765 resultados para Dissertations, academic
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OBJECTIVES: To determine the risk of hospital readmission, nursing home admission, and death, as well as health services utilization over a 6-month follow-up, in community-dwelling elderly persons hospitalized after a noninjurious fall. DESIGN: Prospective cohort study with 6-month follow-up. SETTING: Swiss academic medical center. PARTICIPANTS: Six hundred ninety persons aged 75 and older hospitalized through the emergency department. MEASUREMENTS: Data on demographics and medical, physical, social, and mental status were collected upon admission. Follow-up data were collected from the state centralized billing system (hospital and nursing home admission) and proxies (death). RESULTS: Seventy patients (10%) were hospitalized after a noninjurious fall. Fallers had shorter hospital stays (median 4 vs 8 days, P<.001) and were more frequently discharged to rehabilitation or respite care than nonfallers. During follow-up, fallers were more likely to be institutionalized (adjusted hazard ratio=1.82, 95% confidence interval=1.03-3.19, P=.04) independent of comorbidity and functional and mental status. Overall institutional costs (averaged per day of follow-up) were similar for both groups ($138.5 vs $148.7, P=.66), but fallers had lower hospital costs and significantly higher rehabilitation and long-term care costs ($55.5 vs $24.1, P<.001), even after adjustment for comorbidity, living situation, and functional and cognitive status. CONCLUSION: Elderly patients hospitalized after a noninjurious fall were twice as likely to be institutionalized as those admitted for other medical conditions and had higher intermediate and long-term care services utilization during follow-up, independent of functional and health status. These results provide direction for interventions needed to delay or prevent institutionalization and reduce subsequent costs.
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BACKGROUND: Walk-in centres may improve access to healthcare for some patients, due to their convenient location and extensive opening hours, with no need for an appointment. Herein, we describe and assess a new model of walk-in centre, characterised by care provided by residents and supervision achieved by experienced family doctors. The main aim of the study was to assess patients' satisfaction about the care they received from residents and their supervision by family doctors. The secondary aim was to describe walk-in patients' demographic characteristics and to identify potential associations with satisfaction. METHODS: The study was conducted in the walk-in centre of Lausanne. Patients who consulted between 11th and 31st April were automatically included and received a questionnaire in French. We used a five-point Likert scale, ranging from "not at all satisfied" to "very satisfied", converted from values of 1 to 5. We focused on the satisfaction regarding residents' care and supervision by a family doctor. The former was divided in three categories: "Skills", "Treatment" and "Behaviour". A mean satisfaction score was calculated for each category and a multivariable logistic model was applied in order to identify associations with patients' demographics. RESULTS: The overall response rate was 47% [184/395]. Walk-in patients were more likely to be women (62%), young (median age 31), with a high education level (40% of University degree or equivalent). Patients were "very satisfied" with residents' care, with a median satisfaction score between 4.5 and 5, for each category. Over 90% of patients were "satisfied" or "very satisfied" that a family doctor was involved in the consultation. Age showed the greatest association with satisfaction. CONCLUSION: Patients were highly satisfied with care provided by residents and with the involvement of a family doctor in the consultation. Older age showed the greatest positive association with satisfaction with a positive impact. The high level satisfaction reported by walk-in patients supports this new model of walk-in centre.
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Prepared by the Division of Criminal and Juvenile Justice Planning, Iowa Department of Human Rights
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Prepared by the Division of Criminal and Juvenile Justice Planning, Iowa Department of Human Rights
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Comprend : Testament littéraire
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L'estudi que seguidament descriurem va sorgir en el context del curs de doctorat "Models d'investigació a l'aula" dirigit per la Dra. J.M. Sancho del Departament de Didactica i Organització Escolar de la Universitat de Barcelona, la finalitat principal d'aquest era donar a coneixer la perspectiva de recerca qualitativa, naturalista o interpretativa mitjançant la planificació i la realització d'un treball de recerca. Els components de l'equip investigador, la majoria llicenciats en pedagogia i amb experiencia professional en el món de l'educació, actualment ens trobem en procés de realització de la tesi doctoral. Fruit de les nostres preocupacions i inquietuds del moment com a estudiants de tercer cicle, va sorgir la proposta d'investigar el fet mateix de realitzar una tesi doctoral, específicament des de Ciencies de l'Educació, tasca que tots, un dia o altre hauríem de finalitzar, en cas de voler aconseguir el desitjat grau de doctor.
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This paper describes a project led by the Instituto Brasileiro de Informações em Ciência e Tecnologia (Ibict), a government institution, to build a national digital library for electronic theses and dissertations - Bibliteca Digital de Teses e Dissertações (BDTD). The project has been a collaborative effort among Ibict, universities and other research centers in Brazil. The developers adopted a system architecture based on the Open Archives Initiative (OAI) in which universities and research centers act as data providers and Ibict as a service provider. A Brazilian metadata standard for electronic theses and dissertations was developed for the digital library. A toolkit including open source package was also developed by Ibict to be distributed to potential data providers. BDTD has been integrated with the international initiative: the Networked Digital Library of Thesis and Dissertation (NDLTD). Discussions in the paper address various issues related to project design, development and management as well as the role played by Ibict. Conclusions highlight some important lessons learned to date and challenges for the future in expanding the BDTD project.
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Comprend : La nourrice marâtre, ou Dissertation sur les suites funestes du nourrissage mercenaire
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Comprend : La nourrice marâtre, ou Dissertation sur les suites funestes du nourrissage mercenaire
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L'estudi que seguidament descriurem va sorgir en el context del curs de doctorat "Models d'investigació a l'aula" dirigit per la Dra. J.M. Sancho del Departament de Didactica i Organització Escolar de la Universitat de Barcelona, la finalitat principal d'aquest era donar a coneixer la perspectiva de recerca qualitativa, naturalista o interpretativa mitjançant la planificació i la realització d'un treball de recerca. Els components de l'equip investigador, la majoria llicenciats en pedagogia i amb experiencia professional en el món de l'educació, actualment ens trobem en procés de realització de la tesi doctoral. Fruit de les nostres preocupacions i inquietuds del moment com a estudiants de tercer cicle, va sorgir la proposta d'investigar el fet mateix de realitzar una tesi doctoral, específicament des de Ciencies de l'Educació, tasca que tots, un dia o altre hauríem de finalitzar, en cas de voler aconseguir el desitjat grau de doctor.
