Considering contemporary lifestyle and possibility of travelling imported infections accrued and some illnesses come back that have not occurred nearly at us more. Not only haemorrhagic fevers and other highly infectious illnesses but also hospital multiresistant bacterial strains that mean high risk for patients constitute a threat. The number of nosocomial infectious grows still. The patient is in the case of suspicion or already diagnosed infectious illness isolated and treated in the infectious department or in the tribal department in the room with increased hygienic-epidemiologic regime. The patient is saved in a single room, the possibility of visits is reduced and the staff uses personal protective equipment. The man is holistic being and it can come due to isolation to lack of satisfaction of his/her bio-psycho-social needs. The aim of this thesis is to identify unsatisfied bio-psycho-social needs of patients in increased hygienic-epidemiologic regime and to describe changes in needs of the patient depending on the time of hospitalisation. The theoretic part describes the problematics of infectious illnesses, system of the care for the patient with infectious illness and changes in human needs in the period of the illness. The empiric part of the thesis deals with unsatisfied bio-psycho-social needs of isolated individual through quantitative research. The research suite was made up of 10 patients who were hospitalised in the room with increased hygienic-epidemiologic regime. The survey was carried out in the Hospital Jihlava by semistructured interview and the results of the survey were processed by opened coding by method paper and pencil. It is emphasized that the most needs of the patient have biological, psychical, social and even spiritual aspects. The rate of satisfaction with caregiving depends on the health condition and personality of the patient. Not small influence has the length of the hospitalisation, too. It was found out during the survey that the patients have not enough information about specifics of the care in the infectious department and that is why there is often a misunderstanding of necessity of barrier measures. It is possible to avoid useless misunderstanding through timely and suitable education. It was created an educational material with the title "Guide for patients hospitalised in the infectious department of Hospital Jihlava" for this purpose. Employees of the infectious department of Hospital Jihlava were informed with results of the research during a workshop, too.

Incidence of obesity-related diseases is greater in cases of morbid obesity, which leads to higher health risks. Primarily for those patients in whom clinical intervention proved unsuccessful, bariatric surgery has become viable for the treatment of severe obesity. Starting with a review of the medical literature, the discussion herein involves obesity and its magnitude in adults, placing emphasis on diagnostic criteria, epidemiological data, especially in obese women, etiology, comorbidities, and treatment. It also looks into the complexity of the surgical treatment, its techniques, indication and contraindication criteria, benefits, complications, and nutritional deficiencies. Lastly, women who underwent Capella surgery at the Alberto Antunes University Hospital at the Federal University of Alagoas and who were enrolled in its Bariatric Surgery Program had their metabolic and anthropological profiles assessed and discussed afterwards. One hundred and thirty-five women took part in this prospective study and were assessed preoperatively (T1) and between 12 and 24 months postoperatively (T2). They all underwent Fobi-Capella surgery and were divided into three 45-patient groups, according to different preoperative body mass index (BMI) terciles. Age, body mass (BMI), waist circumference, metabolic profile (total cholesterol, HDL-c, LDL-c, triglycerides, fasting glucose), comorbidities, and the use of medication were all taken into account. Patients signed an informed consent form. Statistical tests were employed when evaluating the groups. Mean age was 33.9 ± 9.3 years. Post-operative results showed a respective decrease of 38.1%, 37.9%, and 28.9% in body mass, BMI, and waist circumference. Serum