Decentralization of health services in Uganda, driven by the structural adjustment programme of the World Bank, was embraced by government as a means to change the health institutional structure and process delivery of health services in the country. Arising from the decentralization process, the transfer of power concerning functions from the top administrative hierachy in health service provision to lower levels, constitutes a major shift in management, philosophy, infrastructure development, communication as well as other functional roles by actors at various levels of health care. This study focused its investigation on ways and levels to which the process of decentralization of health service delivery has attained efficient and effective provision of health services. The study also examined the extent to which the shift of health service provision has influenced the role of local jurisdictions and communities. Challenges faced by local government leaders in planning and raising funds in response to decentralized health serdelivery were examined.

The extent of a community experiencing social vulnerability depends on the community’s ability to access resources that may contribute to coping mechanisms (either within the household or provided externally by a responsible authority) that decrease the impacts and effects of a disaster. Therefore, the purpose of this research was to identify the existence of social and institutional mechanisms that aim to reduce experiences of water inaccessibility and the causes of social vulnerability, and increase coping mechanisms within Kayamandi. Kayamandi is a low income residential community on the north-westerly periphery of the greater Stellenbosch town in the Western Cape. The research attained responses through questionnaires and surveys from residents, community organisations and responsible personnel. These surveys allowed the researcher to produce raw attribute data for each household that assisted in spatially representing vulnerable households and informing the five priority areas of the Hyogo Framework for Action. Contributing to this method of attaining information, secondary geographic data collection was obtained through the Stellenbosch Local Municipality, the National Geospatial Information Directorate and the National Demarcation Board. The findings of this thesis established that household and public water infrastructure contribute to the risk of experiencing social vulnerability that affects economic standings and quality of health within the community. Contributing to this and due to Kayamandi’s politically sensitive and historically fractioned community, social cohesion has also been noted as an area of vulnerability. Although these vulnerabilities are experienced, residents are able to implement technical, social and municipal reliant coping mechanisms. However, although efforts from Stellenbosch Local Municipality do respond to most of the key indicators within the Hyogo Framework for Action, the study found no concrete efforts within the Stellenbosch Local Municipality that illustrate integrated mechanisms to reduce the impacts of disasters and compound effects. / Magister Artium - MA

Baigiamajame darbe tiriami ryšiai tarp miškingumo, miškų pasiekiamumo, rekreacinės paskirties (2B) grupės miškų ir gyvenimo kokybės parametrų. Darbo objektas – Lietuvos savivaldybių (išskyrus Neringos miesto savivaldybę) rodikliai. Darbo tikslas – nustatyti miško rodiklių ir gyvenimo kokybės sąsajas Lietuvos savivaldybių lygmenyje. Darbo metodai – darbe vertinti Lietuvos savivaldybių miškų, gyvenimo kokybės (oro kokybės, sveikatingumo, gimstamumo, nusikalstamumo), kiti, galimai sąlygojantys gyvenimo kokybę, rodikliai. Tyrimui naudoti 2008-2013 m. Lietuvos statistikos departamento, Valstybinės miškų tarnybos, Higienos instituto sveikatos informacijos centro duomenys. Atskirai analizuojami ir palyginami Lietuvos miestų ir rajonų savivaldybių rodikliai. Miškų pasiekiamumo rodiklis savivaldybėms nustatytas taikant GIS technologijas, duomenų apdorojimui ir atvaizdavimui naudota Microsoft Excel programa, STATISTICA programinis paketas, daugiamatės statistikos metodas – RDA (ReDundancy analysis). Darbo rezultatai. Miškingumas turi sąsajų su sveikatingumu ir oro kokybę miestų savivaldybėse. Nustatytas ryšys tarp miškingumo ir taršos anglies monoksidu patvirtina, kad miškingumas teigiamai veikia urbanizuotos teritorijos orą, kartu ir gyventojų sveikatą. Labiau miškingose miestų savivaldybėse gyventojai mažiau lankosi medicinos įstaigose, rečiau pasitaiko insultų atvejai. Miškų pasiekiamumas labiau sąlygoja gyvenimo kokybę miestų savivaldybėse, nei miškingumas. Nustatytas stiprus... [toliau žr. visą tekstą] / Thesis investigated connections between the parameters of the forest cover, forests accessibility, recreational (2B) group forests and quality of the life. Subject of the research – Lithuanian municipalities (except the town of Neringa municipality) indicators. Aim of the research – to identify the connection between forests’ characteristics and quality of the life on the level of Lithuanian municipalities. Methodology – in the work forests of Lithuanian municipalities, quality of the life (air quality, wellness, birthrate, criminality), other potentially influencing the quality of the life indicators were assessed. For the study data from Statistics Lithuania, National Forest Service, Hygiene Institute Health Information Centre form 2008-2013 year period were used. Separately Lithuanian cities and districts indicators were analyzed and compared. Forest accessibility index for municipalities was determined using GIS technology, data processing and visualization was done using Microsoft Excel programme, STATISTICA software package and multivariate statistical method - RDA (ReDundancy analysis). Results. Forest cover has connections with wellness and air quality in cities’ municipalities. Determined link between the forest cover and carbon monoxide emissions confirms that forest cover has the positive effect on the air of urban areas, herewith on the inhabitant's health. In more forested urban municipalities inhabitants less visit clinics, less were paralytic stroke. Forests... [to full text]

