Background: In Kazakhstan, opioid substitution therapy (OST) has been a controversial topic since its introduction in 2008. Aim: To examine and analyse factors influencing approach towards OST among OST patients, opioid-dependent drug users who could re-consider engagement in this therapeutic method, as well as attitudes of selected key organisations and their representatives. Methods: A survey method complemented by semi-structured individual and group interviews has been selected. One hundred respondents participated in the study between October and December 2015. The first group consisted of 46 OST patients. The second group consisted of 54 respondents who met criteria for opioid dependence. This group included patients of residential treatment centres, former OST patients and current injecting drug users. Key persons were interviewed about their attitudes. Results: Patients receiving OST, with the average treatment duration of 29.4 months, reported improved health, improved social functioning and financial well-being, as well as reduction of their involvement in crime. This group showed better results in all examined categories. Most (80 %) were satisfied with the treatment, even though a number of shortcomings have been reported. All OST patients considered necessary to expand the availability...

This study aimed to establish a connection, if any, between perceptions of information disclosure about medical treatment and decisional conflict in bereaved parents of children with cancer. Decisional regret was an important theme in this exploration because decisional conflict strongly aligns with the propensity to mentally redo past events, thereby forming counterfactual alternatives to reality. People generate counterfactuals to hypothesize a more favorable outcome subsequent to a negative event or the death of a child as applicable to this study. A secondary objective was to investigate the potential influence of counterfactual processing and regret on the construct of self-acceptance: a phenomenon researchers have rarely studied in the population of interest. Study participants included parents who lost a child to cancer in the United States after participating in medical treatment prescribed by a licensed oncologist. Cluster and convenience sampling were employed to recruit 92 participants. Quantitative methods were used in obtaining data samples through validated instruments for each independent and dependent variable. The responses collected indicate that a perceived lack of information disclosure about treatment risks and efficacy, yield a positive influence on decisional conflict after the death of a child. Similarly, decisional conflict positively correlates with decisional regret, while the latter negatively correlates with self acceptance in the bereavement process. The research implications call for additional studies that further isolate factors that contribute to decisional conflict. This study advocates for decision making tools and collaborative processes that ensure parents are well informed and involved in making medical decisions from diagnosis through palliative care, if a cure is not possible.

<p>Syftet med uppsatsen var att studera hur Försvarsmakten bör organisera, utbilda och träna ett skyttekompani i framtiden inom några områden. Den skall med hjälp av några av de grundläggande förmågorna ge svar på hur vi organiserar, utbildar och tränar idag samt analysera om några förändringar bör ske för att skapa ett bättre förband.</p><p>Den teoretiska grunden för uppsatsen har varit de grundläggande förmågorna; ledning, rörlighet och uthållighet. Uppsatsen har tagit sin utgångspunkt i bland annat Arméns utvecklingsplan och studien Verkan Mot Markmål. Litteraturstudier har även genomförts av andra studier och dokument. Även två stycken intervjuer har genomförts för att belysa dagsläget respektive framtiden för ett skyttekompani. Resultaten visar på att det finns en bra grund för ledning av ett skyttekompani men även en avsaknad av tillfredsställande sjukvård. De slutsatser som uppsatsen finner är behovet av utveckling och träning av metoder för att ledning. Förmågan att leda utländska enheter och ledas på exempelvis engelska bör finnas ner på plutonsnivå. Vidare konstateras att en fungerande sjukvårdskedja från enskildsoldat och uppåt måste skapas.</p> / <p>The objective of this essay was to examine how we should organize, educate and train a mechanised infantry company in the future. The essay will use the fundamental capabilities to give an answer how we organize, educate and train today. It will also analyse if there should be any changes made in order to create better units.</p><p>Based on studies<strong> </strong>in literature such as the <em>development plan for the army</em>, the study <em>effect towards ground target</em> and interview. I have tried to show the current situation and how the future looks like for a mechanised infantry company.  I have chosen to study three fundamental capabilities; command and control, mobility, endurance. The results indicate that there is a good base to command and control a mechanised infantry company but also that the medical capacity is not satisfying. Some of the conclusions from the essay are that we need development and training in methods to command and control. The capability to command and control foreign units should be found down to platoon level. Regarding medical treatment we must create a work line of medical treatment, from soldier to field hospitals.</p>

