Sexual abuse of children is a complex and sensitive subject that has an influence on children , families and the wider community . In referring to the term sexual abuse it is usually associated with girls. Although there is very little literature available that focus specially on the sexual abuse of boys, it can never be denied. The clinic involved school where the research was conducted is a school for behaviour difficult boys in middle childhood (6-12 years). There are a large number of sexually abused boys or boys who have been exposed to sexual abuse in the concerned school. It is clear that children who have been sexually abused sometimes have a variety of problems including behavioral problems. There is little research available in South Africa that focuses specifically on sexual abuse and behavioral problems. It seems that boys externalize trauma and that lead to behavioral problems. It was therefore necessary to determine the impact of sexual abuse on the boys, to ensure that appropriate services can be delivered to these boys. The purpose of this study was to investigate behavioral problems of sexual abuse of boys in a clinic school by means of a literature study and empirical research. The researcher conducted qualitative and quantitative approach at the same time. For the quantitative approach, the total population of the sexually abused boys in the clinic school was involved in the study and a questionnaire compiled by the researcher was completed. For the qualitative approach, focus group was held with " SBST " ( School Based Support Team ) , teachers and child and youth care workers. There are recommendations made that seek to ensure that proper services can be provided to the sexual abuse of boys in a clinic school, in order to address their problem behavior and rehabilitate them faster. / MSW (Forensic Practice), North-West University, Potchefstroom Campus, 2014

Published Article / The aim of the study on which this article is based was to reflect on the learning experiences of students during integrated management of childhood illness (IMCI) training in an undergraduate programme. IMCI is a set of guidelines that was established by the World Health Organisation (WHO) for cost-effective quality care for children younger than five to prevent diseases and death (WHO, 2004). Skilled primary healthcare workers are required to provide quality care at first contact with these children. The IMCI package was presented as an integral part of the second-year module that focuses on primary healthcare. In order to improve the quality of health services and refocus the health system on primary health-care (South Africa Department of Health, 2010), students have to demonstrate that they have achieved competence. According to Killen (2000:188), competence is a holistic term and focuses on knowledge, skills and values instead of competencies, which refer to specific capabilities. Primary health-care workers who act competently will integrate foundational IMCI knowledge with skills and values as well as with the ability to verify their decisions (Killen, 2000:188). Aqualitative, exploratory and descriptive research design was used to investigate the IMCI learning experiences. Such experiences are one of the indications whether training has been successful and how it can be improved (Suski, 2004:222). Data was collected by means of nominal-group technique (NGT) interviews with second-year nursing students of the training school who complied with the criteria for inclusion. NGT interviews were used effectively to evaluate clinical interaction, education and training.The findings reflected the different emotions experienced during teaching and learning as having been positive, negative or neutral. The consideration of negative emotions will assist with the improvement of IMCI teaching and learning, but all these findings can be useful for other higher-education institutions that present or plan to present IMCI training.

Sexual abuse of children is a complex and sensitive subject that has an influence on children , families and the wider community . In referring to the term sexual abuse it is usually associated with girls. Although there is very little literature available that focus specially on the sexual abuse of boys, it can never be denied. The clinic involved school where the research was conducted is a school for behaviour difficult boys in middle childhood (6-12 years). There are a large number of sexually abused boys or boys who have been exposed to sexual abuse in the concerned school. It is clear that children who have been sexually abused sometimes have a variety of problems including behavioral problems. There is little research available in South Africa that focuses specifically on sexual abuse and behavioral problems. It seems that boys externalize trauma and that lead to behavioral problems. It was therefore necessary to determine the impact of sexual abuse on the boys, to ensure that appropriate services can be delivered to these boys. The purpose of this study was to investigate behavioral problems of sexual abuse of boys in a clinic school by means of a literature study and empirical research. The researcher conducted qualitative and quantitative approach at the same time. For the quantitative approach, the total population of the sexually abused boys in the clinic school was involved in the study and a questionnaire compiled by the researcher was completed. For the qualitative approach, focus group was held with " SBST " ( School Based Support Team ) , teachers and child and youth care workers. There are recommendations made that seek to ensure that proper services can be provided to the sexual abuse of boys in a clinic school, in order to address their problem behavior and rehabilitate them faster. / MSW (Forensic Practice), North-West University, Potchefstroom Campus, 2014

The purpose of this study was to investigate the utilization of Postnatal Services at St. Joseph's Clinic. Sixty women of child- bearing age participated in the study. Convenience sampling was utilised. An integration of Qualitative and Quantitative approaches were used for collection and analysis of data. The results of the study showed that women had high knowledge about the sixth week PNC. Women's attitudes regarding attendance at the sixth week PNC were both positive and negative. The relationship between knowledge and attitude was significant (r = .2999, p = .044) The study concluded that, the attitudes of women towards attendance at the sixth week PNC were mostly negative. Four themes emerged from the study. Some of the recommendations of the study included a need for review of information given to mothers regarding its relevance and appropriateness; a need to foster more positive attitudes in women towards attendance at the sixth week PNC. / Health Studies / M.A. (Nursing Science)

