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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
181

Caracterização do padrão de solicitações psiquiátricas em um hospital geral: estabilidade e mudanças em um período de 30 anos de um serviço de Interconsulta / Referral pattern of requests in a general hospital: stability and change over a period of 30 years of consultation-liaison service

Nakabayashi, Tatiana Iuriko Kawasaki 17 October 2012 (has links)
A Interconsulta Psiquiátrica é considerada por muitos pesquisadores como sendo a área prática e aplicada da Medicina Psicossomática, de conhecimento concernente à investigação da interação entre fatores biológicos e psicossociais no desenvolvi-mento, curso e resultado de todas as doenças. A prevalência de transtornos psiqui-átricos em hospitais gerais pode variar de 20 a 40% entre pacientes internados, po-rém uma reduzida parcela é assistida pela Interconsulta e consequentemente recebe tratamento psiquiátrico. Sendo assim, o presente estudo teve por objetivos: a) obter informações dos dados sociodemográficos dos pacientes e seus históricos em sa¬úde mental (tratamentos anteriores e tentativa de suicídio); b) analisar o uso do ser¬viço de Interconsulta Psiquiátrica, tais como as clínicas solicitantes, função dos pro¬fissionais solicitantes, motivos de solicitação, tempo de internação dos pacientes assistidos, tempo de solicitação do PI e de sua resposta, e o número de atendimen-tos realizados; c) descrever os diagnósticos clínicos e psiquiátricos dos pacientes avaliados através dos critérios estabelecidos pela CID-10; d) analisar intervenções farmacoterapêuticas e não medicamentosas, tais como as condutas sugeridas pelo interconsultor, profissionais solicitados durante a internação, as medicações psico-trópicas em uso e prescritas; e) caracterizar aspectos relacionados aos médicos clí-nicos, aos profissionais de saúde e aos interconsultores; e f) avaliar a qualidade es-trutural da solicitação psiquiátrica realizada pelo profissional clínico e a resposta dada pelo interconsultor. Para tanto, foi realizada uma análise retrospectiva de todas as solicitações consecutivas realizadas entre janeiro de 1981 a dezembro de 2010 para a Psiquiatria do Serviço de Interconsulta em Saúde Mental do Hospital das Clí-nicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo assim como a consulta dos prontuários de todos os pacientes assistidos pelo serviço para obter outras informações. Foram realizadas 4882 solicitações psiquiátricas e a taxa de encaminhamento variou de 0,7 a 1,1%. Dados sociodemográficos dos paci-entes que foram atendidos com mais fre¬quência relacionados ao sexo, cor e/ou et-nia, estado civil, com quem os pacientes residiam (somente para os homens), situa-ção laboral (somente para as mulheres), escolaridade e procedência tenderam a permanecer relativamente estáveis ao longo dos anos. As mulheres apresentaram idade média menor que os homens e foram atendidos com mais frequência: homens e mulheres casados (e mais homens soltei¬ros quando comparados com as mulhe¬res), homens que residiam com seus pais e mulheres que residiam com seus cônju¬ges e filhos, homens afastados de seus tra¬balhos e mulheres responsáveis pelos cuidados da casa, e também pacientes de ambos os sexos com idades entre 21 e 50 anos, pacientes caucasianos, pacientes procedentes do estado de São Paulo e pacientes com escolaridade até ensino fun¬damental completo. As mulheres foram mais frequentemente assistidas pelo serviço de Intercon¬sulta Psiquiátrica ao longo de todos os anos, assim como ficaram menos tempo in¬ternadas e também tiveram solicitações psiquiátricas realizadas em um menor inter¬valo de tempo após a admis¬são hospitalar. Em trinta anos, a Clínica Médica Geral foi a clínica que mais realizou solicitações psiquiátricas, o motivo de solicitação mais frequente foi a presença de sintomas psiquiátricos e o tempo de internação dos pacientes assistidos pela Inter¬consulta foi maior quando comparado aos pacientes internados no hospital de modo geral. Os transtornos neuróticos, somatoformes e relacionados ao estresse foram os diagnósticos psiquiátricos mais comuns entre as mulheres e homens atendidos pelo SISMen, seguido pelos transtornos de humor e transtornos mentais orgânicos nas mulheres e transtornos mentais orgânicos e transtornos devido ao uso de substân¬cias nos homens. Já em relação ao diagnóstico clínico, foram atendidos com mais frequência mulheres com doenças endócrinas, metabólicas e nutricionais e homens com doenças infecciosas e parasitárias; e casos de múltiplas comorbidades