Social workers in private practice / Social work in South Africa appears to have low status and a negative ”welfare” image. The general public seems to regard social workers and the profession with disdain and for the most part is ignorant of what social workers do apart from handing out grants and removing children from their families. This exploratory research focuses on social workers in private practice - how they view their professional selves, the factors that contribute to the development of their professional selves and the factors that hinder or facilitate this development. The impact of public opinion on social workers in private practice is explored and possible solutions to problems experienced by these private practitioners are sought. Modern and postmodern paradigms are summarised as a background to the Rogerian theory, constructivist philosophy and social constructionist theory that underlie this research. The researcher explores the perceptions of each respondent who shares his/her particular reality with the researcher through the meanings he/she attributes to his/her experiences. / Social work / M.A (Social Science (Mental Health))

A obesidade é um grave problema de saúde pública, adquirindo características de epidemia mundial. A saúde bucal é agravada pela presença da obesidade e da síndrome metabólica. A perda dentária prejudica a função mastigatória, condição essencial para o paciente que será submetido à cirurgia bariátrica. Este estudo teve por objetivo avaliar parâmetros epidemiológicos e laboratoriais relacionados à função mastigatória, em pacientes candidatos à cirurgia bariátrica, de classes socioeconômicas distintas, a fim de identificar fatores de risco e influência da condição socioeconômica para a mesma. Trata-se de um estudo observacional transversal, com amostra constituída por dois grupos de pacientes, com condições socioeconômicas distintas, um pertencente ao sistema público de saúde (GSUS) e outro à clínica privada (GCP), candidatos à cirurgia bariátrica. Foram analisadas as condições gerais de saúde, incluindo dados antropométricos, comorbidades presentes (hipertensão arterial, diabetes mellitus, apneia do sono, dislipidemias e artropatias) e uso de medicamentos (anti-hipertensivos, hipoglicemiantes orais, insulina, sinvastatinas, diuréticos, vasodilatadores e antiagregantes plaquetários). Dados de exames laboratoriais (hemoglobina, ferritina, proteínas totais, albumina, colesterol total, glicemia, triglicérides), dos hábitos (tabagismo e etilismo) e o número de unidades funcionais dentárias presentes foi analisado (função mastigatória). Os testes adotados foram Qui-quadrado, ANOVA, Goodman, Regressão Logística Múltipla e Bonferroni. Os grupos GSUS e GCP foram homogêneos quanto ao gênero e faixa etária. Quanto à média de unidades funcionais dentárias, foi maior no grupo privado (p<0,001). A função mastigatória prejudicada foi mais presente no grupo público feminino (p<0,001). Quanto aos exames laboratoriais, a glicemia de jejum foi mais frequentemente alterada no GSUS feminino (p<0,001). Ter origem no serviço público de saúde (OR: 8,420 - p=0,003), maior idade (OR: 1,186 p<0,001), ser do gênero feminino (OR: 0,153, p=0,029), portador de diabetes mellitus (OR: 2,545, p=0,045) e tabagista (OR: 2,951, p=0,043) foram fatores de risco independentes para ter função mastigatória prejudicada. A saúde geral e bucal de pacientes obesos do GSUS foram piores e a ausência dentária foi maior em mulheres deste sistema, ressaltando como fator de risco a condição socioeconômica. / Obesity can be labeled as a worldwide outbreak thus, it has led to a serious public health problem. Oral health can be worsened if it is combined with obesity and metabolic X syndrome. The tooth loss usually harms masticatory function, essential status to whom will be submitted to bariatric surgery. This study aimed to assess epidemiologic parameters and blood tests concerning the number of dental functional units, in patients applying to bariatric surgery, who belong to distinct socioeconomic class range, in order to recognize hazard factors and the bias of this condition over them. Observational cross-section study, with samples comprised by two groups of patients, with distinct socioeconomic class range, one of them belonging to public health system (SUSG) and the other to private clinic (CPG), applicants to bariatric surgery. It was assessed the general healthy conditions, including anthropometric data, comorbidities (hypertension, diabetes mellitus, sleep apnea, dyslipidemias and arthropathy) and medicines usage (antihypertensive, oral hypoglycemic agents, insulin, simvastatin, diuretics, vasodilators and platelet antiaggregant). Blood tests data (hemoglobin, ferritin, protein, albumin, total cholesterol, glycaemia, triglycerides), habits (smoking and alcoholism) and the number of dental functional units presents (masticatory function). The tests applied were Chi-Square, ANOVA, Goodman, Multivariable Logistic Regression e Bonferroni. The groups SUSG and CPG were homogeneous taking into account gender and age range. Regarded as the number of dental functional units, was higher in the private group (p<0.001). The impaired masticatory function was rather present among female public group (p<0.001). Regarded as blood tests, fasting glycaemia were mainly above in female SUSG patients (p<0,001). The following hazard factors have corroborated to have patients rated as impaired masticatory function: Belong to public service (OR: 8.420, p=0.003), higher aging (OR: 1.186, p<0.001), female gender (OR: 0.153, p=0.029), with diabetes mellitus (OR: 2.545, p=0.045) and smoking (OR: 2.951, p=0.043). The general and oral health of obese SUSG patients were worse and the tooth loss was higher in female patients in this same group, highlighting as hazard factor the socioeconomic condition.

