Thesis (M.P.A.)--University of Hong Kong, 2000. / Includes bibliographical references. Also available in print.

Thesis (Ph. D.)--University of Texas at Austin, 2006. / Vita. Includes bibliographical references.

This study is intended to contribute to the existing body of knowledge relative to social protection of Orphans and Vulnerable Children (OVC). It proffers recommendations on sustainable assistance mechanisms which will ensure effective support systems for improved quality of life for OVCs. The impacts of orphanhood and other vulnerability issues on children directly challenge social protection systems and how they support the wellbeing of the children. This presents grave threat to social and economic development as well as the wellbeing of children. Child Support Grant (CSG) is one of South Africa’s largest social protection programmes targeting vulnerable children. The effectiveness of the grants in addressing the concerns of the children is greatly dependent on how it is utilised. The aim of this study is for a review of the support systems for OVCs in South Africa, within the context of social grants to determine its viability to address the challenges of vulnerability. The study is informed by empowerment framework as theoretical paradigm; which postulates that people need to be empowered through sustainable programmes that enhance their capacities to realize their full potentials and become self-sufficient. The study reviewed and appraised relevant approaches that aid empowering OVCs in order to ensure that they are supported to move from state of helplessness to an empowered state. A quantitative research method was used for the survey, data analysis and review. A case study approach was adopted for the study. The population of this study consisted of selected families of OVCs and community volunteers in Port St. Johns and Ndlambe local municipalities of the Eastern Cape Province. The study findings show that the CSG is relevant in the context of providing the needed support for the OVCs, which will enhance their wellbeing and development. It identified CSG as a mechanism which supports the concept of ensuring that OVCs have an adult caregiver who supports them. It shows that the CSG is able to reduce the number of OVCs without an adult caregiver. xii The study identified that many of the caregivers of the OVCs do not have other source of income and this affects their utilisation of the grant to attend to the needs of the children such as caregivers who do not support the wellbeing of the children though they receive CSG. The findings did not identify many challenges with the functioning and management of the CSG scheme. The concerns identified by the study are related to challenges of accessing the grant. The findings show that the caregivers do not encounter obstacles while applying for CSG for reasons related to the fact that some of them are being assisted. It shows that most children that are eligible but are not receiving CSG were for reasons such as caregiver not applying on time for the child or lack of documents required for the application. The study further noted that it was mostly caregivers that were not assisted during the applications process that experienced difficulties. The study observed that supporting the needed infrastructure in resource constrained environment is necessary to assist the children. Building facilities for banking, health care, and recreation as well as educational facilities such as libraries and computer centres were identified as relevant in schemes that aim to improve the quality of lives of children. The study findings revealed that hunger and deprivation could be a defining factor, which influences a child’s interest in education. It concludes that the provision of CSG to families could have strong influence in determining children’s interest in education. The study identified other support systems in the community that complement the CSG mechanism. The supports includes the assistance to process the application for CSG as well as guidance in the utilisation of the grant; after school care programme which provides opportunity for children to receive additional educational support; and material assistance for OVC families. The supports were mostly through community volunteers of organisations in the communities. These supports were found to be useful in supporting the caregivers of the OVCs to support the children.

Class of 2008 Abstract / Objectives: The purpose of this study is to determine the usefulness of expanded pharmaceutical care services and pharmacist involvement in smoking cessation for patients in a community setting, to identify demographical parameters for the population which might benefit the most from pharmacist intervention, and to examine the cost benefit of such intervention. Methods: This descriptive retrospective study was conducted through a MEDLINE search for all available literature regarding the efficacy of pharmacists in a community setting and smoking cessation outcomes. The results from these studies were then analyzed in order to identify demographic factors which may be associated with higher rates of positive outcome, and the potential cost benefit of such intervention. Information examined from the various articles included: type of study, method of data anaylsis, study/intervention location, patient age, sex, race, other comorbid conditions, and success rates including p values/odds ratios when stated. Results: After the original search, 63 publications were found using MEDLINE, including 12 systematic reviews and 3 clinical trials. After filtering, a total of 28 articles were analzyed. No correlations between demographic factors and successful smoking abstinence were found. All publications, save one, found a positive correlation between higher levels of intervention and increased smoking abstinence rates. Cost effectiveness varied depending on which method of NRT was utilized, ranging from $720 to $2360 per QALY saved. Several national health organizations have published guidelines stating the role of the pharmacist as essential in smoking cessation. Conclusions: Pharmacists have begun to play an essential role in smoking cessation, as evidenced by many successful ventures that have taken place to date. Still, there is vast potential for expansion of pharmaceutical care services in this area.

