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Dissertations / Theses on the topic 'Health Sciences Centre'
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Forster, Rowland. "Domestic water conservation study, Health Sciences Centre, Winnipeg, Manitoba." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq23307.pdf.
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Riese, Nichole Margaret Marie. "Perceptions of care, Aboriginal patients at the Winnipeg Health Sciences Centre." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/MQ62834.pdf.
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Smith, Tiffany. "Applying Current Methods for Estimating Influenza Burden to an Academic Health Sciences Centre." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23197.
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Public health planning for influenza is based on morbidity and mortality estimates derived from statistical models. Lower than anticipated 2009 H1N1 pandemic death estimates have raised questions about the method. Examining the statistical method is important for future policy and program development. We compared the main methods of estimating influenza burden through a systematic literature review and by comparing statistical estimates of influenza-attributable burden at the Ottawa Hospital (TOH) to clinical estimates validated through chart review. We identified heterogeneity in methods used to estimate influenza-attributable mortality in the literature which resulted in within-season estimate variation by study. We found statistical estimates of influenza burden at TOH to be 4-8 times greater than clinically validated data. We also found no significant association between the outcomes examined and epidemic periods at TOH. The findings of this study suggest discordance between model estimates by model approach and between model estimates and validated findings. Examining reasons for these discordances should be pursued.
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Lennox-Chhugani, Niamh. "Power and the construction of organisational identity : creating the United Kingdom's first Academic Health Sciences Centre." Thesis, Imperial College London, 2011. http://hdl.handle.net/10044/1/6991.
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This study contributes to our understanding of the reproduction and transformation of organisational identity as it takes place in the context of individual and collective agency and relations of power within the organisation. Organisational identity is socially constructed and continuously reproduced and transformed discursively and non-discursively (Sveningsson and Alvesson, 2003; Czarniawska-Joerges, 2004; Corley et al, 2006) and is rarely as unitary as it appears (Humphreys and Brown, 2002; Foreman and Whetten, 2002). This study asks how power relations influence the construction of organisational identity in the context of multiple identity discourses and how this construction in turn reproduces and transforms power relations in an organisation. I use a reflexive methodology to analyse the empirical data collected during a longitudinal study in which 87 organisational members from all levels of the organisation were interviewed, organisational practices were observed and 83 organisational documents were analysed. This reflexive methodology employs qualitative and inductive methods to obtain and analyse rich situated empirical material. The longitudinal design of the study enables detailed examination of the dynamic processes underlying organisational identity construction over time. The study contributes to our understanding of the construction of organisational identity as an effect of power relations and a medium through which power relations are themselves transformed and reproduced. Firstly, the study contributes to our understanding how multiple organisational identities emerge as a single dominant identity discourse. It identifies processes of strategic ambiguity and inter-discursive recontextualisation strategies such as colonisation and translation which provide the creative space for constructing organisational identity. Secondly, it adds to current theorisation of multiple organisational identity dynamics by analysing these in the context of power relations. Using this analytical lens, organisational identity is seen as the medium through which power relations are reproduced and transformed as well as an outcome of the exercise of power. “Who we are” as an organisation determines which professional and other social groups are considered to be enunciate the identity discourses which 'fit' best and these groups in turn exercise power episodically to reproduce this dominant identity discourse. The final contribution adds to our understanding of how other social identities such as professional identities interact with each other in a healthcare context and with a desired future identity to transform and reproduce power relations between different groups within a complex professionally dominated organisation.
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Rose, Gregory Walter. "Use of an electronic data warehouse to enhance cardiac surgical site infection surveillance at a large Canadian centre." Thesis, University of Ottawa (Canada), 2010. http://hdl.handle.net/10393/28600.
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Surgical site infection surveillance (enumeration, and reporting of cases) reduces infection incidence. Data-driven "trigger" mechanisms focus surveillance on high-probability cases, yet often lack specificity. We aimed to develop trigger mechanisms with greater specificity for surveillance of cardiac surgical site infection.
We developed these mechanisms in a two part study: systematic review to identify potential trigger factors; and nested case-control study to derive trigger mechanisms from a novel information structure called a data warehouse.
Among 158 studies, we identified 570 trigger factors, which we grouped into themes, using the top 33 in the case-control study Using 203 cases and 516 controls, we derived two models for surveillance trigger mechanisms. These models provided true positive rates of 0.941 and 0.931 respectively (non-inferior to the current trigger mechanism), with false positive rates of 0.1085 each (superior to the current trigger mechanism).
These trigger mechanisms may standardize and automate surgical site infection surveillance triggering.
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Stacey, Dawn. "Design and evaluation of an implementation intervention to enhance decision support by call centre nurses for callers facing values-sensitive health decisions." Thesis, University of Ottawa (Canada), 2005. http://hdl.handle.net/10393/10923.
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Purpose. To evaluate the process of implementing decision support by call centre nurses for callers facing values-sensitive health decisions. Design. Exploratory case study guided by the Ottawa Model of Research Use with an embedded randomized controlled trial. Setting. A Canadian province-wide call centre. Intervention. Online autotutorial, skill-building workshop, decision support protocol, and performance feedback using simulated callers. Methods. (1) Barriers assessment using a survey, interviews, focus groups, and quality audit of baseline simulated calls. (2) Comparison of intervention and control groups using a knowledge test, quality audit of simulated calls, and acceptability surveys. (3) Assessment of the uptake and sustainability of decision support using a survey, interviews, and focus groups. Results. (1) Of 108 nurses, 57 responded to the barriers survey. Nurses had positive attitudes toward patient participation in decision making and their role in supporting callers. Main barriers included inadequate nurses' knowledge, skills, and confidence in providing decision support; lack of process to guide decision support calls; patient decision aids not formatted for telephone use; low public awareness; pressure to minimize call length, and unclear program direction. (2) Compared to controls (n=20), nurses (n=19) who participated in the intervention had improved knowledge (M= 74% vs. 60%, p=0.007) and provided a higher quality of decision support particularly in the domains of discussing values and support (M= 81.3% vs. 45.8%,p<0.0001) without significantly increasing call duration (M= 18.5 vs. 16.7 min, p=0.73). Nurses were satisfied with the multifaceted intervention. Twelve control group nurses opted to complete the training after the trial concluded. (3) Within 3 months post-intervention, 25 of the 31 nurses (n=19+12) completed the decision support uptake survey. Of these, 44% had used the protocol with real callers and 88% intended to use it. Nurses spoke positively about their experiences with real callers. Suggestions to improve sustainability included integrating the protocol in the call centre database, reformatting the patient decision aids, clarifying the program direction, establishing call length guidelines tailored to call type, implementing decision support training for all staff, and publicizing the new decision support services. Conclusions. The multifaceted intervention and process evaluation measures may provide a feasible approach to expanding call centre services to include values-sensitive decision support. However, to ensure sustainability, barriers within the practice environment need to be addressed and patient outcomes evaluated.
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Nicholas, Garth. "Survival analysis of patients seen at the Ottawa Hospital Regional Cancer Centre with early breast cancer, 1985--2001: Effect of changes in stage and adjuvant chemotherapy over time." Thesis, University of Ottawa (Canada), 2007. http://hdl.handle.net/10393/27542.
