No description available.

The Health Resources and Services Administration (HRSA) allocated $940 million in 2002, through Title II of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, to help states improve the quality and availability of health related services for people living with HIV/AIDS . These resources are allocated based upon recommendations made by community planning committees, which in turn base their recommendations on HIV/AIDS needs assessments. A methodologically sound, comprehensive needs assessment is a critical component of effective resource allocation decisions. Poor needs assessments might lead to poor resource allocation decisions, which might have life-threatening consequences for people living with HIV/AIDS. Little is known about the quality of Ryan White Title II (RWTII) needs assessments. This dissertation identifies seven elements of a high quality needs assessment, which might serve as an assessment tool for funding agencies and as a guidance tool for grantees. The author uses the seven elements in a review of RWTII needs assessments to provide evidence pertaining to the current level of quality of RWTII needs assessments. The seven elements are then applied in a case study of improved practice to demonstrate how to adequately apply the key elements of a high quality needs assessment.

A pre-service needs inventory was field tested for possible use by counselors of the Utah State Division of Rehabilitation Services. The field testing was carried out by utilizing two groups of consultants for evaluating format, content, and usability of the inventory. Examination of the data collected from the consultants indicated that a pre-service needs inventory was helpful during the intake process and in filling out the Individual Written Rehabilitation Program. It also indicated that the checklist was broad enough to gather sufficient information and that the instructions were adequate. Finally the data indicated that over 75% of the counselors participating in the field test would use the checklist if it were optional.

The present study had an overarching objective of seeking information to better understand the service needs of children entering foster care who are universally enrolled into behavioral health services at the time of their home removal. The first specific aim was to examine how various case attributes (i.e., aspects of a child’s background, personal and familial characteristics, and CPS involvement) related to behavioral health needs at entry, represented by global functioning ratings and service intensity scores. A second specific aim was to explore the existence of natural groupings of foster youth to examine if meaningful groupings occur in relation to demographic and risk and factors. Finally, this study sought to evaluate service needs of subgroups of foster children who are typically under-referred for services. Data were collected from records of 327 school-age youth who were automatically enrolled into treatment from one community-based outpatient behavioral health provider at the time of home removal. The results of this study showed that the average school-age child entering foster care is performing in the at-risk range of global functioning (mean CGAS score of 69.23) and requires at least short-term behavioral health intervention services and/or recovery monitoring (mean CASII Composite Score of 13.1). With respect to severity of impaired functioning, the results indicated that racial background, medical history, speech problems, school grade level (e.g., <1 year, K-3,...9-12), psychological stability, and reasons for removal significantly contributed to scores of global functioning. With regard to the intensity of service needs, the findings suggested gender, historical involvement with child welfare services, foster placement, simultaneous removal of all children, history of sexualized behaviors, and global functioning predicted level of care composite scores. Subgroups of foster youth that are typically under-referred and/or under-utilize services (i.e., preschool age children, children who did not experience physical or sexual abuse, and ethnic minorities) generally did not differ in terms of functionality or service intensity ratings from their counterpart groups; the only exception being that Caucasian/Non-Hispanic youth demonstrated lower average ratings on global functioning than children who identify with other racial backgrounds. The data showed inadequate fit for examining latent classes among youth entering foster care.

