in the public health system under the Health Secretary management. The analysis of the main components has shown the existence of six factors, grouped by pairs in three sets, all of which have shown high internal consistence, with Cronbach's alpha of 0.96 and Confirmatory Factor Analysis ≥ 90 (values above 90 being accepted). The data indicates that the Working Conditions Questionnaire reliably reproduces the structure of the assumed theoretical model and combines the necessary technical properties that allow working conditions in health services to be properly reviewed. In the second phase, 181 questionnaires were answered, distributed as follows: 88 in the Adm hospital and 93 in the OS hospital. At the Adm hospital, 54 were doctors and 39 were nurses. At the OS hospital 57 were doctors and 31 were nurses. The categorical data were presented by frequencies and proportions, while the numerical data were described by means and standard deviations. Analyzing the answers obtained, a tendency is drawn, notably among physicians, of acceptance of private employment bonds, and even valuation of the private sector. Among the nurses, it is noted the ambiguity in relation to working conditions and answers marked by acquiescent attitudes towards the rules of the organization. These positionings are analyzed through a theoretical referential which places hospital assistance under OS management as an enterprise turned advantageous in a context of appropriation of public funds by failing medical businesses, with an imposition of instability of employment bonds and colonization of the public sphere by neoliberal values, such as entrepreneurship, massively propragandized by mass media and accepted by the middle classes, to which most of the physicians and nurses which took part in this research belong to. / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2013-01-07T15:55:05Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 41.pdf: 848742 bytes, checksum: 1d293ae153616b59c2b8699f6667eac2 (MD5) Previous issue date: 2003 / Pretende contribuir para o entendimento dos diferentes significados do Chernoviz - enquanto representante da medicina legitimada pelas instituições oficiais, como a Academia Imperial de Medicina e as Faculdades de Medicina - no ambiente médico da Corte. O Chernoviz foi lido e utilizado por pessoas de diversas categorias sociais e profissionais, para as quais facilitou o entendimento da hermética ciência médica. A fim de precisar algumas caracteríticas do Chernoviz, são introduzidos dois problemas: um deles diz respeito à interpretação do papel dos manuais por uma parte da literatura, segundo a qual, estes livros seriam repositórios de crendices; o segundo reside numa possível antítese entre o estatuto individual do saber médico acadêmico, em relação ao diagnóstico e à terapêutica, e o caráter generalizador que os manuais imputaram a esse mesmo conhecimento.

Made available in DSpace on 2013-01-07T15:59:31Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 12.pdf: 1377881 bytes, checksum: 07d30194145660c8a9740d84bc251271 (MD5) Previous issue date: 2009 / No presente trabalho foi realizada uma reflexão sobre a condução do ensino médico no Brasil. Afirma-se que os catedráticos de Clínica Médica da Faculdade de Medicina do Rio de Janeiro, e em especial o Professor Clementino Fraga Filho, tiveram papel de liderança neste processo. A tese pretendeu mostrar que, acima de quaisquer modelos apontados pela bibliografia especializada franceses, germânicos ou norte-americanos - o grupo de catedráticos clínicos que chamamos de geração dos anos 1950 acreditou que a Clínica Médica seria a base do ensino de medicina. Apresenta-se, aqui, então, a 1ª Cátedra de Clínica Médica, do Professor Clementino Fraga Filho, como um arquétipo de excelência de ensino. Além de terem buscado estimular a homogeneização dos currículos das diversas faculdades de medicina do país, estes professores propuseram a criação de departamentos, em oposição à instituição tradicional cátedra, que, por ser conduzida por um único indivíduo, seu proprietário , constituía-se um entrave para a qualidade do ensino da medicina. Os catedráticos clínicos elaboraram propostas de uma reforma para o ensino médico e para o ensino superior, em geral, que culminaria, em muitos pontos, num evento distinto de suas perspectivas iniciais, a Reforma Universitária de 1968. Suas aspirações curriculares e estruturais para o ensino médico foram frustradas, pois, longe de resultar em maior diálogo entre as diversas disciplinas, a Reforma terminaria em sua fragmentação.

