Hintergrund. Die zahnmedizinische Versorgung und Oralhygiene bei Menschen mit Demenz (MmD) ist auch unter Berücksichtigung der zunehmenden Anzahl der erhaltenen Zähne schwierig. Ziel der Arbeit. Es soll geklärt werden,ob das Angebot einer Beratungsstelle zum Thema Mundgesundheit und Demenz genutzt wird. Material und Methoden. Die Beratungsstelle wurde mit 3 zahnmedizinischen Spezialisten aufgebaut, und ein Jahr lang wurden die telefonischen Anfragen gesammelt sowie ausgewertet. Ergebnisse. Die zahnmedizinische Beratung wurde von 355 Anrufern (180 medizinisch-pflegerisch tätig; 175 Angehörige) im Zeitraum vom 01.06.2012 bis 31.05.2013 genutzt. Von den Anrufern wurden in den ca. 21 min dauernden Gesprächen 2535 Probleme angesprochen. Fast ein Viertel der Anrufer fragte nach einer mobilen Behandlung, und 14,4% suchten einen Zahnarzt, der auf die Behandlung der MmD spezialisiert ist. Orale Erkrankungen, die Mundhygiene und die interpersonellen Schwierigkeiten, die zwischen allen Beteiligten zur oralen Situation auftraten, wurden thematisiert. Drei Viertel des medizinisch-pflegerischen Personals fragten nach Schulungen, um die Mundgesundheit und Oralhygiene bei MmD zu verbessern. Schlussfolgerung. Die Nachfrage bei den Spezialisten zeigte, dass es großen Wissensbedarf sowohl beim Fachpersonal als auch bei den Angehörigen gibt. Die Studie belegt, dass die Probleme in der Mundhöhle von MmD breit gefächert sind. Wissen zu Mund- und Prothesenhygiene sowie den Krankheitsbildern der Mundhöhle könnte strukturiert in die Aus- und Fortbildung eingebracht werden. Neben dem Wissensdefizit wird auch deutlich,dass die zahnmedizinische Versorgungsstruktur nicht für die MmD gesichert ist. Hier sind die Politiker und die Akteure im Gesundheitswesen aufgefordert, die zahnmedizinische Versorgung in den Demenznetzwerken und -strategien zu verankern.:Bibliographische Beschreibung..................................................................4 Einführung..............................................................................................5 Krankheitsbild Demenz.............................................................................5 Einteilung der Formen der Demenz...........................................................8 Verlauf einer Erkrankung an Demenz......................................................10 Ursachen und Symptome der Demenz....................................................12 Zur Notwendigkeit der Behandlung von Menschen mit Demenz...............13 Bisheriger Kenntnisstand zur Versorgungsstruktur von Menschen mit Demenz.................................................................................................14 Zum Nutzen der vorliegenden Studie......................................................15 Publikation.............................................................................................16 Zusammenfassung.................................................................................23 Einleitung..............................................................................................23 Ziel der Studie........................................................................................24 Material und Methode.............................................................................25 Ethische Überlegungen...........................................................................25 Ergebnisse der Studie.............................................................................26 Diskussion.............................................................................................27 Literaturverzeichnis................................................................................29 Anlagen.................................................................................................34 Erklärung über die eigenständige Abfassung der Arbeit............................34 Publikation.............................................................................................36 Danksagung...........................................................................................38 / Background. The complexity of dental care and oral hygiene for people with dementia increases with increasing numbers of residual teeth. Aim. This study was carried out to determine whether the offer of a telephone helpline on oral health and dementia would be utilized. Material and methods. Over a period of 1 year contacts received by a telephone helpline manned by three oral healthcare staff were collected and analyzed. Results. From 01 June 2012 to 31 May 2013 a total of 355 callers (180 healthcare staff and 175 relatives) presented and discussed 2535 problems. The average duration of a call was 21 min. Almost one quarter of the callers were looking for mobile dental care services and 14,4% were looking for a dentist specializedin caring for patients with dementia. Oral disease, oral care and conflicts between stakeholders on aspects of oral health were discussed. Of the healthcare staff three quarters asked about training to improve the oral health of people with dementia. Conclusion. The demand on the specialists of the helpline showed a substantial knowledge deficit of healthcare staff and relatives. The study confirmed a wide range of oral health issues of people with dementia. Knowledge on oral and denture hygiene and on oral disease could be introduced into primary training and continued professional education. In addition to the lack of knowledge, deficits also exist in the oral healthcare system for people with dementia. Poliicians and healthcare stakeholders are encouraged to incorporate oral healthcare for people with dementia into strategies and dementia networks.:Bibliographische Beschreibung..................................................................4 Einführung..............................................................................................5 Krankheitsbild