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Godinho, Pedro Francisco Soares da Silva Mendes. "A closer look at medical affairs." Master's thesis, Universidade de Aveiro, 2014. http://hdl.handle.net/10773/13597.
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Mestrado em Biomedicina FarmacêuticaOver the last 10 years, the Pharmaceutical Industry has been under great scrutiny from regulators, healthcare professionals (HCPs) and patients in general, as in the past it was criticized for the use of aggressive sales and marketing tactics and unethical behaviour. To increase the transparency on the activities developed and its relationship with physicians, it has undergone significant changes in the way that it develops and markets medicines and medical devices. Many of these changes have led to an increase in the responsibility of Medical Affairs to inform the healthcare professionals’ community on the safe and appropriate use of the company´s medicines. Additionally, there is a trend to greatly limit physician access to traditional sales representatives who traditionally were industry’s vehicle of information and replace them by unbiased subject matter experts, the Medical Affairs colleagues. Much of this communication activity involves engaging and developing longterm relationships with key scientific opinion leaders in the disease area of interest. These scientific partnerships are crucial for the improvement of health outcomes that the pharmaceutical companies aim to achieve. The methods used by Medical Affairs to communicate the science vary from manuscripts in peer-reviewed journals, to congresses, continuous medical education meetings and discussion groups. More recently, digital channels have also been more frequently used to engage HCPs and even patients in this scientific exchange. Medical Affairs have significantly impacted the relationship with customers, continuing to build trust and value, transparency in all engagements, providing a balanced discussion of benefits and risks, and leveraging clinically robust dialogues on a peer-to-peer level. Medical Affairs activity, helping to address patients and physicians’ needs and promoting the appropriate use of medicines, will contribute to improve the reputation of the pharmaceutical industry.
No decurso dos últimos 10 anos, a Indústria Farmacêutica (IF) tem estado sob grande escrutínio por parte das Agências Regulamentares, profissionais de saúde e doentes no geral, sobretudo por ter sido criticada no passado pelas suas táticas de marketing e vendas agressivas e comportamento não ético. De forma a aumentar a transparência tanto das atividades desenvolvidas como da sua relação com os médicos, a Indústria alterou significativamente a forma como desenvolve e promove os medicamentos e dispositivos médicos. Muitas destas alterações levaram a uma maior responsabilização dos Assuntos Médicos (AM) na informação prestada à comunidade de prestadores de cuidados de saúde sobre o perfil de segurança e o uso apropriado dos medicamentos de uma empresa farmacêutica. Adicionalmente, verifica-se uma tendência para limitar significativamente o acesso dos delegados de informação médica aos prescritores, que tradicionalmente eram o veículo de informação da Indústria, substituindo-os por colegas imparciais especializados nos medicamentos (os colegas de Assuntos Médicos). Grande parte desta atividade informativa envolve estabelecer e desenvolver relações de longa duração com líderes de opinião numa determinada área terapêutica de interesse. Estas parcerias científicas são cruciais para a melhoria dos resultados em saúde que as companhias farmacêuticas pretendem alcançar. Os métodos utilizados pelos AM para comunicar ciência são diversos, abrangendo publicações em jornais com revisão por pares, congressos, sessões de educação médica contínua e grupos de discussão. Recentemente, os meios digitais passaram a ser também mais utilizados para envolver profissionais de saúde e doentes nesta partilha científica. Os AM impactaram significativamente o relacionamento com os clientes e continuam a construir uma relação de confiança e valor, de transparência, de discussão franca sobre benefícios e riscos e promovendo um diálogo clinicamente robusto entre pares. A atividade dos AM, que ajuda a colmatar as necessidades dos doentes e médicos e promove o uso correto dos medicamentos, contribuirá para melhorar a reputação da IF.
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Sousa, Rui Eduardo Arantes de Passos. "4 years professional experience as a medical affairs manager." Master's thesis, Universidade de Aveiro, 2012. http://hdl.handle.net/10773/10877.
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Mestrado em Biomedicina FarmacêuticNos últimos anos, os departamentos de Assuntos Médicos assumiram um importante papel estratégico nas companhias farmacêuticas e de biotecnologia. Em resposta a um aumento da regulamentação e de exigência de transparência, os departamentos de Assuntos Médicos mudaram o seu foco do apoio às atividades comerciais e de marketing para as responsabilidades na interface com os líderes de opinião, para o desenvolvimento médico, para as comunicações científicas e para outras tarefas médicas emergentes. Durante os quatro anos de experiência profissional como Gestor de Assuntos Médicos tive a oportunidade de desempenhar um conjunto alargado de tarefas que me permitiram desenvolver uma formação sólida, adquirindo ou reforçando competências fulcrais nesta área. Durante trinta e quatro meses trabalhei como Gestor de Assuntos Médicos para a área do Sistema Nervoso Central proporcionando um apoio mais direto às atividades de Marketing, Regulamentares e de Farmacovigilância. Nos últimos treze meses, após me ter tornado Gestor de Assuntos Médicos Internacional, assumi igualmente responsabilidades relacionadas com o desenvolvimento clínico de Fase IV, a gestão das comunicações científicas e escrita médica, a implementação de análises post-hoc e o apoio às atividades de Marketing global. Tive sempre como finalidade o alcançar da excelência no desempenho das tarefas sob minha responsabilidade, simultaneamente cumprindo os mais elevados padrões de ética e deontologia. Através do meu trabalho dedicado contribuí para o sucesso da minha companhia e, ao mesmo tempo, para a melhoria da saúde e do bem-estar de doentes e populações.
In recent years, medical affairs departments have taken on an important strategic role within pharmaceutical and biotechnology companies. In a response to the increased regulations and calls for transparency, medical affairs have shifted their focus away from commercial and marketing support to key opinion leaders interfacing responsibilities, medical advancement and medical communications activities as well as other emerging medical tasks. In my four years professional experience as a Medical Affairs Manager I have performed a wide variety of tasks that allowed me to develop a solid training, acquiring or strengthening core skills and competencies in this field. During thirty-four months I have worked as a Central Nervous System Medical Affairs Manager providing a more direct support to marketing, regulatory and pharmacovigilance activities. In the last thirteen months, after becoming International Medical Affairs Manager, I also took responsibilities related to phase IV clinical development, scientific communication management and medical writing, post-hoc analysis and global marketing support. I have always aimed at excellence while performing the activities under my responsibility, simultaneously attaining the highest professional and ethics standards. Through my devoted work I have positively contributed to the success of my company while contributing to the improvement of health and well-being of patients and populations.
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Galindo, Elisabeth. "Description et évaluation d'une campagne d'information grand public sur la périnatalité dans le département de l'Hérault : "une naissance heureuse, c'est aussi votre affaire"." Montpellier 1, 1989. http://www.theses.fr/1989MON11195.
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Tiveron, Daniela Verardino [UNESP]. "Inspeção pós-morte de bovinos: ocorrência de alterações sanitárias no abate e respectivo impacto em relação ao mercado globalizado." Universidade Estadual Paulista (UNESP), 2014. http://hdl.handle.net/11449/110620.
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000791018.pdf: 1531884 bytes, checksum: ae4013aba1ff9092a7c8a61c550632bf (MD5)A partir de 2005, a comissão do Codex Alimentarius deu início a uma nova empreitada no que diz respeito às práticas da inspeção ante e pós-morte, inserindo-as definitivamente nos planos de segurança e inocuidade. Recomenda-se, a adoção de métodos e técnicas de exames ou de análises que possuam enfoque ou características baseados no sistema APPCC (Análise de Perigos e Pontos Críticos de Controle – HACCP), que tem fundamentos científicos e caráter sistemático, permitindo identificar perigos específicos e medidas para seu controle - prevenção, redução ou eliminação, garantindo a inocuidade dos alimentos em margens de risco (Risk Analysis) aceitáveis internacionalmente. Este estudo visou à análise e a discussão das práticas vigentes durante a inspeção pós-morte de bovinos com base no monitoramento das ocorrências sanitárias durante o ano de 2012 e estudo retrospectivo da evolução dessas ocorrências entre os anos 2007 e 2011, com vistas à discussão e possível adequação dessas práticas com base nos requisitos e recomendações do Codex Alimentarius e do sistema de gestão de caráter preventivo definido pelo plano APPCC, focando-as em análises de risco. Nesse período, foram observados 17.981 casos de cisticercose (1,68%), 557 casos de linfadenite do tipo tuberculosa (0,05%), 1315 ocorrências de abscessos hepáticos (0,12%) e 235 casos de pneumonia (0,02%), num total de 1.067.584 animais abatidos. O índice geral para ocorrência de alterações sanitárias no exame pósmorte para o período foi de 1,9%, significando que dois em cada 100 animais abatidos demandam providências que salvaguardem a saúde dos consumidores. Embora pareça pequena, essa ainda é uma cifra muito elevada que impõe a necessidade do aprimoramento dos programas sanitários na exploração animal e sua efetiva adoção e responsabilização com base nas boas práticas de produção
Since 2005, the Codex Alimentarius committee began a new journey regarding the ante and post morten inspection practices, including this practice permanently at the security and safety plans. Methods and techniques tests adoption are recommended or analyze that have focus or characteristics based on HACCP program that have scientific fundamentals and systematic character that permit identify the specific hazard and measures for their control – prevention, reduction or elimination, ensuring the food safety in risk analysis international tolerable. This review aimed to analyze and discussion from adopted practices during the bovine post mortem inspection based on the sanitary occurrence monitoring during 2012, and based on retrospective study of these sanitary occurrences from 2007 to 2011, order to discuss and possible adequacy from these practices based on Codex Alimentarius requirements and recommendations. In this period were observed, 17.981 cases of cysticercosis (1,68%), 557 tuberculosis (0,5%), 13315 hepatic abscess (0,12%) and 235 pneumonia. (0,02%) in a total of 1.067.584 slaughtered animals. The general index to the sanitary changes occurrence at the post mortem exam at the period were 1,9%, what mean that each 100 animals slaughtered 2 need procedures to take care about customers heath safety. Although looks like a small quantity, it’s a big number that impose the necessity of the sanitary programs upgrading
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Tiveron, Daniela Verardino. "Inspeção pós-morte de bovinos : ocorrência de alterações sanitárias no abate e respectivo impacto em relação ao mercado globalizado /." Jaboticabal, 2014. http://hdl.handle.net/11449/110620.
