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Health facilities generate thousands of tons of waste each year, including non-hazardous waste, hazardous substances, radioactive substances, and infectious substances. This number is increasing as our country continues to develop, as is public concern about its negative effects on human health. Through this study, an adequate management of hospital waste from its origin to its final disposal is suggested, focusing on the correct segregation of waste, since this will minimize the impact. In each medical facility it is necessary to establish a biological treatment system for contaminated waste; in accordance with the provisions of the Hygiene Technical Reference: "Management and total management of solid waste in health establishments, medical support services and research centers", through which the physical, chemical or biological properties of the biologically contaminated waste, to reduce or eliminate the potential danger to your health and the environment, until its final disposal.For this reason, we consider that in each seat of regional government a plan for the generation of biocontaminated waste from EESS should be implemented, managed by the Ministry of Health, with alternative treatment solutions to disinfect biocontaminated waste, the receptivity of the infrastructure for final treatment of biological polluting waste, in an ecological environment., Los establecimientos de salud generan miles de toneladas de desechos cada año, incluidos desechos no peligrosos, sustancias peligrosas, sustancias radiactivas y sustancias infecciosas. Este número aumenta a medida que nuestro país continúa desarrollándose, al igual que la preocupación pública por sus efectos negativos en la salud humana. A través de este estudio se sugiere una adecuada gestión de los residuos hospitalarios desde su origen hasta su disposición final, enfocándose en la correcta segregación de los residuos, ya que esto minimizará el impacto. En cada establecimiento médico es necesario establecer un sistema de tratamiento biológico para los desechos contaminados; de conformidad con lo establecido en la Referencia Técnica de Higiene: “Gestión y manejo total de residuos sólidos en establecimientos de salud, servicios de apoyo médico y centros de investigación”, a través del cual se evaluarán las propiedades físicas, químicas o biológicas de los residuos biológicamente contaminados, para reducir o eliminar el peligro potencial para su salud y el medio ambiente, hasta su disposición final.Por ello, consideramos en cada sede de gobierno regional debería de implementarse un plan de generación de residuos biocontaminados de los EESS, gestionado por el Ministerio de Salud, con soluciones alternativas de tratamiento para desinfectar residuos biocontaminados, la receptividad de la infraestructura para el tratamiento final de residuos contaminantes biológicos, en un entorno ecológico.

Background: State patients are admitted to a psychiatric hospital after being declared as such by the magistrate courts as a result of not found fit to stand trial for the offence they had committed. After successful rehabilitation of state patients at the psychiatric hospital, they need to be re-integrated into their families. Family members’ perceptions regarding re-integration of male state patients are not largely explored in the scientific body of knowledge. Aim: The aim of the study was to determine the perceptions of family members regarding reintegration of male state patients into their families. Setting: This study was conducted in Vhembe District of Limpopo province, South Africa. Method: A qualitative approach using explorative, descriptive and contextual designs was adopted. In-depth interviews were conducted with 10 family members who were purposefully sampled, and data were thematically analysed using Tech Open Coding method. Results: Three themes emerged, namely, family members understand re-integration; family members’ expectations from a mental healthcare user; and threat to re-integration as perceived by family members. Conclusion: Data revealed that family members have varied perceptions regarding re-integration. These perceptions were based on the behaviour displayed or an offence committed by the mental healthcare user before admission and how participants experienced it. The study recommends that an investigation is to be conducted on the kind of support family members need regarding re-integration of state patients into their families.

Background The main focus of the Traditional Health Practitioners Act No 22 (2007) is the regulation of traditional healing in South Africa. The role player who has to deliver this traditional health service to the public is the statutorily recognized traditional health practitioner. However, thus far the precise health practice offered, training and the practitioner’s role as a healer in the society, have not been clearly defined. The various definitions and descriptions in the literature of the identity of the traditional healer are contradictory, making the formulation of a single definition and meaning impossible. Aims The study aimed to determine a definition for traditional health practitioner. Methods This is an exploratory and descriptive study in line with the modern historical approach of the investigation and review of the available research. The emphasis is on using documentation like articles, books and newspapers as primary resources to reflect on everyday thinking and opinions around the identity of the traditional healer. The findings are represented in narrative format. Results The Traditional Health Practitioners Act’s regulations, as embedded in its 52 Sections, create a legal framework of definitions. One specific definition outlines what is meant by the traditional health practitioner. This definition includes four sub-types of healers, namely the diviner, herbalist, traditional birth attendant and traditional surgeon. Various other names for and types of traditional healers seem to exists outside the Act’s statutory definitions. It also seems as if the practice scopes, training and methods of diagnosis and treatments of these different healers are not uniform. Conclusion It seems that the legal definition of a traditional health practitioner, as offered by the Traditional Health Practitioners Act No 22, is vague and insufficiently formulated. This shortcoming frustrates the intention of the Act to make the traditional health practitioner the exclusive role player who has to deliver a traditional health service to the public