Millions of people are infected with the Hepatitis C Virus (HCV) worldwide. In the UK, many individuals continue to live with undiagnosed HCV infection and are increasingly at risk of developing life-threatening cirrhosis and liver cancer. Of those that are diagnosed, only some are referred to an HCV specialist centre where vital treatment could cure their infection. Of those that are referred, only a proportion have actually attended and stayed in follow-up with a specialist centre. Geographic access to healthcare may be an important factor in these trends, but has so far received little attention in the context of HCV. This thesis examines the influence of geographic access to primary and specialist healthcare on HCV detection, trends of referral, chances of specialist centre utilisation and the odds of staying in follow-up. It also explores association between geographic access and the type of location in which diagnoses were made with the risk of mortality from liver-related causes. HCV detection was lower amongst those with poorer geographic access to primary healthcare, but further analyses suggest this trend is due to selection, not causation. Individuals with the furthest to travel were less likely to be referred to an HCV specialist centre, compared to those who lived closer. Travel-time was not a significant predictor of utilisation of HCV specialist centres, but with patients in more remote areas less likely to be referred, it is probable that the utilisation result is biased due to selection. Liver-related mortality was higher for patients diagnosed in hospitals, but the risk of death was not associated with a lack of geographic access to healthcare.

The Scottish Parliament which (re)convened in 1999 was designed to engender a new style of political practice. This ‘new politics’ was intended to address perceived failures within the ‘Westminster approach’ to policy‐making and the ‘democratic deficit’ believed to have emerged during the 1980s in Scotland. Key to achieving this were four principles around which the Parliament’s operations were designed: power‐sharing; accountability; accessibility and participation; and equal opportunities. Citing accessibility and participation as the ‘cornerstone’ of their work, the Parliament’s institutional architects (the Consultative Steering Group) argued that devolution should deliver a participatory democracy, with proactive efforts to be made by the Parliament to involve groups traditionally excluded from the policy process. Due to the increasing prominence in recent years of discourse relating to young people’s disillusionment with organised politics and the CSG’s recommendation that every effort should be made to include them in the new Parliament’s work, this research examines the degree to which greater accessibility to and participation in the Parliament’s work has been delivered for children and young people during the Parliament’s first two terms (1999‐2007). Findings are based upon a mixed‐methodological case‐study approach, involving an audit of the Parliament's activity and qualitative input from MSPs, Parliament staff, representatives of youth charities / organisations / advocacy groups, and young people themselves. The thesis argues that progress has been more pronounced in relation to accessibility than participation for younger people. The neoinstitutionalist theoretical framework suggests that insufficient rule specification in relation to the value of public participation and younger people has resulted in the emergence of hybridised logics of appropriate behaviour, particularly among parliamentarians. The result is the persistence of attitudes and practices which appear to reinforce aspects of Westminster practice and an adultist approach to young people’s role in politics. Drawing upon recent developments in neoinstitutionalist theories of reliable reproduction, institutional breakdown and gradual change, the thesis examines the institutional logic behind the failure to consolidate the Parliament’s founding vision.