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Orientador: Luiz Francisco PrataBanca: Estevam Guilherme Lux Hoppe
Banca: Paulo Sérgio Jorge
Resumo: A partir de 2005, a comissão do Codex Alimentarius deu início a uma nova empreitada no que diz respeito às práticas da inspeção ante e pós-morte, inserindo-as definitivamente nos planos de segurança e inocuidade. Recomenda-se, a adoção de métodos e técnicas de exames ou de análises que possuam enfoque ou características baseados no sistema APPCC (Análise de Perigos e Pontos Críticos de Controle - HACCP), que tem fundamentos científicos e caráter sistemático, permitindo identificar perigos específicos e medidas para seu controle - prevenção, redução ou eliminação, garantindo a inocuidade dos alimentos em margens de risco (Risk Analysis) aceitáveis internacionalmente. Este estudo visou à análise e a discussão das práticas vigentes durante a inspeção pós-morte de bovinos com base no monitoramento das ocorrências sanitárias durante o ano de 2012 e estudo retrospectivo da evolução dessas ocorrências entre os anos 2007 e 2011, com vistas à discussão e possível adequação dessas práticas com base nos requisitos e recomendações do Codex Alimentarius e do sistema de gestão de caráter preventivo definido pelo plano APPCC, focando-as em análises de risco. Nesse período, foram observados 17.981 casos de cisticercose (1,68%), 557 casos de linfadenite do tipo tuberculosa (0,05%), 1315 ocorrências de abscessos hepáticos (0,12%) e 235 casos de pneumonia (0,02%), num total de 1.067.584 animais abatidos. O índice geral para ocorrência de alterações sanitárias no exame pósmorte para o período foi de 1,9%, significando que dois em cada 100 animais abatidos demandam providências que salvaguardem a saúde dos consumidores. Embora pareça pequena, essa ainda é uma cifra muito elevada que impõe a necessidade do aprimoramento dos programas sanitários na exploração animal e sua efetiva adoção e responsabilização com base nas boas práticas de produção
Abstract: Since 2005, the Codex Alimentarius committee began a new journey regarding the ante and post morten inspection practices, including this practice permanently at the security and safety plans. Methods and techniques tests adoption are recommended or analyze that have focus or characteristics based on HACCP program that have scientific fundamentals and systematic character that permit identify the specific hazard and measures for their control - prevention, reduction or elimination, ensuring the food safety in risk analysis international tolerable. This review aimed to analyze and discussion from adopted practices during the bovine post mortem inspection based on the sanitary occurrence monitoring during 2012, and based on retrospective study of these sanitary occurrences from 2007 to 2011, order to discuss and possible adequacy from these practices based on Codex Alimentarius requirements and recommendations. In this period were observed, 17.981 cases of cysticercosis (1,68%), 557 tuberculosis (0,5%), 13315 hepatic abscess (0,12%) and 235 pneumonia. (0,02%) in a total of 1.067.584 slaughtered animals. The general index to the sanitary changes occurrence at the post mortem exam at the period were 1,9%, what mean that each 100 animals slaughtered 2 need procedures to take care about customers heath safety. Although looks like a small quantity, it's a big number that impose the necessity of the sanitary programs upgrading
Mestre
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Chang, Shelley. "Predicting Methicillin-Resistant Staphylococcus Aureus Carriage and Dissemination in a Veterans Affairs Medical Center." Case Western Reserve University School of Graduate Studies / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=case1238795542.
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Sturdivant, Karen Diane. "Employee perceptions of the leadership style of the executive director of a medical center." DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 1988. http://digitalcommons.auctr.edu/dissertations/1586.
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The primary intent of this paper is to examine personnel perceptions of the leadership style of the executive director of a medical center.
This study is significant because leadership is the cornerstone of every organization. Based on the responses given, it was found that employees perceived the executive director's leadership style as autocratic. Also, a majority of the respondents favored the director's leadership style, and felt it to be beneficial to the organization. They stated that the supervisory channels are clearly identified. Relative to job satisfaction, and the issue of whether or not enough time is allowed for the completion of assignments, a large percentage of the respondents indicated that they liked their jobs, even though there were some employees who said they did not have enoueh tirr,e to complete their work.
This study utilizes both primary and secondary data sources. The primary source consists of a seventeen-item questionnaire administered to fifty-two of the sixty-five staff members at the medical center. The secondary sources used were books, research journals, and a United States Health and Human Services Continuation Grant for Community Health Centers. Recommendations to improve the quality of work-life at the center are offered.
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Bercaw, Edwin L. "A behavioral activation approach to smoking cessation for depressed smokers at veterans affairs medical centers." College Park, Md. : University of Maryland, 2007. http://hdl.handle.net/1903/7243.
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Thesis (Ph. D.) -- University of Maryland, College Park, 2007.Thesis research directed by: Psychology. Title from t.p. of PDF. Includes bibliographical references. Published by UMI Dissertation Services, Ann Arbor, Mich. Also available in paper.
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Seago, Brenda. "UTILIZATION OF SIMULATION TO TEACH PELVIC EXAMINATION SKILLS TO MEDICAL STUDENTS: IMPLICATIONS FOR MEDICAL EDUCATION." VCU Scholars Compass, 2010. http://scholarscompass.vcu.edu/etd/2290.
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Medical education is changing. Physicians have less time for teaching clinical skills and for direct observation of medical students, due to sicker patients in the hospital, shorter hospital stays, competing demands of research and patient care, and implementation of the eighty hour work week for residents. The consumer movement increased awareness of medical errors, patient safety and quality of healthcare. Teaching the pelvic examination is ethically complex. Questions have arisen about medical students learning to conduct the pelvic examination on actual patients. This study utilizes the pelvic examination simulator and genital teaching associates (GTAs) to teach pelvic exam skills to optimize limited resources, as well as address safety and ethical concerns. The purpose of the study was to provide medical students with more practice in pelvic examination skills, to test a pelvic examination simulator, and to explore a new model for teaching pelvic examination skills to second year medical students. After IRB approval, one hundred sixty eight second year medical students at Virginia Commonwealth University School of Medicine participated in the study. A two-armed trial design provided all medical students with pelvic exam training on the pelvic exam simulator and genital teaching associate. Data were gathered via an experience and demographic questionnaire, blood pressure readings, the Fear of Pelvic Examination Scale scores and performance scores after the training. Data analysis consisted of descriptive statistics, paired and independent sample t-tests and the linear mixed model. Statistical tests determined the relationship between fear, blood pressure and performance. The findings revealed that the GTA training group had significantly more fear than the pelvic exam simulator group and significantly higher performance scores than the simulator group. The gender analysis indicated that males had significantly more fear than females. Prior experience with pelvic exam simulators did not appear to reduce anxiety among medical students when first conducting pelvic exams with humans. Completion of pelvic exam training with a GTA may reduce fear substantially and make later training with the pelvic exam simulator the optimal first experience. Use of simulation in medical education reduces ethical concerns, optimizes limited resources and reduces patient safety issues.
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Moore, Scott C. "Anatomy of an Intervention: The History of a Change Effort in a Veterans Affairs Medical Center." University of Cincinnati / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1195592167.
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Formoso, Joseph. "Florida's medical malpractice tort reform a cognitive analysis of litigious, legislative promulgation and jurisprudence." Honors in the Major Thesis, University of Central Florida, 2012. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/553.
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Public opinion in recent years has been seemingly manipulated by superfluous stories, bad press, and negative commentaries regarding the perceived "Medical Malpractice Crisis." It has initiated a political attack on Florida's tort system which has resulted in making valid medical malpractice claims even more so difficult for victimized plaintiffs to pursue. After months of diligent research, and with the loyal aid of my university advisors and the dedicated law librarians I've had the honor to work with, I have thoroughly analyzed Florida's past and present medical malpractice tort reforms and governing procedural laws; in addition to arguing, by virtue of this thesis, why these reforms were truly enacted, how traditional tort reforms have egregiously compromised public interests, why Florida's future--with regard to legislative change--is grim, and how new, innovative tort reforms--such as those established overseas--could genuinely benefit Floridians. The premise of the conclusion reached in this research is partially iterated in a quote by the critically acclaimed "Insurance Law Expert," Tom Baker: "...the medical malpractice myth. Built on a foundation of urban legend mixed with the occasional true story, supported by selective references to academic studies, and repeated so often that even the mythmakers forget the exaggeration, half truth, and outright misinformation employed in the service of their greater good, the medical malpractice myth has filled doctors, patients, legislators, and voters with the kind of fear that short circuits critical thinking." --Baker, T. (2005). The medical malpractice myth. Chicago: University of Chicago Press.B.A. and B.S.
Bachelors
Health and Public Affairs
Legal Studies
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Zimmerman, Melissa M. "Leadership Practices of Supervisory Employees: An Exploration of Current Practices at a Southeastern Veterans Affairs Medical Center." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etd/3149.
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As the nation’s healthcare system moves through the 21st century, unprecedented changes are occurring on both a local and global stage. Healthcare organizations are faced with creating and implementing leadership strategies to enhance the overall patient experience. When coupled with the need to ensure increased nurse job satisfaction, improved cost-effectiveness and healthy organizational cultures with fiscally sound budgets, improvement work has led efforts to ensure effective leadership techniques are used across an agency.
This task may be viewed as commonplace for some organizations, while others may perceive this process as a complete paradigm shift from historical practices related to leadership style, behaviors and performance. A successful transition during this time of unprecedented change may depend on an organization’s ability to accept and implement the tenets of transformational leadership. Empirical research illustrates that transformational leadership empowers staff, increases job satisfaction and facilitates cost-effectiveness while constructing an environment conducive to the development of a supportive organizational culture.
In an effort to ascertain the current state of leadership at a southeastern Veterans Affair Medical Center, this research study explored the self-reporting leadership practices of all supervisory staff employed at the facility. As a means of measurement, the Leadership Practices Inventory (LPI) was coupled by demographic questionnaire developed by the researcher. Both measurement tools were used to collect the data.
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Montague, Diane M. "Medication errors in hospitals : to ERR is human, to report is divine." Honors in the Major Thesis, University of Central Florida, 2001. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/235.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Health and Public Affairs
Legal Studies
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Grollmes, Deborah N. "Reduction of aberrant medical errors through United States Navy standardized militaristic training techniques in combination with technological innovations." Honors in the Major Thesis, University of Central Florida, 2001. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/224.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Health and Public Affairs
Health Services Administration
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Mindemann, Lauren Nicole. "Exploring the Need for a Veteran-Specific Grief Program for the Robley Rex Veteran Affairs Medical Center (VAMC)." Miami University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=miami1303397171.
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Noe, Colleen Marie. "Comparison of large group assistive listening devices in an adult classroom setting at the Veterans Affairs Medical Center /." The Ohio State University, 1994. http://rave.ohiolink.edu/etdc/view?acc_num=osu148785987993986.
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Bellan, Natália. "Diretrizes para o processo de registro sanitário dos medicamentos." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/9/9139/tde-30072015-100420/.
