A história da saúde mental pública brasileira está vinculada a um processo de exclusão e segregação, colocado em ação ao longo de séculos pelo banimento social e modelo de atuação hospitalocêntrico, tendo seu dispositivo de maior destaque o hospital psiquiátrico, o manicômio. Diante das condições de violência existentes nestas instituições, movimentos de trabalhadores e usuários ganharam força e promoveram mudanças nesta realidade. A partir da lei 10.216 de 2001, implanta-se oficial e nacionalmente uma nova proposta política de Saúde Mental, que se define como antimanicomial. Essa política expressa as transformações sociopolíticas e técnicas que vinham sendo implementadas ao menos uma década antes, apoiadas na Reforma Psiquiátrica. Contudo, as estratégias psicossocial e antimanicomial propostas e implementadas neste contexto, ao que sugere a bibliografia, parecem negligenciar a dimensão psíquica, colocando todo seu enfoque sobre a dimensão social e política. Hipotetizou-se que as práticas clínicas ficaram identificadas como estratégias do modelo anterior, tradicional, ocasionando uma condição de negação da clínica no novo modelo. Tal condição justificaria a coexistência de ideias e fundamentos contraditórios verificados nas práticas e política de saúde mental atual: ora apresentando marcas provenientes de sua história de segregação, ora fundamentos e concepções antimanicomiais. Tal coexistência parece impossibilitar ou dificultar a efetivação plena e a reflexão sobre a política atual, mantendo práticas manicomiais encobertas por um discurso antimanicomial. A partir da realização de grupos operativos com profissionais de CAPS pode-se corroborar tal hipótese, compreendendo-se que uma aliança inconsciente estabelecida entre os atores da saúde mental pós Reforma Psiquiátrica, mediante um pacto denegativo, extirpou a clínica das ações em saúde mental. Paradoxalmente, neste processo é exatamente a clínica psiquiátrica tradicional que ocupa o espaço vazio deixado pela negação da clínica de consideração da dimensão psíquica, em especial a clínica psicanalítica. / The history of Brazilian public mental health is linked to a process of exclusion and segregation, put into action for centuries by the social ban and hospital-centered model, with the most prominent feature being the psychiatric hospital, the asylum. Faced with the conditions of violence in these institutions, workers 'and users' movements gained strength and promoted changes in this reality. From the law 10.216 of 2001, a new political proposal of Mental Health, which is defined as anti-asylum, is implanted officially and nationally. This policy expresses the sociopolitical and technical transformations that had been implemented at least a decade before, supported by the Psychiatric Reform. However, psychosocial and anti-asylum strategies proposed and implemented in this context, suggested by the bibliography, seem to neglect the psychic dimension, putting all its focus on the social and political dimension. It is hypothesized that clinical practices were identified as strategies of the previous, traditional model, leading to a denial of clinical condition in the new model. Such a condition would justify the coexistence of conflicting ideas and foundations verified in current mental health practices and policies: sometimes presenting marks from their history of segregation, sometimes anti-asylum foundations and conceptions. Such coexistence seems to make it impossible or difficult to fully realize and reflect on current politics, keeping asylum practices covered by an anti-asylum discourse. From the realization of operative groups with CAPS professionals, one can corroborate this hypothesis, understanding that an unconscious alliance established among. The mental health actors after Psychiatric Reform, through a denuclearising pact, removed the clinical practice of mental health actions. Paradoxically, in this process it is precisely the traditional psychiatric clinic that occupies the empty space left by the negation of the clinic of consideration of the psychic dimension, especially the psychoanalytic clinic.