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Breast cancer is the commonest cancer affecting Canadian women. Recent decades have seen a trend of decreasing breast cancer mortality. This has been attributed to several causes, including greater use of screening mammography and increased efficacy of adjuvant chemotherapy. We studied the effect of these two factors on the overall survival of breast cancer patients at the Ottawa Hospital Regional Cancer Centre. Data were collected from 2985 charts from the years 1985, 1988, 1992, 1995, 1998, and 2001. Adjuvant chemotherapy was associated with a decreased hazard of death from any cause (HR=0.783 p=0.0208). A decrease in mean tumour size seen over the time period of the study is potentially attributable to mammography screening. Decreased tumour size was associated with a decreased hazard for death (HR 0.986 p<0.0001). No difference in overall survival between earlier and later cohorts could be demonstrated, perhaps due to shorter follow up in later cohorts.
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Barnes, Robert 1967. "Gonadotrophin-releasing hormone analogue treatment of idiopathic central precocious puberty presenting in girls after age five years : a multi-centre follow-up to final adult height." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=32753.
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Idiopathic central precocious puberty may compromise adult height. Gonadotrophin-releasing hormone analogues (GnRHa) suppress puberty and increase final height prediction, but their influence on final height is unclear, especially in girls with pubertal onset just below eight years of age, the traditional limit of normal.At seven children's hospitals, we identified 53 treated and 24 untreated patients (24 and 7 to final height, respectively) whose pubertal onset was between ages 5--8 years. At baseline, bone age advancement and predicted adult height were similar in the two groups. In both groups, the predicted adult height slightly overestimated the final height. What role, if any, GnRHa therapy played in preventing a shorter adult height is uncertain in these borderline cases. The substantial intra- and inter-observer variability in bone age readings compromised the utility of the height prediction method.
The methodological challenges inherent to this study are identified and discussed.
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Norman, Kerstin. "Call centre work : characteristics, physical, and psychosocial exposure, and health related outcomes." Doctoral thesis, Stockholm : Arbetslivsinstitutet, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-4705.
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Nnoaham, Kelechi Ebere. "A multi-centre study of the impact of endometriosis on health-related quality of life and work productivity." Thesis, University of Oxford, 2011. http://ora.ox.ac.uk/objects/uuid:b514d4e4-f001-4f73-ba57-72f69d742c64.
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Background: Endometriosis is a common condition in women of reproductive age, causing pelvic pain and subfertility, but little is known about its impact on health-related quality of life (HRQoL) and work productivity worldwide. Methods: In 10 countries across five continents, this study recruited 1,418 women, aged 18-45, without a previous surgical diagnosis of endometriosis, scheduled to undergo a laparoscopy to investigate symptoms suggestive of endometriosis or to be sterilised. Pre-operatively, women completed a standardised questionnaire assessing symptoms, diagnostic delay, HRQoL and work productivity using validated instruments. Surgeons completed a standardised questionnaire incorporating findings at laparoscopy including endometriosis stage according to revised American Fertility Society criteria. Results: There was a mean delay of 9.2 years (SD 8.8), principally in primary care, between the onset of symptoms and diagnostic laparoscopy. This diagnostic delay was longer in centres where healthcare was predominantly state-funded (12.8 vs. 7.6 years; p<0.001). In multivariate analyses, the delay was positively associated with the number of pelvic symptoms (chronic pelvic pain, dysmenorrhoea, dyspareunia and heavy periods; p<0.001) and a higher body mass index (p<0.001). Physical HRQoL was significantly reduced in affected women compared to those with similar symptoms and no endometriosis (p=0.012). Not being in paid employment, severe pelvic pain and moderate-severe disease were associated with reduced physical HRQoL (all p<0.001). Each affected woman lost on average 10.0 hours (SD 10.6) of work weekly, due mainly to reduced effectiveness while working. The annual indirect cost of endometriosis associated with work productivity loss ranged from US$399 per woman in Ibadan (Nigeria) to US$18,586 per woman in Boston (USA). Conclusions: Endometriosis significantly impairs HRQoL and work productivity across countries and ethnicities, yet women continue to experience diagnostic delays in primary care. A higher index of suspicion is needed to expedite specialist assessment of symptomatic women. Future research should seek to clarify pain mechanisms in relation to endometriosis severity.
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Lindskov, Cecilia. "Family centre practice and modernity : a qualitative study from Sweden." Doctoral thesis, Högskolan Kristianstad, Sektionen för hälsa och samhälle, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-7943.
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Family centres have become a common institution to promote health and wellbeingamong young children (0-6 years of age) and their parents in Sweden. Thecore of the work is usually based on both maternal and child health care, a preschooland social services, all located under the same roof in the local community.The family centre in this study, known as the "Family House", was the firstof its type to be built in the city of Kristianstad, Sweden.The overall aim of the thesis was to understand family centre practice throughprofessionals' and parents' perceptions of the Family House and its relationship to modernity.The study employed a qualitative design using phenomenography as method tocapture people's perceptions of the practice. The research also drew on the approachof action research, where participants and researchers co-generateknowledge through collaborative communicative processes. Data was generatedfrom semi-structured interviews conducted with nineteen professionals andsixteen individual parents. Dialogue sessions with the professionals of the studyhave been held in order that they and the researcher could enter into a dialoguebased on the findings of the interviews. Data was consequently also generatedfrom these meetings.The way the professionals perceived the practice of the Family House fell intothree categories, namely, as a professional service, the provision of an informalmeeting place for professionals and families with young children or as a broadcommunity-based centre. Parents' perceptions fell into four categories; as aprofessional reception to obtain expert guidance and support, a study circle andliving room to informally share experiences and socialising, and a playgroundfor children where children could interact and learn social skills.One core finding of this thesis is that family centre practice for those involvedcontained a balancing act between simple modern expertise to control the futureand late modern opportunities for self-realisation and reflexivity.Parents and professionals shared the responsibility for children's well-being andthe distinction between private and public was blurred since parents used theHouse as a social arena for developing personal relations. It was also an arenafor integration between Swedes and immigrants based on engagement for bothcultural diversity and similarity.
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Goodlett, Dana Louise. "Resilience in Uncertainty: An Examination of a Moroccan Centre Serving Unwed Mothers." Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6089.
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Utilizing a gender-based violence approach, this study investigated service delivery realities for a Moroccan women’s centre serving unwed mothers and their babies. Primary research methods included participant observation and semi-structured interviews (n=20) with unwed mothers and centre staff. This study aimed to determine what factors lead mothers to seek assistance, types of assistance offered, and challenges and future opportunities for services. Findings indicate a lack of social support to mothers, lack of social and economic support for the centre and reduced service capacity, and the use of deceit in interactions between mothers and staff rooted in cultural notions of shame. Future opportunities for program development and sustainability are discussed. This work hopes to contribute to a richer understanding of gender-based violence in local contexts through the investigation of unwed mother’s experiences of gender-based violence in Moroccan society and how these experiences impact the reality and capabilities of social service provision.
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Jutan, Norma M. "Home care in Ontario: Allocation of limited resources and the needs of light-care clients." Thesis, University of Waterloo, 2006. http://hdl.handle.net/10012/2806.