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O controle sanitário no Brasil merece elevado nível de consideração, pois caracteriza-se por grande importância social e econômica. Abrange um leque grande de produtos e serviços de diversas naturezas, como: medicamentos, alimentos, produtos biológicos, vacinas, hemoderivados, saneantes e desinfetantes, produtos de higiene pessoal, perfumes e cosméticos, controle dos portos, aeroportos, estações de fronteiras e uma ampla variedade de serviços à saúde. A Agência Nacional de Vigilância Sanitária (ANVISA) foi criada no Brasil especificamente conforme artigo 3º da Lei nº 9782/1999, sendo relativamente recente comparando-se com as agências regulatórias no âmbito internacional, e desde então evoluiu, angariando respeito no nível nacional e internacional. Outras agências reguladoras igualmente importantes abrangem variedades de produtos e serviços semelhantes à ANVISA. Inclusive a Food and Drug Administration - (FDA) e a European Medicines Agency (EMA) apresentam em seu \"rool\" de medicamentos os veterinários, enquanto que no Brasil este tipo de produto é regulamentado pelo Ministério de Agricultura, Pecuária e Abastecimento (MAPA). O processo de registro no sistema de vigilância sanitária é um recurso de grande valia para assegurar a comercialização de produtos seguros e eficazes disponíveis à sociedade. Qualquer falha na cadeia produtiva pode impactar nos critérios de qualidade. Assim, a regulamentação sanitária sobre medicamentos abrange toda a cadeia farmacêutica desde o início dos estudos de pesquisa clínica até normas referente à publicidade. O objetivo desse trabalho é contribuir na promoção do conhecimento de regulação sanitária para os medicamentos pelo estudo da estrutura organizacional e atribuições da ANVISA, e paralelamente, efetuar a análise e comparação da regulamentação sanitária entre as diferentes categorias de medicamentos, bem como discutir a estratégia regulatória adotada pelo setor farmacêutico. Como material dessa pesquisa, empregou-se essencialmente, a regulamentação sanitária farmacêutica nacional, tendo como contrapontos a situação política e econômica do país, pautando-se como método a pesquisa qualitativa utilizando-se do modelo documental. Com vistas à estrutura organizacional das agências reguladoras de medicamentos descritas neste trabalho, verificou-se semelhanças inerentes as concepções técnicas e regulatórias, diferenciando-se, principalmente, da brasileira pelo fato dos medicamentos de uso humano e veterinário não estarem contemplados sob a responsabilidade da mesma instituição. Dentre as sete categorias de medicamentos estudadas, a composição técnica de seus dossiês de registro são consideravelmente análogas, sendo distintas as exigências regulatórias tangíveis aos quesitos específicos inerentes a cada tipo de medicamento. No período analisado (2009 a 2010), com o intuito de retratar a tendência regulatória adotada pelo setor farmacêutico brasileiro, as categorias de medicamentos genéricos e similares são as que mais apresentaram solicitações e deferimentos de registros no país.The sanitary control in Brazil deserves a high level of consideration, because it is characterized by large social and economic importance. It encompasses a wide variety of products and services of various natures, as medicines, food, biological products, vaccines, blood products, sanitizing and disinfectants, toiletries, perfumes and cosmetics, control of ports, airports, frontiers stations and an extensive variety of health services. The National Agency for Sanitary Surveillance (ANVISA) was created in Brazil specifically as Article 3 of Law No. 9782/1999 and is relatively recent compared with regulatory agencies internationally, and has since evolved, gaining respect in the national and international level . Other regulatory agencies equally encompass important varieties of products and services similar from ANVISA. Even the Food and Drug Administration - (FDA) and European Medicines Agency (EMA) in its present \"rool\" medicine veterinarians, while in Brazil this type of product is regulated by the Ministry of Agriculture, Livestock and Supply (MAPA). The registration process in health monitoring system is a very valuable resource to ensure that commercialization of safe and effective products available to society. Any failure in the supply chain can impact on the quality criteria. Thus, the sanitary regulation on medicines covers the entire pharmaceutical chain since the early clinical research studies relating to the advertising standards. The objective of this work is to contribute in promoting knowledge of sanitary regulation for medicines by studying the organizational structure and responsibilities of ANVISA, and in parallel, perform analysis and comparison of the sanitary regulation between different categories of medicines, as well as discuss the regulatory strategy adopted by the pharmaceutical industry. As material of this research, we used essentially the national pharmaceutical the sanitary regulation, having as counterpoints the political and economic situation of the country, basing itself as a qualitative research method using the model document. With views to the organizational structure of drug regulatory agencies described in this study, it was found similarities inherent in the concepts and techniques regulatory, differentiating itself mainly by the fact that the Brazilian medicines for human and veterinary use are not covered under the responsibility of the same institution. Among the seven categories of drugs studied, the technical composition of their registration dossiers are considerably analogous, with different regulatory demands tangible to specific questions related to each type of medicine. In the analyzed period (2009 to 2010), in order to portray the regulatory trend adopted by the Brazilian pharmaceutical sector, the categories of generic medicines and similar are the ones that submitted more requests for deferrals and registries in the country.
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Noblin, Alice M. "Intention to use a personal health record (PHR) a cross sectional view of the characteristics and opinions of patients of one internal medicine practice." Doctoral diss., University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/4600.
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A personal health record (PHR) allows a patient to exert control over his/her healthcare by enhancing communication with healthcare providers. According to research, patients find value in having access to information contained in their medical records. Often a glossary is required to aid in interpreting the information and understanding the content. However, giving patients the ability to speak with providers about their medical conditions empowers them to participate as informed healthcare consumers. The majority of patients (75%) at Medical Specialists expressed their intention to adopt the PHR if it is made available to them. Although the perceived usefulness of a PHR was a significant determining factor, comfort level with technology, health literacy, and socioeconomic status were indirectly related to intention to adopt as well. Perceived health status was not found to be a significant factor in this population for determining intention to adopt a PHR. The majority of patients in each category of gender, age, marital status, and race/ethnicity (except American Indian/Alaska Native) expressed interest in adopting a PHR, with most categories being above 70%. Findings indicate a broad acceptance of this new technology by the patients of Medical Specialists. Improvement of adoption and use rates may depend on availability of office staff for hands-on training as well as assistance with interpretation of medical information. Hopefully, over time technology barriers will disappear, and usefulness of the information will promote increased demand.ID: 028916585; System requirements: World Wide Web browser and PDF reader.; Mode of access: World Wide Web.; Thesis (Ph.D.)--University of Central Florida, 2010.; Includes bibliographical references (p. 160-172).
Ph.D.
Doctorate
Health and Public Affairs
Public Affairs
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Schaefer, Jay M. "Is "good" good enough? a small area variation analysis of disparity in expressed rates of access to and satisfaction with child and adolescent healthcare services in east Central Florida." Doctoral diss., University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/4603.
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Further research specific to these phenomenon encompassing a clearer understanding of the type of care received and the individual's specific experiences with their healthcare providers was recommended, with ensuing research to better identify commonalities of interactions with specific area providers, local restrictions imposed by area insurance carriers, influences caused by language and/or cultural barriers, and the like as drivers in understanding the individual dynamics of satisfaction.; The purpose of this dissertation research was to explore indications of disparities within the east Central Florida child and adolescent healthcare services market. Structured as a follow-up study to work completed in 2005 under the direction of the Health Council of East Central Florida assessing parental perceptions of community child and adolescent healthcare services, this research extended that evaluation by aggregating participant responses at the county and small area zip code group levels, contextually testing the uniformity of responses in understanding parent perceptions of access to, and satisfaction with, community healthcare service offerings available for children and adolescents. Under a variety of methodologies significance in the responses concerning access to healthcare services were demonstrated between the counties studied. Statistical modeling, however, could not demonstrate the core demographic differences among these data. Data representing perceptions of satisfaction with the services received by children and adolescents were demonstrated at the small area zip code group level within Orange county. Primary effect assessment of the demographic variables representing these respondents yielded findings generally consistent with theoretical expectations of disparity but, notably, the correlation effects between a number of key independent variables demonstrated a mediation of the primary effects on overall perception of satisfaction. Specifically, it was demonstrated that the interaction of white race with possession of private healthcare insurance, and the interaction of greater levels of educational attainment with black race, caused a proportional reduction in the predicted satisfaction score of these survey respondent cohorts.ID: 029050697; System requirements: World Wide Web browser and PDF reader.; Mode of access: World Wide Web.; Thesis (Ph.D.)--University of Central Florida, 2010.; Includes bibliographical references (p. 117-123).
Ph.D.
Doctorate
Health and Public Affairs
Public Affairs
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Teeple, Lisa J. "Historical development of selected design amenities in central Indiana rural school buildings, 1875-1915." Virtual Press, 1993. http://liblink.bsu.edu/uhtbin/catkey/865947.
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The purposes of this study were: (1) to study the conditions that influenced the construction of early rural schoolhouses in Indiana, (2) to examine how emerging concerns for sanitation and student health surfaced from the construction of early rural schoolhouses, and (3) to provide a data base for individuals who desire to do further research on school buildings and their historic preservation. The research concentrated on the period of 1875 to .1915. Special attention was given to conditions that led to the passage of the Sanitary Schoolhouse Act of 1911.Results revealed that early schoolhouses often were constructed as little more than shelters. Virtually no consideration was given to either educational processes or the health and safety of occupants. As a result, water and other design and care of water and sewage systems resulted insanitary factors became major concerns. The inadequate serious health concerns for students and teachers. These concerns contributed to the passage of laws that eventually led to: (1) the abandonment of early rural schoolhouses, and (2) the construction of more sophisticated structures often designed by professional architects.This study also revealed that some of those early schoolhouses that survived have been converted to residential, business, or civic purposes. Photographs of such buildings in Boone, Hamilton, Hancock, Hendricks, Henry, Madison, and Tipton counties in Indiana are included in the thesis. They provide evidence that preservation is a means with which these buildings can continue to serve a useful existence.There is historical value in understanding conditions that led to the rise and fall of early rural school buildings. Collectively, data about the construction and sanitary conditions provide insights into rural culture, expand an appreciation of the uniqueness of design for these buildings, and enhance the importance and desirability of preserving these structures. The net product of this thesis is to provide a view of the construction of buildings in central Indiana of this period.Department of Architecture
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Perez, Bianca. "A root cause analysis of the barriers to transparency among physicians a systemic perspective." Doctoral diss., University of Central Florida, 2011. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/4821.