A obesidade é um grave problema de saúde pública, adquirindo características de epidemia mundial. A saúde bucal é agravada pela presença da obesidade e da síndrome metabólica. A perda dentária prejudica a função mastigatória, condição essencial para o paciente que será submetido à cirurgia bariátrica. Este estudo teve por objetivo avaliar parâmetros epidemiológicos e laboratoriais relacionados à função mastigatória, em pacientes candidatos à cirurgia bariátrica, de classes socioeconômicas distintas, a fim de identificar fatores de risco e influência da condição socioeconômica para a mesma. Trata-se de um estudo observacional transversal, com amostra constituída por dois grupos de pacientes, com condições socioeconômicas distintas, um pertencente ao sistema público de saúde (GSUS) e outro à clínica privada (GCP), candidatos à cirurgia bariátrica. Foram analisadas as condições gerais de saúde, incluindo dados antropométricos, comorbidades presentes (hipertensão arterial, diabetes mellitus, apneia do sono, dislipidemias e artropatias) e uso de medicamentos (anti-hipertensivos, hipoglicemiantes orais, insulina, sinvastatinas, diuréticos, vasodilatadores e antiagregantes plaquetários). Dados de exames laboratoriais (hemoglobina, ferritina, proteínas totais, albumina, colesterol total, glicemia, triglicérides), dos hábitos (tabagismo e etilismo) e o número de unidades funcionais dentárias presentes foi analisado (função mastigatória). Os testes adotados foram Qui-quadrado, ANOVA, Goodman, Regressão Logística Múltipla e Bonferroni. Os grupos GSUS e GCP foram homogêneos quanto ao gênero e faixa etária. Quanto à média de unidades funcionais dentárias, foi maior no grupo privado (p<0,001). A função mastigatória prejudicada foi mais presente no grupo público feminino (p<0,001). Quanto aos exames laboratoriais, a glicemia de jejum foi mais frequentemente alterada no GSUS feminino (p<0,001). Ter origem no serviço público de saúde (OR: 8,420 - p=0,003), maior idade (OR: 1,186 p<0,001), ser do gênero feminino (OR: 0,153, p=0,029), portador de diabetes mellitus (OR: 2,545, p=0,045) e tabagista (OR: 2,951, p=0,043) foram fatores de risco independentes para ter função mastigatória prejudicada. A saúde geral e bucal de pacientes obesos do GSUS foram piores e a ausência dentária foi maior em mulheres deste sistema, ressaltando como fator de risco a condição socioeconômica. / Obesity can be labeled as a worldwide outbreak thus, it has led to a serious public health problem. Oral health can be worsened if it is combined with obesity and metabolic X syndrome. The tooth loss usually harms masticatory function, essential status to whom will be submitted to bariatric surgery. This study aimed to assess epidemiologic parameters and blood tests concerning the number of dental functional units, in patients applying to bariatric surgery, who belong to distinct socioeconomic class range, in order to recognize hazard factors and the bias of this condition over them. Observational cross-section study, with samples comprised by two groups of patients, with distinct socioeconomic class range, one of them belonging to public health system (SUSG) and the other to private clinic (CPG), applicants to bariatric surgery. It was assessed the general healthy conditions, including anthropometric data, comorbidities (hypertension, diabetes mellitus, sleep apnea, dyslipidemias and arthropathy) and medicines usage (antihypertensive, oral hypoglycemic agents, insulin, simvastatin, diuretics, vasodilators and platelet antiaggregant). Blood tests data (hemoglobin, ferritin, protein, albumin, total cholesterol, glycaemia, triglycerides), habits (smoking and alcoholism) and the number of dental functional units presents (masticatory function). The tests applied were Chi-Square, ANOVA, Goodman, Multivariable Logistic Regression e Bonferroni. The groups SUSG and CPG were homogeneous taking into account gender and age range. Regarded as the number of dental functional units, was higher in the private group (p<0.001). The impaired masticatory function was rather present among female public group (p<0.001). Regarded as blood tests, fasting glycaemia were mainly above in female SUSG patients (p<0,001). The following hazard factors have corroborated to have patients rated as impaired masticatory function: Belong to public service (OR: 8.420, p=0.003), higher aging (OR: 1.186, p<0.001), female gender (OR: 0.153, p=0.029), with diabetes mellitus (OR: 2.545, p=0.045) and smoking (OR: 2.951, p=0.043). The general and oral health of obese SUSG patients were worse and the tooth loss was higher in female patients in this same group, highlighting as hazard factor the socioeconomic condition.