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There is the desire amongst elderly Canadians to remain living at home, maintaining their independence. As the population ages, the health care system is faced with the challenge of allocating limited resources. Home care in Ontario is provided through Community Care Access Centres (CCAC) or Community Support Agencies (CSA). This study made comparisons among CSA clients (using the interRAI-Community Health Assessment, n=796), a sub-population of CCAC clients with lighter-care needs (n=8163) and all other CCAC clients (n=31,078), both using the Minimum Data Set-Home Care (MDS HC). The majority of clients in all groups were female, widowed, and spoke English as their primary language. CCAC clients had more health conditions than did CSA clients. Light-care CCAC clients received less hours of formal support than other CCAC clients and were less likely to have informal support caregivers who reported caregiver burden. Between 1998 and 2005, Ontario provided services to an increasingly impaired home care population, although overall impairment among home care client remained low. For the purposes of benchmarking, MDS HC data from Ontario was compared with MDS HC data from 11 European countries and was found to fall within the range of the other countries in terms of average impairment level of home care clients. Logistic regression was used to predict the likelihood of receiving CCAC services. Not being self-reliant, having decline in activities of daily living, having experienced falls, self-reporting one's health to be poor and reporting less loneliness were all correlates for CCAC service use. Implications and direction for future research were discussed.
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Wenn, Janice. "Kaupapa hauora Māori : ngā whakaaro whakahirahira o ngā kaumātua : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Māori Studies at Te Pumanawa Hauora Research Centre for Māori Health and Development, Massey University, Wellington, Aotearoa/New Zealand." Massey University, 2006. http://hdl.handle.net/10179/995.
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There is a requirement for all services within the New Zealand health system to be accredited with an established quality organisation and to demonstrate an ability to provide a measurable quality service to consumers. For Māori these requirements must make sense in Māori terms. This thesis is based on the view that, for Māori, the concept of health is more effectively expressed as hauora - optimal health and wellbeing for Māori. This thesis makes five contributions to Māori health and Māori health research. First, it identifies a responsive approach to engaging kaumātua effectively in the process of qualitative research. Second, it identifies a fundamental underlying conceptual framework – kaupapa hauora Māori as a means of understanding hauora – expressed in terms derived from kaumātua in Taranaki and Kahungunu. Third, it adapts this conceptual framework into an analytical research framework and then applies it to allow kaupapa hauora Māori (described in terms of worldview, values and ethics) to be identified from a range of data. Fourth, it critically analyses popular models of Māori health – Te Whare Tapa Whā, Te Wheke and Ngā Pou Mana. Finally, it proposes and details post-doctoral research that will translate kaupapa hauora Māori into a quality services framework/tool. “Kaupapa Hauora Māori” is a conceptual framework articulated by kaumātua, and has its origins in te ao Māori, from which the aronga or worldview is developed. The aronga is composed of the kaupapa or values and tikanga or ethics that provide kaumātua with the values base of hauora. These components have been identified by kaumātua and not only inform the concept of KHM but also inform the analytical research framework that is applied to the data. The values have been identified as a core set of values comprising whakapapa, wairua, whenua, whānau, tikanga te reo Māori, tinana, and hinengaro, and the associated tikanga is expressed as behaviour or ethics. These, together, influence the perception and understanding individuals have of their world and of hauora.
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Finholm, Cecilia, and Jennifer Shahin. "Vad är rekreation? : En kvalitativ studie om barns möjligheter till rekreation på fritidshemmet." Thesis, Södertörns högskola, Lärarutbildningen, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-38243.
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Läroplanens syfte gällande rekreation och vila på fritidshemmet ansåg vi vara oklar och öppen för olika motstridiga tolkningar. Det mångtydiga och något diffusa begreppet rekreation var därmed det centrala begreppet i vår studie. Syftet med studien var att undersöka hur pedagoger på fritidshemmet tolkar begreppet rekreation och hur de arbetar med rekreation i sin undervisning. Vi använde oss av semistrukturerade intervjuer som metod och totalt fem pedagoger deltog i studien. Resultatet visade att faktorer så som miljö och förutsättningar till lokaler var betydande för möjlighet till rekreation. Resultatet stämde överens med tidigare forskning, som visade att miljö och rekreerande aktiviteter var nära sammankopplade med hälsa och välbefinnande.The reason we conducted this study is that we considered that conceptions like rest and recreation at the leisure centre were unclear and open for conflicting interpretations. The ambiguous and diffuse concept recreation was therefore the central concept of our thesis. The aim of the thesis was to discover how pedagogues working at the leisure interpreters the concept recreation and how they work with recreation in their daily teaching. The thesis had a total of five question to be answered regarding this topic. One way of gathering the empiricism for our thesis were by qualitative interviews. The interviews were semistructured and were executed at two different schools in Stockholm where a total of five pedagogues were interviewed. The result of the thesis showed that factors such as environmental and prerequisites to facilities is considerable for a successful recreation at the leisure. The result was consistent with previous research, which showed that environment and recruiting activities were closely connected to health and well-being.
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Söreke, Hannah, and Julia Karlsson. "Distriktssköterskans kommunikation med uppringare på vårdcentraler : En observationsstudie om det rådgivande samtalet." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-397185.
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Bakgrund: I västvärlden har telefonrådgivning utvidgats för att minska onödiga sjukvårdsbesök och kostnader för sjukvården. Syftet med telefonrådgivning är att göra vården effektiv, säker och mer tillgänglig för uppringaren. Ett av de vanligaste problemen mellan uppringare och vårdgivare är bristande kommunikation, det som påverkar är när sjuksköterskan inte lyssnar noga och ställer för få frågor. Dessa faktorer ökar risken för felbehandling och misstag. Syfte: Att observera hur distriktssköterskor kommunicerar med uppringare under rådgivande samtal på vårdcentral. Metod: Studien har en deskriptiv design med kvantitativ ansats och görs i form av en empirisk observationsstudie. I studien används en deduktiv ansats då ett strukturerat observationsformulär används. Resultat: Kategori 1) Bedöma, hänvisa och ge råd användes i 96 av 96 samtal (100%). Kategori 2) Ge stöd och omvårdnad användes i 51 av 96 samtal (53%). Kategori 3) Stärka och bekräfta användes i 64 av 96 samtal (66%). Kategori 4) Undervisa och lära ut användes i 45 av 96 samtal (47%). Kategori 5) Att utgå från uppringarens förståelse av problemet användes i 90 av 96 samtal (94%).Slutsats: Distriktssköterskan har ett aktivt lyssnande med uppringaren som utgångspunkt. Distriktssköterskan kommunicerade genom öppna frågor i större delen av samtalen vilket ledde till att uppringaren fick möjlighet att sätta ord på sin situation och sitt lidande. Egenvårdsråd ges i liten utsträckning likaså guidas sällan uppringaren till annan vårdinrättning. Det rådgivande samtalet inom rekommenderad tidsgräns däremot återstår ofta dokumentation efter avslutat samtal vilket kan orsaka stress.Background: In the Western world telephone counseling has been expanded to reduce unnecessary health care visits and healthcare costs. The purpose of telephone counseling is to make the care efficient, secure and more accessible to the population. One of the most common problems between callers and caregivers is lack of communication. Aim: Study how district nurses communicate with callers during telephone counseling at a health care center.Method: The study has a descriptive design with a quantitative approach and is done in the form of an empirical observational study of district nurse interviews with callers at a health center. In the study a deductive approach is used with a structured observation form. Result: Category 1) Assessing, referring and giving advice was used in 96 of 96 calls (100%). Category 2) Support and care was used in 51 of 96 calls (53%). Category 3) Strengthen and confirm was used in 64 of 96 calls (66%). Category 4) Teach the caller was used in 45 of 96 calls (47%). Category 5) Based on the caller's understanding of the problem was used in 90 of 96 calls (94%)Conclusion: The district nurse used active listening and communicated through open questions. This led the caller to put words to his situation and suffering. Self-care advice was given in a small extent, the caller was rarely guided to another care facility. The district nurse held the recommended time in telephone counseling, but documentation often remains after the end of the call which can cause stress.
