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1
Boyce, Bridget Marne. « Oral health care practices and perceptions among nursing home residents a case study / ». Morgantown, W. Va. : [West Virginia University Libraries], 2004. https://etd.wvu.edu/etd/controller.jsp?moduleName=documentdata&jsp%5FetdId=63.
Texte intégralRésumé :
Thesis (M.S.)--West Virginia University, 2004.Title from document title page. Document formatted into pages; contains viii, 92 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 71-76).
2
Chong, Adeline Yang Li. « The effects of chlorhexidine containing toothpastes and tea tree oil containing mouthwashes on plaque and gingival inflammation : a thesis submitted in partial fulfilment for the degree of Masters [sic] of Dental Surgery (Periodontics) ». Title page, contents and summary only, 1999. http://web4.library.adelaide.edu.au/theses/09DM/09dmc548.pdf.
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3
Linjewile-Marealle, Navoneiwa. « Oral health and nutritional status of the children under five years, Queen Elizabeth II Hospital, Maseru, Lesotho ». Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_1437_1190193126.
Texte intégralRésumé :
The aim of this study was to compare the oral health status between well and malnourished children under five years old attending Mother and Child Health clinic in Queen Elizabeth II Hospital in Maseru, Lesotho.
4
Jacobs, Theodore Konrad. « The prevalence of early childhood caries in the Southern Cape Karoo region ». Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_5670_1189599008.
Texte intégralRésumé :
Dental caries is a huge problem among the previously disadvantaged population. Early childhood caries is a problem with infants. This thesis contained information concerning the parents knowledge about their children's oral health and their own personal details. These children were all in the age group 2-5 years. The study findings suggest that parent and parents-to-be, need to be informed on oral health issues concerning their children. This should not solely be the task of dentists but other health care workers as well.
5
Singh, Shenuka. « A critical analysis of the provision for oral health promotion in South African health policy development ». Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=init_4116_1178278944.
Texte intégralRésumé :
The rhetoric of primary health care, health promotion and health service integration is ubiquitous in health policy development in post-apartheid South Africa. However the form in which oral health promotion elements have actually been incorporated into other areas of health care in South Africa and the extent to which they have been implemented, remains unclear. The central aim of this research was to critically analyse oral health promotion elements in health policies in South Africa and determine the extent to which they have been implemented. The study set out to test the hypothesis that oral health promotion is fully integrated into South African health policy and practice.
6
Ng, Kwai-sang Sam, et 吳桂生. « Psychological perspectives of periodontal disease ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B36918210.
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7
Lee, Kwok-lun, et 李國綸. « The oral epidemiology of 45-64 year-old Chinese residents of a housingestate in Hong Kong : coronal and rootcaries ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1988. http://hub.hku.hk/bib/B38628260.
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8
Williams, Anne-Marie M. « Trace elements in nineteenth-century Australian children's teeth in relation to diet, health and the environment ». Thesis, The University of Sydney, 2005. https://hdl.handle.net/2123/27919.
Texte intégralRésumé :
The principal aim of this thesis is to explore the relationship between trace elements in the
tooth enamel of children from the Destitute Children’s Asylum (DCA), who died in the
mid-to-late nineteenth century and their health, diet and environment, as determined from
historical records and osteological stress markers. The secondary aim is to explore the
validity of trace element analysis in archaeological populations in relation to paleodiet and
health status.
The major issue surrounding the use of trace element analysis in archaeological samples
has been the impact of diagenesis, that is where the bone chemistry is altered post-mortem.
Although it is generally considered that enamel is more stable than bone, the degree to
which tooth enamel may be affected by the post-mortem environment is not clear. The
possibility that the enamel of the teeth from the DCA was affected by diagenesis was
examined using a number of techniques including microprobe analysis.
The DCA was set up in 1852 to care for children whose parents were unable or ‘unfit’ to
care for them. In 1995, the cemetery, which operated from 1863 until 1891, was excavated
and 65 burials were found and it is the analysis of these remains that forms the basis of this
thesis. The techniques used for trace element analysis in this thesis were Proton Induced
X-ray Emission (PIXE) and Gamma-ray Emission (PIGE) analysis. PIXE/PIGE allows
for multi—element analysis and can be performed without destruction of the sample, a
particular advantage for archaeological samples.
The examination of trace elements in different teeth allows the trace element exposure of
the Asylum children to be examined over three time periods, in utero, before entry to the
Asylum and after entry to the Asylum. Extensive analysis of both intra- and inter-tooth
variation of trace elements was performed in order to investigate the replicability of trace
element analysis using PIGE/PIXE and to determine the extent to which tooth surface
selection and tooth type affected the outcome.
The relationships between trace element concentrations in the Asylum teeth and
osteological stress markers were examined. It is thought that osteological stress markers
may occur as a result of malnutrition and/or illness, suggesting that stress indicators may
be associated with lower levels of essential elements and possibly a higher toxic element
load.
The use of PIGE/PIXE to analyse tooth enamel was found to have a number of limitations,
most importantly the possible presence of systematic error which impacted on the
interpretation of the results. The selection of tooth surface was found to be important and
the averaging of the results from a number of teeth of the same type gave the best view of
each child’s trace element load.
In terms of the children no significant relationships were found between trace elements
and the diet of the children either before or after entry to the Asylum. This contradicts the
historical records, which suggest the children would have come from a background of
malnutrition with improved diet on entry to the Asylum. However, a major finding in this
thesis was that iron and zinc, the two most commonly deficient elements in humans, had
been altered in the tooth enamel by the post-mortem environment.
The other major finding in this thesis was the significant relationship between the
high concentration of lead in the Asylum teeth and the degree of cribra orbitalia. The
relationship between lead and cribra orbitalia was strongest in the teeth representing life
before entry to the Asylum. However other signs of stress such as Harris lines and enamel
hypoplasias showed no relationship with lead or any other trace elements.
In the future there is clearly value in using trace element analysis to examine the health of
the population, particularly in relation to toxic elements. However, it must not be assumed
that archaeological teeth are free from post-mortem alteration and it is recommended that
future researchers select the elements for analysis with care and examine their samples for
post-mortem alteration using a multitude of techniques.
9
Kramer, Kathryn Daugherty. « The role of behavioral technology in the promotion of oral health behavior ». Thesis, Virginia Polytechnic Institute and State University, 1985. http://hdl.handle.net/10919/90933.
Texte intégralRésumé :
This study implemented two behavior management strategies, self-monitoring and monetary incentives, in a dental clinic and a private periodontal practice to explore the effects of these intervention strategies on subjects' dental flossing frequencies and to compare these strategies to standard educational procedures. Group analysis of four dependent variables generally showed minimal impact of the intervention strategies on flossing frequency. However, when the percentages of subjects within groups who improved on the dependent measures were evaluated, differential effects for some dependent variables were noted between settings and among intervention strategies. Based on those findings, the behavioral strategies of self-monitoring and monetary incentives did appear to enhance the effectiveness of education.