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Transparency in healthcare relates to formally reporting medical errors and disclosing bad outcomes to patients and families. Unfortunately, most physicians are not in the habit of communicating transparently, as many studies have shown the existence of a large medical error information gap. Research also shows that creating a culture of transparency would mutually support patient safety and risk management goals by concomitantly reducing medical errors and alleviating the malpractice crisis. Three predictor variables are used to represent the various dimensions of the context just described. Perfectionism represents the intrapersonal domain, socio-organizational climate represents the interpersonal and institutional domains, and medico-legal environment represents the societal domain. Chin and Benne's normative re-educative strategy provides theoretical support for the notion that successful organizational change hinges upon addressing the structural and cultural barriers displayed by individuals and groups. The Physician Transparency Questionnaire was completed by 270 physicians who were drawn from a multi-site healthcare organization in Central Florida. Structural equation modeling was used to determine whether perfectionism, socio-organizational climate, and medico-legal environment significantly predict two transparency outcomes, namely, error reporting transparency and provider-patient transparency. Perfectionism and socio-organizational climate were found to be statistically significant predictors. Collectively, these variables accounted for nearly half of the variance in each transparency outcome. Within socio-organizational climate, policies had the greatest influence on transparency, followed by immunity and professional norms. Multiple group analysis showed that the covariance model developed in this study generalizes across gender, medical specialty, and occupation. In addition, group means comparisons tests revealed a number of interesting trends in error reporting and disclosure practices that provide insights about the behavioral and cognitive psychology behind transparent communication: 1) Physicians are more inclined to engage in provider-patient transparency compared to error reporting transparency, 2) physicians are more inclined to report serious errors compared to less serious errors, and 3) physicians are more inclined to express sympathy for bad outcomes than they are to apologize for a preventable error or be honest about the details surrounding bad outcomes. These results suggest that change efforts would need to be directed at medical education curricula and health provider organizations to ensure that current and future generations of physicians replace the pursuit for perfectionism with the pursuit for excellence. Also, a number of institutional changes are recommended, such as clearly communicating transparency policies and guidelines, promoting professional norms that encourage learning from mistakes rather than an aversion to error, and reassuring physicians that reporting and disclosure activities will not compromise their reputation. From the perspective of patient safety advocates and risk managers, the results are heartening because they emphasize a key principle in quality improvement - i.e., small changes can yield big results. From an ethical standpoint, this research suggests that healthcare organizations can inhibit (or facilitate) the emergence of professional virtues. Thus, although organizations cannot make a physician become virtuous, it is within their power to create conditions that encourage the physician to practice certain virtues. With respect to leadership styles, this research finds that bottom-up, grassroots change efforts can elicit professional virtues, and that culture change in healthcare lies beyond the scope of the medico-legal system.ID: 030646191; System requirements: World Wide Web browser and PDF reader.; Mode of access: World Wide Web.; Thesis (Ph.D.)--University of Central Florida, 2011.; Includes bibliographical references (p. 126-142).
Ph.D.
Doctorate
Health and Public Affairs
Public Affairs
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Pereira, Carla Raquel Xavier. "The evolving profile, role and relevance of the medical director in a pharmaceutical company." Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/15616.
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Mestrado em Biomedicina FarmacêuticaOver the last years, operations in Pharmaceutical Companies have become more complex, trying to adapt to new demands of the market environment. Overall, the observed change of paradigm requires adapting, mainly by the setting of new priorities, diversification of investments, cost containment strategies, exploring new markets and developping new sets of skills. In this context, new functions have been created, the relevance of some has diminished, and the importance of others has arisen. Amongst these, the medical structure within a Pharmaceutical Company, increased to meet demands, with companies adopting different models to respond to these needs, and becoming a pillar to the business. Assuming the leading role within a medical department, the medical director function often lies in the shadow. It is a key function within Pharma Industry, either on a country or on a Global basis. It has evolved and changed in the past years to meet the constant demands of a changing environment. The Medical Director is a highly skilled and differeniated professional who provides medical and scientific governance within a Pharmaceutical company, since early stages of drug development and up to loss of exclusivity, not only but also by leading a team of other physicians, pharmacists or life scientists whose functions comprise specificities that the medical director needs to understand, provide input to, oversee and lead. As the organization of Pharmaceutical Companies tends to be different, in accordance to values, culture, markets and strategies, the scope of activities of a Medical Director can be broader or may be limited, depending on size of the organization and governance model, but they must fulfil a large set of requirements in order to leverage impact on internal and internal customers. Key technical competencies for medical directors such as an MD degree, a strong clinical foundation, knowledge of drug development, project and team management experience and written and verbal skills are relatively easy to define, but underlying behavioural competencies are more difficult to ascertain, and these are more often the true predictors of success in the role. Beyond seamless proficiency in technical skills, at this level interpersonal skills become far more important, as they are the driver and the distinctive factor between a good and an excelent medical director. And this has impact in the business and in the people doing it.
Nos últimos anos, as operações das empresas farmacêuticas têm-se tornado mais complexas, tentando adaptar-se às novas exigências do ambiente de mercado. Globalmente, a mudança de paradigma observada requer adaptação, principalmente através do estabelecimento de novas prioridades, diversificação dos investimentos, estratégias de contenção de custos, explorando novos mercados e desenvolvendo novos conjuntos de competências. Neste contexto, novas funções foram criadas, a importância de algumas diminuiu, e a importância de outras emergiu. Entre estas, a estrutura médica dentro de uma empresa farmacêutica aumentou para responder às exigências, com as empresas a adoptarem diferentes modelos para responder a estas necessidades, tornando-se um pilar para o negócio. Assumindo o papel de lider dentro de um departamento médico, a função de diretor médico permanece muitas vezes na sombra. É uma função chave dentro da Indústria Farmacêutica, seja num país ou numa base global. Esta função tem evoluído e mudado nos últimos anos para responder às exigências constantes de um ambiente em mudança. O Diretor Médico é um profissional altamente qualificado e diferenciado que confere orientação médica e científica dentro de uma empresa farmacêutica, desde as fases iniciais de desenvolvimento de medicamentos e até perda de exclusividade, não só mas também por liderar uma equipa de outros médicos, farmacêuticos ou cientistas, cujas funções incluem especificidades que o diretor médico precisa compreender, contribuir para, supervisionar e liderar. Como a organização das empresas farmacêuticas tende a ser diferente, de acordo com os valores, cultura, mercados e estratégias, o âmbito das actividades de um diretor médico pode ser mais amplo ou pode ser limitado, dependendo do tamanho e do modelo de organização e governança, mas deve cumprir um largo conjunto de requisitos a fim de maximizar o seu impacto sobre os clientes internos e externos. Competências técnicas fundamentais para diretores médicos, como uma especialização em Medicina, uma forte base clínica, conhecimento de desenvolvimento de medicamentos, experiência em gestão de equipas e de projectos, e elevada capacidade escrita e verbal são relativamente fáceis de definir, mas competências comportamentais subjacentes são mais difíceis de encontrar, e estas são mais frequentemente os verdadeiros preditores de sucesso na função. Além da proficiência irrepreensível em habilidades técnicas, a este nível as habilidades interpessoais tornam-se muito mais importantes, pois são o condutor e o factor distintivo entre um bom e um excelente diretor médico. E isso tem impacto no negócio e nas pessoas que nele trabalham.
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Duffy, Brianne Michelle. "Identification of stressors related to emergency department employment." Honors in the Major Thesis, University of Central Florida, 2003. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/315.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Health and Public Affairs
Nursing
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Opper, Scott. "Redesigning the American healthcare system." Honors in the Major Thesis, University of Central Florida, 2000. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/400.
Full textAbstract:
This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Health and Public Affairs
Social Work
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Sookdeo, Suzette S. "The Relationship Between the Utilization of Student Support Services and Overall Satisfaction in Medical School." Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6588.
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The purpose of this study was to investigate the relationship between the utilization of student support services and overall satisfaction in medical school. Utilization of services, and overall satisfaction were analyzed by gender, race/ethnicity, and medical specialty choice. In addition, the study identified the most utilized support service, and explored whether utilization of services and overall satisfaction were correlated with academic performance.
Two medical schools in the state of Florida were used for the study, University of South Florida Morsani College of Medicine (USF MCOM), and Florida State University College of Medicine (FSU CoM). Separate anonymous, three-part, on-line surveys were created and administered to fourth-year students. Data were collected on the utilization of the specific academic and psychological support services available at each school. Data were analyzed by medical school (n = 87; n = 71), and as a combined set (N = 158).
Results of a multiple regression analysis, using each support service as predictors, indicated that the utilization of the primary service for academic counseling at both medical schools was inversely related to overall satisfaction. Results also revealed that no significant differences existed for utilization of support services and overall satisfaction by gender, race/ethnicity, and medical specialty choice. The most utilized service at USF MCOM was the Office of Student Affairs. At FSU CoM, the Office of Student Counseling Services was the most utilized.
The findings indicated that utilization of USF MCOM services increased as academic performance decreased; however, there was no significant relationship between academic performance and utilization of services at FSU CoM. A significant relationship existed between academic performance and overall satisfaction; as students’ experience of academic difficulties increased, their overall satisfaction with medical school decreased.
The implications from this study can help facilitate an initiative, at both medical schools, to broaden the scope and utilization of the academic and psychological support services to possibly increase their influence on student resiliency, and the overall medical school experience.
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Hubbard, Laura. "Factors Related to Adult Violence and Aggression in Healthcare Settings." Honors in the Major Thesis, University of Central Florida, 2004. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/420.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucfBachelors
Health and Public Affairs
Nursing
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Rehnström, Ida. "MedTech Firms' Business Model Alignment with Healthcare Institutional Logic : Successful Commercialization." Thesis, Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-85334.
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MedTech firms experience barriers when entering the healthcare sector, although their solutions could solve healthcare challenges. The study provides a conceptual framework for MedTech firms' business environment including institutional alignments and misalignments. These insights support MedTech firms' business model development when aiming for successful commercialization. The research is conducted with a multiple case study analyzing MedTech firms' and healthcare organizations' perspective regarding the business environment and relationship dynamics. The study generated three main findings. Firstly, an organizational and institutional logic analysis outlined essential problem areas where MedTech firms and healthcare organizations align differently. Secondly, suggestions on how the MedTech firm can respond to the identified problem areas through their business model are presented. Thirdly, the study provides an example of how social- and business literature can be connected to understand complex business environments. In contrast to a majority of prior research, the study is designed for the MedTech firm's perspective where the final result answering how the business model can be improved based on healthcare organizational and business insights.
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Augusto, Ana Isabel Santos. "Curricular internship in a clinical pharmacology unit." Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/14882.
