From a research and literature survey, the incidence of alcohol related problems is discussed and past and current approaches to intervention and treatment outlined. An ideal model for intervention and treatment based on inter professional work in Primary Health Care Teams is proposed. One Health Centre is the basis of study of responses by the professionals working on a primary health care team approach to the alcohol and alcohol related problems in the area. The knowledge and attitudinal basis of the professionals are measured by questionnaire and interview. Incidence of alcohol and alcohol related problems in one of the two practices in the Health Centre is measured and compared with national guideline figures. Professional responses by professionals to drinkers and to affected persons are analysed by questionnaire and particular attention is given to responses to people living in nuclear families. Two case studies are included for illustrative purposes. The discrepancy between the ideal model and actual practice is established in relation to numbers treated, division of labour and lack of ongoing support to the patient. The model is accepted as the desirable method of intervention. The study ends with sets of recommendations relating to community based prevention strategies, early detection and intervention, ongoing support, monitoring and interdisciplinary collaboration, methodological weaknesses are acknowledged and areas for further future research identified.

<p><strong>ABSTRACT</strong></p><p>Parental support is needed because it promotes a positive development in children, because parents ask for it and because it has positive effects on the public economy. Those responsible in Sweden for Child health care have shown an increased interest in supporting parenthood.</p><p><em>Aim:</em> The overall purpose of this study was to investigate what kind of support parents today desire from child health care. An additional purpose was to investigate if they feel their needs and wishes are met.</p><p><em>Method:</em> The study has a descriptive and qualitative design. The selection was eight parents of children under eighteen months of age: four mothers and four fathers. None of the participants were couples. Data collection was performed with semi structured interviews. Collected data were analyzed according to qualitative content analyses.</p><p><em>Results: </em>Two themes appeared: desired support –<em> </em>the child in focus and organisation – no place for fathers. Seven categories emerged: expectations before the child was born – the health of the child in focus and someone to call, expectations today – the health of the child and support in parenthood, seeking support from others than the Child health care, accessibility is important, continuity creates safety, the purpose of parent education group satisfactory & home visits – from ambivalent to positive experience. The study shows that the informants wants that Child health care focuses on the growth and development of the child, supports parents in their new role as parents and is accessible if the parents have questions. The informants were to great extent content with the support from the child health centre.</p><p><em>Conclusion:</em> According to parents wishes Child health care should focus on the child and it’s health along with strengthening the parents in their new role. The accessibility must improve to make the child health care centre a place even for fathers.</p><p><strong>Key words</strong></p><p>Child health centre, parents, support, desire, expectations.</p>

ABSTRACT Parental support is needed because it promotes a positive development in children, because parents ask for it and because it has positive effects on the public economy. Those responsible in Sweden for Child health care have shown an increased interest in supporting parenthood. Aim: The overall purpose of this study was to investigate what kind of support parents today desire from child health care. An additional purpose was to investigate if they feel their needs and wishes are met. Method: The study has a descriptive and qualitative design. The selection was eight parents of children under eighteen months of age: four mothers and four fathers. None of the participants were couples. Data collection was performed with semi structured interviews. Collected data were analyzed according to qualitative content analyses. Results: Two themes appeared: desired support – the child in focus and organisation – no place for fathers. Seven categories emerged: expectations before the child was born – the health of the child in focus and someone to call, expectations today – the health of the child and support in parenthood, seeking support from others than the Child health care, accessibility is important, continuity creates safety, the purpose of parent education group satisfactory &amp; home visits – from ambivalent to positive experience. The study shows that the informants wants that Child health care focuses on the growth and development of the child, supports parents in their new role as parents and is accessible if the parents have questions. The informants were to great extent content with the support from the child health centre. Conclusion: According to parents wishes Child health care should focus on the child and it’s health along with strengthening the parents in their new role. The accessibility must improve to make the child health care centre a place even for fathers. Key words Child health centre, parents, support, desire, expectations.