Multimodal measures were used to assess changes in the target behavior. The general lack of covariance found among the dependent measures used in this study demonstrated that the interpretation varied with the choice of dependent variable. This finding suggested that past researchers, who used only physiological dependent measures to assess changes in the frequencies of dental flossing and brushing behaviors, should have selected more direct measures of the targeted behaviors (e.g. unobtrusive measures or direct observations).M.S.
10
Chan, Chi-lap Samuel, et 陳自立. « Caries prevalence and feeding habits of toddlers in Hong Kong ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B38628375.
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Freeland, Lisa New. « The medicalization of oral aesthetics : an application of structuration theory ». Thesis, University of North Texas, 2000. https://digital.library.unt.edu/ark:/67531/metadc2722/.
Texte intégralRésumé :
Medicalization has been discussed at length in the sociology of health and illness literature. Typically, dialogue has centered on the effects of medicalization and the process as a phenomenon in professional fields alone. This work is an attempt to study medicalization using a theoretical model, structuration, that allows for inclusion of the larger social system in understanding health system changes and to include consumers of health services in the process as active agents. The example of oral aesthetics provides an opportunity to identify the agents of change, the process of medicalization in the larger social context, and possible indicators of the phenomenon. An attempt to operationalize the complex concept of medicalization marks a move toward creating testable theoretical models for the variety of behaviors and conditions under study as medicalized. Using content analysis of professional dental journals and lay magazines and a review of system rules and resources, shifts in language use and the emergence of medical frameworks were documented to determine if a medicalization of oral aesthetics had occurred. Results show two distinct periods within the last century when oral aesthetics have been medicalized in the United States. Evidence of turn-taking behavior among the agents is noted as well as the relationship of technology and technological language to the process. A model for future testing is suggested that encompass the identified agents, the language and framework, and the elements of social context.
12
Wong, Ho-hang Anthony. « A randomized controlled trial of home tooth-whitening products ». Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B3195439X.
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13
Soe, Ko Ko. « Dental caries, related treatment need and oral health related quality of life in Myanmar adolescents ». Thesis, King's College London (University of London), 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.326061.
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14
Magner, MaryBeth. « The Effects of Managed Care on the Quality of Dental Hygiene Care ». TopSCHOLAR®, 1998. http://digitalcommons.wku.edu/theses/344.
Texte intégralRésumé :
Managed care has become a prominent mechanism for insuring dental care. Empirical research suggests that managed dental plans provide lower quality care to patients. However, few studies have specifically addressed the effects of managed care on the quality of dental hygiene care. Thus, in this study the researcher examines whether dental hygienists deliver a lower level of treatment to managed care patients than to those who are not subject to managed care. Questionnaire data were gathered from 193 members of the American Dental Hygienists' Association residing in the Chicago area. The primary independent variable, managed care, was measured with an item that asked the respondents to indicate the percentage of patients they treat that are insured by a managed dental plan. The questionnaire also contained items that measured the frequency in which the respondents perform 23 tasks that are indicators of quality of dental hygiene care. Principal components factor analysis of these 23 items yielded the study's two dependent variables: periodontal procedures and appointment time. Regression analysis of the data revealed a significant negative relationship between managed care and appointment time. This relationship may be attributable to an economic incentive on the part of dentist-employers who control the amount of time scheduled for dental hygienists' patients. Dentist-employers may reduce the time available for managed care patients in order to allow longer appointments for more profitable fee-for-service patients. The study results did not support the notion that managed care affects the extent to which dental hygienists perform periodontal procedures. These mixed results suggest that future research should examine the relationships between managed care and other aspects of quality of dental hygiene care not addressed in the current study.
15
Wong, Karen K. L. « Intra-pulpal thermal effects of dental lasers and high-intensity lights during light-activated tooth whitening and resin polymerisation on human teeth / ». [St. Lucia, Qld.], 2002. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16897.pdf.
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16
Njenje, Charles Chukwuemeka. « Improving Hand Hygiene in an Intensive Care Unit ». ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5914.
Texte intégralRésumé :
Health-care-associated infections (HCAIs) affect hundreds of millions of people worldwide, causing morbidity and mortality among hospitalized patients. About 2 million patients suffer from HCAIs in the United States, and it is estimated that 99,000 of them die each year. Studies have indicated that transmission of health-care-associated microorganisms occurs through contaminated hands of health care workers. Hand hygiene (HH) is the single most effective way to prevent health-care-associated infections, yet health care workers' hand hygiene compliance remains low. One factor responsible for poor compliance with hand hygiene guide-lines are lack of knowledge of good hand hygiene and lack of hand hygiene techniques. This project evaluated the effect of educational program on hand hygiene for intensive care unit (ICU) healthcare workers. The Health Belief Model was applied as the framework in this project. Key components of the model are perceived susceptibility, perceived severity, perceived benefit, and perceived barriers. A convenience sample of 25 ICU healthcare workers participated in the educational program. Pre- and post- education surveys and tests were assessed using descriptive statistics. Results were consistent with existing findings indicating that education is needed to improve HH compliance and that effective HH reduces infections. The findings from this project may contribute to positive social change by promoting increased HH knowledge and infection prevention while decreasing complications of treatments, costs, morbidity, and mortality, thereby promoting a healthy and safe community.
17
Shaboodien, Shabier Ibrahim. « Oral health knowledge of caregivers and parents of mentally impaired and physically disabled pre-school children in Hong Kong ». Thesis, View the Table of Contents & ; Abstract, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21129484.
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18
Griffiths, John H. « Verbal regulation of behaviour in children : establishing effective dental care ». Thesis, Bangor University, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.357889.
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19
Lungui, Ilona. « Hand Hygiene and Compliance Rates in an Acute Care Setting ». ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6454.
Texte intégralRésumé :
Hospital-acquired infections (HAIs) are a significant problem faced by healthcare organizations globally. The Centers for Disease Control reported that in 2014, 722,000 patients acquired an HAI, and of those, 75,000 died as a result. This project focused on reeducating healthcare staff on hand hygiene practices to prevent HAIs. Preintervention hand hygiene compliance rates were compared to postintervention hand hygiene compliance rates on 2 units in an acute care setting to evaluate if reeducation of healthcare staff on hand hygiene protocols and practices would increase hand hygiene compliance rates. The evidence-based practice model used for this project was Nightingale's environmental theory. The research question for the study examined the effectiveness of hand hygiene reeducation on hand hygiene compliance rates. Participants included 97 nurses and ancillary staff. Hand hygiene compliance rates were compared 1 month before and 1 month after healthcare staff reeducation. Results showed an 18% increase in compliance rates following reeducation. These results might effect positive social change by reinforcing that reeducation has an impact on compliance rates for hand hygiene among nursing and ancillary staff in acute care settings.
20
Lisauckis, Lisa Elena. « Herbal supplement education in dental hygiene curricula ». Morgantown, W. Va. : [West Virginia University Libraries], 2002. http://etd.wvu.edu/templates/showETD.cfm?recnum=2326.