Demenz.............................................................................5 Einteilung der Formen der Demenz...........................................................8 Verlauf einer Erkrankung an Demenz......................................................10 Ursachen und Symptome der Demenz....................................................12 Zur Notwendigkeit der Behandlung von Menschen mit Demenz...............13 Bisheriger Kenntnisstand zur Versorgungsstruktur von Menschen mit Demenz.................................................................................................14 Zum Nutzen der vorliegenden Studie......................................................15 Publikation.............................................................................................16 Zusammenfassung.................................................................................23 Einleitung..............................................................................................23 Ziel der Studie........................................................................................24 Material und Methode.............................................................................25 Ethische Überlegungen...........................................................................25 Ergebnisse der Studie.............................................................................26 Diskussion.............................................................................................27 Literaturverzeichnis................................................................................29 Anlagen.................................................................................................34 Erklärung über die eigenständige Abfassung der Arbeit............................34 Publikation.............................................................................................36 Danksagung...........................................................................................38

Few studies regarding treatment seeking behaviour related to Malaria have been conducted in Uganda, and most of the studies regarding use of mosquito nets that have been conducted are quantitative. There is thus a need for qualitative studies for a deeper understanding of the complex issue of coping with malaria in a resource limited setting. The aim of this study is to understand sociocultural and structural factors influencing the coping with malaria in rural Uganda. Focus is on the local experiences, perceptions and hardships regarding seeking treatment for malaria and preventative measures like the use of mosquito nets. A theoretical framework based on Political ecology of health, with a focus on human agency, is used to analyse these issues. The village Nyakasojo in Kasese district was selected for a field study. The main source of information was open-ended interviews conducted in March 2020. The study showed that the main reason for not using mosquito nets was lack of access to nets and easily torn nets, rather than unwillingness to use mosquito nets. Further, the study showed that the unequal access to healthcare in combination with livelihood vulnerability forces people to wait before seeking treatment and/or taking half doses of antimalarials, probably leading to unnecessary malaria transmission. A more holistic approach to malaria control would be beneficial, including the aspect of treatment in addition to the present narrower focus on prevention.

Region Östergötland engages in many international collaborations as a way to exchange knowledge and insights with other organizations. The organization has had a collaboration focused on patient safety with Moi Teaching and Referral Hospital in Eldoret, Kenya, since 2015. Kenya is considered a low and middle-income country, while Sweden is considered a high-income country. The aim of this study was to describe patient safety development using activity theory, with a special focus on how Region Östergötland supports patient safety development in a low and middle-income country’s healthcare system. Data was collected by conducting interviews with six participants involved in the patient safety collaboration, by visiting Eldoret to conduct a participant observation and by analyzing relevant policy documents. The results showed that many factors are involved in patient safety development, both within an organization and in supporting the development in a low and middle-income country’s healthcare system. Healthcare organizations should strive for commitment to patient safety development from all levels of the organization, and for a safety culture where staff members are comfortable reporting errors. The management must pursue patient safety questions and put aside resources for patient safety development. As Sweden and low and middle-income countries are different in many aspects, it’s important for the supporting part, in this case Region Östergötland, to be attentive to and understanding of prevailing differences caused by available resources, cultural norms, rules and organizational structures. Many of the requirements for an organization’s patient safety development, and for a successful collaboration between Region Östergötland and Moi Teaching and Referral Hospital, were shown to be achieved or at least functioning. Even though all requirements are not fulfilled, they are all matters that can be improved by the continuation of the collaboration. Region Östergötland can learn from the collaboration by seeing how results can be achieved in an organization with few resources, how efficiently changes can be made within an organization, as well as by gaining knowledge about another culture and country. These factors create opportunities for project participants to be inspired and question current methods and norms in their own organization, which can result in improvements of Region Östergötland as on organization in the future.

