Introduction: Unintended pregnancies are associated with poor health and economic outcomes. The use of modern contraceptive methods has been proven to be effective in reducing unintended pregnancy. Historical barriers in access to care experienced by rural communities suggest that rural women may also experience barriers in accessing reproductive health services. However, little is known about geographic variation in reproductive health services. The primary aim of this study is to examine rural and urban differences in access to and utilization of contraceptive methods among publicly funded clinics in South Carolina. Methods: A cross-sectional study of all Federally Qualified Health Center (FQHC) and Department of Health & Environmental Control (DHEC) family planning clinics in South Carolina offering reproductive health services in 2017 was used to examine access to and utilization of contraceptive methods. Administrators or organizational representatives with knowledge of clinic operations were asked to complete a survey specific to the provision of contraceptive services. Two outcomes from the survey were of primary interest. Access to a full range of contraceptive methods was operationalized as a dichotomous variable reflecting whether or not an individual method was directly available on-site. Utilization was defined as the percent of women using individual methods, relative to the overall distribution of women receiving contraceptive services. The Rural-Urban Continuum Codes (RUCC) were used to categorize clinic as rural or urban. RUCC codes 1, 2 and 3 were classified as urban, while codes 4 through 8 were classified as rural. Contraceptive methods were examined individually and aggregated into 3 groups: highly effective reversible methods, moderately effective methods and least effective methods. Bivariate relationships between the two-level RUCC variable and provision of contraceptive methods were examined using a Chi-square test for independence. An independent t-test was also used to examine differences in contraceptive utilization based on rural or urban clinic designation. Results: The study population consisted of 105 clinics, with 60% of clinics in urban areas and 40% in rural areas. Across the state of South Carolina, 75% of clinics offer highly effective contraceptive methods without having to schedule a follow-up visit to receive the method. Although not statistically significant, among clinics that offered highly effective reversible contraceptives on site, 79% of such methods are available in urban communities compared to 74% in rural and communities (p=0.49). About 12% of women at urban clinics utilized highly effective reversible methods compared to 7% of women at rural clinics (p=0.02). This appears to be driven by less access to and utilization of hormonal implants (9% among urban clinics compared to 5% among rural). Conclusion: Access to highly effective methods through publicly funded providers is similar in rural and urban communities; however, rural/urban differences in the utilization of highly effective methods, specifically implants, was noted. Given historical disparities in access and transportation barriers among rural population, decreased access and utilization of methods that allow for longer durations between provider visits could be problematic. These findings suggest that increased efforts ensuring access to long acting reversible contraception in rural clinics is warranted.

