The present architectural proposal aims to foster engagement, support independence, and promote a sense of meaning, comfort, and safety for dementia residents of care facilities. The proposed Iron Heart Memory Village aims to improve the quality of life for dementia residents by redesigning healthcare facilities and integrating everyday lifestyles into their living spaces. Dementia, characterized by cognitive decline and functional impairments, poses significant challenges to individuals and their caregivers. By reimagining program spaces within low-density housing and providing access to public amenities, entertainment, and natural environments, healthcare facilities can emulate familiar everyday settings. In terms of design, Iron Heart Memory Village offers a setting that prioritizes interactions between residents, healthcare professionals, and visitors through low-density residences, individual courtyards designed for the different stages of dementia, shopping, cooking, entertainment, public amenities, and simple living. This proposal considers the proposed site's history, climate, site, demographics, economics, and other factors to best design a building that serves not only dementia residents but also the neighborhood. The proposal addresses the multifaceted needs of dementia residents and their caregivers through sustainable architecture and construction. Innovative architecture, such as green roofs, solar panels, locally sourced materials, open designs, and more, are some of the elements used to enhance mobility, stimulate mental abilities, and create environments conducive to holistic well-being. Through a deeper understanding of dementia as a condition influenced by various factors, including brain damage and other underlying conditions, this project underscores the importance of design and architecture as a means to alleviate symptoms and improve overall outcomes for individuals affected by dementia. / Master of Architecture / Dementia is a big challenge for people, families, and healthcare systems worldwide because it affects memory and everyday activities. As more people get older, dementia is becoming more common. This means we need new ideas to help those with dementia. Many traditional healthcare places struggle to help people with dementia properly, which can make life harder for them and their caregivers. However, new research shows that changing how healthcare buildings are designed and including things from everyday life can make a big difference for people with dementia. This sets the stage for a proposal to improve healthcare places for people with dementia by redesigning them to feel like regular homes. The proposal suggests making healthcare buildings more like real homes by adding things like places to hang out, entertainment options, and nature views. It also suggests activities people enjoy, like shopping and cooking, to help them stay social. Plus, it includes changes to make the buildings easier to get around for people with mobility issues. Overall, the goal is to make life better for people with dementia by making healthcare places feel more like home and helping them stay active and independent. This could also make things easier for their caregivers. The proposal is a plan for this and could be a model for future dementia care.

Hospitals and healthcare facilities are very specific times of microenvironments, which requiring monitoring air quality. People who use healthcare facilities are due to a weakened immune system very sensitive to air quality. Acceptable indoor air quality in healthcare facilities may have adverse effects on job performance at the personnel and their errors may have very serious consequences. The aim of this paper is to evaluate the main components of the inner microclimate (temperature and relative air humidity) and concentrations of carbon dioxide in the environment of selected healthcare facilities in the Czech Republic and to compare the results with the related legislation. The measurements were carried out in two hospitals and nine private medical offices from December 2011 to March 2013. The results showed that the values of microclimate factors and the concentration of carbon dioxide in the environment of patient rooms were different in cold and warm part of the year. In the patient rooms the levels of relative humidity diverged from the legal requirements mostly in winter - while those of temperature in summer. The concentration of carbon dioxide was affected by the occupancy rate and the size of the rooms. Air quality in the operating theater was primarily characterized by very low relative...

Magister Public Health - MPH / Aim: The aim of this study was to assess the prescribing practices and availability of antimalarial drugs to children under five years of age in primary health care facilities in Bondo district.

There are currently many emergencies that may affect the security environment of the Czech Republic. No extraordinary event chooses time or place to intervene. Among the most vulnerable people we can rank people in social facilities or health facilities because these people are dependent on the help of others. Healthcare facilities have their own specificities, which need to be given increased attention, especially in the event of emergencies. Currently, patients' entitlement to health care is high. Care should be provided in its entirety and at a high level. The aim of this thesis is to increase the readiness of Jihlava Hospital for selected emergency events. A research question has been set for this work: What is the readiness of Jihlava Hospital for selected emergencies? Data acquisition will take several forms. The research and analysis of legal norms and documents related to the issue will be crucial. Analysis of synthesis, document induction and environmental observation will be used. Subsequent interviews with employees of Jihlava Hospital and other relevant people will also play an important role. To evaluate the readiness of Jihlava Hospital, a risk analysis will be performed using the KARS method. The result will be a Plan of Emergency Preparedness, which will be given to the hospital. Thesis can also serve research purposes for hospitals to increase their preparedness for emergency situations.

