Magister Educationis - MEd / This thesis constitutes an investigation into the effects of literacy in a community which is severly disadvantaged. The thesis explored various ways in which the concept of literacy could be examined and the political assuments implied in each literacy orientation. In order to explore the effects of literacy following conventional research procedures a pilot study was conducted. During the pilot the data revealed that statistical analysis could not capture the political and 'liberational'nuances generated by literacy. In the light of this, it became necessary to adopt a mode of analysis which could capture the effects of the literacy. This study therefore constitutes a description of the, advantages and disadvantages of radically switching to a different paradigm in the life of a single project.

Indiana University-Purdue University Indianapolis (IUPUI) / “Gendered and Racialized Experiences at Central State Hospital, Indianapolis, 1877 – 1910” analyzes the treatment of African American patients at the now-defunct Central State Hospital in Indianapolis, Indiana, throughout the Gilded Age and Progressive Era, from the late 1870s through the 1900s. This thesis examines the impact of scientific racism and institutionalized sexism on female African American patients’ diagnoses, medical treatment, and the outcome of institutionalization through a close reading of hospital publications and a series of statistical studies of patient data. This thesis also analyzes the intersection of race and gender through the case study of one African American woman, Elizabeth Williams Furniss, who was institutionalized during the 1890s until her death in 1909. I argue that scientific racism and a deeply entrenched sexism significantly shaped the treatment of African American patients and women of all races throughout the Gilded Age and Progressive Era. Preconceived notions of race, gender, and class determined diagnoses, treatments, and treatments outcomes, without regard to individual patients’ needs. I also suggest ways for historians to identify and measure the impact of scientific racism and institutionalized sexism on African American patients in northern psychiatric institutions through statistical studies of patient data.

p. 1-86 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-29T18:03:22Z No. of bitstreams: 2 33333333.pdf: 473549 bytes, checksum: 2dfc0eae6a08355c84462ec48c9de043 (MD5) 222222.pdf: 73067 bytes, checksum: 62d7d785e8b9b6793b8b5e8481c1505a (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-04T17:37:16Z (GMT) No. of bitstreams: 2 33333333.pdf: 473549 bytes, checksum: 2dfc0eae6a08355c84462ec48c9de043 (MD5) 222222.pdf: 73067 bytes, checksum: 62d7d785e8b9b6793b8b5e8481c1505a (MD5) / Made available in DSpace on 2013-05-04T17:37:16Z (GMT). No. of bitstreams: 2 33333333.pdf: 473549 bytes, checksum: 2dfc0eae6a08355c84462ec48c9de043 (MD5) 222222.pdf: 73067 bytes, checksum: 62d7d785e8b9b6793b8b5e8481c1505a (MD5) Previous issue date: 2008 / Neste estudo procura-se descrever o desempenho do Ministério Público Estadual na defesa do direito à saúde garantido pela Constituição Federal de 1988 às pessoas com transtorno mental autoras de delito, quando o procedimento jurídico que lhes é aplicado ainda contempla a internação compulsória por determinação judicial, sob o argumento de propiciar o tratamento psiquiátrico que suprimiria a suposta periculosidade desses agentes, apesar da vigência da Lei n° 10.216/2002 que reorienta a atenção à saúde mental, privilegiando o tratamento próximo da família e de base comunitária. O objetivo é descrever a trajetória do Ministério Público do Estado da Bahia, iniciada em fevereiro de 2003, no cumprimento de uma de suas atribuições constitucionais, por ocasião de uma crise instalada no Hospital de Custódia e Tratamento Psiquiátrico da Bahia que acarretou agravos à saúde dos internos e violações à sua dignidade enquanto pessoas humanas. Os resultados alcançados através de um Termo de Ajustamento de Conduta decorreram de propostas construídas por um grupo de trabalho interistitucional e interdisciplinar, voltadas para a recuperação física e reorientação das práticas, no sentido de superar o estado crítico daquele Hospital e preservar a população interna, até que a mudança de paradigmas legais venha a estender a essas pessoas, as práticas de saúde mental afinadas com o ideal da Reforma Psiquiátrica. / Salvador

