« Le juge des libertés et de la détention ». A l’oxymore de son appellation répond l’ambivalence de l’institution dans le procès pénal. Créé par la loi du 15 juin 2000 renforçant la protection de la présomption d’innocence et les droits des victimes, le magistrat s’impose, à l’origine, comme le compromis attendu entre la nécessité d’un nouveau contrôle de la détention provisoire et l’attachement français à l’institution du juge d’instruction. Investi d’un rôle central en la matière, le juge judiciaire a également vocation à intervenir dans le cadre de mesures diverses, que son contrôle irrigue les enquêtes pénales ou qu’il s’étende à d’autres contentieux, comme en matière de privation de liberté des étrangers, de visites et saisies administratives ou encore de l’hospitalisation sans consentement. La succession de modifications sporadiques de ses pouvoirs confirme sa fonction malléable, au service d’une quête pérenne : la protection des libertés, l’équilibre de l’avant-procès. Au rythme des louvoiements du législateur, le magistrat peine, pourtant, à s’identifier dans le processus pénal : hier au service des libertés, aujourd’hui de la coercition. Alors que l’institution semble poser les sédiments d’une nouvelle perception de la phase préparatoire du procès, l’évolution de son rôle préfigure d’autres mutations : de la justice pénale, des acteurs judiciaires, l’esquisse, enfin, d’une équation processuelle singulière. La présente recherche propose ainsi de situer ce magistrat au coeur de ces évolutions, comme la trame embryonnaire d'un "renouveau" de la phase préparatoire du procès. / « The Judge for freedom and detention » [Le juge des libertés et de la détention]. The oxymoron of its name reflects the ambivalence of this institution in criminal matters. Founded by the June 15, 2000 statute which reinforces the protection of presumption of innocence as well as the victims’ rights, this magistrate originally imposed itself as the expected compromise between the necessity of a new control over custody and ties of the French to the institution of the investigating judge [juge d‟instruction]. Empowered with a central role in this matter, the judiciary judge must also intervene when various measures are considered, both during criminal investigations and other types of litigations, such as those depriving foreigners of their freedom, administrative search and seizures or hospitalization without consent. The succession of the sporadic modifications of its powers only confirms the flexible nature of its function to serve a never ending quest: the protection of civil liberties and the balance of the pre-trial. As the legislator hedges, the institution struggles to find its place within the criminal process. Yesterday dedicated to civil liberties, today to coercion. Whilst the institution seems to set the basis for a new perception of the pre-trial phase, the evolution of its role announces further transformations: to criminal justice, to the judiciary actors and finally, the preparation of a singular equation in the litigation process. The present paper offers to locate this magistrate within these evolutions as the embryonic plot of a “new era” in the pre-trial phase.

Background: The purpose of drug treatment is to reduce morbidity and mortality, and to improve health-related quality of life. However, there are frequent problems associated with drug treatment, especially among the elderly. The aim of this thesis was to investigate the impact of clinical pharmacy services within a multiprofessional healthcare team on quality and safety of patients’ drug therapy, and to study the frequency and nature of medication history errors on admission to hospital. Methods: A model for clinical pharmacy services within a multiprofessional healthcare team (the Lund Integrated Medicines Management model, LIMM) was introduced in three hospital wards. On admission of patients to hospital, clinical pharmacists conducted medication reconciliation (i.e. identified the most accurate list of a patient’s current medications) to identify any errors in the hospital medication list. To identify, solve and prevent any other drug-related problems, the clinical pharmacists interviewed patients and performed medication reviews and monitoring of drug therapy. Drug-related problems were discussed within the multiprofessional team and the physicians adjusted the drug therapy as appropriate. Results: On admission to hospital, drug-related problems, such as low adherence to drug therapy and concerns about treatment, were identified. Different statistical approaches to present results from ordinal data on adherence and beliefs about medicines were suggested. Approximately half of the patients were affected by errors in the medication history at admission to hospital; patients who had many prescription drugs had a higher risk for errors. Medication reconciliation and review reduced the number of inappropriate medications and reduced drug-related hospital revisits. No impact on all-cause hospital revisits was demonstrated. Conclusion: Patients admitted to hospital are at high risk for being affected by medication history errors and there is a high potential to improve their drug therapy. By reducing medication history errors and improving medication appropriateness, clinical pharmacy services within a multiprofessional healthcare team improve the quality and safety of patients’ drug therapy. The impact of routine implementation of medication reconciliation and review on healthcare visits will need further evaluation; the results from this thesis suggest that drug-related hospital revisits could be reduced. / Läkemedelsgenomgångar och läkemedelsavstämning - LIMM-modellen

Background and purpose. The purpose of the study was to determine the costs incurred on the average length of stay (ALOS) on patients with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) related illnesses admitted in hospital and whether there are any other significant costs involved. Method. A quantitative approach was used to collect data; analysed; interpretation and report writing. Purposive sampling and data collection was done using data collection sheet. This was a retrospective cost analysis data from in-patients records (record review) of ages from 15 years to 49 years both gender. Data analysis and presentation of information was presented by the use of tables; different types of graphs and the interpretation thereof. Results. The study found that males (63%) with HIV Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) related illnesses had longer average length of stay in a hospital compared to females. However, females illustrated higher in-patient costs but majority of patients had costs of between R0–R17 500. Patients with longer hospital stay (>3 days of hospitalisation) had higher in-patient costs. Conclusion. The findings also showed that in-patient care costs were directly proportional to length of stay with higher costs for HIV and AIDS patient management care. Our findings are consistent with other studies regarding higher economic implications of care for HIV infected persons being almost as twice as people who are HIV negative due to longer periods of hospitalisation. / Health Studies / M.A. (Public Health)