Mémoire (M.P.M.O.)-- Université du Québec à Chicoutimi, 1993. / Document électronique également accessible en format PDF. CaQCU

abstract: The dissertation examines treatment services received by youth on probation in the Maricopa County, Arizona. The project focuses on three primary issues: 1) the factors associated with receiving treatment services while on probation, 2) the factors associated with receiving treatment services through different funding streams, and 3) whether treatment services and specific characteristics of treatment services, particularly the funding source, influence recidivism outcomes of youth. To answer these questions the research used data obtained from the Maricopa County Juvenile Probation Department from July 2012 thru August 2014. Multivariate regression, along with statistical techniques to control for selection bias, were used to identify the factors associated with receiving treatment services, the factors associated with the funding source of treatment services, and the effect of treatment services on recidivism. The findings from the current dissertation suggest that the receipt of treatment services is not equal across groups, and particularly that minorities are less likely to receive treatment services compared to their White counterparts. Additionally, the findings reveal that certain characteristics of youth and the type of treatment service received influence the funding source, but the source of funding does not influence the effectiveness of the treatment services. Finally, using propensity score matching, the current dissertation found that treatment services were effective in reducing recidivism while under probation supervision and 6 months after probation supervision has ended. Implications for policy and research are discussed in light of these findings. / Dissertation/Thesis / Doctoral Dissertation Criminology and Criminal Justice 2015

abstract: This exploratory quantitative study examined the risks and needs expressed by gender/sexual minority emerging adults in Phoenix, Arizona. Differences in experiences and perceived service needs between gender minorities and cisgender sexual minority emerging adults were also identified. Respondents (N=102) completed a 78-item questionnaire in March and April of 2015. Individuals reported high rates of risk factors and physical needs, with those individuals who were both gender and ethnic minorities more likely to report having a perceived service need than their cisgender white counterparts. In addition, the study found significant positive correlations between housing factors (i.e., having experienced homelessness, ever/currently being in foster care, not having a safe/stable living situation) and other risk factors and needs. Risk factors were also correlated with wishing for a different gender identity or sexual orientation. With the majority of the respondents reporting a service need, implications include the need for culturally competent and accessible services, as well as services that continue to build on the protective factors of having an accepting family, friend group, and a sense of belonging to a community. / Dissertation/Thesis / Masters Thesis Social Work 2016

Ikimokyklinio ugdymo paslaugos labai svarbios ugdant vaikus kaip asmenybes. Jos papildo vaikų ugdymą šeimose, skatina jų socialinį, pažintinį vystymąsi, praturtina vaikų bendravimo su kitais patirtį, padeda pasiruošti mokymuisi mokykloje. Vaikai ikimokyklinio ugdymo įstaigose praleidžia didesnę savo laiko dalį, ugdymo įstaigos tampa vis labiau reikšmingos tokio amžiaus vaikams, todėl ypatingą dėmesį reikia skirti ikimokyklinio ugdymo paslaugų teikimui, jų plėtrai, prieinamumui ir kokybei. Tyrimo tikslas: Atskleisti ikimokyklinio ugdymo paslaugų miesto ir kaimo vaikams ypatumus. Tyrimo uždaviniai: 1) Išanalizuoti pedagoginę, psichologinę bei metodinę literatūrą, susijusią su ikimokyklinio ugdymo paslaugomis miesto ir kaimo vaikams; 2) Išsiaiškinti ikimokyklinio ugdymo paslaugų pasiūlą miesto, rajono centro, rajoninės reikšmės miesto ir kaimo vaikams; 3) Nustatyti ar ikimokyklinio ugdymo paslaugų prieinamumas skiriasi miesto, rajono centro, rajoninės reikšmės miesto ir kaimo vaikams; 4) Išsiaiškinti ikimokyklinio ugdymo paslaugų poreikį miesto, rajono centro, rajoninės reikšmės miesto ir kaimo vaikams; 5) Apibendrinti tyrimo duomenis. Hipotezė: Ikimokyklinio ugdymo paslaugų pasiūla,poreikis ir prieinamumas iš dalies priklauso nuo gyvenamosios vietos (miesto, rajono centro, rajoninės reikšmės miesto ir kaimo). Tyrimo metodai: 1) Literatūros šaltinių analizė; 2) Ikimokyklinio ugdymo įstaigų vadovų anketavimas; 3) Institucijų... [toliau žr. visą tekstą] / Pre-school education services are very important in raising the children as individuals. They complement the education of children in families, promote their social, cognitive development, enriches children's experience of communicating with others, helps prepare for school. Children in pre-school education institutions spend most of their time, educational institutions are becoming increasingly important for children of that age group, so special attention should be given to pre-school education services, their development, availability and quality. Aim of the study: To