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012. / Background: The Durban University of Technology (DUT) chiropractic teaching clinic (CTC) represents a training facility for future chiropractors as well as providing a healthcare service to the local population. It is important to measure the demographic characteristics and presenting complaints of patients attending the DUT CTC as this information prepares the student interns for private practice. It also provides an insight into the popularity of chiropractic in the community. Objectives: This study sought to measure certain demographic variables and presenting conditions of patients attending DUT CTC and to assess whether these have changed over time. Method: A retrospective, cross-sectional descriptive study was performed by drawing patient files of new patients presenting to the DUT CTC for the months of February through April, during 2000, 2006 and 2011 (data from a 1994 study was included for analysis). The files had the following information regarding the patient collected: age, gender, ethnicity, occupation, medical aid, main presenting complaint, as well the duration of the most recent complaint. The data was analysed for trends using statistical software (SPSS v19). Results: Data from 1 311 patient files were analyzed. The number of patients attending the DUT CTC had reduced significantly since 2000. The mean age ranged from 37.0 – 39.7yrs across the samples with a trend of increasing age occurring between 1994 and 2006. Ages ranged from 2 weeks – 89yrs, with 20 – 29yrs being the most common group. Females formed 50.5 – 51.2% of the samples with no significant change over time. White (46.3 – 64.2%) and Indian patients (27.2 – 40.9%) formed the majority, with Black patients showing a trend of increasing representation (from 6.4% in 2000 to 15.8% in 2011). The most common occupations were student (19.7 – 26.8%) and clerical (17 – 23%), with a trend noted between 1994 and 2006 of a decreasing student proportion. This trend reversed from 2006 – 2011. Medical aid subscription among patients reduced significantly (p<0.05) from 56.2% in 1994 to 41.6% in 2011. The main presenting complaints were spinal (68.2 – 84.1%), with low back (30.7 – 40.7%) and neck/head (27.8 – 33.8%) being the most common. Most main complaints were of a chronic nature (45.8 – 61.7%), though a trend of reducing chronicity was noted between 1994 and 2006. A trend of increasing sub-acute complaints was seen between 1994 and 2011. Conclusions: The patients attending DUT CTC are similar to most international CTC’s in terms of patients’ age, gender, occupation, and main presenting complaint. Compared to existing data on South African private practice, the patients at DUT CTC are generally younger, less likely to be female, less likely to be White, more likely to be Indian or Black, less likely to have medical aid, more likely to present with low back pain as appose to neck/head pain, and more likely to present in the acute/sub-acute phase. Between 1994 and 2006, the trend shows that patients at DUT CTC were older, less likely to be White, less likely to be students, less likely to have medical aid, and less likely to present in the chronic phase.

Inledning: Vid en förvärvad hjärnskada är delaktighet i rehabiliteringen en central del för patientens återanpassning till vardagen och eventuellt tillbakabildande av förlorade funktioner. Delaktighet i vårdförloppet leder till en ökad teoretisk förståelse och praktisk insikt hos patienten. Syfte: Syftet med denna studie var att beskriva hur vuxna personer med förvärvad hjärnskada upplever/har upplevt delaktighet under sin vårdtid på en rehabiliteringsavdelning. Metod: Detta är en kvalitativ studie med beskrivande design med semistrukturerade intervjuer som datainsamlingsmetod. Tio patienter som vårdats minst fem arbetsdagar på en rehabiliteringsavdelning intervjuades gällande frågor om delaktighet under vårdtiden på rehabiliteringsavdelningen. En kvalitativ innehållsanalys inspirerad av Graneheim och Lundman (2012) användes för att analysera insamlad data på latentnivå. Resultat: Utifrån temat ”delaktighet” uppstod tre kategorier: kompetent personal, informerad patient, samt självständighet. Temat ”icke-delaktighet” resulterade i två kategorier: bristfällig information och kontrollförlust. Det var flera av informanternas berättelser som liknade varandra i fråga om delaktighet på vårdavdelningen. Samtliga informanter beskrev att de upplevt sig vara delaktiga någon gång under vårdtiden på rehabiliteringsavdelningen. Det handlade bland annat om att de upplevt att de fått tillräcklig information från personalen angående sjukdom och vårdförlopp, att det fanns kompetent personal som anpassade sig efter patienternas individuella behov och önskemål samt möjlighet till självständighet under exempelvis träning. Ett flertal informanter beskrev även upplevelser av att inte vara delaktiga under vårdtiden. Bristfällig information från personalens sida samt en känsla av kontrollförlust var de huvudsakliga anledningarna till detta. Slutsats: Denna studie kan bidra till en ökad förståelse hos vårdpersonal angående delaktighet under rehabiliteringstiden för patienter med förvärvad hjärnskada. Då vårdtiderna kan vara långa på rehabiliteringsavdelningen är det särskilt viktigt med en god kontakt och bra kommunikation med patienterna för delaktighet och en patientcentrerad vård.