This study reviews the growth and development of the Health Centre for Children, Vancouver General Hospital, which has offered, for the past four years, a diagnostic and treatment service to children in low-income families. The aim of the project is to determine to what extent the need in the community for a service of this kind is being met. The main research methods used to obtain the necessary information have been interviews and studies of medical and social case records. The medical structure is described in detail with suggestions for improvement of service in this area. The role which the social worker fulfills is outlined, and is compared with the role which the social worker would ideally assume in a setting of this type. Suggestions for improvement of service are made in this area also. Particular emphasis is placed upon the need for treatment of the "whole" individual, a factor which, because of concentration upon expansion of medical services, appears to have received too little attention in the Health Centre. Although there is still room for improvement in the programme, there is reason to believe that the need in the community for a service of this kind is being met to a great extent. The main indication of this is the comparatively large number of people who use the Health Centre facilities. This is particularly evident when attendances for the four-year period are compared with the numbers who used the only public medical services formerly available. Since the Health Centre will be moving into new and more spacious quarters in the course of the next few months and since, at this time, many major and minor changes will be instituted, this study is considered an interim one. It would be valuable to have a further study completed after four or five years of continued operation. / Arts, Faculty of / Social Work, School of / Graduate

Magister Curationis - MCur / The South African health care system shifted the focus of treating psychiatric disorders from institutional care level mental health services to facilitate this process of integration into the Primary Health Care (PHC) settings. All the provinces were thus engaged in improving mental health care services at community level by providing training for professional nurses in mental health at PHC settings. Consequently, mental health nursing has also changed considerably by shifting the focus of mental health care to the primary care level. It is however, suggested that the current revolving door syndrome experienced at psychiatric institutions was partly due to inadequate community-based psychiatric services. It was also suggested that the attitudes and knowledge of health professionals towards mental illness has a major impact on service delivery, treatment and outcome of mental illness. The aim of this research study was to assess the attitude of nursing staff working at a Community Health Centre (CHC) towards the mental health care user. A CHC was chosen that renders 24 hour services. The inclusive sample included all the different categories of nurses permanently employed at this CHC. The Attitude Scale for Mental Illness questionnaire was used to collect the data. Descriptive statistics: means, median and standard deviations were calculated for the following variables: separatism; stereotyping; restrictiveness; benevolence; pessimistic prediction and stigmatization. In conclusion it can be said that the nursing staff with more experience irrespective of category of nurse has less of a stereotyping attitude towards mental illness. The longer the nurse worked at the setting and irrespective of their nursing qualification the more positive their attitude towards the MHCU became.

Introduction: South Africa has embarked on a massive roll out of ARVs to more than 1.4 million people living with HIV/AIDS. Provision of ARVs to people living with HIV/AIDS encounters many challenges associated with adherence. Properly taken ARVs have been shown to reduce viral loads to undetectable levels and increase the CD4 count. This in turn leads to a drop in opportunistic infections and better health outcomes but the requirements for adherence are high. Several patient-related factors have been reported to affect adherence rates. Nonadherence on the other hand has been reported to lead to the development of drug resistant strains of HIV. It recognised that the resistance to ARVs can quickly lead to build up of highly resistant strains in the blood due to one week of missed medication. Aims and objectives: This study set out to identify factors which affect adherence to HAART among adults on HAART in two health facilities in Gauteng province in 2006.The main objectives were to assess the patient adherence using viral load response and self-report data. Secondly, the study was to determine factors that facilitate adherence and finally barriers to adherence at the two sites. Materials and methods: A cross sectional study was done at the two ARV facilities in Gauteng from July to November 2006. Two physiological methods -CD4 counts and plasma viral load, and one subjective-3 day recall self- report methods were used to asses adherence. Exit interviews and record reviews were done to collect data. Virologic outcome was the preferred surrogate marker for adherence. Univariate and bivariate analyses were done to determine measures of association. Measures of association (Chi square) at a 95% significance level for factors affecting adherence were then determined and results obtained. Results: The mean age was 36.9 years (range 18-70 years) and 73.5% were women. Self-report data (n=343) indicated 98.4% in the higher adherence category (taken 100% of their doses). Viral load data (n=343) showed that 88.8% were in the adherence lower category (<400 RNA copies). Viral load outcome (“adherence”) was significantly associated with the length on treatment (p<0.05) and patients who had been on treatment for 12-24 months had lower viral load than those who had been treatment for a shorter time (<12 months) or longer (>24months). However, gender (p=1.000), age (p=0.223), level of education (p=0.697) and access to social grants (p=0.057) were not associated with “adherence”. Socio-economic status was significantly associated with viral load outcome (p<0.01) as well as cost (n=185; p<0.05). Individuals who incurred the highest costs (>R25) were the least likely to adhere followed by those facing average costs (R15-25) compared to the reference group (< R15). Conclusion: Adherence rates of 88.8% suggest that respondents from both facilities can optimally adhere to their medication when they have been on ARVs for longer than a year. These are minimum adherence rates. There were factors that still hinder adherence at both the individual patient level. There is still a need for more targeted interventions especially towards men who were noted to have a relatively low uptake of HAART within the two sites.