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Mestrado em Biomedicina FarmacêuticaThe present internship report is a detailed description of my experience in the curricular internship performed at the Clinical Pharmacology Unit of the Instituto de Medicina Molecular, from October 13th 2014 to June 5th 2015. This internship was performed as part of the second and final year of the Master’s Degree in Pharmaceutical Biomedicine of the University of Aveiro. During the course of the experience I had the opportunity to participate in several projects in collaboration with different teams, most relevantly the activities related to the regulatory submission of a clinical trial in Portugal and related to the training in Pharmacovigilance. This internship has allowed me to put into practice the knowledge acquired during my academic training and deepen my knowledge on Clinical Research in a practical perspective. Additionally, it has also allowed me to improve many of skills and to understand my interests, capacities, weaknesses and strengths. In conclusion, I can affirm that this internship was an outstanding training and a very valuable professional and personal experience, for the main established objectives were achieved and exceeded.
O presente relatório de estágio descreve detalhadamente a minha experiência no estágio curricular realizado na Unidade de Farmacologia Clínica do Instituto de Medicina Molecular, desde 13 de Outubro de 2014 até 5 de Junho de 2015. Este estágio foi realizado como parte do segundo ano do Mestrado em Biomedicina Farmacêutica da Universidade de Aveiro. Durante o decorrer desta experiência, tive a oportunidade de participar em diversos projetos em colaboração com diferentes equipas, destacando-se as atividades relacionadas com a submissão de um ensaio clínico em Portugal e as atividades no âmbito da formação em Farmacovigilância. Este estágio possibilitou-me pôr em prática os conhecimentos obtidos durante a minha formação académica e aprofundar o meu conhecimento sobre investigação clínica, numa perspetiva prática. Para além disso, permitiu-me melhorar as minhas competências e perceber os meus interesses, capacidades, pontos fracos e fortes. Concluindo, posso afirmar que este estágio foi uma aprendizagem excelente e uma experiência de grande valor a nível profissional e pessoal, tendo conseguido atingir e ultrapassar os principais objetivos estabelecidos.
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Binnie, Phillip B. "The effect of spirituality class on improving spiritual assessment scores and the relationship of spiritual assessment scores to length of stay of patients admitted to the psychiatric residential rehabilitation treatment program at the Miami Veterans Affairs Medical Center." Theological Research Exchange Network (TREN), 1997. http://www.tren.com.
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Esquivel-Yániz, Sonia Hildelisa. "Seguridad de equipos electromédicos: regulación sanitaria para la protección de la salud." Tese apresentada ao Programa de pós-graduação em Saúde Coletiva, 2011. http://www.repositorio.ufba.br/ri/handle/ri/10917.
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Trata-se de um estudo cujo objeto é a regulação sanitária de equipamentos eletromédicos, entendida como o controle sanitário desenvolvido pelo Estado, por meio das ações de vigilância sanitária, visando o controle de riscos e a segurança desses equipamentos. Tem como objetivo descrever e analisar o sistema regulatório brasileiro desses equipamentos a partir das instituições que o compõem, seus instrumentos e processos no exercício do controle sanitário, nos diferentes momentos regulatórios. Trata-se de um estudo de caso, tipo exploratório, tendo-se tomado como traçadores dois equipamentos eletromédicos: o ventilador pulmonar e o mamógrafo. Para a produção de dados foram utilizadas as técnicas de análise documental, entrevistas semi-estruturadas com informantes-chave e observação direta que permitiram descrever as bases normativas, os instrumentos e processos de controle sanitários aplicados ao longo do ciclo de vida dos equipamentos, pelos órgãos de vigilância sanitária e outras entidades que participam do controle. Também foram registradas considerações de fabricantes e usuários sobre as ações de controle sanitário e as limitações em sua execução. Os dados foram classificados e ordenados em uma matriz construída a partir do marco referencial do estudo e das categorias analíticas e operacionais definidas. Os resultados descrevem e analisam os componentes do processo regulatório brasileiro dos equipamentos eletromédicos, as instituições que compõem o sistema regulatório, seus instrumentos, processos e práticas, dificuldades e limites no exercício da regulação sanitária, nos diferentes momentos, bem como caracteriza a relação entre o sistema brasileiro e as normativas recomendadas por organizações internacionais. Foram evidenciadas dificuldades no exercício da regulação sanitária desses produtos, em face da dependência científica e tecnológica do Brasil, dos estágios iniciais dessa atividade no país e a pouca expertise dos profissionais de vigilância sanitária e de outras instituições reguladoras no relativo ao controle de riscos.
Salvador
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Stalling, Veda. "The Phenomenological Evaluation of Social Worker Competencies in Patient-Centered Medical Homes." ScholarWorks, 2016. http://scholarworks.waldenu.edu/dissertations/1871.
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The Patient-Centered Medical Home (PCMH) is an innovative, team-based health care model that was applied during the implementation of the Affordable Care Act (ACA). However, the competencies for PCMH health care social worker team members are not identified within this model. Thus, the purpose of this phenomenological study focused on identifying the core competencies that will enable social workers to perform competently in PCMHs. This study also explored the roles and training needs as related to improving the competence of social workers. Sandberg’s and Parry’s conceptualization of the competency model was used as the theoretical framework. Data were acquired through interviews with 10 PCMH social workers. These data were then inductively coded and analyzed using a modified Moustakas method. Key findings indicated that these social workers believed that improvements in competencies may include training and knowledge with mental health and physical health knowledge which consist of diagnoses, interventions, medications, symptoms, and terminology. It was also noted that knowledge of evidence-based practices for mental health interventions and patient-centered, team-based principles were essential to ACA policy implementation. The positive social change implications of this study include recommendations to health care leadership, educational institutions, and other PCMH providers to develop competency-based training for social workers. Recommendations are also put forth to adapt social work curriculum to ensure the effective implementation of the principles of the ACA policy and to improve social work practice in PCMH health care settings.
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Ribeiro, Eduardo Manuel Fernandes da Silva. "O médico na indústria farmacêutica: contributo para o enquadramento da atividade." Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/15789.
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Mestrado em Biomedicina FarmacêuticaAo longo desta dissertação de mestrado pretendemos analisar e discutir o papel do Médico na Indústria Farmacêutica, contribuindo para um melhor enquadramento de uma atividade ainda não muito conhecida. A partir da análise da implementação da Indústria Farmacêutica em Portugal, descrevemos o seu contributo para a Sociedade aliado ao valor do medicamento. Descrevemos a Medicina Farmacêutica, o treino da atividade e alguns dos órgãos relevantes nesta área, como a Competência em Medicina Farmacêutica da Ordem dos Médicos e a Associação dos Médicos Portugueses da Indústria Farmacêutica. De uma forma detalhada caraterizamos as atividades e competências do Médico nesta indústria que reforçamos com uma análise de um questionário efetuado com as opiniões de colegas Portugueses e estrangeiros com experiência nesta área do conhecimento. Concluímos, reconhecendo a importância da atividade, da sua caraterização e dos seus desafios futuros.
Throughout this master thesis we intend to analyse and discuss the role of the Physician in the pharmaceutical industry, contributing to a better framework of a not widely known activity. From the analysis of Pharmaceutical Industry implementation in Portugal, we describe their contribution to Society, together with the value of the drug. We describe the Pharmaceutical Medicine, the training activity and some of the relevant bodies in this area, such as the Competence in Pharmaceutical Medicine from the Portuguese Medical Association and the Association of Portuguese Physicians from Pharmaceutical Industry. We did a detailed characterization of the competencies and responsibilities of the Physician at this industry that was reinforced with an analysis of a questionnaire carried out with the views of Portuguese and foreign colleagues with experience in this area of knowledge. We conclude, recognizing the importance of the activity, its characteristics and its future challenges.
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Bellan, Natália. "Diretrizes regulatórias aplicáveis à cadeia dos produtos para saúde." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/9/9139/tde-20062016-153219/.
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A ciência e a tecnologia cada vez mais vêm proporcionando avanços em produtos inovadores. Particularmente na área da saúde nota-se eminente sinergismo entre os materiais utilizados, suas propriedades de biocompatibilidade, biofuncionalidade, processabilidade, esterilidade e a área de aplicabilidade no organismo humano. O setor farmacêutico por apresentar grande complexidade exige conhecimentos multidisciplinares, atualizados e em conformidade às tendências internacionais. A Agência Nacional de Vigilância Sanitária (ANVISA) tem sob sua responsabilidade extensa diversidade de bens, serviços e produtos, dentre eles estão os correlatos, que também compreende os produtos para saúde. Os produtos para saúde são classificados conforme o seu risco, no Brasil podendo apresentar até quatro classes, sendo as classes III e IV as que caracterizam maior risco. Para alguns produtos, devido seu risco sanitário, é compulsório a Certificação de Conformidade pelo Instituto Nacional de Metrologia, Qualidade e Tecnologia (INMETRO) previamente a concessão de seu registro sanitário pela ANVISA. Dentre as normas técnicas aplicáveis pelo INMETRO estão as normas da Associação Brasileira de Normas Técnicas (ABNT) e na sua ausência, as normas da International Organization for Standardization (ISO). Outros requisitos técnicos e regulatórios devem ser contemplados com o propósito de comprovação da segurança e eficácia dos produtos. Entretanto, as regulamentações sanitárias inerentes a essa categoria de produtos ainda se encontram incipientes no país. A desenvoltura do setor produtivo nesse segmento pode ser evidenciada pelo aumento de novas solicitações na ANVISA e de seu crescimento na balança comercial. No entanto, observa-se pouco estudo e entendimento do setor regulado e regulador referente à relação mútua entre ANVISA, INMETRO e ABNT e quanto à regulação sanitária aplicável para obtenção da anuência do produto ao consumo. Na conjuntura das demandas apontadas o objetivo deste estudo foi avaliar o processo regulatório aplicável à cadeia produtiva dos produtos para saúde com a finalidade de compreender a relação entre ANVISA, INMETRO e ABNT na garantia da qualidade, segurança e eficácia dos produtos. A metodologia aplicada neste trabalho foi à pesquisa qualitativa. Com o auxílio da pesquisa documental constatou-se que o processo regulatório brasileiro é complexo, específico e robusto e apresenta estrutura e exigências semelhantes dos Estados Unidos e União Europeia. A fiscalização pós-uso é uma tendência internacional e a ANVISA vem adotando com frequência com intuito de acompanhar a qualidade dos produtos comercializados. As três instituições apresentam competências definidas e regulamentadas, bem como mecanismos de inter-relação por meio de conselhos consultivos. O estudo de caso caracterizou que o perfil dos profissionais do setor regulado apresenta em grande percentual formação na área da saúde e nível de pós-graduação, porém o nível de conhecimento dos principais conceitos relativos aos produtos para saúde é parcial, reforçando a necessidade de incentivos de capacitação de recursos humanos em regulação em saúde.The science and technology increasingly been providing advancements in innovative products. Particularly in the health score is eminent synergism between the materials used, their properties of biocompatibility, biofunctionality, processability, sterility and applicability area of the human body. The pharmaceutical sector to present great complexity requires multidisciplinary knowledge, up to date and in line with international trends. The National Health Surveillance Agency (ANVISA) has under its responsibility extensive range of goods, services and products, among them are correlates, which also includes medical devices. Medical devices are classified according to their risk in Brazil may present up to four classes, and classes III and IV which characterize the greatest risk. For some products, because of their health risk, it is compulsory Compliance Certification by the National Institute of Metrology, Quality and Technology (INMETRO) prior to granting its sanitary registry by ANVISA. From among the technical standards the INMETRO are the standards of the Brazilian Association of Technical Standards (ABNT) and in his absence, the standards of the International Organization for Standardization (ISO).Other technical and regulatory requirements must be included for the purpose of proving the safety and efficacy of products. However, the sanitary regulations inherent in this product category is still incipient in the country. The resourcefulness of the productive sector in this segment can be evidenced by the increase in new requests in ANVISA and its growth in the trade balance. However, there is little study and understanding of the regulated and regulatory sector concerning the mutual relationship between ANVISA, INMETRO and ABNT and on the sanitary regulation applicable to obtaining the approval of the product for consumption. In the context of the demands indicated the objective of this study was to evaluate the regulatory procedure applicable to the production chain of medical devices in order to understand the relationship between ANVISA, INMETRO and ABNT in ensuring quality, safety and efficacy of products. The methodology used in this study was the qualitative research. With the assistance of documentary research it was found that the Brazilian regulatory process is complex, specific and robust and has similar structure and requirements of the United States and European Union. The postmarketing monitoring is an international trend and ANVISA has adopted often aiming to monitor the quality of marketed products. The three institutions have defined and regulated competences and interrelation through advisory boards mechanisms. The case study characterized the profile of professionals in the regulated sector has a large percentage of training in health and post-graduate level, but the level of knowledge of the main concepts related to medical devices is partial, reinforcing the need for incentives training of human resources in health regulation.
