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1
Eccleston, Anthony L., and n/a. "Coordinating information provision in government agencies using an integrated information management strategy." University of Canberra. Information, Language & Culture Studies, 1996. http://erl.canberra.edu.au./public/adt-AUC20060404.123006.
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The specific aims of this study were determined on a conceptual appreciation that
management of information assets and services in some government agencies was
deficient in meeting both existing and developing demands. This appreciation
manifested itself in a commitment to investigate the principles and processes
intrinsic to existing management methodologies, to relate these processes to the
needs of users, and to determine a strategy which could more ably meet the
information provision requirements of those users.
The achievement of these aims predicated the use of the case study research
method, selecting as the first case study the Department of Human Services and
Health (DHSH), an agency that had recognised that a problem existed in the
provision of information services, and had initiated action to address that
problem. As a counter, the Department of Defence, an agency which adrmts to a
problem, but which had yet to initiate an active, global program for its resolution,
was chosen as the second case study.
A theoretical model, which reflects extant international thinking and practice, was
initially constructed in order to establish a basis on which to ascertain and
evaluate the information management circumstances of the two case study
departments. This model specified the objectives considered to be fundamental
to effective information management in a public service environment. It included
studying the foundation repositories of information services from which
information in the portfolio domains of government are sought. These services
are the traditional records centres or registries, the library services which provide
a repository of published and grey material in printed, image and magnetic
formats, and the computerised networks holding electronic records at varying
levels of development.
An analysis of findings was carried out separately on each case study agency
before bringing the data together for cross-case analysis. In order to maximise
the veracity and validity of the data collected and its subsequent interpretation by
the researcher, the draft analysed case study findings were submitted to the
respective agencies for review and critique. All matters of substance received
have been incorporated in the final version.
The findings from the two case studies and the cross-case analysis confm that,
despite significant advances in some specific agencies, the initial hypothesis that
government agencies are still deficient in providing optimum services to meet the
information needs of users, is demonstrated. The advances that have been made,
however, similarly support the other thesis hypotheses that the implementation of
an integrated information management strategy in any government agency will
provide a foundation for improved information provision and the timely delivery
of relevant available information to the user.
Finally, a model of optimum processes involved in such a strategy, derived from
the theory and practical products of this study, is offered. This could be the
subject for future evaluation and testing for realistic and functional application.
2
Long, Lynn Hunt. "Relationship Between Extent of Extracurricular Participation, Employment, and Substance Use Among Middle and High School Students." UNF Digital Commons, 2004. http://digitalcommons.unf.edu/etd/288.
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This study examined the relationship between student use of substances and extent of participation in school and/or community sponsored sport or nonsport activity. The study also examined student substance use and extent of participation in sport or nonsport activity together with extent of employment.
Data were provided by 24,699 public school youths who attended grades 6 through 12 and completed the 2001-2002 Duval Secondary Substance Use and Violence Survey: Knowledge, Attitudes, and Behaviors. Frequency tables, crosstabulation, chi-square tests, and loglinear analysis were used to analyze the data.
The study found: (a) a higher percentage of respondents who participated in 11 or more hours of sport/athletic activity or nonsport activity reported using substances almost every day than did respondents who participated in 1-5 hours of activity (b) a higher percentage of students reported using alcohol almost every day when involved in greater than 20 hours of work per week and 11 or more hours of sport/athletic or nonsport participation than did those with lesser involvement in activity in conjunction with work at any level.
Extracurricular programs and student employment may function as protective factors in discouraging adolescent substance use. Extracurricular programs and student employment may also place the student at greater risk for substance abuse when such involvement exceeds 20 hours per week in work and more than 11 hours per week of extracurricular activity.
While extracurricular programs and student employment should be designed and offered to encourage widespread student participation, extent of participation should be monitored to assure healthy participation.
3
Pusateri, Cassandra G. "Mental Health Services in Appalachia." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/3160.
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4
Davies, Ian. "Emerging management education issues for the human services." Thesis, University of Bristol, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.343294.
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5
Ali, Shaun Kevin. "Quebec's health and social services in transition : managing change." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=100737.
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Purpose. To explore the experiences of healthcare managers at a reformed CSSS (Centres de sante et de services sociaux) in Montreal, Quebec and to document the provincial reforms. The objective is to understand the managers' experiences during a period of transition.Method. This study consists of two methods: a document review of relevant policies and reforms of Quebec's health and social services. Secondly, qualitative interview methods were used to explore the experiences of seven managers within a CSSS and their attitudes towards the reform.
Results. Managers described the following: a new window of opportunity, importance of leadership in the reform process, distorted communication, environment of trust, and culture of the organisation.
Conclusion. Quebec's health and social services is an ongoing discourse. Distorted communication creates an atmosphere of uncertainty which hinders the reform process. Implications include the need for further research in understanding healthcare professionals and other actors in the reform process.
6
Skiba, Lindsay M. "Assessment of Disordered Eating Behaviors in College-Aged Female Health and Human Services Majors." Kent State University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=kent1351865179.
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Cook, Jacqueline S. "With good intentions: Appalachian service providers in human services and community mental health." Diss., Virginia Polytechnic Institute and State University, 1986. http://hdl.handle.net/10919/76485.
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This study is a self-assessment of a small group of Appalachian face-to-face service providers in human services and community mental health. It has evolved from their daily experiences. The purpose of the study has been to reflect back to these providers information about themselves. That reflection has been given in the form of an Adlerian life style analysis, a psychological assessment for individuals modified as assessment of a group.
The reflected impression provided its own image for change and an opportunity for the participants to assess what impact, if any, their jobs might be having on other aspects of their lives. In the process of informing the participants about themselves, there has been the intent to give that same information to the people who come for services, supervisors, administrators, policy makers, and ultimately the community of academics and scholars.
The author of this study functioned as a co-worker with the other participants, becoming a part of that system which she was observing. The job gave wide access for observation and work with the participants in a variety of settings. The primary interactions took place in the homes of families referred for alleged child abuse and neglect, to include sexual abuse.
The methodology allowed the research effort to be one of exploration and evolution. Based on the notion expressed by Carol Ehrlich that people can do research for and about themselves rather than having others do it for them, it drew from several theorists, described in order of their use in the study: H.T.Wilson, Brian Fay, Alfred Adler, Stephen Fawcett, and George Gazda.
Presenting one subjective view of reality, conclusions of the study pointed to unconscious guilt on the part of participants with respect to system inadequacies, marked by a desire to feel superior in the helping relationship or in the relationship with those perceived to have authority over them. Unaware of these feelings, and in the simple performance of their jobs, the participants help to perpetuate the systems in which they work and often purport to deplore.Ph. D.
8
Yalcindag, Semih. "Human resource planning models for home health care services : assignment and routing problems." Thesis, Châtenay-Malabry, Ecole centrale de Paris, 2014. http://www.theses.fr/2014ECAP0041.
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L'affectation des patients aux soignants et le séquencement des visites à effectuer par les soignants sont deux problématiques intéressantes observées dans les établissements de soins décentralisés tels que les établissements d'HAD (Hospitalisation à Domicile), de SSIAD (Soins et services infirmiers à Domicile) ou de MAD (Maintien à Domicile). Le premier problème consiste en effet à décider quels soignants fourniront quels services (visites) à quels patients, tandis que le second vise à déterminer la séquence de visites de chaque soignant. Du point de vue de la modélisation, ces deux problèmes peuvent être résolus par une approche séquentielle qui comprend deux étapes ou une approche simultanée. Bien que les résultats de l'approche simultanée soient plus précis en raison de la résolution des problèmes d'affectation et de routage en même temps, son application semble être peu adaptée à des situations réelles, souvent de grande échelle. Dans cette thèse, nous nous concentrons sur l'approche en deux étapes qui considère successivement le problème d'affectation (assignment) et de séquencement (routing) afin de comparer ses performances à celles obtenues par l'approche simultanée. Ainsi, plusieurs variantes de modèles mathématiques sont développées en tenant compte de : (1) la compatibilité de compétences entre les patients et les opérateurs, (2) périodes de planification uniques ou multiples, (3) contraintes au niveau des capacités disponibles des soignants. Le verrou scientifique au niveau de l'approche en deux étapes concerne essentiellement l'estimation de la durée des déplacements des soignants, estimations qui sont nécessaires pour résoudre le problème d'affectation. A cette fin, nous proposons une méthode utilisant des données empiriques basée sur la technique de régression de Kernel (Kernel Regression Technique) permettant d'estimer les durées de déplacement. Cette méthode utilise des données historiques sur les durées de déplacement qui intègrent plusieurs facteurs réalistes concernant les conditions cliniques des patients et les conditions géographiques, ou encore les préférences personnelles des soignants afin d'estimer la durée nécessaire pour visiter un ensemble de patients situés dans la zone de service donnée. Des études numériques basées sur des données réelles en provenance d'un établissement d'HAD italien sont réalisées pour analyser les performances de la méthode d'estimation proposée. Les résultats obtenus montrent que cette nouvelle méthode d'estimation ainsi que l'approche en deux étapes sont des approches prometteuses pour traiter des problématiques de planification de ressources humaines dans les établissements d' HAD, SSIAD ou MADThe care givers' assignment and routing problems are relevant issues for Home Health Care (HHC) service providers. The first problem consists of deciding which care givers will provide services to which patients, whereas the second aims at determining the visiting sequences of care givers. From a modelling perspective, these problems can be solved with either a two-stage approach or a simultaneous approach. Although the currently most known simultaneous approach yields more accurate results by solving the assignment and routing problems at the same time, its resolution remains computationally difficult and not viable for large scale applications. In this thesis, we focus on the two-stage approach that sequentially solves an assignment and a routing problem in order to compare its performances to those of the simultaneous approach. Hence, several variants of mathematical models are developed by taking into account: (1) the skill compatibilities between patients and operators; (2) single or multiple planning periods; (3) imposed or released operator capacity restrictions. An important point regarding the two stage approach concerns the estimation of care givers' travel times that are required to solve the assignment problem. For this purpose, we propose an empirical data-driven method that is based on the Kernel Regression technique to estimate travel times. Such a method uses care givers' historical travel times that integrate several realistic factors such as cared patients' clinical conditions and locations or care givers' personal preferences to estimate the time necessary for visiting a set of patients located in the HHC service area. Numerical studies based on realistic problem instances are used to analyze the performances of the proposed data-driven travel time estimation method and the two-stage approach. Results obtained show that both the newly developed travel time estimation method and the two-stage models are promising approaches for the HHC human resource planning process
9
Pittaway, JK. "Chickpeas and Human Health: The effect of chickpea consumption on some physiological and metabolic parameters." University of Tasmania Library, Special & Rare Material Collections, 2006. http://eprints.utas.edu.au/930.
