During the past two decades interdisciplinary health care teams have come to be considered an integral component in the efficient delivery of health care. Interdisciplinary teams dealing with the increasingly complex problems of patients are now common in many health care settings. The purpose of the present study was to investigate the individual and collective impact of several group process inputs, common to interdisciplinary health care teams, on team members' appraisals of their own group process skills.

Thesis (MPH) -- University of Limpopo, 2011. / Introduction STIs, including easily treatable bacterial infections such as syphilis and gonorrhoea, continue to cause a huge burden of ill health in both developing and developed countries. Syndromic management is currently the best approach for the management of sexually transmitted infections in developing countries, but its successful implementation is often questionable Objectives The overall aim of this study was to assess and compare the quality of STI services in the primary health care clinics in Leribe district, Lesotho. The specific objective of the study was to assess the availability of STI drugs, clinicians’ knowledge of STI management, and the availability of STI examination equipment Methods A descriptive cross-sectional quantitative study was conducted with 23 nurse clinicians in PHC clinics in Leribe district of Lesotho. This study explored the gaps and issues around the provision of syndromic management of STIs using the DISCA tool. Results Most of the facilities have inadequate and non reliable equipment and supplies as well poor and inadequate infrastructure. There is lack of continuous training on STI management, low complete treatment to STI clients with only a few of the health centres giving complete treatment and there was also poor contact tracing of partners. Almost all clinicians cited the correct treatment for managing male urethral syndrome. Conclusion The lack of continuous training compromised STI management because nurse clinicians lacked skills to provide quality services. In general, although the principles of syndromic management are well understood by most clinicians, there are no systems in place to support the use of these guidelines

Thesis (MPH) -- University of Limpopo, 2011. / Background: Health care workers (HCWs) are prone to occupational exposures to blood-borne viruses (BBVs), which include hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Post exposure prophylaxis (PEP) is available for both HBV and HIV, and if administered correctly can reduce the risk of HBV and HIV transmission by 80%. This study investigated the knowledge and practices of HCWs regarding PEP for BBVs at Medunsa Oral Health Care Centre (MOHC). Methods: This was a cross sectional study conducted among 166 HCWs at the MOHC using a self-administered, anonymous questionnaire on knowledge and practices of HCWs regarding PEP for BBVs. Binary logistic regression method was used to determine factors associated with reporting an occupational exposure and uptake of PEP. Results: The response rate was 67%. The mean age was 27yrs (SO =7.67yrs), and 68.7% of . respondents were female. The overall knowledge regarding PEP among the HCWs was inadequate as 46.9% had poor knowledge. The majority (77.7% [128/166]) of HCWs experienced occupational exposures and amongst them 39.0% (50/128) experienced it twice or more. Almost two-thirds (60.9%) of HCWs experienced an occupational exposure while performing scaling and polishing. Only 28.9% (37/128) of those who were potentially exposed to a BBV reported the incident to the authorities. Out of those who reported, 37% (14/37) took PEP for HIV, and 32.4% (12/37) took PEP for HBV. Among those taking HIV PEP, 21.4% (3/14) indicated that they completed the course. HCWs who haq five or more years of experience j were less likely (OR=0.138, p=0.043) to report compared to those who had less than five years of experience. Conclusion: Overall, participants' knowledge regarding PEP as well as reporting of an exposure was inadequate. The majority of HCWs experienced an occupational exposure while performing scaling and polishing.

Thesis (M Med (Family Medicine)) -- University of Limpopo, 2010. / Background: Many patients move from one healthcare provider to another, disturbing the continuity of holistic patient care. Objectives: The aim of this study is; to investigate the reasons why patients leave their nearest clinic, and to determine if these patients are able to use the provided care when they need to. Methods: A cross-sectional, quantitative study was conducted during the winter of 2010. Questionnaires were given to 350 patients attending Karen Park Clinic. Patients completed the questionnaires in the presence of the researcher, who was able to assist where needed. Variables addressed in the questionnaire included: place where they stay; if they visited their nearest clinic; what services there are at their nearest clinic; would they go back to their nearest clinic and if not, what would be the reasons. Results: The majority of respondents stayed in Soshanguve, 153 (43.7%), Mabopane 92(26.3%)Garankuwa, 29(8.3%)and Hebron 20(5.7%), Most ofthe respondents were females 271(77.4%), with 177 (50.6%)aged between 26 and45years. Eighty percent of patients indicated that they visited their nearest clinic and 191(54.6%) said that they will not return to that clinic. The reasons for not returning to the nearest clinic were: - no medication, 39(11.1%); long queues, 59(16.9%); rude staff, 59(16.9%); long waiting time to be helped, 88(25.1%) and other, 63(18.0%). Conclusion: The researcher found that many patients, who first attended their nearest clinic, opted not to return. Reducing long waiting times and long queues at a primary health care centre can be achieved. Satisfied health care providers would provide quality service to patients. Training courses for management committee members could lead to improving the health center's management and patients could be redirected to their nearest clinic by giving them referrals or transfer letters. Purchasing enough medicine will reduce the problem of no medication and increase the capability of the health center. Staff should receive training about health care practices, to reduce the rude behaviors that drive patients away.

Thesis (M Med (Family Medicine)) -- University of Limpopo,2011.

