Chen Qian. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (leaves 141-156). / Abstract and questionnaires in English and Chinese. / ABSTRACT --- p.I / 中文摘要 --- p.III / ACKNOWLEDGEMENTS --- p.IV / ABBREVIATIONS --- p.V / LIST OF TABLES --- p.VII / TABLE OF CONTENTS --- p.IX / Chapter CHAPTER 1: --- INTRODUCTION --- p.1 / Chapter 1.1 --- "General principles of diagnosis, treatment and efficacy evaluation in TCM" --- p.3 / Chapter 1.1.1 --- Basic principle of TCM in diagnosis and treatment --- p.3 / Chapter 1.1.2 --- Principles of combination use of TCM --- p.3 / Chapter 1.1.3 --- Principles of TCM prescription --- p.5 / Chapter 1.2 --- TCM is beneficial to human health --- p.6 / Chapter 1.2.1 --- "TCM is beneficial, but needs further modernized confirmation" --- p.6 / Chapter 1.2.2 --- TCM is effective when used following the principles of TCM --- p.21 / Chapter 1.2.3 --- The proper use and efficacy of TCM need further investigations --- p.21 / Chapter 1.3 --- Unwanted effects of TCM --- p.24 / Chapter 1.3.1 --- Unwanted effects of TCM are commonly seen --- p.24 / Chapter 1.3.2 --- Adverse effects of TCM classified based on medical systems --- p.25 / Chapter 1.3.3 --- Reasons related to adverse effects of TCM --- p.30 / Chapter 1.4 --- Studies on the use of TCM in Hong Kong --- p.31 / Chapter 1.5 --- Hypothesis and purpose of this study --- p.33 / Chapter CHAPTER 2: --- METHODOLOGY --- p.34 / Chapter 2.1 --- Rationale of questionnaire survey --- p.34 / Chapter 2.1.1 --- Choice of study method --- p.34 / Chapter 2.1.2 --- Types of diseases in the survey --- p.39 / Chapter 2.2 --- Issues related to implementation of questionnaire survey --- p.39 / Chapter 2.2.2 --- Interviewers and respondents --- p.40 / Chapter 2.2.3 --- Materials of the survey --- p.41 / Chapter 2.2.4 --- Collection period of questionnaire form --- p.42 / Chapter 2.2.5 --- Procedure of the questionnaire survey --- p.42 / Chapter 2.3 --- Questionnaire format and the content --- p.44 / Chapter 2.4 --- Statistics methods --- p.46 / Chapter 2.5 --- Pilot study for validation of the survey --- p.46 / Chapter CHAPTER 3: --- RESULTS --- p.48 / Chapter 3.1 --- Results from the main patient survey --- p.48 / Chapter 3.1.1 --- General characteristics of main patient group…… --- p.48 / Chapter 3.1.2 --- The attitude of the main patient group towards TCM --- p.48 / Chapter 3.1.3 --- Use of herbal medicines in the main patient group --- p.49 / Chapter 3.1.3.1 --- Chinese herbal medicines used for tonics or food supplements --- p.51 / Chapter 3.1.3.2 --- Chinese herbal medicines used for treating illnesses --- p.52 / Chapter 3.2 --- Results from medical patients --- p.55 / Chapter 3.2.1 --- General characteristics of medical patients in the survey --- p.55 / Chapter 3.2.2 --- The attitude of medical patients towards TCM --- p.56 / Chapter 3.2.3 --- Use of herbal medicines in medical patients --- p.57 / Chapter 3.2.3.1 --- Chinese herbal medicines used for tonics or food supplements --- p.57 / Chapter 3.2.3.2 --- Chinese herbal medicines used for treating illnesses --- p.58 / Chapter 3.2.4 --- Use of herbal medicine in the patients with the metabolic syndrome --- p.61 / Chapter 3.2.4.1 --- About the patients with hypertension and/or dyslipidaemia --- p.62 / Chapter 3.2.4.2 --- About the patients with diabetes mellitus --- p.63 / Chapter 3.3 --- Results from surgical patients --- p.64 / Chapter 3.3.1 --- General characteristics of surgical patients --- p.64 / Chapter 3.3.2 --- The attitude of surgical patients towards TCM --- p.65 / Chapter 3.3.3 --- Use of herbal medicines in surgical patients --- p.66 / Chapter 3.3.3.1 --- Chinese herbal medicines used for tonics or food supplements --- p.66 / Chapter 3.3.3.2 --- Chinese herbal medicines used for treating illnesses --- p.67 / Chapter 3.3.3.3 --- TCM used in gynaecological and surgical patients --- p.70 / Chapter CHAPTER 4: --- DISCUSSION --- p.73 / Chapter 4.1 --- The use of TCM in Hong Kong patients --- p.73 / Chapter 4.2 --- The attitude of patients towards TCM --- p.82 / Chapter 4.3 --- Limitations in the survey --- p.83 / Chapter 4.4 --- Further investigations --- p.89 / Chapter CHAPTER 5: --- CONCLUSIONS --- p.90 / Chapter 5.1 --- TCM is commonly used in Hong Kong patients for either health promotion or illnesses prevention and treatment --- p.90 / Chapter 5 2 --- The use of TCM in Hong Kong patients lacks formal regulation and management --- p.90 / TABLES --- p.91 / APPENDIX --- p.133 / Chapter 1. --- Informed consent form --- p.133 / Chapter 2. --- Questionnaire form (English version) --- p.136 / Chapter 3. --- Questionnaire form (Chinese version) --- p.138 / BIBLIOGRAPHY --- p.141 / Chapter 1. --- Full Publications --- p.141 / Chapter 2. --- Conference abstracts --- p.141 / REFERENCES --- p.144

