Thesis (M.S.)--University of Michigan, 1951.

Thesis (M.S.)--University of Michigan, 1949.

Aim To determine the impact on clinical outcomes of specialist diabetes clinics compared with routine primary care clinics. Methods Observational study measuring clinical performance (process/outcome measures) in the primary care sector. A cohort of patients attending specialist diabetes clinics was compared with a control cohort of patients attending routine primary care clinics. Results Patients seen in specialist diabetes clinics had a significantly higher HbA1c than patients in routine primary care clinics (mean difference 0.58%; P < 0.001) but there was no significant difference in rate of improvement with visits compared with primary care clinics. In contrast, patients seen in the routine primary care clinics had significantly higher cholesterol levels (mean difference 0.24 mmol/l; P < 0.001) compared with patients in specialist diabetes clinics and their improvement was significantly greater over time (mean difference 0.14 mmol/l per visit compared with 0.10 mmol/l; P < 0.006). Patients in routine primary care clinics also had significantly higher diastolic blood pressure (mean difference 1.6 mmHg; P < 0.007) but there was no difference in improvement with time compared with specialist diabetes clinics. Uptake of podiatry and retinal screening was significantly lower in patients attending routine primary care clinics, but this difference disappeared with time, with significant increases in uptake in the primary care clinic group. Weight increased in both groups significantly with time, but more so in the specialist clinic patients (mean increase 0.18 kg per visit more compared with routine clinic primary care patients; P < 0.001). Conclusions This study provides evidence that the provision of primary care services for patients with diabetes, whether traditional general practitioner clinics or diabetes clinics run by general practitioners with special interests, is effective in reducing HbA1c, cholesterol and blood pressure. However, the same provision of care was unable to prevent increasing weight or creatinine over time. No evidence was found that patients in specialist clinics do better than patients in routine primary care clinics.

Mini-dissertation in partial compliance with the requirements for the Masters Degree in Technology: Homoeopathy, in the Department of Homoeopathy at the Durban University of Technology, 2008. / Within healthcare, patient satisfaction is a combination of need, expectation and the experience of care being provided. Patient satisfaction is an intermediate outcome, and is an important measure of the quality of the overall care provided. Healthcare which does not satisfy the patient is usually less effective, because less satisfied patients tend not to comply with instructions, they take longer to follow up with appointments and they have a poor understanding of their medical condition (Wilkin, Hallam and Dogget, 1994; AI-Assaf, 1998). The provision of overall quality healthcare for patients is a key motivation for many service providers. Therefore, determining the level of patient satisfaction forms a very important part of managing and fulfilling the patients' healthcare needs (Smith, 2001a). Furthermore, surveys of patient satisfaction form an essential role in assessing public opinion of the service provided. Thus, the evaluation of the service provided by a clinic can be reflected in the degree of satisfaction perceived by individuals receiving the services as elicited by a patient perception survey. This study assess patient’s perception of the service provided at the Homoeopathic Day Clinic (HDC) at the Durban University of Technology (DUT). The use of a self-administered questionnaire to establish patient satisfaction was applied. No names were required and all data has been kept strictly confidential. This information will subsequently be used to improve the quality of the service offered at this facility and increase the degree of patient satisfaction experienced. The sample group of the first 100 patients that consulted the HDC at the DUT between July and November 2007 that voluntarily participated in this study were included in the study by means of convenience sampling.In this study there is generally a high degree of satisfaction with the healthcare and services provided. Areas of particularly high satisfaction are related to patients’ arrival to the clinic where they were both promptly and politely greeted, as well as in relationship to the approachability/friendliness of the Homoeopathic student, and the instructions given on how to take the medicine. Areas that revealed lower degrees of satisfaction are advertising, both in media and by signage, as well as the accessibility of the clinic for disabled patients.

