Thesis (M. A. Medicine (Family Medicine)) -- University of Limpopo, 2021 / Diabetes is a rising problem globally. The World Health Organization (WHO) has classified diabetes as an epidemic. The major impact of the disease is felt in low- and middle-income countries. The literature has emphasised the fact that most patients living with diabetes are undiagnosed, and those who are diagnosed are poorly controlled. The complications associated with diabetes usually occur over a long period of time and are mainly influenced by poor glycaemic control. In South Africa, diabetes is a major cause of morbidity and mortality and a burden to the already overstretched health system in the country. In this study, factors that impair a patient’s ability to achieve good glycaemic control are investigated. ' Methods In this cross-sectional, descriptive study was conducted at the general outpatients department (GOPD) of the Mankweng hospital in the Capricorn District of the Limpopo Province. A total number of 97 participants formed part of the study. An HbA1c test was used to classify patients into a well-controlled glycaemic group (HbA1c ≤ 7%) or a poorly controlled group (HbA1c > 7%). Factors for poor glycaemic control were investigated. The following factors were investigated to identify characteristics of poorly controlled diabetes patients: demographic data; adherence to treatment; and, clinical measurements characteristics. Frequency tables, univariate logistic regression models and chi-square tests were used to determine factors influencing glycaemic control. Results Of the 97 patients, only 63 (64.9%) had an HbA1C measurement done (measurable outcome). Of these patients, only 13 (15.7%) had well controlled diabetes, while diabetes in 50 patients was poorly controlled. Patients on oral treatment only comprised the bulk of the patients who were well controlled. Following multivariate analysis, being male was found to be a significant predictor of good glycaemic control. Conclusions Most patients who had an HbA1C done were poorly controlled. As a secondary observation, management of diabetes was suboptimal. Male patients treated with oral medication alone were more likely to have good glycaemic control. Key concepts Diabetes mellitus, HbA1C, glycaemic, hospital, general out-patient department, Limpopo

Sociální prostředí jako rizikový faktor pro kurzovém sázení u sportovců léčících se v ambulanci pro gamblery zaměřuje na tři životní období klientů Poradny pro nelátkové závislosti Prevent. Obecně je problematika hazardního hraní v ČR velice aktuální téma. S regulací heren a novou ČR vystupuje do popředí problematika kurzového sázení. V 14 došlo k nárůstu podílu populace, která má zkušenosti s hazardní hrou. Nejvyšší nárůst (Mravčík et al., 2018) Cílem této práce je zmapovat a popsat sociální faktory, které měli přímý vliv na vznik a rozvoj závislosti na kurzovém sázení u sportovců léčících se v ambulantní léčbě. Práce se zaměřuje na tři životní období respondentů. Prvním zkoumaným životním obdobím období počátků sázení a první zkušenosti s hazardem, druhým životním obdobím je přechod z ní do závislosti a třetí ži respondenti rozhodli jít léčit. U všech třech etap života respondentů jsou mapovány a popsány veškeré sociální vlivy a interakce s Práce je založena na metodě kvalitativního výzkumu a vychází z zakotvené teorie a otevřeného kódování. Pro sběr dat byl použit polostrukturovaný rozhovor, který umožnil flexibilitu při samotné formulaci otázek a jejím případném doplnění dalšími otázkami a tím přesnějším získáním potřebných dat. Výzkumu se zúčastnilo celkem šest respondentů, kteří v té době byli...

