PhDH / Department of Public Health / Background: Since the introduction of three-tiered systems appointments, there are a large number of missed appointments among Human immunodeficiency virus-positive clients on Antiretroviral. However, no one knows why these clients missed their scheduled times. Missing of appointments predicts poor adherence and is associated with poor clinical outcomes. Objectives: The proposed study aimed at developing a strategy for reducing the missing of appointments among adults on Antiretroviral Therapy in the Limpopo Province, South Africa. The objectives of the study are to determine patients’ behaviour, the socio-environmental and economic factors that contribute to the missing of appointments and develop strategies to enhance compliance with appointments by Human immunodeficiency virus-positive clients on Antiretroviral therapy in the Limpopo Province. Method: A qualitative research design was used to address the study objectives. Non-probability purposive sampling was used to sample health care centres in Limpopo Province, patients, Professional Nurses and Community Health Workers. Individual interview and focus group discussions strengthened the triangulation of data obtained from the participants. Creswell’s model provided details for data analysis and interpretation. Trustworthiness and Ethics: Measures to ensure data quality, such as credibility, dependability, conformability and transferability, were observed. The researcher ensured compliance with ethical standards to protect the rights of the participants. Approval for this study was obtained from the University of Venda Research Ethics Committee and the Limpopo Department of Health Research Ethics. Results: The study revealed various factors that contribute to the missing of appointments by Human immunodeficiency virus positive-clients on Antiretroviral Therapy. Specific socioeconomic, behavioural, environmental and health service-related factors appear to prevent adherence to appointments. These factors include a lack of family support and client engagement, the absence of financial means, and cultural and religious beliefs. Lack of client involvement in planning their care and poor referral of clients to community health workers were ranked high as being the most contributing factors to clients missing their appointments. Strategy development: Phase 2 of this study dealt with the development of the strategy aimed at reducing the missing of appointment by adults on Antiretroviral Therapy based on the findings of the study. The strengths, weaknesses, opportunities and threats matrix was triangulated in Political, Environmental, Social, Technological and Legal analysis to develop this approach to reduce the missing of appointments among adults on Antiretroviral therapy. A transtheoretical framework illustrated how to implement the strategy. Validation of the developed strategy ensured that the system is free of errors and checked the applicability of the strategies utilising a quantitative design. A simple random sampling approach was used to select the population to participate in this study using the questionnaire developed by the researcher. Almost all respondents agreed that the strategy would facilitate reduced missing appointments by adults on Antiretroviral therapy. Recommendations: Clients involvement and engagement throughout the process of a treatment plan is essential to identify some of the barriers that might contribute to poor adherence to appointment by clients on Antiretroviral therapy. Community health workers and nurses should be capacitated with knowledge and skills to identify the clients at risk of defaulting treatment and appointments and provide counselling that will facilitate behaviour modifications. / HWSETA

No description available.

attitudes amongst the members of different races towards the implementation of affirmative action in the Correctional Services Department of South Africa. A literature study on affirmative action was completed and thereafter a questionnaire was developed. An emperical study was done by questionnaire on the determination of perceptions and attitudes of members of the South African Correctional Services Department towards the application of Affirmative Action policies. serious problems if not correctly managed. It was established that the success in any affirmative action strategy rests on the understanding and acceptance of cultural diversity as manifested in perceptions and attitudes. Management information systems needs to be effective and efficient at all times. Changing perceptions and attitudes increased passion and job satisfaction. Recommendations are made for further research on aspects highlighted by the findings. / Penology / M.A. (Penology)