Approved for public release; distribution is unlimited / The National Naval Medical Center (NNMC), Bethesda, Maryland, set as a strategic goal the improvement of internal efficiency among its many clinical activities. Clinical services lacked the ability to improve their statistical process, which relied on workload and expense data. Since the data systems had removed provider identifiers, it was impossible to produce data on provider productivity and efficiency. Numerous efforts to improve the clinical staff's efficiency were unsuccessful because of data integration limitations. Clinical service managers could not review their clinical service staff roster nor maintain the correct coding of personnel because they did not have access to the Standard Personnel Manpower System (SPMS). The step-wise approach business plan described in this thesis outlines the steps taken to generate productivity and efficiency feedback reports. These reports provided the clinical managers the necessary performance metrics to determine on a monthly basis how effectively their clinical services were operating. / Lieutenant, United States Naval Reserve

A research report submitted in partial fulfillment of the requirements for the degree of Master of Science (Dentistry) In the Department of Paediatric and Restorative Dentistry School of Oral Health Sciences Faculty of Health Sciences University of the Witwatersrand, Johannesburg / A Clinical Audit: Dental Treatment Needs and Treatment Received by 12 and 15 year old children who attended the WITS Dental Hospital during the period January 2006 to December 2010. Background The majority of children and adults are affected by dental caries and its sequelae in South Africa. Children, from lower socioeconomic backgrounds in particular, continue to experience a high burden of dental caries. Objectives - To determine the number and profile of 12 – year – old and of 15 – year – old patients who attended the Wits Dental Hospital during the period of January 2006 to December 2010. - To determine the dental treatment needs of the two index age groups, including caries prevalence and the teeth affected by caries. - To determine the treatment received during this period. - To determine the time taken to complete the treatment needed and the number of patient visits required. - To determine the obstacles to receiving or completing the prescribed treatment. xii | P a g e Subjects and Methods The study was based on a retrospective review of the dental treatment records of 12 – year – old and 15 – year – old children attending the WITS Dental Hospital during the period January 2006 to December 2010. The study was based on children treated in the dental chair and did not include children treated under general anaesthetic. A total of 143 dental treatment records were retrieved , but only 62% (89) of the records met the specified study requirements – (39 for 12 yr olds and 50 for 15 yr olds). Extracted data was recorded by the researcher onto specifically – formulated data capture sheets. Processing and analysis of data was carried out with SPSS for Windows, Version 13 . Chi – square tables were constructed for comparison of proportional distributions. Exact and Monte Carlo test statistics were calculated to identify significant relationships. Results The mean DMFT for the 12 – year – old age group was 3.0 . The DT accounted for 76.6% of the DMFT , the MT for 23.33% and the FT was nil. The mean DMFT for the 15 – year – old age group was 3.8. The DT accounted for 92.1% of the DMFT , the MT for less than 10% and the FT was nil. There is an increase in dental caries from 12 – year – old to 15 – year – old patients. Carious teeth are left untreated. Restorative dental treatment levels are low. Low levels of completed treatment plans noted. Conclusion The rise in dental caries from the 12 – year – old group to the 15 – year – old group, together with high levels of untreated caries and low levels of restorative dental xiii | P a g e treatment indicate the need to improve the oral health of school children. Evidence – based oral health prevention and promotion strategies must guide oral health policy planning, so that supportive environments are created and sustained to facilitate healthy choices and maintain optimal oral health.

Research report submitted to the School of Architecture and Planning, University of the Witwatersrand, in the fulfilment of the requirement for the Masters of Architecture (Professional). / Thesis (M.Arch. (Professional))--University of the Witwatersrand, Faculty of Engineering and the Built Environment, 2016 / A clinic is a uniquely positioned function in a community. It can become the heart of an area, integrating a large range of functions with and for the public. Whether it be through interactions with business, police, artists or the community, all parties can benefit from the interactions. A redeveloping inner city area, especially one undergoing increasing levels of social uprooting, such as New Doornfontein, can benefit greatly from the community reinforcement and rebuilding that a healthcare facility can provide. With the negative impact of gentrification visible, and a drive towards potential social unsustainability in the area, a need for a centralised community driven scheme is apparent. The brief of the project called for a socially sustainable adaptive reuse healthcare-based scheme situated on a series of industrial sites in New Doornfontein. The area has been used by industry for 85 years, where currently businesses continue to operate. However, New Doornfontein has been undergoing a change, with existing industry becoming run down and abandoned, and the expansion of the new Maboneng phase taking over. Residential density is increasing, creating a demand for more social-based facilities such as healthcare and education. / EM2017

No description available.

