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Strecker, Elena K. "Preservice Intervention Specialist and School Psychologist Attitudes Towards Inclusion." Miami University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=miami1563813298080121.
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Robinson, Samantha Charlotte Rose. "The effects of a specialist reading intervention on children's literacy and behaviour." Thesis, University of Canterbury. School of Health Sciences, 2014. http://hdl.handle.net/10092/9886.
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Early reading skills are the foundation of children’s academic success (Lonigan et al., 1999). Unfortunately reading difficulties are highly prevalent in school children (National Center for Education Statistics, 2007) and can have significant and long-lasting negative impacts on academic, social, and vocational achievement (Sylva & Hurry, 1996). A link between difficulties in reading and behaviour problems has also been widely noted in the literature. Few studies have, however, examined the impact of reading interventions on both reading and behaviour skills for children, particularly for children with mild to moderate behavioural issues. This is an important area of research in determining the effects of literacy intervention, and disentangling the complex relationship between reading and behavioural difficulties. Accordingly, the current study aimed to monitor the effectiveness of a specialist reading intervention on children's literacy skills and behaviour.
The research employed a multiple case study design, and was separated into three phases (a pre-testing phase, intervention phase, and post-test phase). Participants consisted of 11 students from two Christchurch Primary schools who had difficulties in reading, as well as five teachers, two literacy teachers, and one teacher aide. Four participants, who exhibited more severe behaviour (as identified by their teacher on the Strengths and Difficulties Questionnaire) at pre-test, were selected as case study participants. Case study participants’ literacy teachers provided additional information regarding the students’ behaviour. All participants completed pre- and post-literacy (reading and spelling) and phonological awareness assessments and students were observed in the classroom setting. Teachers also completed surveys in regards to the students’ classroom behaviour over the course of the intervention.
The Agility with Sound intervention primarily targets phonological awareness and application of phonological decoding strategies in reading. The intervention also focuses on vocabulary development and reading comprehension. At School 1, participants attended four, 1 hour sessions each week as a small-group. At School 2, participants attended three sessions each week for 30 minutes. Differences in intervention scheduling and content across the two schools restricted the research design that could be employed to establish the effects of the specialist teaching.
Results showed that the majority of participants showed an increase in raw score for the Letter-word Identification (n=11), Word Attack (n=7), and Helen Arkell Spelling Test (n=9), indicating that the research intervention had a significant, positive impact on children’s word identification, decoding, and spelling skills. No significant differences were found between pre- and post-test measures of behaviour, however, qualitative data from teachers indicated that for four participants, some change in classroom behaviour was evident following intervention.
Findings from case study students indicated that Participant 9 who had the most reported difficulties during literacy sessions (as reported by her literacy teacher), demonstrated the least progress in literacy; demonstrating decreases in spelling and reading raw scores following the intervention period. The remaining case study participants all demonstrated increases in reading, spelling, and phonological awareness (with the exception of Participant 3 who showed no change in phonological awareness). All participants (with the exception of Participant 11 whose teacher-report of classroom behaviour remained the same from pre- to post-test) also demonstrated decreased raw scores in observation of problem classroom behaviours and teacher-reports of problem classroom behaviours over the course of the intervention period. A correlation analysis did not show a significant association between change in literacy and change in classroom behaviour following the intervention period.
The current research supports the use of Agility with Sound for enhancing school children’s literacy skills, and highlights the importance of combining literacy and behavioural intervention to enhance both literacy and classroom behaviour skills for children with co-morbid difficulties.
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Swain, Elizabeth. "Heart failure patients' illness representations and attitudes towards medication in a specialist nursing intervention." Thesis, University of Leicester, 2004. http://hdl.handle.net/2381/31197.
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Objectives: To examine the impact of a specialist nursing intervention upon the illness representations, self-reported medication adherence, attitudes towards medication and psychological morbidity of heart failure patients. Design: A longitudinal study following a cohort of community based participants who had been previously hospitalised with heart failure over a three month time interval. Method: A total of 28 heart failure patients participated in the study. Participants completed a demographic questionnaire, the Illness Perception Questionnaire (IPQ), the Medication Adherence Report Scale (MARS), the Beliefs About Medicines Questionnaire-General Version (BMQ-G), the Beliefs About Medicines Questionnaire-Specific Version (BMQ-S), the Hospital Anxiety and Depression Scale (HADS) and the Significant Others Scale-Form B (SOS-B) at two interviews. Comparisons of data within the group at the two time points were undertaken. Results: Analysis revealed no statistically significant differences within the group from time one to time two of the nursing intervention in illness representation, self reported medication adherence, attitudes towards medication or physiological morbidity. The exception to this was a significant difference on the BMQ-S subscale, necessity. Between time one and time two participants' beliefs in the necessity of their medication had significantly reduced. Conclusions: Whilst specialist nursing interventions have significantly reduced hospital readmissions, no significant psychological impact of this programme was detected. The potential reasons for the lack of significant results as well as the clinical implications of the findings are explored. The value of routine assessment of psychological morbidity in this population is discussed.
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Carrig, Carol A. "An Intervention Specialist's Journey Through the Zone of Proximal Development." Kent State University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=kent1460491585.
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Davies, Laurie Nicole. "An evaluation of the use of a DIR/Floortime intervention model in a specialist school setting." Thesis, Cardiff University, 2016. http://orca.cf.ac.uk/95849/.
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This study aimed to evaluate the use of the DIR/Floortime intervention in a specialist school setting. The participants were 8 primary school children, aged 3-8 years old and 16 teaching and support staff trained in DIR/Floortime. The study adopted a mixed methods design. Quantitative measures included the Functional, Emotional Assessment Scale (FEAS) (Greenspan et al., .2001), and a measure of ‘Teacher Competency’ designed by the author of this study. Qualitative data was collected via a focus group and analysed via Thematic Analysis. Findings demonstrated significant gains in social and emotional functional behaviours for children with ASD within a specialist school setting. No significant relationship was found between teacher competency in delivering the intervention and children’s gains in social and emotional functioning. Teacher /support staff views on delivering the DIR/Floortime intervention are discussed.
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Mayers, Steven Thomas. "Introducing an evidence based intervention : exploring the experience of collaboration between front-line and specialist practitioners : a thematic analysis." Thesis, University of Leeds, 2016. http://etheses.whiterose.ac.uk/13873/.
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Introduction: The impact of abuse and neglect on a child, their family and the associated societal costs are well documented. Despite this, there are a limited number of evidence based interventions (EBIs) that are available for families when abuse and neglect is identified and little available guidance for how EBIs should be introduced into existing services. This often results in a gap between the research evidence and clinical practice. Literature focusing on introducing EBIs into existing services identifies collaboration between professionals as a key part of this process. The current research aimed to understand the factors that help and hinder the process of collaboration when an EBI was introduced into an existing service, so that these findings might be applied to other intervention and contexts. Method: This process of collaboration was explored with front-line and specialist practitioners, when an EBI for child abuse and neglect: Multi-Systemic Therapy for Child Abuse and Neglect (MST-CAN), was introduced into Leeds Children’s Social Work Services. Eleven semi-structured interviews were carried out with participants from the social work (n = 6) and MST-CAN team (n = 5). The qualitative data was analysed using thematic analysis. Results: Three key themes emerged from the analysis that described the process of collaboration: ‘adapting the intervention to the local context’, ‘committing to the intervention’ and ‘working together to deliver the intervention’. MST-CAN had to be adapted to fit the local context and practitioners had to commit to the intervention before they could begin working together to deliver it. There were ten sub subthemes from the analysis that related to factors that helped and hindered collaboration between professionals. Discussion: The findings of the current research mirrored some of those from previous research and presented new findings in relation to factors that help and hinder collaboration in the context of children’s social care. The results are considered in relation to models of collaboration, implications for clinical work and future research.
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Reynolds, Carly Louise. "An ethnographic study seeking to understand the experiences of students learning ACT-based mindfulness in a small group intervention within a specialist setting." Thesis, University of Bristol, 2017. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.738257.
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Guzman, Janisse. "Adolescent mothers in an intervention study a qualitative analysis of variables relating to their teaching interactions with their infants." Honors in the Major Thesis, University of Central Florida, 2012. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/562.