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Pulses (legumes) are a common dietary constituent of ethnic communities
exhibiting lower rates of cardiovascular disease (CVD). The following
studies examined the effect of including chickpeas in an 'Australian' diet
on CVD risk factors. Participants were free-living volunteers aged 30 to 70
years.
Study 1 investigated the effect of chickpeas on serum lipids, lipoproteins,
glycaemic control, bowel function and satiation (degree of fullness leading
to meal cessation) compared to a higher-fibre wheat-supplemented diet
(Chapter 2). Participants completed two controlled dietary interventions
(chickpea-supplemented and higher-fibre wheat-supplemented), isocaloric
with their usual dietary intake, in random order. The design of the
intervention diets was for matched macronutrient content and dietary fibre
however increased consumption of polyunsaturated fatty acids (PUFA)
during the chickpea-supplemented diet was noted. Small but significant
reductions in mean serum total cholesterol and low density lipoproteincholesterol
(LDL-C) were reported following the chickpea diet compared to
the wheat. Statistical analysis suggested a relationship between increased
consumption of PUFA and reduction in cholesterol during the chickpea
intervention but could not discern the source of PUFA. Chickpea
supplementation did not adversely affect bowel function and participants
found them very satiating. There was no effect on glycaemic control. A
small, sub-study compared the effects of an isocaloric, lower-fibre wheat diet to the higher-fibre wheat, to evaluate the effect of quantity of fibre as
well as source on bowel health and satiety. During the lower-fibre wheat
intervention, some participants reported lower satiation, and poorer bowel
health.
Some of the results from this study were included in a larger, collaborative
study investigating the effect of chickpeas on serum lipids and lipoproteins
in two centres, Launceston and Melbourne. The Melbourne group followed
a similar controlled, random crossover comparison of a chickpeasupplemented
diet to a higher-fibre wheat-supplemented diet, also
endeavouring to match macronutrient content and dietary fibre. The
Melbourne group also reported small but significant reductions in mean
serum LDL- and total cholesterol but reported discrepancies in
consumption of PUFA as well as dietary fibre between the intervention
diets. Statistical analysis of the combined results suggested a relationship
between increased consumption of PUFA and dietary fibre and a reduction
in cholesterol during the chickpea intervention. Appendix 1 is a description
of this collaborative study, formatted as a scientific paper, accepted for
publication.
Study 2 investigated whether results from the controlled study would
translate to ad libitum situations (Chapter 3). The study followed an
ordered crossover design where participants followed their habitual ad
libitum dietary intake for four weeks (familiarisation phase), incorporated a
minimum of four 300g (net weight) cans of chickpeas per week for 12 weeks and then resumed their habitual diet for another four weeks (usual
phase). Small but significant reductions in body weight, body mass index
(BMI), serum TC, fasting insulin and HOMA-IR occurred following the
chickpea phase, compared to the post-chickpea usual phase. Results
suggested that participants positively altered their eating pattern during the
pre-chickpea familiarisation phase, sustained these changes during the
12-week chickpea phase but regressed during the usual phase.
Participants consumed significantly more dietary fibre and PUFA during
the chickpea phase and less total fat and saturated fatty acids (SFA)
compared to the usual phase. Perceived bowel health remained constant
throughout the study, while satiation increased significantly during the
chickpea phase along with a small but significant reduction in mean body
weight.
Incorporating chickpeas into an 'Australian' style diet resulted in increased
consumption of PUFA and dietary fibre that produced small but significant
reductions in serum TC, BMI and glycaemic control, high satiation and little
effect on bowel function. Individuals wishing to reduce CVD risk may
choose to include chickpeas in their diet.
10
Speldewinde, Peter Christiaan. "Ecosystem health : the relationship between dryland salinity and human health." University of Western Australia. School of Population Health, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0127.
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Australia is experiencing widespread ecosystem degradation, including dryland salinity, erosion and vegetation loss. Approximately 1 million hectares (5.5%) of the south-west agricultural zone of Western Australia is affected by dryland salinity and is predicted to rise to 5.4 million hectares by 2050. Such degradation is associated with many environmental outcomes that may impact on human health, including a decrease in primary productivity, an increase in the number of invasive species, a decrease in the number of large trees, overall decrease in biodiversity, and an increase in dust production. The resulting degradation affects not only farm production but also farm values. This study examines the effects of such severe and widespread environmental degradation on the physical and mental health of residents. Western Australia has an extensive medical record database which links individual health records for all hospital admissions, cancer cases, births and deaths. For the 15 diseases examined in this project, the study area of the south west of Western Australia (excluding the capital city of Perth) contained 1,570,985 morbidity records and 27,627 mortality records for the 15 diseases examined in a population of approximately 460,000. Environmental data were obtained from the Western Australian Department of Agriculture?s soil and landscape mapping database. A spatial Bayesian framework was used to examine associations between these disease and environmental variables. The Bayesian model detected the confounding variables of socio-economic status and proportion of the population identified as Aboriginal or Torres Strait Islander. With the inclusion of these confounders in the model, associations were found between environmental degradation (including dryland salinity) and several diseases with known environmentally-mediated triggers, including asthma, ischaemic heart disease, suicide and depression. However, once records of individuals who had been diagnosed with coexistent depression were removed from the analysis, the effect of dryland salinity was no longer statistically detectable for asthma, ischaemic heart disease or suicide, although the effects of socio-economic status and size of the Aboriginal population remained. The spatial component of this study showed an association between land degradation and human health. These results indicated that such processes are driving the degree of psychological ill-health in these populations, although it remains uncertain whether this 4 is secondary to overall coexisting rural poverty or some other environmental mechanism. To further investigate this complex issue an instrument designed to measure mental health problems in rural communities was developed. Components of the survey included possible triggers for mental health, including environmental factors. The interview was administered in a pilot study through a telephone survey of a small number of farmers in South-Western Australia. Using logistic regression a significant association between the mental health of male farmers and dryland salinity was detected. However, the sample size of the survey was too small to detect any statistically significant associations between dryland salinity and the mental health of women. The results of this study indicate that dryland salinity, as with other examples of ecosystem degradation, is associated with an increased burden of human disease.
11
Fry, Pamela Rae. "Phenotypic and Genotypic Characterization of Clostridium difficile of swine and human origin." The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1306880656.
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Cameron, Chris. "Ensuring the welfare of the child : an actor-network theory based analysis of the activities of Human Fertilisation and Embryology Authority Inspectors." Thesis, University of Huddersfield, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.247468.
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Wilkinson, Michael John. "Human and environmental factors associated with HIV/AIDS high-risk behaviour in homosexual and bisexual men in the West Midlands, United Kingdom." Thesis, University of Warwick, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.357400.
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Dail, Adriana Marcella. "Access to Health Services and Health Seeking Behavior Among Former Child Soldiers in Manizales, Colombia." Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6489.