levels of glucose, cholesterol, triglycerides, and LDL-c dropped 21.4%, 19.0%, 48.1%, and 28.1%, respectively. The HDL-c level rose 15.6%. Glycemic levels were brought to normal in all groups. Mean weight loss for the groups was 36.7%, 39.0%, and 38.4%. Patients in groups 1 and 2, preoperatively classified as having class 3 obesity, were deemed overweight at endpoint, whereas those in group 3 came down to class 1 obesity. As to waist circumference, all of them had shown much greater risk for metabolic complications, and only those patients in group 1 progressed to increased risk. The others remained unchanged. The most prevalent comorbidity was dyslipidemia, followed by gastric disorders, joint diseases, hepatic steatosis, systemic arterial hypertension, and diabetes mellitus. Hypertension decreased in 91.8% of the patients, and the remission of diabetes and dyslipidemia stood at 95.7% and 41.5% of the cases, respectively. Cardiovascular risk factors were significantly reduced and the use of medication fell 57.1%. Despite the different pre-operative BMI categories, there were no significant differences across the groups regarding the assessed variables. The three groups showed equally positive results in the follow-up period. / A incidência de doenças secundárias à obesidade é maior em obesos mórbidos, o que implica em grandes riscos à saúde. A cirurgia bariátrica constitui-se em opção de tratamento da obesidade severa com índice de sucesso consistente, especialmente para aqueles em que a intervenção clínica não alcançou resultados positivos. Este estudo discute a problemática e a magnitude da obesidade em adultos, com revisão da literatura, enfatizando critérios diagnósticos, dados epidemiológicos - especialmente em mulheres obesas - etiologia, comorbidezes e tratamento. Evidencia a complexidade do tratamento cirúrgico, as técnicas de cirurgia, critérios de indicação e contra-indicação, benefícios, complicações e deficiências nutricionais. Por fim, analisa e discute o impacto sobre o perfil metabólico e antropométrico de mulheres inseridas no Programa de Cirurgia Bariátrica do Hospital Universitário Profº Alberto Antunes da Universidade Federal de Alagoas, submetidas à cirurgia de Capella. Trata-se de um estudo prospectivo com cento e trinta e cinco mulheres em períodos pré-operatório (T1) e entre 12 a 24 meses de pós-operatório (T2), submetidas à cirurgia de Fobi-Capella e alocadas em três grupos de 45 componentes, segundo diferentes tercis de índice de massa corporal (IMC) pré-operatório. Foram avaliados idade, massa corporal (IMC), circunferência da cintura, perfil metabólico (colesterol total, HDL-c, LDL-c, triglicerídios, glicemia de jejum), comorbidades e uso de medicamentos. Os indivíduos selecionados assinaram o termo de consentimento livre e esclarecido. Testes estatísticos foram usados para analisar os grupos. A idade média foi de 33,9 ± 9,3 anos. Após a cirurgia houve diminuição de 38,1% da massa corporal, 37,9% do IMC e de 28,9% da circunferência da cintura, com redução dos níveis séricos de glicose, colesterol, triglicerídios e LDL-c em 21,4%; 19,0%; 48,1% e 28,1%, respectivamente. O HDL-c aumentou 15,6%. Os níveis glicêmicos normalizaram em todos os grupos. A perda ponderal média dos grupos foi de 36,7%; 39,0% e 38,4%. Os grupos 1 e 2, classificados no pré-operatório como obesidade classe 3, evoluíram para sobrepeso e o grupo 3 para obesidade classe 1. Quanto à circunferência da cintura, todos apresentavam risco muito aumentado para complicações metabólicas e apenas o grupo 1 evoluiu para risco aumentado, com os demais permanecendo na classificação anterior. Dentre as comorbidades, a dislipidemia foi prevalente, seguida de doenças gástricas, doenças articulares, esteatose hepática, hipertensão arterial sistêmica e diabetes mellitus. A hipertensão regrediu em 91,8%; houve remissão de 95,7% do diabetes e de 41,5% da dislipidemia. Observou-se evolução satisfatória dos fatores de risco cardiovasculares e redução de 57,1% do uso de medicamentos. Embora apresentassem diferentes categorias de IMC no período pré-operatório, não houve diferenças significantes quanto às variáveis analisadas entre os grupos, os quais se beneficiaram igualmente do acompanhamento e procedimento cirúrgico.