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The intent of this thesis was to study, in depth, the experiences of four adolescent mothers who underwent a home intervention program. I studied two mothers who did well with teaching their 12-month old children during play, and two mothers who did not do as well. All four mothers received weekly intervention from the time of their child's birth through 12-months of age. I studied the following variables: 1) how much time the home visitors spent on selected child development and parenting topics; 2) the mother's perceived social support; 3) how many community resources the mother used; and 4) if the infant was healthy and within normal developmental range. All of the mothers struggled in their lives, yet varied in the quality and time of most of the variables. It was striking how different each one was from the other. The implications of the study are important for child development specialists who can use the qualitative data within this document to better understand first time adolescent mothers in order to improve the outcomes of the home visitation services that they provide to mothers and infants. After spending time studying these four adolescent mothers, I would recommend that adolescent women not get pregnant. Adolescence is a time that is meant for experiences and self-discovery and should be spent free from a dependent child who critically needs them. Future research and funding should be spent on preventing adolescent pregnancy and ensuring that flexible curriculum be utilized by the home visitors in order to meet the varying needs of adolescent mothers.<br>B.S.<br>Bachelors<br>Education and Human Performance<br>Early Childhood Development
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Guarracino, Sophia Elizabeth. "Students with Learning Disabilities and Attention Deficit Hyperactivity Disorder and Those Who Teach Them: Building Positive Relationships to Increase Academic Success." Bowling Green State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1273496818.
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Lipp, Jamie R. "The Multi-Faceted Role of Ohio's Elementary Reading Specialists: Instruction, Assessment, Leadership and Beyond." Ohio University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou151058921703077.
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Cruickshank, Susanne. "The effectiveness of an intervention by specialist breast care nurses to address the perceived needs and enhance the quality of life of women with breast cancer receiving follow-up care : a randomised controlled trial." Thesis, Edinburgh Napier University, 2014. http://researchrepository.napier.ac.uk/Output/7557.
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Approximately 550,000–570,000 women are alive in the UK who have had a diagnosis of breast cancer with further predictions that this will rise by 3% annually. Most of these women will be receiving follow-up care in a hospital setting and the value of this approach has been questioned for a number of years. Women transition from a very individual, personalised treatment plan to follow-up care which is not organised around individual patient need. Rather a blanket approach is used which does not consider age, risk profile, treatment or need. There is evidence that the current out-patient follow-up provision does not meet the physical, psychological and information needs of women with breast cancer, with women leaving the clinic with unmet needs. While the aim of follow-up is multifactorial, including the provision of psychosocial care, there is little evidence of how this service assesses and addresses unmet needs. Aim The current study sought to examine the effectiveness of providing patient reported needs and psychosocial information to the Specialist Breast Care Nurse at the breast cancer follow-up clinic in reducing cancer needs and improving quality of life compared to standard care. The primary outcome was a change in needs scored at baseline (time 1) and 12 months (time 2). The study also aimed to investigate a number of secondary outcomes namely changes in quality of life at baseline and 12 months, as well as looking at possible effects of the intervention on variables such as age, severity of treatment and time since diagnosis. Method This study was a prospective single blind randomised controlled trial (RCT) involving 93 women who had completed primary treatment for breast cancer and were attending follow-up in a hospital setting. Women were randomised to receive standard follow-up care (control) or a nurse-delivered intervention. The intervention was structured and guided by the self-reported needs and psychosocial information provided by the woman and coupled with a person-centred conversation. This conversation explored the options for the intervention, desire of the woman for assistance and best way to provide it. Results There were high levels of need, anxiety and depression among women attending the follow-up clinic. There was a statistically significant fall in level of need, anxiety and depression in both groups after the intervention. However, no differences between groups in relation to the primary outcome; changes in needs between baseline and time 2, were seen. Quality of life scores fell in both groups; however only the overall quality of life score showed a statistically significant difference between groups in relation to the secondary outcome, changes in quality of life over time. Conclusion The results of this study have shown that using patient-reported needs and psychological information by the specialist breast care nurse in the follow-up clinic to inform an intervention proved to be no better than standard care, but neither is there sufficient evidence to state it was worse. This study has contributed to the methodological evidence base regarding the development and measurement of complex interventions in nursing practice.
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Sidrónio, Bernardete Sousa. "A porta giratória dos maus tratos às crianças e jovens numa CPCJ." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2014. http://hdl.handle.net/10400.26/6414.
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Relatório do Trabalho apresentado para
cumprimento dos requisitos necessários à obtenção
do grau de Mestre em Enfermagem de Saúde
Mental e Psiquiatria<br>O problema das crianças e jovens maltratados, as caraterísticas socioeconómicas das suas famílias e o impacto dos maus-tratos no funcionamento destes indivíduos constituem um dilema mundial. Os maus-tratos fazem parte da história da humanidade, mas se inicialmente a hostilidade contra os mais novos era socialmente aceite, atualmente os esforços das entidades preocupadas com a Infância e Juventude vão no sentido de proteger e promover percursos de vida saudáveis.
Este relatório encontra-se dividido em duas partes: o projeto de intervenção em serviço realizado numa Comissão de Proteção de Crianças e Jovens da Margem Sul do Tejo e a aquisição das competências como Enfermeiro Especialista em Saúde Mental e Psiquiátrica.
No presente projeto de intervenção em serviço, que teve por base a metodologia de projeto, procurou-se conhecer as causas que conduziram à reabertura dos processos das crianças/jovens, seguidos numa CPCJ da Margem Sul do Tejo. O diagnóstico de situação suportou-se: na análise documental, nas entrevistas aos técnicos, aos jovens e suas famílias, nos questionários realizados aos mesmos, nas visitas domiciliares para verificação das condições socioeconómicas, da articulação com outras estruturas da comunidade e na aplicação do um instrumento de recolha de dados FMEA. Os focos de intervenção foram dirigidos para os jovens/famílias com processo reaberto por negligência a nível da educação – abandono e absentismo escolar, com especial relevância no âmbito da saúde mental, e para os profissionais que trabalham junto destes (professores).
Quanto ao planeamento das intervenções tivemos em consideração cada jovem/família e as suas caraterísticas psicológicas, socioeconómicas e culturais. Em relação ao foco abandono escolar e absentismo foram realizadas sessões de psicoeducação aos jovens/família individualmente, de modo a sensibilizar para a importância da escola e perceber quais as razões que levaram ao seu abandono. As intervenções desenvolvidas durante estes atendimentos tiveram por base o suporte psicológico, de modo a ajudar na diminuição da ansiedade, do medo e do stress.
Relativamente a entidade sinalizadora (escolas) que mais, sinalizações realizou à CPCJ, foram desenvolvidas sessões de psicoeducação para os professores (PIEF), com o objetivo de reconhecerem precocemente sintomas e sinais de alteração comportamental e
por sua vez realizar encaminhamentos para as autoridades competentes, de modo a prevenirem a ocorrência de psicopatologias.
Para avaliar a implementação do projeto foram solicitados no final do ano letivo aos estabelecimentos de ensino os relatórios de assiduidade dos jovens em absentismo escolar e um comprovativo das inscrições dos que se encontravam em abandono escolar, foi também pedido aos professores (PIEF) uma reflexão sobre a importância da sessão realizada.
O conhecimento adquirido durante o percurso formativo foi fundamental no reforço de competências e desenvolvimento pessoal e profissional, possibilitando uma intervenção mais precisa em Enfermagem de Saúde Mental e Psiquiátrica, na comunidade.<br>Abstract: The problem of maltreated Children and younger people, the socioeconomics facts of their families and the impact of abuse on the behavior of these individuals, are a global problem. Maltreatment has been a part of the human history, but if this hostility was initially accepted, currently, the efforts of organizations concerned with children and youth, are building pathways to protect and promote healthy lives.
This report is divided in two parts: an investigation project occurred at CPCJ and the acquisition of skills as a mental health nurse.
The current study was based on a methodology project and the objective, is to know the causes that led to the reopening of cases of children/ youth, previously followed by the Commission on Protection of children and Youth of the south bank of Tejo. This study was based on informal interviews to technicians, the young and their families, data analysis, application of data collection of FMEA, home visits to verify their socioeconomics conditions and based on the coordination with others community facilities.
