Thesis (MNutr)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Introduction: Nutritional genomics is a new and emerging field aimed at investigating the complex interactions between genetics and diet and the joint influence this has on disease prevention and health promotion. Research is accelerating at a rapid pace and although still in its infancy, it is important for registered dietitians (RDs) to be knowledgeable and keep abreast of these developments as it promises to revolutionize dietetic practice. International studies have demonstrated low confidence and involvement as well as poor knowledge of both genetics and nutritional genomics amongst RDs. To date no similar studies have been conducted amongst South African (SA) RDs. Methods: A cross-sectional descriptive study was conducted using a national survey of 1881 dietitians registered with the Health Professions Council of South Africa (HPCSA). Data was collected using an existing and validated questionnaire as developed for use in a similar study amongst RDs in the United Kingdom (UK). The self-administered questionnaire consisted of 4 sections to assess the following aspects: i) involvement and confidence in activities relating to genetics and nutritional genomics ii) knowledge of genetics and nutritional genomics iii) factors associated with knowledge and iv) demographic information. The main method of questionnaire distribution was via email (70%) using the Association of Dietetics in South Africa (ADSA) distribution service and questionnaires were posted to those RDs not registered with ADSA (30%). Results: The response rate was 15.2% (n = 279). Results showed low involvement in activities relating to genetics (n = 47, 17%) and nutritional genomics (n = 72, 25.8%). The majority of respondents indicated low confidence in performing activities relating to genetics (n = 161, 58.7%) and nutritional genomics (n = 148, 53.8%). However, a significant positive association was found between involvement and confidence for all activities (p < 0.001). The mean total knowledge score was 48.5 (±19%) and considered as low, with the mean genetics score of 58.5 (± 24%) being significantly higher than the nutritional genomics score of 31.9 (±23%), p < 0.001. Those respondents who reported involvement in discussing the genetic basis of a disease (p = 0.02); providing guidance to patients with genetic disorders (p = 0.01); providing training or education on human genetics (p = 0.01) and discussing with patients how diet may interact with genes to influence risk (p = 0.03) also had higher total knowledge scores. Factors associated with knowledge were greater genetics content in university studies (p < 0.001); higher qualification (p = 0.01); participating in related continuous professional development (CPD) activities (p <0.001) and considering genetics of greater importance to dietetic practice (p = 0.03). Conclusions: The results of this study indicate that there is overall low involvement, confidence and knowledge of genetics and nutritional genomics amongst SA RDs and this compares well with international studies. Recommendations therefore include the development of a competency framework for genetics and nutritional genomics for undergraduate dietetic education as well as CPD activities in order to provide the driving force for the development of this field in SA. / AFRIKAANSE OPSOMMING: Inleiding: Voeding genomika is 'n nuwe en ontwikkelende veld wat die komplekse interaksies tussen dieet en genetika bestudeer, asook die gesamentlike invloed wat dit op gesondheids- bevordering en siekte voorkoming het. Navorsing is vinnig besig om uit te brei en alhoewel dit nog in die begin fase is, is dit belangrik vir geregistreerde dieetkundiges (GDs) om op hoogte te bly van die nuutste ontwikkelinge, aangesien dit die potensiaal het om 'n merkwaardige invloed op die dieetkunde praktyk te hê. Internasionale studies het lae selfvertroue en betrokkenheid, asook lae kennis van genetika en voeding genomika onder GDs bevind. Daar is tans geen studies beskikbaar onder Suid Afrikaanse (SA) GDs nie. Methodes: 'n Dwarssit studie is onderneem deur gebruik te maak van 'n nasionale opname van al 1881 dieetkundiges wat by die Health Professions Council of South Africa (HPCSA) geregistreer is. Data is ingesamel deur 'n gevalideerde self-geadministreerde vraelys wat ook begruik is vir 'n eenderse studie onder dieetkundiges in die Vereenigde Koninkryk (VK). Dit het bestaan uit vier afdelings om die volgende aspekte te evalueer: i) betrokkenheid en selfvertroue in aktiwiteite te make met genetika en voeding genomika ii) kennis van genetika en voeding genomika iii) faktore wat met kennis geassosieer word asook iv) demografiese inligting. Die hoof metode van data insameling was deur middel van epos (70%) met behulp van die Association for Dietetics in South Africa (ADSA) se epos databasis. Vraelyste is aan diegene gepos wat nie geregistreer was by ADSA nie (30%). Resultate: Vyftien persent (n = 279, 15.2%) van GDs het op die vraellys gereaggeer. Resultate het lae betrokkenheid in aktiwitiete met betrekking tot genetika (n = 47, 17%) en voeding genomika (n = 72, 25.8%) gewys. Die meerderheid van die deelnemers het lae selfvertroue gerapporteer in die uitvoering van aktiwiteite wat genetika (n = 161, 58.7%), asook voeding genomika (n = 148, 53.8%) behels. Daar was 'n statistiese beduidende positiewe assosiasie tussen betrokkenheid en selfvertroue vir alle aktiwiteite (p < 0.001). Die gemiddelde kennis telling was 48.5 (±19%) wat as laag beskou kan word. Die gemiddelde kennis vir genetika van 58.5 (± 24%) was statisties beduidend meer as die vir voeding genomika 31.9 (±23%), p < 0.001. Deelnemers wat betrokkenheid aangedui het in die bespreking van die genetiese basis van 'n siekte (p = 0.02); raadgewing aan pasiënte met genetiese siektes (p = 0.01); lewering van opleiding met betrekking tot genetika (p = 0.01) asook die bespreking van die interaksie van dieet en genetika met pasiënte en die invloed hiervan op risiko (p = 0.03), het ook beduidende hoër totale kennis gehad. Faktore wat met kennis geassosieer word is die genetika inhoud in voorgraadse studies (p < 0.001), hoër kwalifikasies (p = 0.01), voorgesette professionele onderrig (VPO) (p <0.001) asook diegene wat genetika as belangrik beskou vir dieetkunde praktyk (p = 0.03). Gevolgtrekking: Die resultate van hierdie studie wys dat daar oor die algemeen lae betrokkenheid, selfvertroue en kennis is van genetika en voeding genomika onder SA GDs. Dit vergelyk goed met international bevindinge. Aanbevelings is dat 'n raamwerk vir die kennis van genetika asook voeding genomika ontwikkel word vir voorgraadse dieetkunde studies, asook die ontwikkeling van VPO aktiwiteite wat die dryfkrag sal voorsien vir die ontwikkeling van hierdie veld in SA.