Bakgrund: Ett vanligt förekommande inslag i många människors liv är stress, som kan göra sig påmind som akut stress, fysisk stress eller den stress som många människor känner av i sin vardag. När människan känner stress aktiveras människans biologiska system för att hantera situationen och stresshormonet kortisol produceras bland annat. The World Health Organisation (WHO) har underrättat om att den materiella stressens roll under graviditeten och uppföljningsstudier har väckt oro för att avkommor från mödrar som utsätts för stress under graviditeten kan ha en ökad risk för specifika sjukdomar såsom missbildningar, astma och psykiska och beteendestörningar. Syfte: Att beskriva om stress under graviditet påverkar fostret och kan kopplas samman med folksjukdomar senare i livet. Metod: En allmän litteraturöversikt har genomförts genom att kunskap inom ett begränsat område kartlagts, beskrivits, kritiskt granskats och analyserats utifrån tio utvalda vetenskapliga artiklar inom ämnesområdet. I analysen valdes fyra teman ut och utifrån dessa fyra teman skapades fyra resultatrubriker. Resultat: Forskning visar att stress under graviditet påverkar barnet och kan kopplas samman med folksjukdomar senare i livet hos barnet. Diskussion: Stress under graviditet är ett komplext problem där många faktorer kan spela roll. Litteraturöversikten visar att de vanligast förekommande folksjukdomarna som diabetes, hjärt-och kärlsjukdom samt fetma, som alla är stora kostnader för samhället, skulle kunna vara resultat av stress under moderns graviditet. / Background: A common part of many people's lives is stress, which can be recognized as acute stress, physical stress or stress that many people experience during their daily lives. When a person feels stressed, the human's biological systems are activated to cope with the situation and the stress hormone cortisol is produced, among other things. The World Health Organization (WHO) has reported that the role of material stress during pregnancy, and follow-up studies has raised concerns that the offspring to mothers exposed for stress during pregnancy may have an increased risk of specific diseases such as malformations, asthma and mental and behavioral disorders. Aim: To describe how stress during pregnancy affects the foetus and can be linked with public illnesses later in the child’s life. Method: A general literature review has been conducted by mapping, describing, critically reviewing and analyzing knowledge in a limited area, based on ten selected scientific articles in the subject area. In the analysis, four themes were selected, and based on these four themes four headings were created. Results: Research shows that stress during pregnancy affects the child and can be linked to public diseases later in life. Discussion: Stress during pregnancy is a complex problem where many factors can play a significant role. The literature review shows that the most common public diseases such as diabetes, cardiovascular disease and obesity, all of which are major costs for society, could be the result of stress during mother's pregnancy.

Our diploma thesis entitled ?The system of prevention of social and pathological phenomena and its implementation at elementary schools? engages in the analysis of possibilities and conditions for and approaches to the implementation of primary pre-vention at elementary schools. The objective of the present diploma is to describe how systems of primary prevention work on the regional and school levels; accordingly, we have performed a comparison of different approaches to this issue at selected schools in the regions of South Bohemia and Pardubice. We have analyzed programmes of the aforesaid regions on the conceptual level, observing the implementation of preventive programmes at particular schools (such as elementary or special). Furthermore, we have examined the assistance as actually pro-vided to schools during the formation of school preventive programmes and their influ-ence on pupils or students as such. We are also interested in how the possibilities that are on offer for the cooperation among schools are utilized and how schools make use of grant programmes provided by regional authorities. The present thesis is divided into two parts, theoretical and practical. The theo-retical part first characterizes and defines basic terms, explaining the most common so-cial and pathological phenomena with the largest impact on the young. Second, a men-tion is made of the system of prevention at both the school and regional levels. Accord-ingly, the practical part focuses on the analysis of school activities in the area of preven-tion, particularly the methodology of prevention, the support of the formation of preven-tive programmes and the influence such programmes have on children. The conclusion summarizes presuppositions and hypotheses which are men-tioned in the introduction. A sociological survey has been conducted at selected schools by means of questionnaires, which will be evaluated at the end of our thesis.