reveal characteristics of the pre-school education services for children in urban and rural areas. Objectives of the study: 1. To examine the pedagogical, psychological and methodological literature relating to pre-school education services in urban and rural children; 2. To clarify pre-school education services availability at the city, the district suburbs in urban and rural children; 3. Set or pre-school education services for the city is different, the district suburbs in urban and rural children; 4. To clarify the pre-school service needs the city, the district, suburbs and rural children; 5. To Summarize the survey data. Hypothesis: pre-primary education services’ availability, need and accessibility depends in part on the place of residence (city, district, suburbs and rural). Research methods: 1. Literature review; 2. Survey of the Heads in Pre-school education... [to full text]

O estudo teve como objetivo geral analisar a utilização frequente por usuários adultos do serviço de urgência de um hospital universitário. Trata-se de uma pesquisa de métodos mistos do tipo explanatório sequencial. Foi realizada uma etapa de caráter quantitativo para descrever as características demográficas e clínicas dos usuários frequentes do serviço de urgência e identificar as características da utilização de serviço de urgência por usuários frequentes. A seguir, foi realizada uma etapa qualitativa, com o propósito de explorar os motivos da utilização frequente do serviço de urgência. Os dados quantitativos foram coletados por meio de registros dos prontuários eletrônicos dos pacientes, a partir de uma amostra de 385 usuários frequentes do Serviço de Emergência de um hospital universitário da região sul do Brasil. Os dados qualitativos foram obtidos por meio de entrevistas semiestruturadas por telefone com 18 usuários frequentes, selecionados por uma amostra intencional. Os dados da etapa quantitativa foram analisados no Programa Statistical Package for the Social Science (SPSS), pela utilização de técnicas de estatística descritiva e inferencial, com nível de significância de 5% (p<0,05). Para o tratamento dos resultados qualitativos, foi utilizada a técnica de análise de conteúdo temática, com a utilização do software Atlasti.6. Os resultados evidenciam que os usuários frequentes são responsáveis por cerca de 24% do total de atendimentos realizados no serviço de urgência. O número de reincidências no serviço variou de 4 a 58 vezes, tendo uma média de 6,59 vezes. A maioria da demanda desses indivíduos no serviço ocorreu em dias úteis (81,3%) e no turno da manhã (58,4%). Os usuários frequentes são um grupo com características heterogêneas, mas com fatores que os tornam mais vulneráveis, como a idade avançada, a baixa escolaridade e a alta prevalência de condições crônicas. Apesar de existir um grupo de pessoas que têm problemas de saúde de caráter não urgente e que permaneceram menos de uma hora no serviço, de forma geral usuários frequentes são classificados com níveis de risco mais elevados, permanecem mais tempo no serviço e têm alta taxa de mortalidade e de internação hospitalar. A busca da unidade de urgência pelos usuários frequentes foi decorrente principalmente de exacerbação ou complicação de condições crônicas e, em menor escala, de agravos agudos recorrentes ou de tratamento prolongado. Para eles, o seu estado de saúde era uma situação de urgência e exigia atendimento imediato. Foram identificados quatro aspectos relacionados à organização da atenção à saúde que configuram a busca repetida por atendimento no setor de urgência: a facilidade de acesso, a capacidade de resolutividade, o vínculo e os retornos agendados para o serviço. A maioria dos indivíduos utilizava também outros serviços de saúde, como a atenção primária e o ambulatório do hospital. Os resultados evidenciaram o perfil dos usuários frequentes e indicaram lacunas no sistema de saúde, contribuindo para melhor compreensão acerca da busca repetida por atendimento nos serviços de urgência. Concluiu-se que usuários frequentes do serviço de urgência têm pior estado de saúde, necessitando de cuidados em toda rede assistencial. / The present study aimed to analyze the frequent use of the emergency service of a university hospital by adult users. A sequential explanatory design was adopted in this mixed method research. A quantitative stage was performed to describe the demographic and clinical characteristics of frequent users of emergency services and to identify the characteristics of emergency service use by these users. A qualitative stage was subsequently performed, aiming to explore the reasons for frequent emergency service use. Quantitative data were collected from patients’ online medical records in a sample comprised of 385 frequent users of the emergency service of a university hospital in Southern Brazil. Qualitative data were obtained from semi-structure interviews conducted by telephone with 18 frequent users, selected by intentional sample. Data from the qualitative stage were analyzed with the Statistical Package for the Social Sciences software (SPSS), as it uses descriptive and inferential statistical techniques with a 5% significance level (p<0.05). Thematic content analysis was used to treat the qualitative