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Giordano, Florent. "La géographie (dés)organisante : savoirs, pouvoirs, normes : analyse interprétative du dispositif de gestion de la santé en région Centre-Val de Loire." Thesis, Tours, 2017. http://www.theses.fr/2017TOUR1010/document.
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La question principale de cette thèse peut être formulée ainsi : Comment les discours, normes et pratiques spatiales peuvent, dans le cadre d’une relation inter-organisationnelle, produire un bon comportement spatial des agents dans une relation de délégation ? Ancré en management stratégique, notre cadre théorique mobilise des approches issues de la géographie et le concept foucaldien de dispositif. La méthodologie de recherche déployée repose sur une étude de cas unique portant sur la gestion de la santé en région Centre-Val-de-Loire. L’analyse du matériau empirique fait ressortir la création d’une chaîne d’auto-régulation inter-organisationnelle permettant de propager ce dispositif reposant sur trois types d’espace, absolu, relatif et relationnel en donnant l’illusion à chacun des maillons qu’il est responsable de ses actions. Nous mettons aussi en évidence le caractère autonome du dispositif qui produit à la fois des marges de manœuvres pour les acteurs et des résultats parfois contre-productifs vis-à-vis de la politique initialement portée par le mandantThe main question of this thesis can be formulated as follows: How can discourses, norms and spatial practices, in the context of inter-organisational relations, produce good spatial conduct of agents in a relation of delegation? Rooted in strategic management, our theoretical framework mobilise approaches from the domain of geography and the Foucauldian notion of dispositif. The methodology we used is based on a unique case study: the health system in the region of Centre-Valde- Loire. The analysis of the empirical material shows the creation of an inter-organisational self-regulation chain, enabling the dissemination of this dispositif based on three types of space (absolute, relative and relational) by giving the illusion to each one of these links that he is responsible for his actions. We also highlight the independent nature of the dispositif that can create room for manoeuvre for actors as well as results that are sometimes counter-productive with regard to the original policies of the mandator
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French, C. E. "Bench to bedside? : boundary spanning in Academic Health Science Centres." Thesis, University College London (University of London), 2016. http://discovery.ucl.ac.uk/1529301/.
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The problem of mobilising research generated knowledge into practice has received increasing attention from policy makers and scholars internationally. Academic Health Science Centres (AHSCs) are partnerships between universities and hospitals which aim to use research discoveries to improve patient care. Despite their complexity and recent international spread, they have not received much attention from social science. This thesis, as a study of this emergent organisational form, contributes to addressing this gap. It conceptualises the ‘bench to bedside’ knowledge mobilisation process within two English AHSC cases as ‘boundary work’ between the domains of research and clinical practice. By analysing qualitative data collected through semi structured interviews (48), observations (130+ hours) and documentary analysis at micro (research/clinical teams) and meso (organisational) levels, it addressed the research question: What boundary processes mobilise knowledge within Academic Health Science Centres? Epistemic, professional and organisational framings were all important conceptualisations of the research/clinical practice boundary. Epistemic elements motivated knowledge mobilisation, with organisational boundaries often proving least permeable. The most effective boundary work encompassed all three. Networked forms of governance prevailed at the organisational level. Joint fields of practice emerged at the micro level with key (instrumental and symbolic) spanning mechanisms including professional hybrids as boundary spanners (e.g. clinician scientists), and objects (e.g. shared data). The ‘bench to bedside’ heuristic operated as an overarching boundary concept, motivationally powerful yet vague enough to bring together diverse groups. This study is one of few to consider the early development of AHSCs from a social science perspective. It contributes empirically and theoretically to the knowledge mobilisation and boundary literature by focussing analysis on the research and clinical practice boundary (as a space for new practice) and the people and objects that work across it, particularly centring on the under-researched role of organisation in this process.
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Rasmussen, Bruce. "Creating and capturing value in the biopharmaceutical sector." full-text, 2008. http://eprints.vu.edu.au/1946/1/Bruce_Rasmussen_PHD_2009.pdf.
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This study addresses the ongoing implications of the realignment of the pharmaceutical industry knowledge base – from small molecule methods to new biomedical technologies – for the competitive positions of traditional pharmaceutical companies and biopharmaceutical start-ups. The theoretical approach draws on the modern theory of the firm and related concepts, to define and develop the concept of the business model. This is employed to guide the empirical analysis, which utilises a combination of data analyses and case studies based on several sources, including detailed company reports and alliance databases. The thesis analyses how the pharmaceutical companies have successfully adjusted their business models to meet the challenge of biotechnology and so retain their powerful position in the industry. Central to this has been the breadth and depth of knowledge transfer through alliance formation. Not only has this been critical to the adjustment process for the large pharmaceutical companies but also for the development of the many biopharmaceutical start ups. Nonetheless the business models of these smaller companies have many weaknesses, which have led to the erosion of the value of their initial strategic assets. Despite the poor financial performance of the vast majority of these firms, the biopharmaceutical sector as a whole has created significant value. This has been captured disproportionately by a handful of large fully integrated biopharmaceutical firms and, to a lesser extent, by the largest dozen pharmaceutical firms.
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Pack, Robert P., and J. Polaha. "Dissemination and Implementation Research in Health: The Science of Using Science." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/1349.
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Hultqvist, Anna, and Caroline Åberg. "Slut, kom : En intervjustudie om kommunikation mellan ambulansdirigenter och ambulanssjuksköterskor." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-64528.