Health and safety at work The topic of the diploma thesis is Health and safety at work (HSW). The topic has been chosen for its importance and topicality. The diploma thesis is structured into eight chapters. The first chapter gives a characterization of HSW. Safe and healthy working conditions are protecting employees and other people against harm to their health and safety. Ensuring of HSW is significant to employees, employers and society in general. The second chapter describes the history of HSW. The third chapter deals with the main legislation provided for the health and safety of people in the workplace. There are also described international organizations and their legal provisions in connection with HSW. The fourth chapter discusses the rights and obligations of both employers and employees. Employers have the primary responsibility for ensuring HSW. On the other hand, employees have to take reasonable care to protect their health and safety and the health and safety of other people in the workplace. Employers have a duty to cooperate with employees, or their representatives, on health and safety matters. There are also described rights of trade unions and representatives of employees in HSW. The fifth chapter describes further conditions for ensuring HSW. The sixth chapter discusses the...

Magister Public Health - MPH / Background: Globally, neonatal mortality (i.e. deaths occurring during the first month of life) accounts for 44% of the 11 million infants that die every year (Lawn, Cousens Zupan, 2005). Early detection of illness and referral of mothers and infants during the peri-natal period to higher levels of care can lead to substantial reductions in maternal and child mortality in developing countries. Establishing effective referral systems from the community to health facilities can be achieved through greater utilization of community health workers and improved health seeking behaviour. Study design: The Good Start Saving Newborn Lives study being conducted in Umlazi, KwaZulu-Natal, is a community randomized trial to assess the effect of an integrated home visit package delivered to mothers during pregnancy and post delivery on uptake of PMTCT interventions and appropriate newborn care practices. The home visit package is delivered by community health workers in fifteen intervention clusters. Control clusters receive routine health facility antenatal and postpartum care. For any identified danger signs during a home visit, community health workers write a referral and if necessary refer infants to a local clinic or hospital. The aim of this study was to assess the effectiveness of this referral system by describing community health worker referral completion rates as well as health-care seeking practices and perceptions of mothers. A cross- sectional survey was undertaken using a structured questionnaire with all mothers who had been referred to a clinic or hospital by a community health worker since the start of the Good Start Saving Newborn Lives Trial. Data collection: Informed consent was obtained from willing participants. Interviews were conducted by a trained research assistant in the mothers home or at the study offices. Road to Health Cards were reviewed to confirm referral completion. Data was collected by means of a cell phone (mobile researcher software) and the database was later transferred to Epi-info and STATA IC 11 for analysis. Descriptive analysis was conducted so as to establish associations between explanatory factors and referral completion and to describe referral processes experienced by caregivers. Significant associations between categorical variables were assessed using chi square tests and continuous variables using analysis of variance. Results: A total of 2423 women were enrolled in the SNL study and 148 had received a referral for a sick infant by a CHW by June 2010. The majority (95%) of infants were referred only once during the time of enrolment, the highest number of which occurred within the first 4 weeks of life (62%) with 22% of these being between birth and 2 weeks of age. Almost all mothers (95%) completed the referral by taking their child to a health facility. Difficulty in breathing and rash accounted for the highest number of referrals (26% and 19% respectively). None of the six mothers who did not complete referral recognised any danger signs in their infants. In only 16% of cases did a health worker give written feedback on the outcome of the referral to the referring CHW. Conclusion: This study found high compliance with referrals for sick infants by community health workers in Umlazi. This supports the current primary health care re-engineering process being undertaken by the South African National Department of Health (SANDOH) which will involve the establishment of family health worker teams including community health workers. A key function of these workers will be to conduct antenatal and postnatal visits to women in their homes and to identify and refer ill children. Failure of mothers to identify danger signs in the infant was associated with non-completion of referral. This highlights the need for thorough counseling of mothers during the antenatal and early postnatal period on neonatal danger signs which can be reinforced by community health workers. Most of the referrals in this study were neonates which strengthens the need for home visit packages delivered by community health workers during the antenatal and post-natal period as currently planned by the South African National Department of Health.Recommendations: This study supports the current plans of the Department of Health for greater involvement of CHWs in Primary Health Care. Attention should be given to improving communication between health facilities and CHWs to ensure continuity of care and greater realization of a team approach to PHC. / South Africa

