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Abstract Tuberculosis (TB) is the leading cause of death from a single infectious disease. Unfortunately, 4.1 million cases were missed in 2017 globally, and Nigeria contributes 9% of the missing TB cases. At least 73% of the estimated TB cases in Nigeria were not reported in 2017 to the National TB Program (NTP); therefore, the true burden of TB was not certain, and this affected planning for prevention and control of TB. This quantitative secondary data analysis (NTP Lagos TB Inventory study database) guided by the integrated behavioral model assessed TB underreporting based on the TB reporting process in Nigeria. Chi-square and binomial logistic regression were used to assess the association between TB underreporting and the characteristics of health facilities (HFs), health workers' (HWs) awareness, barriers to TB reporting, and patient-related factors. The results indicate at least 60% of all HFs underreported TB, with an average of 7.4% underreporting between HFs records and TB program reports. There was a statistically significant association between NTP nonengaged health facilities (χ2 (1) = 20.547, p <.05), HWs' awareness of TB reporting (χ2 (1) = 6.576, p <.05), and barriers for TB reporting (χ2 (1) = 4.106, p < .05) with TB underreporting. The following patient factors were statistically significant predictors of TB underreporting with over 50% increased odds, p<0.05: previously treated, extrapulmonary, unknown TB site, HIV negative, and HIV unknown. This study supports social change through NTPs ensuring the establishment of a coordinating mechanism for TB reporting within and between HFs and supply of TB reporting tools to all HFs to know the true burden of TB for better planning and monitoring of quality care for TB patients.

Aim of the Master thesis is: To evaluate the education demand of the health literacy program in the Kaunas University Hospital. Goals of the paper are: 1. To reveal the interface between the knowledge and behavior of the patients treated in the Kaunas University Hospital. 2. To motivate the education demand of the patients’ health literacy. Research methodology: From December of 2005 to January of 2006 the autonomous survey of the Kaunas University Hospital respondents, using the standardized questionnaire, designed for the patients, was accomplished. 183 patients participated (96.3 % response rate) in the survey. The research material was processed using the SPSS statistical package of data analysis. Research results: The patients who had enough knowledge on the health maintenance (52,2 %) more valuated their health (76,1 %) (χ² = 18; LLS = 4; p = 0,001) as well as were careful about their health while were healthy (67 %) (χ² = 26,3; LLS = 4; p = 0,000), and when got sick have changed their lifestyle and behavior: have changed their nutrition habits (45,8%), have reduced their weight (44 %), tried to leave off smoking (32 %), tried to drink less alcohol (90 %). Because of an unsuitable communication of health specialists, using many complicated medical concepts the patents are not able to understand the provided health information (69,7 %) (χ² = 46; LLS = 4; p = 0,000), and therefore perform worse the medical prescription (16,2 %) (χ² = 19,2; LLS = 4; p = 0,001)... [to full text]

<p> Measurements of soil atmosphere, soil physical parameters, coliform levels and ionic levels were made at 15 soil sites along Ancaster and Grindstone Creeks in winter, 1972-73 and July, 1973. Multivariate analysis of the data indicated large fluxes of septic effluent resulted in soil fabric alterations, anaerobosis, and elevated coliform, nitrate, chloride and sodium levels. According to ecological and health criteria, these hydromorphic soils have very serious limitations as processors and absorbers of septic effluent. </p> / Thesis / Master of Science (MSc)

