The thesis deals with the issue of the formation of the ABC model in healthcare facilities. The aim of this work is the formation of the ABC model on the example of the Infectious Department of the selected teaching hospital. The work is divided into theoretical and practical part. In the framework of the theoretical part are summarised findings from literature review regarding the Activity-Based Costing method and its application in medical organisations. In the practical part are already constructs of the ABC model itself, based on an annual data basis using a procedure adapted to the medical facilities.

Die gegenwärtige Regelung der SächsPfleinrVO für gesondert berechenbare Aufwendungen nach § 82 Abs. 3 SGB XI für Investitionen und Instandhaltungsaufwendungen in Pflegeeinrichtungen enthält einige grundlegende Problembereiche, die einer ökonomischen Logik systematisch widersprechen. Gegenstand des Gutachtens ist die Darstellung der verschiedenen Problembereiche der SächsPfleinrVO und möglicher Lösungsmöglichkeiten. Die Problembereiche können dabei in vier Bereiche zusammengefasst werden: 1. Systematische Problematiken der SächsPfleinrVO 2011/13 2. Verbraucherschutzprobleme der Neuregelung 3. Ausgelöster Verwaltungsaufwand durch die neue SächsPfleinrVO 2011/13 4. Probleme in der operativen Umsetzung der SächsPfleinrVO 2011/13 Dem Erkenntnisinteresse des Auftraggebers folgend liegt der Analyseschwerpunkt bei Problemen, die insbesondere aus Pflegeeinrichtungen resultieren, die vollstationäre Dauerpflegeplätze anbieten. Nach der Darstellung der rechtlichen Grundlagen und der Datengrundlage des Gutachtens, werden diese vier Problembereiche anhand von Beispielen erläutert und mögliche Problemlösungen vorgeschlagen. Mit einer Zusammenfassung und Schlussfolgerungen wird ein Fazit gezogen.

This exploratory study sought to identify factors which motivate individual participation in volunteer services for the Long-Term Ombudsman Program of the Volunteer Center of Riverside County.

Thesis (MPH.) -- University of Limpopo, 2015 / The success of antiretroviral therapy for HIV infection through widespread and resounding has been limited by inadequate adherence to its unforgiving regimens especially over a long term. While health care professionals may not be able to predict adherence, they can help overcome barriers to adherence and take steps to improve it. The aim of the study was to explore and describe the strategies that are utilised by professional nurses in the primary health care facilities regarding adherence to antiretroviral therapy, Capricorn District, Limpopo Province, South Africa. A qualitative research approach was used to describe the strategies that are utilised by professional nurses in the primary health care facilities in the Capricorn District Limpopo Province, referring to Mankweng Hospital. The descriptive qualitative design was used. Unstructured interviews were used to collect data until saturation was reached. Informed consent was obtained prior the data collection. The data was analysed qualitatively using Tesch’s open coding method. 18 (eighteen) professional nurses working in the primary health care facilities participated in the study. The findings revealed that the strategies utilised by professional nurses in the primary health care facilities to improve adherence to ART were described. Information and education, health worker and adherence guidelines, use of adherence partner or treatment buddy, addressing religious beliefs, communication skills, community mobilisation and continuous counselling, were the strategies that were utilised by professional nurses in the primary health care facilities to improve adherence of patients to ART.

This thesis deals with a project whose mission is to optimize the social services of the entity, so as to increase the motivation and productivity of employees. The project is focused on building the corporate childcare facilities for pre-school children of employees. The work also includes an analysis of the risks associated with the construction of facilities and fund the project from European funds.