Background: The Vaal Triangle is an area generally associated with a number of harmful determinants of health since it houses diverse industrial processes and industrial development in South Africa, hence being categorised as an outdoor air pollution priority area in 2006. Method: A cross-sectional inter-comparative study to the 1990 Vaal Triangle Air Pollution and Health Study (VAPS) was conducted in 2010. The main objectives of this study were to measure the prevalence of upper and lower respiratory illnesses of 10-year-old children in 2010 and compare those findings to the 1990 study, and lastly to identify risk and protective factors for respiratory illnesses in 1990 and in 2010. In addition, the association between exposure factors (risk and protective factors) that are sources of indoor air pollution and factors related to diet and household living conditions and their associations with upper and lower respiratory health illnesses in 1990 and 2010 was determined. Results and Discussion: The prevalence of the respiratory health outcomes in the 1990 study and 2010 study cannot be compared directly since a 1-year prevalence was determined in 1990 and a 6-month prevalence in 2010. Throughout the dissertation this should be kept in mind. The change in prevalence of a respiratory health outcome observed in 1990 and in 2010 is just an indication of the possible change. The 1990 1-year prevalence and the 2-week 2010 prevalence of asthma were the same in the two study populations (i.e. 12%). The 6-month prevalence of sinusitis, bronchitis and pneumonia in 2010 was lower when compared to the yearly prevalence of these illnesses in the 1990 study. On completion of the multivariate analyses, in 1990 study, the use of a gas heater acted as a risk factor for pneumonia (a lower respiratory illness), with a odds ratio of 3.67 (1.15-11.71) and a p-value of 0.03, whilst environmental tobacco smoke within the household was protective of hay fever and sinusitis (upper respiratory illnesses). In the 2010 study, the consumption of chicken and/or fish and fruit at least three times a week was protective of bronchitis (with odds ratios of 0.23 and 0.26 respectively). Conclusion and Recommendations: It is not certain whether the change in the respiratory health status of 10-year-olds living in the Vaal Triangle is real as the prevalence of health outcomes in the two studies cannot be compared directly to one another due to the differences in prevalence time periods in the two studies. Nevertheless, a statistically significant change was observed in the prevalence of sinusitis, earache, bronchitis, and pneumonia between the two study populations. It is imperative to have a study protocol; this ensures all levels of measure are consistent in both studies and leads to a dataset of high quality. There is also a need for more analytical epidemiological studies (i.e. cohort, time-series, case-crossover and panel studies) to be done in South Africa, addressing indoor and outdoor air pollution and respiratory health. / Dissertation (MSc)--University of Pretoria, 2013. / gm2014 / School of Health Systems and Public Health (SHSPH) / unrestricted

Thesis (M. A. (Clinical Psychology)) -- University of Limpopo, 2020 / The integration of mental health care (MHC) into primary health care (PHC) has been identified as a practical intervention to: increase accessibility to mental health care; reduce stigma and discrimination against people living with mental illnesses; improve the management of chronic mental illness; and, to reduce the burden of comorbidity of mental illnesses with other chronic illnesses. In the South African context, integrating MHC into PHC also seeks to respond to numerous legislative reforms, with the aim of providing comprehensive health care, particularly to previously disadvantaged populations. The aim of the present study was to explore the perceptions of facility managers in the Tshwane District (Gauteng Province) towards the integration of mental health into PHC. Fifteen participants from the Tshwane district facilities participated in the study. The participants were selected through a non-probability purposive sampling method. Data was collected through in-depth interviews using a semi-structured questionnaire, and analysed using the thematic coding approach. Significant findings suggested that the major hindrances to the realisation of the policy objectives may be due to: the lack of rehabilitation and psychotherapeutic services; insufficient skill and knowledge of mental health on the part of staff; insufficient or unsuitable practice space in the facilities; and, poor cooperation between South African Police Services, Emergency Medical Services and Primary Health Care. Inter-facility communication, district implementation support and policy knowledge has notably increased over the years and were deemed to be amongst the biggest enablers.

