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Background: Cannabis among patients admitted in psychiatric units is higher than the general population and this has been shown in various countries where studies on cannabis use have been undertaken. Such an observation has been made by psychiatrists in South Africa and the association between cannabis use and psychotic presentation among these patients has also been observed. Cannabis use by patients with severe or chronic medical illnesses to ameliorate the symptoms of such illnesses has been documented in the literature. A study to explore use of cannabis among psychiatric inpatients as well as medical patients was undertaken. Purpose: The purpose of this study was to firstly determine the prevalence of cannabis use in psychiatric patients admitted to an acute admissions unit in King Edward VIII Hospital and to correlate it with the psychiatric diagnosis. Secondly, it was to compare the cannabis use in psychiatric patients admitted to an acute admissions unit to patients admitted in a medical ward at King Edward VIII Hospital. Thirdly, to assess self reporting of cannabis use by psychiatric and medical patients. Methods: A case control study was conducted at King Edward VIII Hospital, Durban, where cannabis use among 64 subjects included in the study admitted in a psychiatric ward was compared with a control group of 63 control subjects admitted in a medical ward. Both groups were tested for urinary cannabinoids and a questionnaire was filled. The questionnaire contained demographic details as well as a question on use of substances including cannabis. Results: 17 subjects (26.6%) in the study group tested positive for urinary cannabinoids and 2 subjects (3.2%) in the control group tested positive. Cannabis use was significantly higher among males when compared to females in both the study group and the control group. Only 7 subjects in the study group reported cannabis use and out of those 7 subjects, 4 subjects tested positive for urinary cannabinoids. The commonest diagnosis among the study group subjects were the psychotic disorders and schizophrenia being the most common psychotic disorder. Conclusion: Cannabis use is significantly higher among psychiatric patients as compared to medical patients and it is probably higher than in the general population. Self reporting of cannabis use among psychiatric patients is low and unreliable and psychiatrists treating these patients must continue to use objective measures such as objective testing as well as collateral information to determine such use. In this study most subjects who tested positive for urine cannabis were likely to have a psychotic disorder and tended to be of younger age groups. The low prevalence of cannabis use in the control group makes it unlikely that there was a significant number of subjects in this group who were using cannabis for medicinal purposes. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2008.

Since deinstitutionalization many patients, instead of remaining in the community, revolve through the doors of psychiatric facilities resulting in the "Revolving Door Syndrome". Hence a biopsychosocial evaluation of readmissions was undertaken to see what processes came into play once a patient was discharged from a mental hospital and subsequently readmitted. Seventy Indian patients admitted to the Midlands hospital complex, Pietermaritzburg were interviewed and the data was collected. This comprised 40 readmissions and a control group of 30 first admissions. The diagnosis was made according to DSM-III-R. The results obtained were statistically analyzed and a chi square analysis was done to ascertain if there were any significant differences between the 2 groups. The following were the major findings 1. Most of the patients were in age group 20-29 years. 2. There was a preponderance of males in both groups. 3. Most of the patients in the readmitted group were unemployed and were receiving a disability grant. 4. The majority of patients was single or separated. 5. Most of the patients were discharged on a combination of drug and depot preparation. 6. A large percentage had two and more previous admissions. 7. Length of stay was less than 1 month in a large number of patients. 8. Community tenure was less than 1 year in most of the patients. 9. Even though the majority of patients reported regular attendance, a fair percentage reported attendance at the community clinic. 10. The reason for readmission was mainly aggressive behaviour and aggressive behaviour associated with substance abuse. 11. The discharge diagnosis was schizophrenia in a large number of patients. This study has several important implications for the community care of the patient and various recommendations are made to curtail the revolving door, as follows : 1. There is an urgent need for community based resources. eg. sheltered workshops, supervised housing, industrial and occupational therapy, halfway houses and day hospitals, which would help the chronically mentally ill patients lead more meaningful lives following discharge. 2. The family of the chronically mentally ill patient needs to be actively involved in the management of these patients and mental health workers must solicit the family's support, by educating them about schizophrenia, helping them to increase coping mechanisms and to decrease stress. It is recommended that support groups be held in the community for the families of patients. 3. The patient's family needs to be advised that when the patient show signs of decompensation, they should take the patient to the community clinic, rather than to the District Surgeon to avoid unnecessary rehospitalization. 4. The importance of maintenance medication cannot be overemphasised. There is a need to change the attitude of the patient and family with regard to their negative attitude about medication. 5. The high rate of readmission due to aggressive behaviour (which is aggravated by substance abuse) needs intervention. Substance abuse groups must be held in the community and the community needs to be educated about the consequences of substance abuse in the mentally ill. / Thesis (M.Med.)-University of Natal, 1993.