Bakgrund: Närstående till patienter med psykisk ohälsa och patienter med psykisk ohälsa upplever att det är svårt att få god vård. Bristande kommunikation var en del som gjorde vårdandet sämre. Patienter upplever sig kränkta eller diskriminerade av vården. Syfte: Att beskriva sjuksköterskors upplevelser av att vårda patienter med psykisk ohälsa. Metod: Systematisk litteraturstudie enligt Evans (2002), där 12 kvalitativa vårdvetenskapliga artiklar har analyserats med en beskrivande ansats. Resultat: Sjuksköterskor upplevde att kommunikation var viktigt inom vårdandet, även relationer var viktiga, både till patienter och till patienters närstående. Att upprätthålla en god relation och god kommunikation var delar sjuksköterskor upplevde som svåra, om det inte lyckades kunde sjuksköterskor uppleva att de misslyckats med vårdandet. Slutsats: Sjuksköterskor upplevde att kommunikation och att skapa en relation är viktigt mellan sjuksköterskor och patienter för att vårdandet ska ge förutsättningar för en god vård. Lyckades in en relation skapas upplevde sjuksköterskor ofta att vårdandet misslyckades. Viktigt var även att närstående som ville vara delaktiga i vårdandet tilläts vara involverade för det kunde gynna vårdandet. Bemötandet sjuksköterskor ger kan således ses som en grundläggande del som behöver förbättras för att vårdandet ska upplevas bättre för alla involverade parter. / Background: Relatives to patients with mental illness and patients with mental illness experience that it’s hard to get proper healthcare. Lack of communication was a part of the issues that made the healthcare worse. Patients expressed being discriminated against by the healthcare. Aim: To explore nurse’s experiences of working with mental health patients. Method: Systematic literature review with a descriptive synthesis following Evans (2002), twelve qualitative research articles were analysed with an inductive approach. Result: Nurses experienced that communication was an important part of the care, relations were also an important part for the healthcare, both to patients and to relatives of the patient. If this didn’t occur nurses would experience that the healthcare had failed. Conclusion: Nurses experienced that communication and creating relationships between patients was monumental for the outcome to be good. Did this not succeed, nurses felt that they’d failed. It was also important that relatives of the patient could get involved in the healthcare, since it could benefit the recovery of the patient. How nurses treated both patients and relatives were then a good start in getting improvements for how the treatment could be improved for everyone.