Syftet med denna studie är att bidra med en förståelse för hur rekryterare upplever och hanterar flexibilitet, tillgänglighet och work-life balance i en multinationell och expanderande organisation präglad av det gränslösa arbetslivet. Denna förståelse är betydelsefull då det gränslösa arbetslivet innebär ett stort eget ansvar för individen, vilket skapar en utmaning för individen själv att måna om sin work-life balance och upprätthållandet av ett långsiktigt välmående. För att uppfylla studiens syfte genomfördes femton kvalitativa intervjuer med rekryterare på Spotifys rekryteringsavdelning Talent Acquisition. Resultatet visar en positiv upplevelse av flexibilitet och tillgänglighet tillsammans med en rådande medvetenhet kring de utmaningar som följer av ständig uppkoppling, flexibilitet och tillgänglighet och hur de påverkar medarbetarnas work-life balance, då gränser tenderar att suddas ut och bli mer diffusa. Denna medvetenhet har resulterat i flertalet individuella strategier och hanteringssätt för att hantera det gränslösa arbetslivets utmaningar. / The purpose of this study is to provide an understanding of how recruiters perceive and manage flexibility, accessibility and work-life balance in an multinational and expanding organization characterized by boundaryless work. This understanding is important because the boundaryless work means a great responsibility for the individual, which creates a challenge for the individual to take care of their work-life balance and the maintenance of a long-term wellbeing. To fulfill the purpose of the study, fifteen qualitative interviews were conducted with recruiters on Spotify's recruitment department Talent Acquisition. The result shows a positive experience of flexibility and accessibility, but also shows an awareness of the challenges of constant connectivity, flexibility and accessibility and how they affect employees' work-life balance, and that boundaries tend to become blurred and more diffuse. This awareness has resulted in several individual strategies to handle the challenges of boundaryless work.

Bakgrund: Det är viktigt för äldres välbefinnande och hälsa att känna delaktighet i aktivitet. Delaktighet i aktivitet påverkas av individens egna förutsättningar och miljöns utformning. Hemmet är en viktig aktivitetsmiljö där många äldre spenderar mycket tid. Det är vanligt att äldre flyttar till ett särskilt boende när de är i behov av hjälp och stöd för att klara sin vardag. Syfte: Att studera hur miljön påverkar äldres delaktighet i aktivitet på särskilt boende. Metod: En kvalitativ studie innefattande sju intervjuer med äldre och observationer på tre olika särskilda boenden har genomförts. Resultat: I resultatet framkom de fem kategorierna bristande tillgänglighet i den fysiska miljön, tillgångar i den fysiska miljön, betydelsen av hjälpmedel, betydelsen av att interagera med andra människor samt personalens betydelse för de äldres delaktighet i aktivitet. Den fysiska miljöns utformning bidrog till att de äldre inte uppfattade det särskilda boendet som hemlikt då de inte fick plats med alla de personliga tillhörigheter de önskade. Det visade sig att många äldre kände sig ensamma och inte upplevde någon samhörighet med de medboende. Gemensamma aktiviteter var mycket uppskattat av de äldre bland annat eftersom det gav dem en möjlighet att interagera med andra. Konklusion: Den fysiska och den sociala miljön på ett särskilt boende kunde både främja och hindra äldres delaktighet i aktivitet.