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Fagelson, Marc A., and Richard H. Wilson. "Integrating University and VAMC Resources: Development of an AuD Program." Digital Commons @ East Tennessee State University, 2004. https://dc.etsu.edu/etsu-works/1613.
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Zhang, Lei. "Uncompensated Care Provision and the Economic Behavior of Hospitals: the Influence of the Regulatory Environment." Diss., unrestricted, 2008. http://etd.gsu.edu/theses/available/etd-02242009-152847/.
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Thesis (Ph. D.)--Georgia State University, 2008.Title from file title page. Paul G. Farnham, committee chair; Patricia G. Ketsche , Douglas S. Noonan (Ga. Tech.), Shiferaw Gurmu, Karen J. Minyard, William S. Custer, committee members. Description based on contents viewed June 11, 2009. Includes bibliographical references (p. 146-153).
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Muñoz, Susana Inés Segura. ""Impacto ambiental na área do aterro sanitário e incinerador de resíduos sólidos de Ribeirão Preto, SP: avaliação dos níveis de metais pesados"." Universidade de São Paulo, 2002. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-25072003-084308/.
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Os resíduos sólidos podem conter substâncias químicas com características tóxicas, dentre elas os metais pesados presentes em diversos materiais provenientes de indústrias, funilarias, atividades agrícolas, laboratórios, hospitais e residências. A contaminação por metais pesados apresenta um amplo espectro de toxicidade que inclui efeitos neurotóxicos, hepatotóxicos, nefrotóxicos, teratogênicos, carcinogênicos ou mutagênicos. Em Ribeirão Preto SP há em funcionamento desde 1989, um aterro sanitário (AS) para resíduos domiciliares e um incinerador de resíduos de serviços de saúde (IRSS). Este estudo teve como objetivo fazer um diagnóstico dos níveis de metais pesados na área do AS e IRSS de Ribeirão Preto, entre 2000 e 2001. Foram realizadas análises de amostras de solo, água, chorume e vegetais, em pontos previamente demarcados na área, tendo sido avaliada a presença de mercúrio (Hg), cobre (Cu), chumbo (Pb), cádmio (Cd), manganês (Mn), zinco (Zn) e cromo (Cr) por Espectrofotometria de Absorção Atômica. Visando a obtenção de parâmetros locais, foram também analisadas amostras coletadas na Estação Ecológica na mata Santa Teresa, zona de preservação permanente do município, para comparação de valores. Pela análise dos resultados verificou-se, de um modo geral, que os níveis de metais pesados presentes nas amostras de solo e vegetais na área apresentaram concentrações significativamente superiores às detectadas nas amostras coletadas na mata Santa Teresa, evidenciando-se uma tendência de maiores concentrações no sentido Norte, fato que pode estar associado com a declividade geográfica da área, com a direção dos ventos e com a localização do incinerador. Destacam-se neste estudo os níveis de Cd, Mn e Cu presentes em amostras de solo em níveis que superaram os valores máximos estabelecidos para solos de uso agrícola no Estado de São Paulo pela CETESB, órgão estadual ambiental. O chorume também apresentou níveis de Cd, Pb, Mn, Cu em concentrações superiores às normatizadas para efluentes líquidos, segundo o Decreto 8486/76 do estado de São Paulo. A água subterrânea da área estudada não apresentou níveis de metais acima dos valores máximos permitidos, de acordo com a Portaria 1469/2000 do Ministério da Saúde. Considerando a carência de pesquisas dessa natureza no Brasil, este estudo tem gerado informações que podem constituir-se em ferramenta para a tomada de decisões político-administrativas pelas autoridades responsáveis pelo gerenciamento de resíduos sólidos, não apenas do Município de Ribeirão Preto e região, mas, também, podendo servir de parâmetro para realidades similares no país.Solid waste may content toxic chemical substances such as heavy metals that are present in materials generated by industries, agricultural activities, laboratories, hospitals and houses. The contamination with heavy metals has a wide spectrum of toxicity that includes neurotoxic, hepatotoxic, nephrotoxic, teratogenic, carcinogenic or mutagenic effects. Since 1989, a municipal landfill site (MLS) for urban waste disposal has been in operation in Ribeirao Preto (Sao Paulo, Brazil) integrated with a medical waste incinerator plant (MWIP). This study aimed to do a diagnostic of the heavy metal levels in MLS and MWIP area, in 2000 and 2001. The total cadmiun (Cd), chromium (Cr), lead (Pb), manganese (Mn), zinc (Zn), cooper (Cu) and mercury (Hg) levels were analysed by Atomic Absortion Spectrophotometry in soil, water, percolated liquid and vegetables, in previously delimitated points. Samples from Santa Teresa Forest Ecological Station of Ribeirao Preto were collected as control samples. The results showed that, in general terms, the heavy metals detected in soil and vegetal samples in that area showed significant higher concentrations when compared with Santa Teresa Forest samples. The highest concentrations were detected to the North direction, these results can be associated with the topographic gradient in the area, the prevailing winds and the Incinerator localization. Special atention should be given to Cd, Mn and Cu levels detected in soil samples, that showed higher concentrations that those recomended for agricultural soil in Sao Paulo State by the Environmental Sanitation Company (CETESB). The percolated liquid also showed Cd, Pb, Mn and Cu levels higher than the maximum recomended levels according to the Sao Paulo State Law (Decreto 8486/76). The water samples showed levels according to the Brasilian Health Ministry Law (Portaria 1469/2000). Taking into account that few researches had been developed on this thematic in Brasil, the obtained results constituted an instrument for the decision makers and public managers, not only for Ribeirao Preto and region but for other cities around the country.
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Slade, Catherine Putnam. "Does Patient-Centered Care affect Racial Disparities in Health?" Digital Archive @ GSU, 2007. http://digitalarchive.gsu.edu/pmap_diss/24.
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This thesis presents a challenge to policy initiatives that presume that patient-centered care will reduce racial disparities in health. Data from the Medical Expenditure Panel Survey were used to test patient assessment of provider behavior defined as patient-centered care according to the National Health Disparities Report of the Agency for Healthcare Research and Quality of the Department of Health and Human Services. Results indicated patient-centered care improves self-rated health status, but blacks still report worse health status than whites experiencing comparable patient-centered care. Further, black-white differences in patient-centered care had no affect on health status. Rival theories of black-white differences in health, including social class and health literacy, provided better explanations of disparities than assessment of provider behaviors. These findings suggest that policies designed to financially incentivize patient-centered care practices by providers should be considered with caution. While patient-centered care is better quality care, financial incentives could have a negative effect on minority health if providers are deterred from practices that serve disproportionate numbers of poor and less literate patients and their families. Measurement of the concept of patient-centered care in future health disparities research was also discussed.
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Яременко, Людмила Миколаївна, Людмила Николаевна Яременко, Liudmyla Mykolaivna Yaremenko, and О. Федорченко. "Інтерпрофесійні культурно-мистецькі обшири лікаря Кесаря Білиловського." Thesis, Сумський державний університет, 2016. http://essuir.sumdu.edu.ua/handle/123456789/49494.
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У статті розглянуті деякі аспекти культурно-мистецької діяльності лікаря Кесаря Білиловського на рубежі ХІХ –ХХ ст., зокрема як видавця альманаху «Складка»; його медико-санітарні нариси у розвитку медичної допомоги на теренах Росії та України й пропаганді гігієни, здорового способу життя.In the article considered some aspects of cultural and artistic activities doctor’s Kesar Bilulovskiy at the turn of ХІХ –ХХ century, in particular, as the publisher of the almanac “Sckladka”; his medical and sanitary essays in the development of health care on the territory Russia and Ukraine and hygiene promotion, healthy lifestyles.
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Mota, Aline Veras Leite. "Análise do discurso da jurisprudência do STJ nas ações de indenização por erro médico: impacto no sistema de saúde." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/17/17157/tde-14102015-230345/.