Thesis (M.A.)--Villanova University, 2008. / Political Science Dept. Includes bibliographical references.

No description available.

The thesis considers the characteristics of the nursing labour market in which the National Health Service operated from 1948 until I983 and presents econometric estimates of the supply functions of nursing staff. The monopsony of the central government in the market for nurses permits it to depress the pay of nurses. Together with the peculiar budgeting system of the N.H.S., this resulted in a 'shortage' of nurses, in the economic sense of excess demand, from 1948 until 1976, when the market became demand constrained Until 1976, the number of nurses employed was determined by supply. This permits the observed number of nurses employed by the N.H.S. until I976 to be treated as observations on a supply function. The time series of observations until I976 is used to estimate supply functions for six different groups of nursing staff employed in non-psychiatric hospitals in England and wales. These groups are: whole-time and part-time Registered Nurses: whole-time and part-time Enrolled Nurses: whole-time and part-time Nursing Auxiliaries, These six groups are distinct in their response to pay and other factors affecting nurse labour supply. Separate consideration is given to nurse training. Entry to student and pupil nurse training is considered separately. Econometric estimates of the impact of pay, unemployment and the number of young women in the population on entry to nurse training are presented. There are sections devoted to the problem of withdrawal during training. A separate study of midwifery staff uses data which is seldom available to estimate the impact of pay and other factors on the survivor function. The thesis concludes by considering the impact of changing the pay negotiating procedures of the N.H.S. on its cost.

Information technology (m has become crucial to the functioning of modern hospitals. It includes a range of human elements, infornlation, equipment, knowledge and systems. It is important to hospitals, as these are complex environments including many systems with diversity of functions, sub-systems, and professionals. The adoption of technology can be explained by four general theories: economic, political, social and globalization theory. Based on these theories five sets of reasons can account for the adoption of IT in a hospital environnlent. They are, practical; to solve existing problems, economic/business; to achieve d profit or reduce costs or both, rational; to achieve efficienL1' and effectiveness, social; to respond to pressure from society for political reasons and to increase positive image, and supply driven forces by which IT producers seek to sell their products and services. However, no one theory or set of reasons can by itself explain the precise drive for use of IT because nluch depends on each hospital's needs and surrounding drcunlStances. The purposes of this research are to investigate the extent to which IT is being used in Gulf Corporation Council (GCC) public hospitals, why IT has been adopted, and the impact of IT on hospital managementThe methods used in conducting this research were based lllainly on three established methods for searching and collecting infomlation; a literature review, the surveyor questionnaire, intervie,,'s and case studies. Five case studies in Qatar, the United Arab Emirates (UAE) and Bahrain were undertaken to cover Gee hospitals and medical centres populations. Most health and medical services in Gee Countries are provided by public hospitals which account for approximately 64% of total hospital provision, employ most medical professionals, mainly expatriates, and contain most patient beds. In Gee hospitals, IT is still in the early stages of implementation. IT has been found to be adopted at a low level due to reasons such as lack of awareness, other priorities in health policy strategies, and the low level of funding allocated. IT can provide hospitals with many benefits, solve many problems and has many inlpacts on human and functional systems, internal power balances and on the social status of hospitals. The benefits are found to be mostly in the areas of processing work. Therefore, the areas which were given priority for IT implementation were medical records, finance, and personnel areas. No significant impacts v"ere found on hospital structure, chain of conlllland, span of control and nUlllber of employees, however, itwas found that IT increased management power, hospitals' social in1age and hospital political power, while there were disagreements about IT impacts on employees' social relations. The evaluation of IT impacts on Gee hospital management shows that the impacts were not at the same level of intensity or direction, for example, sonle impacts ,",'ere positive and some negative; some significant, moderate or nurunlal, some ambiguous or obvious, were some were slow and some fast. Some efforts at Gee States level were made to develop a model of adopting IT but no real results were detected. However, the future role of IT in Gee public hospitals will be increasing perhaps at a slower pace, but two strategic issues should be given proper consideration; first; the role of the education system, research centers, and industrictl foundation, and the second strategy concerns hospital systems and services structure. This later is related to increased privatization of medical services, economic pressure, and changes in governments' employment strategy. The importance of this thesis is to draw the attention of decisionmakers to the role of IT as an efficient managerial tool in some respects and to provide a foundation for future studies

