Abstract not available

The aim of this small-scale study was to examine the phenomenon of "stuckness" (Kanter, 1979) in ways that would inform and direct efforts to maintain and reinforce community college faculty effectiveness. Focus was on full-time faculty who had been teaching ten or more years in the same community college. The sample (N = 27) was drawn from five member institutions of the Massachusetts Regional Community College System. Using a survey instrument, an interview schedule, and a validated measure of job satisfaction (Wood, 1973), the investigator tested two basic hypotheses: (1) that the psycho-social conditions of stuckness and its extreme opposite, generativity, are present among senior community college faculty; and (2) that stuck and generative faculty, respectively, have in common distinct clusters of characteristics. The data revealed six variables of particular significance in characterizing the psycho-social state of an instructor--overall job satisfaction, attitude toward students, time spent on campus each week, satisfaction derived from teaching, current feeling about having entered teaching, and having (or not having) a student-oriented five-year plan. An unanticipated outcome was the identification of a third distinct category, "insulated," related to the developmental stage of "levelling off" (Hall and Nougaim, 1968). Insulated faculty report overall job satisfaction but do not manifest other characteristics associated with the generative cluster. Conclusions instructive to institutional efforts to maintain, renew, and reinforce faculty effectiveness were: (1) Generativity would appear to be, at least to a degree, impervious to the absence of hygiene factors. (2) Similarly, stuckness is an internalized condition of minor frequency that appears unrelated to external factors. (3) Because insulated faculty comprise the largest group and appear to be influenced more than other groups by hygiene factors, they represent the most promising target group for institutional intervention. (4) Formal programs of staff development have little impact on senior faculty, continuing involvement in professional development being an effect of generativity, not a cause. The researcher recommends replication of the study using a sample large enough to permit testing for statistical significance, as well as a similar study of less senior faculty. He suggests that linguistic analysis may also be used for identifying psycho-social states of faculty.

Three ninety-minute in-depth phenomenological interviews were held with each of eighteen returning women students in nine community colleges in four states. The central problem of the study was to identify the constitutive factors in the experience of these returning women students, to explore their educational experience as they viewed it, and to discover what it meant to them. Through a qualitative analysis of the interview material, the study attempts to understand, describe, and explain, from a feminist perspective, the educational experience of women from twenty-five to seventy years of age who have returned to traditional schooling after an absence of four to fifty years and who have chosen a community college as their first point of re-entry. The study examines those factors which appear to lead to growth and change for individual women and to a sense of equity and power in their lives. Forces that limit growth are also identified. Significant themes in the experience of the participants are such issues as: how older women students are advised and taught in the community college; what it is like to study, keep a job, and care for children simultaneously; and how race, class, age, and gender intersect in the two-year educational setting. Implications are drawn and recommendations for action on the part of community college administrators, faculty, staff, and students are made.

The purpose of this study was to identify salient factors influencing the effectiveness of middle managers in higher education and to develop recommendations that will reinforce conditions contributing to effectiveness and alter conditions found to be inhibiting effectiveness. Chairpersons of career divisions in the Massachusetts Community College System were studied. The case-study approach was utilized, with the interview as the primary method for data collection. The maximum variation sampling strategy with a purposeful sample was used. The primary unit of analysis was the individual chairperson and the primary data source was a sample of 10 chairpersons of career divisions at seven of the System's 15 colleges. The sample comprised 27 percent of the chairpersons of career divisions. Three academic deans and three faculty members of career divisions were also interviewed. The data sources were triangulated. A case record was developed and the data were analyzed. The data indicated that there was much agreement among all of the data sources as to the factors which influenced the effectiveness of chairpersons of career divisions. The data revealed that the three basic categories of factors which influenced the effectiveness of division chairpersons were: leadership skills, organizational conditions, and the attitudes/expectations/values of the division chairpersons. Several implications were inferred from the findings and several recommedations were made. The recommendations were that: (1) a common job description needed to be developed for all division chairpersons; (2) deans needed to provide annual performance counseling for division chairpersons; (3) staff development opportunities needed to encourage human resource development; (4) the organizational character of community colleges needed to encourage human resource development; (5) division chairpersons needed to be given a substantive role in collective-bargaining negotiations; (6) state government needed to provide additional human and material resources to allow the division chairpersons to function more effectively.