Darbo tikslas. Įvertinti pacientų pasitenkinimą terapinio profilio (neurologo, kardiologo, endokrinologo) ambulatoriškai teikiamomis paslaugomis apskrities ligoninės Konsultacinėje poliklinikoje. Tyrimo metodai. 2008-01-21 – 01-31 apskrities ligoninės Konsultacinėje poliklinikoje atlikta pacientų besikreipiančių neurologo, kardiologo ir endokrinologo konsultacijai anoniminė anketinė apklausa. Išdalinta 400 anketų. Užpildytos 387 anketos (atsako dažnis 96,75%). Statistinė duomenų analizė buvo atlikta personaliniu kompiuteriu, naudojant statistinės analizės SPSS 10.03 programinį paketą. Įvairūs pasitenkinimo aspektai įvertinti pagal Licherto skalę 5 balų sistemoje. Rezultatai. 89,2% respondentų buvo patenkinti arba labai patenkinti paslaugos kokybe. Labiausiai respondentus tenkino neurologo konsultacijos kokybė ir jų pasitenkinimas, išreikštas balų vidurkiu buvo 4,44 iš 5 galimų. 93,7% apklaustųjų buvo patenkinti gydytojų bendravimu. Gydytojų bendravimas labiausiai tenkino neurologo pacientus ir išreikštas balų vidurkiu buvo 4,52. 40,9% respondentų pateko pas gydytojus konsultacijai tą pačią ar kitą dieną, 20,7% - per 3-10 dienų nuo registravimosi. 10,6% respondentų laukė 11-14 dienų, 23,3% pateko po 2-4 savaičių, 4,5% laukė ilgiau nei mėnesį. Laukimo laikas tenkino 65,2% respondentų. Aukštesnio išsilavinimo ar jaunesnio amžiaus respondentai buvo mažiau patenkinti laukimu. Pasitenkinimas kardiologo konsultacijos laukimu buvo didžiausias (4,21 balo). 89,4%... [toliau žr. visą tekstą] / Aim of the study: to evaluate the patients satisfaction with out-patient care services in therapeutic care (neurology, cardiology, and endocrinology) at consultation clinics of county hospital. Material and methods. The anonymous survey was conducted in January 2008 at consultation clinics of county hospital. The sample comprised of patients seeking consultation of neurology, cardiology or endocrinology specialists. Altogether, 400 questionnaires were distributed, out of which 387 counted as properly fulfilled (response rate 96.75%). Statistical data analysis was performed using statistical package „SPSS for Windows 10.03“. The satisfaction items were evaluated using Likert scale (scoring 1 to 5). Results. Altogether, 89.2% of responders were satisfied with the quality of care. Mostly, they were satisfied with neurology consultations (average Likert score 4.44). The communication with physician was also evaluated highly – 93.7% of responders were satisfied with it. Again, this was mostly expressed in neurology (average Likert score 4.52). Access to consultation was different: 40.9% of patients got consultation the same or following day after registration, 20.7% following 3–10 days, 10.6% following 11–14 days, 23.3% following 2–4 weeks, and 4.5% waited for longer than one month. The duration of waiting time was evaluated as satisfactory by 65.2% of responders, with the highest scores in cardiology (average Likert score 4.21). Higher education and younger age was related with... [to full text]

Magister Public Health - MPH / The Outpatient Therapeutic Programme (OTP) is an integrated public health innovation for treating severe acute malnutrition without medical complications in children 6 to 59 months of age as outpatients within their communities using Ready to Use Therapeutic Food with the aim of reducing case fatality rates. The OTP approach is implemented in the three districts in Eastern Province of Zambia namely; Chipata, Katete and Petauke. Since inception of the OTP in the province, an evaluation of the OTP has not been conducted. The study is aimed at assessing the effectiveness of the implementation of the OTP for management of severe acute malnutrition in the three districts of Eastern Province of Zambia.