The focus of intervention was directed at young people / families with reopened cases for negligence in education - school absenteeism and dropout, with particular relevance in the context of mental health and for professionals who work with them (teachers).
Regarding the planning, we took into account each young people / family and their psychological, socioeconomic and cultural characteristics.
In relation to the dropout and absenteeism focus, we performed individual psychoeducation appointments with young people / families in order to raise awareness of the importance of school and realize the reasons that led to the dropout. The interventions developed during these appointments were based in psychological support in order to help decrease anxiety, fear and stress.
In the institution (school) with more cases flagged, we developed psycho-education sessions for teachers (of PIEF) with the aim to recognize early signs as behavior changes and symptoms of child abuse and forwarding these cases to competent authorities, to prevent the occurrence of psychopathology.
To evaluate the project we asked the attendance reporting of school absenteeism and a certificate of registration of the dropouts at the end of the school year. It was also asked a reflection from the teachers (PIEF) about the psycho-education meeting.
The knowledge acquired during the training path was fundamental to enhance skills and personal and professional development, enabling a more precise intervention in Mental Health and psychiatric nursing at the community.
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Heindl, Twyla. "Reading Specialist's Perceptions and Role in Implementing Response to Intervention." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/463.
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The roles of reading specialists differ from campus to campus throughout the study site due to varied implementations of Response to Intervention (RTI). To ensure that students were receiving consistent interventions based on their needs, the site needed to examine how and when instructional services were delivered to struggling students, as well as the role of the reading specialist in the process. The purpose of this qualitative case study was to explore the perceptions, experiences, and roles of reading specialists as the RTI framework was implemented at the elementary school level. This study was guided by Vygotsky's social constructivist learning theory, which holds that understanding is built through interactions, observations, and experiences. The research questions focused on the reading specialists' understanding of RTI, reading specialists' roles in RTI, challenges of implementing RTI, and professional development provided on RTI. Data were transcribed, categorized, open coded, and thematically analyzed. Member checks were used to strengthen the trustworthiness of the findings. Results revealed 5 major themes: understanding the RTI process, supporting struggling students, lack of funding and resources, collaboration/communication, and staff development. The findings can contribute to positive social change by leading administrators, instructional support teachers, and reading specialists to an increased understanding of the RTI process, and thereby improving RTI implementation procedures for struggling readers and subsequently increasing student achievement.
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Bailey, Donisha Noel. "The Collaboration Experiences of Elementary School Intervention Specialists in Inclusive Classroom Settings." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6519.
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Collaboration is one of the most significant components of inclusive education, according to professional literature. The purpose of this study was to understand the perceptions of intervention specialists in terms of collaboration with general education teachers in elementary school inclusive classrooms and administrative support of collaboration. The collaboration and the community of practice theories were used for the conceptual framework in this study to understand how collaboration is an ongoing interaction between people to achieve a common goal. Research questions were designed to understand the perceptions of intervention specialists who work in inclusive classrooms regarding collaboration and administrative support by documenting their experiences through interviews. In this basic qualitative study, 9 intervention specialists were interviewed. Interview data were analyzed using thematic coding. The results of this study indicated that each participant was a part of a weekly collaboration meeting with teachers, an administrator, and an instructional coach. Most participants reported that they had to complete a 5-step form, and it was not a good source of time because it did not directly focus on students' needs. Most participants also reported that they did not receive training in college or professional development at work on how to collaborate or work in inclusive classroom settings. Participants reported that their administrators were supportive, but some classroom teachers were not. The implications of social change for this study include insight on the importance of collaboration in inclusive classrooms and insight on how administrators can create training programs for the collaboration of all teachers who work in inclusive classrooms.
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Calhoun, Jerlisa M. "Intervention Specialists' Perceptions of a Tutoring Program for High School Students with Disabilities." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5544.
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Students with disabilities (SWD) at an urban high school in Midwestern United States experienced academic, social, and emotional problems. When SWD experience difficulties in high school, they may drop out and face potentially life-long problems. The purpose of this case study was to understand how a Response to Intervention (RTI) tutoring program addressed the academic, social, and emotional needs of students using the RTI model as a conceptual framework. The research questions addressed intervention specialists' perceptions of how use of the RTI model helped them meet SWD needs and what tutoring documents revealed about tutoring practices. Data sources consisted of interviews with 7 purposely selected intervention specialists who worked as special education teachers at the research site for at least 2 years, lesson plans provided by participants, and reviews of 20 student work samples including pre and post assessments. The data were analyzed by coding for emerging ideas related to interventions within the RTI framework and academic and social/emotional issues. The findings revealed that intervention specialists perceived the overarching academic difficulty for SWD was reading deficits, the out-of-class tutoring program was beneficial for SWD academically by using one-on-one and small-group instruction to scaffold success, and RTI was successful socially/emotionally by guiding students to use appropriate classroom behaviors. The results of the documentary data was that the created lessons were academically appropriate for the SWD they taught in the tutoring center. This study can contribute to positive social change by providing guidance to intervention specialists for increasing SWD social and academic success.
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Yockey, Tammy Denise. "Gifted Intervention Specialists' Time Use, Gifted Services, and Implications on Future Course Offerings After Receiving Gifted Services." Miami University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=miami1587056387226279.
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Cross, Katelyn M. "Preservice Early Childhood, Middle Childhood, and Learning Intervention Specialists: Perceptions of Music Use in the Classroom." Bowling Green State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1428254560.
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Knights, Nicky Holly. "Evaluating an intensive recovery programme for adolescents who have been bullied : a mixed methods study." Thesis, University of Hertfordshire, 2012. http://hdl.handle.net/2299/8116.
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Bullying is a serious problem for many adolescents, and one that can have detrimental effects on normal developmental processes, as chronic and severe bullying can obstruct the fulfilment of essential psychological needs. However, there are currently few targeted interventions available for chronic and severe bullying cases. The purpose of this study was to evaluate the effectiveness of the Red Balloon Learner Centres (RBLC) which are a full time personal and academic recovery programme for bullied adolescents. A mixed-methodology was utilised, and quantitative outcome measures included: depression, anxiety and trauma symptoms, self-esteem and academic engagement and self-concept. The study was non equivalent groups design (NEGD) and incorporated a comparison group of bullied adolescents from Hertfordshire local authority (LA). The aim was to compare the recovery process between groups over time by taking an initial baseline measure, and conducting follow-up assessments every three months. Both groups demonstrated significant improvements in outcome variables over time, but there were no significant differences between groups at six month follow-up on any outcome variable. Both groups reported similar recovery themes that related to need fulfilment in the areas of safety and security, control, belonging and self-esteem. Recovery is not just the absence of internalising symptomology, but constructive fulfilment of needs. Social needs were felt to be most affected by chronic and severe bullying and most difficult to fulfil constructively. It is recommended that interventions for chronically and severely bullied adolescents should enable constructive need fulfilment, which may involve changes to the ethos and culture of schools, collaborative therapeutic intervention and targeted skill building.
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Fisher-Borne, Marcie Rounds Kathleen. "The design, implementation and evaluation of a statewide cultural competency training for North Carolina disease intervention specialists." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2009. http://dc.lib.unc.edu/u?/etd,2368.
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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2009.<br>Title from electronic title page (viewed Jun. 26, 2009). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the School of Social Work." Discipline: Social Work; Department/School: Social Work.
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Kondrotienė, Lina. "Specialistų, dirbančių su ankstyvojo ir ikimokyklinio amžiaus vaikais, turinčiais specialiųjų poreikių, ir jų šeimomis, profesinės kompetencijos." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2008. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2008~D_20080926_174019-60016.
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Darbe atlikta teorinė kompetencijos sampratos ir specialistų, dirbančių su ankstyvojo ir ikimokyklinio amžiaus vaikais, turinčiais specialiųjų poreikių, bei jų šeimomis, profesinio pasirengimo ypatumų analizė.
Iškelta hipotezė, kad Lietuvos specialistų, dirbančių su ankstyvojo ir ikimokyklinio amžiaus vaikais, turinčiais specialiųjų poreikių, bei jų šeimomis, profesinio pasirengimo turinys iš dalies atitinka Europos ankstyvosios intervencijos specialistų profesinio rengimo programos turinį, o profesinės kompetencijos įgyjamos ir per praktiką.
