published_or_final_version / Architecture / Master / Master of Architecture

AIDS has established itself over more than three decades as a major international pandemic3. While initial cases of the disease were documented in 1981 in the USA and Europe, cases in Africa became known at around the same time. It is however probable that the disease existed in Africa long before this time (Pratt, 1986:17). Due to the prominence of the AIDS epidemic and its related opportunistic diseases in South Africa and most acutely in KwaZulu-Natal (Smith, 2002 and South African Department of Health Report 2006) , the associated impact of the need for care of those living with and those affected by the virus has been brought to the fore. The accommodation of these persons occurs in a variety of building forms and types, and may vary depending on the stage within the individual’s health cycle related to the impact of the virus. With the advent of medication, termed anti-retroviral therapy, designed to retard the development of the virus, life expectancy has been extended, but with no confirmed cure and viral resistances, death is inevitable. While those living with the virus may continue to live productive lives for some time, the infirm largely seek care within medical facilities. Should access to formal health services be difficult due to remoteness or a lack of transport, such people are often cared for within the homes of surviving family members – often by children - or by their community. With the largest impact on the population being found within the 20 – 29 age bracket in the late 1990's (Smith, 1999: HIV Positive Results, June 1998), shifting to the 25 – 34 age bracket from 2003 onwards (South African Department of Health Report 2006), tertiary education institutions, through their clinics, have increasingly dealt with the management of student and staff health. Other building types affected by the AIDS epidemic4 include prisons and mortuaries, while care for those remaining behind after the death of family members to AIDS is usually within children’s homes or street shelters. The impact of AIDS on the built environment professions will permeate its way to all involved. Through selected case studies one will observe the impact of the epidemic on existing facilities and examine current methods employed to accommodate the problem. Architects, through the modification of existing structures or through the design of new facilities, are assisting in the struggle. New methods of dealing with the care of patients are being considered as well as alternative and innovative design approaches. This includes the need for flexibility of building layouts and universal design. Most proposals in the researched context require cost effective and workable solutions. Hope for the future lies with the management of the virus through medication, enabling the extension of life expectancies. Architects need to adapt to the incumbent problem while medical researchers develop a workable vaccine to confine HIV/ AIDS to the history books with the likes of Bubonic Plague, Smallpox and Typhus. It is through good architectural design and detailing that Architects can assist in the AIDS fight. This can be achieved firstly through research – gaining an understanding of the AIDS Brief – then designing for the specific needs for the infected and affected. These needs will include comfort, accessibility, anthropometrics, ease of maintenance, affordability, ventilation and illumination conducive to good health, and sustainability. Architects therefore have a major role to play within this epidemic. / Thesis (M.Arch.)-University of KwaZulu-Natal, Durban, 2008.