Inserida no intercâmbio teórico entre a psicanálise e a antropologia estrutural, a presente pesquisa busca analisar os papéis e implicações da noção de mito para a constituição de um projeto de formalização da experiência psicanalítica. Em pesquisa anterior, constatamos como na conferência O mito individual do neurótico (1953), Jacques Lacan realizou a aplicação do modelo lógico através da qual o antropólogo Claude Lévi-Strauss tratou da estrutura mítica a fórmula canônica do mito (1955) ao caso freudiano do Homem dos Ratos. Desta premissa, uma questão se impôs: em que medida o modelo da estrutura inerente ao fenômeno mítico foi condição necessária para a apropriação lacaniana do ideário estrutural e quais os efeitos de tal momento constitutivo sobre seu futuro projeto de formalização da clínica psicanalítica. Com tal objetivo em vista, mapeamos inicialmente na obra de Freud as dimensões do tema do mito. Vimos como sua aparição é contemporânea à emergência da psicanálise como uma prática clínica, e como está ligado a um programa antropológico de universalização das descobertas psicanalíticas, cuja maior expressão é a publicação de Totem e Tabu (1912-13) e sua ampliação do valor metodológico da lógica mítica para a apreensão da origem da cultura. A partir de uma revisão das leituras e críticas à psicanálise pelas principais vertentes da antropologia no início do século XX, observamos como o valor epistêmico-metodológico da obra freudiana apenas será plenamente reconhecido com o advento do projeto estrutural de antropologia engendrado por Lévi-Strauss e responsável por inscrever o mito como objeto privilegiado de estudo. Acompanhamos os principais movimentos de Lévi-Strauss pela análise mítica (1949; 1955; 1964; 1985), ressaltando o papel central do modelo da fórmula canônica do mito. A análise das derivações matemáticas de seus termos fundamentais levou-nos a reconhecer seu valor para a psicanálise lacaniana. Neste modelo, Lacan encontrará (a) uma noção de estrutura que assimila a dimensão da dialética e do impossível em seus termos, (b) a base de sua teoria do significante, (c) um meta-modelo de formalização que o acompanhará por toda 9 sua obra. A partir desta revisão analisaremos se os desvios conceituais da assimilação lacaniana do modelo de Lévi-Strauss, poderiam retroativamente contribuir para uma revisão do valor da análise mitológica para além dos limites psicanalíticos. Para tal, nos valeremos de uma releitura das análises estruturais do mito de Édipo e do Homem dos Ratos. Cientes dos limites de nosso recorte, indicamos ao fim possíveis desdobramentos deste percurso para pesquisas futuras / Situated in the theoretical debate between psychoanalysis and structural anthropology, this research aims to analyse the roles and implications of the concept of myth for the establishment of formalizations project of psychoanalytical experience. In previous research, we found that in the conference The neurotic \'s individual myth (1953), Jacques Lacan applied the logical model by which the anthropologist Claude Lévi-Strauss read the mythic structure the canonical formula of myth (1955) to revised the Freudian case of the Rat Man. From this premise, a question remained: to what extent the model of the structure inherent of the mythical phenomenon was necessary for the appropriation of Lacanian ideas structural condition and what the effects of such constitutive moment on his future formalizations of the psychoanalytic practice. With this aim in view, we initially mapped in Freud\'s work the dimensions of the theme of the myth. We saw how its appearance is contemporary to the emergence of psychoanalysis as a clinical practice, and how it is connected to an anthropological program of universalization of the psychoanalytic discoveries, whose highest expression is the publication of Totem and Taboo (1912-13) and its expansion of the methodological value the mythical logic to apprehend the origin of culture. From a review of the readings and critiques of psychoanalysis by the anthropologists in the early twentieth century, we saw how the epistemic and methodological value of Freud\'s work will be fully recognized with the advent of structural anthropology introduced by Lévi-Strauss, and responsible for signing the myth as a privileged object of study. We followed the Lévi-Strausss main movements in mythical analysis (1949, 1955, 1964, 1985), highlighting the central role of canonical formula of myth. The analysis of the mathematical derivations of its fundamental terms led us to recognize its value to Lacanian psychoanalysis. In this model, Lacan find (a) a type of structure that assimilates the dimension of the dialectic and the theme of impossible in its terms, (b) the basis of his theory of the signifier, (c) a meta-model for formalizing remains 11 throughout his work. From this review we analyse if the conceptual deviations of Lacanian assimilation of Lévi-Strauss model, could retroactively contribute to a revision of the value of the mythological analysis beyond the psychoanalytic limits. To this goal, we reread the structural analysis of the myth of Oedipus and the Rat Man. Aware of the limits of this research, we indicate possible outcomes at the end for future studies