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Through the Colombian Institute for Family Welfare (ICBF), the Colombian government aims to provide comprehensive reintegration for children demobilized from the country’s various armed groups. The reestablishment of rights, including the right to health (guaranteed by the Colombian constitution), is a key factor in successful reintegration. This thesis explores the topic of access to health care and health seeking behavior among former child soldiers in Manizales, Colombia who are over the age of 18 and were previously in the Hogar Tutor program (foster care-based youth reintegration) in Manizales. This thesis utilizes semi-structured interviews (n=9) and body mapping (n=9) with former child soldiers, key-informant interviews, participant observation, and a review of archival and secondary sources, including survey data, which is used to complement this research. This research is focused on understanding the barriers participants are experiencing in accessing health care, how participants understand and experience health and the health care system, and how health is handled within reintegration programs. Findings illustrate the incompatibility of transitional justice and the right to health within a neoliberal health system. This research suggests that former child soldiers face significant barriers in access to health care, experience persistent health conditions related to the conflict, and may be insufficiently aware of their rights as both citizens and victims of the armed conflict. These challenges likely affect the ability of former child soldiers to successfully reintegrate. This thesis provides recommendations for future research, as well as for the implementation of- and changes to- health education efforts within the ICBF and the Colombia Agency for Reintegration (ACR).
15
Lloyd, Bridget. "Stakeholder perceptions of human resource requirements for health services based on primary health care and implemented through a national health insurance scheme." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_7813_1363786823.
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In 2007, at its 52nd Conference in Polokwane, the African National Congress (ANC) called for the implementation of a National Health Insurance (NHI) scheme. The announcement resulted in much debate, with critics voicing concerns about the state of the public health system, lack of consultation and the expense of a NHI scheme. However, little attention has been paid to the
human resource (HR) needs, despite the fact that 57% of recurrent expenditure on health1 is on HR. This research aimed to identify the HR requirements to support the implementation of an effective and equitable health system funded by a NHI in South Africa. An overview of the current burden of disease and distribution of HR is provided. Through interviewing key stakeholders the study attempted to elicit information about factors which will hamper or assist in developing such a health system, specifically looking at the HR situation and needs. The research explores HR
odels and proposes key HR requirements for implementation of a health system funded by a NHI in South Africa, including skills mix and projected numbers of health workers and
proposes ways to improve the deficient HR situation. Exploratory qualitative research methods were used comprising in-depth individual interviews, with a purposive sample of key informants, including: public health professionals and health managers (working in rural and urban areas)
researchers
academics and NGO managers. The contents of the interviews were analysed to identify common responses about and suggestions for HR requirements within the framework of a NHI. 1 Personal communication Dr Mark Blecher, Director Social Services (Health), National Treasury, 17 July 2009 The literature review includes policy documents, position papers and articles from journals and bulletins. Key informants were asked to identify literature and research material to support recommendations. The research findings indicate that despite the South African Government&rsquo
s expressed commitment to Primary Health Care (PHC), the National Department of Health has continued to support and sustain a clinical model of health service delivery (Motsoaledi, 2010), primarily utilising doctors and nurses. The clinic based services are limited in their ability to reach community level, and, being focused on curative aspects, are often inadequate with regard to prevention, health promotion and rehabilitation services. While the curricula of health professionals have been through some changes, the training has continued to be curative in focus and the clinical training sites have not been significantly expanded to include peripheral sites. While there are many Community Health Workers in the country, they remain disorganised and peripheral to the public health system. The mid level worker category
has not been fully explored. Finally there are no clear strategies for recruitment and retention of health workers in rural and under-resourced areas. In addition to the continued use of a clinical model, transformation of the health system hasbeen hampered by inadequate numbers of health workers, particularly in the rural and periurban townships and informal settlements. There is no clear strategy for addressing the critical
health worker shortage in under-resourced areas, particularly rural areas. The last section makes recommendations, which will be submitted to the relevant task teams working on the NHI. It is intended that recommendations arising out of the research will influence the process and decisions about HRH within a NHI funded health system.
16
Walker, Benjamin F. "The advent of managed care an examination of the impact on behavioral human service delivery /." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 2006. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.P.A. )--Kutztown University of Pennsylvania, 2006.Source: Masters Abstracts International, Volume: 45-06, page: 2963. Typescript. Abstract precedes thesis as 2 leaves. Includes bibliographical references (leaves 77-84).
17
Sandu, Adriana Iuliana. "Poverty, institutions and child health in post-communist rural Romania a view from below /." Related electronic resource: Current Research at SU : database of SU dissertations, recent titles available full text, 2006. http://proquest.umi.com/login?COPT=REJTPTU0NWQmSU5UPTAmVkVSPTI=&clientId=3739.
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Minn, Pierre H. "Health as a human right and medical humanitarianism on the Haitian-Dominican border." Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=83129.
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At a government hospital in the town of Dajabon, in the northwestern Dominican Republic, doctors and nurses must make decisions on whether or not to treat Haitian patients who have crossed the border in search of health care. This thesis examines the discourses and practices of Haitian patients and Dominican health care providers in the context of two co-existing but contrasting rhetorics: health as a human right, and medical humanitarianism. Using data collected through semi-structured interviews and participant observation, I examine how social, political, and economic forces shape medical encounters on the Haitian-Dominican border.
19
Sockett, Paul Nigel. "The economic and social impact of human salmonellosis in England and Wales : a study of the costs and epidemiology of illness and the benefits of prevention." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1993. http://researchonline.lshtm.ac.uk/682221/.
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This thesis presents a detailed analysis of illness related costs of human salmonellosis In England and Wales, estimated at £263 million (minimum), including intangible costs, in 1988, and explores potential benefits of preventive activities aimed at the poultry industry. To explore trends In reported infection and the factors which may influence those trends, salmonella reporting between 1960 and 1989 was examined. Trends in foodborne Illness were associated with increased reporting of salmonella infection. The factors which contributed to this increase included Intrinsic factors such as the microbiological quality of food, and extrinsic factors such as ambient temperature which may amplify intrinsic effects. Evidence that poultry products were important vehicles of human Illness was supported by trends in infections in animals and poultry, and food consumption patterns. Thus a significant decrease in human infection would result from reduction in poultry contamination. The findings of a unique and detailed survey of 1,482 human salmonella cases, presented in this thesis, indicated tangible costs of illness of £996,350 to £1,091,131. Over a third (E392,822 - £426,887) were costs related to investigation and treatment of cases and over half (E507,555 -E559,401) was production loss associated with sickness related absence from work. The remaining costs Identified represented important costs to affected Individuals and their families. Additional intangible costs of £1.57 million to £5.07 million were ascribed to value of lives lost and to pain and suffering estimates. Extrapolation of costs, utilizing an index of severity developed for this study and categorisation of cases by level of treatment demanded, indicated national, tangible, costs of £231 million to £331 million; additional intangible costs were £32 million to £119 million). The cost-effectiveness of limiting these totals was explored by two approaches. Cost reduction by changes in cases management (eg. reducing faecal specimens tested and time off work) indicated small potential savings. However, substantial benefits were indicated by cost-benefit analysis of preventive activities including irradiation of poultry carcasses and use of competitive exclusion methods in poultry rearing.
20
Mboto, Clement Ibi. "Studies on Human Immunodeficiency Virus and hepatitus C virus coinfection in the Gambia." Thesis, Kingston University, 2005. http://eprints.kingston.ac.uk/20370/.
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Co-infection with Hepatitis C Virus (HCV) is a common occurrence in Human Immunodeficiency Virus (HIV)-positive patients and an increasing cause of morbidity and mortality. Little is known however of the burden or the natural history of these infections or their interactions in most parts of sub-Saharan Africa, where both viruses are endemic. In this study a total of 1500 people aged 11 months to 76 years referred to the serology unit of Royal Victoria Teaching Hospital between the months of July to December 2003 were evaluated for anti-HIV, anti-HCV and CD4+ T-cell count and compared with the subjects' socio-demographic and risk factors. HIV and HIV/ HCV seropositive persons who consented to a follow-up study were age and sex matched with HIV and HCV seronegative control subjects and followed for 18 months with biannual monitoring of trends in CD4 count against a possible HIV or HCV seroconversion of the seronegative control subjects. The overall prevalence of antibodies to HIV and HCV was 6.7% (101/1500) (Cl, 5.6-8.2) and 2.1% (31/1500) (95 % CI, 1.4-2.9) respectively. HIV rates in asymptomatic adults were 3.6 %( 43/1189) (OR: 0.16; Cl: 0.13-0.28) and 1.0 %( 12/1189 (OR: 0.16; Cl: 0.08-0.34) for HCV. HIV/HCV co-infections rate was 0.6% among all the subjects sampled and 8.6% in HIV positive persons. The HIV rate in this study is twice the UNAIDS/WHO estimate for the country and twice the numbers of women than men were infected with HIV at a comparatively younger age, while males 55 years and over had higher HIV rates than those below 35. HCV and HIV/HCV coinfection was more commonly associated with males than females. This study showed that Hepatitis C serotype 2 is the most prevalent type in the country and was predominantly associated with HIV-1, and suggests that HCV serotype 2 spread earlier than serotypes 1 and 3. The mean CD4 count of apparently healthy males and females was 489/μl and 496/μl respectively, while the mean CD4 count at diagnosis (CD4dx) of HIV, and HIV/HCV persons was 310 cells/μl and 306 cells/μl respectively. Only about half of the apparently healthy population had CD4 counts of 500 cells and over (51 %), while 1.1 % (15/1377) had counts below 200 cells per microlitre for no explained reasons. HN/HCV co-infected person recorded a lower CD4 count at diagnosis than HIV alone infected persons and also a more significant decline in CD4+ than HIV infected alone persons. The study shows that high HIV rates were independent of the educational status of the individual, while history of sexually transmitted diseases, high income earning and involvements in polygamous marriages were all significant risk factors for HIV, HCV and HIV/HCV co-infection. Female circumcision, knowledge and use of condoms, blood oath, histories of blood transfusion and wife inheritance were not associated with HIV or HCV transmission. The study found an HIV incidence rate of 1.4% (4/288) during the 18 months follow-up period and identified Sexually Transmitted Diseases (STDs) as the associated risk factor. There is need for a new CD4+ staging in the country based on the population within the country and the initiation of a large scale longitudinal study to elucidate the risk factors associated with HCV in the country. The study has provided baseline data on CD4 and its trends in co-infected persons and also a baseline on the distribution and epidemiological pattern and associated risk factors of co-infection between HIV and HCV in the country. It has also determined the incidence of HIV and its associated risk factors in the country. The study has therefore contributed to our understanding of the natural history of these infections and provided an important frame work for possible intervention.