This thesis deals with upbringing of children by homosexual couples and its analysis through the legal perspective, psychological perspective and through the perspective of Christian ethics. The aim of the thesis is with regard to researched literature on the possibilities of the upbringing of children by homosexual couples to analyse the above mentioned topic, and possibly to find an answer to if the existing approaches to homoparentality are justifiable or not. The presentation of the approach of Christian ethics to the respective topic will not be left out.

This diploma thesis discusses the issue of registered partnership and the Czech public´s opinion of it from the social and legal aspect of a new establishment. The theoretical section characterises the basic terms applying to this issue. The purpose of this work is to establish the predominant attitudes in Czech society towards homosexuality and homosexual orientation as such, including attitudes towards registered partnership. Three hypotheses have been determined. H 1: A greater part of the Czech public perceives introduction of the registered Partnership Act to be a positive step for homosexually orientated citizens. H 2: more than half of respondents do not have enough information about the issue of registered partnership. H 3: More than half of respondents are chiefly influenced by the media in their attitudes. The research section contains processing and evaluation of data obtained by the quantitative method of inquiries made through a questionnaire, when an anonymous questionnaire investigation established the general public´s attitudes towards homosexuality and registered partnership. The obtained data implies that the Czech public is aware of the establishment of registered partnership as such, but knowledge of specific aspects, which are significant from the social or legal aspect, are not on the required level. A pleasing discovery is that the Czech public has an open approach to the establishment of registered partnership and agrees with its introduction to practice by means of approval of Act number 115/2006 Coll.

Registered capital of a limited liability company Abstract This master thesis deals with the institution of the registered capital in a limited liability company, its meaning and its purpose. The aim of the master thesis is to evaluate the current legislation, to compare it with the adjustment of the registered capital in other countries (especially in Germany), as well as to propose its concrete improvements. The new legislation of the limited liability company is very different from the previous legislation; the abolition of the minimum registered capital is one change brought by the new legislation. This is the result, not the cause of questioning the registered capital as the creditor protection institute. The registered capital does not perform the guarantee function, because the regulation of the registered capital does not provide (and the neither did the previous Act) effective guarantees that the company will have funds corresponding to the amount of the registered capital after the establishment of the company as well as during the period of its existence. Other provisions concerning the actual creation and maintenance of the registered capital were (except, for instance, the registered capital test) preserved. This is positive, especially because of great number of companies that have...