The setting for the research is the urban areas of Cape Town, South Africa where the notification rate of tuberculosis is the highest in the world. Despite the availability of modern drugs, the cure rate is low and approximately 40% of diagnosed patients do not adhere to treatment. This has serious implications for the spread of multiple drug-resistant tuberculosis. The relationship between the patient and health care providers is one of the main determinants of compliance to medical treatment. The main aim of the thesis is to develop an understanding of how nurses experience their work with patients who have pulmonary tuberculosis. The research explores how nurses interact with patients, how nurses perceive their relationship with patients and the processes and organisational arrangements which contribute to the patterns of nurse-patient interaction. The interpretive research design was largely informed by an ethnographic approach. The iterative research process led to several sub-studies; the analysis of each sub-study led to a further cycle of data collection. Data collection techniques include participant observation of nurse-patient interaction and depth interviews with nurses and key informants. An exploration of opportunities to change the prevailing work patterns yielded data on nurses' responses to change. The data were captured as field notes or audio taped and analysed thematically by using qualitative methods and by the application of psychodynamic theory. The research identifies task orientation and patient-centredness as the main patterns of nurse-patient interaction. Task orientation was found to be the dominant work pattern. Its origins are traced to the colonial history and to the influence of Taylorist labour practices. Task orientated work patterns are maintained because of complex mechanisms which operate at both intrapersonal and interpersonal levels. It is argued that the history of racial politics and racial identity has influenced the ways in which nurses manage the degree of distance between themselves and patients. The findings suggest that the closer the nurses identify with patients in terms of ethnic background, the more the nurses may feel the need to distance themselves from the patients. The notion of tuberculosis as a stigmatised disease, the concept of compliance, and the implementation of control measures such as directly observed therapy are critically examined. An exploration of the illness experiences of nurses who become infected with tuberculosis, provides an opportunity to explore how nurses perceive the role of the caregiver when they are in the unfamiliar position of being patients. The findings have implications for public health interventions aimed at transforming nurse-patient interaction. It is recommended that change management processes explicitly acknowledge the consequences of decades of apartheid policies and practices on the behaviour of health professionals and the users of health services. In the years to come change agents will need to address the emotional pain of the past, as well as the more well-known sources of organisational resistance to change.

Objectives: The primary objective of this study was to assess whether active tuberculosis (TB) accelerates the course of HIV-1 infection by measuring progression to AIDS and mortality in HIV-infected patients. Secondary objectives were to evaluate whether TB should be considered an AIDS-defining illness in an area with a high prevalence of TB, and to assess the risk factors for developing TB in HIV-1 infected patients. Setting: New Somerset and Groote Schuur Hospital adult HIV clinics, Department of Medicine, Faculty of Health Sciences, University of Cape Town. Design: Prospective patient cohort study with five years of follow-up. Sample: Adult HIV-infected patients presenting to the two HIV clinics between 1992 and 1996. Methods: The TB case definition was a positive culture or a compatible clinical picture combined with a positive smear or a histologic diagnosis. TB patients were treated with 6-month short course regimens. The Kaplan-Meier method was used to estimate the overall survival times of tuberculosis and non-tuberculosis patients. The generalized log rank test was used to compare the survival curves of these two groups. The Cox proportional hazards regression method was used to determine the risk of death associated with tuberculosis while adjusting for potential confounding variables (i.e. age, CD4+ count, history of an AIDS-defining illness, use of co-trimoxazole prophylaxis, and antiretroviral therapy, etc.). The Kaplan-Meier method was used to evaluate the prognosis of HIV-infected patients with TB vs the prognosis of HIV-infected with other HIV ( or AIDS, as defined by the WHO or the CDC staging systems) related diseases at baseline. The generalized log rank test was used to compare the survival curves of the TB group vs the other groups. Predictors of active TB in HIV-infected patients were assessed using univariate and multivariate logistic regression models.