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As organizações de saúde, instituições de ensino, pesquisadores e profissionais têm investido em mecanismos que visam aperfeiçoar a assistência integral à saúde ofertada aos pacientes. Todavia, a assistência pode estar sujeita a falhas que podem acarretar danos indesejados aos pacientes, familiares e profissionais, além de prejuízos ao sistema de saúde. Acionar o Poder Judiciário é um dos mecanismos adotados para reparar o dano causado. Nos últimos anos, no Brasil, especialmente a partir de 2003, observa-se um crescimento das demandas judiciais relacionadas aos serviços prestados pelos profissionais da saúde, reflexo das mudanças ocorridas na sociedade e da ampliação dos direitos sociais e fundamentais. Justifica-se, assim, um estudo retrospectivo de casos julgados, com análise da jurisprudência do Superior Tribunal de Justiça (STJ), no período de 2003 a 2013, acerca das ações judiciais movidas em face dos profissionais de saúde e instituições de saúde no âmbito público e privado. Realizada analise quantitativa e qualitativa do conteúdo dos discursos dos Ministros do STJ sobre o tema erro médico, aplicando o método do Discurso do Sujeito Coletivo (DSC). O estudo das decisões proferidas contribuiu para a compreensão dos assuntos que têm predomínio na jurisprudência do STJ sobre o erro médico. O trabalho identificou o sexo feminino como o mais vulnerável aos supostos erros médicos e as especialidades médicas diretamente relacionadas com a saúde feminina como a mais acionadas judicialmente. Ginecologia/Obstetrícia (27,08%), Ortopedia (12,5%) e Cirurgia Plástica (10,42%) foram, respectivamente, as especialidades mais demandadas. Em conclusão, o estudo traz subsídio para as organizações de saúde identificarem possíveis áreas estratégicas de atuação, no sentido de implementarem ações para reduzir a probabilidade de erros médicos, identificando mecanismos eficientes para o acompanhamento e a racionalização de possíveis falhas e para atuarem, preventivamente, nas práticas de gestão visando reduzir danos aos pacientes, diminuir custos decorrentes das indenizações, possibilitando, uma prestação de serviço de saúde de maior excelência, qualificado e seguro no sistema único e no sistema suplementar de saúde.Healthcare organizations, educational institutions, researchers and healthcare professionals have invested in mechanisms to improve the integral medical assistance offered to patients, but these assistance could have failures that may result in injury to patients, family members, and damage to system. One of the mechanisms to repair the damage is to claim to the Judiciary. In Brazil, especially since 2003, there has been an increase the lawsuit number related to medical malpractice, reflecting the changes in society and the expansion of social and fundamental rights. This is a retrospective study of judged cases by the Superior Court of Justice, in the period from 2003 to 2013, regarding the lawsuits against healthcare professionals and institutions in the public and private practice. Performed quantitative and qualitative analysis of the Superior Court of Justice Ministers speeches content, using the collective subject discourse method. Analyze of decisions contributed to understanding of the predominated issues in the malpractice lawsuit. The study identified the women as the most vulnerable to medical errors and medical specialties directly related to women\'s health as the most driven in court. Gynecology/Obstetrics (27.08%), Orthopedics (12.5%) and Plastic Surgery (10.42%) were, respectively, the most demanded specialties. In conclusion, the study provides subsidy for healthcare organizations identify potential areas of action to implement strategies to reduce the likelihood of injury to patients, decreasing costs and medical malpractice.
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Silva, Natércia Fonseca de Carvalho da. "FUZZYVISA: modelo de avaliação de risco da vigilância sanitária para inspeção de resíduos de serviços de saúde utilizando lógica Fuzzy." Universidade do Estado do Rio de Janeiro, 2010. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=1711.
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Este trabalho apresenta um modelo de inspeção sanitária, utilizando lógica fuzzy, sobre gerenciamento de resíduos de serviços de saúde, construído com as informações e experiência de especialista, baseadas nas inspeções de estabelecimentos assistenciais de saúde no Estado do Rio de Janeiro. A partir da estruturação de regras utilizadas na inspeção sanitária sobre Resíduos de Serviços de Saúde (RSS), e do regulamento técnico sobre gerenciamento de RSS, a RDC 306/04 da ANVISA, foi construído um modelo que simula a atuação de um agente especialista da vigilância sanitária, contemplando os elementos difusos que compõem os fatores analisados na inspeção sanitária. O objetivo deste trabalho é apresentar um instrumento, estruturado com base na prática da inspeção sanitária sobre gerenciamento de RSS, utilizando a lógica fuzzy, capaz otimizar a inspeção, gerar indicadores de controle sanitário que permitam monitorar a condição satisfatória do gerenciamento destes resíduos, dar aporte ao planejamento das ações de vigilância sanitária sobre os RSS e acima de tudo propor um instrumento que possa reverter-se em mecanismo eficiente de fiscalização sanitária. O modelo fuzzy foi desenvolvido com uso do software Matlab 2007b, sendo testado com dados de 10 relatórios de inspeções realizadas no período de maio a novembro de 2009.This study shows a health inspections model of waste management of health establishments in Rio de Janeiro state. The model was built by fuzzys logic and with experts information. It was based in ANVISA rules about waste management in health services: RSS, a RDC 306/04. It makes a simulation of an expert actuation with the diffuse elements of health inspection. The objective of this study is to show a health inspection management waste practice structured instrument, using fuzzys logic, able to optimize the inspection, produce indicators of health control to monitor the satisfactory condition of healh services waste management and guide the planning actions. The fuzzy model was developed with Matlab software and tasted with 10 inspection reports dated of 2009, between may and november.
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Lécu, Anne. "L'épreuve : La « prison-pharmakon » : remède et poison." Thesis, Paris Est, 2010. http://www.theses.fr/2010PEST2014.
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Ce qui arrive à l’homme du XXIe siècle en prison est en partie analogue à ce qui arrive àl’homme tout court. Nous avons perdu l’innocence (seuls les enfants ne l’ont pas encore perdue), ettentons de la récupérer en nous revendiquant victimes. Présumés coupables, isolés, observés, voilà ceque nous sommes devenus. L’homo carceralus est une sorte de type qui hante notre cultureoccidentale. Fruit du nihilisme et de la gnose. C’est pourquoi il est pertinent de chercher à penser sonépreuve, non de l’extérieur, mais comme ce qui peut nous arriver à chacun, et d’en repérer ce quil’empoisonne ou ce qui la libère. Car la gnose, qui est peut-être sophisme ou nihilisme, est menteuselorsqu’elle fait croire que l’on sort de l’épreuve par “en haut”, par la fuite hors des conditions de viehumaines, dans le scientisme naturaliste, le savoir statistique ou la technique. La résignation et la fuiteen avant ont le même visage, celui de la fatalité : ni l’une et ni l’autre n’aiment ce monde, ni ce temps.Or, ce n’est pas ailleurs que du sens peut advenir. Si la prison est un pharmakon, remède etpoison, c’est qu’elle reste une institution humaine. La grandeur de l’homme est d’être puissance descontraires, capacité de surmonter tout déterminisme, capacité de ne pas se résigner à la fatalité, aucoeur même de sa misère. Encore faut-il ne pas être abandonné seul dans l’épreuve, tant il est vrai quec’est l’autre, et particulièrement l’autre ébranlé, grâce à qui la traversée est possible, par “en bas”. Lesoin en prison s’enracine dans cette « solidarité des ébranlés ». Pour naviguer entre les différentsdispositifs pénitentiaires et sanitaires qui visent à contrôler et à prévoir le comportement des captifs, lemédecin doit faire preuve de mêtis, cette intelligence des interstices, au service de son patient. Et enmême temps, il doit garder de façon catégorique le secret médical, au nom de ce que l’homme restetoujours opaque à toutes les sciences et les techniques, plus grand que lui-même, en sa fragilité. Cesavoir « de nuit » n’est autre que le savoir socratique : « je sais que je ne sais pas »That which is happening to XXIst century man in prison is, in part, similar to what ishappening to all of us. Our innocence lost, (innocence is retained only by the child), we try to regain itby claiming to be the victim. We are presumed guilty, isolated, observed. Homo carceralus hauntsour Western culture; fruit of nihilism and gnosis. It is the reason we should reflect on his ordeal, notfrom the outside, but as something that could happen to each and every one of us, and in which todiscover where the poison lies and what the remedy could be. For gnosis, (either sophism ornihilism), is false when we are led to believe that we exit an ordeal by escaping our human conditionin the ‘upward’ direction of the natural sciences, statistical knowledge or technique. Resignation andheadlong pursuit share a characteristic, that of a predestined tendency towards disaster. Neither theone nor the other sits comfortably in this world or our times.But meaning does not have to come from elsewhere. If prison is pharmakon, both remedy andpoison, it is because it is a human institution. Man’s greatness is his conflicting authority : having thecapacity to overcome determinism, the ability not to resign himself to his fate, even at his lowestpoint. But it is imperative not to be left alone through this ordeal, for it is true that it is the other,particularly the ‘weakened other’, thanks to whom the crossing is possible from ‘below’. Care inprison is rooted in this ‘solidarity of the weak’. To navigate the different penitentiary and healthsystems, which seek to control and foresee the captives’ behaviour, the medical doctor must exertmêtis, become complicit with the patient in order to serve the patient. And at the same timecategorical medical confidentiality must be maintained, in the name of which the patient in his or herfragility, remains invisible to all sciences and techniques which are yet greater than he or she is. This‘secret’ knowledge is none other than Socratic knowledge: ‘I know that I do not know’
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Daimaru, Ken. "Préserver la santé des armées dans le Japon moderne : la médecine militaire face à la guerre russo-japonaise." Thesis, Paris 10, 2017. http://www.theses.fr/2017PA100168.
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Cette thèse consiste à interroger les expériences de la guerre russo-japonaise (1904-1905), en rapprochant deux objets historiques : l'histoire de la guerre et l'histoire de la médecine. Son objectif est de documenter et d’analyser l'organisation du Service de santé de l’armée impériale japonaise et les pratiques médicales qui en déroulent au tournant du vingtième siècle. En examinant la professionalisation de la médecine militaire pendant l’ère Meiji (1868–1912) et son implication pendant le conflit de 1904-1905, il est question de comprendre la production culturelle des discours, des objets et des images liées aux maladies et aux blessures de guerre. Cette analyse repose sur les regards croisés des différents acteurs (Japonais et observateurs internationaux) sur le corps blessé et malade, que les atteintes soient physiques ou psychiques. Les résultats montrent comment le bouleversement sur le champ de bataille, induit par l’augmentation de la puissance de feu et la réorganisation tactique et stratégique suscitée par cette dernière, est aussi le pendant d’une médicalisation des activités combattantes, de la recherche militaire et de la production d’expertises. Le paradigme du « combat asceptique » et le succès de la lutte contre les maladies servent à légitimer le rôle de la médecine dans les armées. Par ailleurs, la transformation des formes de violence de guerre accentue aussi la fragilité des médecins sur le champ de bataille, où les effets de l’industrialisation progressent. À l’épreuve de la professionnalisation, de la spécialisation et des pratiques individuelles, cette thèse discute les apports et les limites des stratégies adoptées par les médecins japonais pour préserver la santé des armées face à la violence de la guerre industrielleThis thesis analyses the experiences of the Russo-Japanese War (1904-1905), bringing together two historical objects of inquiry: the history of warfare and the history of medicine. Its purpose is to document and understand the organization of the Imperial Japanese Army Sanitary Corps and the medical practices that unfolded within it at the turn of the twentieth century. Focusing on the creation and the institutionalization of the care of the war wounded and sick during the Meiji era (1868-1912) and its implications for the conflict of 1904-1905, this thesis highlights the institutional and social dynamics of military medicine and the cultural production of discourses, objects and images related to war diseases and wounds. Our theoretical framework articulates the entanglement of the various actors’ perceptions (Japanese doctors and international observers) on the wounded and/or diseased body. Our results show how the transformation of the battlefield, induced by increased firepower and the resulting tactical and strategic reorganization, was also a driving force for the medicalization of combat activities, military research and the production of expertise. These processes reshaped the paradigms of combat aimed at maintaining the competitiveness of the military, that the success of preventive medicine serves to legitimize. They also accentuate the fragility of the army and the structure of medicine on the battlefield, which were under increasing stress due to the rapid progress of industrialization. The professional specialization and individual practices observed during the war lead us to discuss the benefits and limits of the strategies adopted by Japanese military surgeons to resist the increasingly destructive realities of industrial warfare
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Vaněk, Ondřej. "Zdravotně technické a plynovodní instalace v obytné budově." Master's thesis, Vysoké učení technické v Brně. Fakulta stavební, 2016. http://www.nusl.cz/ntk/nusl-240328.