Texte intégralRésumé :
Thesis (M.S.)--West Virginia University, 2002.Title from document title page. Document formatted into pages; contains viii, 63 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 48-50).
21
Henry, Rachel K. « A Comparison of Millennial and Non-Millennial Dental Hygiene Student and Faculty Classroom Expectations ». The Ohio State University, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=osu1419262693.
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22
Wong, Ho-hang Anthony, et 黃浩行. « A randomized controlled trial of home tooth-whitening products ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B3195439X.
Texte intégral
23
Yip, Shuaih-yee Bethia, et 葉率意. « Oral care practice in cancer nursing ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B45011990.
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24
Cravens, Cedric A. « Tr?-Vigil, LLC, a hand hygiene company for health care organizations ». Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10167528.
Texte intégralRésumé :
Nosocomial infections are a significant medical burden to every health care setting in the United States. Also known as health-associated infections or hospital-acquired infections (HAIs), they are infections that people acquire while they are receiving treatment for another condition in a health care setting. To decrease rates of HAIs, Tr?-Vigil, LLC will provide health care facilities with point-of-care hand hygiene capability in the form of portable hand sanitizers that clip onto lab coats or scrubs, along with a monitoring system that tracks medical staff usage of the sanitizers. This business plan will demonstrate how Tr?-Vigil intends to deliver a vital health care service, while being a sustainable and profitable company.
25
Chang, Nai-Chung Nelson. « Identifying factors influencing hand hygiene compliance during the patient care sequence ». Diss., University of Iowa, 2018. https://ir.uiowa.edu/etd/6390.
Texte intégralRésumé :
Healthcare-associated infections (HAI) are a significant issue in healthcare facilities worldwide. Hand hygiene (HH) remains the most effective method for preventing the incidence of HAI in routine patient care. Past and current interventions focused on the overall improvement of HH compliance, but studies found that the amount of time required to achieve full HH compliance with the existing guidelines may not be practical. Improving HH compliance at critical moments during patient care may be more effective than improving HH compliance at all opportunities. However, there are little to no studies on healthcare workers’ (HCWs) behavior regarding HH during the patient care process.
Secondary data analysis on a prospective dataset from the STAR-ICU trial was completed to identify HCWs’ behavior patterns regarding HH during the patient care process. Multiple logistic regression for transitions with random effects using repeated measures and transition modeling was used to identify possible associations between HH compliance and patient care tasks, the order of tasks, and workload. The models adjusted for the effects of HCW type, glove use, and isolation precautions.
The study identified 28,826 task sequences and 42,349 HH opportunities. HCWs were slightly less likely to do HH before critical tasks compared with other tasks (OR: 0.97, 95% CI: 0.96-0.99), but more likely to do HH after contaminating tasks compared with other tasks (OR: 1.12, 95% CI: 1.10-1.13). HCWs are also more likely to move from task sequences that have a relatively lower risk to patients to task sequences that have a relatively higher risk to patients than vice versa (65.4% versus 34.7%). HCWs are also less likely to do HH after moving from tasks that have a relatively lower risk to patients to tasks that have a relatively higher risk to patients than vice versa (OR: 0.93, 95% CI:0.92-0.95). HCWs’ HH compliance rates decreased as the workload level increased (OR: 0.93, 95% CI: 0.89-0.98). Workload did not appear to affect HH compliance before critical tasks or after contaminating tasks and did not affect the order in which HCWs perform patient care tasks. Increase in workload was associated with an increase in the odds of critical tasks occurring (OR: 1.55, 95% CI: 1.45-1.65).
In conclusion, HCWs are more likely to perform HH after contaminating tasks to prevent contaminating themselves and to reduce the risk of transmission in subsequent task sequences. However, they do not perform tasks in an order that minimizes risk to the patient; instead, it appears that they perform tasks as they come up in routine care. Furthermore, HH is not being performed at critical moments during patient care. Lastly, workload did not affect the order in which HCWs perform patient care tasks, suggesting that HCWs behavior patterns contribute significantly to how they care for patients and perform HH. Interventions targeting the order in which HCWs perform patient care tasks and improving HH compliance before critical tasks may be more effective than those designed to improve HH compliance at all HH opportunities for reducing HAI rates.
26
Lau, Chun-ling, et 劉俊玲. « Factors affecting hand hygiene compliance in intensive care units : a systematic review ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48423890.
Texte intégralRésumé :
Hospital-acquired, or nosocomial infections (HAIs) are the major source of mortality and morbidity for hospitalized patients. It is estimated that 7-10% patients developed HAIs during their hospital stays, with most patients got infected from intensive care units (ICU) [1,2]. Hand hygiene (HH) is recognized as the most easy and effective way to prevent HAIs. However, the observed hand hygiene compliance rates among healthcare workers (HCWs) have been regarded as unacceptably low, especially in ICU [3]. This literature review is to discuss the factors influencing the hand hygiene compliance among HCWs in ICU, in both the individual and institutional level, and suggest which factor was important in both levels. Recommendations in comprehensive approach on hand hygiene practices will also be included.published_or_final_version
Public Health
Master
Master of Public Health
27
Wang, Jennifer. « Health care behaviour of Hmong refugees in Sydney ». Thesis, The University of Sydney, 1998. https://hdl.handle.net/2123/27572.
Texte intégralRésumé :
The Hmong, a minority group from Laos, began arriving in Australia in 1976, having fled their country after the Pathet Lao (Lao communists) came into power in May, 1975. Little has been written on the Hmong in Australia but one survey
conducted in 1987 on the Hmong community in Sydney identified it as socioeconomically disadvantaged (Lee 1987). At the same time, studies from the United States were discovering a significant problem of poor health status and
unsatisfactory health care behaviour within various Hmong refugee communities in that country (Bliatout 1988a; Deinard and Dunnigan 1987; Scott 1982; Strand and Jones 1983). This study aims to examine the health care behaviour of Hmong in Sydney, and related socio-economic issues, in part to discover whether Hmong in Sydney exhibit similar health care behaviour and health status to Hmong in the United States. It will therefore both provide basic information on the Hmong in Australia, and specifically focus on the health care behaviour of Hmong in Sydney and, secondly, compare this with situations in the United States.
28
Tongkoom, Subongkoch. « The prevalence of dental anomalies in the primary dentition of Chinesechildren ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1994. http://hub.hku.hk/bib/B31953980.
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29
Bauchmoyer, Susan Marie. « Predicting Academic and National Board Dental Hygiene Examination Performance Based on Academic Factors ». The Ohio State University, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=osu1418401625.
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30
Dean, Lesa. « Dental Care in Long-Term Care Facilities of Warren County, Kentucky ». TopSCHOLAR®, 1986. https://digitalcommons.wku.edu/theses/2252.