Thesis (M.S.P.H.)--University of South Florida, 2008. / Title from PDF of title page. Document formatted into pages; contains 26 pages. Includes bibliographical references.

Psychotherapists in full-time, long-term private practice face a variety of occupational demands. They usually maintain private practices for long periods of their lives often under difficult circumstances and emotional pressures and have come to sustain their practices. From literature it is revealed that various demands, as well as benefits and successes are part and parcel of working in private practice full-time. These various factors can have an impact on the well-being of psychotherapists. Apart from the literature review, the personal experience of the researcher, a psychotherapist in full-time private practice, also contributed to ideas and hypotheses about the study. From a position of exploration and further enquiry, the researcher was interested to explore the experiences of psychotherapists in full-time private practice from a fortigenic perspective. A second objective was to determine if this study could contribute to the development of the theoretical assumptions of positive psychology. The research is grounded in the theoretical perspective of positive psychology and fortigenesis. Both these fields are relatively new in psychology and seem to still be forging a niche within the discipline. This perspective was deliberately chosen due to the applicability to the exploration of strengths and vigour, with regards to the maintenance of the professional context of the psychotherapist. The qualitative research process is presented in a narrative approach by means of narrative synthesis and synergy. The findings of the research conversations are presented in the form of a literary short story. Suggestions are made about the fortigenic qualities of psychotherapists essential for maintaining their work in full-time private practice. It’s applicability and usefulness is discussed. Furthermore, suggestions are made with regards to the field of positive psychology and the way forward for this sub-discipline. Ideas relating to narrative research and qualitative research are also discussed. / Thesis (PhD)--University of Pretoria, 2010. / Psychology / unrestricted

This master thesis presents the field of Occupational Therapy within rehabilitation care and points out the possibilities of its use in follow-up care and field outpatient practice. The thesis aims at the elaboration of a business plan for establishing an Occupational Therapy private practice, which would provide Occupational Therapy service and rehabilitation for people with lasting functional deficit in their own social environment or in an Occupational Therapy outpatient department. The theoretic part focuses on the theoretic basis of business, requirements for establishing of a private practice and concept of strategic management and analysis. It continues with the structure of business plan and presents the field of Occupational Therapy, its history, actual situation and position within the comprehensive care. The practical part contains an analytic part describing the exhaustive strategic analysis, of which the results are summarized in a SWOT analysis, and a research describing the survey inquiry among physicians authorized to prescribe the Occupational Therapy. The business plan for an Occupational Therapy (field or outpatient) private practice is elaborated based on the results. In conclusion, the present plan is evaluated from the point of view of feasibility, profitability and...

Implementation of electronic health records by the Health Information Technology for Economic and Clinical Health has led to the implementation of electronic dental records (EDRs) and digital radiography in dental offices. The purpose of this study was to determine the state of the implementation and usage of EDRs and digital radiographs by the private general and pediatric dental practices in Mississippi as well as reasons why the dental practices are not moving forward with the advanced technology. A survey was emailed to 712 dental practices: 116 responded (16% response rate), and 104 consented to participate (89.66%). Results indicated dental practices in Mississippi using EDRs was 46.07%, EDRs with paper records was 42.70%, and only paper records was 11.24%. Results indicated dental practices using digital radiography was 76.40%, conventional radiography was 13.48%, and both was 10.11%. Common reasons for not advancing were cost, insufficient training, computer/software issues, and “too old.”