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Introduktion: Dagens sjukvård består av olika vårdkedjor där larmcentralen och ambulanssjukvården utgör den första länken för många patienter. Larmcentralen ansvarar för att ta emot, hantera och prioritera nödsamtal som sedan dirigeras ut till ambulansverksamheten. God interprofessionell kommunikation är en förutsättning för att länken ska vara intakt och därmed främja en patientsäker vård. Den forskningsbrist som råder i området motiverar studiens genomförande. Syfte: Att beskriva förutsättningar för kommunikation mellan ambulansdirigenter och ambulanspersonal utifrån ambulansdirigenters och ambulanssjuksköterskors erfarenheter. Metod: Studien är en kvalitativ intervjustudie med induktiv ansats. Ett bekvämlighetsurval tillämpades och tolv semistrukturerade intervjuer genomfördes. Analysen utgick ifrån en latent innehållsanalys i enlighet med Lundman och Hällgren Graneheim (2012). Resultat: Ett tema formades ur den latenta analysen, vilket benämns Mot samma mål trots olika förutsättningar. Resultatet redovisas utifrån två huvudkategorier; teknikens förtjänster och begränsningar samt personliga förmågor. Dessa bygger på sex underkategorier som beskriver informanternas erfarenheter gällande kommunikationen dem emellan. Underkategorierna benämns vara beroende av kommunikationsteknik, behov av samtal, bemötande, hantera stress, ifrågasättande och bristande tillit samt förståelse för varandras uppdrag. Det framkom att fungerande teknik och korrekt hantering av den är centralt för kommunikationen. Oavsett vad rutiner säger så finns det i vissa situationer ett behov av muntlig kommunikation. De personliga egenskaperna påverkar hur kommunikationen fortlöper. Slutsats: Tekniken måste fungera och personalen måste vara välutbildade inom det tekniska handhavandet. Möjligheten till hospitering inom de båda verksamheterna anses vara av stor vikt för att bidra till en ökad förståelse, vilket på sikt kan förbättra den interprofessionella kommunikationen mellan dem.Introduction: Today's health care consists of different care chains where SOS Alarm and the ambulance service constitute the first link for many patients. SOS Alarm is responsible for receiving, manage and prioritize emergency calls which are then routed out to the ambulance. Good interprofessional communication is a prerequisite for the link to be intact and thereby achieve a safe care for the patient. The lack of research in the area justifies the implementation of this study. Aim: To describe the conditions for communication between ambulance conductors and ambulance staff based on the experiences of ambulance conductors and ambulance nurses. Method: The study is a qualitative interview study with an inductive approach. A convenience sample was applied and twelve semi-structured interviews were conducted. The analysis was based on a latent content analysis in accordance with Lundman and Hällgren Graneheim (2012). Result: A theme was formed from the latent analysis, which is called Towards the same goals despite different conditions. The result is reported on two main categories: The benefits and limitations of the technology as well as personal abilities. These are based on six subcategories which describes the informants' experiences regarding communication between them. The subcategories are called dependency on communication technology, need for conversation, attitude, dealing with stress, questioning and lack of confidence, and understanding of each other's assignments. It emerged that working technology and proper handling of it are central to communication. Regardless of what routines say, there is a need for oral communication in certain situations. Personal qualities affect how communication progresses. Conclusion: Is that the technology must be working and the staff must be well-trained in the technical handling. The possibility of visits in each other’s organizations are considered to be of great importance to contribute to a greater understanding, which ultimately can improve communication between them.
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Hess, Richard, Nicholas E. Hagemeier, Kyle S. Hagen, and Emily L. Sorah. "Interprofessional and Interpersonal Communication: Self-Efficacy Beliefs of Academic Health Science Center Students." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/1460.
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Objectives: To assess and compare interprofessional and interpersonal communication self-efficacy beliefs of medical, nursing and pharmacy students before and after participation in a communication skills course. Method: Using self-efficacy as a theoretical framework, a 37-item survey instrument was developed based on Interprofessional Education Collaborative (IPEC) Core Competencies and course learning objectives. Medical, nursing, and pharmacy students voluntarily completed the survey instrument before and after the required course. Nonparametric tests were employed to examine matched pre- and post-assessments within colleges and to explore differences in self-efficacy beliefs across college. Results: A response rate of 87% (168/193) was achieved. Overall, nursing students entered the course with higher self-efficacy beliefs as compared to medical and pharmacy students. Pharmacy students indicated particularly low self-efficacy beliefs regarding their ability to communicate with other health professionals (p=0.009) and contribute to healthcare teams (p=0.002). Matched pre/post analyses indicated statically significant increases in student self-efficacy beliefs across all colleges. After the course, pharmacy students continued to perceive a relative lack of confidence in their ability to develop positive relationships with other health care providers as compared to medical and nursing students (p=0.02). Implications: Our findings suggest that completion of an interprofessional communications course was associated with a positive effect on self-efficacy beliefs aligned with IPEC competencies across all colleges. Pharmacy students, in particular, noted significant improvements in self-efficacy beliefs across multiple domains. Research is being conducted to examine relationships between validated observational assessments and student self-perceptions.
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Proctor-Williams, Kerry, and Elizabeth Alley. "Implementing IPE in an Academic Health Science Center: changing Attitudes, Beliefs, & Knowledge." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/1823.
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Completion of 3-year pilot Interprofessional Education Program involving graduate students in an Academic Health Science Center yielded pre- and post-program evaluations of attitudes, beliefs, and knowledge of students and faculty. This session offers a description of a program without curricular level changes, presentation of research outcomes, and resulting planned modifications.
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Emslie, Brenda. "Clinical occupational therapists' experience of their role as clinical educators during the fieldwork experience of occupational therapy students." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/20180.
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Thesis (MPhil )-- Stellenbosch University, 2012.ENGLISH ABSTRACT: Fieldwork is an essential part of the occupational therapy student’s education, and optimal learning is dependent on effective facilitation by a clinical Occupational Therapist. This study explored the lived experience of the clinical Occupational Therapists in their role as clinical educators by means of a phenomenological inquiry. Ten semi-structured interviews were conducted with clinical Occupational Therapists involved in clinical education. The data was analysed by using thematic content analysis, and was discussed according to the Lived Experience of a Clinical Educator Model. The results indicated that the clinical OTs’ sense of self, which revealed strong humanistic values, acted as the core element influencing the way in which they related to others and were able to juggle many roles in order to perform their role as clinical educator. It furthermore influenced the ways in which they managed balance and harmony in the workplace, as well as the process of growth and development. Incongruence during the performance of their roles as clinical educators was mainly caused by insufficient collaboration between the clinical educators and the university, the prescriptive nature of the fieldwork curriculum, workload pressures, the students’ attitudes and their lack of knowledge, as well as insufficient training of new clinical educators. The results may be helpful in fostering a collaborative relationship between the university and the clinical Occupational Therapists, as well as renewed attention to growth and development, all of which will benefit the students’ education.
AFRIKAANSE OPSOMMING: Kliniese werk vorm ‘n essensiële deel van die arbeidsterapie-student se opleiding en dit is noodsaaklik dat die leerproses effektief gefasiliteer word deur ‘n bekwame kliniese Arbeidsterapeut. Hierdie studie het die Arbeidsterapeute se belewing van hul rol as kliniese opvoeders nagevors deur middel van ‘n fenomenologiese ondersoek. Tien semigestruktureerde onderhoude is met kliniese Arbeidsterapeute, tans betrokke by kliniese opleiding, gevoer. Die data is verwerk deur middel van tematiese inhouds-analise en is bespreek aan die hand van die Lived Experience of a Clinical Educator Model. Die resultate het aangedui dat die kliniese terapeute se bewustheid van hulself (‘sense of self’) die kern element vorm wat hul verhoudings, sowel as die wyse waarop hulle al hul onderskeie rolle en take behartig, beïnvloed. Sterk humanistiese waardes kom voor in hierdie kern element. Dit is verder bepalend in die wyse waarop die Arbeidsterapeute balans en harmonie in hul werkplek verseker, sowel as hul professionele groei en ontwikkeling. Inkongruensie tydens die rolvervulling word veroorsaak deur onvoldoende samewerking tussen die universiteit en kliniese opvoeders, ‘n voorskriftelike kurrikulum, werksdruk, studente se negatiewe houding en gebrek aan kennis, sowel as onvoldoende opleiding van die terapeute wat nuut begin met kliniese opleiding. Die resultate mag in die toekoms behulpsaam wees in die totstandkoming van ‘n samewerkende verhouding tussen die universiteit en kliniese terapeute, met genoegsame aandag wat geskenk word aan professionele groei en onwikkeling. Dit kan tot voordeel van die studente se leerproses aangewend word.