Texte intégralRésumé :
Many physical changes occur as one ages, including changes associated with the oral cavity. A review of the literature suggests that the provision of dental care to institutionalized elderly patients presents problems due to a variety of factors. The purpose of this study is to assess the level or dental care provided to residents of long-term care facilities located in Warren County, Kentucky. In addition, secondary objectives Include the ascertainment of who provides dental care to residents and the amount or in-service dental training made available to staff members of the facility.
Each administrator of the long term care facilities located in Warren County participated in an *interview conducted by the author. During the interview, information was obtained for a 21 item questionnaire concerning the facility, the number and age range or the residents, and types of dental services provided within the facility.
Results obtained from the questionnaire indicated that 77 percent or the residents in long-tern care facilities in Warren County are 70 years of age or older. No significant differences were noted in the types or dental services provided to residents. However, the dental services provided ranged from those that were obtained in a private dental office via transportation or the resident to outside dental facilities to routine oral hygiene measures carried out by staff members employed by the facility.
The findings revealed significant differences in the dental status of the MRDD residents when compared to the nursing home residents. Other findings indicated that none of the long-term care facilities had dental operatories or dental radiographic equipment on the premises.
Additional research would be required in order to address uncertainties discovered in the study. A followup to the questionnaire Interview with the consulting dentists may be included to determine to what capacity and to what extent they are utilized by the facilities. Other recommendations include the utilization of entrance dental examinations to determine if services offered do meet the needs of the residents and periodic dental examinations to aid in detection and thus reduce the prevalence of dental diseases in this population.
31
Travis, Shirley S. « Self-care dependency among elders in long-term care settings ». Diss., Virginia Polytechnic Institute and State University, 1985. http://hdl.handle.net/10919/49945.
Texte intégralRésumé :
General acceptance of a pattern of activities of daily living (ADL) dependency has led to the use of an additive method of determining self-care dependency and need for long-term care. This traditional method of determining ADL levels is convenient, and it is practical to the extent that individuals in a long-term care population do fit a scaled pattern of dependency. This research was based on 3611 cases from the Preadmission Screening Program of the Virginia Medical Assistance Program. Tabular and staged logistic regression analyses examined: 1) characteristics of this group of long-term care elders, 2) the extent of ADL divergence in various recommended care settings, 3) the relationship between rehabilitation status and ADL divergence, 4) other factors influencing divergence from the ADL dependency hierarchy.
The results of this study demonstrated that a large proportion of those screened did not match the original Index of ADL. Therefore, the justification for counting ADL dependency, based on an underlying hierarchy of ADL, was not upheld. Further research was indicated for improving eligibility and placement criteria that would reflect a fluid rather than a static system of long-term care. For example, rehabilitative trajectory could serve as an indicator of projected changes in assistance for self-care.Ph. D.
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Rooshenas, Leila. « Managing common infections in Day Care settings : Day Care providers' sickness exclusion beliefs, advice, and their consequences for parents ». Thesis, Cardiff University, 2012. http://orca.cf.ac.uk/38020/.
Texte intégralRésumé :
Background and Aims: Judicial antibiotic prescribing and appropriate use of healthcare resources are public health priorities. Preschool-aged children that attend day care frequently consult general practitioners (GPs) and receive antibiotics, despite experiencing mainly self-limiting and/or viral infections. North-American surveys indicate that day care providers unnecessarily exclude children with infections, and make exceptions to exclusion on the basis of antibiotic treatment. Commentators suggest that this may lead to unnecessary consultations and inappropriate antibiotic requests. This study’s main aim was to explore whether UK-based day care providers’ management of infections encourages parents to unnecessarily consult GPs, and inappropriately seek antibiotics. A secondary aim was to describe the content and nature of written day care sickness exclusion policies. Questionnaire Methods and Results: Questionnaires were distributed to 329 day care providers in three socio-demographically contrasting areas of South-East Wales, to gather descriptive data regarding sickness exclusion policies. 216 (66%) responses were received. Policies were mostly self-written, diverse in content and detail, and often non-evidence-based. Qualitative Methods and Results: Day care providers’ management of infections, and the influence this had on parents’ consulting and antibiotic-seeking behaviours, were explored through semi-structured interviews with 24 purposefully selected day care providers, and 28 opportunistically-selected parents that used their services. Interviews underwent inductive thematic analysis. All day care providers encouraged parents to consult GPs for self-limiting infections, and often inappropriately advised antibiotic treatment through written policies and verbal communication. Some parents felt that day care attendance increased their tendency to consult for symptoms they would usually manage themselves. The purpose of consultation was often to expedite return to day care, rather than alleviate concern. Parents understood that antibiotics were unlikely to be beneficial, but still sought and received treatment in order to appease day care providers’ requirements. Conclusion: Day care providers’ inappropriate advice to parents, together with non-evidence-based exclusion policies, contribute to unnecessary GP consultations and inappropriate antibiotic-seeking behaviour.
33
Cousineau, Lisa Marie. « Pharmaceutical and personal care product concentrations in the upper Susquehanna River ». Diss., Online access via UMI:, 2008.
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34
Price, Tabitha. « How to Care for Patients with Diabetes ». Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/2533.
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Excerpt: More than 25.8 million people in the United States have diabetes. This metabolic disorder is associated with many health complications that result from microvascular and macrovascular diseases.
35
Ramírez, Montoya María Fernanda, Simón Farley Fareld Chacaliaza, Pariasca Jose Herrera, Barrantes Alessandra Ventosilla et Yabar Stephany Gisella Gonzales. « Spartan Men Care ». Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2020. http://hdl.handle.net/10757/652796.
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Hoy en día, no solo las mujeres se preocupan por el cuidado de la piel sino también los hombres. Sumado a esta nueva tendencia, se puede observar el ascenso de la preferencia en productos de origen natural que contribuyen al aporte de beneficios a la piel y a la reducción del daño ocasionado por los químicos.
En este sentido, se ha encontrado un mercado potencial, los hombres específicamente del estilo de vida sofisticado, una parte de la población, definida por Arellano Marketing, como preocupados por el status, la moda y la imagen. Partiendo de la imagen, es sabido que en la actualidad el mercado de productos estéticos para hombres se encuentra en crecimiento desde hace algunos años habiendo generado hasta S/1,000 millones en el año 2018.