Indiana University-Purdue University Indianapolis (IUPUI) / Introduction: The prevalence of diabetes mellitus (DM) is rapidly increasing among the aging United States population. This poses a challenge to dental providers since DM and multiple oral conditions have been identified as comorbidities. Hypertension (HTN) is associated with more poorly controlled DM and has been identified as contributing to RCT tooth loss in prior studies. Links have also been established between DM and the survival rate of root canal treated teeth, however, previous research has focused on institutional settings despite the majority of RCT being performed in private dental practices. This study will use data from private dental practices to evaluate the survival rate of RCT teeth in patients with DM and HTN. Materials and Methods: This retrospective study evaluated the survival rate of endodontic treated teeth among patients with DM and HTN using National Dental PBRN Practice data. Electronic dental records from 42 private dental practices in the United States over a period of 15 years with a minimum 2-year follow-up comprising 11,532 root canal treated teeth were analyzed. Kaplan-Meier survival curves were used to demonstrate the effects of HTN and DM on RCT tooth survival and Cox proportional hazards survival analysis was used to evaluate the DM and HTN effects after accounting for age, gender, insurance, year of treatment, tooth type, and crown and filling placement as covariates. Results: Patients with HTN only had significantly lower risk of failure than patients with both HTN and DM (p=0.003). Patients with neither HTN nor DM had significantly lower risk of failure than patients with both HTN and DM (p=0.020). Patients with DM only did not have significantly different risk of failure than patients with both HTN and DM (p=0.223). Patients with DM only did not have significantly different risk of failure than patients with HTN only (p=0.361). Patients with neither HTN nor DM did not have significantly different risk of failure than patients with HTN only (p=0.121) or patients with DM only (p=0.800). Conclusions: Patients with both DM and HTN have an increased chance of root canal treated tooth failure while patients with only DM or only HTN do not. Evaluation of severity of DM may be more important in determining RCT failure and studies utilizing laboratory values should be considered for future research.

The study is aimed at the development of a Practice Model for Private Practice Management in Social work. It is evident from the literature that no practice model for private practice management exists, peculiar to the nature and modus operandi of Social work. A further problem is that the knowledge base of Social work is often derived and adopted from other professions and disciplines to address problem areas in Social work private practice. The problem lies far deeper. The lack of a practice model for private practice management also implies the lack of guidelines on how to employ social workers within the field of private practice. Poor remuneration and socio-economic change in the external environment put financial and emotional pressure on the social worker, which causes him to leave the social work profession. With reference to the above mentioned the researcher developed a practise model for private practice management in Social work to an extend that the content nature and magnitude of private practice is being familiarised and utilised in practice through this practise model. In order to reach this goal, a theoretical frame of reference for private practice management in Social work is created, the profile of existing private practices in South Africa is explored, a practice model for private practice management is developed through the intervention research model and the developed practice model's value is evaluated through focus groups consisting of private practitioners. Interdependent herewith all relevant concepts, principles, processes and elements as components of a practice model is investigated in both the field of social work and economic and management sciences. From the economic and management science a distinction is made between aspects applicable within entrepreneurship and management to private practice management. Based on a comprehensive literature study the practice model is developed and supported by a secondary data analysis from the national databank of the South African Social Workers in Private Practice. The utilisation value of the developed model is evaluated through three separate focus groups consisting of social workers in private practice. The qualitative data analysed through this process is carefully incorporated into a final practice model. Conclusions and recommendations as a result of the research process conclude the study. Copyright 2004, University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. Please cite as follows: Bloem, CHM 2004, 'n Praktykmodel vir privaatpraktykbestuur in maatskaplike werk (Afrikaans), PhD thesis, University of Pretoria, Pretoria, viewed yymmdd < http://upetd.up.ac.za/thesis/available/etd-12152006-111832 / > / Thesis (PhD)--University of Pretoria, 2006. / Social Work and Criminology / Unrestricted