clínicas se tornaram mais frequentes com o passar dos anos. As principais condutas sugeri¬das pelos interconsultores foram: atendimento individual, orientação à equipe e prescrição de psicofármacos para ambos os pacientes, permanecendo frequentes ao longo dos anos, com destaque para um aumento progressivo de casos em que medicações psicotrópicas foram prescritas a partir de meados dos anos 90. E com o passar dos anos, os planos de tratamento se tornaram mais complexos e abran¬gentes e houve um aumento progressivo no número de encaminhamentos para atendimento psiquiátrico ambulatorial. Em relação à qualidade estrutural das solici¬tações psiquiátricas e das respostas dadas pelos interconsultores, ambas foram consideradas aceitáveis ou boas na maioria dos casos, sendo um indicativo positivo na qualidade de comunicação entre os profissionais. Pode-se dizer que este foi o primeiro estudo longitudinal a analisar consecutivamente trinta anos e também toda a população assistida por um serviço de Interconsulta Psiquiátrica / Consultation-liaison Psychiatry is considered by many researchers as the practical and applied area of psychosomatic medicine, which is an area of knowledge concerning the investigation of the interaction between biological and psychosocial factors in the development, course and outcome of all diseases. The prevalence of psychiatric disorders in general hospitals range from 20 to 40% of hospitalized patients, but a small portion is assisted by the consultation-liaison and consequently receives psychiatric treatment. Considering this background, this study aimed: a) to obtain information about sociodemographic characteristics of patients and their mental health history (previous treatment and attempted suicide); b) to analyze the referral patterns of consultation-liaison psychiatry, such as referral sources, reasons for referral, length of stay, lagtime and other; c) to describe clinical and psychiatric diagnoses according by ICD-10; d) to analyze pharmacotherapeutic and non-drug interventions; e) to describe aspects related to physicians, health professionals and psychiatrists; and f) to analyze the structural quality of the request made by the physicians and psychiatrists. For this purpose, it was performed a retrospective analysis of all consecutive referrals made between January 1981 and December 2010 to consultation-liaison psychiatry of Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo as well as the review of medical charts of all patients assisted by the service. 4882 referrals were made and consultation rate ranged from 0.7 to 1.1%. Sociodemographic characteristics related to sex, color or ethnicity, marital status, patients who lived (for men), employment status (for women), education and origin tended to remain relatively stable over the years. Women had a lower average age than men and were seen more frequently: married men and women (and more single men compared with women), men who lived with their parents and women who lived with their spouses and children, and also patients of both sexes aged between 21 and 50 years, caucasian patients and patients from the state of Sao Paulo. Women were more often assisted by the consultation-liaison service over the years and the length of stay and lagtime were lower than men. In thirty years, internal medicine was the most frequent referral source, presence of psychiatric symptoms was the common reason for referral and the length of stay of patients assisted by consultation-liaison psychiatry was higher compared to those admitted to the hospital in general. The main clinical diagnoses for women and men were endocrine, nutritional and metabolic, cardiovascular diseases and infectious and parasitic diseases and cases with multiple morbidities have become more frequent over the years. One third of patients were diagnosed with neurotic disorders, stress related and somatoform disorders in women and men, followed by mood disorders and organic mental disorders in women, and organic mental disorders and due to substance use in men. The main interventions were individual therapy, guidelines for staff and prescription of psychotropic drugs for women and men. There was a increase in the number of referrals to outpatient psychiatric care. Psychiatric referrals and responses by psychiatrist were considered acceptable or good in most cases, a positive indicative on the quality of communication between professionals. This was the first longitudinal study to examine thirty years consecutively and also the entire population assisted by Consultation-liaison Psychiatry.
182