results, using the Atlasti.6 software. The results show that frequent users were responsible for approximately 24% of all emergency service visits. The number of service recurrences varied from four to 58 times and the mean was 6.59 times. Most of the demand for this service occurred on weekdays (81.3%) and in the morning shift (58.4%). Frequent users comprise a group with heterogeneous characteristics, although with factors that caused them to be vulnerable, such as advanced age, low level of education and high prevalence of chronic conditions. Despite the existence of a group of individuals with health problems considered not to be urgent who remained in the service for less than an hour, frequent users were usually categorized into higher risk levels, remained in the service for longer periods and had high mortality and hospitalization rates. The search for emergency services by frequent users mainly resulted from the exacerbation or complication of chronic conditions and, to a lesser degree, from recurrent acute health problems or those with a long period of treatment. According to these users, their health status was an urgent matter and required immediate treatment. This study identified four aspects associated with the health care organization, which represent the continuous search for emergency care: easy access to this service, higher resolvability, the connection between patients and service and the followup visits booked for this service. The majority of individuals also used other health services, such as primary care units and the hospital’s outpatient clinic. The results revealed the profile of frequent users and indicated gaps in the health system, thus contributing to better understanding of the continuous search for care in emergency services. It could be concluded that frequent users of emergency services have poorer health conditions, requiring care from the entire health network. / El estudio tuvo como objetivo general analizar la utilización frecuente por parte de pacientes adultos del servicio de urgencias de un hospital universitario. Investigación de métodos mixtos, del tipo explicativo secuencial. Fue realizada una etapa cuantitativa para describir las características demográficas y clínicas de la utilización del servicio de urgencia por parte de pacientes frecuentes. Posteriormente, fue efectuada una etapa cualitativa, con el objeto de explorar los motivos de la utilización frecuente del servicio de urgencias. Los datos cuantitativos fueron recolectados mediante registro de las historias clínicas electrónicas de los pacientes, a partir de una muestra de 385 pacientes frecuentes del Servicio de Emergencias de un hospital universitario de la región Sur de Brasil. Los datos cualitativos se obtuvieron mediante entrevistas telefónicas semiestructuradas con 18 pacientes frecuentes, seleccionados según una muestra intencional. Los datos de la etapa cuantitativa fueron analizados con el Statistical Package for the Social Sciences (SPSS), utilizando técnicas de estadística descriptiva e inferencial con nivel de significatividad de 5% (p<0,05). Para el tratamiento de los resultados cualitativos, se utilizó el análisis de contenido temático, apoyada por el software Atlasti.6. Los resultados evidencian que los pacientes frecuentes son responsables de cerca del 24% del total de atenciones realizadas en el servicio de urgencia. El número de reincidencias en el servicio varió de 4 a 58 veces, promediando 6,59 veces. La mayor parte de la demanda de tales individuos en el servicio sucedió en días hábiles (81,3%) y en el turno matutino (58,4%). Los pacientes frecuentes son un grupo con características heterogéneas, pero con factores que los vuelven más vulnerables, como la edad avanzada, la baja escolarización y la alta prevalencia de condiciones crónicas. A pesar de existir un grupo de personas que sufren de problemas de salud de carácter no urgente y que permanecen menos de una hora en el servicio, en general los pacientes frecuentes son clasificados con niveles de riesgo más elevados, permanecen más tiempo en el servicio y tienen alta tasa de mortalidad y de internación hospitalaria. La búsqueda de la unidad de urgencia por parte de los pacientes frecuentes derivó principalmente de la exacerbación o complicación de condiciones crónicas y, en menor escala, de padecimientos agudos recurrentes o de tratamiento prolongado. Para ellos, su estado de salud constituía una situación de urgencia y exigía atención inmediata. Fueron identificados cuatro aspectos relacionados a la organización de la atención sanitaria que configuran la búsqueda reiterada de atención en el sector de urgencias: la facilidad de acceso, la capacidad de resolución, el vínculo y las visitas de retorno al servicio agendadas. La mayoría de los individuos utilizaba también otros servicios de salud, como la atención básica y el ambulatorio hospitalario. Los resultados evidenciaron el perfil de los pacientes frecuentes e indicaron carencias en el sistema de salud, contribuyendo a una mejor comprensión de la búsqueda reiterada de atención en los servicios de urgencia. Se concluyó en que los pacientes frecuentes del servicio de urgencia sufren un peor estado de salud, necesitando de cuidados en toda red asistencial.