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Antunes, Denise Silveira. "Assessment of a framework for the allocation of primary dental services." University of the Western Cape, 2017. http://hdl.handle.net/11394/5603.
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Philosophiae Doctor - PhDBackground: Standardized and evidence-based resource allocation frameworks for timely provision of primary dental services may support equitable distribution of comprehensive dental care. However, such frameworks, which can be applicable to primary care settings in Brazil, are not available. The purpose of this study was to explore the complex issue of equity allocation of dental staff for primary dental care services, by estimating time to dental disease progression in order to analyze costs when survival targets are set for patients waiting for primary dental care. The inclusion of wait time benchmarks for dental services in the design of the framework was an attempt to increase knowledge on the quality of access experienced by people living within catchment areas of the Family Health Strategy in Brazil. In view of ever scarce resources for public health services, ethical dilemmas arise in resource allocation when allocation choices require priority setting among individuals who face similar health needs. Since equity of access must be assured for all Brazilian citizens, the present study proposed a rational resource allocation model to help decision-makers in reconciling equity access and budgets. Aim: This study aimed to compare equity of access to dental services and costs of dental staff of two models for primary care settings. Additionally, staffing requirements and staff costs were projected over a three-year time period. Both models comprised three inter-related components: (i) universal access to oral health care, (ii) comprehensiveness of primary dental care and (iii) equity of access to primary dental services. Method: The present study was part empirical and part modeling in design. In the empirical phase, a set of maximum wait times for dental care determined by experts (Model 1) vs. wait times derived from survival analysis (Model 2) was compared. A one-year follow-up of a cohort of dental patients assigned to five primary health care clinics was conducted. The event of interest was clinical deterioration in the waiting time for dental visits. At each consultation with a dentist either for routine or emergency reasons, the oral quadrants of the patient were assessed and classified according to their urgency for dental care (from 1, less urgent to 5, more urgent). In the modeling phase, costs of dental staff were estimated on the basis of survival probabilities found in Model 1 and on survival targets simulated in Model 2. The amount of staff required as calculated by combining data on: dental service needs, activity standards for dental services, workload components in dental care, cost per working hour of dental staff, and probabilities of clinical deterioration in the wait for dental visits. Main Findings: In Model 1 (wait times determined by experts), survival probabilities were found to be unevenly distributed between diagnostic categories: category 4= 0.939 (SE 0.019); category 3= 0.829 (SE 0.035); category 2= 0.351 (SE 0.061) and category 1= 0.120 (SE 0.044). The cost of dental staff in Model 1 was estimated to be R$104 110.88 (BRL). In cost simulations of Model 2, where wait times were derived from the survival analysis study, a similar 0.900 survival probability target for all sampled quadrants (n=7 376) was found regardless of their final classification in the study year. The resulting cost of Model 2 was R$99 305.89 (BRL). Conclusions: From an equity-access perspective, the survival analysis concluded that wait times for dental visits determined by the experts may engender inequitable survival probabilities for oral quadrants classified in different diagnostic categories. From a dental-staff costs perspective, one concluded that less resources were required by setting an equitable 90% survival target for all oral quadrants studied.
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Al-umaran, Saleh. "Culture dimensions of information systems security in Saudi Arabia national health services." Thesis, De Montfort University, 2015. http://hdl.handle.net/2086/11393.
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The study of organisations’ information security cultures has attracted scholars as well as healthcare services industry to research the topic and find appropriate tools and approaches to develop a positive culture. The vast majority of studies in Saudi national health services are on the use of technology to protect and secure health services information. On the other hand, there is a lack of research on the role and impact of an organisation’s cultural dimensions on information security. This research investigated and analysed the role and impact of cultural dimensions on information security in Saudi Arabia health service. Hypotheses were tested and two surveys were carried out in order to collect data and information from three major hospitals in Saudi Arabia (SA). The first survey identified the main cultural-dimension problems in SA health services and developed an initial information security culture framework model. The second survey evaluated and tested the developed framework model to test its usefulness, reliability and applicability. The model is based on human behaviour theory, where the individual’s attitude is the key element of the individual’s intention to behave as well as of his or her actual behaviour. The research identified a set of cultural and sub-cultural dimensions in SA health information security and services.
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Tsawe, Mluleki. "Inequalities in the use of maternal and reproductive health services in Sierra Leone." University of the Western Cape, 2019. http://hdl.handle.net/11394/6660.
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Philosophiae Doctor - PhDThis thesis extends the literature on the trends and magnitude of health inequalities in the area of maternal and reproductive health services in Sierra Leone, and particular across sub-Saharan Africa. It attempted to provide a good understanding of, not only the determinants of maternal and reproductive healthcare use, but also factors that enable health inequalities to exist in Sierra Leone. This is an appropriate topic in population health studies as it aims to address important questions on the research agenda in the context of sub-Saharan Africa, particularly in a country with poor health outcomes such as Sierra Leone. A proper understanding of not only the coverage rates of population health outcomes but also the extent of health inequalities as well as the factors that contribute to these inequalities is crucial for any government. The thesis applied various techniques in the analysis of DHS data (from 2008 and 2013 rounds) in an attempt to answer the research questions.
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Burroughs, Emily. "Ethical Standards of Human Services Professionals in Trauma Informed Care Across Diverse Settings." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/honors/538.
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Ethics are important in every aspect of our professional lives. Actions have consequences and in the Human Services field, decisions that we make will potentially directly impact our clients. A human services professional’s responsibility is to care for their clients and provide them with the appropriate resources needed to succeed in their daily lives. When a professional begins working with a trauma victim, they must be sure to assess their ethical behaviors and provide proper resources to the victim. This work is often referred to as trauma informed care which goes beyond the typical helping process of professionals. It is a unique kind of care that requires a great deal of time and dedication in order to help the client through the difficult experience of trauma.
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Burns-Johnson, Toshiba L. "Are Government Websites Achieving Universal Accessibility?: An Analysis of State Department of Health and Human Services’ Websites." Thesis, School of Information and Library Science, 2007. http://hdl.handle.net/1901/417.
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Research reports that the search for health information is the fourth most popular activity being done on the web (Pew Internet & American Life Project, 2004). However, for disabled persons, barriers experienced when interfacing with the Internet may cause healthcare websites to be inaccessible to them. This study explores the level of accessibility of healthcare websites and the relationship between accessibility and usability by determining how compliant state department of health and human services websites are with accessibility and usability guidelines. A content analysis of each state’s department of health and human services website was conducted. Results revealed that state department of health and human services websites are not very compliant with accessibility guidelines, are somewhat compliant with usability guidelines, and overall are not very accessible. The findings also indicate that there is a significant moderate relationship between accessibility and usability which suggests that the two concepts are interconnected.
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Alshammasi, Abdrabalamir Abbas Abdullah. "The influence of economic, political and socio-cultural factors on the development of health services in Saudi Arabia." Thesis, University of Hull, 1986. http://hydra.hull.ac.uk/resources/hull:5105.
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In this thesis I examine the influence of economic, political and socio-cultural factors on the development of health services in Saudi Arabia. There are four main parts and a conclusion. In Part One I review the situation in developing countries. Many commentators have argued that economic factors, and to some extent political factors, are the main determinant of health services development in developing countries. Socio-cultural factors are generally neglected in these analysis. In this thesis I redress the balance by examining the relationship between economic, political and socio-cultural factors in the development of the Saudi health care system.In Part Two I analyse the Saudi resource situation. Although the health service is not considered a priority in the overall Saudi development strategy, the government provides generous financial resources for its development. However, non-financial resources remain a problem. Relatively abundant financial resources can provide a short-term solution to some of the resource shortages, such as the lack of skilled manpower, but the use of expatriate health personnel may have unanticipated negative consequences.In Part Three I examine the resource allocation process. The Saudi political system contains a mixture of modern and traditional elements, and the decision making process is affected by traditional social relationships. The King and public bureaucrats play a key role in the allocation process, but local leaders and Governors have wide scope to influence their decisions. While health provision is not a political issue in the country, it contributes to the social cohesion between the government and the general public.In Part Four I examine the influence of socio-cultural factors on the development of the Saudi health service. In the Saudi society socio-cultural factors affect the behaviour of individuals in their interaction with the health system. For example, the annual pilgrimage to Mecca by millions of moslems from all over the world presents a formidable challenge to health authorities. Health authorities accept the importance of socio-cultural factors, and respond by compromising policies. In the conclusion I consider the policy and theoretical implications of the study. In particular I examine the need for the formal recongnition and incorporation of socio-cultural factors into health policy decision making. This would lead to the generation of alternative policy options which complement other options based on economic and political considerations. The socio-cultural oriented approach can contribute significantly to the improvement of the long term prospect for health services in Saudi Arabia, and developing countries generally.