Can PRUs work? : a search for an answer from within a lived experience

Dodman, Hilary Frances January 2016 (has links)
This study draws on theories of punishment (Cavadino and Dignan 2007), leadership (West-Burnham 2013), social rules, (Burns and Machado 2014) and resilience (Fredrikson and Branigan 2005) to develop an understanding of Pupil Referral Units (PRUs). PRUs came into being through statute in 1993. They were set up to provide formal educational settings for young people who had been excluded from school. LEAs have responsibility for the education and welfare of all children in their catchment areas, irrespective of which school they attend. If an exclusion occurs, the LEA is obliged to assume responsibility, under section 19(1) of the 1996 Education Act, for the child's education by whatever means seems appropriate to its designated officers. Placement in a Pupil Referral Unit is a course of action they may pursue. This study sets out to discover through a series of narrative interviews conducted within a Key Stage 4 PRU, whether the multiple purposes of the PRU can be achieved, given the issues that present themselves in the isolated setting of the Unit, the resources available and the complex needs of the young people concerned. Fifteen interviews were conducted within a PRU in the academic year 2011-2012. Four were held with the Head; 11 further interviews involved 12 people; 8 members of staff and 4 pupils. A study of the evidence they provided led to a qualified positive response to the research question; i.e. that PRUs can' work' given a number of factors that are listed in the conclusion.
183

Caracterização do padrão de solicitações psiquiátricas em um hospital geral: estabilidade e mudanças em um período de 30 anos de um serviço de Interconsulta / Referral pattern of requests in a general hospital: stability and change over a period of 30 years of consultation-liaison service

