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Magister Scientiae (Physiotherapy) - MSc(Physio) / Variability of profile and practices (roles) of the ICU physiotherapists exists globally. The profile and current practices (roles) of the private practice physiotherapist in the private ICU has been minimally explored especially in South Africa (SA). A dearth of survey data and in-depth exploration of the latter exists in the current literature. The aim of this study was to determine and explore the profile and current practices (roles) of the ICU physiotherapists in private ICUs in SA. / 2022

<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>

ABSTRACT Thyroid disease is one of the most common endocrine disorders in clinical practice. Critical illness is often associated with alterations in thyroid hormone functions. Thyroid dysfunction is a serious matter if managed inaccurately; it may increase morbidity and mortality. The purpose of this Doctor of Nursing Practice project is to identify the knowledge, attitudes, behaviors and practice of advanced practice nurses (acute care nurse practitioners (ACNP) and adult gerontology acute care nurse practitioners (AGACNP)) on current thyroid dysfunction management in the acute care setting. The DNP project demonstrated that most acute care nurse practitioners believe that TD screening, diagnosis and management is important in the acute care setting. The survey results also indicated that most of the AGACNP/ACNPs would initiate treatment while managing patient in an acute care setting and will likely collaborate with endocrinology for overall management or follow ups to ensure quality and comprehensive care in management of TD. Keywords: thyroid disease, thyroid dysfunction, identify, knowledge, attitudes, behaviors, acute care

Background: As the number of older adults in Thailand continues to increase, along with increased incidence of surgical intervention that causes pain, the quality of pain care in older adults is needed. Nurses are primarily responsible for assessing and managing pain in older adults (Jose Closs, 2008; Prowse, 2007). The use of evidence-based practices (EBPs) improves quality of care and saves healthcare cost. However, in Thailand where empirical study of using EBP related to pain in older adults is limited, research to understand how Thai nurses use EBP acute pain in older adults is needed.Purpose:The purpose of this study is to describe current practices, perceived barriers and perceived facilitators of Thai nurses on using EBP for assessing and managing acute pain in postoperative older adults.Method:A descriptive exploratory survey was conducted in 8 mid and large-size hospitals in Thailand. The Acute Pain EBP Questionnaire (APEBPQ) (Suwanraj, 2009) was distributed to 240 Thai nurses. 236 questionnaires were returned with the response rate of 98.3 percent. Open-ended questions related to barriers and facilitators of using EBPs were coded to identify major themes. MANOVA was performed to explore the differences between years of nursing experience on perceived barriers and facilitatorsResultsThe majority of participants are female (96.8%) with mean age 35.5 years (range=23-54). Thai nurses reported using 51/53 recommendations from EBPG Acute Pain most of the time/always (95%). Using an equianalgesic table (1.80±1.16) and assessing MMSE in older adults with postoperative pain (1.74±1.15) were occasionally used. Research reports published in English was the greatest barriers. Nurses perceived greatest support from a Head ward than other colleagues. Nurses with 11-20 years of nursing experience had higher reported barriers than those with 1-10 years of nursing experience.Practice Implications: This study will provide important information on barriers and facilitators of using EBPs related to pain assessment and pain management in Thailand. The results of the study will be used to develop strategies to promote the use of EBPs acute pain among Thai nurses who provide nursing care for postoperative older adults.

<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>

By facilitating timely diagnosis and treatment initiation, population-wide newborn screening programs have led to important reductions in morbidity and mortality for many rare diseases, including medium-chain acyl-CoA dehydrogenase (MCAD) deficiency and very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency. Newborn screening has also expanded the spectrum of disease severity for MCAD and VLCAD deficiencies to include a higher proportion of milder cases, raising questions about appropriate disease management. To date there has been no systematic attempt to characterize best management practices in terms of the guidance that is available to those who provide care for MCAD and VCLAD deficiencies; nor has there been an attempt to understand the extent to which current practices align with such currently available guidance. The two projects that are part of this thesis sought to address these research gaps with a particular focus on two key disease-specific management practices we identified in advance as priorities: the use of carnitine supplementation and the recommended duration of fasting. The objective of the first project was to systematically review the quality and content of clinical practice guidelines and/or recommendations for the diagnosis and management of both MCAD and VLCAD deficiencies. Two independent reviewers assessed the eligibility of citations retrieved from a comprehensive search of the peer-reviewed and grey literature. We appraised the quality of the reviewed guidance and extracted information on the content of recommendations. From the 25 guidance documents that met our inclusion criteria, only 7 incorporated evidence reviews, indicating that guidance in this field does not generally meet established methodological standards for the rigorous development of clinical practice guidelines. With respect to content, we identified unclear and inconsistent recommendations regarding fasting times and the use of carnitine supplementation. Further empirical evidence in these areas is necessary to inform the development of future rigorous guidelines. The objective of the second project was to identify actual practices in the management of MCAD deficiency. We conducted a scoping review of published literature on treatment practices around the world and a secondary analysis of data documenting treatments received by participants in a Canadian pediatric cohort study. For the scoping review, citations retrieved from our comprehensive search strategy were screened by two independent reviewers. We extracted information on study characteristics and disease management. Our secondary analysis included longitudinal data for Canadian children with MCAD deficiency, born between 2006 and 2015 and enrolled in a cohort study at one of 13 centres. For both project components, we described carnitine supplementation and fasting times, overall and according to potential indicators of disease severity (genotype, biochemical phenotype). We identified 5 relevant publications in the scoping review and analyzed data for 107 children participating in the Canadian cohort. Management practices related to carnitine supplementation and fasting times for MCAD deficiency were highly variable based on both data sources. There was some evidence of an association between genotype and carnitine use, which, based on the scoping review, may be due to a relationship between genotype and carnitine deficiency. While actual practice was in some ways aligned with the guidance we reviewed in the first project, these results underscore the need for further evidence to address areas of uncertainty that have been prioritized by patients and families, clinicians, and health researchers, including questions regarding the potential to tailor treatment to predicted disease severity and an emphasis on controversial therapies such as carnitine supplementation.