Es por ello que “Spartan Man Care” busca abordar el negocio de los productos naturales especializados en hombres que se preocupan por su aspecto físico. Además, es importante resaltar que hoy en día a pesar del mercado potencial existente en los hombres, no existe una variedad de productos dirigidos a ellos, por lo que hay una oportunidad de negocio latente para trabajar. Actualmente, el total de hombres considerados sofisticados en Lima dentro del rango de 25 a 39 años es de 121, 392. De este total el 14% compra productos de higiene con regularidad, representado por 16,995 habitantes y S/3, 976,830 en soles. Finalmente, se determinó que la ganancia del proyecto, calculada a través del VAN, será de S/126, 316 de retorno sobre la inversión.Today, not only women care about skin care but also men. In addition to this new trend, you can see the rise in preference in products of natural origin that contribute to providing benefits to the skin and reducing the damage caused by chemicals. In this sense, a potential market has been found, men specifically for the sophisticated lifestyle, a part of the population, defined by Arellano Marketing, as concerned about status, fashion and image. Based on the image, it is known that currently the market for men's cosmetic products has been growing for some years, having generated up to S / 1,000 million in 2018. That is why "Spartan Man Care" seeks to address the business of natural products specialized in men who care about their physical appearance. Furthermore, it is important to note that today despite the potential market for men, there is no variety of products for them, so there is a latent business opportunity to work. Currently, the total of men considered sophisticated in Lima within the range of 25 to 39 years is 121, 392. Of this total, 14% purchase hygiene products regularly, represented by 16,995 inhabitants and S / 3,976,830 in soles. Finally, it was determined that the project's profit, calculated through the NPV, will be S / 126, 316 of return on investment.
Trabajo de investigación
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嚴蕙怡 et Wai-yi Yim. « Evidence-based eye care protocol for ICU patients with altered level of consciousness ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43251778.
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何穎恩 et Wing-yan Vivian Ho. « An evidence-based guideline on emollient therapy for skin care in premature infants ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193052.
Texte intégralRésumé :
Skin is the major protective barrier in a human body. In premature infants, the immature skin barrier reduces the protection against germs. Emollient therapy is an effective prophylactic measure to improve premature infants’ skin condition so as to protect the premature infants against infection. A systematic review of studies shows that emollient therapy is a simple, safe and cost effective intervention for premature infants to improve skin condition. Evidence shows that emollient therapy can also decrease transdermal water loss, conserve heat and energy, stabilize fluid and electrolytes and prevent nosocomial sepsis. The potential of implementing the proposed evidence-based guideline is explored. It will be carried out in a clinical setting. The transferability of the findings, feasibility and cost-benefit ratio of the emollient therapy will be discussed. In order to ensure the evidence-based guideline will be carried out smoothly, a communication plan is necessary to be made in consultation with the stakeholders. A pilot study will also be conducted before the innovation is implemented to ensure frontline staff members to be familiar with the emollient therapy. At the end, the effectiveness of the emollient therapy will be evaluated in terms of skin score. Patients’ outcome and healthcare provider’s outcome will also be evaluated.published_or_final_version
Nursing Studies
Master
Master of Nursing
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Guzzi, Johnna M. « Impact of early childhood perceptions and experiences on oral health practices in later life ». Morgantown, W. Va. : [West Virginia University Libraries], 2002. http://etd.wvu.edu/templates/showETD.cfm?recnum=2651.
Texte intégralRésumé :
Thesis (M.S.)--West Virginia University, 2002.Title from document title page. Document formatted into pages; contains ix, 83 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 64-66).
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Knowlton, Samantha Dawn. « Measuring bioaerosol concentrations generated from toilet flushes during hospital-based patient care ». Thesis, University of Iowa, 2017. https://ir.uiowa.edu/etd/5539.
Texte intégralRésumé :
Infectious diseases account for over 15 million deaths worldwide. Those who are at greatest risk of contracting an infectious disease are immunocompromised. These individuals may be admitted to a healthcare-based setting where they may become infected. In the United States, 1.7 million immunocompromised individuals contract a healthcare-associated infection which lengthens stay, increases medical costs, and puts lives at stake. The transmission routes for these infections occur from direct contact with healthcare staff and contaminated surfaces. Indirect contact methods, such as bioaerosols suggest, but are not a well-examined route of infection. One possible bioaerosol generator includes the flushing of loose stools in toilets from infected patients. To date, no study has investigated the particle or bioaerosol changes in the air resulting from toilet flushing loose fecal wastes in a healthcare setting. The purpose of this study was to investigate changes in the air before and after a toilet flush to support hypotheses that toilets can produce an aerosol containing viable microorganisms, potentially spreading infectious disease.
Particle and bioaerosol concentrations were measured in hospital bathrooms across 3 sampling conditions; no waste no flush, no waste with flush, and fecal waste with flush. Particle concentrations were measured with a particle counter 3 minutes before a flushing event and throughout the bioaerosol collection period. Bioaerosol concentrations were measured with BioStage impactors fixed on a sampling cart at distances of 0.15, 0.5, and 1 m that was placed in front of a toilet. For each sampling trial, 3 time measurements were recorded after a flushing event (i.e., 5, 10, 15 minutes).
Particle concentrations measured before and after the flush were found to be significantly different in 0.3 (p-values= 0.002, 0.002, 0.015), 0.5 (p-values= 0.002, 0.002, 0.018), 1 (p-values= 0.003, 0.003, 0.027), and 3 µm (p-values= 0.016, 0.032) size bins of the no waste with flush and 0.3 (p-values= 0.009, 0.007, 0.007), 0.5 (p-values= 0.018, 0.006, 0.004), 1 µm (p-values= 0.023, 0.013,) size bins of the fecal waste with flush conditions. Bioaerosol concentrations measured in the no waste no flush and fecal waste with flush were found to be significantly different (p-value= 0.005). However, the bioaerosol concentrations measured were not significantly different across time (p-value= 0.977) or distance (p-value= 0.911).
From the study, we concluded that toilets in this unit produce particles when flushed. The particles aerosolized include microorganisms remaining from previous use or from loose fecal wastes. Differences in bioaerosol concentrations across conditions also suggest that toilets flushed containing wastes may be a likely source of bioaerosols that could allow transmission of infectious microorganisms. No observed differences across time and distance of bioaerosol concentrations suggests that generated aerosols quickly diffuse in the air. Since this study is the first to quantify particles and bioaerosols produced from flushing a hospital toilet, future studies are needed for comparison and for intervention development.
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Jose, Babu. « Dental caries and oral hygiene practices of children and caregivers inKerala, India ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B31954224.
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Shiao, Judith Shu-Chu School of Health Services Management UNSW. « Needlestick injury in health care workers in Taiwan ». Awarded by:University of New South Wales. School of Health Services Management, 2000. http://handle.unsw.edu.au/1959.4/17829.