Tatiana Iuriko Kawasaki Nakabayashi 17 October 2012 (has links)
A Interconsulta Psiquiátrica é considerada por muitos pesquisadores como sendo a área prática e aplicada da Medicina Psicossomática, de conhecimento concernente à investigação da interação entre fatores biológicos e psicossociais no desenvolvi-mento, curso e resultado de todas as doenças. A prevalência de transtornos psiqui-átricos em hospitais gerais pode variar de 20 a 40% entre pacientes internados, po-rém uma reduzida parcela é assistida pela Interconsulta e consequentemente recebe tratamento psiquiátrico. Sendo assim, o presente estudo teve por objetivos: a) obter informações dos dados sociodemográficos dos pacientes e seus históricos em sa¬úde mental (tratamentos anteriores e tentativa de suicídio); b) analisar o uso do ser¬viço de Interconsulta Psiquiátrica, tais como as clínicas solicitantes, função dos pro¬fissionais solicitantes, motivos de solicitação, tempo de internação dos pacientes assistidos, tempo de solicitação do PI e de sua resposta, e o número de atendimen-tos realizados; c) descrever os diagnósticos clínicos e psiquiátricos dos pacientes avaliados através dos critérios estabelecidos pela CID-10; d) analisar intervenções farmacoterapêuticas e não medicamentosas, tais como as condutas sugeridas pelo interconsultor, profissionais solicitados durante a internação, as medicações psico-trópicas em uso e prescritas; e) caracterizar aspectos relacionados aos médicos clí-nicos, aos profissionais de saúde e aos interconsultores; e f) avaliar a qualidade es-trutural da solicitação psiquiátrica realizada pelo profissional clínico e a resposta dada pelo interconsultor. Para tanto, foi realizada uma análise retrospectiva de todas as solicitações consecutivas realizadas entre janeiro de 1981 a dezembro de 2010 para a Psiquiatria do Serviço de Interconsulta em Saúde Mental do Hospital das Clí-nicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo assim como a consulta dos prontuários de todos os pacientes assistidos pelo serviço para obter outras informações. Foram realizadas 4882 solicitações psiquiátricas e a taxa de encaminhamento variou de 0,7 a 1,1%. Dados sociodemográficos dos paci-entes que foram atendidos com mais fre¬quência relacionados ao sexo, cor e/ou et-nia, estado civil, com quem os pacientes residiam (somente para os homens), situa-ção laboral (somente para as mulheres), escolaridade e procedência tenderam a permanecer relativamente estáveis ao longo dos anos. As mulheres apresentaram idade média menor que os homens e foram atendidos com mais frequência: homens e mulheres casados (e mais homens soltei¬ros quando comparados com as mulhe¬res), homens que residiam com seus pais e mulheres que residiam com seus cônju¬ges e filhos, homens afastados de seus tra¬balhos e mulheres responsáveis pelos cuidados da casa, e também pacientes de ambos os sexos com idades entre 21 e 50 anos, pacientes caucasianos, pacientes procedentes do estado de São Paulo e pacientes com escolaridade até ensino fun¬damental completo. As mulheres foram mais frequentemente assistidas pelo serviço de Intercon¬sulta Psiquiátrica ao longo de todos os anos, assim como ficaram menos tempo in¬ternadas e também tiveram solicitações psiquiátricas realizadas em um menor inter¬valo de tempo após a admis¬são hospitalar. Em trinta anos, a Clínica Médica Geral foi a clínica que mais realizou solicitações psiquiátricas, o motivo de solicitação mais frequente foi a presença de sintomas psiquiátricos e o tempo de internação dos pacientes assistidos pela Inter¬consulta foi maior quando comparado aos pacientes internados no hospital de modo geral. Os transtornos neuróticos, somatoformes e relacionados ao estresse foram os diagnósticos psiquiátricos mais comuns entre as mulheres e homens atendidos pelo SISMen, seguido pelos transtornos de humor e transtornos mentais orgânicos nas mulheres e transtornos mentais orgânicos e transtornos devido ao uso de substân¬cias nos homens. Já em relação ao diagnóstico clínico, foram atendidos com mais frequência mulheres com doenças endócrinas, metabólicas e nutricionais e homens com doenças infecciosas e parasitárias; e casos de múltiplas comorbidades clínicas se tornaram mais frequentes com o passar dos anos. As principais condutas sugeri¬das pelos interconsultores foram: atendimento individual, orientação à equipe e prescrição de psicofármacos para ambos os pacientes, permanecendo frequentes ao longo dos anos, com destaque para um aumento progressivo de casos em que medicações psicotrópicas foram prescritas a partir de meados dos anos 90. E com o passar dos anos, os planos de tratamento se tornaram mais complexos e abran¬gentes e houve um aumento progressivo no número de encaminhamentos para atendimento psiquiátrico ambulatorial. Em relação à qualidade estrutural das solici¬tações psiquiátricas e das respostas dadas pelos interconsultores, ambas foram consideradas aceitáveis ou boas na maioria dos casos, sendo um indicativo positivo na qualidade de comunicação entre os profissionais. Pode-se dizer que este foi o primeiro estudo longitudinal a analisar consecutivamente trinta anos e também toda a população assistida por um serviço de Interconsulta Psiquiátrica / Consultation-liaison Psychiatry is considered by many researchers as the practical and applied area of psychosomatic medicine, which is an area of knowledge concerning the investigation of the interaction between biological and psychosocial factors in the development, course and outcome of all diseases. The prevalence of psychiatric disorders in general hospitals range from 20 to 40% of hospitalized patients, but a small portion is assisted by the consultation-liaison and consequently receives psychiatric treatment. Considering this background, this study aimed: a) to obtain information about sociodemographic characteristics of patients and their mental health history (previous treatment and attempted suicide); b) to analyze the referral patterns of consultation-liaison psychiatry, such as referral sources, reasons for referral, length of stay, lagtime and other; c) to describe clinical and psychiatric diagnoses according by ICD-10; d) to analyze pharmacotherapeutic and non-drug interventions; e) to describe aspects related to physicians, health professionals and psychiatrists; and f) to analyze the structural quality of the request made by the physicians and psychiatrists. For this purpose, it was performed a retrospective analysis of all consecutive referrals made between January 1981 and December 2010 to consultation-liaison psychiatry of Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo as well as the review of medical charts of all patients assisted by the service. 4882 referrals were made and consultation rate ranged from 0.7 to 1.1%. Sociodemographic characteristics related to sex, color or ethnicity, marital status, patients who lived (for men), employment status (for women), education and origin tended to remain relatively stable over the years. Women had a lower average age than men and were seen more frequently: married men and women (and more single men compared with women), men who lived with their parents and women who lived with their spouses and children, and also patients of both sexes aged between 21 and 50 years, caucasian patients and patients from the state of Sao Paulo. Women were more often assisted by the consultation-liaison service over the years and the length of stay and lagtime were lower than men. In thirty years, internal medicine was the most frequent referral source, presence of psychiatric symptoms was the common reason for referral and the length of stay of patients assisted by consultation-liaison psychiatry was higher compared to those admitted to the hospital in general. The main clinical diagnoses for women and men were endocrine, nutritional and metabolic, cardiovascular diseases and infectious and parasitic diseases and cases with multiple morbidities have become more frequent over the years. One third of patients were diagnosed with neurotic disorders, stress related and somatoform disorders in women and men, followed by mood disorders and organic mental disorders in women, and organic mental disorders and due to substance use in men. The main interventions were individual therapy, guidelines for staff and prescription of psychotropic drugs for women and men. There was a increase in the number of referrals to outpatient psychiatric care. Psychiatric referrals and responses by psychiatrist were considered acceptable or good in most cases, a positive indicative on the quality of communication between professionals. This was the first longitudinal study to examine thirty years consecutively and also the entire population assisted by Consultation-liaison Psychiatry.
184