[pt] O estudo tem como foco a negociação de identidades em situação de conflito em contexto de consulta médica pediátrica de crianças e adolescentes com diagnóstico de Transtorno de Déficit de Atenção e Hiperatividade (TDAH), em atendimento de rotina conduzido pela médica. O objetivo consiste em criar inteligibilidades sobre os conflitos familiares consequentes do transtorno e as identidades projetadas/negociadas por pais, crianças e adolescentes com TDAH, para si e para o outro. A pesquisa está ancorada em linhas teóricas da fala-em-interação em atendimento clínico. Situa-se na Linguística Aplicada das Profissões, em articulação com a Análise da Conversa Etnometodológica, em contexto institucional, com a Sociolinguística Interacional e com os estudos discursivos sobre identidades. A metodologia da pesquisa, de natureza qualitativa e interpretativista, com gravação em vídeo de quatro consultas pediátricas, tem caráter etnográfico, mediante observação participante na antessala de atendimento. Os dados foram transcritos de acordo com convenções da Análise da Conversa Etnometodológica. Os resultados das análises mostram a prática profissional da médica nos enquadres de consulta clínica e de orientação psicoeducativa. A médica realiza tanto atividades relacionadas a tarefas de avaliação física e comportamental das crianças e dos adolescentes, em ações que visam ao tratamento medicamentoso e psicológico do TDAH, quanto atos comunicativos como formuladora, mediadora e conselheira na intermediação de conflitos emergentes da inter-relação TDAH, família e escola, resultantes do comportamento dos filhos nas relações familiares e do baixo rendimento acadêmico destes no contexto escolar. Os pais se alinham junto à médica, no enquadre de transtornos escolares dos filhos, e estabelecem enquadres conflitantes junto aos filhos; projetam para si identidades cujos atributos oscilam entre participativos, compreensivos e responsáveis, e impacientes, frustrados e esgotados. As identidades que projetam para os filhos apresentam-se, por vezes, contraditórias, entre filhos amorosos, perspicazes e irritantes; e alunos inteligentes, ineptos e displicentes. As crianças e os adolescentes, embora se alinhem com a médica, nos enquadres de consulta e orientação, rejeitam o estigma de TDAH e projetam para si identidades de alunos e filhos respeitosos e intelectualmente capazes; e para seus pais, na maioria das vezes, de pais impacientes e exigentes em sua educação. O estudo proporciona maior entendimento da complexidade e das múltiplas atividades da atuação profissional da médica na consulta pediátrica, e contribui para uma melhor compreensão das experiências cotidianas de pais, crianças e adolescentes com TDAH, marcadas por conflitos desestruturantes da harmonia entre esses atores sociais nos contextos da escola e da família. / [en] The study focuses on the negotiation of identities during conflict situations in the context of pediatric appointments for children and teenagers diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), in routine care conducted by the doctor. The main purpose consists on creating intelligibilities about the family conflicts resultant from the disorder and the identities projected/negotiated by the parents, children and teenagers with ADHA, for themselves and others. The research is based on theoretical lines of speech-in-interaction regarding clinical care. It is situated on Professions Applied Linguistics, in articulation with the Ethnomethodological Conversation Analysis, in an institutional context, in Interational Sociolinguistics and on discursive studies about identities. The research methodology, of a qualitative and interpretive nature, with video recording of four pediatric appointments, has an ethnographic character, by a participant observation in the Doctor’s office waiting room. Data were transcribed in accordance with conventions of the Ethnomethodological Conversation Analysis. The analyzes results indicate the professional practice of the Doctor concerning clinical care and the psycho-educative orientation. The Doctor carries out activities related to physical evaluation and behavior tasks of children and teenagers, in actions that aim at the ADHA medicated and psychological treatment, and also the communicative acts as a formulator, mediator and advisor when intermediating conflicts emerging from the ADHA, family and school inter-relation, resultant from the behavior of the children in family relation and the their low academic performance in the school context. The parents align with the Doctor, in the framings of their children school disorders, and stablish conflicting framings together with their children; they project to themselves the identities whose attributes oscillate between participative, comprehensive and responsible, and impatient, frustrated and exhausted. The identities that project toward children are occasionally presented as contradictory, among the children considered lovely, insightful and annoying; and intelligent, inept and ungracious students. Children and teenagers, although being aligned with the Doctor, in the framings of appointments and orientation reject the ADHA stigma and project to themselves the identities of students and children considered to be respectful and intellectually capable; and for their parents, most of the time, identities of impatient and demanding parents regarding education. The study provides a greater understanding of the complexity and the multiple activities of the professional performance of the Doctor during the pediatric care, and contributes for a better understanding of the daily experiences of parents, children and teenagers with ADHA, marked by destabilizing conflicts of harmony between these social authors in the school and family contexts.