Recent developments in the field of education have led to a proliferation of educational technologies (or “ed-tech”), yet access to educational content for students with special needs remains a challenge. This research study aims to assess the current state of accessibility in emerging ed-tech and to identify barriers in enabling educational content to be born accessible. Detailed discussions with various ed-tech platforms revealed less of a need for technical tools, but a more prevailing need for knowledge and education around accessibility – what it means and how best to incorporate accessibility into their platforms. The more experienced teams advocate incorporating accessibility into product development right from the design phase, while the younger teams expressed challenges in navigating accessibility laws and the dire need for easy-to-follow guidelines and best practices. A detailed review of educators' content creation processes reveals multiple dependencies in the ecosystem of ed-tech where partnerships and compatibilities are crucial in enabling accessibility throughout the process. Likewise, an urgent need exists for increasing awareness of accessibility among instructors authoring educational content using emerging ed-tech.

National parks have famously been called "America's best idea" and preserve the nation's natural and cultural resources for the enjoyment of all. One of the current working priorities of the National Park Service (NPS) is enhancing the relevancy and engagement of the national parks with diverse audiences, especially for underserved groups. To address this priority, transportation is needed to provide access to national parks, but transportation may not be equally accessible to all groups in society. Understanding the effects of transportation on visitation to the national parks by racial/ethnic groups is essential for the NPS to improve the accessibility of transportation systems and encourage greater visitation by racial/ethnic minority groups. Moreover, transportation can be more than a means of access, it can also be a form of recreation itself, providing opportunities for visitors to experience and appreciate parks and related areas. But, differences in desirability of transportation recreation opportunities across recreation settings and among racial/ethnic groups are rarely addressed. The intent of this dissertation is three-fold: 1) identify transportation related barriers impacting visitation to national parks by racial/ethnic groups, and the effects of transportation on the visiting national parks, 2) identify the differences in indicators of the transportation recreation opportunity spectrum among racial/ethnic visitors and across recreation settings, 3) measure spatial accessibility of national parks and the effects of spatial accessibility and other factors on visitation to national parks among racial/ethnic groups. The first phase of research is designed to identify barriers to visiting national parks that are related to marginality, subculture, and discrimination hypotheses, and examine the effects of transportation incentives on visitation among racial/ethnic groups. Study results found that racial/ethnic minority groups visited national parks less frequently than Whites. Hispanics were more likely to perceive transportation-related barriers to visiting national parks than Whites. Moreover, providing transportation incentives can increase visitation by Hispanics significantly. The second phase of research developed indicators for a transportation recreation opportunity spectrum (T-ROS), and examined the differences in desirability for T-ROS indicators among alternative transportation modes, different types of recreation settings, and different racial/ethnic groups. Study results identified the important indicators for transportation service in different types of recreation areas, which can help inform transportation planning and management for the NPS. The final phase of research examined the spatial accessibility of national parks from different geographic locations by incorporating geospatial analytics, assessed the spatial accessibility of different types of national parks among racial/ethnic groups, and estimated the effects of spatial accessibility on visitation to national parks. Results showed that Hispanics and Blacks had higher accessibility to national parks than Whites within short distance radii, however, Blacks and Hispanics were more likely to perceive distance as a barrier to visiting national parks than Whites. Study results can help the NPS understand the spatial structure of national parks, provide visual information for visitors about proximate national parks and recreation opportunities, and identified effective management strategies for enhancing visitation of racial/ethnic minority groups from different geographic areas.

Les villes Indonésiennes telles que Jakarta, Surabaya, Medan et Semarang ont un niveau de développement très rapide. Elles concentrent beaucoup d'activités économiques et d'emplois. L'infrastructure du transport ne soutient pas ce développement économique et le marché de l'emploi. La recherche sur mobilité et accessibilité au marché de l'emploi dans les villes Indonésiennes est quasiment rare. Dans cette recherche, nous voulons essayer de montrer les caractéristiques de la mobilité et du marché de l'emploi en Indonésie afin d'enrichir la connaissance de ce domaine notamment pour le cas du pays en voie de développement / IIndonesian cities such as Jakarta, Surabaya, Medan and Semarang have a rapid development level. These cities concentrate many economic activities and employments. Transport infrastructure do not support this rapid economic development and labor market. Research on mobility and accessibility of labor market in Indonesian cities is quite few. In this research, we would like to show the characteristic of mobility and labor market in Indonesia in order to enrich the knowledge of this domain especially for developing country case