Atliktas kokybinis tyrimas, kurio tikslas išanalizuoti, kokias profesines kompetencijas specialistai, dirbantys su ankstyvojo ir ikimokyklinio amžiaus vaikais, turinčiais specialiųjų poreikių, ir jų šeimomis (t.y. ankstyvosios intervencijos specialistai) įgyja universitetinėse studijose bei kvalifikacijos kėlimo kursuose ir įvertinti specialistų turimų kompetencijų tinkamumą darbui ankstyvosios intervencijos srityje. Tyrimo duomenys buvo renkami naudojant atviro tipo klausimyną, parengtą remiantis Leonardo da Vinčio projekto „Ankstyvosios intervencijos vaikystėje specialistų rengimo Europinis pažymėjimas“ (EBIFF) esminėmis nuostatomis, kuriame specialistai kartu su tyrėja išsamiai apibūdino savo įgytas žinias ir gebėjimus, remdamiesi formaliais dokumentais (bakalauro ir magistro studijų diplomų priedėliais ir kitais jų kompetenciją įrodančiais dokumentais). Specialistų profesinės kompetencijos sąlygiškai vertinamos atsižvelgiant į... [toliau žr. visą tekstą]<br>The theoretical analysis of the concept of competence and peculiarity of professional training of the specialists, who work with early and preschool age children with special needs and their families, had been performed in this work.
The hypothesis stating that the principles of professional training of Lithuanian specialists, who work with early and preschool age children with special needs and their families, partly matches the content of the European programme, which resumes the principles of professional training for the early intervention specialists. The hypothesis also states that professional competence is gained through the process of practice.
The qualitative investigation, whose aim was to analyze what professional competence is gained by the specialists, who work with early and preschool age children with special needs and their families (these are the early intervention specialists), during the university studies and courses of professional improvement and evaluate the suitability of their present competence for the work in the field of the early intervention, had been performed. The data had been collected using the open type of questionnaire, which was prepared according to the main regulations of the Leonardo da Vinci project “The European passport of the early childhood intervention specialists’ training” (EBIFF). During the investigation, the specialists along with the investigator had comprehensively described knowledge and skills they already had... [to full text]
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Chatterjee, Piya. "Elusive Attitudes and Perceptions of Inclusion Of Dual Licensure Candidates in Early Childhood InclusiveTeacher Preparation Program." University of Akron / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=akron1594996633900818.
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Magiati, Iliana. "An evaluation of the effectiveness of home-based behavioural and specialist pre-school interventions for young children with autism : a two-year follow-up study." Thesis, St George's, University of London, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.417389.
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Butler, Magdalena, and Ulrika Westerlind. "Specialistsjuksköterskans värmebevarande omvårdnadsåtgärder i det perioperativa vårdförloppet." Thesis, Röda Korsets Högskola, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-278.
Full textAbstract:
Bakgrund: Under det perioperativa vårdförloppet föreligger många riskfaktorer för patienten att utveckla oavsiktlig hypotermi. Detta kan leda till flertalet operativa och postoperativa komplikationer vilket kan skapa obehag och lidande för patienten, förlänga vårdtider och generera ökade kostnader för samhället. Den perioperativa specialistsjuksköterskans omvårdnadsansvar innefattar ett flertal värmebevarande omvårdnadsåtgärder för att förebygga och behandla hypotermi hos patienten. Syfte: Syftet med studien var att beskriva anestesi-, operations- och intensivvårdssjuksköterskors värmebevarande omvårdnadsåtgärder i det perioperativa vårdförloppet. Metod: En studie med deskriptiv analys utfördes. Data samlades in genom en strukturerad intervjuguide. Sammanlagt deltog 36 specialistsjuksköterskor i studien. Resultat: Specialistsjuksköterskornas värmebevarande omvårdnadsåtgärder bestod utav både passiva och aktiva åtgärder varav tre var utmärkande; att använda luftvärmetäcke, att ge varma infusions- och spolvätskor samt att undvika onödig exponering av patienten. Rutinmässig temperaturmätning av patienten saknades i det perioperativa vårdförloppet. Dokumentering av värmebevarande omvårdnadsåtgärder utfördes i hög grad inom det perioperativa specialistsjukskötersketeamet. Slutsats: Flertalet aktiva och passiva värmebevarande omvårdnadsåtgärder utfördes perioperativt trots avsaknad av skriftliga lokala arbetsrutiner och nationella riktlinjer. Förvärmning av patienten eller operationsbädden förekom däremot inte som aktiva förebyggande omvårdnadsåtgärder. Klinisk betydelse: Studien önskar lyfta fram ett viktigt omvårdnadsområde för specialistsjuksköterskor verksamma inom perioperativ vård. Studieresultatet skulle kunna ligga till grund för utbildningsinsatser och utformandet av lokala arbetsrutiner gällande värmebevarande omvårdnadsåtgärder.<br>Background: During perioperative care multiple risks exist for the patient to develop accidental hypothermia. This can cause increased morbidity, unnecessary patient suffering, prolonged recovery time and subsequently increased costs for the society. Perioperative nursing care involves several warmth preserving interventions to prevent inadvertent hypothermia. Objective: The aim of this study was to describe the perioperative specialist nurses warmth preserving nursing interventions in perioperative care. Method: A study with descriptive analyses has been performed. Data was collected through a structured interview guide. A total of 36 specialist nurses participated in the study. Result: The specialist nurses’ warmth preserving interventions consisted of both passive and active interventions where three were more distinctive; to use forced air warming blankets, to give warm intravenous and/or irrigation fluid and to avoid unnecessary exposure of the patient. Warmth preserving nursing interventions was well documented within the perioperative nursing team. Temperature monitoring was not routinely performed. Conclusion:. Several active and passive warmth preserving interventions were carried out, even though local and national guidelines regarding warmth preserving interentions were missing. Prewarming of patient or operating table was not implemented as active preventative measures. Clinical significance: This study wishes to aid in the ongoing work of improving perioperative care by giving focus to an important area within nursing. The study result will hopefully encourage to further education and to the development of local guidelines regarding warmth preserving interventions.
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Picton, Hannah Kathryn. "Post-stroke depression (PSD) and post-stroke emotional liability (PSEL) : a systematic review of non-pharmacological interventions for PSD, and a qualitative study of specialist professionals' conceptualisation of PSEL." Thesis, University of Edinburgh, 2014. http://hdl.handle.net/1842/9760.
Full textAbstract:
Aims: a review of the literature on non-pharmacological interventions for post-stroke depression (PSD) was completed with the aim of examining issues regarding the design and methodology of trials for non-pharmacological interventions for PSD. The empirical research study used a constructivist Grounded Theory approach to explore specialist stroke professionals' conceptualisations of post-stroke emotional lability (PSEL). The author also aimed to examine how staff experienced, understood and identified PSEL in clinical practice, and particularly how they differentiated it from PSD. Method: A systematic review of RCT and non-RCT studies was conducted to address the first aim. In relation to the second aim, a qualitative investigation of specialist professionals' conceptualisations of PSEL was conducted using Charmaz' (2006) version of constructivist Grounded Theory. Results: The systematic review highlighted the importance of appropriate sampling methods, multiple treatment design, rigorous data collection, the implementation and monitoring of interventions, assessment of participant suitability for the intervention, and issues related to long-term sustainability (follow-up) when designing and evaluating non-pharmacological interventions for PSD. The qualitative investigation yielded a conceptual model of how specialist professionals conceptualise and identify PSEL in their clinical practice. Conclusions and implications: The findings from the systematic review and the qualitative investigation highlighted a range of issues for specialist stroke services. The systematic review emphasised the importance of further evaluation and consideration of carefully planned randomised controlled trials for investigating non-pharmacological interventions for PSD. The qualitative study indicated a need for further guidance on the assessment and identification of PSEL, training for staff, and further examination of the caused of PSEL.
