Магистерская диссертация выполнена на 89 страницах, состоит из введения, двух глав, заключения, списка литературы из 62 наименований, содержит 9 рисунков, 5 таблиц, имеет 3 приложения. Объект исследования – жизнестойкость личности. Предмет исследования – связь жизнестойкости и ее показателей с толерантностью к неопределенности у студентов гуманитарных и технических направлений подготовки. Современные условия жизни человека часто описываются как экстремальные и способствующие возникновению стресса. Также современная ситуация характеризуется возрастанием неопределенности во всех жизненных сферах. По этой причине заинтересованность ученых в изучении жизнестойкости и толерантности к неопределенности растет. В первой главе рассмотрен феномен жизнестойкости, а также толерантности к неопределенности в работах отечественных и зарубежных психологов, проанализированы особенности проявления жизнестойкости и толерантности к неопределенности в студенческом возрасте. Во второй главе описаны методы и ход эмпирического исследования взаимосвязи жизнестойкости и толерантности к неопределенности, проанализированы и приведены результаты описательной статистики, сравнительного и корреляционного анализа. Участие в исследовании приняли 102 студента, в возрасте от 18 до 22 лет. В ходе исследования было выявлено, что существует достоверное различие по показателю «интолерантность к неопределенности» у студентов гуманитарных и технических направлений подготовки, положительная взаимосвязь между толерантностью к неопределённости и приятием риска у студентов гуманитарных и технических специальностей, а также существует положительная взаимосвязь между вовлеченностью и отношением к неопределенным ситуациям у студентов гуманитарных специальностей. Исследование взаимосвязи жизнестойкости и толерантности к неопределенности у студентов имеет высокую значимость, поскольку способствует улучшению качества жизни, эффективности работы и достижению успеха в различных сферах деятельности. Результаты исследования могут быть использованы в развитии жизнестойкости и толерантности к неопределенности у студентов, а также в образовательном процессе и в разработке программ по улучшению психологического здоровья и снижению стресса у студентов. Это поможет учащимся лучше справляться с учебными и жизненными вызовами. / The master's thesis is written on 89 pages, consists of an introduction, two chapters, a conclusion, a list of references from 62 titles, contains 9 figures, 5 tables, has 3 appendices. The object of the study is the resilience of the individual. The subject of the study is the relationship between resilience and its indicators with tolerance to uncertainty in students of the humanitarian and technical fields of study. Modern human living conditions are often described as extreme and conducive to stress. Also, the modern situation is characterized by an increase in uncertainty in all spheres of life. For this reason, the interest of scientists in the study of resilience and tolerance to uncertainty is growing. The first chapter examines the phenomenon of resilience, as well as tolerance to uncertainty in the works of domestic and foreign psychologists, analyzes the features of the manifestation of resilience and tolerance to uncertainty in student age. The second chapter describes the methods and course of the empirical study of the relationship between resilience and tolerance to uncertainty, analyzes and presents the results of descriptive statistics, comparative and correlation analysis. A total of 102 students aged 18 to 22 took part in the study. The study revealed that there is a reliable difference in the indicator "intolerance to uncertainty" among students in the humanities and technical fields of study, a positive relationship between tolerance to uncertainty and risk acceptance among students in the humanities and technical specialties, and there is also a positive relationship between involvement and attitude towards uncertain situations among students in the humanities. The study of the relationship between resilience and tolerance to uncertainty in students is of great importance, since it contributes to improving the quality of life, work efficiency and achieving success in various fields of activity. The results of the study can be used in developing resilience and tolerance to uncertainty in students, as well as in the educational process and in developing programs to improve psychological health and reduce stress in students. This will help students better cope with academic and life challenges.