Background and Purpose Caregivers of patients with stroke are central in providing for the patient‟s needs, facilitating participation of the patient in their daily functional ability, maintaining functional improvements gained in rehabilitation and the long-term well-being of stroke survivors. The strain and ultimate decrease in quality of life of the caregiver can lead to breakdown in the support they provide to the patient. The well-being and quality of life of the caregiver is therefore of vital importance in the rehabilitation of the patient with stroke. It is therefore necessary to evaluate relevant factors in the South African context that affect the quality of life of the caregiver, so as to foresee and prevent possible breakdown in the support provided by the caregiver to the patient with stroke. The objectives of the study are to establish the functional level of patients six to 36 months post-stroke, the level of strain and quality of life of the caregiver six to 36 months post-stroke, and the influence of demographic factors, caregiver strain and patient‟s functional ability on quality of life of the caregiver. Method A cross-sectional study was performed on 35 patients six to 36 months post-stroke and their primary caregiver, obtained from a sample of convenience from six local clinics/hospitals in the Johannesburg area. Demographic information was gathered from both patient and caregiver by means of a questionnaire. The Barthel Index (BI) was used to assess the patients‟ functional ability at the point of interview. Caregiver strain and caregiver quality of life were measured using the Caregiver Strain Index (CSI) and EQ-5D and EQ-5D VAS respectively. Results Of the 35 patients with stroke, 19 (54.3%) were male, and 16 (45.7%) were female, with the mean age of 55.9 years. Of the 35 primary caregivers, 6 (17.1%) were male, and 29 (82.9%) were female, with the mean age of 50.7 years. Sixty percent of patients ranged from being independent in functional ability to being moderately dependent on the caregiver for their functional ability. Seventy seven percent of caregivers reported severe strain as a result of caring for the patient with stroke. Thirty one percent of caregivers reported midrange (50/100) quality of life using the EQ-5D VAS. No association was established between patient‟s functional ability and caregiver quality of life (Pearson x²=0.59). Negative association was established between caregiver strain and quality of life (Kendall‟s Tau-b=-0.23), however it was of marginal significance (Pearson x²=0.06). Logistic regression showed caregivers under severe strain were 1.6 times of higher odds to experience a decrease in quality of life than caregivers with less strain. Caregiver age showed a negative correlation with caregiver quality of life (Kendall‟s Tau-b=-0.48; Pearson x²=0.009). Logistic regression showed older caregivers were 0.19 times of higher odds to experience a decrease in quality of life than younger caregivers. Conclusion There is no association between the patient‟s functional ability and the quality of life of the caregiver six to 36 months post-stroke. A negative association is shown between caregiver strain and caregiver age, and caregiver quality of life. The realm of caregiver quality of life is both dynamic and contextual. Knowledge of the effects of the contextual factors enables the health services and professionals to respond appropriately to assist in foreseeing and alleviating those factors that negatively affect caregiver quality of life. As it is understood that caregivers provide support for the patient with stroke, promoting the caregiver‟s well-being in turn will promote patient care and their ultimate well-being.