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Rosenfeld, Mark. "Whiplash-associated disorders from a physical therapy and health-economic perspective : a study of an active physical therapy involvement and intervention for the treatment of acute whiplash-associated disorders and an analysis of its costs and consequenses /." Göteborg : Institute of Neuroscience and Physiology, Division of Physical Therapy, Sahlgrenska Academy at Göteborg University, 2006. http://hdl.handle.net/2077/711.
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Small, Stacey. "Attention-deficit/hyperactivity disorder : general education elementary school teachers' knowledge, training, and ratings of acceptability of interventions." [Tampa, Fla. : s.n.], 2003. http://purl.fcla.edu/fcla/etd/SFE0000084.
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Naldini, Federico. "Algoritmi Euristici per la Schedulazione degli Interventi nel Blocco Operatorio." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amslaurea.unibo.it/11685/.
Full textAbstract:
Questa tesi riguarda il problema della schedulazione degli interventi nel blocco operatorio di un presidio ospedaliero, noto anche come Operating Theatre Planning & Scheduling. Il blocco operatorio è la struttura che eroga servizi a più alto impatto sui costi di un presidio ospedaliero ed è legato ad attività ad alto rischio. E' quindi fondamentale gestire in modo ottimale questa risorsa.
In questa tesi, si considera come caso studio l'applicazione reale di un presidio ospedaliero dell'Emilia Romagna con un orizzonte temporale di una settimana, ovvero la cosiddetta programmazione operativa. L'obiettivo è quello di ottenere un utilizzo efficiente del blocco operatorio, garantendo al contempo la priorità agli interventi più urgenti.
Data la complessità del problema, vengono proposti algoritmi euristici che permettano di ottenere buone soluzioni in tempi di calcolo ridotti. Studi precedenti hanno infatti evidenziato la difficoltà di trovare soluzioni ottime al problema, mediante l'utilizzo di solver commerciali per modelli di Programmazione Lineare Intera, senza introdurre ipotesi semplificative.
Sono stati elaborati tre algoritmi euristici costruttivi di tipo multi-start che permettono di generare soluzioni ammissibili con diverse caratteristiche. Gli algoritmi si differenziano principalmente per le modalità con cui collocano gli interventi nel tempo disponibile delle risorse (induction room, operating room, recovery room), cercando di migliorarne l’utilizzazione e dando priorità ai pazienti più urgenti.
Gli algoritmi sono stati implementati utilizzando il linguaggio JAVA e sono stati testati su istanze realistiche fornite dal presidio ospedaliero. I risultati hanno evidenziato un alto grado di utilizzazione delle sale operatorie, un fattore molto rilevante per una ottimale gestione del blocco operatorio.
E' stata, infine, svolta un'analisi di sensitività alla variabilità delle durate.
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Raghavan, R., Robert J. Newell, F. Waseem, and Neil A. Small. "A randomized controlled trial of a specialist liaison worker model for young people with intellectual disabilities with challenging behaviour and mental health needs." 2009. http://hdl.handle.net/10454/4517.
Full textAbstract:
no<br>Background Twenty six young people with intellectual
disabilities and mental health needs from Pakistani and
Bangladeshi communities were recruited as part of a
bigger study to examine the effectiveness of a liaison
worker in helping young people and their families
access appropriate intellectual disabilities and mental
health services.
Method Twelve young people were randomly allocated
to the treatment group, which had the help of the liaison
worker, and 14 young people were allocated to the
control group without the help of a liaison worker.
Baseline measures were undertaken with all the young
people and their carers. This was followed by a 9-month
trial, consisting of the liaison worker helping the treatment
group to get in touch with and take up appropriate
services, mainly in the areas of psychiatric
appointments, benefits advice, house adaptations, leisure
facilities and support and care for the young person.
The control group participants did not have the access
to the liaison worker and were accessing services using
the normal routine. Assessments were carried out posttreatment
to assess whether the use of a liaison worker
had had any effect on outcomes for the two groups.
Results Twelve young people completed the study in the
treatment group and 14 in the control group. Participants
allocated to the specialist liaison worker had statistically
significantly more frequent contact with
services and with more outcomes, than the control
group, and significantly lower scores on the Strengths
and Difficulties Questionnaire (SDQ).
Conclusion The use of specialist liaison services in ensuring
adequate access to services for young people with
learning disabilities and mental health needs from the
South Asian community proved to be significant and
effective compared with young people and their families
accessing services on their own.
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HEJDUKOVÁ, Dana. "Zkušenosti dětí s přípravou na vyšetření nebo zákrok." Master's thesis, 2010. http://www.nusl.cz/ntk/nusl-52383.
Full textAbstract:
The topic of my thesis is "Experiences of children with preparation for medical examination and intervention". Children are more sensitive and therefore more vulnerable, with respect to their age and development it is necessary to carefully consider what to tell them and how. Each child has the right for sufficient information given at the right time and the right way, taking into account its age and intellectual maturity. Adequate communication protects a child from stress and needless anxiety. The theoretical section of the thesis is divided into 3 parts. The first one deals with the child's right to information and also the game specialist profession. The second part focuses on the psychological preoperative preparation in general, communication specifics in dealing with children and on preparation at different periods of age. The third part is devoted to the physical preoperative preparation. The empirical section has two objectives. The first one is to see if in children's wards the child´s preparation before examination or medical intervention is performed and by whom. The second objective is to determine whether the preparation performed affects fear and anxiety experienced by the child prior to the examination or intervention. In the research section the qualitative research technique of non-standardized interview was used. The interview the individual, anonymous, was conducted with the consent of the child and its parents, sometimes with participation of the parents. The research survey was carried out between October 2009 and February 2010. The research sample consisted of 19 respondents (11 girls and 8 boys), children aged 5 to 17 years who underwent an examination or medical intervention in 5 hospitals of the Czech Republic. The outcomes of the research show that most respondents were preparing for the examination by their mothers or doctors in a medical facility, one third of respondents were not given any concern in this respect. The most frequently used form of the preparation was oral communication. The preparation carried out by the game specialist was the best appreciated by the children. The preparation decreased the respondents´ feeling of fear or anxiety. The findings and results of the survey may provide the medical facilities management with an incentive to improve the quality of nursing care provided in terms of children´s informedness as required by the Convention on the Rights of the Child, the Convention on Human Rights and Biomedicine and the Charter of the Rights of the Hospitalized Child.
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YANG, CHIN-CHOU, and 楊晉州. "Intervention of Health Promotion: The Effectiveness of Treatment of Chronic Psychiatric Diabetes Patients with A Long-Term-Care Team Based on A Specialist of Endocrinology and Metabolism in A Psychiatric Center." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/mp2jb7.
Full textAbstract:
碩士<br>輔仁大學<br>跨專業長期照護碩士學位學程在職專班<br>108<br>Introduction:
Diabetes is prevalent in many countries and its costs of medical care are increasing. The proportion of diabetes is higher in psychiatric patients than that of general population, and the difficulties of treatment also raises significantly.
Purpose:
Most studies about integrated diabetes care were focused on non-psychiatric patients. Our study will analyze the glycemic change in chronic psychiatric patients with type 2 diabetes in a psychiatric center, after a full-time specialist of endocrinology and metabolism participated in the long-term-care team and directly involved in the integrated care.
Methods:
Our retrospective study included 56 resident patients in the chronic psychiatric wards. The specialist of endocrinology and metabolism was engaged in the integrated care team since January 2018. We first used paired-t test to analyze the glycemic change between 2016 and 2017 before our interventional care, and then analyze the glycemic change between 2017 and 2018 after our interventional care.
Results:
The results showed that this care model has positive impacts on the patient's eating habits and activity habits. Chi-square test analysis showed significant relationship between the improvement of eating habits and average glycated hemoglobin (HbA1c) level (X2=4.487, p=0.034), and also between the improvement of activity habits and average HbA1c level (X2=11.864, p=0.001). The average HbA1c and fasting blood glucose (AC) of all patients were both significantly improved (p<0.05). For female patients, the average HbA1c and AC were both improved, but there was no significant change noted (p>0.05). For male patients, the average HbA1c was significantly improved, but there was no significant change found in average AC (P>0.05).