Thesis (MPH.) -- University of Limpopo, 2021 / Background: Achieving high vaccination coverage is crucial in the control, prevention and elimination of childhood vaccine preventable diseases. The Expanded Program of Immunization (EPI) aims for 95% coverage for each antigen and complete vaccination schedules for 90% of children under 12 months of age. All the vaccines included in the national vaccination schedule (Bacille Calmette Guerin (BCG), Oral Polio Vaccine, Diphtheria-Pertussis-Tetanus (DPT) vaccine, Measles and Hepatitis B vaccine are provided free of charge in the primary health services in South African public health care facilities. Although the coverage of all vaccines in South Africa has increased especially in recent years, the EPI targets has not been achieved yet in some parts of the coutnry and there are still differences within provinces. Therefore, the primary objective of this study was to investigate the prevalence and determinants of childhood immunization coverage at Primary Healthcare facilities, Bushbuckridge, sub district of the Mpumalanga Province, South Africa. The mean age of the children was 1.4±2.5 years (ranged: 1 months to 12 years. Slightly more than half (56%) of the children were less than 6-months. Nearly two-thirds (63%) of the children were females and only 37% were males. Methodology: A cross-sectional descriptive study was conducted among selected Primary Healthcare facilities in Ehlanzeni District, Bushbuckridge Sub- district, Mpumalanga Province. Simple random sampling was used to get a minimum sample size of 426 mothers and/or caregivers paired with their children required for the study. The researcher administered a validated or tested self-designed questionnaires to the participants. Data analysis was done using the STATA statistical software version 12 for Windows (STATA Corporation, College Station, Texas). Results: The mean age of the participants was 34.1±9.2 years ranged from 15 to 57 years. Almost one-third (28.6%) of the mothers and/or caregivers were 40 years and older and the majority (70%) were unmarried. Majority of the participants had secondary ix education with 65.5% and 23.4% had primary education. Nearly eighty per cent (79.2%) of the maternal and/or caregivers were unemployed. The prevalence rate of fully immunized children was 88% and a significant higher proportion of children in the age group 12 years at 57% were likely not to be fully immunized (p<0.05), followed by age group 6 -11 years, 18 months – 5 years, 6-8 months and 9-11 months at 48%, 26%, 17% 13% respectively. No statistical significant relationship was found between maternal and/or caregiver age, marital status, level of education, employment status and immunization coverage of the child. However, participants aged 40 years and older, less educated and unemployed were likely to have missed immunization of their children. Mother and/or caregivers with a tertiary education were 3.46 times more likely to get their children immunized than those with none/primary education [OR = 3.46, (95% CI:0.75;15.9), p<0.2)]. The employed mother and/or caregivers were 2.01 times more likely to get their children immunized than the unemployed mother and/or caregivers [OR = 2.01, (95% CI: 0.82; 4.89), p<0.20]. In the multivariate model, level of education and employment status were found not to be significantly associated with immunization of the child. Conclusion: The overall immunization coverage in the present study was relatively high and significantly decreased with age. At 6 weeks, all age groups between 0-6 weeks were immunized, while at 10 weeks, with exception of children in the age group 10 -13 weeks and 18 months – 5 years. At 6 months, the young children (age 9-11 months) were likely to default or missed measles vaccination. At 6 and 12 years, the Td vaccination coverage was relatively low. Mothers and/ or caregivers who missed child immunization were likely to experience shortage of vaccines at health facility and said it takes the whole day to immunize a child but the result were not significant. Mother and/or caregivers with a tertiary education and employed were more likely to immunize their children than mothers and/or caregivers with primary, secondary education and the unemployed.