Magister Pharmaceuticae - MPharm / 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 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 depend 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 maybe 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. 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. / South Africa

Magister Pharmaceuticae - MPharm / 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 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 depend 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 maybe 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 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. Aims The primary and secondary aims of the study were to: • Assess current practice patterns of TBI/HIV at primary healthcare clinics in the Western Cape, • Assess the need for a clinic-based TBIHIV training among final year pharmacy students in UWC. 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). Results and discussion Findings from the baseline study indicate the need for 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) favoured the services of a pharmacist in the clinic. In conclusion, findings from the post-intervention patient study clearly underpin that a clinic-based role for the pharmacist is imminent. All seven (100%) of the experimental students passed the assessment and had marks 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 programme could be supplemented with theoretical concepts in the final year of undergraduate pharmacy training.

Introdução- Estudos sistematizados atualizados sobre a supervisão em psicoterapia de orientação analítica (POA) são escassos, consideram a percepção dos alunos ou supervisores separadamente e em geral não consideram o ensino entre médicos residentes de psiquiatria. Ainda, para que se exerça a função de supervisor nesta área não há exigências ou cursos obrigatórios e apesar das orientações relacionadas à supervisão analítica servirem de modelo, aspectos fundamentais do ensino da POA não são claramente descritos. Objetivos- O objetivo principal deste estudo é descrever a prática atual de supervisão em POA. Secundariamente, pretende-se estudar aspectos da “relação real” de supervisores e alunos, descrever possíveis fatores desta relação que influenciem no aprendizado e expor situações particulares da prática da supervisão nesta área. Participantes- Foram incluídas seis duplas de supervisores e alunos, graduados em medicina e psicologia, que tivessem concluído processo de supervisão há menos de um ano, enquanto cursavam o primeiro ou o segundo ano do curso de formação em POA em dois Centros de ensino de POA de Porto Alegre, RS. Método- Dois questionários com perguntas abertas e fechadas nortearam entrevistas realizadas com cada componente das duplas em estudo. Os instrumentos foram elaborados de maneira a contemplar a percepção dos supervisores e dos alunos a respeito dos tópicos de interesse dessa pesquisa. As entrevistas foram gravadas e transcritas na íntegra para posterior análise qualitativa pelo método de Bardin. Resultados e conclusões- Os resultados foram organizados em três categorias finais de resposta: 1) “Estrutura da supervisão” (contendo respostas relacionadas ao contrato, material de trabalho e avaliações); 2) “Relação real supervisor-aluno” (englobando aspectos da dupla 7 atual e outros relacionados ao aproveitamento da supervisão) e 3) “Percepções e contribuições dos supervisores” (compreendendo questões relacionadas à tecnologia, tratamento do aluno e as diferenças entre a supervisão em psicanálise e psicoterapia psicodinâmica). Os dados foram apresentados e discutidos de acordo com a literatura e sugestões de aspecto prático foram propostas para contribuir com o processo de ensino e aprendizado da técnica. / Introduction- Updated and systematized studies on psychoanalytic psychotherapy (POA) supervision are scarce. In addition, the perceptions of students and supervisors are considered separately, as well as, generally, not much is given to teaching among resident physicians of psychiatry. There are no mandatory requirements or courses to perform the role of supervisor in this field, and although the recommendations related to analytical supervision work as a guide, the fundamental aspects of POA teaching are not clearly described. Objectives- The main objective of this study is to describe the current practice of supervision in POA. In addition, aspects of the real relationship between supervisors and students, possible factors that influence learning and particular situations of the practice of analytical will be exposed. Participants- Six supervisors and six respective students- psychiatrists and psychologistswho completed the supervision process in less than a year ago (during the first or second year of training), linked to two outpatient POA schools located in the city of Porto Alegre, south of Brazil. Method- The interviews were audio recorded and transcribed. The participants were stimulated to express their ideas freely and the questions and comments made by the interviewer aimed to deepen the work topics of interest. Late, data were analyzed, according to Bardin´s Content Analysis methodology. Results and conclusions- The content analysis resulted in 8 intermediate categories and 3 final categories, namely: 1) supervision structuring, 2) real supervisor-supervisee´s relationship and 3) supervisor´s contributions. (including questions related to technology, report of experiences of practice as supervisors). The data were presented, discussed and practical suggestions were proposed to contribute to the process of teaching and learning the technique of POA.