Thesis (MSc. (Med.)(Pharmacy))--University of Limpopo, 2009. / ABSTRACT Background: When a patient is discharged from the hospital, the doctor may prescribe medication to be used at home which is called TTO (To Take Out) medication. Failure by the patient to collect TTO medication might be intentional or may indicate a lack of appropriate structures and procedures at the hospital to provide such care on discharge, and/or failure by the health care professionals to reach concordance with the patient to ensure that he/she continues to take medications as prescribed. Objectives: The purposes of this study were to examine the prevalence of primary non-compliance with medication in this private hospital and to explore its association with various factors contributing to its existence. Methodology: The study was conducted at a private hospital in Gauteng, South Africa. The study focused on discharged patients who did not redeem their TTO medication. Thus only patients discharged from the hospital within a thirty day period between 25 May 2009 and 23 June 2009 were included in the study. For each subject the discharge medication prescription was reviewed and the following determined: number of items prescribed, number of items dispensed at the hospital pharmacy, whether any items were non-dispensed, whether any items were partially dispensed and reason for any item non-dispensed or partially dispensed. A telephone call was made to those subjects for whom a discharge medication script was prescribed, but no medication was dispensed at discharge. Information was collected from the patients to identify possible reasons for not redeeming discharge medication. Results: In total 1365 records were evaluated. TTO medication was prescribed for 1161 (85%) patients discharged. All items were redeemed in full by 854 (74%) of the patients, 118 (10%) patients redeemed no discharge medication, 101 (9%) patients redeemed only some items prescribed, 74 (6%) patients redeemed all items partly, 14 (1%) patients redeemed some items partly and some not at all and for seven v patients details were not known. Four reasons and five types of medication together accounted for 54% of the total value not redeemed. The four reasons include the following: medical aid TTO rules, patient unaware of TTO being prescribed, ward stock given, patient still had stock at home, and the types of medication included: blood and haematopoietic agents, analgesics, antimicrobials, agents of the gastrointestinal tract and unclassified. Conclusion: Some patients reported that they took own decision not to redeem the medication and some still had stock at home, a fact that should lead healthcare providers to ensure that they reach concordance with their patients.

Thesis (MPH)--University of Limpopo, 2010. / INTRODUCTION: Sub-optimal adherence to prescribed medications is documented as a major cause of drug resistance in tuberculosis (TB). Directly observed treatment – short course (DOTS) remains the WHO gold standard for improving adherence. Concerns with DOT as the single solution have been raised and a range of adherence strategies are increasingly being recommended. RESEARCH QUESTION: Can the SIMpill electronic reminder system increase medication adherence amongst TB patients? METHODOLOGY: A cohort of TB patients in the Frances Baard District (Northern Cape) was recruited to the project. Each patient was given their TB medication in a special SIMpill container that uses cellular phone technology to remind those patients who forget to take their medication on time. Each time the container is opened an SMS is sent to a computer server. If the container is not opened at the prescribed time the SIMpill computer sends a reminder SMS to the patient. The data collected on the computer server was analysed to show which patients opened the medication container within the agreed tolerance time, which required to be reminded by SMS, and which failed to take their medication. After the treatment programme, patients were taken through a structured questionnaire to find out their views on the functioning and user acceptability of the SIMpill system. RESULTS: 65 patients completed the SIMpill project and were subsequently interviewed. 97% of patients felt the SMS reminders helped them take their medication. The aggregated data from the SIMpill computer server showed adherence levels averaged 83% with no SMS reminders, rising to 92% if SMS reminders needed to be sent. CONCLUSION: Poor adherence is a problem in long-term therapy programmes such as those required for TB treatment. Using the SIMpill system with a cohort of 65 patients, adherence increased from 83% to 92% if SMS reminders needed to be sent by the SIMpill system