What constitutes quality of learning in primary care? A social systems view of that central question regards the relationships between dimensions of learning, purposes of primary care, and quality of practice. The question of learning quality was approached in three ways. First, perceptions of learning quality were elicited through recorded interviews with fifteen participants representing diverse roles in a primary care medical clinic. Analysis of the interviews indicated learning sources, factors, and functional dimensions of learning. Second, because learning is constituted in a social practice, the social context of learning in primary care clinics was modeled with qualitative systems diagrams. This exposed systemic barriers and facilitators of learning in practice. Third, learning is directed toward fulfilling the purposes of primary care. The nature of those purposes is not well articulated. A framework of seven core purposes was developed from the perspective of systems phenomenology. This framework extends the biopsychosocial framework in several regards. Perceptions of learning quality, the structural situation of learning in clinical practice, and the core purposes of primary care, all contribute to a social systems understanding of what constitutes learning quality, and how primary care organizations might procure it and assess it. Systems phenomenology represents a significant innovation in social systems science methods. / Graduation date: 2002

The U.S. pharmaceutical industry has been remarkably successful in developing new treatments for many of the leading causes of morbidity and mortality. These new treatments and their high prices lead government and private parties to increase spending and raise the issue of access. Price and cost increases have stimulated insurance costs, raising questions about the value of new technologies. A key way to address the increase in pharmaceutical prices is to investigate the impact of newer therapies on overall health expenditure. There is a conflict among researchers about the benefits and costs of newer and better drugs. Some researchers argue that newer and better drugs keep people out of hospitals and provide significant cost savings. Another group of researchers argue in their work that newer drugs do not really provide significant cost savings. This dissertation investigates the impacts of break-through drug classes on overall health care expenditures. Empirical evidence presented in this dissertation shows that drugs belonging to new drug classes provide significant advances in treatment of conditions compared to other drugs. The results indicate that all new drug classes except Fluoroquinolones provide substantial cost savings on overall health care expenditures. This dissertation also explores the relations between FDA Therapeutic Drug Classification and total health care expenditures. It offers a better methodology by incorporating both the quality and the age of the drugs to capture their effects on total health care expenditures. It studies the impacts of the quality and the age of the drugs on the diseases of following therapeutic classes: musculoskeletal system and connective tissue, skin and subcutaneous tissue, neoplasm, mental disorders, nervous system and sense organs, circulatory system, respiratory system, digestive system, genitourinary system. The nature of therapeutic conditions coupled with their duration lead us to conclude that for some therapeutic categories newer priority drugs are preferable, for others newer standard drugs are better. The results suggest that there is no general rule to state that newer priority drugs decrease health care expenditures.

In an attempt to improve patient care and compensate for growing demands, new tools and strategies are under constant review and development for improvements and analyses. Advances in technology, analyses of the use of public funding, acquiring additional capital, and adapting practical tools and resources from other industries are commonly considered to improve the situation. This work provides a series of recommendations and analyses of solutions for emergency healthcare developed with Oakville Trafalgar Memorial Hospital (OTMH) in mind that can be scaled and adapted for all hospitals and emergency departments. Solutions applied were analyzed for their effect on patient care and health care providers. Recommendations for future improvements and work have been made and numerous concepts were drawn from previous studies and applications in other industries, and adapted for OTMH. It is concluded that the solutions had a positive effect on both the staff experience as well as patient throughput.

In an attempt to improve patient care and compensate for growing demands, new tools and strategies are under constant review and development for improvements and analyses. Advances in technology, analyses of the use of public funding, acquiring additional capital, and adapting practical tools and resources from other industries are commonly considered to improve the situation. This work provides a series of recommendations and analyses of solutions for emergency healthcare developed with Oakville Trafalgar Memorial Hospital (OTMH) in mind that can be scaled and adapted for all hospitals and emergency departments. Solutions applied were analyzed for their effect on patient care and health care providers. Recommendations for future improvements and work have been made and numerous concepts were drawn from previous studies and applications in other industries, and adapted for OTMH. It is concluded that the solutions had a positive effect on both the staff experience as well as patient throughput.

The U.S. pharmaceutical industry has been remarkably successful in developing new treatments for many of the leading causes of morbidity and mortality. These new treatments and their high prices lead government and private parties to increase spending and raise the issue of access. Price and cost increases have stimulated insurance costs, raising questions about the value of new technologies. A key way to address the increase in pharmaceutical prices is to investigate the impact of newer therapies on overall health expenditure. There is a conflict among researchers about the benefits and costs of newer and better drugs. Some researchers argue that newer and better drugs keep people out of hospitals and provide significant cost savings. Another group of researchers argue in their work that newer drugs do not really provide significant cost savings. This dissertation investigates the impacts of break-through drug classes on overall health care expenditures. Empirical evidence presented in this dissertation shows that drugs belonging to new drug classes provide significant advances in treatment of conditions compared to other drugs. The results indicate that all new drug classes except Fluoroquinolones provide substantial cost savings on overall health care expenditures. This dissertation also explores the relations between FDA Therapeutic Drug Classification and total health care expenditures. It offers a better methodology by incorporating both the quality and the age of the drugs to capture their effects on total health care expenditures. It studies the impacts of the quality and the age of the drugs on the diseases of following therapeutic classes: musculoskeletal system and connective tissue, skin and subcutaneous tissue, neoplasm, mental disorders, nervous system and sense organs, circulatory system, respiratory system, digestive system, genitourinary system. The nature of therapeutic conditions coupled with their duration lead us to conclude that for some therapeutic categories newer priority drugs are preferable, for others newer standard drugs are better. The results suggest that there is no general rule to state that newer priority drugs decrease health care expenditures.