This study aimed at describing and interpreting the changing symbolic meanings of the Acquired Immunodefiency Syndrome (AIDS) which encountering a Human Immunodefiency Virus (HIV)-positive patient introduced into the personal and professional identities of six health care professionals in a subregion of the Eastern Cape. With the exponential increase of HIV/AIDS in South Africa, medical practitioners have become increasingly exposed to HIV infected patients. This study has considered the psychological structures developed by practitioners in an attempt to control and understand their situation in the context of HIV/AIDS. In order to describe these psychological structures the existential phenomenological approaches of L. Binswanger (in Needleman, 1963), A. Giorgi (1975) and F.J.Wertz (1985) were employed. Through these procedures, the structure of the experience of encountering an HIV infected patient was elucidated. This comprised the first goal of this study. The second goal focused on interpreting these descriptions by way of the symbolic meanings and definitions implicit in the structure of this experience. For this latter purpose the approach of symbo1ic interactionism was used, in particu1ar the understandings outlined by H. Blumer (1969). This theory was seen as appropriate in that the encounter between the practitioner and patient was primarily located in interpersonal parameters. The findings were discussed in terms of the two dominant metaphorical frameworks used by the subjects to comprehend the disease - namely the perspectives of society and the biomedical model. These two frameworks were critically evaluated in the context of HIV/AIDS, the needs of HIV infected individuals as well as the needs of the general practitioner. The process of the encounter was found to be very significant for practitioners in terms of their conceptualisations of HIV/AIDS. Old understandings were reinterpreted within the interpersonal context and replaced with more appropriate symbolic metaphors upon which to base practise. This study has revealed these new understandings were limited and constrained with regard to understanding and treating HIV/AIDS in that the subjects were still influenced by the metaphors of the biomedical model. These constraints were examined in the light of both personal and professional meanings and identities. This study concluded by making suggestions for modification of the medical practitioner's role in the context of HIV/AIDS.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2009. / Chiropractic in Israel has become a more integrated part of many aspects of health care policies, in that it is practised in multidisciplinary medical teams, is now included in HMOs and hospitals services, and has contributed to research and military programmes. However, the chiropractic profession still has its problems. Without laws or legitimate recognition to protect chiropractors, the playing fields could never be levelled for all chiropractors in Israel. Patient use and demand for complementary and alternative practitioners, including chiropractors, is gradually increasing. However, there has been no research to investigate the perceptions of chiropractors, medical doctors and chiropractic patients (i.e. key stakeholders) regarding the integration of the chiropractic profession in the Israeli health care system. The purpose of this study was to explore and describe the perceptions of a selected group of stakeholders about the integration of the chiropractic profession in the Israeli health care system. Such an exploration might help the profession to secure its position and claim a higher status in society. This is desirable to educate the public and the authorities on the many positive advantages of chiropractic, include access to chiropractic services for people who traditionally have not been able to use these services because of economic barriers or internal government and authorities limiting laws, as well to enhance its public image such as honesty, integrity and objectivity in the health care, and to avoid any criticism of organized medicine. It therefore stands to reason that the factors that might contribute to this type of development should be considered as soon as possible in those countries where chiropractors practise. This type of investigation is important not only in the Israeli setting, but indeed in every country where the profession is aiming toward increased recognition and awareness of the contribution of chiropractic to health care. Chiropractic now has the opportunity to expand its influence and take a more active role in health care issues. Therefore, although geographically removed, South Africa stands to gain interesting and useful information from an investigation of this nature. The investigation was carried out within a post positivist approach close to that of critical realism, using an interpretive methodology. The sampling was purposive as individuals were targeted for their knowledge in three main topics, these being the scope of chiropractic practice, inter-professional relations between Doctors of Chiropractic (DCs) and Medical Doctors (MDs), and developmental issues. The participants included five chiropractors, three medical doctors and three chiropractic patients, who all resided in the metropolitan area of Tel Aviv. were presented in tabular form in order to facilitate analysis and interpretation. Although there were some discrepancies regarding the knowledge and background of the participants about the topics discussed, all the participants met the inclusion criteria. The results show that chiropractic stands at the crossroads of mainstream and alternative medicine. Therefore it is important to establish a leading statement on identity, which must be clear, concise and immediately relevant to both the public and the profession. Although inter-professional relations between MDs and DCs in Israel are improving, further research should be conducted to provide suggestions on how chiropractors can overcome barriers and improve communication with MDs and other health care professionals in the Israeli health care system. In general, the participants agreed that governmental legislation, recognition and support are important endorsements with respect to the societal relevance and development of the profession. Therefore issues such as public awareness of chiropractic education and scope of practice, research and evidence-based practice must be emphasized accordingly in order to facilitate the development of chiropractic practice in Israel. / M