Texte intégralRésumé :
Objectives: Risk associated with needlestick injuries (NSI) in health care workers (HCWs) in Taiwan has not been characterized. We conducted this investigation to study 1) the prevalence and yearly incidence of NSI in HCWs in Taiwan, and the risk factors associated with NSIs; 2) reporting behavior when a NSI was sustained; and 3) seroprevalence of blood-borne pathogens among inpatients. Combination of the above information allowed for risk estimation for contracting hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in HCWs. Methodology: A cross-sectional questionnaire survey for life-time experience and frequency of NSI was conducted in a random sample from four strata of accredited hospitals according to the number of employees, from July 1996 to June 1997 in Taiwan. All full time employees, including physicians, nurses, technicians, and supporting personnel were recruited. Seroprevalence was examined for HBV, HCV and HIV among inpatients six years in age or older in one teaching hospital during July 1997 to June 1998. Results: A total of 10,469 health care workers were recruited from 16 out of 132 accredited hospitals and 82.6% (8,645) completed the survey, including nurses (61.0%), physicians (16.1%), medical technicians (14.9%), supporting personnel (7.9%). The prevalence of NSI were 93.1%, 86.6%, 78.3%, 61.0% in nurses, physicians, technicians, and supporting personnel respectively. The reported incidence of needlestick and other sharps injuries was 1.30 and 1.21 times per person in the past 12 months. Of the most recent episodes of NSIs, ordinary syringe needles accounted for 80.3% (95% CI, 79.4% - 81.2%) of hollow-bore needles associated incidents, and 74.1% (95% CI, 72.8% - 75.4%) of them were contaminated. The most frequently reported circumstance was the "Breakdown of Universal Precautions", recapping-related behaviors (81.6%, 95% CI 80.3% - 82.9%) of HCWs. More than a quarter (27.8%, 2,399) of HCWs were unprotected (either not vaccinated or having an unknown serological status) against HBV. Seroconversion in stuck HCWs was reported 1.8% for HBV (135), 0.2% (18) for HCV, 0.2% (15) for both HBV and HCV, 0.1% (5) for syphilis and less than 0.1% (2) for HIV. ^M A total of 81.8% of NSIs were unreported. Similarly, high incidence of NSI and low reporting rate were also found in student nurses. Seroprevalence of HBV, HCV, and HIV among inpatients were found higher than the reported rate in source patients of this survey. Seroprevalence of HBsAg was 16.7% in hospitalized patients, 1.7% positive for HBeAg, 12.7% for Anti-HCV, and 0.8% for Anti-HIV. Different seroprevalence rates of HBsAb (+), HBsAg (+), Anti-HCV (+), Anti-HIV (+) in different seasons were also found significant (p<0.001). The risk of seroconversion to HBV was thus estimated to be 0.003 ~ 0.008 time per person-year, HCV 0.003 ~ 0.007 per person-year, and HIV 0.4 ~ 1.2 /100, 000 person-year. Considering the number of HCWs in Taiwan, a total of 330 ~ 917 HCWs will seroconvert to HBV (+) in a year, 330 ~ 880 HCWs seroconvert to HCV (+), and less than one to two HCWs seroconvert to HIV (+). Conclusions: Needlestick and sharps injuries were highly prevalent among Taiwanese HCW and across job categories. Risk of seroconversion is real and significant. Preventive measures are warranted for reduction of contracting blood-borne pathogens in HCWs in Taiwan.
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Slater, Karen. « Improving Care of Peripheral Intravenous Needleless Connectors ». Thesis, Griffith University, 2022. http://hdl.handle.net/10072/412414.
Texte intégralRésumé :
Background: Most hospitalised patients have a peripheral intravenous catheter (PIVC) at some point during hospitalisation. Although the rate of bloodstream infection (BSI) for PIVCs is low, the sheer number of devices inserted makes them a device of interest, since cumulatively many infections occur worldwide each year. Access to intravenous (IV) lines for the administration of medication and fluids in most of the developed world is through the needleless connector (NC) component of a PIVC. NCs were introduced several decades ago to reduce the risk of needlestick injuries amongst healthcare workers. Although they have been successful in reducing needlestick injuries, there has been an unintended consequence of NCs being associated with increased patient BSI. Patient BSI leads to prolonged length of hospital stay and higher costs, as well as significant morbidity and mortality. About half of all BSIs are attributed to the insertion process and half to on-going maintenance care. One of the most important aspects of maintenance care is NC disinfection, which should take place prior to each access of the NC. When disinfection does not occur, or is inadequate, there is a risk of microorganisms gaining access to the patient’s bloodstream. The optimal cleaning duration and disinfectant agent for NC disinfection have not been established. There have been many laboratory-based studies of NC disinfection but few in the clinical environment. Establishment of the optimal disinfectant agent and disinfection duration is vital to prevent patient BSI and improve patient outcomes. It is also important to establish current practice and identify how this compares to best practice guidelines and what factors influence clinicians’ practice behaviours, since providing evidence-based practice is vital to improve patient outcomes and decrease the risk of patient BSI.Aims and Objectives The aim of this PhD was to establish the most effective method for disinfection of PIVC NCs in the clinical environment and to examine current local infection prevention practices to improve NC care. The research findings will inform healthcare worker practice in the care of PIVC NCs to prevent BSIs. Four objectives guided the three phases of the research: 1. To determine the most effective active disinfectant agent and scrub time to disinfect NCs; 2. To establish adequate NC drying times after disinfection; 3. To evaluate current local practice of PIVC NC care; and 4. To identify nurses’ self-reported practice and attitudes regarding NC care and identify factors that influence their behaviour. Design: This PhD had a multi-method research design. It was underpinned by the Mitchell and Gardiner Infection Prevention and Control conceptual framework. This framework entails a multi-faceted approach to infection prevention. There were three phases to this research: a factorial randomised controlled trial (RCT) comparing disinfectant solutions and disinfectant times, with an associated NC drying time experimental study; an observational study to establish local PIVC care; and finally, a survey of nurses’ practice and attitudes about NC care. Phase 1, Part 1: Research questions: 1. What disinfection agent, 70% isopropyl alcohol (IPA) or 2% chlorhexidine in 70% alcohol (CHG-IPA), is more effective in eliminating microorganisms on PIVC NCs? 2. What disinfection time (5, 10, or 15 seconds) is most effective in eliminating microorganisms on PIVC NCs? Setting: Tertiary adult hospital in Brisbane, Australia. Sample: 300 NCs on PIVCs of adult in-patients located on the internal medical units. Main findings: There was no statistical difference between 70% IPA and 2% CHG in 70% IPA (p = .62) in disinfecting the external surface of NCs in the clinical environment; both were effective, but neither removed all microorganisms. There was no statistical difference in the effectiveness of 5, 10, or 15 (p = .21) second scrub times. Phase 1, Part 2 Research questions: 1. What is the effective drying time of 70% IPA, 2% CHG in 70% IPA, and 10% povidone iodine for NC disinfection? 2. Does the drying time of the three recommended disinfectants differ? Setting: Non-clinical area of tertiary adult hospital in Brisbane, Australia Sample: Three commonly available disinfectant preparation pads/wipes were compared. Main findings: The drying time of the three tested disinfectants differed substantially. After a 15-second scrub, 70% IPA was consistently dry after 5 seconds and 2% CHG in 70% IPA was consistently dry after 20 seconds. Drying time for povidone iodine 10% was not established, as it remained wet at 6 minutes, making its use clinically unfeasible. Phase 2 Research questions: 1. How often do nurses decontaminate their hands prior to accessing PIVC NCs (Moment 2 of the 5 Moments of Hand Hygiene)? 2. How often do nurses disinfect PIVC NCS prior to accessing them? 3. What is the length of time that nurses spend disinfecting PIVC NCs prior to accessing them? 4. What is the length of time that nurses let NCs dry after disinfection, prior to accessing them? Setting: Tertiary adult hospital in Brisbane, Australia Sample: 108 observations of nurses working in the emergency department, two medical wards, and two surgical wards. Main findings: Compliance with disinfection of NCs was high (99%), although disinfection time was a much shorter duration than that recommended in the hospital policy (average 6.1 seconds vs 15 seconds). Compliance with hand hygiene prior to drawing up medication (33%) and immediately prior to medication administration (43%) was suboptimal. The most common duration that nurses allowed NCs to dry was 6–10 seconds. Working in the emergency department setting and use f gloves were associated with poorer compliance with hand hygiene.Phase 3: Research questions: 1. What are nurses’ self-reported practices of NC care? 2. How do self-reported practices of NC care compare to current clinical guidelines and results from previous studies? 