About 30.00% of schizophrenic patients fail to respond to conventional antipsychotics. Clozapine shows superior efficacy, for both the positive and negative symptoms of schizophrenia, over conventional antipsychotics. The reputation of clozapine lies mainly with its repeated proven efficacy in the treatment of refractory schizophrenia. However, clozapine has quite a severe side effect profile. Patients receiving clozapine therapy may develop serious adverse effects such as agranulocytosis, neutropenia and metabolic syndrome. Therefore guidelines are required which recommend that regular haematological and metabolic monitoring be performed. These monitoring guidelines should assist medical practitioners in the early detection and reporting of serious adverse effects associated with clozapine therapy. South Africa lacks uniform provincial or national guidelines regulating practices in the treatment of mental disorders. International guidelines may be considered, which are not specifically adapted for the South African setting. These guidelines recommend both the haematological and metabolic monitoring of clozapine. At present there are no South African guidelines recommending the metabolic monitoring of clozapine. The general aim of the study was to determine the prescribing and monitoring patterns of clozapine at Elizabeth Donkin Hospital in the Nelson Mandela Metropole. Due to the absence of specific South African guidelines and the severe side effect profile of clozapine, some of the research objectives were to determine whether the initiation of clozapine, as well as the haematological and metabolic monitoring performed, was compliant with international clinical guidelines. In this pharmacoepidemiological study a retrospective drug utilisation review was performed. The study was observational in design and included quantitative data. Data were collected from the files of 65 patients (N=65) discharged on clozapine between 1 December 2010 and 29 February 2012. Follow-up investigations were performed at the clinics and long-term care centres both three months and six months after discharge. In 52.30% (n=34) of the cases clozapine was previously prescribed. Compliance with the National Institute for Health and Clinical Excellence (NICE) guidelines for the appropriate initiation of clozapine was 63.10% (n=41). Compliance with the Standard Treatment guidelines for the initiation of clozapine by a psychiatrist was 63.10% (n=41). Noncompliance with the recommended guidelines for haematological monitoring occurred in 77.40% of patients in the hospital setting (n=48) as well as in 95.70% of patients during the three-month follow-up at the clinics (n=44). Non-compliance with the guidelines for metabolic monitoring occurred in all the observed patients in the hospital setting (n=62) as well as in 45.70% of patients in the clinic setting (n=21). It was found that 71.00% (n=46) of patients were still on clozapine three months after discharge and 65.00% (n=42) were still on clozapine six months after discharge from hospital, resulting in discontinuation rates of 29.00% and 35.00% respectively. It was found that clozapine was inadequately monitored although in most cases the initiation of clozapine was compliant with the recommended guidelines. However, practitioners should be trained on the existing prescribing and monitoring guidelines to promote the rational use of clozapine in the public health sector of South Africa. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