Während die Bestechung und Bestechlichkeit von, in öffentlichen Krankenhäusern angestellten Ärzten, als Folge des „Herzklappenskandals“ und der darauf beruhenden Reform des Korruptionsstrafrechts bereits seit 1997 nach den §§ 331 ff. StGB strafbar sind, unterfielen niedergelassene Vertragsärzte auch nach der Rechtsprechung des Großen Strafsenats bis zum Inkrafttreten der §§ 299a ff. StGB am 04.06.2016 nicht den Korruptionsdelikten. Thematisch damit verbunden war und ist die Frage, ob Vorteilsgewährungspraktiken in diesem Bereich vom Tatbestand der Untreue erfasst sein könnten. Ihrer Beantwortung dient der erste Teil der Arbeit. Der zweite Teil fokussiert die Relevanz der Korruptionsvorschriften für das gewählte Arbeitsthema. Die Einbettung der Gesamtthematik in den Kontext der Korruptionsdelikte führt die Ausgangsbetrachtungen zur Untreue fort und ergänzt diese durch eine Bewertung nach den neuen Gesetzesregelungen. Das gewählte Arbeitsthema zeigt, wie wesentlich die Beschäftigung mit den relevanten Normen des Rechts der Gesetzlichen Krankenversicherung für die strafrechtlichen Bewertungen in diesem Bereich ist. Dies gilt umso mehr, wenn mit sozial- und beziehungsweise oder berufsrechtlichen Verstößen strafrechtliche Konsequenzen einhergehen und die fehlerhafte Anwendung der einschlägigen Rechtsnormen anderer Rechtsbereiche zwangsläufig auch zu falschen strafrechtlichen Schlussfolgerungen führt. Dieser Kritik sieht sich auch die Rechtsprechung des Bundesgerichtshofes zur sogenannten Vertragsarztuntreue ausgesetzt. Auch hier wurden die Besonderheiten des Sozialversicherungsrechts nicht mit der notwendigen Sorgfalt eruiert und stattdessen eine - seit mehreren Jahren - nicht mehr vertretene Rechtsprechung des Bundessozialgerichts zur Grundlage der strafrechtlichen Bewertungen gemacht. Dass dies weder den Anforderungen des Bundesverfassungsgerichts entspricht, noch mit den sozial- und strafrechtlichen Vorgaben vereinbar ist, zeigen die Ausführungen der Arbeit. In der Form eines kritischen Ausblicks werden abschließend, die Grenzen zulässiger verordnungsbezogener Vergütungen durch die Krankenkassen aufgezeigt und deren strafrechtliche Relevanz eingeordnet. Letzteres erfolgt am Beispiel eines Vertrags zur Förderung sog. biosimilarer Arzneimittel durch die Zahlung einer prozentualen Einsparbeteiligung als Gegenleistung für deren bevorzugte Verordnung. Die Konstellation verdeutlicht, dass auch die monetäre Einflussnahme der Krankenkassen auf das Verordnungsverhalten der Vertragsärzte strafrechtsrelevante Wirkung haben kann, wenn sie zu unberechtigten Wettbewerbsverzerrungen führt. / As a consequence of the so-called “heart valve scandal”, and the reform of the German criminal law on corruption that followed in the wake of the scandal, it has been a criminal offence under sections 331 et seqq. of the German Criminal Code [Strafgesetzbuch – StGB] since 1997 to give bribes to medical practitioners employed in public hospitals, or for such medical practitioners to take bribes. However, until sections 299a et seqq. StGB entered into force on 4 June 2016, acts committed by medical practitioners in private practices were not deemed to be corruption offences under the Criminal Code. This was also affirmed by the case-law of the Grand Criminal Panel of the German Federal Court of Justice [Großer Senat für Strafsachen]. A topic that has been repeatedly discussed in connection with the aforementioned issue is whether the practice of granting benefits in healthcare might constitute an offence of embezzlement. The first part of this dissertation provides an answer to that question. The second part focuses on the significance that corruption provisions have for the topic discussed herein. Following the initial analysis of the issue of embezzlement mentioned, this issue is expanded by a discussion of the overall topic in the context of corruption offences, supplemented by an assessment of the topic in the light of new legislation introduced. An analysis of the topic chosen for this dissertation shows how important it is to study the relevant legal provisions of the law on statutory health insurance in order to be able to carry out an assessment of the topic from the perspective of criminal law. This applies all the more so in cases where a breach of social law and/or the law of professional rules and regulations might have consequences under criminal law, and the faulty application of applicable legal rules from legal areas outside criminal law would inevitably also lead to wrong conclusions being drawn on the basis of criminal law. The case-law of the German Federal Court of Justice [Bundesgerichtshof] on so-called “embezzlement by medical practitioners in private practice” [Vertragsarztuntreue] has been criticised in this respect. The Federal Court of Justice did not take account of the specifics of German social security law in a sufficiently diligent manner, and instead used outdated case-law of the German Federal Social Court [Bundessozialgericht] as a basis for its criminal-law assessment—precedents that were overruled by the Federal Social Court itself many years ago. This dissertation shows that this does not meet the requirements of the German Federal Constitutional Court [Bundesverfassungsgericht] and that such an approach is incompatible with requirements under social and criminal law. Finally, the limits of admissible prescription-related remuneration by health insurances are discussed and demonstrated from a critical, future-oriented perspective, together with the significance these limits have from a criminal law perspective. The significance of such limits is discussed using as an example a selective-agreement model designed to promote so-called “biosimilar medicines” by paying medical practitioners a percentage of the savings achieved in return for practitioners prescribing such medicines rather than more expensive ones. The circumstances discussed illustrate that the monetary influence that health insurances exert over the way in which medical practitioners in private practice prescribe such things as medicines may have consequences under criminal law if such influence may lead to competition being distorted. In the light of the above, health insurances should not be provided with additional criminal-law-related exceptional provisions that would enable them to exert further influence over the neutrality of decision-making in the area of medical prescriptions.