Background – The researcher conducted an explorative, qualitative study to identify the perceptions and experiences about ART of patients currently on treatment at Themba Lethu clinic (TLC) in Johannesburg in order to establish strategies to decrease the high level of non-adherence to antiretroviral therapy (ART). This study included 30 HIV positive patients on ART who came to Themba Lethu clinic for their regular clinic visit. The researcher used the purposive sampling procedure to target particular individuals and categories of individuals for investigation. Interviews and questionnaires were used as a method of collecting primary information. The researcher posed a series of questions to willing participants about their characteristics, opinions, attitudes, or previous experiences by and tabulates their answers. Results – The research finds that the participants ‘ages ranged from 26 – 62 years (M = 39.4). The participants stay in the suburbs around Johannesburg in Gauteng and 77% of them have been living there for more than 5 years. Only 40% of these patients were originally born in Gauteng while others come from different provinces in South Africa including some of the sub-Saharan countries (13%). The participants were less likely to have completed secondary education but were more likely to have completed Matric. 30% of participants are afraid of stigma, 40% are concerned about side-effects, 33.33% believes that ART cures AIDS, 70 % are non-adherent and 20% visited traditional healers while on ART. Conclusion – There must be on-going education, counseling and support to increase adherence and decrease the clinic loss to follow-ups. Intervention to improve care and treatment should utilize the role of traditional healers to reduce the disease progression and to improve adherence to ART. Traditional healers could also work more closely with modern health professionals to provide AIDS information and evaluation of HIV/AIDS symptoms.

ABSTRACT This abstract provides a brief summary of the research study (Nieswiadomy, 2002). The South African report on confidential enquiries into maternal deaths identified delayed and/or infrequent antenatal care as a significant avoidable factor contributing to maternal mortality in South Africa (SA) (Department of Health (DOH), 2001). There are still women in South Africa whose first antenatal care contact with the midwives obstetrical unit (MOU) is in the third trimester of their pregnancy. The aim of this study was to determine the health seeking practices amongst primigravidae at a level 1 MOU, based in a peri-urban area in Gauteng province, SA. The health seeking practice of concern was antenatal clinic attendance. The research design was qualitative, descriptive, exploratory and contextual. The research method implemented was unstructured individual in-depth interviews. The population consisted of primigravidae who were attending antenatal clinic at a level 1 MOU. The sample consisted of primigravidae who booked at the level 1 MOU’s antenatal clinic in the third trimester of their pregnancy. Maximum variety purposive sampling, with inclusion and exclusion criteria, was used and sampling continued until data were saturated. The sample size consisted of 10 participants whereby 2 of them were the pilot study and eight were the interviews that followed the pilot study. Data were collected by means of individual in-depth interviews. One question was asked: ‘What experiences influenced you to go for your first antenatal visit when you did?’ Interviews were audio taped, transcribed and analyzed by using Tesch’s eight steps of data analysis (Creswell, 1994). Lincoln and Guba’s four strategies for trustworthiness were applied and ethical considerations were implemented. The results were discussed under two themes. Those themes were: needs, and delayed booking. The recommendations were made regarding the recommendations that arose from the study, recommendations for research, nursing practice and nursing education.

Cette recherche se situe dans le champ de la psychopathologie sociale clinique. En référence à la métapsychologie psychanalytique, elle est construite à partir de l’étude de cas. Depuis la place de clinicienne en institution, en portant notre attention sur les différents espaces de la réalité psychique, nous proposons de questionner les liens entre exclusion sociale et temporalité. Nous avons rencontré, dans la clinique et dans le processus de la recherche, différents niveaux de confusion dans l’ordre du temps et avons proposé, pris par la question de l’origine, qu’un espace intérieur se constitue à l’orée de la vie dans le lien avec les premiers objets : l’espace du silence. A partir d’une analyse de la relation transféro-contre-transférentielle dans le cadre d’une clinique individuelle, groupale, institutionnelle ainsi qu’avec l’analyse d’une oeuvre littéraire, nous avons interrogé, à travers la formation de cet espace premier, le devenir sujet dans le lien à l’autre. Ce devenir implique une ouverture à une temporalité propre à chacun et permettant l’inscription dans une histoire singulière. Le sujet "exclu" se construirait comme étranger en lui-même, dans une forme de confusion qui renverrait à un brouillage entre l’intérieur et l’extérieur, entre fantasme et réalité. Sa temporalité serait construite à partir de cryptes renfermant le temps de l’objet, elle ouvrirait sur un temps qui s’étalerait dans un "en dehors" enfoui : un temps qui tournerait sur lui-même, nous renvoyant aux figures de la mélancolie. A sa rencontre, le clinicien serait convoqué à un point de retour, lieu de l’absence totale. Il y aurait, et ce travail de recherche en serait une voie, à figurer quelque chose de ce chaos des origines. / This research has been conduct in the field of clinical social psychopathology. It is based on case study, in reference to psychoanalytical metapsychology. By focusing our attention on the different spaces of psychic reality, and through a vast experience as a clinical psychologist, we are going to question the links between social exclusion and temporality. Throughout the clinical cases and research process, we have been confronted with different levels of time order confusion. As we took in account the question of origin, we have suggested that an inner space is constituted at the edge of life in the bond with the first objects: the space of silence. On the basis of an analysis of the transference and countertransference relationship in the context of an individual, group and institutional therapy, as well as the analysis of a literary work, we have questioned the establishment of interpersonal relationships of one subject, through the construction of its first space. This process involves an opening to a temporality proper to each one that allows the integration in a singular history. The "excluded" subject would build itself as a stranger to itself in a form of confusion that would refer to a blur between the inside and the outside, between fantasy and reality. Its temporality would be built from crypts containing the time of the object, it would open on a time that would spread out in a buried "outside": a time that would turn on itself, referring us to the figures of melancholy. When meeting the subject, the clinical psychologist would be brought back to a point of return, the place of nothingness. This research work would be one way to decipher and understand the chaos of origins.