About 30.00% of schizophrenic patients fail to respond to conventional antipsychotics. Clozapine shows superior efficacy, for both the positive and negative symptoms of schizophrenia, over conventional antipsychotics. The reputation of clozapine lies mainly with its repeated proven efficacy in the treatment of refractory schizophrenia. However, clozapine has quite a severe side effect profile. Patients receiving clozapine therapy may develop serious adverse effects such as agranulocytosis, neutropenia and metabolic syndrome. Therefore guidelines are required which recommend that regular haematological and metabolic monitoring be performed. These monitoring guidelines should assist medical practitioners in the early detection and reporting of serious adverse effects associated with clozapine therapy. South Africa lacks uniform provincial or national guidelines regulating practices in the treatment of mental disorders. International guidelines may be considered, which are not specifically adapted for the South African setting. These guidelines recommend both the haematological and metabolic monitoring of clozapine. At present there are no South African guidelines recommending the metabolic monitoring of clozapine. The general aim of the study was to determine the prescribing and monitoring patterns of clozapine at Elizabeth Donkin Hospital in the Nelson Mandela Metropole. Due to the absence of specific South African guidelines and the severe side effect profile of clozapine, some of the research objectives were to determine whether the initiation of clozapine, as well as the haematological and metabolic monitoring performed, was compliant with international clinical guidelines. In this pharmacoepidemiological study a retrospective drug utilisation review was performed. The study was observational in design and included quantitative data. Data were collected from the files of 65 patients (N=65) discharged on clozapine between 1 December 2010 and 29 February 2012. Follow-up investigations were performed at the clinics and long-term care centres both three months and six months after discharge. In 52.30% (n=34) of the cases clozapine was previously prescribed. Compliance with the National Institute for Health and Clinical Excellence (NICE) guidelines for the appropriate initiation of clozapine was 63.10% (n=41). Compliance with the Standard Treatment guidelines for the initiation of clozapine by a psychiatrist was 63.10% (n=41). Noncompliance with the recommended guidelines for haematological monitoring occurred in 77.40% of patients in the hospital setting (n=48) as well as in 95.70% of patients during the three-month follow-up at the clinics (n=44). Non-compliance with the guidelines for metabolic monitoring occurred in all the observed patients in the hospital setting (n=62) as well as in 45.70% of patients in the clinic setting (n=21). It was found that 71.00% (n=46) of patients were still on clozapine three months after discharge and 65.00% (n=42) were still on clozapine six months after discharge from hospital, resulting in discontinuation rates of 29.00% and 35.00% respectively. It was found that clozapine was inadequately monitored although in most cases the initiation of clozapine was compliant with the recommended guidelines. However, practitioners should be trained on the existing prescribing and monitoring guidelines to promote the rational use of clozapine in the public health sector of South Africa. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

Within the framework of ethnography, an inquiry was made into the many dimensions of psychological treatment and training in a psychiatric hospital, with particular reference to State Patients. Ethnography is the study of an intact cultural or social group based mainly on observations over a prolonged period of time in which the researcher is a participant. The multicultural aspects of the therapeutic community were also inquired into. Ethnographic data was collected and processed over a period of 16 years in three psychiatric hospitals, the main source of data gathered from Weskoppies Hospital in Pretoria. The ecosystemic psychotherapeutic perspective was used as a meta-model to describe eight therapeutic approaches in which intern-psychologists were trained. The hospital is described as a therapeutic community in which rehabilitation is a multi-professional responsibility. Each profession, or sub-culture, has its own framework and culture in which it works within the broader system of the psychiatric hospital. Ethical considerations and recommendations are levelled at the academic and practical aspects of clinical psychology, hospital management, and different levels of government. / Psychology / D.Litt. et Phil.

The purpose of this study was to explore alcohol use among psychiatric in-patients in a mental hospital in Ethiopia. A quantitative, descriptive, cross-sectional study design was used. Data were collected through face to face structured interviews and a document analysis checklist. A researcher-modified interview-version of the Alcohol Use Disorder Identification Test (AUDIT) questionnaire was used to measure alcohol use. The study population comprised of 70 psychiatric in-patients. Data analysis showed that being male, living in an urban area, being diagnosed with schizophrenia, and having parents who drink alcohol had a statistical significant association with the alcohol use of the respondents. Respondents reported that it was difficult to abstain or stop using alcohol. They also felt discriminated against when forbidden by relatives to drink. It was alarming to find that thioridazine, which has been discontinued in most countries for the treatment of psychosis, was still being prescribed in Ethiopia. The study highlighted the need for health education to strengthen patients’ perceptions about the negative consequences of alcohol use. Care should be taken when prescribing psychotropic drugs such as thioridazine to psychiatric in-patients because of possible cardiotoxic effects. / Health Studies / M.A. (Public Health)