This thesis deals with the perceptions of health care in healthcare facilities in South Bohemia as seen by the public. The theoretical part defines health care and health; it also informs about the quality of health care and its evaluation. It deals with health services, healthcare policy and reforms in this sector. It describes the current legislation, part which is international treaties or laws. As an example of a treaty, the thesis mentions Convention on the Protection of Human Rights and the Dignity of the Human Being with regard to the application of biology and medicine, or the Charter of Fundamental Rights and Freedoms. The section about laws mentions particularly Act No. 20/1966 Coll. on Public Health Care. In protecting the rights of patients, the Code of Patients? Rights plays an important role in. An essential part of theory is also the system of healthcare facilities, health services, healthcare professionals and the rights and obligations of various actors in the provision of health care. The objective of the thesis was to map client satisfaction with health care provided in healthcare facilities of South Bohemia. The research part, preceded by a preliminary study, was conducted by means of a quantitative questionnaire survey. The basic research group consisted of persons from the general public living in South Bohemia. In the end, two out of three hypotheses were conformed. They are: (1) health care in South Bohemia was perceived positively by the clients of healthcare facilities and (2) women perceive health care in South Bohemia more critically than men. The third hypothesis, the one that was not confirmed, showed that the clients of healthcare facilities in South Bohemia have not noticed any improvement of health care during the last five years. With regard to the outcome of the third hypothesis, a question can be brought forward as to whether health care is developing in the right direction. Therefore, it would be appropriate to pay more attention to this issue. The results can be published in professional journals and they can serve as inspiration for healthcare professionals. They may also contribute to public awareness of health care and health services in South Bohemia.

Dans un contexte hospitalier de multiplicité des usagers, de stress et différents contextes d’interactions des professionnels de la santé avec leur environnement physique à l’hôpital, cette étude doctorale a pour objectif de comprendre comment ces professionnels vivent dans leur environnement de travail et quels attributs de cet environnement physique facilitent leur travail et favorisent leur bien-être. Avec la construction de nouveaux grands centres hospitaliers universitaires (CHU) au Québec cette dernière décennie, l'environnement hospitalier est en mutation. Il intègre de nouvelles approches de conception pour atténuer le stress des utilisateurs et assurer leur bien-être, en utilisant l'approche de conception centrée sur le patient dans laquelle l'accent principal des concepteurs est mis sur son bien-être. Dans ce contexte, nous ne savons pas vraiment comment l'environnement physique affecte l’expérience vécue des professionnels de la santé, sachant également que la littérature scientifique montre un manque de connaissances acquises concernant leur interaction avec le cadre physique au travail. Inscrite dans une perspective constructiviste, cette étude a exploré le contexte de deux unités de soins du nouveau Centre Hospitalier de l’Université de Montréal. L’analyse des données est basée sur une approche comparative et interprétative des expériences vécues des professionnels de la santé à travers les entrevues de 44 participants, les cartes cognitives, l’observation de l'environnement physique et du comportement spatial de ces professionnels de la santé dans les deux unités de soins étudiées. Les résultats montrent que les professionnels de la santé évaluent favorablement leur environnement de travail. Cependant, ils perçoivent certains attributs de l'environnement physique comme peu facilitateurs ou générant du stress. Ce stress auquel ils font face, affecte aussi la qualité des soins mise en rapport avec l'environnement physique. Celui-ci affecte le fonctionnement et la gestion d'une unité de soins. Notre contribution consiste en la construction du portrait du vécu de ces professionnels, l’identification des enjeux de la qualité des soins et de limitation du stress de ces professionnels liés à l'environnement physique. Cette étude souligne l'importance d'adapter le système organisationnel et de gestion à la configuration spatiale de l’unité de soins pour atteindre une meilleure performance. / The objective of this doctoral research is to understand how healthcare professionals live in their work environment and what attributes of this physical environment facilitate their work and promote their well-being. The recent emerging hospital context and the construction of new large university hospital centres (CHU) in Quebec during the last decade have changed the nature of the hospital environment significantly. This new environment considers the multiplicity of users, stressors and multiple interactions of health professionals. Furthermore, this new hospital complex integrates new design approaches to alleviate users stress levels and ensure their well-being. The patient centred design approach implemented prioritizes the patient’s well-being and yet little is known about how the physical environment affects the experiences of healthcare professionals. This study examines these issues and their pertinence in light of prior scientific literature, that until recently has placed less emphasis on the healthcare professionals’ interactions within the physical work environment itself. Using a constructivist approach, this study explores these issues in the context of experiences within two care units at one new university hospital complex known as the CHU (Centre Hospitalier de l'Université de Montréal), Canada. Data collection methods included observations of the physical setting and healthcare experiences, supported by semi structured interviews and cognitive mapping that were used to collect data from 44 healthcare professionals. Data analysis uses both a comparative and interpretative approach to analyse the lived experiences of healthcare professionals from diverse perspectives. Results indicate that healthcare professionals evaluated their work environment as supportive. However, they perceived some attributes of the physical environment in this hospital as stressors and the stress faced by these professionals affect the quality of care of patients within the physical environment. The physical environment has an impact on the functioning of the care unit and its management. This study’s contribution includes establishing a portrait of the lived experiences of healthcare professionals and identify both the quality of care issues and the stress limitations among healthcare professionals as these are related to the physical environment. It highlights the importance of adapting the organizational and management system to the spatial configuration of care units in order to achieve optimal performance.