Cette thèse part de la proposition d\'une rencontre possible entre psychanalyse et génétique médicale par le biais des soins offerts aux enfants porteurs de syndromes génétiques, notamment le syndrome de l\'X fragile. Nous avons trouvé dans les recherches en épigénétique une voie de rapprochement de ces différents champs du savoir. L\'idée selon laquelle l\'environnement est capable de modifier l\'expression des gènes représente la rupture d\'un certain déterminisme génétique autrefois accepté, et ouvre un espace où penser la singularité. Notre travail propose d\'élargir le concept d\'environnement, en y considérant la relation de l\'enfant avec l\'Autre, lieu du langage, comme opérateur de marques sur son corps : marques symboliques, constituées dès le tout début de la rencontre de l\'infans et de ceux qui s\'occupent de lui. C\'est justement dans cet espace d\'échange avec l\'Autre qu\'a lieu l\'émergence d\'un sujet. Nous avons opté pour les concepts de sujet et de transfert pour soutenir l\'articulation de la clinique psychanalytique et de la génétique médicale en ce qui concerne le traitement. Nous avons donc exposé trois cas cliniques issus de notre pratique, d\'enfants traversés par le diagnostic de l\'X fragile afin d\'illustrer de quelle manière les conceptions de sujet et de transfert se reflètent dans la clinique. Tenant compte que la psychothérapie est également prise comme objet d\'étude de l\'épigénétique, et qu\'elle est donc considérée comme un environnement capable de provoquer, voire de renverser des marques épigénétiques, l\'enjeu de notre travail repose sur la proposition suivante : et pourquoi pas la psychanalyse également ? La psychothérapie psychanalytique, ancrée sur le transfert, ne peut-elle pas, elle aussi, laisser des marques sur le petit patient / The current thesis assumes a possible encounter between psychoanalysis and medical genetics based on the treatment applied to children carrying genetic syndromes such as the Fragile X Syndrome. Epigenetic studies are a way to approximate different knowledge fields. The assumption that the environment is able to change gene expression strays from the genetic determinism we once believed and opens the way for us to reason about singularity. The proposition in the present study lies on expanding the concept of environment, by taking into consideration the relation between the child and the Other in the environment in question, as well as the place of language as the operator marking the childs body. These symbolic marks start emerging in the first encounter between the infans and caregivers. The subject emerges precisely 3 within an environment of exchanges that is set with the Other. The concepts of subject and transference were chosen to support the treatment articulation between psychoanalytic clinic and medical genetics. Thus, the present study reports three clinical cases followed by the authors, which involved children diagnosed with fragile X syndrome. These cases illustrate how the aforementioned concepts affect the clinical practice. Since psychotherapy has also been taken as the object of epigenetic studies, and as it is considered an environment able to cause, and even reverse, epigenetic marks, the current study relies on the following proposition: why not psychoanalysis as well? Can the psychoanalytic psychotherapy, anchored in the concept of transference, leave marks on the little patient too?

A partir da Reforma Psiquiátrica, observamos uma valorização da participação da família no tratamento, buscando por alternativas de atenção a esses familiares nos serviços. Acrescentando ao debate os desafios da aproximação da clínica ao Sistema Único de Saúde, o conceito de clínica ampliada surge, associando a noção de subjetividade à de cidadania e enfatizando a importância de lidar com a singularidade de cada situação concreta como parte de contextos e relações sociais. Em consonância com essas preocupações, existe, em um Hospital-Dia de Psiquiatria, um Programa de Assistência Familiar. Dentre diversas atividades oferecidas nesse programa, as Reuniões Familiares são o contexto específico de estudo desta pesquisa. Essas reuniões são conduzidas a partir de contribuições da terapia familiar de uma orientação construcionista social, que tem como foco os processos de construção e transformação de sentido. A presente pesquisa teve como objetivo analisar a aproximação de uma prática com famílias (as reuniões familiares) à noção de clínica ampliada no cuidado em saúde mental. Especificamente, visou: a) compreender o processo de produção de sentidos nessa prática, analisando a construção de recursos conversacionais na interação, bem como seus efeitos para as transformações de sentidos de problema e de si ao longo do processo; e b) descrever como esses recursos contribuem para a ampliação da prática clínica com famílias. Para isso, 