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Jackson, Pulver Lisa Rae. "An argument on culture safety in health service delivery towards better health outcomes for Aboriginal peoples /." University of Sydney. Public Health and Community Medicine, 2003. http://hdl.handle.net/2123/609.
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The bureaucratic measure of health service, health performance indicators, suggest that we are not effective in our legislative responsibility to deliver suitable health care to some of the populations we are meant to serve. Debate has raged over the years as to the reasons for this, with no credible explanation accepted by those considered stakeholders. One thing is clear though, we have gone from being a culture believing that the needs of the many far outweigh those of the few, to one where we are barely serving the needs of the 'any'. This is most evident in the care delivered to the Aboriginal and Torres Strait Islander people of Australia.
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Chapman, Hilary S. "Overcoming barriers to participation in training : lessons from the home health care workers of 1199/SEIU, New York's Health and Human Services Union." Thesis, Massachusetts Institute of Technology, 2002. http://hdl.handle.net/1721.1/50128.
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Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 2002.Includes bibliographical references (leaves 69-72).
This thesis explores the barriers to participation in the 1199 Home Care Industry Bill Michelson Education Fund (Home Care Education Fund). The Home Care Education Fund is structured as a Taft-Hartley, joint labor-management training fund to provide skills upgrading opportunities to unionized home care workers. It is the only such fun in the United States devoted exclusively to home care workers. Home care is a growing sector of the health care industry, and home attendants and home health aides are projected to be among the fastest-growing occupations in the following decade, according to the Bureau of Labor Statistics. Home care workers are also some of the most economically disadvantaged workers in the health care sector, earning poverty-level wages and, with the exception of 1199/SEIU members, lacking health insurance and pension benefits. Three sets of stakeholder groups were interviewed for this thesis: home care workers, who participated in a series of focus group meetings and personal interviews; home care agency employers; and Home Care Education Fund and ETJSP staff members. A written survey instrument was implemented to home care agency employers regarding their staffing levels and training benefits to supplement personal interviews. Each group articulated a coherent set of barriers facing home care workers, with unique challenges facing the agency employers and Education Fund staff in meeting the workers' needs. It is argued that shared interests bind these groups together and that a considerable overlap exists between the provision of quality medical care, welfare and job training policies. Further, there is an urgent need to support a frontline, marginalized workforce that is caring for thousands of disabled and elderly clients on a daily basis. The ultimate goal of this thesis is to identify those key barriers that prevent participation in the Home Care Education Fund so that staff and trustees may work together to tailor their services to meet their unique needs. It concludes with supporting recommendations for workforce development policy.
by Hilary Sharpless Chapman.
M.C.P.
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Landgren, Sara. "Non-use of Digital Health Meeting Services Among Swedish Elderly Living in the Countryside." Thesis, Uppsala universitet, Institutionen för informatik och media, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-414834.
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Digital consultations in primary care have the advantage of offering equal healthcare for people residing in the countryside. While it is gaining acceptance among young- and middle-aged people, the elderly are reluctant to use it. The aim of this study was hence to identify reasons for non-use among elderly in the countryside and describe perceived possible challenges and opportunities with digital consultations. Semi-structured interviews were conducted with 13 persons over 65 years old residing in the Swedish countryside. There was a mistrust for services offered by private companies and their public funding, a lack of knowledge of available services, and a lack of perceived usefulness. Personal interaction and continuity was more important than time or travel conveniences, although these advantages were recognized. To prevent digital exclusion, caregivers need to offer information, encouragement, or tools for the elderly. Digital primary care also needs to offer familiarity, with continuity and personal connections.
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Kabeja, Adeline. "Effectiveness of task shifting in antiretroviral treatment services in health centres, Gasabo district, Rwanda." Thesis, University of the Western Cape, 2012. http://hdl.handle.net/11394/4049.
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Magister Public Health - MPHIn the context of human resource crisis in African countries, the World Health Organization has proposed task-shifting as an approach to meet the ever-increasing need for HIV/AIDS care and treatment services. Rwanda started the process of task shifting towards nurse-based care in ART services in June 2010. After one year of implementation, a need to determine whether task shifting program has been implemented as intended and if it achieved its primary goal of increasing accessibility of people living with HIV to ARV therapy and improving nurse capacity in HIV patient care was imperative.A multi-method program evaluation study design, combining cross sectional, retrospective review and retrospective cohort sub-studies were used to evaluate the implementation,maintenance processes and outcomes of task shifting in 13 Health Centres (HCs) located in the catchment area of Kibagabaga District Hospital, in Rwanda. The study population consisted of HCs providing task shifted care (n=13), nurses working in the ART services of the 13 HCs(n=36), and more than 9,000 patients enrolled in ART care in the 13 HCs since 2006. All 13 HCs and 36 nurses were included in the evaluation. Routine data on patients enrolled in the pre-task shifting period (n=6 876) were compared with the post task shifting period (n=2 159), with a specific focus on data in the 20-months periods prior to and after task shifting. A cohort of patients 15 years and older, initiated onto ART specifically by nurses from June to December 2010 was sampled (n=170) and data extracted from patients medical files.Data collection was guided by a set of selected indicators. Three different data collection tools were used to extract data related to planning, overall programmatic data and individual data from respectively, the program action plans/reports, HIV central databases and patients medical files. Descriptive analysis was performed using frequencies, means and standard deviations (SD). The paired and un-paired t-tests were used to compare means, and chi-square test was used to compare categorical variables. To compare and to test statistical difference between two repeated measurements on a single sample but with non-normally distributed data, Wilcoxon signed rank test was used. To judge if current task shifted care is better, similar or worse than non-task shifted care, comparisons were made of program outputs and outcomes from the central database prior to and after the period of task shifting, and also with the cohort of nurse initiated patients.Results showed that 61% of nurses working in the ART program were fully trained and certificated to provide ART. Seven out of 13 HCs met the target of a minimum of 2 nurses trained in ART service delivery. Supervision and mentorship systems for the 13 HCs were well organized on paper, although no evidence documenting visits by mentors from the local district hospital to clinics was found. In term of accessibility, the mean number of patients newly initiated on ART per month in the HCs increased significantly, from 77.8/month (SD=22.7) to 93.9/month (SD=20.9) (t test (df=38), p=0.025). A small minority of patients was enrolled in late stages of HIV, with only 15% of the patient cohort having CD4 counts of less than 100 cell /μL at initiation on ART. The baseline median CD4 cell count was 267.5 cells /μL in the cohort as a whole. With respect to quality of care, only 8.8% of patients in the cohort had respected all appointments over a mean follow up period of 17.2 months; and although follow up CD4 counts had been performed on the majority of patients (80%), it was done after a mean of 8.5 months(SD=2.7) on ART, and only a quarter (24.7%) had been tested by 6 months (as stipulated by guidelines). From central ART program data, a small but significant increase of patients on 2nd line drugs was observed after implementation of task shifting (from 1.98% to 3.00%, 2=13.26,p<0.001), although the meaning of this shift is not entirely clear.The median weight gain was 1 kg and median CD4 increase was 89.5 cells /μL in the cohort after 6 months of receiving task shifted care and treatment. These increases were statistically significant for both male and female patients (Wilcoxon signed rank test, p<0.001). With regard to loss to follow up, only three of the 170 patients in the cohort followed up by nurses had been lost to follow-up after a mean of 17.2 months on treatment. The routine data showed a decrease of patients lost to follow up, from 7.0% in the pre-task shifting period to 2.5% in the post-task shifting period. In general, the mortality rate was slightly lower in the post-task shifting period than in the pre-task shifting (5.5% vs 6.9% respectively), although this was not statistically significant (2=2.4, df=1, p=0.1209).This study indicates that, after over one year of implementation of task shifting, task shifting enabled the transfer of required capacity to a relatively high number of nurses. In an already well established programme, task shifting achieved moderate improvements in uptake (access) to ART, significant reductions in loss to follow up, and good clinical outcomes. However,evaluation of process quality highlighted some concerns with respect to adherence to testing guidelines on the part of providers and follow up visits on the part of patients. Improvements in processes of monitoring and follow up are imperative for optimal mid-term and long-term task shifting in the ART program.
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Rademan, Janet Ellen. "The identification of contextually relevant health and well-being information needs for the youth through human-centered co-design." Thesis, Cape Peninsula University of Technology, 2015. http://hdl.handle.net/20.500.11838/2409.