Master of Public Health - MPH / Background: According to the Joint United Nations Programme on HIV/AIDS (UNAIDS) 340 000 children between 0-14years of age are living with HIV in South Africa as of 2019. Decentralization of HIV services was included in South Africa’s paediatric guidelines since 2010 in a bid to improve access to care. The current study sought to address the paucity of Eastern Cape (EC) data on the outcomes of down-referred paediatric antiretroviral therapy (ART) patients. These outcomes included retention in care (RIC) and virological suppression after 12 months Methodology: This retrospective analysis was conducted in the Buffalo City Municipality (BCM) district of the EC. The study population included HIV positive males and females, 0-14 years of age at transfer, who were initiated on ART at a tertiary or a regional hospital and subsequently down-referred, between June 2013 and June 2017. Data were collected from electronic databases at the facilities (Tier.net), patient files and patient registers. A descriptive analysis was performed using SPSS Statistics software version 26. Results: In total, 80.1% of patients successfully down-referred to a primary healthcare (PHC) facility, in a median of 42 days. Of those, 95.4% of patients were retained in care at 6 months and 93.1% at 12 months after arrival, with a median of 4 scheduled monthly visits missed. For those with results, virological suppression was maintained in 96.7% of patients at 6 months, 92.2% at 12 months and 96.2% for the entire post-transfer period of 2-14 months. In the 2-14 months post down-referral only 76.9% of patients had at least one viral load (VL) result and 50.3% had one CD4 result. For those with results, immune response (IR) to ART was maintained in 100% of patients at 6 months, 94.3% at 12 months and 97.7% in the 2-14 month period post successful down-referral. Conclusions: This study confirmed that loss to follow-up (LTFU) and treatment interruption at the point of transfer are significant risk factors for paediatric ART patients. This study also demonstrated high levels of RIC once patients had successfully down-referred. However, missed clinic visits suggest possible treatment interruptions for many patients post down-referral. While good virological and immunological responses to ART were maintained at the PHC facilities, suboptimal VL and CD4 monitoring was highlighted by the low proportion of available results. Therefore, while there are a number of issues to address, this study confirms that down-referral is a feasible option for up-scaling paediatric HIV care in the EC.

