My Diploma work is called ``Reasons for Children´s Placement in Institutional and Correctional Facilities``. The aim of the work was to find out and analyse why children were transferred into the facilities of institutional and correctional education and to map all legal measures which could procede. The theoretical part deals with socio-pathological phenomena in families, legal framework of placing children in special-care facilities, children´s social and legal security, different school institutions and their inmates´ rights and duties as well as psychological impact of institutional care on children´s development. In the practical part a method of quantitative sociological research, a secondary data analysis, has been used. The research database consisted of all children who were placed in any special-care facility as a result of court-ordered institutional and correctional education, preliminary measures or parent agreed-to placement in an diagnostic institute. Three hypotheses based on the professional literature findings were defined. 1. The main reason why children are placed in institutional facilities is a dysfunctional family where the children´s education is threatened by some sociopathological phenomena. 2. Children are mostly placed in the institutional facilities aged 12 {--} 15. 3. The fact schools do not solve the behavioural problems in children in the long term affects negatively more than one quarter of institutionalised children. The first hypothesis was not confirmed while the other two were.

INTRODUÇÃO: A despeito de todos os avanços no tratamento cirúrgico do câncer, ainda existem fatores complicadores para a adequada evolução no pós-operatório. Realizou-se estudo retrospectivo em uma população de pacientes submetidos a tratamento cirúrgico oncológico eletivo para o câncer retal, a fim de caracterizá-los epidemiologicamente e determinar quais variáveis estão associadas a maior morbimortalidade tais como aumento de permanência hospitalar, utilização de unidade de terapia intensiva, reoperações, óbito em 30 dias e custos hospitalares totais. MÉTODO: Foram selecionados todos os pacientes submetidos a cirurgias retais eletivas para o tratamento oncológico no período de 01 de outubro de 2008 a 31 de dezembro de 2012, resultando numa amostra de 405 pacientes de idade adulta e ambos os sexos. Realizou-se análise univariada para cada desfecho e análise multivariada através de regressão logística com ajustamento para as seguintes variáveis: sexo, idade, índice massa corpórea, estadiamento TNM, procedimento realizado, escore ASA, via de acesso, realização de QRT neoadjuvante, intervalo entre a neoadjuvância e a cirurgia e tempo cirúrgico, com validação interna através da técnica de bootstrap. RESULTADOS: Foram identificados como fatores de risco para aumento de permanência hospitalar a obesidade classe II e III (OR 15,44; IC95% 1,05 - 227,52; p = 0,05) e anestesia combinada - regional associada à geral (OR 5,38; IC95% 1,08 - 29,95; p = 0,04); amputação abdominoperineal foi fator de risco para reoperação em 30 dias (OR 4,54; IC95% 1,15 - 17,90; p = 0,03); amputação abdominoperineal (OR 5,38; IC95% 1,21 - 23,73; p = 0,03) e exenteração pélvica (OR 19,98; IC95% 0,99 - 401,32; p = 0,05) foram fatores de risco para utilização de UTI; idade acima de 79 anos (OR 13,99; IC95% 1,51 - 128,95; p = 0,02) foi fator de risco para complicação pós-operatória; idade acima de 79 anos (OR 0,07; IC95% 0,01 - 0,39; p = 0,01) foi fator de proteção para tempo cirúrgico elevado, obesidade classe II e III (OR 12,87; IC95% 1,54 - 107,67; p = 0,02) e via de acesso laparoscópica com transição para aberta (OR 8,7; IC95% 2,67 - 28,36; p < 0,001) foram fatores de risco para tempo cirúrgico elevado. CONCLUSÕES: Obesidade classe II e III e anestesia combinada são fatores de risco para tempo de permanência hospitalar prolongado para pacientes submetidos a cirurgia para tratamento de câncer retal. Outros estudos se fazem necessários para entender quais são os mecanismos que levam a anestesia combinada, eventualmente, a este aumento de permanência hospitalar / INTRODUCTION: Despite all the developments in the surgical treatment of cancer, there are still complicating factors for a correct postoperative evolution. There were conducted a retrospective study in a population of patients submitted to surgical rectal cancer treatment to characterize them epidemiologically and determine which variables are associated with increased morbimortality such as increased hospital length of stay, use of intensive care unit, reoperations, 30-day mortality and total hospital costs. METHOD: All patients submitted to colorectal surgery treatment for cancer during the period October 1st, 2008 to December 31th, 2012, resulting in a sample of 405 patients of both genders. Univariate analysis was conducted for each outcome and multivariate analysis through logistic regression with adjustment for the following variables: sex, age, body mass index, TNM stage, procedure performed, ASA score, laparoscopic or open surgery, neoadjuvant treatment, interval between the neoadjuvant therapy and the surgery, and operative time, with internal validation by the bootstrap technique. RESULTS: there were identified as risk factors for increased hospital stay, the obesity class II and III (OR 15.44; 95% CI 1.05-227.52; p = 0.05) and combined anesthesia - regional and general (OR 5.38; 95% CI 1.08-29.95; p = 0.04); abdominoperineal amputation was a risk factor for 30-day reoperation (OR 4.54; 1.15 95% CI-17.90; p = 0.03); abdominoperineal amputation (OR 5.38; 95% CI 1.21-23.73; p = 0.03) and pelvic exenteration (OR 19.98; 95% CI 0.99-401.32; p = 0.05) were risk factors for ICU use; age over 79 years (OR 13.99; CI 1.51-128.95; p = 0.02) was a risk factor for postoperative complication; age over 79 years (OR 0.07; CI 0.01-0.39; p = 0.01) was protective factor to prolonged operative time , obesity class II and III (OR 12.87; CI 1.54-107.67; p = 0.02) and laparoscopic approach with transition to open (OR 8.7; CI 2.67-28.36; p 0.001) were risk factors to prolonged operative time. CONCLUSIONS: Obese class II and III and combined anesthesia are risk factors for prolonged hospital stay for patients undergoing surgery for rectal cancer treatment. Further studies are needed to understand the mechanisms that lead combined anesthesia to increase hospital stay