3. What influences nurses’ behaviour in relation to NC care and how does this compare to previous studies? Setting: Tertiary adult hospital in Brisbane, Australia Sample: Registered and Enrolled nurses working within the clinical divisions. Main findings Most nurses (89%) stated that they always disinfect NCs prior to access. Nurses’ ability to recognise and undertake the correct sequencing for clamping and line/syringe disconnection was low; 79% of nurses identified the correct clamping and disconnection for negative pressure NCs, and 34% identified the correct sequencing for positive pressure devices. Nurses’ behaviour was most influenced by other senior nurses. The risk of introducing bacteria into the patient’s bloodstream was of great concern to most nurses. Conclusion: PIVC-associated BSI, reflecting suboptimal PIVC maintenance care, remains a serious problem. The results of this PhD focusing on NC disinfection highlight that NCs in the clinical environment are frequently contaminated with microorganisms found on the skin. The RCT—the first on this topic undertaken in a clinical environment—determined that the disinfectants and timeframes tested were very effective in removing most microorganisms from NCs in the clinical environment, but there was no difference between the disinfectants or application durations trialled. The drying time study—the first to examine drying time for commonly used disinfectant preparation pads/wipes on NCs—determined that IPA had the shortest drying time. The observational study established that most nurses disinfect NCs prior to access, but for a shorter duration than is currently recommended. Hand hygiene associated with NC care was suboptimal. The survey—the first comprehensive Australian study—established significant nursing knowledge gaps in NC care and identified opportunities for improvement (particularly the sequencing of disconnecting and clamping NCs and lines), which has the potential to reduce BSIs; it also established that local senior nurses were most likely to influence behaviour. Maintenance care of PIVC NCs has previously been minimally researched and is likely the missing link in infection prevention strategies. This PhD has provided comprehensive new evidence and attention now needs to be directed toward improving the maintenance care of NCs to reduce patient BSI and improve patient safety.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing & Midwifery
Griffith Health
Full Text
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Wells, Larry Kevin. « Efficacy of Ibuprofen and Ibuprofen/Acetaminophen on Postoperative Pain in Symptomatic Necrotic Teeth ». The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1283354429.
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Tucker, Helen Jean. « Integrated care : the presence, nature and development of integrated care in community health services in England and Ireland ». Thesis, University of Warwick, 2012. http://wrap.warwick.ac.uk/56879/.
Texte intégralRésumé :
Background: Integrated care is a policy imperative in health and social care services globally, and yet there are reported difficulties in defining, developing and sustaining this way of working. Research Question: This research explores staff views and experiences of the presence, nature and development of integrated care in two programmes of community services. Method: A case study approach was adopted using secondary analysis of qualitative data from staff questionnaires using themed content analysis and pattern matching, with findings triangulated with documentary sources. The study considers the presence and nature of integrated care using the conceptual framework “to what extent integrated care is for everyone (inclusive) and not just for some (exclusive)” as interpreted from the literature. The development of integrated care was explored using systems theory for the management of change in a complex environment. Findings: A meta-analysis of the two case studies demonstrated that integration was present in all 66 services within the two programmes. The nature of integrated care varied and was demonstrated as multiple types (in community hospitals) and processes (in community services). The most frequently reported type was multidisciplinary working. The processes most teams chose to develop were information sharing systems. The development of integration within the case studies was affected by a number of factors, such as commitment and staffing. Conclusion: This study provides new evidence of the presence, nature and development of integration within a wide range of established services spanning all ages. From this and other measures, the extent to which integrated care is presented as “exclusive” can be questioned. These findings have informed the development of a framework of five principles, reflecting whether integrated care is: for everyone, extensive, enduring, can be enabled and essential. The implications and application of this research for policy, service development and training are discussed, and proposals for further research include testing the applicability of this framework and widening this study.
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Delport, S. V. « Health and health care of the preschool child in Hout Bay ». Master's thesis, University of Cape Town, 1987. http://hdl.handle.net/11427/27215.
Texte intégralRésumé :
At present not enough is known about the health of preschool children in the poorer communities of Cape Town. This study, was undertaken to assess the health and health care of preschool children in one such community: that of the Hout Bay harbour township. A clinic and community-based surveillance programme was devised to make this assessment. Data were obtained by monitoring the records at the Community Health Centre in the township. A study sample of 214 children from the community was also selected by random stratified cluster sampling. This sample was assessed by means of a questionnaire and a full physical examination. Analysis of data was performed on the IBM main-frame computer. A large number of medical problems were identified on screening the community sample. Most of these problems were minor ones and could be managed appropriately at the Health Centre. On the basis of the referral patterns and the small number of newly diagnosed functionally important health problems, the provision of health care in-the area was considered to be adequate. The high immunisation rate in the preschool children and the excellent attendance figures at the child health clinics indicates that the services provided are well utilised by the population. Dental caries was found to be a major health problem in the area. A strong case for the introduction of a dental health educational programme and for the fluoridisation of drinking water can made on the basis of these findings. An ongoing health screening programme would be beneficial. It could be accomplished by utilising appropriately trained nursing personnel.
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Crawford, Kathryn J. « Assessment of noise in a medical intensive care unit ». Thesis, University of Iowa, 2016. https://ir.uiowa.edu/etd/2061.
Texte intégralRésumé :
Exposure to noise in hospital intensive care units (ICUs) can disrupt patients’ sleep and delay their recovery. In this intervention study, noise levels were measured in eight patient rooms of a medical ICU (MICU) every minute with sound level meters for eight weeks before and after an intervention. Implemented over six weeks, the intervention was designed to educate nurses and other staff members to reduce noise levels through behavior modification, including instituting a “quiet time” in the afternoons, encouraging patients to keep televisions off or at lower volumes, and speaking more quietly during conversations. Sound equivalent levels (Leq) were calculated from one-minute measurements for each hour in each room. These hourly Leq (Leq-H) values were compared by pod (group of rooms within the MICU), room position (in proximity to a central nurses’ station), occupancy status, and time of day. Days with more than ten hours of one-minute noise levels above 60 dBA were flagged as the loudest time periods and compared to MICU activity logs. The intervention was ineffective with Leq-H values always above World Health Organization guidelines for ICUs (35 dBA in day; 30 dBA at night) before and after the intervention. Leq-H values frequently exceeded more modest project goals during the day regardless of the intervention (50% of Leq-H > 55 dBA both pre- and post-intervention) and at night (68% and 62% of Leq-H > 50 dBA pre- and post-intervention). Statistical analysis of the Leq-H suggests a general source is contributing to the high baseline noise in the MICU, most likely the heating, ventilation, and air-conditioning (HVAC) system. Our analysis of one-minute data indicated that high noise was often associated with high-volume respiratory-support devices. We concluded that our intervention focusing on administrative controls (e.g., education and training) was not enough to reduce noise in the MICU but that an intervention designed with engineering controls (e.g., shielding, substitution) would be more effective.