Bakgrund: Behovet av ögonsjukvård ökar, ett sätt att möta det ökande behovet är genom sjuksköterskemottagningar. Uppgiftsväxling till sjuksköterskemottagningar medför förändringar för såväl patienter, sjuksköterskor som hälso- och sjukvårdens organisation. Det är därför betydelsefullt att tillvarata erfarenheter för att säkerställa vård med hög kvalité och främja en god arbetsmiljö. Syfte: Syftet var att belysa erfarenheter av sjuksköterskemottagning inom ögonsjukvård. Metod: En systematisk litteraturstudie med kvalitativ design och induktiv ansats. Resultat: Kategorierna som framkom var: nya arbetsuppgifter, säker vård, effektiv resursanvändning och vårdrelation. Med rätt förutsättningar kunde uppgiftsväxling genomföras på ett säkert sätt inom ögonsjukvård, därmed ökades mottagningarnas kapacitet. De nya arbetsuppgifterna föregicks av utbildning och upplevdes utveckla yrkesrollen. Förbättrad tillgänglighet och mer tid under besöken upplevdes som positivt av patienterna och stärkte vårdrelationen med sjuksköterskorna. Både patienter och sjuksköterskors erfarenheter av sjuksköterskemottagningar var positiva. Slutsats: Uppgiftsväxling till sjuksköterskemottagning kan stärka yrkesrollen, genomföras på ett säkert sätt, öka kapaciteten och stärka vårdrelationen. När sjuksköterskemottagningar utvecklas behöver förutsättningar skapas för en god arbetsmiljö och säker vård. Mer forskning behövs om hur arbetsmiljön och gruppdynamiken inom yrkeskåren och mellan yrkesgrupper påverkas vid uppgiftsväxling. Specialistsjuksköterskeutbildningen med inriktning mot ögonsjukvård behöver förbereda studenterna på en dynamisk yrkesroll. / Background: The need for ophthalmic care is increasing, one way to meet the increasing need is through nurse-run clinics, which entails changes for patients, nurses as well as the health care system. It is important to take advantage of experiences to ensure high-quality care and promote a good working environment Aim: The aim was to highlight experiences of nurse-run clinic in ophthalmology. Method: A systematic literature review with qualitive design and inductive approach. Results: The categories that emerged were: new tasks, safe care, using resources efficiently and care relationship. Both patients and nurses' experiences of nursing clinics were positive. With the right conditions, task-shifting could be carried out safely in ophthalmic care, thereby increasing the capacity of the clinics. The new tasks were preceded by training and were perceived to affect the professional role in a positive way. Improved accessibility and increased time during the visits were perceived as positive by the patients and strengthened the care relationship with the nurses. Conclusion: As nurse-run clinics develop, conditions need to be created for a good working environment and safe care. Task-shifting to nurse-run clinics can strengthen the professional role, be carried out safely, increase capacity and strengthen the care relationship. More research is needed on how the work environment and group dynamics within the profession and between occupational groups are affected when task-shifting is implemented. Specialist nurse education in ophthalmic care need to prepare students for a dynamic professional role.

Magister Chirurgiae Dentium (MChD) / This study was undertaken to examine the preventive dental and medical attendance behaviour of mothers of young children. The 'Theory of Reasoned Action' used to predict intention to visit the dentist and the doctor, failed to account for more than 11% of the variance in dental behaviour and 9t in the variance in medical behaviour in all the subjects. However, on assessing these behaviours for the 2 different age groups, for the younger age group, the prediction improved to 19% for the dental intention in terms of the total attitude and subjective norm score, and to 45% and 34% respectively for the individual attitudes and subjective norms. In the older age group, the prediction improved to 20% for the dental intention in terms of the total attitude and subjective norm score, and to 39% and 30% respectively for the individual attitude and subjective norms. This finding is further supported by factor analysis of the data, whereby using a principal components analysis structure, other patterns to the data were found which indicates that preventive dental and medical behaviour is a complex behavioural category, consisting of more than one action. Two dimensionso of affect accounted for 59% of dental attitudinal data and 57.9% of the dental subjective norm data, whereas three dimensions of affect accounted for 64.5% of the medical attitudinal data and 64.8% of the medical subjective norm data. The mothers had positive attitudes to both the two dental and three medical actions highlighted by the principal components analysis. The younger mothers showed stronger attitudes associated with the treatment outcome action, whereas the older mothers showed a more positive preventive orientation by the dental data. Although two-thirds of the young mothers received dental advice from the health visitors, they were highly selective on what information to accept and put into effect. An indication here is that health messages including dental health are perceived differently by the 2 age groups even though they are from the same social class group. This finding holds in important implications for the method, approach and content of dental heath of education. In terms of the medical data, the three actions highlighted, indicated that while a health directed behaviour, in terms of a healthy outcome e.g. normal growth is important, an expectation as well as a more emotional, love and tender care factor were also implicated. A healthy baby may however not be the only factor of importance to the mother, but also the mechanisms of achieving such a state of health, matters not only in terms of the convenience but also, greatly depend on the love and level of care the mother gives the child. This aspect may even be more accentuated in one parent families, in which especially the young mother is under enormous socia-economic pressure to take up employment, foresaking time she would otherwise have spend with the child. The effect of subjective norms on preventive health behaviour shows evidence of a 'inner cicle' or 'kinship' as reference group to the mother, which mediates between and modifies the influence of the health profession in as far as compliance with health care is expected from the mother. It therefore appears that in the lower social classes, there exists an intricate social network, exercising an important effect on the way of life of the mother, and since this network may be one of the few supports she has, its influence will be exerted in various dimensions of the mothers' life including health. There appears to be a hidden pathway or code of conduct, defined by these social norms and to which the mother feels she owes her allegiance. The level of communality between the social networks and preventive dental behaviour should be further investigated. This study has clearly indicated that some of the dental and medical attitudes and subjective norms under consideration, has a marked independent yet related effect on preventive health behaviour whereas other attitudes and subjective norms acted independently or sometimes not at all. The dental health educator, must therefore determine for each community and individual which action is the most appropiate target for behavioural change. Furthermore, this study has shown that if beliefs are to be modified, referents to support such a behaviour change, must therefore be appropiate to attaining this objective. since preventive medical and dental behaviour consists of various actions, the application of the Azjen and Fishbein model, should be to a specific action of the behaviour, which assumes importance in the target community, important others. associated with Baric (20) has emphasised the role of the family as an important influence on attitude and behaviour, while Boothroyd- Broóks (39) has pointed to the contribution of society as important mediators in secular life. The results from this study would tend to support the views of Suchman(193), Baric(20) and Boothroyd-Brooks(39) that, kinship, family and social norms were important in the development of behaviour but, to sustain such a behaviour, a deeper understanding is required of the social forces operative through the social network, which shapes the mothers' health behaviour into action. be this medical or dental attendance for herself or for that of her children.