Conclusion:
To our best knowledge, this is the first study of diabetes care based on a full-time specialist of endocrinology and metabolism, who was directly involved in the long-term care team in a psychiatric center. The results showed that this care model has positive impacts on the patient's eating habits and activity habits. The average HbA1c and AC were both significantly improved after our intervention. This study not only provides a positive and feasible approach to medical systems of long-term care, but also setup a health promotion measure that deserves attention and should be actively implemented and promoted.
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Gaspar, Elsa Maria Martins. "Consulta de enfermagem de saúde mental e psiquiátrica em contexto domiciliário." Master's thesis, 2011. http://hdl.handle.net/10400.14/8894.
Full textAbstract:
O presente relatório pretende traduzir o percurso formativo que desenvolvi no âmbito do Mestrado em Enfermagem de Natureza Profissional na Área de Especialização em Enfermagem de Saúde Mental e Psiquiátrica.
Deste percurso faz parte a componente curricular e a sua aplicação ao estágio que realizei, na Unidade Comunitária de Cuidados Psiquiátricos de Odivelas, local onde exerço funções e onde tive oportunidade de dar início a uma nova abordagem de Enfermagem em Saúde Mental e Psiquiatria – sistematizar a consulta de enfermagem de saúde mental psiquiátrica em contexto domiciliário.
De modo a tornar exequível a sistematização desta consulta, estabeleci como estratégia organizar duas fases importantes neste processo: A primeira relativa ao planeamento, que decorreu no módulo I do estágio e a segunda que decorreu no módulo III e visou a implementação da consulta de enfermagem de saúde mental psiquiátrica no domicílio.
No que diz respeito ao planeamento desta consulta foi importante efectuar o diagnóstico de situação, desenvolver um conjunto de instrumentos de apoio e orientação para a consulta e desenvolver estratégias de articulação efectivas com outras estruturas da comunidade.
Quanto à implementação da mesma foi útil mobilizar os instrumentos elaborados no momento do planeamento e dinamizar a rede de articulação como forma de apoiar o utente e família com necessidades em saúde mental.
Para avaliar a implementação da consulta de enfermagem de saúde mental psiquiátrica no domicílio auscultei a satisfação dos utilizadores desta consulta operacionalizada em quatro dimensões acessibilidade, efectividade, continuidade e aspectos interpessoais.
O desenvolvimento pessoal e profissional que vivenciei no decorrer deste percurso formativo foi enquadrado pela minha particular sensibilidade à intervenção em enfermagem de saúde mental e psiquiátrica na comunidade.
Tendo em conta os objectivos estabelecidos, as actividades desenvolvidas e a reflexão crítica efectuada procurarei demonstrar, neste relatório que aprofundei e adquiri as competências inerentes ao perfil do enfermeiro especialista em saúde mental e psiquiátrica, tal como preconizado no plano de estudos deste curso e aprovado pela Ordem dos Enfermeiros.<br>This report is intended to demonstrate the training path that I developed in the Masters of Nursing in a professional nature in the area of specialization in Mental Health Nursing and Psychiatry.
This route is part of the curriculum component and its application to the stage that I made in the ―Unidade Comunitária de Cuidados Psiquiátricos de Odivelas‖, where I practice, and where I had the opportunity to initiate a new approach to mental health nursing - a systematic consultation of psychiatric mental health in the home.
In order to make possible the systematization of this consultation, I established as a strategy to organize two important stages in this process: the first relating to planning, which took place in Stage I of the internship and the second held in Module III and aimed at implementing the psychiatric mental health consultation in the home.
For the planning of the consultation in the home, it was important to make the diagnosis of the situation, develop a set of support tools and guidance for consultation, and develop strategies for effective liaison with other community facilities.
For the implementation of outpatient the consultation, it was helpful mobilizing the instruments developed at the time of planning and energize the network of advocacy as a way of supporting users and families with mental health needs.
To evaluate the implementation of the consult, I conducted an instrument, that sought to know the opinion of the users of this consultation, in four dimensions: accessibility, effectiveness, continuity and interpersonal aspects.
The personal and professional development that I experienced during this formative journey was framed by my particular sensitivity to the intervention in mental health nursing and psychiatric in the community.
Taking into account the objectives, the activities and critical thinking that I have made. This report shows that I have acquired and deepened the skills related to the profile of nurse specialist in psychiatric and mental health, as outlined in the syllabus of this course and approved by the Order of Nurses.
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Fitzsimmons, D. A., J. Thompson, C. L. Bentley, and Gail Mountain. "Comparison of patient perceptions of Telehealth-supported and specialist nursing interventions for early stage COPD: a qualitative study." 2016. http://hdl.handle.net/10454/11039.
Full textAbstract:
Yes<br>Background: The increasing prevalence and associated cost of treating Chronic Obstructive Pulmonary Disease
(COPD) is unsustainable, and focus is needed on self-management and prevention of hospital admissions.
Telehealth monitoring of patients’ vital signs allows clinicians to prioritise their workload and enables patients to
take more responsibility for their health. This paper reports the results of a qualitative study embedded within a
feasibility and pilot Randomised Controlled Trial (RCT) of Telehealth-supported care within a community-based
COPD supported-discharge service. The aim of the study was to qualitatively explore the experiences of patients
with COPD who had received either a Telehealth-supported or a specialist nursing intervention following their
discharge from hospital after an admission for a COPD exacerbation.
Methods: Patients were invited to either participate in semi-structured interviews or to complete a semi-structured
self-administered questionnaire on completion of the intervention. Nine patients were interviewed (67 % female)
and seventeen patients completed the questionnaires. In addition, three clinicians responsible for the delivery of
both interventions were interviewed to obtain their perspectives on the new services.
Results: Seven underlying themes emerged from the patient interviews and were further explored in the
questionnaires: (1) patient demographics; (2) information received by the participants; (3) installation of the
Telehealth technology; (4) Telehealth service functionality; (5) visits; (6) service withdrawal; and (7) service
perceptions. Recipients of both services reported feelings of safety derived from the delivery of an integrated,
community-based service.
Conclusions: Although recipients of the Telehealth service received 50 % fewer home visits from the
clinicians than recipients of a more traditional community-based nursing intervention, the patients were
enthusiastic about the service, with some describing it as the best service they had ever received. This
suggests that a Telehealth intervention is an acceptable alternative to a more traditional home nursing visit
model for monitoring community-based patients with COPD following their discharge from hospital.
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Chen, Yao-Shen, and 陳垚生. "Impact of an Antimicrobial Stewardship Programby Linking Early Intervention of Infectious Disease Specialists and Microbiologic Reports on Management of Bacteremic Patients." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/57793164920574303478.
Full textAbstract:
碩士<br>高雄醫學大學<br>醫務管理學研究所碩士在職專班<br>100<br>Background & Purposes. Inappropriate and over use of antimicrobial agents and its’ related emergence of antimicrobial resistance are major public issues concerned currently. Bacteremia is a severe infection and leads into considerable morbidity, mortality, and medical costs. The emergence of antimicrobial resistance embarrasses the selection in treatment of infectious diseases and injures patient safety. The study was targeted to retrospectively review the impact of an antimicrobial stewardship program by linking early intervention of infectious disease specialists and microbiologic reports on management of bacteremic patients.
Materials & Methods. A 1,400-bed medical center in southern Taiwan and 377 targeted bacteremic patients with important or drug-resistant pathogens. To collect administrative data of hospitalized patients, pharmacy prescription and expenditure, and clinical relevant information, by chart review, in targeted bacteremic patients caused by important or multidrug-resistant pathogens respectively.