Bakgrund: Postoperativa sårinfektioner är en vanlig komplikation till kirurgi och orsakar lidande för patienten och extra kostnader för samhället. Preoperativ dusch är en viktig faktor som kan förhindra uppkomsten av komplikationer efter en operation. Sjuksköterskan ansvarar för att kunna anpassa informationen till patienten om den preoperativa duschen så att patienten känner sig välinformerad och trygg i situationen. Syfte: Syftet med denna studie var att undersöka hur information om genomförandet och vikten av den preoperativa duschen anpassas till patienten. Metod: Deskriptiv design med kvalitativ induktiv ansats. Semistrukurerade intervjuer genomfördes med 11 sjuksköterskor. För analys av resultatet har kvalitativ innehållsanalys inspirerad av Graneheim och Lundman (2004) använts.  Resultat: Studiens resultat visade att anpassad information om genomförandet och vikten av den preoperativa duschen var viktig för att öka patientens känsla av trygghet och delaktighet. Att använda ett gemensamt språk med ord anpassade till patienten lyftes fram som viktigt för att kunna ge anpassad information. I intervjuerna framkom även att det fanns ett behov av skriftlig information på olika språk. Sjuksköterskorna var överens om att faktorer i arbetsmiljön – såsom tidspress, hög arbetsbelastning samt dåligt samarbete mellan avdelningar - var en stor anledning till att information blev bristfällig och nedprioriterades. Slutsats: Sjuksköterskornas information om den preoperativa duschen fokuserade främst på genomförandet och lite vikt las på varför den skulle göras. Att ha tid identifierades som en viktig förutsättning för att kunna anpassa information till patienten, och på så viss öka deras känslor av delaktighet och trygghet. Informationen om den preoperativa duschen nedprioriterades ofta på grund av att andra arbetsuppgifter ansågs viktigare. För att öka sjuksköterskornas förståelse för betydelsen av den preoperativa duschen skulle operationssjuksköterskan kunna dela med sig av sin kompetens och hjälpa till med utformandet av skriftlig information. / Background: Surgical site infections are common complications of surgery and causes suffering for the patient and extra costs for the society. The preoperative shower is an important factor that can prevent the occurrence of complications caused by surgery. The Registered Nurse is responsible to inform the patient about the preoperative shower so that the patient feels well-informed and safe in the situation.  Aim: The aim of this study is to explore how information about the implementation and the importance of the preoperative shower is adapted to the patient.  Method: Descriptive design with a qualitative inductive onset. Semi-structured interviews were conducted with 11 Registered Nurses. A qualitative content analysis inspired by Graneheim and Lundman (2004) was used for the analysis.  Result: The result showed that adapted information about the implementation and importance of the preoperative shower was important for enhancing the patient’s feeling of safety and participation. To use a common language with words adapted to the patient was regarded as important for the ability to give an adapted information. The necessity of written information in different languages was also identified in the interviews. The Registered Nurses agreed that factors in the work-environment – such as insufficient time, an extensive workload and poor co-operation between wards – were strong reasons causing information to become inadequate and not prioritised. Conclusion: The Registered Nurses information about the preoperative shower focused mainly on its implementation, and little on its importance. To be given time was identified as important for the ability to adept the information to the patient, and thus enhance the patients feeling of participation and safety. Information about the preoperative shower was often given lower priority due to other, higher prioritised, duties. To enhance the Registered Nurses understanding of the meaning of the preoperative shower the theater nurse could share their knowledge and be helpful in the design of written information.

Övervikt och fetma bland barn är ett omfattande och komplext problem. BHV-sjuksköterskan har genom sin unika position en betydelsefull roll i det hälsofrämjande samt förebyggande arbetet. En tidig upptäckt främjar barnets hälsa både på kort och lång sikt ur ett folkhälso- samt hållbarhetsperspektiv. Body Mass Index är idag den metod som används inom barnhälsovården för att identifiera barn med övervikt eller fetma. Forskning kring BHV-sjuksköterskan användning av BMI är sparsam. Den här studien beskriver BHV-sjuksköterskans erfarenhet av att använda BMI-kurvan vid de olika hälsokontrollerna på barnavårdscentralen. Tio BHV- sjuksköterskor intervjuades till studien. Dataanalysen har skett genom en kvalitativ innehållsanalys enligt Elo &amp; Kyngäs. Under analysen identifierades tre stycken huvudkategorier med tillhörande 10 stycken subkategorier som beskriver resultatet. De tre huvudkategorierna är ”En naturlig del av besöket”, ”Stöd till vårdande samtal” samt ”Ett användbart instrument”. Resultatdiskussionen lyfter fram att BHV-sjuksköterskan anser att BMI-kurvan utgör ett bra stöd och verktyg för att identifiera barn med övervikt eller fetma. BMI-kurvan beskrivs som tydlig och utifrån kurvan kunde BHV- sjuksköterskan samtala om barnets viktutveckling samt livsstilsfaktorer såsom kost och fysisk aktivitet. I studien framkommer det att BMI-kurvan inte används regelmässigt utan BHV-sjuksköterskan fäster istället stor tilltro till sin egen kliniska blick, vilket även bekräftas i den befintliga forskningen inom ämnet.