Background: One of society's most pressing social challenges is the state of people's psychological health. Healthcare institutions have adopted e-health due to the noticeable rise in psychological health issues and growing societal reliance on digital technologies. Internet based Cognitive behavioural therapy (iCBT) is essential for those with psychological health issues. Since 2012, the Department of Swedish Municipalities and Regions (SKR) has coordinated the 1177 healthcare programme, a digitisation initiative. By 2025, the Swedish Government hopes to be a global leader in digitising social services and health care. This ehealth system must promote the welfare and good health, which are founded on the idea of equality between individuals. It must increase patient engagement and confidence while bridging the gap between patient needs and what the healthcare system can supply.  Aim: To describe the access to e-health within Swedish healthcare programs for psychological health problems.  Method: Summative qualitative content analysis of data from websites regarding access to e-health services or iCBT in the Swedish local authorities and regions through an inductive approach.  Findings: The results show that e-health services and resources are unequally distributed among local authorities and regions in Sweden.  Conclusion: Results of the study show that unequal e-health service and resource distribution might result in stigmatization and a decline in patient's willingness to seek care. / Bakgrund: Psykisk ohälsa är en av de stora samhällsutmaningarna idag. Hälso- och sjukvården har implementerat e-hälsa på grund av den märkbara ökningen av psykiska hälsoproblem och samhällets växande beroende av digital teknik. Internet baserad kognitiv beteende terapi (iKBT) som levereras online är viktig för dem med psykiska hälsoproblem. Sedan 2012 har Sveriges kommuner och regioner (SKR) samordnat digital vårdprogram 1177. Svenska regeringen syftar till att vara världsledande inom digitalisering av socialtjänst och hälso- och sjukvård. Detta e-hälsosystem måste främja välfärden och den goda hälsan, som bygger på idén om jämlikhet mellan individer. Det måste öka patienternas engagemang och förtroende samtidigt som den måste överbrygga klyftan mellan patienternas behov och vad hälso- och sjukvården kan tillhandahålla. Syfte: Att beskriva tillgången till e-hälsa i svenska vårdprogram för psykisk ohälsa. Metod: Summativ kvalitativ innehållsanalys av data från webbplatser om tillgänglighet till e-hälsa tjänster eller iKBT i de svenska kommuner och regioner genom en induktiv ansats. Resultat: Resultaten visar att tillhandahållandet av e-hälsa tjänster och resurser är ojämnt fördelat mellan olika kommuner och regioner i Sverige. Konklusion: Studie visar att ojämn fördelning av e-hälsa tjänster och resurser kan orsaka stigmatisering och minskad motivation bland de patienter som tänker söka vård och hjälp.