This thesis identifies the constraints to FP utilisation at the policy, service, community and household levels based on the perspectives of policy makers, providers of services, and men and women in different communities of Jordan. It contributes strategies to widen access to FP that are transferable to other countries of the Middle East and the developing world. The policy environment is analysed to assess whether it encourages or deters FP utilisation. The National Population Strategy is highlighted. Improving co-ordination between the different policy players is a major challenge faced in its implementation. FP utilisation is portrayed in four clinics using different models of provision. Service statistics, clinic observations, in-depth interviews, focus and natural group discussions are used to compare the degree of access to FP. Strengthening co- ordination mechanisms between the service providers is an important strategy to increase FP utilisation. The findings suggest that FP decisions are mostly influenced by men who remain concerned, to a varying degree, with the permissibility of FP utilisation in Islam. A culturally competent strategy proposed to increase utilisation is to communicate to men that FP is permissible in Islam. Religious men are proposed vehicles for implementing this communication strategy, basing their discourse on socio-cultural tradition, namely Islamic jurisprudence. The thesis has three sections introduction, findings and conclusions. Chapter One explores the literature. Chapter Two reviews the Jordanian setting. Chapter Three sets out the methods used in this research. Chapter Four examines the policy environment and policy makers' perspectives. Chapters Five to Eight explore the models of service provision concluding with an evaluation of the strengths and weaknesses of the different models. Chapter Nine elaborates on the community's perspectives. Chapter Ten is the concluding chapter that sets out strategies to widen access to FP, by utilising the socio-cultural context of the region.

This thesis examines the roles adopted by clinical pharmacists in the United Kingdom (UK), the evidence for the effectiveness of the interventions arising from these roles, and the challenges to and opportunities for future developments in clinical pharmacy. The research was undertaken in four phases: problem definition; national survey of services currently provided; in-depth interviews on roles; and a review of literature on effectiveness. A literature search provided background information on the evolution of pharmacy and of clinical pharmacy, particularly in the UK. These developments in have been set in the context of changes in health care provision and in the roles of the other health care professions and occupational groups. Preliminary interviews, meetings and group work were carried out to facilitate clarification of the research questions and to assist in the choice of methods. Two nationwide postal questionnaire surveys were conducted. One inquired about the provision of clinical pharmacy services to the primary care sector and the other about service provision within secondary care facilities in the National Health Service (NHS). The response rates were 91% and 90% respectively. The results show some diversity in the provision of clinical pharmacy services and provide possible explanations for this variation. Subsequently, semi-structured interviews were conducted with pharmacists, pharmacy technicians, doctors, nurses and managers at eight sites selected to represent different characteristics of hospitals. These qualitative data were analyzed by constant comparison. The results provide a picture of the clinical roles that hospital pharmacists are, and should be, providing. In addition, they indicate the potential barriers to, and opportunities for, future role development. An assessment of the evaluative literature on clinical pharmacy services was undertaken. Most literature is descriptive and much of the evaluative literature has shortcomings. The results present the evidence for the effectiveness of clinical pharmacy services in improving patient care and financial outcomes in the UK NHS. Finally, quantitative information gathered in the questionnaire survey, qualitative information from the interviews and the literature evidence were combined to create models of the future role of the hospital clinical pharmacist in the UK.