Migrant women are often omitted within the migrant discourse/research, with that in mind, the research study brings to the fore migrant women's experiences when accessing public health care services within underdeveloped communities. The study explored Zimbabwean migrant women's experiences in accessing public health care services in Makhado, a small town based in Limpopo, South Africa which has only two public health care services namely, Louis Trichardt Memorial Hospital and Louis Trichardt clinic. To conduct this study, ethical clearance was obtained in November 2018 from the Department of Sociology at the University of Cape Town. The qualitative research method was adopted in collecting the data. The study conducted in-depth interviews with five Zimbabwean migrant women who had made use of the two public health care services in Makhado. Field notes, diary entry, an impromptu focus group were used to collect the study data. The sample for the study was purposively selected. The study worked with a total of twelve participants, in-depth interviews with five Zimbabwean women, and a focus group with seven health care workers. The collected data was manually transcribed and was analyzed using the framework analysis. Main themes and sub-themes were extracted from the transcribed interview scripts. The study revealed that migrants accessing the two hospitals in Makhado faced challenges such as language barriers, discrimination, and adverse health personnel attitudes based on the patient's citizenship status. Furthermore, the challenges that nurses are faced within their workplace, which include lack of resources, absenteeism, long working hours and overcrowded public health care services within their workplace contributed towards their negative attitude in assisting patients. As a result, migrants bore the challenges faced by the nurses within the public health care services. Therefore, the migrants reverted to having other alternatives such as traditional healers, churches, connections with nurses working in the hospitals, private hospitals and over the counter medication. However, participants underscored that in order for betterment within the public health care services, the following measures ought to be implemented, these include the introduction of independent centres, an increase of mobile clinics, increased number of interpreters, better working environment for the health personnel within the public health care facilities and intensive education training of the health personnel around the awareness migrant issues when accessing public health care services. Foucault's (1980) theory on power and knowledge, played a significant role in understanding the operational systems of public health care services. It also assisted in understanding how public health care services function, to exclude and control migrant patients, through the introduction of fees and required documentation to access public health care services.