1. Unterschiedliche Definitionen der Gesundheit mit verschiedenen Betrachtungsweisen (WHO: Der Mensch eine biopsychosoziale Einheit. Schulmedizin: ohne klinischen und paraklinischen Befund mit Orientierung an kritikbedürftigen Referenzmittelwerten) führt bei Fachleuten, Behörden und Laien zu Verwirrungen, wenn es um die Beurteilung gesundheitlicher Schäden geht. 2. Es wurde die Aufgabe gestellt zu prüfen, welche der beiden Definitionen der Realität näher kommt. 3. Mittels der chronopsychobiologischen Regulationsdiagnostik, des Dreiphasenentspannungstests (Hecht und Balzer 2001), wurden unter dem Aspekt der beiden Gesundheitsdefinitionen drei Gruppen untersucht (je 40 Probanden). - klinisch Gesunde (klinisch Gesunde nach Schulmedizin ) - Gesunde nach Definition der WHO - Probanden mit nichtorganische Insomnie (ohne pathologische klinische und paraklinische Befunde) 4. Die mit den verwendeten Methoden gewonnenen Daten wiesen aus, dass zwischen den klinisch Gesunden und den Probanden mit nichtorganischer Insomnie weitgehend größere Ähnlichkeiten bestehen. Beide Gruppen zeigten aber zu der Gruppe der Gesunden nach WHO-Definition, welche die biopsychosoziale Einheit des Menschen berücksichtigt, noch hochsignifikante Unterschiede. Die Gruppe der klinisch Gesunden kann daher auf Grund unserer Ergebnisse nicht den Anspruch erheben, real gesund zu sein. 5. Mit der Bezugnahme auf die Internationale Klassifikation der Krankheiten (ICD 10F) haben die von uns untersuchten klinisch Gesunden und die nichtorganischen Insomniker eine mehr oder weniger stark ausgeprägte Symptomatik von psychischen Störungen. Dies müsste bei der Beurteilung von Schadstoff-, Lärm-, und EMF-Wirkungen auf den Menschen, wie auch bei den klinisch-pharmakoloischen Untersuchungen beachtet werden. Die in der Arbeit erzielten Ergebnisse bedürfen durch weitere Untersuchungen eine Fundierung. Sie signalisieren aber sowohl unter praktischen als auch unter theoretischen Aspekten einen dringenden Forschungsbedarf. / 1. Differing definitions of health using different criterea (WHO: The human being as a bio- psycho-social unit versus classical medicine: without clinical and paraclinical results based on suspect reference values) bring confusion to experts, authorities and laymen when assessing health damages. 2. The given task was to check which of the two definitions is closer to reality. 3. Using the chrono-psycho-biological diagnostic of regulation, the three-phase-relaxation test (Hecht and Balzer 2001), three groups were examined considering the aspects of the two health definitions (40 test subjects in the study group). - clinically healthy (clinically healthy per classical medicine definition) - healthy per definition of the WHO - test persons with non organic insomnia (i.e. no pathological or paraclinical findings) 4. The data gained from the employed methods revealed bigger similarities between clinically healthy persons and those with non organic insomnia. Both groups still showed highly significant differences to the group which fulfils the definition of the WHO regarding a human as a bio-psycho-social unit. As a result of this study, persons, though classified as "clinically healthy" might nevertheless not absolutely be healthy in reality. 5. In reference to the international classification of illnesses (ICD 10 F) the groups examined, both of clinically healthy and those with non organic insomnia, have more or less severe psychological symptoms. This should be taken into account when assessing the effects of pollution, noise, and EMF as well as clinical pharmacological studies. These present findings still need broader confirmation by further investigations. However, they clearly indicate, for practical and theoretical considerations, an urgent need for further research.

Made available in DSpace on 2011-05-04T12:36:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / A presente dissertação tem como propósito geral discutir estratégias de ensino implantadas tanto na formação de profissionais de saúde de nível superior quanto de nível médio que utilizam como premissa a relação prática-teoria-prática. Estas estratégias têm ganhado posição de destaque nos debates atualmente traçados em prol da realização de mudanças na formação no campo da saúde. Inicialmente é apresentado o contexto em que surge esse movimento de mudança, suas principais críticas e princípios. Analisam-se as Diretrizes Curriculares Nacionais dos Cursos de Graduação em Saúde fazendo um paralelo com as Diretrizes Curriculares Nacionais para o Ensino Técnico área da saúde, apontando algumas de suas similaridades e particularidades. Relatam-se experiências de ensino no nível superior, a partir de textos levantados na base de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), disponível no site da Biblioteca Virtual em Saúde(BVS). Apresenta-se ainda uma discussão sobre os processos de ensino integrados a serviços de saúde, aprofundando a questão da inserção de alunos no serviço desde o início de seu curso universitário. São descritas nove experiências dessa inserção precoce, apresentando a ótica dos autores acerca dos principais obstáculos enfrentados e seus resultados. Em relação ao nível médio, é narrada a experiência pedagógica da Escola Politécnica de Saúde Joaquim Venâncio (EPSJV), da Fundação Oswaldo Cruz (FIOCRUZ), e que visa realizar a integração entre os conteúdos abordados em sala de aula e a prática profissional. A EPSJV tem posição de destaque na produção de conhecimento acerca da formação de técnicos em saúde. Ao descrever e analisar esta experiência, tenta-se aproximar questões comuns ao nível superior e médio de formação de trabalhadores para o sistema de saúde. / The main purpose of this work is to discuss educational strategies currently used in Brazil at both under graduate and university health education. These strategies have as proposition the use of the ratio practice-theory-practice and are gradually gaining more space on the debates that battle to change the education on the health sector. Initially, the context in which this change activity emerges, its main critiques and principals are presented. An analyses of Brazil’s national curricular guideline concerning under graduate and university education to the health sector is made, pointing out its similarities and particularities. The educational experiences that take place at the university are reported based on articles brought up at a virtual Latin- American data base called Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), which its content is possible to access by a virtual health library home page called Biblioteca Virtual em Saúde (BVS). The educational processes that take pace at health services are also discussed. At this matter, it is given emphasis on a strategy commonly called in Brazil as “early introduction”, in which students are taken to health services since their first year of graduation. Nine of these kinds of experiences are described, showing the authors vision concerning the main obstacles faced and their results. About under graduate education, the document presents the Escola Politécnica de Saúde Joaquim Venâncio’s (EPSJV), one of Fundação Oswaldo Cruz’s (FIOCRUZ) units, experience. The purpose of this strategy is to better integrate the contents approached during classes and the professional practice. This school in particular has a prominent status at the academic knowledge production involving under graduate education to the health sector. By describing and analyzing its experience, attempts to approximate the similarities between under graduate and university education of health workers to Brazil’s health system.