Neuroleptic drugs are essential in the treatment of schizophrenia and many other psychiatric disorders. These drugs do however cause a wide range of side effects which can be very distressing to patients. In particular the acute neurological side effects of parkinsonism, akathisia and dystonia, which are termed extrapyramidal syndromes, can be a limiting factor in the use of these drugs (Weiden et al 1987). Fort Napier Hospital is a large psychiatric referral hospital and the majority of patients admitted require neuroleptic drug treatment. Extrapyramidal side effects are regularly seen amongst these patients. This study was designed to discover the incidence of parkinsonism, akathisia and dystonia amongst patients treated with neuroleptic drugs and what specific factors were responsible for these side effects. Relevant literature on this topic was reviewed and comparable studies done in America, Europe and South Africa are discussed. The study sample consisted of one hundred patients who were examined regularly over a two week period for signs of parkinsonism, akathisia, or dystonia which were rated quantitatively according to specific rating scales. Patient and drug variables were then analysed to assess what factors were responsible for these side effects. The incidence of drug-induced parkinsonism was 29%, akathisia 35% and dystonia 20%. Combinations of these three syndromes were observed resulting in an overall incidence of 47%. High potency drugs such as haloperidol and trifluoperazine were responsible for a large percentage of all the side effects, while of the low potency drugs, thioridazine produced less side effects than chlorpromazine. Oral drugs combined with intramuscular depot drugs resulted in a high incidence of side effects. The phase of treatment was clinically important with dystonia occurring more often within the first three days of treatment, akathisia within ten days and parkinsonism after ten to fourteen days. Other factors that were studied included the patients age, sex and prior history of neuroleptic-induced neurological side effects. Due to the predominantly young patient population in this study, the mean age of those patients who developed parkinsonism was 26,7 years, akathisia 27,5 years and dystonia 25,8 years. These side effects were seen more commonly in males than in females. Of the 27 patients in this study who had a prior history of neurological side effects, 15 (56%) developed similar side effects following re-exposure to neuroleptic drugs. Conclusions derived from this study include the need for clinicians to select the correct type and dose of neuroleptic for individual patients in order to minimize the development of neurological side effects. Accurate, early diagnosis of side effects by regular examination of patients is necessary for effective patient management. Clinicians should be made more aware of the side effects that can develop with the use of neuroleptic drugs and the effect these side effects have on patients. / Thesis (M.Med)-University of Natal, 1993.

The service sector of many developing countries is playing an increasingly significant role in terms of its contribution to both revenue and labour employment. As for Thailand, it contributed to approximately 53 per cent of GDP in 2003 and is growing every year. The performance of service firms is, therefore, of much interest to both executives and academics. While most empirical research in service firms in Thailand has focused mostly on service quality or customer satisfaction, other aspects of the important factors for the firms' success such as the relationships of customer satisfaction/loyalty and employee satisfaction/loyalty to the firm, performance have not received adequate academic attention. / Most of the research work on the relationships between key stakeholders of service firms has been conducted in developed countries, particularly the USA and the UK. The three key stakeholders of firms normally include customers, employees, and shareholders. Quite surprisingly, relatively little empirical research to study the links between those stakeholders has been carried out in Asia and Thailand in particular. This research is probably the first academic attempt in Thailand to address this gap by empirically examining the three constructs, customer satisfaction, customer loyalty, and firm preference that have been found in past research to have positive associations. The private hospitals which are located in Bangkok and listed on the Stock Exchange of Thailand (SET) were the sample population. Four hospitals agreed to take part in this study. / This study used secondary data that were already available from the four hospitals. The data include patient satisfaction surveys they regularly conduct and financial performance measures, such as revenue, profit, and return on assets, which are publicly available in their annual reports and the SET's online database. The data were processed and examined using correlation analysis method. The three variables studied were processed and examined using correlation analysis method. The three variables studied were patient satisfaction, patient loyalty, and hospital performance. The data on patient surveys and other relevant data were given with written consent from the four hospitals. The data on patient satisfaction and loyalty were derived from scores in the patient surveys. As for the hospital performance measures, they were derived from the financial data in the annual reports from the four-year period of 2001-2004. The data of the four hospitals was studied by two methods. The first method was processing all data of the four hospitals as a whole and then analysing them in one aggregate. A major limitation of this study is that the data of the four hospitals on patient loyalty was not complete. / Based on correlation analyses, the results from both methods reveal that some of the hypotheses were supported. Specifically, the results from the first method show that patient satisfaction was positively associated with the two measures of patient loyalty, referrals and repeat visits. However, significant relationships between patient satisfaction and hospital performance and between patient loyalty and hospital performance were not found. As for the second method, the results reveal that there were some positive relationships between variables of three hospitals. Only the results of one hospital show no significant associations between all the three variables. The findings were analysed in detail and implications for researchers and practitioners were also given. Based on the results of this exploratory research, more empirical studies with complete data in the private hospital market are warranted to be able to obtain more conclusive results. / Thesis (DBA(DoctorateofBusinessAdministration))--University of South Australia, 2006.

Thesis (PhD)--University of South Australia, 2002.

Thesis (Ph. D.)--University of New South Wales, 1999. / Also available online.

Thesis (Ph.D.)--University of Western Sydney, Nepean, 1996. / Bibliography: leaves 283-313.