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Thesis (MTech (Design))--Cape Peninsula University of Technology, 2015.Available health and well-being information is limited in communities with insufficient health care resources. This affects the community negatively on multiple levels in which the health and well-being needs of individuals are not satisfied. This research project explored the impact of human centred co-design, using tools such as health and well-being needs questionnaires including a health needs assessment as well as a quality of life scale. The aim was making accurate health and well-being information more accessible to the youth. The target group was Durbanville youth aged between 14 and 18 years. The sample included different ages ( = 15), races (79% White, 21% Coloured) and near equal gender distribution (55% female, 45% male). The sample (N = 33) was comprised of three groups: Group A, B, and C. A Human-Centered Design (HCD) framework was used during the project referring to the following three steps: Hear, Create, and Deliver. During the Hear phase, stories and inspiration from the participants were gathered. Group A (n = 10) completed a health and well-being information needs questionnaire. Group B (n = 15) discussed the topic, and created affinity diagrams. This was how the health and well-being status and information needs were established. During the Create phase; frameworks, opportunities, solutions, and prototypes were developed by the participants. Group B co-designed the concept prototype: a possible mobile application solution for practical access to health and well-being information. Group C (n = 8) provided feedback and input on the concept prototype and created storyboards to visually display scenarios in which they would use the mobile application. This step produced a youth-friendly health and well-being information service concept prototype. During the Deliver phase, the relevant health and well-being information solution was established as a youth-friendly health and well-being mobile application: WeHelp. Also, group A, B, and C were introduced to a similar existing resource named MobieG. Thus, the present study contributed directly to the participants’ health and well-being awareness. The research provided significant health and well-being insights. For example, the youth of Durbanville revealed extremely low scores on the emotional well-being domain. The data collected makes it possible for future researchers to create a practical, youth-friendly, health and well-being information service.
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Brule, Joyel J. "Application at the bedside: Moving from knowing how to knowing why in nursing." ScholarWorks, 2008. http://scholarworks.waldenu.edu/dissertations/617.
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The nursing field is beginning to emerge as a profession with curricula that emphasis nursing as a discipline distinguished from a medically dominated paradigm. This changing focus places emphasis on professional competence upon graduation and entry into practice to foster fitness for purpose within an environment of continuously changing expectations of the nurse by society. Despite a growing body of research on transition into practice, a gap exists as to when this transition occurs and how this finding may influence educational preparation of nurses. This qualitative, exploratory study examined nurses' perceptions of their transformation from novice to professional practitioner by examining a pivotal moment in their practice that affected their self-reported professional competence, Twenty-five nurses who had worked in a hospital setting between 2 and 5 years were interviewed. The primary research question sought to address whether a common thread became apparent after conducting interviews that may have implications for nurse educators to enhance or change their curriculum. Analysis of the interviews was conducted utilizing a constructivist approach. The data collected were analyzed using ATLAS.ti, Using participants' words that described people, settings, themes and ideas that appeared in the data, coding was done acknowledging that some codes were based on the research questions and the initial review of the data. A common theme emerged from analysis that respondents felt that what they were taught in school was not valid in real life. Nurse educators need to re-envision their social responsibility and interrogate the traditional principles that have guided the curricula to prepare and train nurses' for the holistic welfare of all individuals in society. This is necessary to meet the needs of a changing social structure within the nursing profession and society as a whole.
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Mfuko, Ncedo. "An assessment of primary health care services from the : perspective of the recipients in the Khayelitsha community health centre." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_3124_1305890834.
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The general aim of this study is to undertake an assessment of the health care service provision in the Khayelitsha Community Health Centre taking into consideration the underlying principles of the Primary Health Care. More specific objectives include: an overview and discussion of the framework approach to primary health care and its use
the documentation of the practice of primary health care in the Khayelitsha Community Health Centre
an analysis of the results and findings which will highlight the obstacles in the pursuit of a better primary health care service. The perspective of the patients and nurses will be solicited and examined with a view to highlighting factors that facilitate and constrain the delivery of service
and finally to draw conclusions and make recommendations.
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Kwok, Kun-chung. "An exploratory study of the Mental Health Review Tribunal in Hong Kong /." [Hong Kong : University of Hong Kong], 1993. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13744501.
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Blyth, Samuel. "Human well-being and mangrove forests: case study on the role of coastal ecosystem services in two communities in Madagascar." Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=119698.
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The investigation of socio-ecological interactions involving mangrove ecosystem services (ES) illustrates the complexity of the relationships between functional ecosystems, market integration and the ability to maintain human well-being. The Belo-sur-Mer system of mangrove forests, located on the west coast of Madagascar, provides a range of ES to the communities of Antanamanimbo and Marofihitsy. Mangrove fisheries provide the majority of monetary incomes in both communities, representing 53.53 % of total annual incomes for Antanamanimbo and 59.76 % for Marofihitsy. Greater market integration in Antanamanimbo corresponds with larger material, energy and monetary throughputs. The role of mangrove ES in generating incomes is complemented by their importance as key components in local diets, communities' reliance on the mangrove as a safety-net for incomes and food production, for harvesting fuelwood and lumber, and in supporting cultural identities. Despite large differences in the size of household incomes and scale of mangrove resource extraction between these communities, their levels of human well-being are very similar. This suggests that the relationship between human well-being and natural systems is multi-dimensional and relies heavily on components that are not accounted for by the market system. Considering the role of mangrove ES in this local socio-economic context provides an invaluable tool to be used in guiding local decision making and establishing an effective balance between conservation and development.L'étude des interactions socio-écologiques impliquant les écoservices des mangroves (ÉS) illustrer la complexité des relations entre les écosystèmes fonctionnels, l'intégration du marché et la capacité à maintenir le bien-être humain. Le système Belo-sur-Mer de mangroves situées sur la côte ouest de l'île de Madagascar, fournit une gamme d'ÉS aux communautés d'Antanamanimbo et de Marofihitsy. La pêche dans les mangroves fournit la majorité des revenus financiers dans les deux communautés, représentant 53,53% du revenu annuel total pour les Antanamanimbo et 59,76% pour les Marofihitsy. Une plus grande intégration du marché chez les Antanamanimbo correspond à un métabolisme social plus élevé dans cette communauté, y compris des revenus plus élevés et une extraction plus intensive des ressources de la mangrove. Les ÉS de la mangrove agissent en tant que générateurs de revenus, éléments clés dans les régimes alimentaires locaux, filet de sécurité pour les revenus et la production alimentaire, source de bois de feu et de construction, et partie intégrante des identités culturelles. Malgré de grandes différences entre ces communautés dans la taille des revenus ménagers et dans l'échelle de l'extraction des ressources de la mangrove, leurs niveaux de qualité de vie humaine sont très semblables. Ceci suggère que la relation entre le bien-être humain et les systèmes naturels est multidimensionnelle et s'appuie fortement sur des facteurs qui ne sont pas pris en compte par le système du marché. Prendre compte du rôle des ÉS des mangroves dans ce contexte socio-économique local constitue un outil précieux à être utilisé dans la prise de décision et l'établissement d'un équilibre entre la conservation et le développement locale.
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Dennis, Matthew. "The role of community-led innovation in the adaptive capacity of ecosystem services in an urban social-ecological system." Thesis, University of Salford, 2015. http://usir.salford.ac.uk/35449/.
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Urban areas are hubs of creativity and innovation providing fertile ground for novel responses to modern environmental challenges. One such response is the community-led management of urban green spaces as a form of organised social-ecological innovation (OSEI). Previous studies have attempted to conceptualise the ecological, social and political potential of such informal approaches to urban green space management. However, little work has been carried out into their efficacy in the landscape, either by describing the social-ecological conditions influencing their occurrence or by quantifying the actual benefits in terms of ecosystem service provision. This research explores the emergence and impact of OSEI in a continuous urban landscape comprising the metropolitan areas of Manchester, Salford and Trafford (UK). The social-ecological context and content of OSEI were investigated using a cross-scale approach. At the landscape scale a snowball-sampling method mapped the occurrence of OSEIs using GIS and remote sensing technology. At the micro-scale, a case study quantified relative levels of provision across four key ecosystem services. The analysis presented OSEI as an adaptive response to environmental stressors, clustered around “hubs” of social-ecological innovation in the urban landscape. The distribution of OSEIs was influenced by historical context, degree of urbanisation and dependent on levels of, and dynamics between, social and ecological deprivation. Urban agriculture was instrumental as a catalyst for the emergence of OSEI and the associated production of a range of ecosystem services. Site productivity was also influenced by spatial and design considerations. This thesis has detailed the character of OSEI as a coherent phenomenon in the urban landscape which exhibits valuable response diversity according to social-ecological conditions. This, together with an evaluation of factors influencing ecosystem service provision at the local scale, has informed the validity of OSEI as an element of adaptive capacity which contributes to resilience in urban social-ecological systems.
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Hess, Brian H. "Evaluating the Performance Diagnostic Checklist-Human Services to Treat Performance Problems of Adults with Intellectual Disabilities." DigitalCommons@USU, 2019. https://digitalcommons.usu.edu/etd/7486.