Includes bibliographical references. / Health Departments across South Africa face increasing financing constraints comparable to other developing countries and reported internationally. During the 1997/98 financial year, the Department of Health (DOH), Provincial Administration of the Western Cape (PAWC) faced huge cuts in its financial resource allocation from the National Department as policy shifted to wards addressing past inequity between the provinces. In the Western Cape Province, 200 regional hospital beds have already been closed with a further 500 beds located in academic health centres earmarked for closure. Hospitals in the province consume over 73% of the health care budge at PAWC and faced with budget cuts, research teams were approached to evaluate the supply of acute care hospital beds focusing on efficiency and equity in order to guide rational policy decisions to achieve savings from hospitals.

Various financial models were developed in the process of planning for the restructuring of academic health services in the Western Cape. In an attempt to inform and assist this process, these models are described, critically analysed and in certain cases further developed. Since most of these models are dynamic and have been developed within computer spreadsheet applications, the relevant files are included here on computer disk and form an integral part of this submission. The background to restructuring is first explored, the models are examined, and then the implications for policy, resource allocation and academic health services are discussed.

Submitted in fulfillment of the requirements for the award of a degree of Masters of Arts in Library and Information Science from the Department of Information Studies at the University of Zululand, 1997. / Since the establishment of the first libraries paradigm shifts occured, especially during times of political, social and cultural upheavals and change. It was the public library, more than any other library system, which had to continually adapt its services as its clientele changed from the privileged few who could read and write, to the masses who looked upon the library as an instrument for mass education. Although the Western public library service did not fulfil a formal educational role, it aimed to support informal and life¬long education . On the African continent public libraries were perceived as tools for mass education for a population thirsting for knowledge. Whereas in developed countries public libraries could still function by providing a relatively passive, buildings-based service, this was not possible in developing countries. What was needed to be relevant to the needs of the public, was a pro-active service, based on each specific community's needs. The ills of the public library system transplanted to Africa prevented such pro¬active and innovative services, thus leaving in its wake a disillusioned public as well as governments. Alternative approaches to rendering the services needed have been attempted, but with little sustained effort and success. At face value the South African public library system has seemed to be a well-organised and well-developed service. Unfortunately the country's political past hampered the provision of equal services to all race groups. This resulted in a service based on the needs of just one race group, excluding the majority of the population from gaining equal access to information. This situation is currently under revision, and serious efforts are being made to rectify the situation. As is the case with the rest of Africa, it would seem that far reaching adaptations to the existing service structure need to be made to enable the whole society to benefit from the services provided by libraries. Some pro-active and innovative library professionals have already started implementing alternative services to communities previously excluded from using library services provided for developed communities. These vanguard services, known as community libraries and resource centres have found innovative ways and means of serving their respective communities. The characteristics of community libraries were analysed in order to determine the functioning of this innovative system. The Pinetown community libraries aim to bring an information service to their disadvantaged communities. The research has shown that these community libraries are providing a service which has moved a considerable distance along the road of becoming a pro-active community service. Although there are still many shortcomings, the process of transformation is well under way.

A dissertation of limited scope submitted to the Faculty of Arts in partial fulfilment of the requirements for the course-work Master of Arts degree in the Department of Social Work at the University of Zululand, 2000. / This study examined the impact of crime on socio-economic development at Somopho Tribal Authority, which is a rural area under Nselem (Lower Umfolozi) district. The researcher is concerned with the growing rate of crime, which is perceived to have affected community development. Survey research methods were employed in this study and adhered to two techniques of data collection, namely, self-administered questionnaires and person-to-person interviews. The limitations of the study were economic and time factors. Hypotheses were tested, confirmed that there is indeed a relationship between high crime levels and unemployment. The study found that the Somopho area is fraught with problems of high unemployment high crime levels and lack of physical infrastructure. Secondly, it was shown that the levels of crime like robbery and assault cases are the order of the day. Many crimes are committed either during the day or at night. This study made several recommendations relating to what should be done to ensure that local residents, potential developers and investors feel safe at Somopho. .Among other recommendations put forward are the establishment of community relations with the police, like community policing forums (CPFs) and development community safety centres.