Patients in the intensive care unit (ICU) setting are prone to develop muscle weakness and the causes are multi-factorial. Muscle strength in adult, critically ill patients on mechanical ventilation decreases with immobility. The influence of muscle strength on different muscle groups and its influence on progressive mobility in the adult, critically ill patient on mechanical ventilation has not been examined. Identifying muscle strength in this patient population can benefit overall muscle health and minimize muscle deconditioning through a progressive mobility plan. The objective of this dissertation was to describe muscle strength in different muscle groups and to describe the influence of muscle strength on mobility in critically ill adult patients on mechanical ventilation (MV). Fifty ICU patients were enrolled in this descriptive, cross sectional study. Abdominal core, bilateral hand grip and extremity strength was measured using three measurement tools. Mobility was measured using the following scale: 0=lying in bed; 1=sitting on edge of bed; 2=sitting on edge of bed to standing; 3=walking to bedside chair and 4=walking >7 feet from the standing position. Predictors of mobility were examined using stepwise regression. Abdominal core, bilateral hand grip and extremity strength demonstrated statistically significant relationships with all variables. Extremity strength accounted for 82% of the variance in mobility and was the sole predictor (β=0.903; F=212.9; p=0.000). Future research addressing the outcomes of implementing a mobility protocol in this patient population and prioritizing when such a protocol should be implemented would be beneficial to ongoing plans to decrease MV, ICU and hospital days. Muscle strength tests implemented at the bedside are crucial to implementing a progressive mobility plan for critically ill adults while they are on MV therapy.

nÃo hà / A implantaÃÃo do ConsÃrcio PÃblico de SaÃde da MicrorregiÃo de Sobral â Cearà trouxe um grande incremento na oferta de procedimentos especializados em SaÃde Bucal à 11a RegiÃo de SaÃde do Estado do CearÃ. O objetivo geral deste trabalho foi avaliar o serviÃo de atenÃÃo especializada nesta RegiÃo de SaÃde, apÃs implantaÃÃo deste ConsÃrcio. Para tanto, realizou-se um estudo exploratÃrio-descritivo, com abordagem quantitativa por meio da coleta e anÃlise de dados secundÃrios de oferta, utilizaÃÃo e financiamento desse serviÃo especializado e da aplicaÃÃo de entrevista semiestruturada aos Coordenadores de SaÃde Bucal dos municÃpios consorciados. Os resultados evidenciaram que a unidade de saÃde parece estar adequadamente preparada para atender à demanda pactuada. Contudo, foram encontradas algumas barreiras geogrÃficas (distÃncia de alguns municÃpios à sede do serviÃo, carÃncia de meios de transporte para o deslocamento dos pacientes), financeiras (custos desse transporte) e organizacionais (oferta de vagas no turno da noite e a falta de uma oferta adequada de procedimentos, baseada em dados epidemiolÃgicos). Essas barreiras parecem explicar bem a baixa taxa mÃdia de aproveitamento de marcaÃÃo de consultas (58,6%), a alta taxa mÃdia de pacientes faltosos (20%) e a baixa taxa mÃdia de utilizaÃÃo do serviÃo (46,2%), que trazem consigo um importante impacto financeiro para os municÃpios consorciados e uma clara incapacidade no cumprimento dos princÃpios do SUS. A ampla discussÃo a respeito dessas dificuldades à necessÃria para que se consiga melhores taxas de utilizaÃÃo do serviÃo ofertado, justificando assim o alto investimento na construÃÃo de uma rede assistencial em saÃde bucal nesta regiÃo. / The implantation of the Consortium of Public Health in Microregion Sobral - Cearà brought a large increase in the supply of specialized procedures in oral health in the 11th Region Health of the State of CearÃ. The aim of this study was to evaluate the specialized service in this care Health Region after implantation of this Consortium. To this end, we carried out a descriptive exploratory study with a quantitative approach by collecting and analyzing secondary data supply, utilization and financing of specialized service and application of semi-structured interview to Oral Health Coordinators municipalities consortium. The results showed that the health unit appears to be adequately prepared to meet the demands agreed. However, we found some geographical barriers (distance of some municipalities to host the service, lack of means of transport for the movement of patients), financial (cost of transport) and organizational (offer procedures at night and the lack of an offer proper procedures, based on epidemiological data). These barriers seem well explain the low average utilization of appointments (58.6%), high average rate of missing patients (20%) and low average utilization rate of service (46.2%), which bring with a significant financial impact on municipalities consortium and a clear inability on the fulfillment of the principles of the SUS. A broad discussion of these difficulties is necessary so that we can better utilization rates of the service offered, thus justifying the high investment in building a network of oral health care in this region.