The study comprises an investigation of the quality of the clinical teaching environment of undergraduate students in the accredited Primary health care ( PHC) facilities used by a provincial nursing college in Limpopo. The researcher, who is employed full time in one of the accredited PHC facilities to which undergraduate students are admitted for clinical practice, became aware of the tension between the undergraduate students and professional nurses working in the PHC facility during the performance of clinical practice. Undergraduate students accused the professional nurses of neither supervising them properly during the execution of their clinical practice, nor assessing them on the prescribed practical outcomes. On the other hand, the professional nurses working in the PHC facility complained that undergraduate students were placed at the PHC facilities in large numbers with no clinical accompanist accompanying them. The research objectives were to determine the quality of clinical practice in the PHC clinical learning environment as rated by undergraduate students allocated by a provincial nursing college located working in a PHC facility in a district of Limpopo Province, and to formulate recommendations for the professional nurses in PHC districtmanagement to incorporate supervision for undergraduate students in order to enhance clinical teaching for undergraduate students in Primary health care facilities. The researcher used a quantitative, descriptive, explorative and contextual design. An all-inclusive sampling method was used to select research participants. Participants were undergraduate students of a provincial nursing college in Limpopo. Informed consent was obtained. Ethical approval was obtained from the relevant authorities. Data was collected by using an internationally validated Clinical Learning Environment Supervision and Nurse Teacher Instrument (Saariskoki & Leino-Kilpi, 2008:259-267).. Data analysis was done by using descriptive statistics and revealed that the clinical practice environment was not conducive to enhancing practical skills development in the real practical PHC practice. Evaluation of study, limitations and recommendations for education, research, practice and policy were discussed. / MCur, North-West University, Potchefstroom Campus, 2014

Despite the growing numbers and valuable contributions of older individuals to society, they continue to face negative attitudes towards them. Such attitudes are largely influenced by portrayal of older persons in the media. Understanding how the media portrays older people to the public can provide significant insights into the nature of the images from which older people may make comparisons and which inform the perceptions, opinions, and attitudes of other people. There is little knowledge of perceptions of media portrayal in old age, and this study aimed to obtain insight from the point of view of older people regarding how they are portrayed in the printed media. Qualitative research has been applied to gain insight in the older persons’ perceptions. The case study method was chosen since it allowed the researcher to gain an in–depth understanding of older person’s perceptions regarding how they are portrayed in the media. The participants in this study consisted of nine male and 12 female individuals residing in a residential care facility. Persons between the ages of 60 and 85 were purposively chosen since they can contribute to meaningful insight regarding how they are portrayed in the print media. Data was collected by means of conducting focus group discussions and individual interviews. The use of these methods enabled dynamic interactions resulting in the production of rich, detailed information. Data was analyzed using thematic content analysis and key–word–in–context analysis. Guidelines to ensure the integrity of the findings have been applied. The findings indicated that older persons perceive their portrayal in the media to be minimal in terms of the exposure that they receive. Older persons feel that on the seldom occasion when they are in the media, they are presented as an isolated population separated from younger persons. The portrayal of older persons in the media is also perceived as stereotypical in the sense that older persons are presented as sick, inactive, weak and fragile. The implications of such portrayal according to older persons are that they influence intergenerational relationships and they also confirm stereotypical assumptions about older persons. Older persons feel that they rather want to be portrayed in terms of the valuable contributions that they are making to all spheres of life, despite old age. The media should thus promote positive ageing, which could contribute to the stimulation and motivation of older persons. Findings of this study also indicate that while older persons enjoy reading magazines and newspapers they are often limited to do so due to financial restrictions and physical limitations such as poor eyesight. The findings of this research of older persons perceptions regarding their portrayal in the media has implications for intergenerational relationships as well as to advertisers and marketers who are looking to appeal to the older population. / Thesis (M.A. (Research Psychology))--North-West University, Potchefstroom Campus, 2011.

Despite the growing numbers and valuable contributions of older individuals to society, they continue to face negative attitudes towards them. Such attitudes are largely influenced by portrayal of older persons in the media. Understanding how the media portrays older people to the public can provide significant insights into the nature of the images from which older people may make comparisons and which inform the perceptions, opinions, and attitudes of other people. There is little knowledge of perceptions of media portrayal in old age, and this study aimed to obtain insight from the point of view of older people regarding how they are portrayed in the printed media. Qualitative research has been applied to gain insight in the older persons’ perceptions. The case study method was chosen since it allowed the researcher to gain an in–depth understanding of older person’s perceptions regarding how they are portrayed in the media. The participants in this study consisted of nine male and 12 female individuals residing in a residential care facility. Persons between the ages of 60 and 85 were purposively chosen since they can contribute to meaningful insight regarding how they are portrayed in the print media. Data was collected by means of conducting focus group discussions and individual interviews. The use of these methods enabled dynamic interactions resulting in the production of rich, detailed information. Data was analyzed using thematic content analysis and key–word–in–context analysis. Guidelines to ensure the integrity of the findings have been applied. The findings indicated that older persons perceive their portrayal in the media to be minimal in terms of the exposure that they receive. Older persons feel that on the seldom occasion when they are in the media, they are presented as an isolated population separated from younger persons. The portrayal of older persons in the media is also perceived as stereotypical in the sense that older persons are presented as sick, inactive, weak and fragile. The implications of such portrayal according to older persons are that they influence intergenerational relationships and they also confirm stereotypical assumptions about older persons. Older persons feel that they rather want to be portrayed in terms of the valuable contributions that they are making to all spheres of life, despite old age. The media should thus promote positive ageing, which could contribute to the stimulation and motivation of older persons. Findings of this study also indicate that while older persons enjoy reading magazines and newspapers they are often limited to do so due to financial restrictions and physical limitations such as poor eyesight. The findings of this research of older persons perceptions regarding their portrayal in the media has implications for intergenerational relationships as well as to advertisers and marketers who are looking to appeal to the older population. / Thesis (M.A. (Research Psychology))--North-West University, Potchefstroom Campus, 2011.