Non-communicable diseases are on the increase worldwide, causing more than 36 million deaths each year. Evidence of the link between the role of nutrition and reducing non-communicable diseases is predominant in the literature. The factors influencing intervention strategies/policies and activities, however, need attention. AIM: The study aims to examine the factors that influence nutrition interventions within the United Arab Emirates’ healthcare system. METHOD: This research adapts an interdisciplinary approach where a triangulation mixed methodology is applied. Both qualitative and quantitative methods are used, through the analysis of ten interviews with policy makers, four case studies and 161 questionnaires. Furthermore, the research framework, which emerged from the literature search and qualitative analysis, is tested and validated by rigorous quantitative analysis using SPSS. The statistical analysis, using factor analysis, MANCOVA and ranking analysis aims to provide solid support for the resulting factors. MAIN FINDING: The study identifies five factors that influence nutrition interventions in a healthcare system, and could enhance the effectiveness of nutrition interventions. The factors are 1) quality and processes, 2) training and use of technology, 3) senior management involvement and responsibility, 4) patient diversity, and 5) multidisciplinary teams. CONCLUSION: This study contributes to the emerging literature on management in nutrition interventions and the theory and importance of preventative measures in relation to nutrition. This study provides a roadmap for policy makers to adopt in order to enhance the role of nutrition interventions in healthcare settings. / Culture Department of the Emirates’ Embassy and Ministry of Higher Education (UAE)

No description available.

Структура магистерской диссертации включает в себя введение, три главы, заключение, список использованных источников и приложения. в которых подробно проанализированы проблемы здравоохранения, в т.ч. в части оплаты труда медицинских работников, представлена система государственного финансирования здравоохранения РФ, проведено международное сравнение целевых показателей (смертность, рождаемость, продолжительность жизни, доля расходов на здравоохранение от ВВП). В заключении предложены мероприятия по повышению эффективности здравоохранения. / The structure of the master's thesis includes an introduction, three chapters, a conclusion, a list of sources used and appendices. In which the problems of healthcare are analyzed in detail, including in terms of remuneration of medical workers, the system of state financing of healthcare in the Russian Federation is presented, an international comparison of targets (mortality, fertility, life expectancy, the share of healthcare costs from GDP) is carried out. In conclusion, measures to improve the efficiency of healthcare are proposed.

The need for donor funding has increased significantly over the last decade. Without donor funding millions of people wouldn’t be alive today. Thanks either to research finding a cure, successful treatment, funds donated for food, aid toward building infrastructure, or giving people the opportunity to further their education. Donor funding thus facilitates a better future. A literature review was conducted to give background on the health sector and how these funds were distributed, ethical clearance, different types of reporting, the role project managers pays in a project and the sustainability of projects. Expenses in different countries were evaluated by gathering data from the internet, while two international funded projects are also used to state how funders divide their line items into different categories. The empirical study used a qualitative research approach by collecting and analysing data obtained from the MDG 2010 report and other freely available data on the web. The main findings from this thesis are: *The Millennium Development Goals (MDG’s) influence donor funding as it gives donors a guide towards funding needs. Donors are also influenced by their own preferences or what poses a burden to them individually. *The different types of reporting required for funding received, delay a project and the bureaucratic structures thereof are a hindrance. *Ethical clearance plays a fundamental role in the outcome of a project, as without ethical clearance a project cannot commence. *The objectives of a project play a critical role when applying for funding. This can change the focus of a project. *Expenses differ from country to country and funders need to take this into account when giving funding to recipient countries. *Project Managers and community involvement plays a critical role in ensuring sustainability of projects. THE SUSTAINABILITY OF DONOR FUNDED PROJECTS IN THE HEALTH SECTOR *The MDG’s are not on track and aid are focus on singular goals instead of multiple goals, to ensure an overall improved result. There is a major gap between needed funds and given funds. A single injection of funds will not be the solution to our health problem; different