This thesis is a microhistorical investigation of the dynamics of control and resistance in Pollsmoor Prison and Valkenberg Psychiatric Hospital’s Maximum Security section from 1964 to 1994 in South Africa. It examines the evolution of daily life inside these institutions, both situated in the Western Cape, and the extent to which these institutions were part of the security apparatus developed by the apartheid state. The permeability of Pollsmoor and Valkenberg shed light on the connections between repression, resistance, collaboration and survival inside and outside closed institutions. The division of incarcerated populations according to race, gender, age and behaviour reflected wider logics of governance of the South African society. Similarly, the modalities of resistance and collaboration adopted by ‘political’, ‘common law’ and ‘insane’ prisoners on the inside echoed the processes of popular mobilisation on the outside. The construction of a ‘healthy nation’ through the production and control of deviances was hence far from being a smooth process. The thesis is divided into three parts, each composed of three chapters. The first part analyses the way a system of law and order, based on delineation, the bestowal of privileges and violent repression, was imposed in prisons and psychiatric hospitals’ Maximum Security sections and how this evolved according to the changing social and political imperatives of the apartheid state. The second part shifts the gaze to the level of the courts, where psychiatric and criminological discourses became increasingly entangled throughout the period. The operating modalities of the judicial system reflected the fears and expectatives of the white minority, while providing a racialised image of black populations as both dangerous and childlike. Finally, the third part analyses the links between outside and inside resistances and adaptations to the regime of apartheid. It focuses on the 1994 prison revolts as prisms to understand the processes of subjectivation and politicisation which had emerged in closed institutions during apartheid.

Univerzita Karlova v Praze 1. lékařská fakulta Studijní program: Specializace ve zdravotnictví Obor: Adiktologie Bc. et Bc. Kristýna Kopecká Nutriční návyky pacientů léčících se ze závislosti na alkoholu ve vybraných psychiatrických nemocnicích The Nutritional habits of Pacients Recovering From Alcohol Addiction in Selected Psychiatric Hospitals Diplomová práce Vedoucí práce: PhDr. Lenka Čablová PRAHA 2016 Abstract Introduction: Nutritional habits significantly affect the health and quality of life and they are an important part of a healthy lifestyle. Following nutritional recommendations is very important for the general population as well as for people recovering from alcohol dependence. One of the goals of treatment is improving the quality of life and well-balanced diet can actually help. Goals: The main objective of the research is to determine what are the eating habits of people recovering from alcohol dependence during their stay in selected psychiatric hospitals. Another objective is to determine the difference in eating habits of respondents before entering treatment and after entering treatment. The aim is also to describe the relationship between dietary habits and socio-demographic data. It is set as a sub-goal to also map the results of the YFAS questionnaire. Methods and sample: A tool...

M.Cur. / Violence and aggression in psychiatric hospitals are a worldwide known phenomenon. South Africa is no exception to the rule. Previous researches conducted in psychiatric institutions have mainly focused on the patients, leaving everyone to guess how this violence affects nurses who are in contact with the patients on a daily basis and who are key role-players in the care, treatment, and rehabilitation of the patients under their responsibility. The research aimed to explore and describe the lived experience of aggression and violence by the registered nurses in a Gauteng psychiatric institution, the essence of this violence, and how nurses cope with this violence, in order to formulate guidelines and recommendations that could assist them to manage violence. A qualitative, explorative, descriptive, and contextual study design was utilised. Data was collected by means of semi-structured interviews, and naïve sketches. Tesch’s method was used for data analysis, here and an independent coder was utilised. The uniqueness of this study was to bring to the surface the other side of violence as it is perceived and lived by the nurses. The findings show that the nurses face violence on a daily basis. Among the contributing factors there are: the type of patients admitted in the hospital; the staff shortage; the lack of support among the members of the multidisciplinary team (MDT); and the lack of structured and comprehensive orientation. The consequences of this violence to the nurses are emotional, psychological, and physical and take the form of: fear, anger, frustration, despair, hopelessness and helplessness, substance abuses, absenteeism, retaliation, a development of an “I don’t care attitude”, injuries, and damage to personal properties such as clothes, and spectacles.