Bakgrund: Anmälningarna av barnmisshandel har ökat på sistone och hälsovårdspersonal har som plikt att anmäla vid misstanke av barnmisshandel till Socialtjänsten. Det finns många riskfaktorer relaterade till om ett barn kommer att bli misshandlade eller inte, både kring förövarna men även riskfaktorer kring barnet. Statistisk sett är majoriteten av förövarna föräldrarna till barnet.   Syfte: Att beskriva sjuksköterskans erfarenheter av barnmisshandel inom Hälso- och Sjukvården samt vidare beskriva en metodologisk ansats valda artiklar använt sig av. Metod: Beskrivande litteraturstudie utifrån nio kvalitativa och tre kvantitativa artiklar där medverkande sjuksköterskor haft erfarenhet av barn som utsatts misshandel.   Resultat: Det framkom att sjuksköterskans erfarenhet av sin egna förmåga, känslor, stöd och omgivning påverkar hur och om anmälningen av barnmisshandel genomförs. Trots att sjuksköterskor i studierna var medvetna om anmälningsplikten var det en del sjuksköterskor som inte anmälde vid misstanke om barnmisshandel. Sjuksköterskorna erfors även av många olika känslor när de var inblandad i barnmisshandelsfall, samt att samtliga sjuksköterskor i studien erfor att de saknade kunskap av barnmisshandel och många önskade att de haft mer stöd när det kom till våld mot barn.   Slutsats: Erfarenheten av barnmisshandelsfall tog hårt på sjuksköterskorna till den grad att vissa ignorerade tecknen och undvek att anmäla till Socialtjänsten. Sjuksköterskorna erfor att de behövde mer stöd från en erfaren kollega men även att de behövde mer kunskap och erfarenhet. / Background:  Reports of child abuse have increased recently and healthcare staff are obligated by law to report any possible suspicion of child maltreatment to the Social Services. There are a lot of risk factors involved concerning whether a child will be abused or not, factors related to the perpetrators but also factors related to the child itself. Statistically the majority of perpetrators are the child's own parents. Aim: To describe the registered nurses experiences of child abuse within healthcare and also to describe one methodological aspect of the articles that this study is based upon.   Method: A descriptive literature review based on nine qualitative and three quantitative articles, where the participating registered nurses have experience of children that have been abused. Results: It was found that the nurse’s own personal experiences, based upon their own feelings, the support they received and the actual environment affects how and indeed if child abuse will be reported. Although the registered nurses were aware that they are obliged to report all cases, some nurses failed to report child abuse to the Social Services. The nurses experienced a variety of emotions that arose when they were involved in child abuse cases. All nurses in this study experienced that they lacked knowledge concerning child abuse also a lot of nurses wished that they had had more support during child abuse cases. Conclusion: The experience of child abuse cases severely affected the nurses even to the extent that some ignored the signs and failed to report to the Social Services. The registered nurses experienced a need for more support from an experienced colleague and wanted to attain more knowledge and experience themselves.

The problem of this investigation was threefold: ascertaining differences in degrees of burnout as a function of registered nurses' educational tracks in Texas, ascertaining degrees of burnout for registered nurses as a function of job tenure, and examining certain demographic variables and their relationships with registered nurses' educational tracks. Nurses were classified by educational track (diploma, associate degree, baccalaureate degree) and employment (full time, part time, not active). The instrument employed comprised the Pines and Aronson Tedium-Burnout Diagnosis, for which reliability and validity were previously established, and a demographic questionnaire.

Background: The overuse of the emergency department (ED) for non- critical patients has been associated with overcrowding and a rise in healthcare cost. Green Valley Fire Department (GVFD) has created a program, Fire-Based Urgent Medicals Service (FBUMS) with a nurse practitioner (NP). Patients can call 9-1-1 or the ""NP hotline"" and request to be seen by the NP instead of being immediately transported to the hospital via ambulance. Purpose: The purpose of this project is to evaluate the impact of the nurse practitioner led FBUMS, on ED visits and ambulance transports. Methods: A survey was mailed to all persons, age 18 and older, who were seen by the NP with FBUMS between February 2017 and March 2017. The survey asked about the reasons for contacting GVFD, the type of treatment received, and whether they went to ED after treatment. Data analysis: Descriptive statistics including frequencies, percentages, means and standard deviations were used to analyze each of the answered survey questions in Microsoft Excel©. Results: Surveys completed (n=42). The majority, 39 (92.9%) stated they did not receive care at the ED within 72 hours following their appointment with the NP, three (7.1%) stated they did. By dramatically decreasing transport to the hospital and associated ED treatment, it is estimated to have saved approximately $53,425 in ambulance costs and $54,210 in ED treatment for a total savings of $99,632.52. Conclusion: A Fire-Based Urgent Medical Service led by a nurse practitioner decreased emergency room visits and ambulance transports.