Background In 2007, a practice directive was issued for the new legal entity traditional health practitioner with the promulgation of the Traditional Health Practitioners Act (No 22 of 2007) in the Republic of South Africa. Although the Act describes this new pathway in terms of various definitions, the future practice rights and impact on healthcare were left undefined and unwritten. To date the negative legal implications and career consequences that the Act has for the regulated health practitioners, have gone unnoticed. The derogation and degrading of their work domains and rights, seem of no concern.1 Aims The aim of the present study is to determine and describe the unwritten new practice rights of the traditional health practitioner. Methods This is an exploratory and descriptive study in line with the modern historical approach of investigation by means of a literature review. The emphasis is on using documentation such as articles, books and newspapers as primary resources to reflect on the traditional health practitioner’s new unsaid and unwritten future practice rights. Results The future practice and services of traditional health practitioners seem to incorporate many new unwritten practice rights and activities, which is contrary to the Act’s written intentions. Conclusion The new traditional health practitioner‘s future practice rights are legally comprehensive and masked. It holds serious consequences for the practices of the established healthcare professions.

Background Before the promulgation of the Traditional Health Practitioners Act No 22 (2007), there was no formal guideline or training culture to steer traditional healing in South Africa. Training was and is still mostly informal. Sometimes a new healer is trained by other traditional healers. In many cases, the traditional healer is self-taught without any learning whatsoever. Aims The present study aims to describe the various resolutions of the Act to plan, develop and manage traditional healthcare training in the future. Methods This is an exploratory and descriptive study in line with the modern historical approach of investigation and review. The emphasis is on using contemporary documentation, like articles, books and newspapers, as primary resources to reflect on the development and promulgation of the Traditional Health Practitioners Act No 22 (2007). The findings are offered in a narrative format. Results It seems that Act No 22 (2007) was promulgated without comprehensive research and in-depth discussion on training with all the role players who have a vested interest. Conclusion It is clear that training ideals such as formal study programmes, qualified staff and institutional bodies to train and to educate future traditional healers are not immediately attainable. The nearly ten years of minimal activity to enact Act No 22 since its promulgation confirms this failure. Inexpensive and uncomplicated training paths are needed until a system can be developed. One such path is the continuation of informal in-house training with another traditional healer