Inom hälso- och sjukvården används stora mängder plast i allt från medicinska instrument till mat- och dryckesservering samt lokalvård. Plasten besitter egenskapersom både bidrar till att upprätthålla höga hygienkrav och skyddar mot livshotande virus. Stora mängder engångsplastprodukter används både eftersom det förenklarmaterialhantering för vårdpersonal samt eftersom flergångsprodukter ofta förknippas med infektionsrisker. Majoriteten av hälso- och sjukvårdens plastavfall förbrännsdäremot efter användning, vilket bidrar till ökade klimatförändringar och begränsarmöjligheterna att uppnå globala hållbarhetsmål. Då plasten anses nödvändig inomexempelvis sjukvården kan den inte helt fasas ut, däremot behöver materialåtervinningen öka. Ett hinder för återvinning är att plastavfallet potentiellt kan vara kontaminerat av läkemedel, kroppsvätskor eller smittförande ämnen som riskerar att vara hälso- ochmiljöskadliga. Plastavfall som blir kontaminerat kräver därför separat hantering frånövrigt avfall och ofta är det osäkert om avfallet är kontaminerat eller inte. Dennastudie ämnade att undersöka hur engångsplastprodukter hanteras inom hälso- ochsjukvården samt eventuella möjligheter och hinder för att skapa mer cirkulära plastflöden genom ökad materialåtervinning. Detta genom en kombination av en litteraturstudie och en fallstudie där möjliga åtgärder identifierades. Fallstudien genomfördes på lungmottagningen och kirurgavdelningen vid Gävle sjukhus där informationfrämst samlades in genom observationer och personlig kommunikation. Studien omfattar även en granskning av de besökta verksamheternas inköpsstatistik för att identifiera vilka plasttyper som förekommer i deras produkter. Resultatet tyder på att åtgärder för att underlätta en effektiv materialåtervinning avsjukvårdsplast kräver samarbete mellan aktörer i olika delar av produktens värdekedja, från de tillverkare som designar produkterna till de återvinnare som hanteraravfallet. För de besökta verksamheterna på Gävle sjukhus är några av de största hindren relaterade till platsbrist för utökad avfallssortering samt en stor variation av olikaplasttyper och material i de produkter som används. Slutsatser som kan dras är atten mer grundlig sammanställning av materialsammansättning i produkterna än densom återfinns i denna studie och en nära dialog med återvinnare krävs, för att implementera åtgärder för utökad materialåtervinning. En ökad utsortering av plastavfallfrån hälso- och sjukvården anses vara möjlig, men olika åtgärder kan krävas för olikatyper av plastavfall. / The healthcare sector consumes large amounts of plastic for different applications,from medical instruments to food and beverage service and facility maintenance.The properties of the plastics contribute to maintaining high hygiene standards andprovide protection against life-threatening viruses. Large quantities of single-useplastic products are used because it simplifies the work of healthcare staff and because reusable products are often associated with risks of infection. The majority ofplastic waste within healthcare is incinerated after use, which contributes to increased climate change and limits the opportunities to achieve global goals of sustainability. Since plastic is considered necessary within the healthcare sector, it cannot be completely phased out but the material recycling needs to be increased.  One obstacle to recycling is that the plastic waste can potentially be contaminated bypharmaceuticals, body fluids or infectious substances that risk being harmful tohealth and the environment. Contaminated plastic waste therefore requires separatehandling from other waste and it is often uncertain whether the waste is contaminated or not. This study aimed to investigate how single-use plastic products aremanaged within healthcare and potential opportunities and obstacles to create morecircular plastic flows through increased material recycling. This was done through acombination of a literature review and a case study where possible measures wereidentified. The case study was conducted at the Lung Department and the SurgeryDepartment at the Hospital of Gävle, where information was primarily collectedthrough a series of observations and personal communication. The study also includes an investigation of the purchasing statistics of the visited departments in orderto identify the types of plastic found in their products.  The results indicate that measures to facilitate an efficient material recycling ofhealthcare plastic require cooperation between actors in different parts of theproduct's value chain, from the manufacturers who design the products to the recyclers who handle the waste. For the visited departments at the Hospital of Gävle,some of the biggest obstacles are related to a lack of space for expanded waste sorting as well as a large variety of different types of plastic and materials in the productsused. Conclusions that can be drawn are that a more thorough compilation of material composition in the products than that found in this study, and a close dialoguewith recyclers, are required to implement measures for increased material recycling. An increased sorting of plastic waste from healthcare is considered possible,but different measures may be required for different types of plastic waste.