O estudo teve como objetivo geral analisar a utilização frequente por usuários adultos do serviço de urgência de um hospital universitário. Trata-se de uma pesquisa de métodos mistos do tipo explanatório sequencial. Foi realizada uma etapa de caráter quantitativo para descrever as características demográficas e clínicas dos usuários frequentes do serviço de urgência e identificar as características da utilização de serviço de urgência por usuários frequentes. A seguir, foi realizada uma etapa qualitativa, com o propósito de explorar os motivos da utilização frequente do serviço de urgência. Os dados quantitativos foram coletados por meio de registros dos prontuários eletrônicos dos pacientes, a partir de uma amostra de 385 usuários frequentes do Serviço de Emergência de um hospital universitário da região sul do Brasil. Os dados qualitativos foram obtidos por meio de entrevistas semiestruturadas por telefone com 18 usuários frequentes, selecionados por uma amostra intencional. Os dados da etapa quantitativa foram analisados no Programa Statistical Package for the Social Science (SPSS), pela utilização de técnicas de estatística descritiva e inferencial, com nível de significância de 5% (p<0,05). Para o tratamento dos resultados qualitativos, foi utilizada a técnica de análise de conteúdo temática, com a utilização do software Atlasti.6. Os resultados evidenciam que os usuários frequentes são responsáveis por cerca de 24% do total de atendimentos realizados no serviço de urgência. O número de reincidências no serviço variou de 4 a 58 vezes, tendo uma média de 6,59 vezes. A maioria da demanda desses indivíduos no serviço ocorreu em dias úteis (81,3%) e no turno da manhã (58,4%). Os usuários frequentes são um grupo com características heterogêneas, mas com fatores que os tornam mais vulneráveis, como a idade avançada, a baixa escolaridade e a alta prevalência de condições crônicas. Apesar de existir um grupo de pessoas que têm problemas de saúde de caráter não urgente e que permaneceram menos de uma hora no serviço, de forma geral usuários frequentes são classificados com níveis de risco mais elevados, permanecem mais tempo no serviço e têm alta taxa de mortalidade e de internação hospitalar. A busca da unidade de urgência pelos usuários frequentes foi decorrente principalmente de exacerbação ou complicação de condições crônicas e, em menor escala, de agravos agudos recorrentes ou de tratamento prolongado. Para eles, o seu estado de saúde era uma situação de urgência e exigia atendimento imediato. Foram identificados quatro aspectos relacionados à organização da atenção à saúde que configuram a busca repetida por atendimento no setor de urgência: a facilidade de acesso, a capacidade de resolutividade, o vínculo e os retornos agendados para o serviço. A maioria dos indivíduos utilizava também outros serviços de saúde, como a atenção primária e o ambulatório do hospital. Os resultados evidenciaram o perfil dos usuários frequentes e indicaram lacunas no sistema de saúde, contribuindo para melhor compreensão acerca da busca repetida por atendimento nos serviços de urgência. Concluiu-se que usuários frequentes do serviço de urgência têm pior estado de saúde, necessitando de cuidados em toda rede assistencial. / The present study aimed to analyze the frequent use of the emergency service of a university hospital by adult users. A sequential explanatory design was adopted in this mixed method research. A quantitative stage was performed to describe the demographic and clinical characteristics of frequent users of emergency services and to identify the characteristics of emergency service use by these users. A qualitative stage was subsequently performed, aiming to explore the reasons for frequent emergency service use. Quantitative data were collected from patients’ online medical records in a sample comprised of 385 frequent users of the emergency service of a university hospital in Southern Brazil. Qualitative data were obtained from semi-structure interviews conducted by telephone with 18 frequent users, selected by intentional sample. Data from the qualitative stage were analyzed with the Statistical Package for the Social Sciences software (SPSS), as it uses descriptive and inferential statistical techniques with a 5% significance level (p<0.05). Thematic content analysis was used to treat the qualitative results, using the Atlasti.6 software. The results show that frequent users were responsible for approximately 24% of all emergency service visits. The number of service recurrences varied from four to 58 times and the mean was 6.59 times. Most of the demand for this service occurred on weekdays (81.3%) and in the morning shift (58.4%). Frequent users comprise a group with heterogeneous characteristics, although with factors that caused them to