Utredningen om sambandet mellan redovisning och beskattning (SOU 2008:80) : en fallstudie av remissvaren

Jansson, Susanne, Steinholtz, Ulrika January 2009 (has links)
<p>Vårt syfte med den här uppsatsen är att besvara följande frågeställningar:</p><ul><li>Vilka fördelar och nackdelar ser remissinstanserna med utredningens förslag?</li><li>Är det några speciella områden där åsikterna går isär eller är liknande?</li><li>Vilket stöd finns för utredningens förslag? </li></ul><p>Bakgrunden till att vi valt just detta ämne är att sambandet mellan redovisning och beskattning är ett komplicerat område som är sammankopplat på olika sätt.</p> / <p>Our purpose with this paper is to find out:<strong><em></em></strong></p><ul><li>What advantages and disadvantages does the proposal have, according to the bodies to which the proposal has been referred for consultation?</li><li>Are there any special areas where the opinions are alike or part from each other?</li><li>What is the support for the proposal?</li></ul><p>The reason for choosing this specific subject is that the connection between accounting and taxation is a complicated area, with many interconnections in different ways.</p>
185

Assessing Antenatal Care in Rural Zimbabwe

Majoko, Franz January 2005 (has links)
<p>Antenatal care has been associated with improved maternal and perinatal outcomes but there is no agreement on the most effective model in terms of content as well as the number and timing of visits. A cluster randomised controlled trial was conducted in a rural area of Zimbabwe to assess a 5-visit goal-oriented antenatal care model against standard care. In the same population was also determined the sensitivity of factors used for risk screening to predict pregnancy complications and the effectiveness of the referral system in managing women with identified risk markers or pregnancy complications. </p><p>Pregnancy records of 10 572 out of total 13 517 recruited women were available for analysis. The new model did not change the number of visits but resulted in better use of health care. The classical risk screening system had low predictive value and identified too large a risk group for referral. Nulliparous women had an increased risk for pregnancy complications whereas women with previous uncomplicated pregnancies were at low risk of complications even with high parity. Multiparous women with previous complications had an increased risk of complications but better utilisation of health care services for delivery reduced adverse perinatal outcomes. There was a functional referral system in Gutu and women complied with referral indications but efficiency of the system was reduced by failure of care providers to comply with referral recommendations. </p><p>Antenatal care can be improved in a rural setting through a focussed programme and the unpredictability of many pregnancy complications limits the value of antenatal risk screening. Until universal access to essential obstetric care facilities is attained in low resource settings, a critical re-examination of risk factors could avoid overburdening the referral system.</p>
186