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Bishop, Wilsie. "Integrating IPE into an Academic Health Sciences Center: A Bottom-Up and Top-Down Approach." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/ijhse/vol3/iss2/2.
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Joshi, Ajay. "Childcare center directors' oral health literacy and attitudes towards pediatric oral health." Thesis, NSUWorks, 2014. https://nsuworks.nova.edu/hpd_cdm_stuetd/43.
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A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry.
Goal and Objectives. The main goal of this study is to assess childcare center directors (CCCDs) oral health literacy, knowledge, and attitudes towards pediatric oral health. We also determined the associations between CCCDs oral health literacy, knowledge, attitudes towards pediatric oral health, and 1) number of oral health preventive strategies (OHPS) implemented in their child care center (CCC), and 2) intent to adopt OHPS in the future. Background. Childcare utilization has substantially increased over the past decade with children enrolled in these centers spending substantial amount of time. CCCs, a non-traditional setting, can be used to actively promote pediatric oral health. However, before this setting can be used to promote oral health, a better understanding of Florida CCCDs' oral health literacy, knowledge, and attitudes on pediatric oral health is needed. Methods. In this cross-sectional study we used a 45-item pre-tested questionnaire to survey Florida CCCDs working primarily in licensed CCCs through survey monkey online portal. Descriptive, bivariate statistics and multivariate regression analyses were conducted using SAS analysis software. Results. Of the 877 CCCD participants, 90% did not train staff about traumatic dental injuries, 87% did not have an oral health consultant, and 82% did not promote enrollees to brush their teeth after meals or snacks. Mean oral health literacy (12.3±2.3) and attitude levels (16.8±2.7) were high, however mean oral health knowledge (1.6±2.0) was low. CCCDs with more years of experience (p=0.01), who work at Head Start CCCs ( p<0.0001), and have more positive attitudes (p<0.0001), were more likely to have implemented OHPS in their centers compared to their counterparts. Non-White CCCDs (p=0.03), those with more positive attitudes(p=0.001), and who reported to have already implemented one or more OHPS (p=0.002) were more willing to implement OHPS in the future compared to their counterparts. Conclusions. No significant associations between oral health literacy, knowledge and number of OHPS implemented were observed. Similarly, oral health literacy, oral health knowledge was not associated with intent to implement OHPS in the future. CCCDs with more positive attitudes towards pediatric oral health had implemented more OHPS within their CCCs, and also were willing to implement more OHPS in the future compared to their counterparts.
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Bossaer, John B., Jeffrey A. Gray, Stacy E. Miller, Gavin Enck, Vamsi C. Gaddipati, and Robert E. Enck. "Use and Misuse of Cognitive Enhancers by Students at an Academic Health Science Center." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/2320.
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Purpose: Prescription stimulant use as "cognitive enhancers" has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center.
Method: Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary and anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive.
Results: Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%).
Conclusions: Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., "cognitive enhancement"), educational quality, and patient safety or health care quality.
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Krakauer, Renate. "A Learning College for health care, the applicability of learning-centred education to The Michener Institute for Applied Health Sciences (Ontario)." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/NQ58901.pdf.
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Cornelius, William M. Smith Al. "A qualitative study of the development of a health sciences center at a two-year community college." Waco, Tex. : Baylor University, 2008. http://hdl.handle.net/2104/5154.
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Fredriksson, Ingela. "Leisure-time youth-center as health-promotion settings." Licentiate thesis, Örebro universitet, Institutionen för hälsovetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-51612.
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Leisure time is an important part of young people’s lives. Despite this, leisure-time settings have hitherto had only a minor role in setting-based health-promotion initiatives. Improving adolescents’ quality of leisuretime activities can reduce social differences in health, thus youth-centers can be appropriate settings for promoting health. However, young people with immigrant backgrounds participate less in organized leisure-time activities. The overall aim of this study is to explore young people’s leisure time as their health-promotion setting in two NGO-run youth-centers in multicultural, socially deprived suburbs in Sweden. This study took a practice-based approach using a mixture of methods in close collaboration with the youth-centers. Data collection was done through surveys with young people (n = 207) and interviews with young people and leaders (n = 16). Study I, about who participates in youthcenter activities, used an explanatory mixed method. Study II, about the youth-centers’ strategies, used an explorative qualitative method with an inductive content analysis. This study shows that youth-centers have great potential to be a healthpromotion setting if their strategies include some important factors, both in theory and in daily practice. To be a health-promotion setting, a youthcenter needs to be open and inclusive for its target group, foster supportive relationships, emphasize youth empowerment, and integrate family, school, and community in its strategies. Local knowledge about young people's backgrounds, needs, interests, and motivations to attend youth-center activities – as well as good contact with young people's families – is important because it can increase participation in leisure-time activities for young people in multicultural and socio- economically disadvantaged neighborhoods and can thus help to reduce social inequalities in health.
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Harrison, Donald Lee 1956. "Modeling the cost-effectiveness of a regional poison control center using decision analysis." Diss., The University of Arizona, 1996. http://hdl.handle.net/10150/282117.
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Using decision analysis techniques, the cost-effectiveness of two alternatives for treating human poison exposures were modeled. The alternatives were the treatment of poisonings with the services of a regional poison control center versus without access to any poison control center. The relative cost-effectiveness was modeled based on two outcomes (morbidity and mortality) for each of four typical poison exposures: acetaminophen overdose, tricyclic antidepressant overdose, cleaning substance exposure in children, and cough/cold preparation overdose in children. Additionally, analyses were conducted to test the sensitivity of the cost-effectiveness ratio to outcome probability, average inpatient and emergency room charges, and proportion of poison exposures managed on site by the regional poison control center. This research was conducted from society's point of view.
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Moorman, Mark Thomas. "Alcohol and Other Drugs: Attitudes and Use Among Graduate/Professional Students at a Health Science Center." Thesis, University of North Texas, 2002. https://digital.library.unt.edu/ark:/67531/metadc3226/.
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Alcohol and other drug use continue to be a major issue on college and university campuses. Few studies have examined alcohol and other drug related issues for a graduate or professional student population. This study examines attitudes, incidents, and consequences of alcohol and other drug use among students enrolled at an academic heath science center. This study incorporated a descriptive research design and utilized the CORE Alcohol and Drug Survey for the collection of data. The data were then analyzed using descriptive statistics and represented in tables as frequencies and percentages. The survey was mailed to all students enrolled in didactic course work at the University of North Texas Health Science Center (UNTHSC) during the fall 2001 semester. This included master's students in physician assistant studies, master's and doctoral students in the biomedical sciences, master's and doctoral students in public health, as well as first and second year medical students. Of the 565 students enrolled in didactic course work, 321 responded to the survey for a return rate of 56.8 %. Statistically significant findings are reported for students at UNTHSC in relation to perceptions of use, actual use, reasons for use, and consequences for use. Similar findings are shown relative to age, gender, marital status, ethnicity, and academic program. Additionally, the UNTHSC students reported statistically significant lower levels of alcohol and drug use, as well as consequences of use than the students represented in the CORE Institutes 2000 national data set. This study identifies the need to investigate alcohol and drug related attitudes, behaviors, and consequences among students studying for professions in health related fields. However, the findings are only relevant to UNTHSC and cannot be generalized to any other population. The study provides personnel at UNTHSC a guide for the development of prevention and intervention programs.