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Tidigare forskning inom detta område har fokuserat på barns vård, däremot har barns upplevelser utifrån ett aktivitetsperspektiv under sjukhusvistelse inte uppmärksammats. Författarnas uppfattning var att aktiviteter som erbjuds på barn- och ungdomskliniker oftast passar yngre barn och därför ansågs det relevant att tillfråga äldre barn om deras upplevelser av att kunna vara delaktiga i aktiviteter på sjukhus. Syftet var att beskriva barns upplevelser av möjlighet till delaktighet i meningsfulla aktiviteter under sjukhusvistelse. Kvalitativ metod användes med semi-strukturerade intervjuer. Ett bekvämlighetsurval användes och respondenterna var 12 barn i åldrarna 8-15 som befann sig på två barn- och ungdomskliniker i södra Sverige. Datamaterialet bearbetades med en kvalitativ innehållsanalys. Tolkningen av datamaterialet resulterade i det övergripande temat “Upplevelse av möjlighet till delaktighet i meningsfulla aktiviteter”. Resultatet delades in i tre kategorier; delaktighet, meningsfull aktivitet och aktiviteter på sjukhus. Slutsatsen var att barnen upplevde både möjligheter och begränsningar i att kunna vara delaktiga i aktiviteter under sin sjukhusvistelse. Majoriteten av barnen upplevde sig ha goda möjligheter till att kunna vara delaktiga i meningsfulla aktiviteter såsom att vistas på lekterapi, spela tv-spel och umgås med familj och vänner. / Previous science has focused on children’s clinical care and the children’s experience from an activity perspective during their hospital stay has not been focused on. The author’s opinion was that the activities in children’s and youth clinics often are suited for younger children. Therefor it seemed relevant to ask older children about their experience of participation in activities at the hospital. The aim was to describe children’s experiences of the possibility to participate in meaningful activities during their hospital stay. A qualitative method were used with semi-structured interviews. A convenience sample were used and the study included 12 children aged 8-15 in two children and youth clinics in southern Sweden. For data analysis a qualitative content analysis was used. The analysis resulted in the overall theme “Experience of possibility to participation in meaningful activities”. The result ended up in the three categories; participation, meaningful activities and activities at the hospital. The conclusion were that the children experienced both possibilities and limitations in order to participate in activities. The majority of the children experienced good possibilities to participate in meaningful activities as the play therapy, play video-games and spend time with family and friends.

The Doctor Interactive Group Medical Appointment (DIGMA) is a group health intervention that combines the services of behavioral health and primary care. The DIGMA was first invented by Edward Noffsinger in 1996, in response to his own difficulties with the overtaxed primary care system at Kaiser Permanente in California (Noffsinger, 1999). Integrating healthcare services in this way has practical implications such as efficient use of resources, treating multiple complaints at once, and beginning to view the mind and body as one (Noffsinger, 1999; Engel, 1977). The DIGMA at the Austin Veterans Outpatient Clinic was designed to address the specific needs of veterans with hypertension. It consists of 4 sessions of 1.5 hours each and addresses such varied topics as exercise, stress-management, nutrition, and medication adherence. These topics are discussed in a group format with the tenets of group psychotherapy (Yalom & Leszcz, 2005) as a backdrop. An exploratory study was warranted to determine whether programs of this sort would be effective on a broad scale. A pretest/posttest design was utilized to determine if the DIGMA was effective at reducing symptoms of hypertension; improving health promoting behavior; increasing self-efficacy to manage hypertension; and increasing internal health locus of control while decreasing chance and powerful others health locus of control. Groups were conducted over a period of seven months with a total of 73 male veterans enrolled in the study. The final n was 58. Findings indicated that both systolic and diastolic blood pressure readings were reduced significantly from pretest to posttest. Health promoting behavior increased significantly; hypertension self efficacy increased significantly; and locus of control did not change significantly from pretest to posttest. The exploratory study concluded that the DIGMA may be efficacious for a variety of aspects of the management of hypertension. It is suggested that further research be conducted but that integrating services in this way can lead to improved patient outcomes and can also be cost-effective. / text

<p>Tuberculosis (TB) is a major contributor to the disease burden in developing countries resulting in deaths of approximately 2 million people a year. South Africa (SA) has one of the highest annual&nbsp / TB incidences with an estimate of 558 per 100 000 population (2003) and the situation shows no sign of abating. TB remains the most common opportunistic infection and cause of death&nbsp / amongst HIV- infected patients. Both TB and HIV treatment depend exclusively on multi-drug regimens that require close monitoring among health care professionals. With increasing workload&nbsp / due to staff shortage and high patient load, the quality of care in nurse-led primary care clinics maybe compromised. Existing clinic staff may overlook drug-drug interactions, side effects and may&nbsp / not be aware of the consequences when a formulation is modified during multi-drug therapy administration. As the custodian of medicines, pharmacists are ideally placed to monitor therapy.&nbsp / Clinicbased training programmes which are offered to nurses provide an opportunity to work alongside clinic staff and engage in patient-centered care where the pharmacotherapeutic outcome of TB and HIV drug regimens could be closely monitored. </p>