33 reuniões familiares (os atendimentos de três famílias) foram acompanhadas na instituição. Essas sessões foram gravadas em áudio e transcritas integralmente, constituindo-se, assim, o corpus de pesquisa. Uma compreensão construcionista social sobre a prática de pesquisa orienta metodologicamente este trabalho. Todas as sessões foram submetidas a uma análise temático-sequencial do processo de produção de sentidos. A partir disso, descrevemos a negociação e transformação de sentidos em torno de um problema considerado, pelo paciente e pela família, como central em suas vidas. Para cada caso, o principal recurso conversacional construído no processo terapêutico foi analisado e descrito. São eles: a) convidar o social para dentro do individual; b) tecer o diálogo familiar; e c) conhecer a si em outras vozes. A análise de cada caso considerou: como algo foi construído como um problema a ser trabalhado; como o uso do recurso se deu; e que efeitos esse uso produziu no decorrer do caso. Oferecemos como tese uma leitura construcionista social para a clínica ampliada, chamando atenção para como a ampliação da clínica se produz a partir dos efeitos de determinados modos de se relacionar no contexto das práticas. É no momento interativo que profissionais e pacientes, ao conversarem sobre suas questões de saúde, conjuntamente criam entendimentos sobre quem são, o quê são seus problemas e o que podem fazer com relação a eles. Discutimos como o uso dos recursos se constrói nas interações e contribui para a prática da clínica ampliada. Descrevemos essas práticas como politicamente implicadas. Em última instância, a pesquisa descreve recursos práticos para profissionais interessados em trabalhar em um enquadre crítico e transformador no cuidado em saúde mental / Since the Brazilian Psychiatric Reform, we have witnessed an increased value of family participation in treatment. Alternatives of attention to family members in the context of services have been sought. When the challenges of bringing clinical practices into the Unified Health System are added to the debate, the concept of the expanded clinic arises, and this concept associates the notions of subjectivity and citizenship. Emphasis is placed on the importance of dealing with each concrete situation as part of contexts and social relations. A Program of Family Care in a Psychiatric Day Hospital exists in line with these concerns. This program offers several activities for families. Family Reunions are amongst these activities, and they are the specific context of this research. The contributions of a social constructionist orientation for family therapy guide family reunions with a focus on processes of meaning making. This research aimed to analyze the approximation of a practice with families (family reunions) to the notion of the expanded clinic in mental health care. The research specifically aims to: a) understand the process of meaning making in this practice, while analyzing the construction of conversational resources in the interaction, as well as their effects to the transformations of the meanings of problem and self throughout the process; and b) describe how these resources contribute to the expansion of clinical practices with families. Thirty-three family reunions (three family cases) were followed in the institution. These sessions were audio recorded, and fully transcribed, in order to constitute the research corpus. A social constructionist understanding about research practices is the methodological guide for this investigation. All sessions were submitted to a thematic-sequential analysis of the process of meaning making. We have described the negotiation and transformation of meanings about a problem that was considered, by the patient and by their family, as central to their lives. For each case, the main conversational resource constructed during the process was analyzed and described. These conversational resources are: a) inviting the social into the individual; b) weaving family dialogue; and c) knowing yourself in other voices. The analysis of each case considered: how something was constructed as a problem to be worked out; how the use of the resources was carried through; and the effects the use of this resource created throughout the case. We offer, as our thesis, a social constructionist reading of the expanded clinic, where we call attention to how the expansion of clinical practice is crafted from the effects that particular ways of interacting create in the context of practices. It is in the interactive moment that professionals and patients jointly generate understandings about who they are, what their problems are, and what they can do in relation to them, while they talk about their health issues. We discuss how the use of these resources is constructed in interactions, and how this use can contribute to the practice of the expanded clinic. We also describe clinical practices as politically committed. The research ultimately describes practical resources for those professionals interested in working within a critical and transformative frame in mental health care