Pain is the most prevalent medical problem that elderly persons experience in a long-term care home. Nurses play an essential role in managing their pain. The purpose of this study was to explore nurses’ pain management practices in Ontario long-term care homes facilities. The ultimate aim was to recommend measures for effective pain management in aged people. The setting for this study was a selected long-term care home in Ontario, Canada, a 160-bed nursing home for aged people offering various medical care services. Semi-structured focus group interviews, averaging approximately one hour, were conducted. The population of this study was 45 nurses. The researcher used a purposive sampling method to select a sample of 25 nurses. Open-ended questions were used to explore pain management practices and to find barriers to effective pain management. Qualitative data analysis was used to review the data to identify common issues that recurred, and they were summarised in a narrative form. This study demonstrated the importance of recognising and overcoming barriers to the effective management of pain and reinforcing good practices in long-term care homes. Therefore, improved pain management practices are required to manage pain in a long-term care home effectively. / Health Studies / M.A. (Nursing Sciences)

This master's thesis study is devoted to the features of teaching speaking students of creative specialties. The structure of the work consists of two chapters: theoretical and practical. The theoretical part discusses the main directions in teaching students to speak at non-linguistic faculties, age and psychological characteristics of students in secondary vocational education institutions and the most common methods and techniques for teaching speaking. The second chapter on the basis of the educational-methodical complex of exercises for teaching speaking of this group of students is described, created in addition to the main textbook. Experimental-search proved the effectiveness of using such a manual in English lessons for students of creative specialties, such as music and acting. Some provisions of the dissertation research are presented and published in the scientific article "The possibilities of musical art in mastering the English language by students of creative specialties" in the scientific journal "Meridian" under the editorship of Yu. I. Zhegusov in January 2020. / Данное магистерское диссертационное исследование посвящено особенностям обучения говорению студентов творческих специальностей. Структура работы состоит из двух глав: теоретической и практической. В теоретической части рассматриваются основные направления в обучении говорению студентов на неязыковых факультетах, возрастные и психологические особенности обучающихся учреждений среднего профессионального образования и наиболее распространенные методы и приемы по обучении говорению. Во второй главе на основе описывается учебно-методический комплекс упражнений на обучение говорению данной группы студентов, созданный в дополнение к основному учебнику. Опытно-поисковым путем доказана эффективность использования такого пособия на уроках английского языка у студентов творческих специальностей, таких как музыка и актерское мастерство. Некоторые положения диссертационного исследования представлены и опубликованы в научной статье «Возможности музыкального искусства в освоении английского языка студентами творческих специальностей» в научном журнале «Меридиан» под ред. Ю. И. Жегусова в январе 2020 года.

Background: Historically, patients with cancer have been perceived as poor candidates for ICU admission. General ICU admission criteria lists cancer patients as low priority in ICU admission depriving them of the care they rightfully deserve. The purpose of this literary synthesis was to examine ICU admission criteria, risk factors, and outcomes of ICU admission in relation to hematological and solid tumor cancers and discuss ways that practitioners and nurses can educate patients with cancer and their families on appropriateness of ICU care. Methods: A total of 768 articles were found in a literature search including all literature from 2005 to 2016 from all countries using the databases CINAHL Plus, MEDLINE, PsycINFO, and Academic Search Premier. These were further narrowed down based on relevancy by topic or reading abstracts. A total of 13 articles utilizing the inclusion and exclusion criteria of the literature search were included in the final literature synthesis. Results: In addition to general ICU admission criteria several other criteria and scores can be helpful in admitting patients with cancer to the ICU including cancer specific criteria, mortality predictor tools, performance status, and ICU trials. Mortality predictors, in combination with other patient characteristics, demonstrated effectiveness to predict outcomes in patients with cancer. Survival rates in hematological and solid tumor cancers have improved from the past, and lower prognostic scores can predict who will have better outcomes. Conclusion: Cancer specific criteria, mortality predictor tools, performance status, and ICU trials in addition to general ICU criteria should be used for admission of cancer patients into ICU. Practitioners and nurses should become familiar with the newest outcomes in patients with cancer to make collaborative informed decisions about ICU admission.