Thesis (MPH.) -- University of Limpopo, 2021 / Background: Chronic illnesses, including non-communicable diseases (NCDs), continue to be a public health concern, globally, and contribute to the high burden of diseases. These health challenges have led to the introduction of community health workers (CHWs) in both developed and developing countries as a way of dealing with these challenges. It is more than five years since ward-based outreach teams (WBOTs) were introduced into the Julesburg area in order to respond to the needs of the community, based on the government’s focus on quadruple burden of diseases. The researcher is aware of the increasing workload, unclear roles and responsibilities, different approaches to CHWs’ work taken, and the ever-changing focus of their work, based on the community needs and diseases that the community faces at a particular time. It is for this reason that the researcher is interested in understanding the CHWs’ experiences and the manner in which they cope with challenges when working in their ever-changing environment, workload, work focus and roles and responsibilities. Methods: A qualitative exploratory, descriptive and contextual study approach was used; data was collected using focus group discussions with CHWs and one-on-one interviews with key informants, using their supervisors to gather more information that could not have been shared by CHWs. Result: The findings from the focus group discussions revealed that the CHWs have a high workload, while receiving stipend and are not permanently employed. CHWs have had experiences that make them feel unimportant and not needed, as well as enduring poor working conditions without sufficient personal protective equipment (PPE). Even though they experience dissatisfaction, they are passionate about continuing with their community-based work for many years, evidenced by those who have up to 22 years of service.

Introducción: Las enfermedades mentales son un padecimiento frecuente en todo el mundo y las personas que las padecen suelen encontrarse bajo estereotipos, estigmatización y desoladoras circunstancias. La estigmatización por parte de los profesionales de la salud hacia las personas con trastornos psiquiátricos es una problemática que no es muy visibilizada, pero está presente tanto a nivel mundial como nacional y que afecta a la inserción, tratamiento y recuperación de estos pacientes, puesto que en su mayoría son etiquetados como agresivos e intimidantes. Objetivos: Determinar la actitud de los estudiantes de medicina humana ante la salud mental en cuatro dimensiones: autoritarismo, benevolencia, restricción social e ideología, según sexo y año de estudio. Metodología: Se realizó un estudio de tipo transversal, descriptivo, no experimental. Se empleó el cuestionario CAMI, determinando la actitud en cuatro dimensiones: Autoritarismo, Benevolencia, Restricción Social e Ideología hacia la comunidad, asociando las variables año de estudio y sexo. Resultados: Se encuestaron 231estudiantes de medicina humana, de los cuales un 69,7%, 70,1%, 68,8% y 60,2% presentaron una actitud favorable en las subescalas de Autoritarismo, Benevolencia, Restricción Social e Ideologías de la salud mental en comunidad respectivamente. Conclusiones: Los estudiantes de medicina mostraron una actitud favorable ante la salud mental, sin embargo, aún hay un porcentaje significativo que presentó una postura desfavorable. No se encontró diferencia significativa en cuanto al sexo ni al año de estudio. / Introduction: Mental illnesses are a common condition throughout the world and people who suffer from them often find themselves under stereotypes, stigmatization and bleak circumstances. Stigmatization by health professionals towards people with psychiatric disorders is a problem that is not highly visible, but is present both globally and nationally and that affects the insertion, treatment and recovery of these patients, since they are mostly labeled as aggressive and intimidating. Objectives: To determine the attitude of medical students towards mental health in four dimensions: authoritarianism, benevolence, social restriction and ideology, according to sex and year of study. Methodology: A cross-sectional, descriptive, non-experimental study was carried out. The CAMI questionnaire was used, determining the attitude in four dimensions: Authoritarianism, Benevolence, Social Restriction and Ideology towards the community, associating the variables year of study and sex. Results: 231 medical students were surveyed, of which 69,7%, 70,1%, 68,8% and 60,2% presented a favorable attitude in the subscales of Authoritarianism, Benevolence, Social Restriction and Ideologies of mental health in the community respectively. Conclusions: Medical students showed a favorable attitude towards mental health, however, there is still a significant percentage that presented an unfavorable attitude. No significant difference was found in terms of sex or year of study.