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Unemployment is a problem for individuals with disabilities. Supported employment provides occupational supports for individuals with disabilities to get a job and keep that job once hired. The Performance Diagnostic Checklist-Human Services (PDC-HS) is used to address performance problems with employees in human services settings. This study evaluated using the PDC-HS with three adults with intellectual disabilities working in supported employment at a library cleaning shelves. The results of the PDC-HS identified insufficient training and prompting as barriers. The matched intervention package was effective in increasing performance of the shelf-cleaning task for all participants. Participant responses to a social validity questionnaire indicated that all participants thought the study was fair, they liked the way they were taught to clean the shelf, and felt that being in the study helped them improve at their job.
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Parker, Dennis. "An Analysis of the Perceptions of African American Churches in their Delivery of Health and Human Services in Southeast DC." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/2846.
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President Bush’s Executive Order 13279 (December 12, 2002) encouraged the government to work with faith-based organizations to provide human services (i.e., Temporary Assistance for Needy Families, employment, homelessness services, and health care) to serve America’s low-income populations. Faith-Based Initiatives, and now President Obama’s Faith and Neighborhood Partnerships Initiative have created the foundation for further partnerships between faith-based organizations and local, state, and federal governments. Limited information exists regarding the overall effectiveness of the programs in encouraging churches, specifically African American churches, to engage in services delivery. This study explores the perceptions of church leaders that influence faith-based organizations, specifically African American churches in the southeast region of Washington, DC, to provide human services. The District of Columbia has eight local wards: southeast Washington encompasses Wards 7 and 8, and has a high concentration of poverty and African Americans. The District of Columbia Department of Human Services (2010) reports that in the year 2009, 97% of Ward 7 residents were African American with 26% residing in poverty; 94% of Ward 8 residents were African American with 35% residing in poverty. The work of early sociologists, W. E. B. Dubois and Franklin Frazier is utilized to frame the theoretical background (Ethnic Identity Model) for this study. Additionally, this study relies on an African American church analysis by Lincoln and Mamiya (1990) to highlight the historical and current role of the African American church. The purpose of this study was to examine the churches of southeast Washington, DC and the level of human services provided between 2000 and 2010, during both the Bush and Obama Administrations, to understand the perceptions of the factors that influenced the level of human services during the same time frame. The study utilized a qualitative design with descriptive statistics to shed light on human service delivery of faith-based organizations in the African American community. A semistructured interview was performed on a convenience sample of 20 pastors/church leaders of churches in southeast Washington, DC. These 20 churches were identified through the District of Columbia’s yellow pages and, additionally, other data sets including advocacy organizations and community groups. This study found that neither President’s Bush’s or Obama Faith Based Initiative significantly influenced the level of provision of human services by African American Churches located in Wards 7 and 8 of southeast Washington DC. Also this study found that the majority of African American churches in wards 7 & 8 in Washington DC are more flexible and able to determine the types of services they provide by the presenting community needs. The study results will inform policymakers about whether, and how, the churches’ role in service delivery changed after the implementation of President Bush’s Faith-Based Initiative. Presidents Bush and Obama view churches and community-based organizations as strong frontline resources to address desperate challenges related to poverty, but little is known about the effectiveness of their initiatives. The results of this analysis will assist churches, community organizations, and policy formulators in providing information that will help policymakers to make more informed decisions about the potential impact of churches for service delivery in the African American community. It will also provide information about barriers to participating as partners with the government.
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Richerson, Lauren A. "Child, family, and school predictors of outcome of a school-based intervention for children with disruptive behavior problems." Ohio : Ohio University, 2004. http://www.ohiolink.edu/etd/view.cgi?ohiou1090939935.
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Cornetta, Vitoria Kedy. "Comparação da força de trabalho em serviços de saúde." Universidade de São Paulo, 1991. http://www.teses.usp.br/teses/disponiveis/6/6131/tde-25072016-181335/.
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A autora estuda a comparação da força de trabalho em serviços de saúde, visando o grau de satisfação e insatisfação dos profissionais de saúde, em dois municípios semi -rurais, sendo um de médio porte e outro de pequeno porte, um localizado na Grande São Paulo e outro no Estado de São Paulo. participaram do estudo, integrantes de seis categorias funcionais: médicos, enfermeiras, assistentes sociais, auxiliares de enfermagem, atendentes e serventes, que realizam suas atividades nas Unidades Básicas de Saúde, nos respectivos municípios. No estudo foi desenvolvido um histórico das principais políticas de saúde e de recursos humanos, no período de 1960 a 1990, apresentando as principais características da época, sua evolução no Brasil e no Estado de São Paulo. A seguir foram descritos os perfis dos municípios estudados e suas principais características. Foi abordada a metodologia utilizada na pesquisa bem como a análise, discussão e resultados obtidos através dos dados coletados junto aos profissionais de saúde. Dos resultados do estudo, as informações fornecidas permitiram verificar que os profissionais pesquisados salientaram vários fatores que podem contribuir e podem influenciar diretamente na obtenção da satisfação e insatisfação no trabalho. Pela frequência com que se manifestaram, observa-se a ordem de importância dada a esses fatores, que podem direcionar a uma política de recursos humanos satisfatória para melhoria do desempenho humano e da eficácia organizacional.A autora estuda a comparação da força de trabalho em serviços de saúde, visando o grau de satisfação e insatisfação dos profissionais de saúde, em dois municípios semi -rurais, sendo um de médio porte e outro de pequeno porte, um localizado na Grande São Paulo e outro no Estado de São Paulo. participaram do estudo, integrantes de seis categorias funcionais: médicos, enfermeiras, assistentes sociais, auxiliares de enfermagem, atendentes e serventes, que realizam suas atividades nas Unidades Básicas de Saúde, nos respectivos municípios. No estudo foi desenvolvido um histórico das principais políticas de saúde e de recursos humanos, no período de 1960 a 1990, apresentando as principais características da época, sua evolução no Brasil e no Estado de São Paulo. A seguir foram descritos os perfis dos municípios estudados e suas principais características. Foi abordada a metodologia utilizada na pesquisa bem como a análise, discussão e resultados obtidos através dos dados coletados junto aos profissionais de saúde. Dos resultados do estudo, as informações fornecidas permitiram verificar que os profissionais pesquisados salientaram vários fatores que podem contribuir e podem influenciar diretamente na obtenção da satisfação e insatisfação no trabalho. Pela frequência com que se manifestaram, observa-se a ordem de importância dada a esses fatores, que podem direcionar a uma política de recursos humanos satisfatória para melhoria do desempenho humano e da eficácia organizacional.
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Steiner-Pappalardo, Nicole L. "Joining to expand faith-based mental health resources : bi-directional referral and collaboration between psychologists and the church /." Clergy and Clinician Collaboration and Referral Network, 2005. http://c3rn.org/.
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Hall, Justin A. "Empathy Levels in Health Professions Students." Youngstown State University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ysu1567593626920704.
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Ikpeazu, A. E. "Can the Midwives Service Scheme (MSS) present an effective and health systems strengthening response to the shortages in human resources for maternal health services in Nigeria?" Thesis, London School of Hygiene and Tropical Medicine (University of London), 2018. http://researchonline.lshtm.ac.uk/4647053/.
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The flagship Midwives Service Scheme (MSS) was introduced in 2009 as the first large-scale intervention to address rural retention of midwives in Nigeria. This was a multi-component intervention including financial incentives to midwives, provision of accommodation and systems level support, aiming to improve human resource capacity to provide quality services. This study explores how effectively the scheme’s design and implementation drew on the health system’s context, resources, needs and population preferences, and how it contributed to strengthening health systems at all levels. To meet the objectives, 87 in-depth interviews and eight focus group discussions with policymakers, implementers, midwives and community members were conducted in two Nigerian states and at the federal level. Drawing on a systems-thinking approach, the study developed a new framework examining the fit of the intervention with the local health system’s context considering: i) leadership and commitment ii) policy and financing context iii) human resource management capacity, and iv) stakeholder participation. The framework informed the framing of the study and guided data collection; however, themes were identified and synthesised inductively. The broad principles and features of the scheme were widely supported by program managers and policy-makers across the three health systems levels (local, state, federal). However, its design was based on federal level program managers’ knowledge of maternal health and health worker issues, and limited recognition of the decentralised nature of the health system. Implementation was hampered by inadequate management and logistical capacity to deal with the complex design, poor absorptive capacity of states for the posted midwives, failure to provide continued supervision, and welfare issues that affected the midwives. The MSS was successful in attracting midwives including those employed in the private sector due to the promised pay package and capacity building opportunities offered under it. Several factors affected motivation of midwives and impacted on midwife retention. These include low and unpaid salaries and incentives, housing difficulties and distance of housing from the facility, and travel costs and hardships incurred from commuting to the facility. Unmet career development priorities were an additional source of demotivation. The findings point to poor retention of midwives in both states. Retention was better among retired midwives compared to other categories. Younger midwives were more mobile and exited the scheme mainly to the private sector. The MSS had the potential to bring about system-wide changes; however, weak implementation severely hampered its achievement of the intended outcomes and dampened the expectations of significant improvements in the health systems. The findings underscore the importance of reflecting overall health systems structures and processes and local contextual factors, including local health workers’ preferences in designing effective human resource retention schemes. The scheme is potentially replicable as a bundled package of interventions to improve access to skilled workers in rural communities in LMICs. Since decentralisation critically modifies the decision-making space, an inclusive process where sub-national actors participate in choosing policy options should be a prerequisite.