Currently, it’s a major concern of the hospital managers and managers of the solid wastes from healthcare services. In order to promote the adequate management of this waste, each establishment is responsible for designing, implementing and monitoring the plan of healthcare wastes management. Therefore, the present study aims to implement the plan of healthcare wastes management at Hospital Municipal de São Pedro do Sul - RS, through the application of a spreadsheet of performance indicators to the management process of the healthcare wastes. In order to reach the proposed objective, a survey of the important indicators in the management process of healthcare wastes in the hospital was carried out, through bibliographical / documentary research, technical visits, on-site observations, photographic records, conversations with employees involved in management of healthcare wastes, and data collection. A spreadsheet with these indicators was then prepared and applied to the local reality from hospital. At the end, a spreadsheet with 55 indicators distributed in 8 categories was obtained. This spreadsheet incorporated the legal parameters and reflected the environmental performance of the health facility, highlighting more critical issues of the management system of the healthcare wastes at hospital, allowing strategic direction to improve actions. We also quantified the healthcare wastes production at hospital under study. It was found that Group D - Nonrecyclable waste contributed the most representativeness (71%), followed by Group A waste (16%), waste from the group D - recyclable (7%) and Group E waste (6%). Sensization activities were carried out on the management of healthcare wastes at to hospital professionals. Subsequently, a diagnosis was made of the level of knowledge about the healthcare wastes of the hospital professionals, through the application of semi-structured interviews, in two scenarios: Scenario I (before sensitization activities) and Scenario II (after sensitization activities). Before the sensitization activities, 78.57% of the professionals didn’t know if the hospital had a plan of healthcare wastes management, and 89.29% never had access to this document. These data demonstrate the importance of the hospital to implement a system of continuing education addressing the issue of management of healthcare wastes for all employees. Atualmente, uma grande preocupação dos gestores dos estabelecimentos hospitalares é o gerenciamento dos Resíduos Sólidos de Serviços de Saúde (RSSS).Com o propósito de promover a adequada gestão destes resíduos, cada estabelecimento é responsável por elaborar, implementar e monitorar o Plano de Gerenciamento de Resíduos de Serviços de Saúde (PGRSS). Por conseguinte, o presente estudo tem como objetivo avaliar a implementação do PGRSS no Hospital Municipal de São Pedro do Sul (HMSPS) – RS, por meio da aplicação de uma planilha de indicadores de desempenho relevantes ao processo de gerenciamento dos RSSS. Para atingir o objetivo proposto, foi realizado o levantamento dos indicadores importantes no processo de manejo dos resíduos no HMSPS, mediante pesquisa bibliográfica/documental, visitas técnicas, observações in loco, registros fotográficos, conversas com funcionários envolvidos no manejo dos RSSS, apontamentos e levantamento de dados. Ao final, obteve-se uma planilha com 55 indicadores distribuídos em 8 categorias. Esta planilha foi aplicada à realidade local do hospital, sendo que incorporou os parâmetros legais e refletiu o desempenho ambiental do estabelecimento, evidenciando questões mais críticas do sistema de gerenciamento dos RSSS e permitindo direcionar estrategicamente as ações de melhoria. Também foi realizada a quantificação da produção de RSSS no hospital em estudo, constatando-se que os resíduos do Grupo D - Não recicláveis contribuem com a maior representatividade (71%), seguidos dos resíduos do Grupo A (16%), resíduos do grupo D – recicláveis (7%) e Resíduos do Grupo E (6%).Foram realizadas atividades de sensibilização sobre o gerenciamento de RSSS aos profissionais do hospital. Em seguida, efetuou-se um diagnóstico do nível de conhecimento sobre RSSS dos profissionais do hospital, por meio da aplicação de entrevistas semiestruturadas, em dois cenários: Cenário I (antes da realização de atividades de sensibilização) e no Cenário II (após realização de atividades de sensibilização). Antes das atividades de sensibilização, 78,57% dos profissionais não sabiam informar se o hospital possuía PGRSS, sendo que 89,29% nunca tiveram acesso a esse documento. Esses dados demonstram a importância do hospital implantar um sistema de educação continuada, de caráter permanente, abordando a temática de gestão de RSSS para todos os funcionários.

Basic purpose of this study is about investigating the effects of intellectual capital on job satisfaction and organizational attractiveness during the person-organization fit on employees of university hospital. For this purpose; questi on form, which created with personal information form, job satisfaction scale, organizational attractiveness scale, capital perception scale and person-organization fit scale, was applied on 330 persons, who work for university hospital. The statistical technics was used for testing the hypotheses, which were created for this study; “Pearson Correlation Analysis Linear” and “Multivariate Regression Models”. The results of study put forward that the intellectual capital structure of health establishment is effective on health employees to get job satisfaction and to find their establishment as attractive.

Nés au cours de la deuxième moitié du XIXe siècle, les hospices maritimes se développent rapidement sur les divers littoraux italiens. Si le modèle hospitalier constitue une référence typologique incontournable pour les acteurs confrontés à ce nouveau type architectural, il est toutefois indéniable que les bâtiments conçus au bord de la mer, pour le soin des enfants atteints de tuberculose, ont dès le début essayé de se défaire de l’aspect quelque peu sinistre et morne propre aux établissements de santé. C’est ainsi qu’ils jouent un rôle primordial dans l’histoire des colonies de vacances dont la naissance sera intimement liée aux partis architecturaux, aux visées thérapeutiques et aux innovations technologiques mis au point au sein des hospices maritimes. Maritime hospices began to be created along the Italian coast during the second half of the nineteenth century. The architectural model of the hospital was undoubtedly the typological reference for the actors dealing with this new building type. But at the same time it is clear that for these buildings, designed at the seaside for looking after children suffering from tuberculosis, these actors attempted to avoid the rather sinister and depressing aspects characteristic of health establishments. These buildings consequently play an essential rôle in the history of holiday colonies. The earliest of these colonies were inspired by the architectural choices, the therapeutical aims and the technological innovations first developed in these maritime hospices.