be vulnerable, such as advanced age, low level of education and high prevalence of chronic conditions. Despite the existence of a group of individuals with health problems considered not to be urgent who remained in the service for less than an hour, frequent users were usually categorized into higher risk levels, remained in the service for longer periods and had high mortality and hospitalization rates. The search for emergency services by frequent users mainly resulted from the exacerbation or complication of chronic conditions and, to a lesser degree, from recurrent acute health problems or those with a long period of treatment. According to these users, their health status was an urgent matter and required immediate treatment. This study identified four aspects associated with the health care organization, which represent the continuous search for emergency care: easy access to this service, higher resolvability, the connection between patients and service and the followup visits booked for this service. The majority of individuals also used other health services, such as primary care units and the hospital’s outpatient clinic. The results revealed the profile of frequent users and indicated gaps in the health system, thus contributing to better understanding of the continuous search for care in emergency services. It could be concluded that frequent users of emergency services have poorer health conditions, requiring care from the entire health network. / El estudio tuvo como objetivo general analizar la utilización frecuente por parte de pacientes adultos del servicio de urgencias de un hospital universitario. Investigación de métodos mixtos, del tipo explicativo secuencial. Fue realizada una etapa cuantitativa para describir las características demográficas y clínicas de la utilización del servicio de urgencia por parte de pacientes frecuentes. Posteriormente, fue efectuada una etapa cualitativa, con el objeto de explorar los motivos de la utilización frecuente del servicio de urgencias. Los datos cuantitativos fueron recolectados mediante registro de las historias clínicas electrónicas de los pacientes, a partir de una muestra de 385 pacientes frecuentes del Servicio de Emergencias de un hospital universitario de la región Sur de Brasil. Los datos cualitativos se obtuvieron mediante entrevistas telefónicas semiestructuradas con 18 pacientes frecuentes, seleccionados según una muestra intencional. Los datos de la etapa cuantitativa fueron analizados con el Statistical Package for the Social Sciences (SPSS), utilizando técnicas de estadística descriptiva e inferencial con nivel de significatividad de 5% (p<0,05). Para el tratamiento de los resultados cualitativos, se utilizó el análisis de contenido temático, apoyada por el software Atlasti.6. Los resultados evidencian que los pacientes frecuentes son responsables de cerca del 24% del total de atenciones realizadas en el servicio de urgencia. El número de reincidencias en el servicio varió de 4 a 58 veces, promediando 6,59 veces. La mayor parte de la demanda de tales individuos en el servicio sucedió en días hábiles (81,3%) y en el turno matutino (58,4%). Los pacientes frecuentes son un grupo con características heterogéneas, pero con factores que los vuelven más vulnerables, como la edad avanzada, la baja escolarización y la alta prevalencia de condiciones crónicas. A pesar de existir un grupo de personas que sufren de problemas de salud de carácter no urgente y que permanecen menos de una hora en el servicio, en general los pacientes frecuentes son clasificados con niveles de riesgo más elevados, permanecen más tiempo en el servicio y tienen alta tasa de mortalidad y de internación hospitalaria. La búsqueda de la unidad de urgencia por parte de los pacientes frecuentes derivó principalmente de la exacerbación o complicación de condiciones crónicas y, en menor escala, de padecimientos agudos recurrentes o de tratamiento prolongado. Para ellos, su estado de salud constituía una situación de urgencia y exigía atención inmediata. Fueron identificados cuatro aspectos relacionados a la organización de la atención sanitaria que configuran la búsqueda reiterada de atención en el sector de urgencias: la facilidad de acceso, la capacidad de resolución, el vínculo y las visitas de retorno al servicio agendadas. La mayoría de los individuos utilizaba también otros servicios de salud, como la atención básica y el ambulatorio hospitalario. Los resultados evidenciaron el perfil de los pacientes frecuentes e indicaron carencias en el sistema de salud, contribuyendo a una mejor comprensión de la búsqueda reiterada de atención en los servicios de urgencia. Se concluyó en que los pacientes frecuentes del servicio de urgencia sufren un peor estado de salud, necesitando de cuidados en toda red asistencial.