Ziel dieser Studie ist, einen aktuellen Statusbericht zu Standortdichte, räumlicher Bedarfsabdeckung und demografischen Rahmenbedingungen für die ambulante und stationäre hos-pizliche und palliative Versorgung in Sachsen zu erstellen. Dabei sollen aktuelle Versorgungslücken identifiziert und der künftige Bedarf (2020–2030–2050) an Angeboten auf Ebene der Landkreise und Kreisfreien Städte herausgearbeitet werden. Für die Ableitung der Normwerte zeigt sich, dass angesichts der hohen Sterblichkeitsunterschiede zwischen den Bundesländern eine Bedarfsermittlung auf der Basis bundesdurchschnittlicher Normwerte je Bevölkerung nicht zufriedenstellend ist. Deshalb empfiehlt die Studie, in der regionalen Planung der Hospiz- und Palliativversorgung auf die erwarteten Sterbefälle abzustellen, die sich unter Berücksichtigung der Altersstruktur ergeben. Dieses bedeutet, dass die Normwerte der DGP zur Berechnung der Sollwerte um Bevölkerungsstruktur und Sterblichkeit korrigiert werden. In einer abschließenden Bewertung werden – vor dem Hintergrund einer Stärken- und Schwächenanalyse aus Experteninterviews – weitere Handlungsempfehlungen abgeleitet, die auch die Dimensionen von Qualität der Leistungserbringung, Ausbildung, Finanzierung und deren Anreizwirkung sowie Integration einbeziehen.:1 Ausgangssituation 13 2 Aufgabenbeschreibung 14 3 Bestandsaufnahme der Hospiz- und Palliativversorgung in Sachsen 16 3.1 Definition und Abgrenzung der Hospiz- und Palliativversorgung 16 3.1.1 Hospizversorgung 16 3.1.2 Palliativversorgung 17 3.2 Datengrundlagen 19 3.3 Ambulante Hospiz- und Palliativversorgung 20 3.3.1 Ambulante Hospizdienste (AHD) 21 3.3.2 Spezialisierte Ambulante Palliativversorgung (SAPV) 23 3.4 Stationäre Hospiz- und Palliativversorgung 23 3.4.1 Stationäre Hospize 24 3.4.2 Palliativstationen in Krankenhäusern 25 3.5 Räumliche Verteilung der Versorgungsangebote in Sachsen 25 3.5.1 Region Chemnitz 25 3.5.2 Region Dresden 26 3.5.3 Region Leipzig 27 4 Bewertung und Vergleich der hospizlichen und palliativen Versorgungsstrukturen Sachsens 28 4.1 Versorgungsangebote in anderen Ländern 28 4.1.1 Ambulante Hospizdienste 28 4.1.2 Allgemeine ambulante und spezialisierte Palliativversorgung 30 4.1.3 Stationäre Hospizversorgung für Erwachsene 33 4.1.4 Stationäre Palliativversorgung für Erwachsene 34 4.1.5 Hospiz- und Palliativversorgung für Kinder 34 4.2 Zusammenfassung des Vergleichs mit anderen Bundesländern 35 4.3 Benchmarks für die Versorgung 36 4.3.1 Vorgaben des DHPV und der DGP 37 4.3.2 Empfehlungen der Spitzenverbände 39 4.4 Fazit des Vergleichs 40 5 Bedarfsberechnung 41 5.1.1 Ambulante Hospiz- und Palliativversorgung 42 5.1.2 Stationäre Hospiz- und Palliativversorgung 46 6 Bedarfsprognose auf Kreisebene 50 6.1 Bevölkerungsprognose 50 6.2 Prognose der Gestorbenen für das Berechnungsmodell des zukünftigen Versorgungsbedarfs 53 6.3 Prognose für die ambulanten Hospiz- und Palliativdienste 54 6.3.1 Ambulante Hospizdienste 54 6.3.2 Spezialisierte Ambulante Palliativversorgung 55 6.4 Stationäre Hospiz- und Palliativeinrichtungen 57 6.4.1 Hospizbetten 57 6.4.2 Palliativbetten 59 7 Weiterentwicklung der Hospiz- und Palliativarbeit in Sachsen 62 7.1 Bewertung der Ist-Situation der hospizlichen Versorgung in Bezug auf die Zweite Landeshospizkonzeption 62 7.1.1 Grundsätze und Ziele 62 7.1.2 Öffentliche Förderung der Hospiz- und Palliativversorgung 63 7.2 SWOT-Analyse aus Experteninterviews 67 7.2.1 Zur Hospizversorgung 67 7.2.2 Zur Palliativversorgung 70 7.3 Handlungsfelder und Kriterien zur Weiterentwicklung von Hospiz- und Palliativversorgung 71 7.3.1 Zur Hospizversorgung 72 7.3.2 Zur Palliativversorgung 74 7.3.3 Weitere Handlungsempfehlungen 76 8 Literaturverzeichnis 78 Anhang 84 Aktuelle Standorte der Hospiz- und Palliativeinrichtungen 84 Kartenteil 90 Bevölkerung 90 Hospiz- und Palliativeinrichtungen 2012 105