Background and Purpose: To investigate the effect of an individualized exercise program versus a generic group-based exercise program on balance, gait, and functional performance of older adults categorized as having mild balance dysfunction and living in residential care facilities. Methods: Single blind randomized control design. One hundred-twenty residents fulfilled screening criteria for mild balance dysfunction based on the BioSwayTM balance and the Multi-Directional Reach Test (MDRT) primary outcome measures. Secondary assessment was completed using the Modified Physical Performance Test (PPT), hand-held dynamometer (lower-limb muscle strength testing), and gait speed analysis. Sixty subjects received individualized treatment from physical therapists (8 weeks). Another sixty subjects received generic group-based exercises (8 weeks). All outcome measures were collected at baseline and post-intervention (ninth week); and BioSwayTM and PPT measures at follow-up (thirteenth week) for the individualized group. Results: Individualized group (n=60) showed significant improvement compared to the group-based group (n=60) on the two BioSwayTM scores (limits of stability, p < .001; and postural stability, p = .016), the MDRT scores (forward reach, p < .001; backward reach, p = .007; right lateral reach, p < .001; and left lateral reach p < .001), the strength scores (hip flexors, p = .010; knee extensors, p = .002; hip abductors, p = .009; and ankle dorsiflexors, p = .025), the PPT outcomes (p < .001), and the gait scores (p = .012). Effect sizes ranged from small to large, with the largest sizes for limits of stability and MDRT. There were no significant differences between groups for the mCTSIB (p = .538). However, 96.7% of subjects in the individualized group scored within one SD of the reference mean, relative to 75% in the group-based group. At follow-up, the individualized group showed significant differences over time with medium to large effect sizes on the PPT (p < .001), limits of stability (p < .001), postural stability (p < .001), and mCTSIB (p = .005) measures. Post-hoc analysis revealed retention of gains for all measures at follow-up, except the mCTSIB. Conclusion: The individualized group showed significant improvements in the areas of balance, strength, mobility, and functional outcomes.

This oral interpretation thesis studies the use of oral interpretation in social contexts. The context chosen was the Hospice movement, which deals with assisting terminally ill persons and their families through the stages of death and bereavement. A readers theatre script was compiled for "Ann's Haven: Hospice of Denton County," which was selected for the locus of this thesis. The script was presented to various civic groups for the purpose of informing the public and eliciting support for Ann's Haven. It was found that oral interpretation is a viable rhetorical tool and is well liked by audiences as a means of public enlightenment.

Cooper, Heron and Heward define maintenance as the extent to which a learner continues to perform a target behavior after the intervention has been terminated. Testing for maintenance allows the trainer to see if gains were sustained following the termination of a treatment program. In addition, once it is shown that a learner's skills have remained in the repertoire, assessment of generalization is possible. Previous literature in behavior skills training have assessed maintenance in a variety of settings for a variety of skills. Following maintenance assessments, booster sessions are commonly used to re-train skills that did not maintain at criterion levels. The current project assessed the maintenance of caregivers' skills following a training package used to teach three behavior management techniques (use reinforcement, pivot, protect-redirect) at a large, residential care facility. Procedures were developed to assess caregivers' maintenance of the three behavior management techniques using a pre-test- post-test design. If needed, skills were re-established using 5-20 minute booster sessions. The results showed that time between post-test and maintenance did not seem to have a strong effect on maintenance scores. In general, post-test scores were somewhat indicative of maintenance scores, and patterns were most apparent across tools.

Training and empirically evaluating caregivers’ implementation of behavior management skills is a particularly challenging task in large residential contexts. A pyramidal training approach provides an efficient and effective way to conduct large-scale competency-based behavior skills training. The purpose of this project was to develop and evaluate a large-scale pyramidal staff training program for behavior management skills. One hundred nine caregivers and 11 behavior service professionals at a large, residential care facility participated in this project. Interobserver agreement was utilized to develop and refine measurements systems to detect caregiver acquisition of skills, behavior service professionals’ ability to score caregiver performance and behavior service professionals’ ability to deliver a specified portion of the curriculum. Pre- and post-test probes were conducted utilizing standard role play scenarios and checklists to evaluate caregiver acquisition of three specific behavior management skills. The results supported the following conclusions: first, interobserver agreement measures were useful to develop a reliable measurement system, to refine some curriculum elements, and to evaluate measurement conducted by behavior service professionals. Second, behavior skills training (BST) resulted in caregiver acquisition of all three behavior management techniques. Third, the pyramidal training approach was effective to teach behavior service professionals to deliver BST and accurately measure the performances of trainees.