sectors need to collaborate together as we are facing a multi-dimensional problem. Trade and reform must also form part of this aid, ensuring a sustainable progression in the life’s of people. Donor funded projects may have a sustainable future, when taking in account the abovementioned findings. With the world trend in reporting changing rapidly, cost and management accountants as well as financial accountants and project managers have to equip them to adhere to the new way of reporting, namely integrated and sustainability reporting. South Africa is way behind and needs to catch up fast if they want to stay competitive in the “global donor funding market”. The limitations in this study were that not all expenses were evaluated and only 15 countries were looked at. An indebt look was taken into Africa with the empirical review, while Asia is also combating poor health issues. Some African countries like Sierra Leone and Zimbabwe did not have sufficient data to compare with other countries. From the research conducted, the following topics were identified that require further research: *Why are most projects in Third World countries not sustainable? *What plans are put into action to ensure that the MDG goals are reached? *Investigate what works for First World countries health systems and consider how that can be applied to Third World countries to ensure that they also get the best health care available. *Do donors take into account the different costs of countries when allocating funding to that specific country? *Establishing models to evaluate the sustainability of pilot projects and normal projects. *Establishing a model on how to distribute donor funds across different needs and not only one specific need. / MCom (Management Accountancy), North-West University, Vaal Triangle Campus, 2013

A growing number of factors, including costs, technological advancements, ageing populations, and medical errors, are leading industrialized countries to invest in research on alternative solutions to improve their health-care systems and increase patients’ quality of life. Personal health systems (PHS) examplify the use of information and communication technologies that enable a paradigm shift from the traditional hospital-centered healthcare delivery model toward a preventive and person-centered approach. PHS offer the means to monitor a patient’s health using wearable, portable or implantable systems that offer ubiquitous, unobtrusive biodata acquisition, allowing remote monitoring of treatment and access to the patient’s status. Electrical bioimpedance (EBI) technology is non-invasive, quick and relatively affordable technique that can be used for assessing and monitoring different health conditions, e.g., body composition assessments for nutrition. When combined with state-of-the-art advances in sensors and textiles, EBI technologies are fostering the implementation of wearable bioimpedance monitors that use functional garments for personalized healthcare applications. This research work is focused on the development of wearable EBI-based monitoring systems for ubiquitous health monitoring applications. The monitoring systems are built upon portable monitoring instrumentation and custom-made textile electrode garments. Portable EBI-based monitors have been developed using the latest material technology and advances in system-on-chip technology. For instance, a portable EBI spectrometer has been validated against a commercial spectrometer for total body composition assessment using functional textile electrode garments. The development of wearable EBI-based monitoring units using functional garments and dry textile electrodes for body composition assessment and respiratory monitoring has been shown to be a feasible approach. The availability of these measurement systems indicates progress toward the real implementation of personalized healthcare systems. / <p>QC 20170517</p>

Introdução: São Paulo é uma megacidade com ocupação espacial heterogênea e desigualdades em saúde. Objetivos: Verificar se há aglomerados de nascidos vivos em hospitais SUS e não SUS e estudar as distâncias entre as residências das mães até os hospitais de parto. Métodos: Foi realizado um estudo com nascidos vivos (NV) de mães residentes e ocorridos em oito hospitais (4 SUS e 4 não-SUS) de alta complexidade do município de SP, em 2008. As informações foram obtidas da base de dados das declarações de nascido vivo unificada SEADE/SES e as bases cartográficas do Centro de Estudos da Metrópole. Foi empregado estimador de intensidade de Kernel para identificar aglomerados espaciais. A distância teórica entre residências maternas até o hospital do parto foi obtida em linha reta. Resultados: Os NV estudados representaram 27,8 por cento do total do MSP. Os NV dos hospitais SUS formaram 3 aglomerados, situados em distritos periféricos. A distância média percorrida entre a residência materna e o hospital do parto foi de 9,2 km para os NV de hospitais SUS e de 9,9 km para os não-SUS. Verificou-se uma proporção maior de mães de alta escolaridade (12,8 vezes), com mais