Results. Between the pre- and post-intervention phases (January 1, 2011 – June 30,2011 vs. July 1, 2011 – December 31, 2011), there was no difference in administrative indicators. In the post-phase, the amounts in usage of intravenous and oral antimicrobial agents decreased by 217.8 DDD/1,000 inpatients-day (PD) (11.7%); the reduction occurred most in penicillins, cephalosporins, and quinolones (>10%). The expenditure of all antimicrobials, antimicrobials for inpatients, and average daily cost of inpatient-day decreased in post-phase: NT$ 7,070,288(9.0%), NT$5,991,896 (12.2%), and NT$ 40.5/PD (14.0%), respectively. The carbapenem-resistant rate in Acinetobacter baumannii and Pseudomonas aeruginosa decreased from 50% to 43% and 8.9% to 6.0%, respectively (p < 0.05). The percentage of extended-spectrum β-lactamase producing Escherichia coli and vancomycin-resistant Enterococcus faecium increased from 16.6% to 19.2% and from 14.0% to 30.7%, respectively, (p < 0.05). In an analysis of 377 bacteremic patients caused by important pathogens, patients in pre-phase were with older age (72.3 ± 15. vs. 68.8 ± 16.2, p = 0.031), more cases with chronic heart failure (10.6% vs. 4.1%, p = 0.018) and in bed-ridden (25.1% vs. 13.5%, p = 0.005).However, cases in post-phase with higher severity of infection by McCabe-Jackson category (p = 0003), and more cases presenting acute hematologic failure and acute liver failure. In comparison between two phases, there was no difference in delay time between bacteremia onset and use of appropriate antimicrobials, timing of appropriate antimicrobials used, and mortality rate.
Conclusion. This study underlines the importance of antimicrobial stewardship program. By linking early intervention of infectious disease specialists and microbiologic reports on management of bacteremic patients can effectively reduce the expenditure of antimicrobial expenditure in hospital.
34
Dabbagh, Basma. "Ectopic Eruption of the Maxillary First Permanent Molar: Rate and Predictive Factors of Self-correction and Survey of Specialists Attitudes Regarding Intervention." Thesis, 2013. http://hdl.handle.net/1807/42806.
Full textAbstract:
Purpose: To retrospectively assess the incidence and predictive factors for self-correction of ectopic eruption of maxillary permanent first molars (EE) and the prevailing attitudes amongst surveyed specialists regarding intervention in cases of EE.
Methods: Charts of patients diagnosed with EE were assessed for predictive clinical and radiographic factors. An online survey was sent to pediatric dentists and orthodontists.
Results: The rate of self-correction was 71%. One third of self-corrections occurred after age 9. Increased amount of impaction (r(43)=0.59, p<.001) and degree of resorption (r(57)=0.41, p=.001) were positively correlated with irreversibility. Orthodontists estimated the spontaneous self-correction rate to be lower (t(1178)=19.2, p<.001) than pediatric dentists.
Conclusions: One third of self-corrections occurred after 9 years of age and delaying treatment of EE may be a viable option when uncertain of the outcome. Reliable predictive factors of irreversibility of EE were identified. Differences exist between pediatric dentists and orthodontists regarding management of EE.
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Masureik-Berger, Arlene Roslyn. "Metacognitive strategies for learning disabled adolescents in specialised education." Diss., 2015. http://hdl.handle.net/10500/18159.
Full textAbstract:
Learning disabilities are a life-long problem for many individuals.
Besides the adjustments all adolescents experience in
life, learning disabled adolescents must contend with academic
problems at school which have a drastic effect on their selfesteem.
This becomes particularly evident when these pupils
face the demands of the secondary school syllabus where they
have to be able to concentrate, read for information, memorise
facts, answer questions and solve problems, and write
assignments. By the time learning disabled adolescents reach
secondary school they have already experienced so much failure
that they become passive towards their studies.
Teaching these pupils metacognitive learning strategies
covering these skills helps them to become more independent
learners. Through executive training procedures they are
assisted to become more involved in their studies, the promotion
of better self-regulation and self-monitoring is fostered,
and as their scores improve, so does their motivation and selfconcept<br>Educational Studies<br>M.Ed. (Orthopedagogics)
36
Rodrigues, Sandra Sofia Esteves. "Diminuição da ansiedade na pessoa com alterações da funcionalidade : proposta de intervenções especializadas em enfermagem." Master's thesis, 2016. http://hdl.handle.net/10400.14/21910.
Full textAbstract:
A problemática da ansiedade tem grande impacto na saúde e altera as rotinas da vida
diária. Pode ser a patologia de base, surgir como efeito secundário da medicação ou
constituir-se uma comorbilidade de outras patologias. É assim, um problema grave,
global e incapacitante para muitas pessoas.
A enfermagem possui conhecimento especializado capaz de reduzir os seus sinais e
sintomas. O presente trabalho pretende transmitir os resultados das intervenções
realizadas e os ganhos em saúde para os utentes com alterações ao nível da perturbação
da ansiedade. Assim, é imprescindível o desenvolvimento de competências nesta área,
numa lógica de melhoria contínua dos cuidados de enfermagem.
Este trabalho tem como título a “Diminuição da ansiedade com alterações da
funcionalidade: proposta de intervenções especializadas em enfermagem”, sendo o seu
objetivo geral o desenvolvimento de competências nesta área e, de modo a obter
resposta à problemática referida anteriormente, iniciei um longo percurso formativo,
que incluiu intervenções especializadas com a intenção de contribuir para o bem-estar
de quatro utentes com o diagnóstico de enfermagem “ansiedade presente em grau
elevado”.
Ao longo do relatório realiza-se uma abordagem sobre e no percurso nos diferentes
contextos de estágio, assim como a descrição dos mesmos. Posteriormente são
retratadas as atividades realizadas, a abordagem a outros diagnósticos de enfermagem
aos diferentes níveis de prevenção. Todas as vivências e experiências ao longo destes
meses, permitiram uma evolução gradual no meu desenvolvimento e a aquisição de
competências específicas adequadas ao nível de uma futura enfermeira especialista em
Saúde Mental e Psiquiátrica e Mestre em Enfermagem.<br>The problematic of anxiety is fierce and it changes the everyday routines, whether its
origin has a pathological base, secondary effects to the use of medication or in co
morbidity with other pathologies. Thus being a serious worldwide problem and may
lead to a disabled individual. Nursing has specialized knowledge capable of producing
in others symptom and signal reduction. This research report intends to transmit the
results of proposed interventions and health gains for patients with anxiety perturbation
variations.
Throughout the report an approach on the traineeship is made and its course in the
several contexts, as well as the description of these.
Posteriorly the performed activities are portrayed, the approach to other nursing
diagnostics to different levels of prevention.
All the experiences lived throughout these months allowed a gradual progress in my
development and the acquisition of specific skills suitable at the level of a future
specialized nurse in Mental and Psychiatric Health and Master in Nursing.
37
Ferreira, Edmund John. "An analysis of business interventions and their effect on the perceived success of South African small and medium enterprises." Thesis, 2007. http://hdl.handle.net/10500/1925.
Full textAbstract:
A prestudy by the author of the assistance available to small business owners
in South Africa revealed that although much assistance is available, many
small businesses still fail. The question that arose was whether small
business owners are receiving the proper assistance in respect of the right
functional areas of the business, for the appropriate duration, at the right
stage of the business life cycle and by the right people. Taking all these
issues into account, the main purpose of this study was to determine what
types of business interventions have the greatest impact on the success of
entrepreneurs and small and medium enterprise owners.
The literature study includes the history of small business development in
South Africa and the interventions that have taken place in this and other
countries. It also provides a definition of a successful small business and the
generic business needs of small business owners.
The sample used in this study was drawn from the members of the
Confederation of Employers of South Africa (Cofesa). The research findings
of this study are reliable for the SME owners who are members of Cofesa.
The Cofesa group is not representative with regards to demographics,
location, economic sectors or qualifications of South African SMEs. The
following are some of the findings of the study of successful small business
owners:
* They generally make use of assistance in the areas of finance, marketing
and human resources.
* Most of them make use of assistance on a continuous basis during all the
stages of the business life cycle, suggesting the way forward for aspirant
business owners who should start making use of assistance even before
starting their businesses.
* Consultants or business specialists are mainly used for assistance.
* More than two-thirds of the business owners thought that their businesses
were more successful after they had received assistance.
* The assistance was neither the cause of failure nor was it the main cause
of their success.
Assistance is a contributing factor to success but not the main reason for it.
The success of a SME will depend mainly on other factors such as type of
product, product quality and marketing. Assistance, however, proves vital and
should first be provided for the areas as identified by the respondents in this
study (mainly finance, marketing and human resources).<br>Business Management<br>D. Com.
38
Senay, Andréa. "Concordance entre les interventions de l’infirmière et de médecins spécialistes dans la prise en charge des fractures de fragilisation." Thèse, 2014. http://hdl.handle.net/1866/12126.