Thesis (M.S.P.H.)--University of South Florida, 2008. / Title from PDF of title page. Document formatted into pages; contains 26 pages. Includes bibliographical references.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2007. / Source: Masters Abstracts International, Volume: 46-01, page: 0311. Adviser: Osama Mikhail. Includes bibliographical references.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 47-01, page: . Includes bibliographical references

The thesis is focused on health and injuries in nursing homes and health care facilities and their prevention. Given that accidents cause high morbidity and mortality of the elderly, it is important to think about prevention and the search for the causes of these accidents. The main objective of the empirical part of the study was to determine the causes of clients accidents in social and medical facilities and compare both types of facilities. For research in the empirical part of this work has been used quantitative research strategy, method of questioning techniques of data collection questionnaire. Research has shown that 87% of respondents suffer from musculoskeletal diseases. 44% of respondents, women more often than men, had received the fall and subsequent hospitalization. The thesis may help to understand the issues of accidents of the elderly and health effect on the quality of people's life living in health and social care facilities.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Introduction. Aging favors the appearance of propitious clinical conditions to a high use of medicines, a reality in the elderly over 65 years of age. However, the number of medicines used should not be the only predictor of a medication regimen complexity, other factors may increase the complexity of pharmacotherapy leading to possible problems related to pharmacotherapy. In this perspective, there are few national studies that evaluate the medication regimen complexity in the elderly, especially those that evaluate outcomes influenced by this complexity, so as to allow interventions for its optimization. Thus, the objective of this dissertation was to evaluate the pharmacotherapeutic profile and the health outcomes associated with the medication regimen complexity. Methods. This study was carried out in two stages. In the first stage, a descriptive cross-sectional study was performed to evaluate the medication regimen complexity of elderly patients in three long-term care facilities using the Medication Regimen Complexity Index (MRCI). This study was conducted for 12 months in three long-term care facilities in the state of Sergipe. In the second stage, a systematic review was performed to identify in the literature which outcomes were influenced by the medication regimen complexity, using the MRCI. We analyzed all study designs published until February 2017 who met the following eligibility criteria: using the MRCI instrument to measure the medication regimen complexity, assessing the medication regimen complexity for global regimens, related the medication regimen complexity with clinical and/or humanistic and/or economic outcome, was written in English, Spanish or Portuguese. Results. In the first stage, the evaluation of the medication regimen complexity obtained an average of 15.1 points (± 9.8), with a minimum of two and a maximum of 59 points. The highest levels of complexity were associated with the dose frequency, with a mean of 5.5 (± 3.6) points. A significant relationship between the medication regimen complexity and the variables polypharmacy, drug interaction, drug potentially inappropriate for the elderly and therapeutic duplicity was found (p <0.001). In the second stage, of the 610 studies evaluated, 20 met the eligibility criteria. The health outcomes most influenced by the medication regimen complexity were the clinical outcomes: hospitalization, hospital readmission and adherence to pharmacotherapy, most