A presente pesquisa procurou estudar o sintoma psicomotor na infância, este abrange distúrbios como dislexias, disortografias, problemas de coordenação e equilíbrio e alguns diagnósticos de Transtorno de Deficit de Atenção e Hiperatividade cujos casos vem aumentando exponencialmente na atualidade. A etiologia do sintoma psicomotor por muito tempo permaneceu obscura e relacionada exclusivamente a lesões e distúrbios neuronais, os quais deixavam como únicas alternativas tratamentos medicamentosos e reeducativos. Com os estudos psicanalíticos iniciados por J. Lacan e M. Mannoni acerca desses sintomas, a etiologia se tornou gradativamente mais clara, e os relacionou a fantasia familiar em que a criança é imersa como objeto de satisfação. Dessa forma, este trabalho visou pesquisar a formação deste tipo de sintoma, o gozo e fantasia da criança e cuidadores envolvidos nessa relação. Para tanto foi realizada uma pesquisa bibliográfica sobre os conceitos psicanalíticos e atendimentos clínicos a crianças com sintomas psicomotores através do Laboratório Sujeito e Corpo da Universidade de São Paulo. Os resultados indicam que o gozo no sintoma psicomotor envolve duas pessoas, mais frequêntemente mãe ou pessoa na função materna e o filho, os quais se colocam em uma relação de interdependência, a ponto de não haver espaço para uma autonomia e independência necessárias ao desenvolvimento da criança. Os sintomas psicomotores são resultado de uma satisfação fantasística que envolve o corpo da criança nessa relação / This research sought to study the psychomotor symptoms in childhood, it includes disturbances such as dyslexia, dysorthographies, problems with coordination and balance and some diagnoses of Hyperactivity and Attention Deficit Disorder which cases have been exponentially increased at the present. The etiology of the psychomotor symptoms for a long time remained obscure and exclusively related to injury and neuronal disorders, which has left as the only alternatives medical and reeducational treatments. With the psychoanalytic studies started by J. Lacan and M. Mannoni about these symptoms, the etiology became gradually clearer, and it was related to the family fantasy in which the child is immersed as objects of satisfaction. Thus, this study aimed to investigate the constitution of this symptom, the enjoyment and fantasy of children and caregivers involved in this relationship. To achieve these goals, it was made a bibliographical research on psychoanalytic concepts and clinical attendances for children with psychomotor symptoms through the Sujeito e Corpo Lab, at the University of São Paulo. The results indicate that the joy in psychomotor symptom involves two people, more often the mother-child, which arise in a relationship of interdependence and leave no space for autonomy and independence necessary for the child development. The psychomotor symptoms are the result of a fantasmatic satisfaction which envolves the children body in this relationship

Good continuity of care is considered desirable and is often referred to as an essential component in creating a more patient-centered health care. However, what is meant by continuity of care is not entirely self-evident and there are different ways to quantify and address it. The purpose of this study is to introduce a method for continuous measurement of continuity, where visits between patients and physicians in various care clinics are of interest. Five established measurements (indices) of continuity of care were evaluated; MFPC, K, COC, MCI and SECON. Calculations on these indices were made using hospital visits-related data from January 2011 to April 2015, where a  time window of 1.5 years was used when calculating index values. The results from the calculations show a high correlation between all indices when calculated on an average of all patients at a clinic. Based on this, properties such as intuitive interpretation and simple calculations made MFPC-index this study’s single choice of index. It can be used to examine the change of  a clinic’s patient’s continuity over time. The index also allows to assign a value to a physician, showing how much continuity that doctor contributes to all its patients. A tool was also developed to visualises how many visits each patient has had with how many different doctors at a clinic. This tool allows the identification of individual patients whose continuity can be seen as undesired. These three components of the method for continuous measurement of continuity can be seen as representations of continuity from a system’s, physician’s and patient’s perspective.