Syftet med uppsatsen var att studera hur Försvarsmakten bör organisera, utbilda och träna ett skyttekompani i framtiden inom några områden. Den skall med hjälp av några av de grundläggande förmågorna ge svar på hur vi organiserar, utbildar och tränar idag samt analysera om några förändringar bör ske för att skapa ett bättre förband. Den teoretiska grunden för uppsatsen har varit de grundläggande förmågorna; ledning, rörlighet och uthållighet. Uppsatsen har tagit sin utgångspunkt i bland annat Arméns utvecklingsplan och studien Verkan Mot Markmål. Litteraturstudier har även genomförts av andra studier och dokument. Även två stycken intervjuer har genomförts för att belysa dagsläget respektive framtiden för ett skyttekompani. Resultaten visar på att det finns en bra grund för ledning av ett skyttekompani men även en avsaknad av tillfredsställande sjukvård. De slutsatser som uppsatsen finner är behovet av utveckling och träning av metoder för att ledning. Förmågan att leda utländska enheter och ledas på exempelvis engelska bör finnas ner på plutonsnivå. Vidare konstateras att en fungerande sjukvårdskedja från enskildsoldat och uppåt måste skapas. / The objective of this essay was to examine how we should organize, educate and train a mechanised infantry company in the future. The essay will use the fundamental capabilities to give an answer how we organize, educate and train today. It will also analyse if there should be any changes made in order to create better units. Based on studies in literature such as the development plan for the army, the study effect towards ground target and interview. I have tried to show the current situation and how the future looks like for a mechanised infantry company.  I have chosen to study three fundamental capabilities; command and control, mobility, endurance. The results indicate that there is a good base to command and control a mechanised infantry company but also that the medical capacity is not satisfying. Some of the conclusions from the essay are that we need development and training in methods to command and control. The capability to command and control foreign units should be found down to platoon level. Regarding medical treatment we must create a work line of medical treatment, from soldier to field hospitals.

近年來遠程醫療成為中國大陸大力推動的政策，其不僅被賦予催化分級醫療的角色，在照護產業應用上亦被寄予厚望。本研究透過穿戴式裝置的例子，說明遠程醫療的推動仍面臨諸多挑戰。中央政府透過組建醫療聯合體、跨省技術等試點政策，大力推動遠程醫療。地方醫院基於保護醫療收益，對於遠程醫療抱持著不配合的態度，地方政府之間的競爭亦加劇了這樣的發展，推動過程面臨了明顯的瓶頸。與遠程醫療最相近的產品應用，當屬穿戴式裝置，本研究指出在穿戴式裝置依然以地區醫院為母體，鮮少有跨不同事業單位的大規模串聯。從政策與產業兩大領域來看，遠程醫療要全面性推廣仍有一段路要走，然而中國大陸強力推動產業的決心仍值得吾人關注。 / In recent years, policy of telemedicine, proposed by Chinese mainland, played an important role in hierarchical medical system. The care industry has been highly expected. This study research data of the formation of medical treatment combination, interprovincial technology and other pilot policies which were proposed by central government with wearable device to describe the challenge of the promotion in telemedicine industry. In fact, local hospital keep an uncooperative attitude to develop remote medical care in order to protect the medical benefits. Furthermore, competitiveness between local governments made things worse. It is clear that the promotion of telemedicine is facing a bottleneck now. Wearable device, the closest product application in telemedicine industry, is used as keyword to search the data in dilemma of local hospitals. The result show that there is few small units across the large industry chain.From the policy and industry two major areas of view, comprehensive promotion of telemedicine is still a way to go, nonetheless, the Chinese mainland’s determination to promote the industry's is still worthy of my attention.

My thesis theme from the branch of insurance industry has been chosen for a reason of my long-term experience. The particular theme of "accident insurance" has been then chosen and based on the fact that in general it belongs to one of the most important types of insurance and everybody should arrange for it. In the part of theory I would like to clarify basic terms of the field of accident insurance as well as those of insurance industry as a whole. At the same time I would like to illustrate how and where an insurance contract can be concluded and what one should be aware of before and in the course of concluding such an insurance contract. An integral part of the theory will also be legislation dealing with the insurance industry and its development. The practical part will be focused on looking for different insurance amounts people should be insured for. In addition there will be given a particular example of effecting an accident insurance of more people as well as of a person and various insurance companies' offers in my place of living will be analysed. In conclusion let me make basic calculations concerning the insurance clear and analyse the data that will be at my disposal.