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Ngobi, John Baptist. "Access Barriers to Reaching Human Immunodeficiency Virus Testing Services in Ottawa: Mixed Methods Study." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/39635.
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Barriers to reaching human immunodeficiency virus (HIV) testing prevent Canada from achieving The Joint United Nations Programme on HIV and AIDS (UNAIDS) target of 90 percent of undiagnosed people living with HIV knowing their HIV status by 2020 and receive treatment.(1) Fourteen percent (9,090 of 63,100) of Canadians living with HIV were unaware of their status by the end of 2016.(1)(p.9)Individuals exposed to HIV through heterosexual contact are overrepresented (28%) among the undiagnosed people living with HIV in Canada compared to other groups, such as men who have sex with men (18%) and people who inject drugs (20%).(2)(par.15)The reasons preventing this population to present themselves for testing in Ottawa, Ontario, remain poorly understood in the literature. Most of the literature on barriers to accessing HIV testing focuses on the traditional key groups who are likely to test, and limits analysis of these barriers on one or two levels. Equally, health service providers rarely understand challenges behind HIV testing for particularly young heterosexual African migrant men. These challenges may be contributing key barriers to HIV testing. On other hand, late presentation to treatment remains a global issue. Psychosocial outcomes especially after a new positive diagnosis can delay reaching early treatment and prevention services. Indeed, all test results negative or positive have consequences. Even those with a new negative test can return to risk taking behaviour if they delay accessing prevention education. Yet no systematic study exists in this area essential for quality improvement. Programming more equitable HIV testing services will require more comprehensive evidence about challenges and barriers behind accessing HIV testing and treatment to achieve UNAIDS target of 90 percent of undiagnosed people living with HIV knowing their status and receive treatment. This research aimed to contribute to this evidence through two phases. Phase 1 used the Joanna Briggs Institute methods to implement a scoping review on psychosocial outcomes and their measurements immediately following a new HIV diagnosis. This review considered all participants who tested for HIV – whether their results were positive or negative, as any test results have consequences, and regardless of age, sex, or setting – reported in published articles between 2007 -to the present date. Paper 1 presents the scoping review. Phase 2 relied on a qualitative methodology using Grounded Theory informed by a socio-ecological framework and a framework of access to healthcare to understand experiences of accessing HIV testing services in two parts: 1) to examine barriers to reaching HIV testing among young heterosexual African migrants, focusing on young men, in Ottawa (Paper 2); and 2) to identify challenges experienced by health service providers who make accessible HIV testing services to this population in Ottawa (Paper 3). There is some ambiguity in the use of the terms “first generation immigrants” and “second generation immigrants” (or children of first immigrants). In this study, the term migrants referred to both. Selecting participants from both groups (first and second generation) was important to include a wide variety of experiences and interpretations that reflect the study population. Furthermore, the term “health service providers” was used to refer to both healthcare providers and frontline service providers. Healthcare providers referred to those who conduct HIV testing in health facilities, whereas frontline service providers referred to those who provide care and support services needed by members in their communities before and after testing within AIDS organizations and community-based organizations.
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Garris, Bill R., and Amy J. Weber. "Relationships Influence Health: Family Theory in Health-Care Research." Digital Commons @ East Tennessee State University, 2018. https://doi.org/10.1111/jftr.12294.
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This article reviews the presence of family theory in health-care research. First, we demonstrate some disconnect between models of the patient, which tend to focus on the individual, and a large body of research that finds that relationships influence health. We summarize the contributions of family science and medical family therapy and conclude that family science models and measures are generally underutilized. As a result, practitioners do not have access to the rich tool kit of lenses and interventions offered by systems thinking. We propose several possible ways that family scientists can contribute to health-care research, such as using the family as the unit of analysis, exploring theories of the family as they relate to health, and suggesting greater involvement of family scientists in health research.
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Virk, Amrit Kaur. "Expanding health care services for poor populations in developing countries : exploring India's RSBY national health insurance programme for low-income groups." Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:3e65305c-ba60-408a-8c0a-8957767f6596.
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Health is deemed central to a nation’s development. Accordingly, health care reform and expansion are key policy priorities in developing countries. Many such nations are now testing various methods of funding and delivering health care to local disadvantaged populations. Similarly, India launched the Rashtriya Swasthya Bima Yojana (RSBY) national health insurance programme for low-income groups in 2008. The RSBY intends preventing catastrophic health-related expenditure by improving recipients’ access to hospital-based care. This thesis is an in-depth qualitative evaluation of the RSBY in Delhi state. It examines the RSBY’s effectiveness in fulfilling its goals and meeting local health care needs. Walt and Gilson’s (1994) actors-content-process-context model informs the research design and an actor-centred “responsive” (Stake 1975) or “constructivist” approach guides data analysis. Three research questions are examined: (i). Why was a health insurance programme launched and why now? Why was this model favoured over alternate methods of service expansion? (ii). Is the RSBY delivered as intended? If not, why? (iii) How does the RSBY affect patients’ access to services? The findings are based on documentary sources, observation of implementation sites and activities and 164 semi-structured interviews with RSBY policymakers, insurers, NGOs, doctors, and patients. The results show improved access to curative and surgical care for RSBY patients. However, RSBY’s focus on hospitalisation and omission of primary and outpatient services had undesired negative effects. The lack of ambulatory facilities led RSBY patients to self-medicate or use dubious quality informal providers. By only allowing inpatient care, the RSBY also seemingly encouraged the substitution of outpatient care with costlier hospitalisations. In effect, the RSBY’s design contributed to cost increases and poor patient outcomes. While more funds and human resources were needed to improve RSBY implementation, the performance of frontline agencies could potentially improve through more stable, longer-term contracts. Similarly, modifying RSBY’s monetary incentives for doctors may lead to better service delivery by them. By evaluating the RSBY’s strong points and shortcomings, this thesis provides key lessons on strengthening policy design and health service delivery in developing countries. Thereby, it makes a broader contribution to understanding the determinants of successful policymaking.
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Mendenhall, Matthew Dean. "Towards a Grounded Theory Explanation of Mental Health Provider Perspectives on Consumer Involved Services." Cleveland, Ohio : Case Western Reserve University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=case1258222145.
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Thesis(Ph.D.)--Case Western Reserve University, 2010Title from PDF (viewed on 2010-01-28) Department of Social Welfare Includes abstract Includes bibliographical references and appendices Available online via the OhioLINK ETD Center
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Matsuda, Sandra J. "Information-seeking activity of rural health practitioners /." free to MU campus, to others for purchase, 1999. http://wwwlib.umi.com/cr/mo/fullcit?p9946278.
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November, Mark David. "Skills development and its relevance in a healthcare facility: a case study of Tygerberg Hospital." University of the Western Cape, 2013. http://hdl.handle.net/11394/4825.
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Masters in Public Administration - MPAThe public health sector over the years had been under constant criticism for the lack of or substandard service delivery. The post1994 democratic era was accompanied by slogans such as ‘a better life for all ’. These slogans in part stem from the Constitution of the Republic of South Africa, 1996. The Constitution, chapter two, in its discussion on the Bill of Rights states that everyone has the right to quality health care services. The critics argue that the fundamental r right enshrined with in the Constitution in as far as it pertains to healthcare has been violated. The state introduced various interventions, such as human resource capacity development t programs, to turn the dismal state of public health care around. This research focused on the impact and the relevance of the human resource development within the public health sector. The following research question had been formulated to guide the research; is skills development within the state undertaken for compliance sake or is it a focused interventionist approach aimed at improving the skills set of staff to perform effectively and efficiently? The research was qualitative in nature and the case methodology was used. In this regard Tygerberg hospital was used as the case study. A number of findings emanated from the data collection process, amongst other, that the skills development is not workplace specific but rather undertaken for compliance sake. Furthermore, that no individual staff development plans exist. The end result is that the skills development intervention aimed at improving the staff capacity and the state of health service generally is not making any meaningful impact. The major recommendation is that a health audit must be done, which must inform the development of the hospital staff skills development plan. This in turn must be used to develop individual staff f development plans. This alignment of development plans from provincial level to hospitals and then to the individual will result in a more focussed skills intervention and ultimately an improved public health sector.
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Byrd, Rebekah J., and Bradley Erford. "Journal of Mental Health Counseling (JMHC) Publication Pattern Review: A Meta-study of Author and Article Characteristics from 1994-20." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/882.
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Patterns of articles published in the Journal of Mental Health Counseling (JMHC) from 1994 through 2009 were reviewed. Characteristics of authors (e.g., sex, employment setting, nation of domicile) and articles (e.g., topic, type, design, sample, sample size, participant type, statistical procedures and sophistication) are described and analyzed for trends over time.