Made available in DSpace on 2014-12-17T15:30:53Z (GMT). No. of bitstreams: 1 GeorgiaCAS.pdf: 1172018 bytes, checksum: ddbd3f0e4914969b01e2de84e34c11fb (MD5) Previous issue date: 2009-04-13 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The Specialized Dental Care Centers (CEO) were developed to provide specialized dental care to the population, given the accumulated needs of health since the past. They must operate as units of reference for the Oral Health Team of the Primary Care, complementing the dental procedures performed at this level of attention. This study aims to assess the performance of CEOs of the Grande Natal Health Region as a strategy of Secondary Care consolidation in oral health through users, dentists and managers. For this to try to identify factors about access, hosting and satisfaction with the service, the actions developed in these centers, integration between the CEOs and the Basic Health Units (UBS), considering the reference and counter reference. Data were collected through semi-structured interview, conducted in four CEOs, among 253 users, 31 dentists and 4 managers. It was submitted to descriptive statistical analysis and to content analysis by software ALCESTE 4.5. The results revealed that the specialties of prosthesis, endodontics and surgery were the most sought by 38.2%, 23.7% and 21.7% of respondents, respectively. It was noticed that among users aged 18 to 30 years-old the greatest demand is for the specialty of endodontics (44.4%) and over 50 years for prosthesis (76.4%). There is a weakness in the reference and counter reference between UBS and CEO, because part of users goes directly to the centers without going before to the Primary Care and the majority does not want to return to the dentist of Health Unit. Satisfaction with care was reported by 90.9% of users, because they resolved the problems needed and were welcomed by the team. But the delay in care was the main factor for not satisfaction. For most dentists, some users could solve their problems completely in Primary Care, which shows the existence of unnecessary referrals to the CEOs, however they consider the existence of limiting factors in UBS that compromise the service. Most dentists revealed that some users do not get to CEOs with the basic dental treatment done, and some of them do not counter reference users. It can be concluded that the studied CEOs are being resolutive for those who access them, offering necessary care for the population, and if they don t account with this service, will encounter obstacles to resolution of problems, ranging seek care service in particular, in another public sector, or even giving up treatment. However, it is perceived the need of professionals training to understand the importance of the reference and counter reference, to that they can better serve and guide users. It is also important that cities offer better conditions to UBS and CEOs, so they can work together, with complementary actions of oral health, seeking full care, aiming for better resolution to the users' health problems / Os Centros de Especialidades Odontol?gicas (CEOs) foram criados para assegurar atendimentos odontol?gicos especializados ? popula??o brasileira, diante das necessidades de sa?de acumuladas h? bastante tempo. Devem funcionar como unidades de refer?ncia para as Equipes de Sa?de Bucal da Aten??o B?sica, com procedimentos cl?nicos odontol?gicos complementares aos realizados neste n?vel de aten??o. Este estudo objetiva avaliar o desempenho dos CEOs da Regi?o de Sa?de da Grande Natal como estrat?gia de consolida??o da Aten??o Secund?ria em sa?de bucal atrav?s dos usu?rios, cirurgi?es-dentistas e diretores. Para isto busca-se identificar fatores relacionados ao acesso, acolhimento e satisfa??o com o servi?o, as a??es desenvolvidas nestes centros, integra??o entre os CEOs e as Unidades B?sicas de Sa?de (UBS), considerando a rela??o de refer?ncia e contra-refer?ncia. Os dados foram coletados atrav?s de entrevista semi-estruturada, realizadas em quatro CEOs, entre 253 usu?rios, 31 dentistas e 4 diretores, e submetidos ? an?lise estat?stica descritiva e ? an?lise de conte?do informatizada atrav?s do software ALCESTE 4.5. Os resultados mostraram que as especialidades de pr?tese, endodontia e cirurgia foram as mais procuradas, por 38,2%, 23,7% e 21,7% dos entrevistados, respectivamente. Percebeu-se que entre os usu?rios na faixa et?ria de 18 a 30 anos a maior procura ? para a especialidade de endodontia (44,4%) e os acima de 50 anos, para pr?tese (76,4%). Observa-se uma fragilidade no sistema de refer?ncia e contra-refer?ncia entre a UBS e o CEO, na medida