Thesis (Msc.(Med.)(Pharmacy))--University of Limpopo, 2010 / Background Information regarding disease epidemiology, treatment options and emerging infections and resistance constantly challenge the knowledge of the health care practitioner. Antibiotic prescribing patterns was identified by the Dr George Mukhari hospital antibiotics committee as an area of concern. Due to this concern it was decided to investigate the prescribing patterns in adult patients with meningitis admitted to the internal medicine wards at Dr George Mukhari hospital. Objectives To determine the current antimicrobial prescribing patterns in adult patients diagnosed with meningitis, to record the causative organisms and sensitivity patterns, to record the outcom e, cost and length of treatment. Method Patient and prescriptions data were recorded prospectively on specially designed data sheets from five internal medicine wards for four months (May to August 2008). Patients were followed until discharged. Results Sixty-six patients were enrolled; 41 recovered, 22 died, 2 refused treatment and 1 absconded. Ceftriaxone was prescribed the most frequently and was administered to 58 patients; four patients with confirmed cryptococcal meningitis received amphotericin B IVI, three patients were started on iv Rifafour® for suspected tuberculosis meningitis and one was started on cefuroxime. Specimens from only 22 patients were sent for culture and sensitivity tests; ten were positive for yeast-like organisms, three for S pneumoniae and one for N meningitides and tuberculosis respectively. The average duration of treatment of patients with meningitis was 9.2days. The total cost of antiinfectives used for treatment of meningitis amounted to R111, 292.53 and the average cost per patient was R1 686.25. The cost of all medicines prescribed for the 66 patients amounted to R116, 490.43. Conclusion Ceftriaxone was used frequently as empiric therapy. Specimens for culture and sensitivity were not sent routinely. Therefore it was difficult to monitor and observe any resistance patterns and to contain cost of treatment.

Thesis M Med (Psych)--University of Limpopo, 2010. / INTRODUCTION: The yield of EEG amongst psychiatric patients has been reported to be low and the value of EEG in the practice of psychiatry is questionable.EEG is used as part of a diagnostic work up for patients with psychiatric disorders .Often the reason given for its use is to exclude epilepsy as a cause of psychiatric symptoms. Epilepsy is primarily a clinical diagnosis, but the EEG may provide strong support by the findings of inter – ictal Epileptogenic discharge METHOD: All the adult EEGs requested at Dr George Mukhari psychiatric hospital, over a 36 month period,were reviewed to describe the outcome of the requested EEG reports. The study is a simple retrospective analysis of 111 consecutive EEG requested to the department of Neurology at DGMH from psychiatric unit at DGMH. Subjects were both inpatients and outpatients. All the EEG was reported by a qualified Neurologist. Data were extracted from the EEG request form and the patients’ clinical files, which reported on the clinical reason for the EEG test, nature of psychiatric diagnosis of patients, the psychiatric treatment received prior to the EEG test and the nature of the EEG results RESULTS: There were 111 EEG reports analysed, and 69 EEG reports for males and 42 EEG reports for females. The reason for EEG request was dominated mainly by exclusion of epilepsy. Majority of the patients were diagnosed with a psychotic disorder , followed second by a mood disorder , all of which was attributed to GMC (epilepsy).About 62.73% of patients were on a combination of treatment of antipsychotic drug and anticonvulsants, whilst 34.55% were on antipsychotic monotherapy prior to the EEG test. Further analysis of the requested EEG form was carried out in whom the test was to determine whether or not the patients were suffering from epilepsy. EEG abnormalities were identified amongst 24% of the patients. About 11,7% of patients presented with non specific EEG results. Out of a total number of 111 patients whom an EEG test was requested and epilepsy was highly suspected from clinical presentation, only 14 patients (12.6%),presented with epileptiform discharge on their EEG results. However majority of the patients (76%) demonstrated normal EEG pattern, which doesn’t exclude a diagnosis of epilepsy. CONCLUSION: The yield of EEG in psychiatry is low. To diagnose epilepsy as a cause of psychiatric presentation,clinicians should continue to rely on the clinical history of attacks and not the EEG. In the practice of psychiatry it is not recommended to routinely order an EEG to exclude a diagnosis of epilepsy, more so to confirm a psychiatric diagnosis. The presence of a psychiatric symptoms in patients who presents with epilepsy, is rarely associated with meaningful EEG changes