Assessing Antenatal Care in Rural Zimbabwe

Majoko, Franz January 2005 (has links)
Antenatal care has been associated with improved maternal and perinatal outcomes but there is no agreement on the most effective model in terms of content as well as the number and timing of visits. A cluster randomised controlled trial was conducted in a rural area of Zimbabwe to assess a 5-visit goal-oriented antenatal care model against standard care. In the same population was also determined the sensitivity of factors used for risk screening to predict pregnancy complications and the effectiveness of the referral system in managing women with identified risk markers or pregnancy complications. Pregnancy records of 10 572 out of total 13 517 recruited women were available for analysis. The new model did not change the number of visits but resulted in better use of health care. The classical risk screening system had low predictive value and identified too large a risk group for referral. Nulliparous women had an increased risk for pregnancy complications whereas women with previous uncomplicated pregnancies were at low risk of complications even with high parity. Multiparous women with previous complications had an increased risk of complications but better utilisation of health care services for delivery reduced adverse perinatal outcomes. There was a functional referral system in Gutu and women complied with referral indications but efficiency of the system was reduced by failure of care providers to comply with referral recommendations. Antenatal care can be improved in a rural setting through a focussed programme and the unpredictability of many pregnancy complications limits the value of antenatal risk screening. Until universal access to essential obstetric care facilities is attained in low resource settings, a critical re-examination of risk factors could avoid overburdening the referral system.
187

Utredningen om sambandet mellan redovisning och beskattning (SOU 2008:80) : en fallstudie av remissvaren

Jansson, Susanne, Steinholtz, Ulrika January 2009 (has links)
Vårt syfte med den här uppsatsen är att besvara följande frågeställningar: Vilka fördelar och nackdelar ser remissinstanserna med utredningens förslag? Är det några speciella områden där åsikterna går isär eller är liknande? Vilket stöd finns för utredningens förslag? Bakgrunden till att vi valt just detta ämne är att sambandet mellan redovisning och beskattning är ett komplicerat område som är sammankopplat på olika sätt. / Our purpose with this paper is to find out: What advantages and disadvantages does the proposal have, according to the bodies to which the proposal has been referred for consultation? Are there any special areas where the opinions are alike or part from each other? What is the support for the proposal? The reason for choosing this specific subject is that the connection between accounting and taxation is a complicated area, with many interconnections in different ways.
188

Physical activity levels and health promotion strategies among physiotherapists in Rwanda