<p>Local government is arguably the most significant sphere of government to lay citizens, as it is the point of contact of citizens with their government. Local government enables a direct link between the general public and the basic services that they are entitled to by means of their constitutional and legislatively entrenched rights. It is the only sphere of government that allows and encourages face-to-face engagement between citizens and their governors, providing the necessary platform for interaction, contact and communication. It is imperative therefore that this tier of government operate optimally and competently, as it represents a reflection of the operation of government wholly. Research unfortunately illustrates that public perceptions of local government are negative, with levels of trust in local government being substantially lower than those in provincial and national governments. The responsibility for failure to perform would lie squarely on the shoulders of those individuals leading any institution. The leading incumbents driving a municipality are the political and administrative heads, i.e. executive mayor and municipal manager.</p>

<p>Local government is arguably the most significant sphere of government to lay citizens, as it is the point of contact of citizens with their government. Local government enables a direct link between the general public and the basic services that they are entitled to by means of their constitutional and legislatively entrenched rights. It is the only sphere of government that allows and encourages face-to-face engagement between citizens and their governors, providing the necessary platform for interaction, contact and communication. It is imperative therefore that this tier of government operate optimally and competently, as it represents a reflection of the operation of government wholly. Research unfortunately illustrates that public perceptions of local government are negative, with levels of trust in local government being substantially lower than those in provincial and national governments. The responsibility for failure to perform would lie squarely on the shoulders of those individuals leading any institution. The leading incumbents driving a municipality are the political and administrative heads, i.e. executive mayor and municipal manager.</p>

No description available.

attitudes amongst the members of different races towards the implementation of affirmative action in the Correctional Services Department of South Africa. A literature study on affirmative action was completed and thereafter a questionnaire was developed. An emperical study was done by questionnaire on the determination of perceptions and attitudes of members of the South African Correctional Services Department towards the application of Affirmative Action policies. serious problems if not correctly managed. It was established that the success in any affirmative action strategy rests on the understanding and acceptance of cultural diversity as manifested in perceptions and attitudes. Management information systems needs to be effective and efficient at all times. Changing perceptions and attitudes increased passion and job satisfaction. Recommendations are made for further research on aspects highlighted by the findings. / Penology / M.A. (Penology)

Magister Legum - LLM / Local government is arguably the most significant sphere of government to lay citizens, as it is the point of contact of citizens with their government. Local government enables a direct link between the general public and the basic services that they are entitled to by means of their constitutional and legislatively entrenched rights. It is the only sphere of government that allows and encourages face-to-face engagement between citizens and their governors, providing the necessary platform for interaction, contact and communication. It is imperative therefore that this tier of government operate optimally and competently, as it represents a reflection of the operation of government wholly. Research unfortunately illustrates that public perceptions of local government are negative, with levels of trust in local government being substantially lower than those in provincial and national governments. The responsibility for failure to perform would lie squarely on the shoulders of those individuals leading any institution. The leading incumbents driving a municipality are the political and administrative heads, i.e. executive mayor and municipal manager. / South Africa

OBJECTIVES: To model the frequency of 'last minute' cancellations of planned elective procedures in the English NHS with respect to the patient and provider factors that led to these cancellations. METHODS: A dataset of 5,288,604 elective patients spell in the English NHS from January 1st, 2007 to December 31st, 2007 was extracted from the Hospital Episode Statistics. A binary dependent variable indicating whether or not a patient had a Health Resource Group coded as S22--'Planned elective procedure not carried out'--was modeled using a probit regression estimated via maximum likelihood including patient, case and hospital level covariates. RESULTS: Longer waiting times and being admitted on a Monday were associated with a greater rate of cancelled procedures. Male patients, patients from lower socio-economic groups and older patients had higher rates of cancelled procedures. There was significant variation in cancellation rates between hospitals; Foundation Trusts and private facilities had the lowest cancellation rates. CONCLUSIONS: Further research is needed on why Foundation Trusts exhibit lower cancellation rates. Hospitals with relatively high cancellation rates should be encouraged to tackle this problem. Further evidence is needed on whether hospitals are more likely to cancel operations where the procedure tariff is lower than the S22 tariff as this creates a perverse incentive to cancel. Understanding the underlying causes of why male, older and patients from lower socio-economic groups are more likely to have their operations cancelled is important to inform the appropriate policy response. This research suggests that interventions designed to reduce cancellation rates should be targeted to high-cancellation groups.