Full textAbstract:
Introduction. L’ostéoporose est une maladie chronique habituellement asymptomatique jusqu’à ce qu’il y ait fracture de fragilisation (FF). Ces fractures engendrent des coûts importants dont une partie pourrait être évitée par la prise en charge de ces patients pour l’ostéoporose. L’implantation d’un programme de prévention des fractures subséquentes géré par des infirmières en orthopédie pourrait permettre de parer à ces problèmes.
Objectifs. L’objectif principal de ce projet était de déterminer si une infirmière peut gérer de façon efficace et sécuritaire un service de liaison pour fracture.
Méthode. Les décisions cliniques d’infirmières entre 2010 et 2012 pour 525 patients d’un service de liaison pour fracture à l’étude ont été évaluées par deux médecins spécialistes indépendants avec expertise dans les soins pour l’ostéoporose.
Résultats. Les infirmières ont pu identifier la totalité des sujets à risque et référer 26.7% de ceux-ci à un spécialiste. L’accord entre chacun des évaluateurs et les infirmières était de >97%. Les évaluateurs ont donné les mêmes réponses à >96% pour chaque type de décision et le niveau d’accord inter-juge était presque parfait (AC1 >0.960). Aucune référence n’a été jugée inutile. Les comorbidités majeures ont toutes été prises en charge.
Conclusion. L’accord élevé entre les décisions cliniques des infirmières et des médecins évaluateurs démontre que la prise en charge par une infirmière est sécuritaire et recommandable pour les patients avec FF. Ce type d’intervention pourrait contribuer à résoudre les problèmes d’accessibilité aux soins chez les patients avec fragilité osseuse, ainsi qu’à diminuer le fardeau économique que représente le traitement des FF pour la société.<br>Introduction. Osteoporosis is a chronic condition which is usually asymptomatic until a fragility fracture (FF) occurs. These fractures lead to increased morbidity and mortality in patients. Moreover, a major care gap exists in the investigation for bone fragility and initiation of treatment for individuals who sustain a FF. The implementation of a subsequent fracture prevention program managed by nurses could be the key in resolving these problems.
Objectives. The main objective of this project was to determine if a nurse can manage safely and efficiently a fracture liaison service (FLS).
Methods. Clinical decisions of nurses for 525 subjects in a studied FLS between 2010 and 2012 were assessed by two independent physicians with expertise in osteoporosis treatment.
Results. The nurses succeeded in identifying all patients at risk and referred 26.7% of patients to a specialist. Thereby, they managed 73.3% of subjects with FF. No needless referrals were made according to both physicians. Agreement between each evaluator and the nurses was of >97%. Physicians’ decisions were the same in >96% for each type of decision and AC1 coefficient was of >0.960 (almost perfect level of agreement). All major comorbidities were adequately managed.
Conclusion. High agreement between nurses and physicians’ clinical decisions indicate that the management by a nurse of a FLS is safe and recommended for patients with FF. This kind of intervention could help resolve the existing care gap in osteoporosis care as well as the societal economic burden associated with treatment of FF.
39
Santos, Mónica. "Avaliação da dor no doente crítico: uma norma de boa prática clínica!" Master's thesis, 2014. http://hdl.handle.net/10400.26/6817.
Full textAbstract:
Relatório de Trabalho de Projeto apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Enfermagem Médico-Cirúrgica<br>O presente Relatório de Trabalho de Projeto insere-se no plano de estudos do 2º Mestrado em Enfermagem Médico-Cirúrgica da Escola Superior de Saúde do Instituto Politécnico de Setúbal e surge como um documento ilustrativo da aprendizagem adquirida durante os três estágios realizados na Unidade de Cuidados Intensivos (UCI) de um hospital do sul do País. Visa descrever e apresentar uma reflexão crítica das competências comuns e específicas do Enfermeiro Especialista em Enfermagem à Pessoa em Situação Crítica e das competências de Mestre em Enfermagem Médico-Cirúrgica, aí desenvolvidas.
Ao longo dos estágios houve a oportunidade de desenvolver um Projeto de Intervenção em Serviço (PIS) e um Projeto de Aquisição de Competências (PAC). Seguindo a Metodologia de Projeto, a problemática identificada no âmbito do PIS incidiu sobre o controlo da dor no doente crítico, certificada com a aplicação de instrumentos de colheita de dados como questionários e entrevista semiestruturada e de um instrumento de gestão. No seguimento, foram planeadas, executadas e avaliadas atividades desenvolvidas que permitiram atingir os objetivos inicialmente traçados, nomeadamente formar a equipa de enfermagem da UCI, criar um dossier temático em suporte informático e implementar a escala comportamental Behavioral Pain Scale (BPS) para avaliação da dor no doente crítico. O desenrolar deste PIS permitiu, para além das competências comuns, o desenvolvimento da competência específica Cuida da pessoa a vivenciar processos complexos de doença crítica e/ou falência orgânica.
No âmbito do PAC, com o conhecimento de dados estatísticos e ao observar algumas inconformidades entre os modos de atuação dos enfermeiros e a evidência científica, tomou-se como objetivos elaborar um procedimento setorial sobre medidas preventivas da pneumonia associada à ventilação mecânica (PAV) e construir uma checklist de verificação, que permitiram desenvolver a competência específica Maximiza a intervenção na prevenção e controlo da infeção perante a pessoa em situação crítica e/ou falência orgânica face à complexidade da situação e à necessidade de respostas em tempo útil e adequadas. A acrescentar, ao constatar-se a inexistência de uma política de notificação de incidentes e com o objetivo de contribuir para a sua implementação, formou-se a equipa da UCI, criou-se um dossier temático e realizou-se um formulário de notificação de incidentes da UCI, atividades que permitiram desenvolver a competência específica Dinamiza a resposta a situações de catástrofe ou emergência multi-vítima, da conceção à ação.
Neste relatório, são ainda integrados todos os conhecimentos teóricos adquiridos nas unidades curriculares lecionadas ao longo deste curso de mestrado e todos os aspetos que levaram à aquisição/desenvolvimento das competências de Mestre em Enfermagem Médico-Cirúrgica (EMC).<br>Abstract: The present Project Report is part of the study plan of the 2nd Masters in Medical-surgical nursing of Escola Superior de Saúde of Instituto Politécnico de Setúbal. It is an illustrative document of the learning acquired during the three internships undertaken at the Intensive Care Unit (ICU) of a hospital in the south of Portugal. The Report intends to describe and present a critical reflection of the common and of the specific competencies of the Nurse Specialized in Nursing to the Person in Critical Situation and of the competencies of the Master in Medical-Surgical Nursing, developed in that hospital.
Throughout the internships there was the opportunity to develop a Project of Intervention in Service (PIS) and a Project of Acquisition of Competencies (PAC). Following the Project Methodology, the problematic identified in the scope of PIS focused on the pain control in the critical patient, certified with the application of data collection instruments such as questionnaires and semi-structured interview and a management instrument. Afterwards, developed activities were planned, executed and evaluated, to allow attaining the goals initially defined, namely to form an ICU Nursing team, to create a digital theme binder and to implement the Behavioural Pain Scale (BPS) to evaluate the pain in the critical patient. The development of this PIS allowed, besides the common competencies, the development of the specific competency Care for the person living complex processes of critical illness and/or organ failure.
In the scope of PAC, with the knowledge of statistic data when observing some non-conformities between the action methods of the nurses and the scientific evidence, were defined as objectives to elaborate a sectorial procedure about ventilator-associate pneumonia preventive measures (VAP) and to build a checklist that allowed to develop the specific competency Maximize the intervention in the prevention and control of the infection in the person in critical situation and/or organ failure in view of the complexity of the situation and the need for adequate responses in time. Furthermore, by realizing the lack of a policy for incident reporting and with the goal to contribute to its implementation, the ICU team was trained, a theme binder was created and an ICU incident notification form was done. These activities allowed to develop the specific competency Dynamise the response to catastrophe situations or multi-victim emergency – from creation to implementation.
In this report, is also included all theoretical knowledge acquired in the learning units throughout this Masters course as well as all aspects that lead to the acquisition/development of the competencies of Master in Medical-Surgical Nursing (MSN).