No description available.

The move toward primary health care renewal in Canada and in industrialized nations around the world is resulting in a fundamental change in the way health care is delivered. Citizen participation is one of the five pillars of primary health care-not just participation in decisions related to an individuals health care treatment, but also from the larger perspective of decision-making that affects policy and structure within an organization. Health care organizations want to be responsive to the needs of their communities, and consumer-savvy citizens increasingly expect to play a part in the decision-making process of organizations. <p>The relationship between health care administrators, providers and citizens is sculpted by fundamental philosophies, values and processes. These include organizational culture, change process, social capital, citizen role definition and shared power or citizen empowerment. This research seeks to link the concepts and create an understanding of the dynamic and complex relationships which result in effective or ineffective citizen participation in decision-making within organizations. A theoretical framework was used which addresses these fundamental philosophies.<p> The object of this research is to explore the processes and structures of organizations that facilitate or hinder meaningful citizen participation. Community health centres (CHCs) have long been recognized in Canada and around the world as leaders in the facilitation of citizen participation, and this research reviews pertinent documents from fourteen CHCs across Canada. Some of the data collected from a national research project on community health centres is used. Through secondary analysis, the original results of the document audit are compared to the original results of a quantitative survey administered to volunteers, clients, health care professionals and board members at each site that collected information about community capacity, organizational capacity and outcomes. <p> Results of this thesis research are presented in a framework of community and organizational characteristics influencing the degree of public participation supported in the literature. The research presented in this thesis shows some relationship between supportive factors identified in the organizations documents and the degree of participation and satisfaction identified in the quantitative survey results. Possible reasons for this relationship are explored and recommendations are made based on a hierarchical model of participation, with greater citizen participation as the goal.

The move toward primary health care renewal in Canada and in industrialized nations around the world is resulting in a fundamental change in the way health care is delivered. Citizen participation is one of the five pillars of primary health care-not just participation in decisions related to an individuals health care treatment, but also from the larger perspective of decision-making that affects policy and structure within an organization. Health care organizations want to be responsive to the needs of their communities, and consumer-savvy citizens increasingly expect to play a part in the decision-making process of organizations. <p>The relationship between health care administrators, providers and citizens is sculpted by fundamental philosophies, values and processes. These include organizational culture, change process, social capital, citizen role definition and shared power or citizen empowerment. This research seeks to link the concepts and create an understanding of the dynamic and complex relationships which result in effective or ineffective citizen participation in decision-making within organizations. A theoretical framework was used which addresses these fundamental philosophies.<p> The object of this research is to explore the processes and structures of organizations that facilitate or hinder meaningful citizen participation. Community health centres (CHCs) have long been recognized in Canada and around the world as leaders in the facilitation of citizen participation, and this research reviews pertinent documents from fourteen CHCs across Canada. Some of the data collected from a national research project on community health centres is used. Through secondary analysis, the original results of the document audit are compared to the original results of a quantitative survey administered to volunteers, clients, health care professionals and board members at each site that collected information about community capacity, organizational capacity and outcomes. <p> Results of this thesis research are presented in a framework of community and organizational characteristics influencing the degree of public participation supported in the literature. The research presented in this thesis shows some relationship between supportive factors identified in the organizations documents and the degree of participation and satisfaction identified in the quantitative survey results. Possible reasons for this relationship are explored and recommendations are made based on a hierarchical model of participation, with greater citizen participation as the goal.

Recorded at Sunny Hill Centre for Children on Apr. 19, 2007