Un référentiel est un document textuel qui cherche à décrire une réalité, souvent complexe, pour qu’elle fasse « référence » et qu’ainsi, elle devienne discutable pour chacun. Il existe des référentiels de diplômes professionnels, des référentiels de compétences utilisés dans l’entreprise, des référentiels d’évaluation, de formation…Cependant, la conception de référentiels pose question sur deux plans : aux problèmes méthodologiques souvent mis en avant, s’ajoutent de vrais enjeux théoriques. La question est de parvenir à saisir, dans un document par nature inerte et généralisant, une activité de travail dynamique et singulière. Cette thèse cherche à montrer, en s’appuyant sur deux interventions avec des masseurs-kinésithérapeutes, conduites avec des méthodologies de clinique de l’activité, comme on peut référentialiser, non les éléments réglés du métier, mais ce qui reste discuté entre professionnels et ainsi obtenir un référentiel qui peut favoriser le développement du métier décrit et seconder les opérateurs dans la reprise en main de leur pouvoir d’agir. / A reference table is a textual document which tries to describe a reality, often complex, so that it made "reference" and so that so, it becomes debatable for each. There are reference tables of vocational degrees, reference tables of skills used in the company, reference tables of evaluation, training …However, the conception of reference tables asks question on two plans: in the often advanced methodological problems, are added real theoretical stakes. The question is to succeed in seizing, in a by nature sluggish and generalizing document, a singular and dynamic working activity.This thesis tries to show, by leaning on two interventions with physiotherapists, led with methodologies of clinic of activity, as we can référentialiser, not elements settled by the job, but what remains controversial between professionals and so to obtain a reference table which can favor the development of the described job.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The occurrence of various diseases (disorders) related to work has increased in recent decades. Within the context of occupational health, professional services hemodialysis require specific procedures and use of personal protective safety and health. Thus, this study aimed to analyze the occupational risks in a Renal Clinic located in central-RS. From the observational analysis of risk maps and instrument data collection, we implemented improvements in local. The research in question is classified as to the objectives as exploratory, descriptive, and the purpose of describing the characteristics of the Renal Clinic, so the search has qualitative and quantitative aspects. The data collection instrument was applied to 79 employees and 49 returned during the period February / March 2010. The initial sample consisted of professionals: nurses, administrative assistants, the warehouse, technical / auxiliary nurses and general services. After, it was planned preventive actions, both in physical and / or organizational environment, some improvements were implemented from April to November 2010, aiming to contribute to quality of working environment and quality of life for employees. Secondly, we used a new tool for data collection with questions about the results of implementations, while it was answered by 27 of the 30 permanent staff in the Renal Clinic located attached to the Hospital Home Health. Through the results, it was noted that the implementations have been significant and that changes are needed to reduce occupational disorders, promoting better quality of life. / A ocorrência de diversas patologias (distúrbios) relacionadas ao trabalho vem crescendo nas últimas décadas. Dentro do contexto da saúde do trabalhador, os profissionais dos serviços de hemodiálise demandam procedimentos específicos e uso de medidas de proteção e segurança à saúde. Neste sentido, este estudo teve como objetivo analisar os riscos ocupacionais em uma Clínica Renal situada na região central-RS. A partir da análise observacional, dos mapas de riscos e do instrumento de coleta de dados, implementou-se melhorias no local. A pesquisa em questão classifica-se quanto aos objetivos como exploratória-descritiva, tendo a finalidade de descrever as características das Clínicas Renais, portanto a pesquisa possui aspectos qualitativos e quantitativos. O instrumento de coleta de dados foi aplicado aos 79 funcionários e retornou 49, no período de fevereiro e março de 2010. A amostra inicial constituiu-se de profissionais: enfermeiros, auxiliares administrativos, do almoxarifado, técnico/auxiliares de enfermagem e dos serviços gerais. Após, planejou-se ações preventivas, tanto nos aspectos físicos e/ou organizacionais do ambiente, foram implementadas algumas melhorias no período de abril à novembro de 2010, visando contribuir para qualidade do ambiente de trabalho e qualidade de vida dos funcionários. Num segundo momento, utilizou-se um novo instrumento de coleta de dados com questões sobre os resultados das implementações, ao passo que o mesmo foi respondido por 27 funcionários dos 30 permanentes na Clínica Renal situada anexa ao Hospital Casa de Saúde. Através dos resultados, observou-se que as implementações foram significativas e que mudanças são necessárias para redução dos distúrbios ocupacionais, promovendo melhor qualidade de vida.

