This study aims to identify referral criteria for music therapy which can be used at an institution for children affected by HIV / AIDS in South Africa. The purpose of this research is a) to identify the needs of institutionalised children and how music therapy can be applied to treat these needs; b) to establish the current referral process in this institution; and c) to develop referral criteria which can be used to refer these children to music therapy. Interviews conducted with different staff members at the institution, as well as a music therapist who worked at the institution, showed that some of the needs, challenges and resulting behaviours of the children are not currently referred to music therapy. This study shows that music therapy can be used to address a wide range of these difficulties. / Dissertation (MMus)--University of Pretoria, 2007. / Music / MMus / Unrestricted

Although less than half of all patients with mental disorders seek mental health treatment per se, approximately 80% of all people will visit their primary care physician (PCPs) within a year (Strosahl, 1998). However, it is not well understood how to best handle patients presenting with mental health issues in primary care practices. The purpose of this project was to implement an intervention involving a screening measure for anxiety and mood disorders in a primary care setting to increase the volume of anxiety and mood disorder screening, to increase the accuracy of disorder detection, and to also enhance PCPs patterns of referral to mental health professionals (MHPs). Though starting with a quantitative design, difficulties encountered throughout the project eventually led to a largely qualitative analysis, which did yield useful information. A pilot project demonstrated anxiety and mood disorders were commonly noted in patients’ medical charts (46%), but also found referrals were rarely made for mental health services (7%), despite colocation of a licensed psychologist and licensed clinical social worker within the practice. This indicated that services available to provide comprehensive integrated total health care may not be have been used to their full potential. In the main project, 59 participants from a family medicine clinic and 20 PCPs from that clinic participated. The My Mood Monitor (M3) was administered to the patients and became part of their Electronic Medical Records (EMR). The M3 screens for anxiety, depression, and bipolar disorders within primary care settings. In 2 separate noon conferences, PCPs were trained on diagnostic criteria for anxiety disorders and mood disorders, interpretation of M3 results, and the internal Mental Health Professional referral process. The project was hampered by a full-scale switch from paper-based medical records to an EMR and accompanying lack of user experience with EMR functions, lack of efficient transfer of M3 results into the EMR, and an unforeseen switch of psychologists mid-way through the study. However, results were obtained that showed relatively low levels of PCP review of M3 results, potentially high rates of anxiety disorders and mood disorders within the setting, relatively high levels of PCP knowledge of diagnostic criteria for anxiety and mood disorders, and that patients may not prefer a ‘warm handoff’ model of mental health referral. These findings are couched within a number of important caveats, but future directions for research were clearly implied.

Introduktion Röntgenremissen ligger till grund för röntgensjuksköterskan och radiologens planering och utförande av undersökning. Det är av stor vikt att remitterande läkare skriver en informativ och relevant remiss för att röntgensjuksköterskor ska ha möjlighet att utföra ett patient- och personalsäkert arbete som samtidigt är effektivt. Tidigare forskning visar att bristfälliga remisser förekommer runt om i världen. Syfte Att undersöka och sammanställa röntgensjuksköterskans upplevda brister i akuta konventionella röntgenremisser. Metod Kvantitativ enkätstudie med fem deltagande röntgensjuksköterskor från ett sjukhus i norra Sverige. Kartläggning av vilka brister som kan finnas i röntgenremissen utan någon djupare statistisk analys. Resultat Av de besvarade 71 remisserna, 33 från hälsocentral och 38 från annan remittent upplevdes 32 remisser tillfredsställande. Brister förekom i 39 remisser varav 17 remisser från hälsocentral och 22 remisser från annan remittent. Vissa remisser ansågs tillfredsställande trots brister. Slutsats Studien visar att allvarliga brister i remisser till akut konventionell röntgen förekommer i olika utsträckning. Brister i remisser leder till mer arbete för röntgensjuksköterskan när möjligheterna att planera och prioritera försämras. / Introduction The x-ray referral is the basis for the radiographer and radiologist’s planning and execution of a radiographic study. It is of critical importance that the referring physician writes an informative and thorough referral for the radiographer to conduct at safe and efficient study from a staff and patient perspective. The literature on the subject shows that suboptimal referrals occur throughout the world. Purpose To study and compile the radiographers experienced deficiencies of acute conventional x-ray referrals. Method A quantitative survey study with 5 participating radiographers at a hospital located in the north of Sweden. Results Among the 71 referrals included in the study, 33 from primary care and 38 from a different referring medical professional 32 were noted as satisfactory. Deficiencies occurred in 39 referrals, 17 from primary care physicians and 22 from other medical professionals. Some referrals were considered satisfactory even though they contained some deficiency. Conclusion The study shows that severe errors are occurring in a significant number of referrals to the emergency conventional x-ray unit. Deficiencies in referrals leads to more work for the radiographer when the opportunities to plan and prioritize deteriorate.