Multiple sclerosis, (MS), presents affected individuals with an uncertain future, and has broad physical and psychosocial implications for their daily functioning. This study aimed to investigate the psychological well-being of people with MS with an emphasis on positive psychological functioning. It also aimed to extend previous research that suggested reporting perceived benefits during adversity may be indicative of cognitive adaptation. Disease-related variables (mobility, fatigue) and psychosocial factors (optimism, coping) were examined to ascertain the effects of living with MS upon well-being. Well-being was determined using two general measures (The Profile of Mood States (POMS), Shacham, 1983; and the Ryff Psychological Well-being Scale (PWB), Ryff & Keyes, 1995), and Mohr et al.�s (1999) MS psychosocial factors (Demoralization, Deteriorated Relationships, Benefit Finding). Participants were 154 people with MS who were recruited through the MS Societies of Victoria and Tasmania. Results showed participants reported both negative and positive consequences from their MS experiences. Higher levels of Demoralization and Deteriorated Relationships were related to decreased well-being. However, no association was found between Benefit Finding and psychological well-being. Benefit Finding was also unrelated to optimism, and the disease-related variables (mobility, fatigue). Only positive reappraisal coping was predictive of reporting of benefits which lends support to the notion that it is a coping strategy. To examine the effects of mobility the sample was divided into three groups: normal gait, mild gait problems but not using aids and those who require aids for mobility. Significant differences between the mobility groups were found on Demoralization and fatigue levels. As participants� difficulties with mobilisation increased so too did their levels of demoralisation. However, those with mild gait problems reported fatigue levels comparable with those experiencing more complex gait difficulties. No differences were found between the groups on the general psychological measures, which may indicate some form of resilience or psychological adaptation occurring. More generally, results showed that participants who were more optimistic, less fatigued, and used less of particular coping strategies (either less avoidant coping or less blaming self or others) to deal with their MS problems reported higher well-being (less demoralisation, less psychological distress and higher positive functioning). In conclusion, the use of multi-dimensional outcomes enabled a comprehensive examination of well-being and highlighted the effects of specific illness-related factors and coping strategies. As demonstrated in this study, despite the adversity of living with MS, people are able to maintain a healthy sense of self and their relationships, and report benefits from their experiences.

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2007. / Title from title screen (site viewed Dec. 4, 2007). PDF text: xii, 199 p. : col. ill. ; 1 Mb. UMI publication number: AAT 3271929. Includes bibliographical references. Also available in microfilm and microfiche formats.

Thesis--Sociale Wetenschapen--Nijmegen--Radboud Universiteit Nijmegen, 2005. / Résumé en néerlandais. Bibliogr. p. 187-198.

Thèse d'exercice : Pharmacie : Université de Nantes : 2005. / Bibliogr. f. 34-49.