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Stabel, Aaron Arthur. "Effects of modeling on HIV testing rates at a university health center." Scholarly Commons, 2002. https://scholarlycommons.pacific.edu/uop_etds/2700.
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This study examined the effects of publicly modeling the HIV testing procedure on testing rates at a university health center. Thirteen models, demographically similar to the university student population, modeled the HIV counseling and testing procedure at a campus student center. The intervention was employed twice during the fall semester. HIV testing rates for that semester were compared to the two previous fall semesters. Results showed that HIV testing rates during the semester of intervention were not significantly higher than previous semesters. Results did not demonstrate a marked increase in the number of tests administered within 2 weeks following each modeling intervention. Modeling was not an effective means to increasing utilization of HIV testing centers on this university campus.
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Colley, Kay Lynne Newsom Ron. "Latino success stories in higher education a qualitative study of recent graduates from a health science center /." [Denton, Tex.] : University of North Texas, 2007. http://digital.library.unt.edu/permalink/meta-dc-3687.
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Baird, Bruce. "Water minimization assessment : Health Sciences Centre, Winnipeg, Manitoba." 1996. http://hdl.handle.net/1993/23114.
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Forster, Rowland. "Domestic water conservation study, Health Sciences Centre, Winnipeg, Manitoba." 1997. http://hdl.handle.net/1993/1077.
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The purpose of this practicum was to conduct a domestic water conservation study to identify and evaluate the various domestic water conservation measures available to the HSC. Specific objectives included: (i) determining existing domestic water conservation practices in hospitals; (ii) identifying different alternatives for the reduction of domestic water consumption at the HSC; (iii) determining the economic feasibility of retrofits and renovations based on capital and operating costs, annual cost savings, and pay-back periods; (iv) undertaking a controlled trial, or case study, of alternatives suitable to operability issues. The water conservation study began with a review of related literature including various Internet and published information to identify potential domestic water conservation measures in order to outline the major strengths and weaknesses of each. A second survey directed towards the manufacturers of water conservation products was then performed to obtain an understanding of existing water conservation products particularly those designed for hospital use. It was discovered from the two surveys that there were eight water conservation measures available for the HSC to consider in their water conservation strategy. These included: faucet aerators, faucet moderators, flow restricting inserts, low-flow showerheads, low-flow showerhead adapters, ultra-low volume toilets, flush valves, and staff education measures. (Abstract shortened by UMI.)
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Gougeon, Monique A. "Healing and the healthcare environment: redesigning the hemodialysis centre at Health Sciences Centre in Winnipeg, Manitoba." 2009. http://hdl.handle.net/1993/3105.
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Stress within healthcare environments can be the result of uncertainty, illness, or the environment itself. In order to promote
better health outcomes for dialysis users, scientific literature advocates stress reduction within healthcare environments. Dialysis patients are subject to numerous stressors, including the threat of potential losses and lifestyle change. Studies have revealed that patients who suffer from chronic illness perceive different levels of quality of life than those who are considered healthy and because of these lifestyle changes they employ various coping mechanisms when dealing with stress. There is a rising movement to mitigate stress through the use of holistic healing, an approach that addresses a person’s mental, emotional, physical, and spiritual elements to create a total healing environment. In accordance with this growing movement, the intent of this practicum is to create an outpatient
centre for Manitoba’s dialysis patients that increases their perceived quality of life.
The inquiry process began by questioning dialysis patients and conducting observational research at the Winnipeg Health Sciences Centre. Literature and precedent reviews were conducted, and the
design programme was developed. The result of this research-based design proposal is an outpatient hemodialysis centre located within the Winnipeg Health Sciences Centre that helps mitigate stress while patients attempt to cope with lifestyle changes.
The resulting design is one that is warm, welcoming, home-like and comfortable, which is supported by the theories explained in the literature review. This environment provides a greater sense of control, creates positive distractions and allows spiritually evoking opportunities to take place for all users of this new facility.February 2009
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Lansfield, Jessica Loraine. "Exploring Therapeutic Relationships In Recreation Therapy at Sunnybrook Health Sciences Centre." Thesis, 2010. http://hdl.handle.net/10012/5214.
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Therapeutic relationships were explored using participatory action research in recreation therapy at Sunnybrook Health Sciences Centre (SHSC). The 22 recreation therapists at SHSC comprised the research team and were actively involved throughout the research process; they determined the research questions, the research process, and engaged in data collection and data analysis. This study explored how recreation therapists understood their therapeutic relationships, how different waves of influences were negotiated and philosophies of care that emerged in their therapeutic relationships. At first glance, therapeutic relationships were understood as meaningful connections and shared experiences that developed over time between a recreation therapist and individual receiving care. Later on, therapeutic relationships emerged as a complex process with welcoming, continuing and closing phases. Positive therapeutic relationships were defined by qualities such as caring, trust, respect, and non-judgment for everyone involved. Therapeutic relationships were also influenced by the organizational context, unit specific cultures, family, and staff members and recreation therapists continually negotiated the expectations, power and boundaries of these influences within their therapeutic relationships. The recreation therapists also discussed the different roles, they and the individuals receiving care could engage in during their therapeutic relationships ranging from the traditional, contemporary or controversial. Findings revealed that recreation therapists’ practices were predominantly influenced by person-centered care philosophies, although the biomedical model and relationship-centred care philosophies were also apparent. The practice of being in the moment emerged as a means of enhancing therapeutic relationships, whereas self-reflective practice assisted the recreation therapists to negotiate different waves of influence on their therapeutic relationships.
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Tan, Yin Yin. "Multi-objective optimization for scheduling elective surgical patients at the Health Sciences Centre in Winnipeg." 2008. http://hdl.handle.net/1993/3081.
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Health Sciences Centre (HSC) in Winnipeg is the major healthcare facility serving Manitoba, Northwestern Ontario, and Nunavut. An evaluation of HSC’s adult surgical patient flow revealed that one major barrier to smooth flow was their Operating Room (OR) scheduling system. This thesis presents a new two-stage elective OR scheduling system for HSC, which generates weekly OR schedules that reduce artificial variability in order to facilitate smooth patient flow. The first stage reduces day-to-day variability while the second stage reduces variability occurring within a day. The scheduling processes in both stages are mathematically modelled as multi-objective optimization problems. An attempt was made to solve both models using lexicographic goal programming. However, this proved to be an unacceptable method for the second stage, so a new multi-objective genetic algorithm, Nondominated Sorting Genetic Algorithm II – Operating Room (NSGAII-OR), was developed. Results indicate that if the system is implemented at HSC, their surgical patient flow will likely improve.October 2008
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Beirão, Tiago Miguel Brandão de Melo. "Liver transplantation for autoimmune hepatitis: a single-centre experience in Portugal." Dissertação, 2019. https://hdl.handle.net/10216/121279.
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Beirão, Tiago Miguel Brandão de Melo. "Liver transplantation for autoimmune hepatitis: a single-centre experience in Portugal." Master's thesis, 2019. https://hdl.handle.net/10216/121279.