Artrite-encefalite dos Caprinos (CAE) é uma enfermidade infecciosa, multissistêmica, causada por um lentivírus, e infecta caprinos de todas as idades, independente do sexo, raça e tipos de produção econômica. Os principais sintomas descritos são leucoencefalomielite, artrite, pneumonia crônica intersticial e mamite intersticial endurativa. A CAE possui distribuição mundial, no Estado de São Paulo encontra-se amplamente disseminada no rebanho caprino. Com o intuito de aprofundar os conhecimentos sobre o vírus da Artrite-encefalite dos caprinos (CAEV) serão realizados estudos de sequenciamento de parte do cDNA e análise filogenética de amostras detectadas de órgãos, líquido sinovial, sêmen e leite de caprinos naturalmente infectados e soropositivos ao IDGA para o vírus da CAE e correlacionar as variantes genéticas com a sintomatologia, a forma clinica preferencial e a patogenicidade. Para o estudo filogenético serão amplificados, por RT-PCR, e sequenciados, parte do gene pol e o gene tat das amostras. Este estudo possibilitará o conhecimento das estirpes virais existentes no rebanho caprino do estado de São Paulo e a sua patogenicidade. A pesquisa de mutações encontradas por meio da análise do estudo filogenético do vírus poderá mostrar se a variante encontrada apresenta predileção por uma determinada expressão clínica. O seqüenciamento genético poderá permitir, também no futuro, uma maior eficiência na produção de antígenos virais para sorodiagnóstico e vacinas a partir das cepas circulantes encontradas. / Caprine arthritis-encephalitis (CAE) is an infectious disease, multisystem caused by a lentivirus, and infects goats of all ages, regardless of sex, race and types of economic production. The main symptoms are leukoencephalomyelitis, arthritis, chronic interstitial pneumonia and interstitial mastitis induration. CAE has a worldwide distribution in the State of São Paulo is widely disseminated in the goat herd. Aiming to deepen knowledge about the virus caprine arthritis-encephalitis (CAEV) studies will be performed sequencing of part of the cDNA and phylogenetic analysis of samples detected in organs, synovial fluid, semen and milk of goats naturally infected and seropositive AGID test for CAE virus and to correlate genetic variants with the symptoms, the clinical form of preferential and pathogenicity. For the phylogenetic study will be amplified by RT-PCR and sequenced, part of the pol gene and the gene tat of the samples. This study will allow the knowledge of existing viral strains in goat herd in the state of Sao Paulo and its pathogenicity. The analysis of mutations found by analyzing the phylogenetic analysis of the virus may show if the variant has found a predilection for a particular clinical expression. The gene sequencing will allow, in future, greater efficiency in the production of viral antigens for serodiagnosis and vaccines from the circulating strains found.