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Darr, Robert Edward. « Barriers To Men Entering Undergraduate Dental Hygiene Programs ». The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1471863587.
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McLean, Christopher Duncan. « Thinking about patients and talking about persons in critical care nursing ». Thesis, University of Southampton, 2012. https://eprints.soton.ac.uk/349086/.
Texte intégralRésumé :
Nursing scholarship and healthcare policy set an expectation that nurses should think about patients as persons. Nevertheless, the literature reveals that critical care nurses can struggle to perceive patients as persons, and thus suggests they may think about patients in different ways. This thesis presents the findings of an ethnographic study undertaken within one critical care unit in the United Kingdom which examined how critical care nurses do think about patients. A purposive sampling strategy recruited 7 participants representing both experienced and inexperienced critical care nurses. Data were collected over a period of 8 months during 2006 to 2007, and primarily comprised the field notes from 92 hours of participant observation supplemented by 13 tape recorded interviews. Data analysis was influenced by Foucault and Goffman and adopted the perspective of linguistic ethnography. Analysis revealed that all participants thought about patients in seven distinct ways: as ‘social beings’, as ‘valued individuals’, as ‘routine work’, as a ‘set of needs’, as a ‘body’, as ‘(un)stable’ or as a ‘medical case’. Accounts of participants’ practice revealed that they had a tacit understanding that these different ways of thinking related to aspects of one coherent whole, but no one way of thinking could be characterised as thinking about this ‘whole person’. Nurses could only think about one aspect of the patient at a time. Nurses’ practice was not guided or explained by their thinking about patients as persons, but rather expert practice was characterised by nurses’ fluid and appropriate movement between different ways of thinking about patients. When participants talked about their practice it was evident that these nurses could only legitimately talk about themselves as giving care to persons. Participants characterised some of the ways in which they had to think about patients as impersonal, and this actively hindered these nurses from describing or reflecting upon elements of their practice. There is therefore conflict and dissonance between nurses’ expectation that they should think about patients as persons, and the fact that delivering nursing care requires them to think about patients in different ways. The development of future critical care nurses will require practitioners and educators to recognise that nurses think about patients in different ways, and that expert practice is characterised by the clinical wisdom which enables nurses to think about patients in ways which are appropriate to the moment. Nurse scholars and educationalists should therefore avoid claims to a unique professional knowledge base which suggest to nurses that some ways of thinking are always inappropriate or inherently reductionist. Instead, there is a need for scholars and policy makers to articulate a vision of person centred care clearly, and in ways which avoid constructing dissonance between nurses’ ideals, and the ways in which they do and must think about patients.
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Snyman, J. S. « Effectiveness of the basic antenatal care package in primary health care clinics ». Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/728.
Texte intégralRésumé :
Pregnancy challenges the health care system in a unique way in that it involves at least two individuals – the woman and the fetus. The death rates of both pregnant women (maternal mortality) and newborns (perinatal mortality) are often used to indicate the quality of care the health system is providing. In terms of maternal and perinatal outcomes South Africa scores poorly compared to other upper-middle income countries (Penn-Kekana & Blaauw, 2002:14). The high stillbirth rate compared to the neonatal death rate reflects poor quality of antenatal care. Maternal and perinatal mortality is recognised as a problem and as a priority for action in the Millennium Development Goals (Thieren & Beusenberg, 2005:11). The Saving Mothers (Pattinson, 2002: 37-135) and Saving Babies (Pattinson, 2004:4-35) reports describe the causes and avoidable factors of these deaths with recommendations on how to improve care. The quality of care during the antenatal period may impact on the health of the pregnant woman and the outcome of the pregnancy, in particular on the still birth rate. In primary health care services there are many factors which may impact on and influence the quality of antenatal care. For example with the implementation of the comprehensive primary health care services package (Department of Health, 2001a:21-35) changes at clinic level resulted in a large number of primary health care professional nurses having to provide antenatal care, who previously may only have worked with one aspect of the primary health care package such as minor ailments or childcare. Because skills of midwifery or antenatal care, had not been practiced by some of these professional nurses, perhaps since completion of basic training, their level of competence has declined, and they have not been exposed to new developments in the field of midwifery. The practice of primary health care nurses is also influenced by the impact of diseases not specifically related to pregnancy like HIV/AIDS and tuberculosis. The principles of quality antenatal care are known (Chalmers et al. 2001:203) but despite the knowledge about these principles the maternal and perinatal mortality remains high. The Basic Antenatal Care quality improvement package is designed to assist clinical management and decision making in antenatal care. The implementation of the BANC package may influence the quality of antenatal care positively, which in turn may impact on the outcome of pregnancy for the mother and her baby. The aim of this study was to evaluate the effectiveness of the Basic antenatal care (BANC) package to improve the quality of antenatal care at primary health care clinics.
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Tang, Pui-kwan, et 鄧佩君. « Voice problems of secondary school teachers and the need for preventative education ». Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206591.
Texte intégralRésumé :
Voice problems are common among teachers due to their job characteristics. Thus, the quality of teaching, daily communication, emotion would be adversely affected. However, the past studies mainly focused on primary school and preschool teachers. There is lack of investigation on voice problems of secondary school teachers. Moreover, the need for voice use training for secondary school teachers was not addressed in the past.
This study investigated the prevalence of voice problems in secondary school teachers in Hong Kong and the need for preventive education. A questionnaire was decided with domains in demographics, job natures, impact on voice disorders, risk factors, history of seeking help because of voice problems, view on different treatment options and opinion towards the need of voice protection training. Subjects were recruited from four local secondary schools in Hong Kong.
85 questionnaires were collected and analyzed. The results showed a high prevalence of voice disorders (75%) among secondary school teachers. Also it revealed different levels of impact on work performance, emotion and daily communication. Laryngitis was the only risk factor found to be significantly correlated with the voice disorder. On the other hand, the rate of seeking professional help and their knowledge about voice rehabilitation were low. Most of the respondents realized the need for voice protection training. It suggested that the voice problems of secondary school teachers should be highlighted and more voice protection information and voice training should be provided.published_or_final_version
Surgery
Master
Master of Medical Sciences