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Cardoso, Rosa Inês Duarte. "Pulmonary exacerbations in paediatric patients: Retrospective study in a cystic fibrosis centre." Dissertação, 2020. https://hdl.handle.net/10216/128603.
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Cardoso, Rosa Inês Duarte. "Pulmonary exacerbations in paediatric patients: Retrospective study in a cystic fibrosis centre." Master's thesis, 2020. https://hdl.handle.net/10216/128603.
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Danjoux, Nathalie M. "An evaluation of the adoption and diffusion of surgical innovations in an Ontario academic health sciences centre." 2006. http://link.library.utoronto.ca/eir/EIRdetail.cfm?Resources__ID=450461&T=F.
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Luís, Michael Sapateiro. "Trastuzumab in advanced Gastric Cancer: proportion of eligible cases in a single Centre." Dissertação, 2013. https://repositorio-aberto.up.pt/handle/10216/71494.
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Luís, Michael Sapateiro. "Trastuzumab in advanced Gastric Cancer: proportion of eligible cases in a single Centre." Master's thesis, 2013. https://repositorio-aberto.up.pt/handle/10216/71494.
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McLaughlin, Patrick. "Kinematic and centre of pressure (COP) parameters in golf putting." 2008. http://eprints.vu.edu.au/1415/1/mclaughlinvol1.pdf.
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The aims of the present study were to: develop a portable and reliable fieldbased system for assessment of centre of pressure movement during the putting task; identify different putting techniques used by experienced golfers; identify the relationship between handicap and putting performance; identify the relationship between putting performance and putting stroke kinematics; identify the relationship between putting performance and movement of the centre of pressure; and to assess the effect of a 3 week balance biofeedback training program on subsequent putting performance and centre of pressure movement during the putting task. In order to enable data collection to occur on the golf course, a portable rubber mat containing 256 individual capacitance pressure sensors (novel pliance®, Munich, Germany) was validated for standing COP output against an AMTI force platform. Assessment of the equality of the output from both systems was assessed using the non-central F test. The peak-to-peak amplitude of movement of COP data in the medio-lateral (COPx, p=0.023) and antero-posterior (COPy, p=0.023) directions were found to be significantly the same. In-field testing required each participant (n=38) to complete five putts at a hole 4m away, and five putts at a hole 8m away. Testing was conducted on the practice putting green of a private golf course. The result of each putt was assessed by recording the distance the ball finished from the hole, as well as other descriptors of direction (left, right, centre) and length (short, long, holed out). Participants (n=38) completed these putts whilst standing on the previously validated mat. Video of each putt was recorded using a 50Hz video camera located perpendicular to the line of the putt. The video was later used to track the path of the putter head. The movement of the putter head was used to establish the key events and phases in the putting stroke – backswing, downswing, ball contact and follow through. Putting performance was assessed using exact putt result, absolute putt result and number of holed out putts. Players were initially grouped according to handicap such that there were low (0-9), middle (10-18) and high handicap groups (19-27). On putting performance, the low handicap group were significantly more likely to achieve a holed out putt at both the 4m and 8m putting tasks (p < 0.05). On the other measures some trends were evident but there were no significant differences between groups. In order to determine whether putting techniques existed, analysis of kinematic and COP data was completed using cluster analysis techniques. Ultimately, a two cluster solution was indicated as optimal for both tasks meaning there are two distinct putting techniques used by the golfers. At the 4m task these two putting techniques were identified as: 1. Less movement (relative to cluster 2) of COPx in the backswing and downswing phases with velocity of COPx at ball contact closer to zero (on average). Low COPx velocity. 2. Larger movement (relative to cluster 1) of COPx in the backswing and downswing phases with velocity of COPx at ball contact non-zero. High COPx velocity. In the 8m putting task, these two techniques were identified as: 1. Short, sharp with minimal COPx movements – a technique that involves comparatively smaller movements of the putter head and the COPx throughout the putting stroke relative to cluster 2. Velocity of the COPx at ball contact is minimal but is a heterogeneous mixture of movements away and towards the hole. Low motion. 2. Long, slow with greater movements of the COPx – a technique that incorporates larger displacements of the putter head and COPx throughout the putting stroke relative to cluster 1. Velocity of the COPx at ball contact is higher than cluster 1 but is homogeneous. High motion. On both tasks, players in cluster 1 had significantly lower handicaps than cluster 2 (4m task – cluster 1 = 12.4±5.9; cluster 2 = 16.4±6.6; p = 0.002; d = 0.63: 8m task – cluster 1 = 11.9±5.5, cluster 2 = 18.3±7.6; p < 0.001; d = 0.91) so would be classified as more skilled, however, no putting technique was significantly better than the other on putting performance. Importantly, all a player’s puttswere not necessarily classified into the same technique grouping. This highlighted the importance of treating each putt as an individual trial rather than using averaged data in the cluster analysis method. At the 4m putting task, the mean putt distance data were not significantly different for both exact putt result (cluster 1 = 14.0±44.5cm; cluster 2 = 25.7±44.5cm; p=0.22; d=0.26) and absolute putt result (cluster 1 = 36.8±28.5cm; cluster 2 = 39.5±32.3cm; p=0.66; d=0.09). Techniques were not significantly different (÷2 = 0.08, p = 0.78) in their ability to produce a holed putt. At the 8m putting task, both the measures of exact putt result (24±77cm vs. 2±71cm; p = 0.7; d = 0.29) and absolute putt result (60±54cm vs. 56±43cm; p = 0.11; d = 0.08) reveal non-significant differences between the techniques. Again, techniques were not significantly different (÷2 = 0.04, p = 0.85) in their ability to produce a holed putt. All players involved in the field based study were offered the opportunity to participate in a follow up study using real time biofeedback training to improve putting technique. Of the current sample, 7 players chose to participate in a three week training program followed by a re-testing session. The biofeedback training was aimed at minimizing COP movement during stance and the putting stroke. On re-testing, the sample of players showed no improvement in putting performance or COP related parameters. The effect of the training program on some players was to, in fact, produce a poorer putting performance and greater movement of the COPx during the stroke. On both putting tasks, there was a significant increase in movement of COPx during the backswing on re-testing. The effect of biofeedback training for improved putting performance was, at best, limited. A new field-based method for assessment of COP has been validated and established. Putting performance data provides evidence to suggest that handicap level and putting performance are related if performance is measured solely by the number of putts holed. Cluster analysis is shown to be a very suitable method for differentiating putting techniques. The movement of the COP was highly influential in distinguishing putting techniques at both tasks, but had no influence on putting performance. Putting techniques have not been described previously in the published scientific literature. Further field-based assessment of putting performance, especially during golf competition is required, along with a more detailed understanding on how far from the hole players of different handicap levels hit their first putts.
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Mota, Clara Pedro Correia Gomes da. "Ten years of Stroke Code: a retrospective review of diagnostic performance at a comprehensive stroke centre." Dissertação, 2018. https://repositorio-aberto.up.pt/handle/10216/112054.
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Mota, Clara Pedro Correia Gomes da. "Ten years of Stroke Code: a retrospective review of diagnostic performance at a comprehensive stroke centre." Master's thesis, 2018. https://hdl.handle.net/10216/112054.
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Martins, Inês Noites. "Neonatal cardiomyopathy: a 20 years overview of a reference centre." Dissertação, 2019. https://hdl.handle.net/10216/120595.
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