de 35 anos de idade (3,2 vezes), nascimentos com 7 ou mais consultas de pré-natal (1,5 vezes) entre os NV de hospitais não-SUS que nos hospitais SUS. Os NV de hospitais SUS apresentaram proporções de mães adolescentes (17,9 vezes), grandes multíparas (21 vezes) e partos por via vaginal (5,2 vezes) maior que nos não-SUS. Não houve diferença estatisticamente significante da prevalência de baixo peso ao nascer e NV pré-termos. Discussão: Há uma associação entre a distribuição espacial dos nascimentos ocorridos em hospitais SUS e não-SUS. Os aglomerados de NV SUS situaram-se em distritos onde há condições de vida precárias e altas taxas de fecundidade. Os NV de hospitais não-SUS formaram um aglomerado na região central de alta renda e baixa fecundidade, seguindo padrão observado em outros estudos. As distâncias médias entre as residências maternas e hospitais de parto foram próximas nos dois tipos de rede. Os diferenciais das características maternas dos NV em hospitais SUS e não-SUS foram mais acentuados que aqueles encontrados em estudos realizados somente com técnicas de georrefenciamento, possivelmente devido aos hospitais não-SUS estudados atenderem a clientela de planos de saúde de alto poder aquisitivo. A ausência de diferença estatisticamente significante entre a prevalência de nascimentos pré-termo e de baixo peso ao nascer possivelmente se deve ao estudo ter sido realizado apenas em hospitais de alta complexidade. O diferencial encontrado na realização de consultas de pré-natal mostra o efeito positivo do SUS no acesso atenção pré-natal. Conclusão: Os aglomerados de nascimentos SUS e não-SUS mostram existir marcados diferenças quanto às características sociodemográficas. O SUS mostrou ter um efeito de positivo na promoção de maior equidade no acesso à atenção pré-natal e ao parto. / Sao Paulo is a megacity of heterogeneous spatial occupation and inequalities in health. Objectives: To determine whether there are clusters of live births (LBs) in hospitals of Unified Systems (SUS) and in others (non-SUS) and study the distances between the residences of the mothers concerned and the respective hospitals. Methods: A study was conducted a study of LBs of resident mothers which had occurred in eight hospitals (4 of the SUS and 4 others, not of the SUS) of hight complexity in the municipality of SP, in 2008. The information was obtained from the unified SEADE/SES database of the declarations of LBs and the cartographic bases from the Metropolitan Study Center (Centro de Estudos da Metrópole). Kernel\'s intensity estimator was employed to identify spatial clusters. The theorithical distance between the maternal residences and the respective maternity hospitals was taken as that given by a straight line between the two. Results: The LBs studied accounted for 27.8 per cent of the total of the municipality. The LBs of the SUS hospitals formed 3 clusters, all situated on the outlying districis. The average distance travelled from the maternal residence to the maternity hospital was 9.2 Km for the LBs of the SUS hospitals and 9.9 Km for the non-SUS ones. Higher proportions of mothers with a hight level of schooling (12.8 times), of more than 35 years of age (3.2times) and of births with 7 or more pre-natal medical visits (1.5 times) were found among the LBs of the non-SUS hospitals than among those of the SUS hospitals. The LBs of the SUS hospitals presented higher proportions of adolescent mothers (17.9 times), multiparous mothers (21 times) and vaginal deliveries (5.2 times) than those of the non-SUS ones. There was no statistically significant difference between the respective prevalences of low birth weight and pre-term LBs. Discussion: There is an association between the spatial distribution of the deliveries which occurred in the SUS and the non-SUS hospitals. The clusters of the SUS LBs where situated in districts characterized by precarious living conditions and high fertility rates. The LBs of the non-SUS hospitals formed a cluster in the central region, of high income and low fertility, in agreement with the pattern observed in other studies. The average distances between the maternal residences and the hospitals were near the two types of network. The differentials of the maternal characteristics of the LBs in SUS and non-SUS hospitals were more accentuated than those found in studies with georeferencing techniques alone, possibly as a result of the non-SUS hospitals studied attending to a clientele of high acquisitive power, with health insurance plans. The lack of any statistically significant difference between the prevalence of pre-term births and low birth weight is possibly due to this study\'s having been performed in hospitals of high complexity. The difference found in the frequency of pre-natal visits shows the positive effect of the SUS in terms of access to pre-natal attendance. Conclusion: The clusters of SUS and non-SUS showed there marked differences in sociodemographic characteristics. SUS has shown a positive effect in the promotion of greater equity in terms of access to pre-natal care and child birth