"Although the number of new infections has dramatically decreased during the last ten years, portraying this country [Uganda] as the 'AIDS miracle', the number of people already infected and progressing to AIDS is increasing. Acces to anti-retroviral (ARV) drugs, as well as to medicines for treatment of opportunistic infections (TOI), is essential for people living with HIV/AIDS (PLWHA) to enjoy their right to life and health. Although access to these essentail medicines forms part of the core content of the right to health, which states should be able to provide irrespective of their available resources, slightly more than half of the people in need in Uganda were accessing them in June 2005. Of 63,896 PLWHA accessing ARVs, still 83.5 percent are paying the medicines out of their pockets. This is despite the fact that Uganda receives funds from various sources, among which Global Fund to Fight AIDS, Tuberculosis and Malaria (GF) and the US President's Emergency Plan for AIDS Relief (PEPFAR). Although the cost of ARV treatment in Uganda has dramatically decreased since 1997, the price of treatment remains still unaffordable for most Ugandans. ... This study comprises five chapters. The present chapter exposes the problem, the objectives of the study and the research questions, reviews the literature available on the subject, outlines the study's structure, proposes a methodology and points out the study's limitations and relevance. Chapter two sets out the international legal framework of the study. It oulines the scope of the right of PLWHA to access to essential treatment under different international instruments of relevance for Uganda and its connection with other human rights. The chapter also assesses the implications of this right for state and non-state actors. Chapter three sets out the national legal, policy and judicial framework. It explores the action taken by the various branches of the government in addressing the international obligations with regard to access essential treatment. This chapter will also look at the role played by other relevant stakeholders in the realisation of this right in Uganda. Chapter four analyses the various obstacles that impede the realisation of this right at national level, taking into account the globalisation process, the political situation of Uganda, as well as other socio-economic factors. Chapter five provides the final conclusions and recommends legal, judicial and administrative channels towards the realisation of the right to access essential treatment for OLWHA in Uganda." -- Introduction. / Thesis (LLM (Human Rights and Democratisation in Africa)) -- University of Pretoria, 2005. / [Prepared under the supervision of] Dr. Ben Kiromba Twinomugisha, Makerere University / http://www.chr.up.ac.za/academic_pro/llm1/dissertations.html / Centre for Human Rights / LLM

Le régime applicable au consentement à l’acte médical des personnes vulnérables que sont les mineurs et les majeurs sous protection juridique est un sujet délicat pour le législateur. Ce dernier doit instaurer une législation conciliant protection de l’intégrité physique du patient, et respect de son autonomie. Le droit positif échoue à trouver cet équilibre. Les mineurs sont privés de leur capacité d’exercice à toutes les étapes de leur vie, quel que soit leur âge ou leur degré de maturité. Elle réserve également un traitement disparate aux majeurs protégés. Leur autonomie variant selon la prise en compte ou non de leur régime de protection par le Code de la santé publique. À ces difficultés s’ajoute celle de l’existence de nombreux actes spécifiquement réglementés dont les règles ne sont pas toujours cohérentes ni compatibles avec les réalités de la pratique médicale. Une réflexion est menée sur les limites du régime actuel ainsi que sur l’élaboration d’une nouvelle législation plus respectueuse de l’autonomie des mineurs et des majeurs protégés. La possibilité de consentir à un acte médical dépendra non pas du statut juridique du patient, mais de son « aptitude à consentir », notion tirée des législations suisse et québécoise. Toutefois, la volonté de protéger l’autonomie du patient ne devant pas conduire à une mise en péril de son intégrité physique, un encadrement de sa capacité d’exercice sera instauré selon que le soin est ou non requis par son état de santé. / The system of Consent to medical treatment for vulnerable persons – whether minors or adults without capacity – is a sensitive subject for legislator. The law has to combine protection of the patients’ physical integrity as well as the respect for their autonomy. The current state of law fails to achieve this purpose. Minors patients are deprived of their right to consent on their own, regardless of their age or level of maturity. Adults without capacity are treated in various ways depending on whether their legal protection is taken into account or not by the Public Health Code. An additional challenge is the existence of various medical acts that depend on specific regulations. Here we discuss the current limits of the law and propose a new system for the consent to medical treatment, which would be more respectful of the autonomy of minors patients or adults without capacity. Consent to medical treatment would depend on the ability to consent rather than on each patient’s legal status, such as stated in legislations from Switzerland or Quebec. However, the will to confer a larger autonomy should not put patient’s physical integrity at risk. Therefore, patients’ capacity for decision-making would depend whether the proposed care is required or not by their health state.

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In recent decades, there has been a steady increase in the number of people, including adolescents, undergoing medical body modification (MBM) to alter their physically healthy bodies in invasive and nearly irreversible ways through medical treatment (e.g. surgery). While MBM is often recommended for youth with persisting gender dysphoria (GD), in body dysmorphic disorder (BDD) it has been considered contraindicated. Here, we outline the current controversies surrounding MBM practice and recommendations in adolescents with GD versus those with BDD in order to better understand under what circumstances we may or may not support adolescents who want to change their bodies medically and often irreversibly. We compare the two disorders in terms of the overlap and uniqueness of their behavioural and psychological features. In doing so, we discuss limitations of the existing (often low-quality) evidence for and against MBM in young patients. We conclude that the currently available evidence is too preliminary and far from conclusive to make any robust recommendations in terms of benefits and harms of MBM in youth with persisting GD or BDD. However, we strongly recommend further urgent scientific discussions and systematic research efforts into more robust evaluations and the identification of more precise psychological characteristics that may serve as decision criteria for or against MBM – particularly in those adolescents who did not respond to non-MBM, that is, psychiatric/psychological treatment and psychosocial support, if available at all. This will greatly benefit youth healthcare professionals in their challenging clinical practice of making decisions regarding MBM today and in the future.