em que parte dos usu?rios v?o diretamente aos centros sem passar antes pela Aten??o B?sica e a maioria n?o deseja retornar ao dentista da Unidade de Sa?de. A satisfa??o com o atendimento foi relatada por 90,9% dos usu?rios, pois conseguiram resolver os problemas que precisavam e foram bem acolhidos pela equipe. Por?m, a demora no atendimento foi o principal fator para a n?o satisfa??o. Para a maioria dos dentistas, alguns usu?rios poderiam resolver seus problemas completamente na Aten??o B?sica, o que revela a exist?ncia de encaminhamentos desnecess?rios aos CEOs, entretanto consideram a exist?ncia de fatores limitantes nas UBS que comprometem o atendimento. Grande parte dos dentistas revelou que a maioria dos usu?rios n?o chega aos CEOs com o tratamento odontol?gico b?sico realizado, e alguns n?o contra-referenciam os usu?rios. Pode-se concluir que os CEOs estudados est?o sendo resolutivos para aqueles que os acessaram, oferecendo atendimentos necess?rios ? popula??o que, se n?o contasse com esse servi?o, encontraria entraves ? resolu??o dos problemas, indo buscar atendimento no servi?o particular, em outro setor p?blico, ou at? desistindo do tratamento. Contudo, percebe-se a necessidade de capacita??o dos profissionais para que compreendam a import?ncia da refer?ncia e da contra-refer?ncia e que possam melhor atender e orientar os usu?rios. Tamb?m ? preciso que os munic?pios ofere?am melhores condi??es ?s UBS e aos CEOs, para que possam atuar conjuntamente, com a??es complementares de sa?de bucal, atendendo a popula??o de maneira integral e resolutiva

Background: Disruptive technology describes technology that is significantly more advanced than previous iterations, such as: 3D printing, genetic manipulation, stem cell research, innovative surgical procedures, and computer-based charting software. These technologies often require extensive overhauls to implement into older systems and must overcome many difficult financial and societal complications before they can be widely used. In a field like healthcare that makes frequent advancements, these difficulties can mean that the technology will not be utilized to its full potential or implemented at all. Objective: To determine the inhibiting factors that prevent disruptive technology from being implemented in conventional healthcare. Methods: Peer reviewed articles were gathered from Cumulative Index to Nursing and Allied Health Literature (CINAHL), Educational Resources Information Center (ERIC), Elton B. Stephens Co. Host (Ebsco Host), Medical Literature On-line (Medline), and Psychological Information Database (PsychINFO). Articles were included if written in English and focusing on technology that was or is difficult to implement. Results: Research suggests that the primary reason disruptive technology is not implemented sooner is the cost versus benefit ratio. Those technologies with extremely high benefits that greatly improve efficiency, safety, or expense are integrated relatively quickly, especially if their cost is reasonable. Secondary reasons for difficulty with integration include ethical dilemmas, extreme complexity, technical limitations, maintenance, security, and fallibility. Conclusion: Research indicates that a decrease in production cost and selling price along with removing any issues that may depreciate the technology will provide better incentives for healthcare systems to integrate disruptive technologies on a wider scale.

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<p>All images in this document may not be produced without the expressed written consent of the author.</p> / <p>The innovative research method of “body mapping” was used in this study with geriatric inpatients receiving daily hæmodialysis therapy for end-stage renal disease at Toronto Rehabilitation Institute.</p> <p>Five people took part in this study; three participants completed all study phases. They created three body maps each and took part in one follow up, semi-structured interview to share their experiences of body mapping. Two themes were drawn from the data: (1) body mapping gives patients a voice to communicate their experiences in the dialysis unit; and (2) body mapping makes visible participants’ illness adjustment patterns, and levels of connection, or disconnection in the dialysis unit.</p> <p>Based on the ways body mapping benefitted participants in this study, it is reasonable to suggest that this visual communication tool could be useful in other research settings, and as a clinical tool to support patients’ attention to their bodies and their interactions with healthcare providers.</p> / Master of Arts (MA)