of the studies presented satisfactory results to association the outcomes with the complexity and obtained good methodological quality. Conclusion. This dissertation made it possible to evaluate the pharmacotherapeutic profile of elderly patients, showed that besides polypharmacy, potential drug interaction, therapeutic duplicity and potentially inappropriate medicines for the elderly are risk factors for the increased medication regimen complexity in these patients. Furthermore, identified that the health outcomes most influenced by the medication regimen complexity were ones clinical: hospitalization, hospital readmission and adherence to the pharmacotherapy. / Introdução. O envelhecimento favorece o aparecimento de condições clínicas propícias para o elevado uso de medicamentos, observado principalmente em pacientes acima de 65 anos de idade. Entretanto, o número de medicamentos utilizados não deve ser o único preditor de uma farmacoterapia complexa, pois outros fatores podem elevar a complexidade, conduzindo a possíveis problemas relacionados à farmacoterapia. Nesta perspectiva, são escassos os estudos nacionais que avaliam a complexidade da farmacoterapia em idosos, principalmente os que analisam desfechos influenciados por essa complexidade, de modo a permitir intervenções para sua otimização. Assim, o objetivo desta dissertação foi avaliar o perfil farmacoterapêutico e os desfechos em saúde associados à complexidade da farmacoterapia. Metodologia. Este estudo foi realizado em duas etapas. Na primeira, foi realizado um estudo transversal descritivo para avaliar a complexidade da farmacoterapia de idosos atendidos em três instituições de longa permanência para idosos (ILPIs), por meio do instrumento Medication Regimen Complexity Index (MRCI). Este estudo foi conduzido por 12 meses em três instituições no Estado de Sergipe. Na segunda etapa, foi realizada uma revisão sistemática, a fim de identificar, na literatura, quais desfechos estão associados à complexidade da farmacoterapia, medida pelo instrumento MRCI. Foram analisados todos os delineamentos de estudos publicados até fevereiro de 2017 que atenderam aos seguintes critérios de elegibilidade: usar o instrumento MRCI para medir a complexidade da farmacoterapia; avaliar a complexidade da farmacoterapia para os regimes globais dos pacientes; e relacionar a complexidade da farmacoterapia com desfechos clínicos e/ou humanísticos e/ou econômicos, publicados em inglês, espanhol ou português. Resultados. Na primeira etapa, a avaliação da complexidade da farmacoterapia obteve média de 15,1 pontos (± 9,8), com mínimo de dois e máximo de 59 pontos. Os níveis mais altos de complexidade foram associados à frequência de dose, com uma média de 5,5 (± 3,6). Além disso, foi identificada relação significativa entre a complexidade da farmacoterapia e as variáveis polifarmácia, interação medicamentosa, medicamento potencialmente inapropriado para idosos e duplicidade terapêutica (p< 0,001). Na segunda etapa, dos 610 estudos avaliados, 20 preencheram os critérios de elegibilidade. Os desfechos em saúde mais influenciados pela complexidade da farmacoterapia foram os desfechos clínicos: hospitalização, readmissão hospitalar e adesão à farmacoterapia. A maioria dos estudos apresentou resultados satisfatórios para associação dos desfechos com a complexidade e obtiveram boa qualidade metodológica. Conclusão. Esta dissertação possibilitou avaliar o perfil farmacoterapêutico de pacientes idosos e identificar que, além da polifarmácia, interação medicamentosa potencial, duplicidade terapêutica e medicamentos potencialmente inapropriados para idosos são fatores de risco para o aumento da complexidade da farmacoterapia nestes pacientes. Além disso, identificou-se que os desfechos em saúde mais influenciados pela complexidade da farmacoterapia foram os clínicos: hospitalização, readmissão hospitalar e adesão a farmacoterapia. / Aracaju, SE