Funding of services to residents in publicly funded long-term care (LTC) facilities has historically rested upon a list of physical needs. However, more than 60% of residents in nursing homes have dementia; a condition in which physical needs are only a part of the overall clinical picture. Since past funding formulas focused primarily on the physical characteristics of residents, the Ontario government has adopted the RUG (Resource Utilization Groups)-III (34 Group) for use in LTC facilities which follows the adoption of the Minimum Data Set (MDS) 2.0 assessment instrument. Some still question whether the newer formula adequately reflects the care needs of residents with dementia despite its validation in many countries. The purpose of this study was to determine the comprehensiveness of the RUG-III (34 Group) in addressing the needs of residents with dementia living in LTC. First, a critical systematic review of the literature was conducted to determine the needs of residents with dementia. Numerous electronic databases were searched for articles published between January 2000 and September 2010, and later cross-referenced. Second, needs identified from the literature were matched to the items of the RUG-III which are selected variables of the MDS 2.0. Third, the priority of the items in the RUG-III was analysed in accordance with the importance of the identified needs. The documented needs were taken from 68 studies and classified into 19 main categories. The needs most supported by the literature were the management of behavioural problems, social needs, the need for daily individualized activities/care and emotional needs/personhood. Among the needs identified, activities of daily living (ADLs), cognitive needs and general overall physical health met the most RUG-III items. These needs were found to be well represented within the system. Other needs of importance such as social needs are not thoroughly considered in the grouping methodology though matched to MDS variables. The fact that these needs are not well addressed in the RUG-III poses concerns. Future research is needed to validate the significance of these needs. Considerations should be made as to the adequacy of the funding system and the allocation of funding.

No description available.

This study examined the influence of three predictor variables on perceptions of assisted living: psychological well-being, functional status, and coping strategies. A multiple regression analysis was used to examine the influence of these factors on perceptions of the transition to assisted living.

This qualitative exploratory study explored adolescents’ perceptions of the HIV youth friendly centre at a hospital in Lesotho in order to improve adolescent-friendly health care services in Lesotho. Data was obtained through interviewing nine purposively selected adolescents aged 18–19 years who accessed health care services at the centre, and was analysed using an adapted version of Colaizzi’s seven-step thematic analysis. Six themes emerged from this study: attributes experienced during adolescents’ visits to health care facilities, adolescents’ perceptions of the health care facility, waiting times, facts related to HIV pre-test counselling, description of services available for adolescents’ health, and challenges faced by adolescents in relation to their HIV positive status. The adolescents explained the factors that encouraged them to be tested, and to commit to HIV management and treatment. The findings showed that it is important to reserve a dedicated space for adolescents, to provide comprehensive health services at one site, to ensure adolescents’ privacy and confidentiality, to indicate patient flow clearly, to indicate the service offering clearly, to offer flexible operating hours and days, to involve youth in the service provision, to keep queues short, and to establish peer support groups. / Health Studies / M.A. (Public Health)

Project of health center with facilities for civic amenities. It is a three-storey above ground object. On the ground floor there is a pharmacy, a veterinary station and a medical office. On the second floor there are six medical offices and a technical room. On the third floor there are 4 spaces for civic amenities. Vertical load-bearing structure consists of masonry of ceramic blocks and internal monolithic reinforced concrete skeleton. Horizontal load-bearing structure is made of reinforced concrete beams and prestressed reinforced concrete panels. The building is based on concrete foundation strips and reinforced concrete pads. The building is roofed with a warm flat green roof. Thermal insulation of the facade is made of mineral wool insulation and has a ventilated facade.

This diploma thesis medical house in Hustopece deals with a design and project documentation for construction health facilities in Hustopece. Object is used to provide a daily patient care. There are nine private medical facilities of various specializations, pharmacy and optics. Object with its proposal allows wheelchair access. This is a hasnot four-storey building. Structure consists of monolithic reinforced concrete skeleton with stiffening walls, footings based and passports. internal unsound are designed from the drywall. Building roof is flat, edging attic.

MPH / Department of Public Health

Die gegenwärtige Regelung der SächsPfleinrVO für gesondert berechenbare Aufwendungen nach § 82 Abs. 3 SGB XI für Investitionen und Instandhaltungsaufwendungen in Pflegeeinrichtungen enthält einige grundlegende Problembereiche, die einer ökonomischen Logik systematisch widersprechen. Gegenstand des Gutachtens ist die Darstellung der verschiedenen Problembereiche der SächsPfleinrVO und möglicher Lösungsmöglichkeiten. Die Problembereiche können dabei in vier Bereiche zusammengefasst werden: 1. Systematische Problematiken der SächsPfleinrVO 2011/13 2. Verbraucherschutzprobleme der Neuregelung 3. Ausgelöster Verwaltungsaufwand durch die neue SächsPfleinrVO 2011/13 4. Probleme in der operativen Umsetzung der SächsPfleinrVO 2011/13 Dem Erkenntnisinteresse des Auftraggebers folgend liegt der Analyseschwerpunkt bei Problemen, die insbesondere aus Pflegeeinrichtungen resultieren, die vollstationäre Dauerpflegeplätze anbieten. Nach der Darstellung der rechtlichen Grundlagen und der Datengrundlage des Gutachtens, werden diese vier Problembereiche anhand von Beispielen erläutert und mögliche Problemlösungen vorgeschlagen. Mit einer Zusammenfassung und Schlussfolgerungen wird ein Fazit gezogen.