"The purpose of this study was to determine, if possible, whether there was any significant change in the 'social consequences' experienced by thirty-one alcoholic patients during the first six months they are in treatment as compared to the six months immediately prior to their entering treatment. The 'significant change' was determined on the basis of the 'social consequences' they suffered as a result of their relapse into compulsive drinking, and the difference 'before' and 'during' was tested by the chi square test for the significance of the difference"--Introduction. / Typescript. / "June, 1959." / "Submitted to the Graduate Council of Florida State University in partial fulfillment of the requirements for the degree of Master of Social Work." / Advisor: Dorothy D. Hayes, Professor Directing Study. / Includes bibliographical references.

Thesis (M.A.) / Boston Medical Center’s pediatric outpatient clinic has resident clinic flow problems that negatively affect its patient care level. Due to system backup, in August 2012, resident patients spent an average of 71 minutes in the clinic for a scheduled 20-minute appointment. This study used quality improvement methodology (QI) to investigate potential solutions to the clinic flow problems. Our aim was, by May 2013 decrease the average patient time-in-clinic for resident vaccination patients between 2 and 30 months of age by 20%. Using Plan-Do-Study-Act (PDSA) cycles within QI, the research team implemented three interventions between August 2012 and May 2013 that focused on improving communication between members of the clinic medical team. Throughout the year, the research team measured the time-in-clinic for the patient population, plotted the data with run charts, and determined if the interventions resulted in a corresponding decrease in time. By May 2013, the interventions resulted in an average decrease in time across all resident classes. First years showed a 4.5% decrease. Second years showed a 5.7% decrease. Third years showed a 20% decrease. While these decreases are significant, due to time limitations, we could not determine if the interventions resulted in a lasting improvement to clinic flow. / 2031-01-01

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Considering the current National Health Insurance system and the status of finance, many hospitals and clinics are cooperating or doing strategic alliance to achieve economies of scale. Although strategic alliance is common in Western medicine hospitals/ clinics, few Chinese medicine clinics have been done this way. Therefore, this study would like to discuss the behaviors of Chinese medicine clinics to understand how to use strategic alliance and differentiated business models to disencumber crisis for existence. This study selects two Chinese medicine clinics using strategic alliance to conduct case studies. After comparing business models and the ways of strategic alliance between the two clinics, it have been founded that the differences from business models lead to the two clinics have different motivations and methods of strategic alliance. Finally, this study provides some suggestions based on case studies in order to be referred by other Chinese medicine clinics.

Abstract Under the currently condition of he health care and medical financial in Taiwan, some hospitals already start the business management. The most successful case is Chang-Gung memorial Hospital. But due to the strong competition in the market, some basic clinics start to ally with their competition for more effectively using the medical resources and running. The alliance strategy gradually unify the basic medical market with their professional , fluently interflow, decreasing material , brand union, marketing and management. In Taiwan this kind of alliance strategy is common in the western medicine and seldom Chinese medicine has done in this way. This research is basic on the alliance strategy of Chinese medicine. To escape of the survival problem, the basic Chinese medicine clinics must understand how to use their area to ally and run with their competitions. This study is taken one Chinese medicine alliance as sample in Kaohsiung to start the research in order to understand their alliance strategy and how they run the business. The result of research can be the reference for the ones who need the alliance strategy.

A Study on Professional Role of the Clinic Pharmacist in Taiwan Abstract To lower the cost and enhance the quality of medical service, the Government implemented the National Health Insurance in 1995, and the system of Separation of Medicine and Pharmacy in 1997. However, the separation caused both sides of doctor and pharmacist to ignite a vigorous battle in striving and competing for dispensing right. Thus made the government to adopt a regionalized and phased parallel system to execute the separation . In other words, local medical doctors can either hire pharmacists to fill the prescriptions in the clinics or hand the prescriptions to patients and have the prescriptions filled in drugstores. This study chose quantitative method to explore the role of clinic pharmacist, and to further explore the relation between the separation of the two services and the professional role of pharmacists. Questionnaires were distributed to all clinic doctors and pharmacists in the city of Kaohsiung, the results were collected as the resource of important evidentiary data. Through Gap Analysis¡Bt test¡BMultivariate Analysis of Variance¡Band Pearson Correlation, we¡¦ve come to the following findings: there is indeed a gap between doctors and pharmacists regarding the understanding and recognition toward the professional role of pharmacist, especially to the ability in providing medication consultation demonstrated by pharmacist; contrary opinions were held by the two sides regarding the separation of the two services, the position of clinic pharmacists, as well as the importance of and support to patients¡¦ right in knowing the medication they are taking, physicians even consider the hiring of pharmacists is only for fulfilling the requirement of the National Health Insurance System; the recognition between doctors and pharmacists to pharmacist¡¦s professional role (patients medicating instruction, ability in providing medication consultation, and double-checking of physician¡¦s prescription) is actually related in proportion with their attitudes toward the separation of Medicine and Pharmacy ,and the position of clinic pharmacists. It is hoped that the conclusion of this study is helpful in improving the understanding between physicians and pharmacists, thus alleviate the long-term conflict in the issue, enhance mutual respect to professional right, point out a crisp direction for the Government to follow when designing and promoting the system of the Separation of Medicine and Pharmacy. Key words: Separation of Medicine and Pharmacy, Clinic Pharmacist Professional Role

Project Thesis (D. Min.)--Denver Conservative Baptist Seminary, 1991. / Appendix includes coursework pamphlets mounted on numbered leaves. Includes bibliographical references (leaves 179-196).