The use of so many different therapeutic approaches to stuttering raises frequent questions about methodology and treatment. Confidence in a methodology and treatment approach depends upon follow-up research conducted with systemic analysis of the individuals prior to treatment and following treatment. The purpose of this study was to conduct a follow-up evaluation on R.L. Casteel's Four Stage Stuttering Program at Portland State University and to examine the degree of maintained fluency in relation to entering baseline, time in program, and exit stage.

The purpose of this study is to ascertain whether or not the Good Samaritan Pain Evaluation Clinic can be considered a success.

Sexuell och reproduktiv hälsa och rättigheter är grundläggande för människors hälsa och välbefinnande. Ungdomars sexuella och reproduktiva hälsa ligger till grund för deras framtida hälsa, och även för kommande generationers hälsa. Ungdomar ska ha rätt att själva bestämma över sin sexuella och reproduktiva hälsa. Ungdomstiden är en viktig tid i livet, där det sker fysiska, psykiska och psykosociala förändringar. I Sverige har ungdomsmottagningarna i uppgift att främja en god psykisk och fysisk hälsa för ungdomar, dock är det upp till varje enskild region eller kommun att besluta huruvida de ska ha en ungdomsmottagning, samt hur verksamheten ska utformas. Syftet med denna studie var att undersöka den geografiska fördelningen av ungdomsmottagningar i Sverige. Vidare var syftet att studera sambandet mellan den geografiska fördelningen av ungdomsmottagningar och incidensen av klamydiainfektioner, förlossningar, aborter respektive expediering av preventivmedel bland ungdomar. Metoden som använts för att besvara syftet var en tvärsnittsstudie. Den första delen av syftet har besvarats med deskriptiv statistik, den andra delen har analyserats med hjälp av en en bivariat regressionsanalys. Resultatet visade att fördelningen av ungdomsmottagningar såg olika ut i regionerna. Vidare visade resutatet att det fanns ett samband mellan antal ungdomsmottagningar och antalet ungdomar i regionen. Det fanns också ett samband mellan antal ungdomsmottagningar i regionen och antal expedieringar av korttidsverkande preventivmedel per ungdom, samt ett samband mellan antal ungdomsmottagningar per km² och antal expedieringar av långtidsverkande preventivmedel per ungdom. Slutsatsen av denna studie var att ungdomars sexuella och reproduktiva hälsa kan påverkas av tillgängligheten till en ungdomsmottagning. / Sexual and reproductive health is a fundamental part of human rights. Youths sexual and reproductive health are very important for not just the youth’s future health but also for the health of the next generation. Youths have a right to control and decide their own sexual and reproductive health. Adolescence is an important time period in a young person’s life where they experience changes and development in their physical and mental health. Youth clinics in Sweden have a mission to improve and care for the mental and physical health of all youths although it is up to each individual region within Sweden to determine the number of clinics within that specific region and how the clinics will achieve that mission. The purpose of this study was to compare the number of clinics within the different regions of Sweden and study whether the number of clinics and the accessibility to clinics has a correlation with the number of chlamydia infections, adolescent childbirths, abortions and proscribed contraceptives. This study uses cross-sectionell studies along with descriptive statistics and bivariate regression analysis in order to examine if there is a correlation between the number of clinics and the number of reported cases. The result of this analysis showed that there is a difference between the number of clinics in each region. It also showed that there is a correlation between the number of clinics in a region compared per youth and the amount of proscribed short-time contraceptives. The study also showed a correlation between prescribed long-acting contraceptives to youths compared to youth clinics per square kilometer. The conclusion of this study was that youths sexual and reproductive health is affected to some degree by the accessibility to youth clinics. It shows that if the youths have more access to information regarding sexual and reproductive health it will improve the state of their sexual and reproductive health.

No description available.