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The thesis deals with sanitary engineering and gas installation in an apartment building with a healthcare facility. The theoretical part is focused on the installation systems, which are addressed to the suitability of the system in the given project, and the advantages and disadvantages of these systems. Computational and project part addresses the sewer, water mains and gas in the specified object. Designed building is without a basement and eight storeys. On the first floor is located technical facilities around the building and three residential units. All other floors are located on each floor of four residential units. This thesis is done on the basis of current Czech and European regulations.
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Mauck, Erin. "A Qualitative Analysis of End-of-Life Healthcare in Tennessee: Politics, Principles, and Perceptions." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etd/3846.
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The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.
For this study, data were collected using semi-structured, in-depth interviews with an open interview guide. These interviews were conducted in a two-tiered format. Tier 1 included ten leading experts in various areas of end-of-life healthcare and aging in Tennessee. Tier 2 included nine legislators who were members of the health committees of either the Tennessee House of Representatives or the Tennessee Senate. Qualitative data were organized into numerous categories, and an initial phase of open coding was completed. From this phase of coding, emergent themes and focuses were discovered. This was followed by focused coding on all nineteen interviews using coding software to organize subtleties.
Findings of the Tier 1 interviews indicated that there are many areas of end-of-life healthcare that need improvement including increased funding, expanded caregiver support, improved doctor-patient communication, and increased use of advance directives. Emergent themes included the influence of money, having difficult conversations, the stigma of death and dying, and supporting the caregiver. Tier 2 findings highlighted the motivations behind voting decisions and the level of awareness legislators have in areas of end-of-life healthcare policy. Both tiers also explored the support and opposition of physician-assisted death.
The findings of this dissertation are intended to inform health professionals and state legislators. The data gathered through this exploratory research and the knowledge gained will lead to a greater understanding of end-of-life healthcare in Tennessee, and what needs to be done to improve its quality. This will allow individuals and families faced with end-of-life decisions to navigate the process with expanded options, access, and support.
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Ott, Kenneth Brad. "The Closure of New Orleans' Charity Hospital After Hurricane Katrina: A Case of Disaster Capitalism." ScholarWorks@UNO, 2012. http://scholarworks.uno.edu/td/1472.
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Abstract
Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, took advantage of the mass internal displacement of New Orleans’ populace in the aftermath of Hurricane Katrina in an attempt to abandon Charity Hospital’s iconic but neglected facility and to supplant its original safety net mission serving the poor and uninsured for its neoliberal transformation to favor LSU’s academic medical enterprise.
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Hadačová, Jana. "Zdravotně technické a plynovodní instalace v bytovém domě se zdravotnickým zařízením." Master's thesis, Vysoké učení technické v Brně. Fakulta stavební, 2015. http://www.nusl.cz/ntk/nusl-227759.
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This diploma thesis deals with health-technical and gas piping in the asylum building. The topic Rain Water Handling is the theoretical part where the usage of water is discussed according to the legal regulations and its functionality. The computational and project part deals with sewerage, water and gas distribution system in this two floors non-cellar asylum building. This bachelor thesis is written according to Czech and European regulations
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Бідюкова, М. С. "Правове регулювання матеріального забезпечення працівників ОВС." Thesis, Харківський національний університет внутрішніх справ, 2008. http://essuir.sumdu.edu.ua/handle/123456789/51722.
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У роботі з’ясовується сутність матеріального забезпечення працівників ОВС, визначається його поняття. Розглянуто принципи матеріального забезпечення працівників ОВС. Проаналізовано сучасний стан правового регулювання матеріального забезпечення працівників ОВС. З’ясовано сутність та особливості окремих видів матеріального забезпечення працівників ОВС, зокрема грошового забезпечення, пільг та компенсацій, державного обов’язкового особистого страхування, житлового забезпечення, медичного та санаторно-курортного забезпечення, пенсійного забезпечення працівників ОВС. Подано конкретні пропозиції та рекомендації щодо удосконалення матеріального забезпечення працівників ОВС України.Essence of legal relation of policemen’s salary maintenance is elucidated in this research work; its notion is determined. Principles of policemen’s salary maintenance are viewed. Modern state of legal regulation of policemen’s salary maintenance is analyzed. Essence and peculiarities of separate kinds of policemen’s salary maintenance such as payment, privileges and compensations, state obligatory personal insurance, housing guaranteeing, medical and health resort guaranteeing, pension guaranteeing are elucidated. Concrete propositions and recommendations as for improving policemen’s salary maintenance are presented.
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Lucas, D. Pulane. "Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital." VCU Scholars Compass, 2013. http://scholarscompass.vcu.edu/etd/2996.
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Advances in medical technology have altered the need for certain types of surgery to be performed in traditional inpatient hospital settings. Less invasive surgical procedures allow a growing number of medical treatments to take place on an outpatient basis. Hospitals face growing competition from ambulatory surgery centers (ASCs). The competitive threats posed by ASCs are important, given that inpatient surgery has been the cornerstone of hospital services for over a century. Additional research is needed to understand how surgical volume shifts between and within acute care general hospitals (ACGHs) and ASCs. This study investigates how medical technology within the hospital industry is changing medical services delivery. The main purposes of this study are to (1) test Clayton M. Christensen’s theory of disruptive innovation in health care, and (2) examine the effects of disruptive innovation on appendectomy, cholecystectomy, and bariatric surgery (ACBS) utilization. Disruptive innovation theory contends that advanced technology combined with innovative business models—located outside of traditional product markets or delivery systems—will produce simplified, quality products and services at lower costs with broader accessibility. Consequently, new markets will emerge, and conventional industry leaders will experience a loss of market share to “non-traditional” new entrants into the marketplace. The underlying assumption of this work is that ASCs (innovative business models) have adopted laparoscopy (innovative technology) and their unification has initiated disruptive innovation within the hospital industry. The disruptive effects have spawned shifts in surgical volumes from open to laparoscopic procedures, from inpatient to ambulatory settings, and from hospitals to ASCs. The research hypothesizes that: (1) there will be larger increases in the percentage of laparoscopic ACBS performed than open ACBS procedures; (2) ambulatory ACBS will experience larger percent increases than inpatient ACBS procedures; and (3) ASCs will experience larger percent increases than ACGHs. The study tracks the utilization of open, laparoscopic, inpatient and ambulatory ACBS. The research questions that guide the inquiry are: 1. How has ACBS utilization changed over this time? 2. Do ACGHs and ASCs differ in the utilization of ACBS? 3. How do states differ in the utilization of ACBS? 4. Do study findings support disruptive innovation theory in the hospital industry? The quantitative study employs a panel design using hospital discharge data from 2004 and 2009. The unit of analysis is the facility. The sampling frame is comprised of ACGHs and ASCs in Florida and Wisconsin. The study employs exploratory and confirmatory data analysis. This work finds that disruptive innovation theory is an effective model for assessing the hospital industry. The model provides a useful framework for analyzing the interplay between ACGHs and ASCs. While study findings did not support the stated hypotheses, the impact of government interventions into the competitive marketplace supports the claims of disruptive innovation theory. Regulations that intervened in the hospital industry facilitated interactions between ASCs and ACGHs, reducing the number of ASCs performing ACBS and altering the trajectory of ACBS volume by shifting surgeries from ASCs to ACGHs.
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Yeh, Ching-Chung, and 葉慶仲. "AN OPTIMIZATION MODEL FOR MANPOWER ASSIGNMENT TO OFFICIAL AUDITING IN SANITARY AFFAIRS." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/4f36hp.
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碩士國立中央大學
土木工程學系碩士在職專班
96
The economy of our country grows vigorously in recent year. It makes the national income raised and the life style of society’s living changed. The concession related to sanitation is increasing constantly. The sanitary issue that people forgather in concession has an increasing drift. In order to insure the health of nationals, the officials have to enhance the auditing activities of various kinds of hygienic condition of concession. The arrangement of auditing manpower which was not an optimistic arrangement was usually made artificially in the pastime. The front office usually takes much time to deal with in the past as well. The most important issue that front office concerns is to keep the manpower arrangement optimistic and fair. We develop an optimistic manpower assignment’s model with the aid of computer programming to resolve the minimum working days of auditor and the combination of manpower assignment according to the study focusing on the sanitary auditing activities for the Sanitation Office. The susceptibility of the parameters act on the minimum working days help us to realize that the minimum working days change by the parameters have been setted in this model. After case studying, we find that the manpower assignment model is superior to artificial method. The results reveal that the optimistic model looks after benefit and fairness of manpower assignment. It can be the manpower assignment’s reference of officials in practice.
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Hou, Ming-chien, and 侯名謙. "The Study of Applying Radio Frequency Identification to Medical Affairs." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/93368594125302175270.
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碩士義守大學
資訊管理學系碩士班
93
Radio Frequency Identification (RFID) has become very suitable for medical affairs because of its low-power transmitting frequency and wireless tracking characteristic. It has currently been used in many medicine centers for tracking highly contagious patients. For addressing the issues of accurately tracking patients’ locations, reducing the communication cost of existing RFID systems, and occupying less database space, this research refers to the architecture of the current mobile communication system and proposes a hierarchical RFID architecture, different from the current one. The proposed architecture can locate patients’ current positions more accurately and reduce locating delay greatly. Based on patients’ moving regularity under a medical environment, this research will also modify the original concurrent search algorithm in mobile communication to efficiently find RFID tags on the proposed hierarchical RFID architecture. At last, a program for collecting patients’ actual moving positions and frequencies will be designed to validate the performance of the modified concurrent search algorithm in locating patients’ positions. In summary, this research hopes to help understand the contribution of RFID to the medicine field by planning and implementing an RFID system.