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This dissertation aims to analyze physicians and their spaces of professional representation, specifically, to analyze which forms of participation in instances of professional performance of doctors Aracaju. Within this, the central empirical object is the doctors who occupy or have held positions of presidency in these entities, studying about their biographical careers and trajectories, as well as their professional paths. We are looking forward to attending to the professionals representing the Aracaju medical profession, focusing on the Medical Society of Sergipe (SOMESE), the Medical Union of the State of Sergipe (SINDIMED-SE), the Sergipan Academy of Medicine (ASM- SE) and at the Regional Medical Council of Sergipe (CREMESE). In order to account for such an endeavor, we try to submit to the critical analysis the trajectories of doctors who hold management positions in these institutions. On the other hand, we consider it fundamental to understand also the system of social relations that doctors establish among themselves, studying in this sense, precisely their institutional actions. In order to understand the doctor in general, it was necessary to make a survey about what had already been discussed about this professional, which led us to realize the usefulness of being based on fundamental readings that refer precisely to the sociology of Professional Groups, as well as Also those that are in the line of Symbolic Interactionism and Political Sociology; As we seek to investigate physicians in their social gathering and consecration spaces, such as the traditional lunch meetings that take place every Thursday at the Medical Society and on Tuesdays at the Union of Physicians. Secondly, we perceive the need to reconstruct some of the historical context in which the development of medicine in Sergipe took place, as well as to try to understand how the foundations of these entities and their relations with the State and local politics were founded. In a third step, we undertake an analysis of the daily interactions of physicians in their moments of greater relaxation, as in the examples, lunch meetings that also happen on Fridays, where a more select group of physicians, known as' G-8 ', which leads us to know the medical actor in his social daily life. From this, we seek to demonstrate in how the professional performance of physicians in their spaces of representation, are based on the inextricable relationship between the requirement of professional expertise, that is, master a specialized technical knowledge, while having The formation of an ability compatible with the exercise of a political knowledge, which is intrinsically connected to the technical knowledge of the medical professional. / Essa dissertação tem como objetivo analisar os médicos e os seus espaços de representação profissional, em específico, analisar quais as formas de participação em instâncias de atuação profissional dos médicos Aracaju. Dentro disso, o objeto empírico central são os médicos que ocupam ou ocuparam cargos de presidência nessas entidades, estudando acerca das suas carreiras e trajetórias biográficas, assim como seus percursos profissionais. Estamos querendo nos atentar aqui, às entidades de representação profissional da classe médica aracajuana, às quais focalizamos na Sociedade Médica de Sergipe (SOMESE), no Sindicato dos Médicos do Estado de Sergipe (SINDIMED-SE), na Academia Sergipana de Medicina (ASM-SE) e no Conselho Regional de Medicina de Sergipe (CREMESE). Para dar conta de tal empreitada, tratamos de submeter à análise as trajetórias de médicos que possuem cargos de direção nessas instituições. Por outro lado, consideramos fundamental compreender também o sistema de relações sociais que os médicos estabelecem entre si, estudando nesse sentido, justamente suas ações institucionais. Para compreender sobre o médico em geral, foi mister fazer um levantamento sobre o que já vinha sendo debatido acerca desse profissional, o que nos levou a percebermos a utilidade de nos basearmos em leituras fundamentais que versam justamente sobre a sociologia dos Grupos Profissionais, assim como também as que se inserem na linha do Interacionismo Simbólico e da Sociologia Política; já que buscamos investigar os médicos em seus espaços de confraternização e consagração social, como as tradicionais reuniões-almoço que acontecem todas as quintas-feiras na Sociedade Médica e às terças-feiras no Sindicato dos Médicos. Num segundo momento, percebemos a necessidade de reconstruirmos um pouco do contexto histórico em que se deu o desenvolvimento da medicina em Sergipe, assim como buscar entender como se deu a fundação dessas entidades e suas relações com o Estado e a política local. Numa terceira etapa, empreendemos realizar uma análise do cotidiano das interações dos médicos em seus momentos de maior descontração, como nos exemplos, das reuniões-almoço que acontecem também às sextas-feiras, quando participa um grupo mais seleto de médicos, conhecidos, como ‘G-8’, o que nos leva a conhecer o ator médico em seu cotidiano social. A partir disso, buscamos demonstrar em como a atuação profissional dos médicos em seus espaços de representação, estão calcadas na relação indissociável entre o requerimento de uma ‘expertise’ profissional, isto é, dominar um saber técnico especializado, ao mesmo tempo em que se tem a formação de uma habilidade coadunada ao exercício de um saber político, que fica conectado de maneira intrínseca ao saber técnico do profissional médico. / São Cristóvão, SE