The United States experiences opioid addiction at epidemic levels. In 2012, the National Institute of Drug Abuse reported that 23.1 million Americans were in need of addiction treatment services, although only 2.5 million were enrolled in treatment. Following an amendment to the Drug Addiction Treatment Act of 2000 (Public Law 106-310), advanced practice nurses were qualified as providers who could bridge the healthcare gap in treatment access. The purpose of this project was to determine the interest of advanced practice nurses in (a) prescribing buprenorphine and (b) establishing guidelines that would allow them to do so. This quantitative project used a 10-question Internet-based survey with a convenience sample of 95 nurses (recruited online) who were currently practicing in advanced nursing roles. Social media platforms, including Facebook, were used to recruit participants. The survey included questions about expanding the scope of practice in addiction treatment and establishing guidelines that would allow nursing knowledge and expertise to be used in outpatient opiate addiction treatment. Critical social theory and Kingdon's theory of policy analysis were applied to support the project. The Survey Monkey data analysis tool was used to generate descriptive statistics, which demonstrated respondents' support for an expanded scope of practice. If the recommendations of this project are adopted by national legislation, increased accessibility to addiction treatment services will save millions of dollars in justice system, healthcare system, employment, and societal costs. Nursing policy advocates nationally can apply these results to support efforts to expand scope of practice to include prescribing buprenorphine.

The motivation for this study is the increase of treatment needs of heroin dependents at SANCA, (South African National Council of Alcohol and Drug Abuse) Witbank. SANCA Witbank wants to ensure that the most effective treatment can be supplied. Research goals are to:  Do a literature study of out-patient treatment programmes.  Assess the needs of heroin out-patient dependents with regard to out-patient treatment programmes.  Make recommendations with regard to out-patient treatment programmes for heroin dependents. It was an exploratory research subject and the data collection methods were qualitative and quantitative. Interview schedules were used as research tools. Schedule B was completed by the researcher with heroin dependents that visited SANCA Witbank for the period 31 January 2005 to 4 February 2005. Schedule A was completed by the researcher with personnel of SANCA out-patient clinics and the questions were discussed and completed telephonically. The conclusion is that the treatment programme of SANCA Witbank is in line with the rest of the drug dependent field and only minimal recommendations were made. / Social Work / MA(SS)(MENTAL HEALTH)

The motivation for this study is the increase of treatment needs of heroin dependents at SANCA, (South African National Council of Alcohol and Drug Abuse) Witbank. SANCA Witbank wants to ensure that the most effective treatment can be supplied. Research goals are to:  Do a literature study of out-patient treatment programmes.  Assess the needs of heroin out-patient dependents with regard to out-patient treatment programmes.  Make recommendations with regard to out-patient treatment programmes for heroin dependents. It was an exploratory research subject and the data collection methods were qualitative and quantitative. Interview schedules were used as research tools. Schedule B was completed by the researcher with heroin dependents that visited SANCA Witbank for the period 31 January 2005 to 4 February 2005. Schedule A was completed by the researcher with personnel of SANCA out-patient clinics and the questions were discussed and completed telephonically. The conclusion is that the treatment programme of SANCA Witbank is in line with the rest of the drug dependent field and only minimal recommendations were made. / Social Work / MA(SS)(MENTAL HEALTH)