Ngarambe, Robert January 2011 (has links)
<p>Physical inactivity has become a global health concern and is among the 10 leading causes of death and disability. This has led to increased concern for chronic diseases of lifestyle (CDL).&nbsp / Studies have revealed that regular physical activity is effective in combating several CDL such as cardiovascular disease, diabetes, cancer, hypertension and obesity. Physiotherapists are in a&nbsp / position to combat inactivity and effectively promote physical activity to their clients. Studies however have shown that participation in physical activity among physiotherapists could have an&nbsp / impact on the promotion of physical activity and their health practices. This study therefore sought to establish the relationship between physical activity levels of physiotherapists and their&nbsp / physical&nbsp / activity promotion strategies and barriers to promoting physical activity. Sequential Mixed Method Design was used in this study. Data was collected by means of a self administered&nbsp / questionnaire and a total of 92 physiotherapists voluntarily answered the questionnaire. A focus group discussion comprising of 10 purposively selected physiotherapists was conducted. The&nbsp / questionnaire assessed physical activity levels&nbsp / and physical activity promoting strategies of the participants while the focus groupdiscussion looked at the barriers to promoting physical&nbsp / activity. The Statistical Packages for Social Sciences (SPSS) version 18 was used for data capturing and analysis. Descriptive statistics were employed to summarize demographic information&nbsp / as means, standard deviation, frequencies and percentages. Inferential statistics (chi-square) was used to test the associations between different categorical variables (p&lt / 0.05). For the qualitative data, focus group discussions were used to collect data. Tape recorded interviews were transcribed verbatim, field notes typed, sorting and arranging data was done and themes&nbsp / &nbsp / were generated. Thematic analysis was then done under the generated themes. Ethical issues pertaining to informed consent, anonymity, confidentiality and the right to withdraw from the&nbsp / study were respected in this current study. The findings in the current study revealed that a big number of the participants were physical active both at work and recreation domains. However,&nbsp / there was no statistically significant association between physical activity and the demographicvariables. The results in this study revealed that the majority of participants were good&nbsp / physical activity promoting practices, although there was no significant association between physical activity levels and the physical activity promoting practices. The finding in this study revealed that discussing physical&nbsp / activity and giving out information regarding physical activity to their clients were the most common methods used in promoting physical activity. However, participants also highlighted barriers they&nbsp / ace in promotion of physical activity such as policies on physical activity, cultural influence, nature of work, time management as well as environmental barriers. The study demonstrates the&nbsp / need for all stakeholders to come up with solutions to break the barriers to promotion of physical activity. In return it will bring about enormous health&nbsp / benefits to the general population.</p>
189

The development of a patient information guide to reduce non-emergency after-hours phone calls in a family practice residency

Moore, Jordan A. 03 June 2011 (has links)
Family practice physicians receive many non-emergency after-hours phone calls. Patients themselves could care for non-emergencies until their doctor is in his office. The purpose of this study is the development and testing of a patient information booklet to provide patient education for non-emergency self care. The booklet will hopefully result in better home health care and a reduction of non-emergency after-hours phone calls. The booklet could be a valuable asset for the family physician for both patient education and the reduction of physician occupational dissatisfaction.This booklet will also provide information about the Ball Memorial Hospital Family Practice Center and the specialty of Family Practice. This study will suggest a method to determine if such a booklet actually reduces the number of non-emergency after-hours phone calls received by residents of the Family Practice Center.Ball State UniversityMuncie, IN 47306
190

An Evaluation of the Early Steps Referral Process in Hillsborough County to Detect Delays in Access to Early Intervention Services

Johnson, Jessica Fry 01 January 2011 (has links)
Early intervention services are important in obtaining better outcomes for infants with a developmental delay or a condition that may result in a delay. In Florida, a primary resource for providing these services is the Early Steps Program. This study analyzed the Early Steps referral process to identify barriers to prompt access. The guiding hypothesis was if differences exist in key outcomes of the referral process, then these differences may reveal where improvements can be made. Improving access to early intervention should produce better outcomes and reduce the costs of services required later by addressing developmental concerns earlier. The dataset included records for 10,688 infants referred to the Hillsborough County Early Steps Program between 2006 and 2009. Two measures (age at referral and time to IFSP) represented points within the referral process where delays could be quantified. Age at referral is a measure of how long it takes for a delay to be identified and the infant referred for evaluation. The time from the referral to the date an IFSP is created provides a measure of the delay in beginning services. Delays in obtaining a referral were associated with being referred by a family member, the referral code Developmental Delay At Risk and barrier codes Child/Family Issues and No Show/Unsuccessful Contact. Delays in completing the IFSP were related to being younger at referral, being referred by one of the sources that made less frequent referrals to Early Steps, an eligibility determination related to behavior concerns, maternal education that stopped at grade 8 or below and being Black.

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