Aim This study aimed to evaluate the effectiveness of the Van Beek activator in treating Class II malocclusions in the university student clinic, and to identify factors influencing treatment success. Additionally, a qualitative assessment was conducted to evaluate the quality of the recorded orthodontic journals by the students of the clinic and to rate the degree of adherence to the policy-clinic template. Material and method Data from 229 patients who had their treatment finished within the years 2012-2022 at the university clinic, including in-house and referred patients, were collected and analysed using SPSS. Results The orthodontic journals maintained a high quality, while following annotations for check-ups and end of treatment varied in quality. The success rate of Van Beek treatments was approximately 69%, which is comparable to previous studies done at the university clinic. The degree of patient cooperation was found to be significantly associated with treatment outcome, with patients who showed excellent cooperation achieving the pre-set treatment aims more frequently. Referred patients showed a higher degree of cooperation and better treatment outcomes compared to in-house patients, possibly due to a higher treatment need and more serious response to the treatment. Conclusion The Van Beek activator was found to be effective in reducing overjet, as previously reported in functional appliance studies. Overall, the study highlights the importance of patient motivation and cooperation in achieving successful orthodontic treatment outcomes. Further studies are needed to evaluate the long-term effectiveness of the Van Beek activator and to confirm the findings of this study. / Syfte Syftet med studien var att utvärdera effektiviteten av van Beek-aktivatorn vid behandling av postnormalt bett på Malmö universitets studentklinik, och att identifiera faktorer som påverkar lyckandet av behandling. Utöver det utfördes även en kvalitetsgranskning av de utförda behandlingarna för att utvärdera kvalitén på studenternas ortodontijournalanteckningar och följsamheten till journalmallen vid start av behandling. Material och metod Data från totalt 229 patienter, både remitterade och interna, som avslutade sina behandlingar på studentkliniken mellan år 2012–2022, samlades in och analyserades med hjälp av SPSS. Resultat Ortodontijournalanteckningarna höll en hög kvalitet, medan anteckningar för kontroller och avslutande av behandlingar varierade i kvalitet. Lyckandefrekvensen för van Beek-behandlingar var ca 69%, vilket är jämförbart med tidigare utförda studier på studentkliniker. Graden av kooperation visade sig vara signifikant associerad med behandlingsresultat, där patienter med utmärkt kooperation uppnådde behandlingsmålen i högre grad än övriga patienter. Remitterade patienter koopererade bättre än interna patienter och uppnådde i större utsträckning lyckade behandlingsresultat, möjligtvis på grund av ett större behandlingsbehov och en mer seriös respons på behandling. Slutsats Van Beek-aktivatorn var effektiv vid minskning av HÖB, som tidigare rapporterats i studier på avtagbara tandställningar. Studien belyser vikten av patienters motivation och kooperation för att uppnå lyckade behandlingsresultat. Ytterligare studier behöver utföras för att utvärdera den långsiktiga effektiviteten av Van Beek-aktivatorn, samt att bekräfta fynden i studien.

Background/Rationale - East Tennessee State University developed four interprofessional (IP) team-based education and practice clinics from within an already established network of nine nurse-managed clinics. The purpose of these IP clinic teams is to build capacity for interprofessional practice (IPP) and deliver effective health management to patients with multiple chronic conditions (MCC) through evidence-based practice to improve health outcomes in underserved populations. Description of Innovative Approach - This project took the innovative approach of acknowledging the specialized knowledge, skills, and contributions of nursing, pharmacy, and nutrition specialties, empowering each discipline to be an active decision-maker in the healthcare team. The IP team embedded themselves in existing nurse managed clinics, conducting “student led” clinics at the various sites. A Clinical Fellows Model was utilized to enhance the students learning experience and to promote IPP upon graduation. Challenges and Strategies of IP Team Development - During the first year of the project, the IP team overcame barriers with purposeful strategy which has created unique opportunities for the remaining grant period. Challenges and barriers were overcome with attention to building team collaboration through education and familiarity with working in the interprofessional setting. Discussion – The Clinical Fellows Model was derived from four IP competencies: roles and responsibilities, values and ethics, teamwork, and communication. The student led IP clinics have grown in the number of sites and disciplines supporting East Tennessee State University’s vision of true interprofessional education and practice for managing patients with MCC.