This master thesis is focused on marketing of Santé, the private clinic. The first part is theoretical and has two main chapters. Marketing in the field of health care is the first chapter, including the differences between health care marketing and marketing in other fields and other characteristics of the medical system. Next a product is defined, in health care it is the provided service. Marketing mix is described not as 4P but as 4C. Then there is the practical point of view on the health care system. Very important is the patients' satisfaction, which is measured by many different surveys, such as the best hospital, or quality perceived by the patients. The other chapter discusses used methods, defines marketing research and the S-T-P strategy. The practical part of thesis introduces the company Santé followed by the description of their clientele, which is differentiated as individual and companies' clientele. Marketing mix of the company consists of the 4 components already mentioned higher. Next is the SWOT analysis. Analysis of the competition focused on the main competitors of Santé. Very significant moment is the research project created to suit the needs of this thesis only. A complex questionnaire researching the privet clinic market as a whole was prepared. Analysis of the data was complex as well. Open questions were analyzed separately, closed questions were processed with the help of SPPS computer program. By the end of the thesis there are some recommendations for the company that originate in the research project and also from the confrontation of the theory and practice. Last is the conclusion, bibliography and the annex, where you can find already mentioned questionnaire.

Nesta tese, são colocadas em pauta as relações entre o saber e o fazer, com base em interrogantes da atuação no campo da clínica dos distúrbios de linguagem. Como a transferência e a linguagem se articulam nas relações que acontecem no interior dessa clínica, elas constituem sua questão norteadora. A partir desta, são problematizadas as relações entre o terapeuta e seu paciente, o terapeuta e os pais (no caso da infância), o terapeuta e outros profissionais, o terapeuta e seu fazer. Inicia-se a discussão com o estudo da História da clínica, para situar-se, nos dias de hoje, como se configuram noções como normal/patológico e sintoma na clínica fonoaudiológica e contextualizar a clínica dos distúrbios de linguagem. Parte-se, em seguida, em direção a dois referenciais teóricos que sustentam a tese: o primeiro tem origem na psicanálise freudo-lacaniana, abordada a partir, principalmente, da noção de transferência, a qual, juntamente com suas derivações, é “traduzida” para o campo da clínica dos distúrbios de linguagem com a função de inaugurar, constituir e sustentar as relações que se constroem nessa clínica. Prossegue-se apoiando-se na Linguística, em especial nos estudos sobre a enunciação de Émile Benveniste, como forma de compreender os movimentos entre eu, tu e ele que se dão a cada ato de enunciação. Tendo à disposição o conjunto dessas reflexões, passa-se a fazer os cruzamentos entre o que a prática clínica interroga e o que faz eco, a partir das leituras realizadas. Ao final da tese, conclui-se que as relações entre o saber e o fazer na clínica dos distúrbios de linguagem são pautadas, o tempo todo, pelos movimentos que acontecem entre linguagem, transferência e clínica, a cada ato de enunciação que ali se apresenta. / In this thesis, the issue in question is the relation between knowledge and doing, which are based on questions from the practice in the clinical field of language disorders. Since transference and language are articulated in the relationships that take place within this clinic, they are the leading question. Stemming from the leading question, the following relations are speculated: the relations between the therapist and his patient, the therapist and the parents (in the case of childhood), the therapist and other professionals, and the therapist and his work. The discussion begins with the study of the History of the Clinic, in order to understand nowadays how to configure notions such as normal/pathological symptom in the Speech-Language Pathology Clinic and how best to contextualize them in the clinic of language disorders. The first part is based on the Freud-Lacanian Psychoanalysis, which is based mainly on the notion of Transference, which, together with its derivations, is “translated” into the field of the clinic of language disorders with the function of inaugurating, constituting and sustaining the relationships that are built in this clinic. The next moment is based on Linguistics, especially in Studies on the Enunciation of Émile Benveniste, as a way of understanding the movements between I”, you” and he that occur to each act of enunciation. Having all these reflections at hand, the intersections between what clinical practice interrogates and what echoes are made from the readings made. Finally, we found out that the relationships between the knowledge and the performance in the clinic of language disorders are always based on the movements that happen among language, transference and clinic in each act of enunciation that occurs there.

Magister Pharmaceuticae - MPharm / Tuberculosis and mv Tuberculosis (TB) is a major contributor to the disease burden in developing countries resulting in the deaths of approximately 2 million people a year. South Africa (SA) has one ( of the highest annual 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 amongst HIV- infected patients. Both TB and HIV treatment depends exclusively on multi-drug regimens that require close monitoring among health care professionals. With increasing workload due to staff shortage and high patient load, the quality of care in nurse-led primary care clinics may be compromised. Existing clinic staff may overlook drug-drug interactions, side effects and may 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. Clinic-based training programs that are offered to nurses provide an opportunity to work alongside clinic staff and engage in patient-centered care where the pharmacotherapeutic the outcome of TB and HIV drug regimens could be closely monitored. XVll Aims The primary and secondary aims of the study were to: • Assess current practice patterns of TBIHIV at primary healthcare clinics in the Western Cape, • Assess the need for a clinic-based TBIHIV training among final year pharmacy students in UWC. http://uwc.ac.za Objectives To achieve the primary aim the researcher; 1. Conducted a baseline study at Ravensmead Community Health Centre(CHC) to assess current TBIHIV practice among HCP's and co-infected patients, 2. Assessed current practice patterns at Delft South ARV clinic and Elsies River TB clinic (pre-intervention), 3. Designed and implemented a clinic-based TBIHIV intervention tool for potential use by pharmacists at Delft South and Elsies River clinics (intervention phase), 4. Evaluated patient receptivity of the intervention tool amongst patients at Delft South and Elsies River clinics (post-intervention phase). XVlll To achieve the secondary aim the researcher; 5. Introduced a clinic-based training for seven final year pharmacy students, 6. Designed and administered an assessment to both control and experimental students, 7. Assessed scores between students who received the training (experimental group) with those who did not receive the training (control group). Results and discussion Findings from the baseline study indicate the need for the involvement of a trained pharmacist in TB and HIV management. Even though three-quarters (77.8%; 14) of the patients preferred receiving their TB information from the clinic nurse, almost two-thirds (63.2%; 12) of the patients believed that pharmacists assisted with their treatment provision. Patient data obtained from the clinic record card showed that almost two-thirds of the patients reported that they had experienced side effects (64.4%); the therapy of more than one-quarter (26.4%) showed drug-drug interactions and onset of adverse effects (1.1 %). Post-intervention, the data showed that patients' viewed the pharmacist's role more positively. Almost all responses (97.5%; 39) favored the services of a pharmacist in the clinic. In conclusion, findings from the post-intervention patient study underpin that a clinic-based role for the pharmacist is imminent. All seven (100%) of the experimental students passed the assessment and had scores in the range between 26 and 45 and more than three-quarters (78.4 %; 29) of the control students passed with marks within this range. Conclusion A trained pharmacist would be competent to work alongside nursing staff in optimizing care provision in the clinical management of TB and HIV in patients. The existing clinic-based TB/HIV program could be supplemented with theoretical concepts in the final year of undergraduate pharmacy training.