Doctor Scientiae / Following the introduction of the Health Act of 1995, the Primary Healthcare Package for South Africa, a set of norms and standards was developed in 2000, to ensure good quality of care and to act as a guide to provide good service at this level of care. Related to this, and bringing health services to the people, was the aspect of rehabilitation. It was highlighted that rehabilitation services should be restructured and strengthened in order to improve access to these services for those who did not have them before. This led to the development of the National Rehabilitation Policy in 2000, which focused on improving accessibility to all rehabilitation services, in order to facilitate the realisation of every citizen’s constitutional right to have access to healthcare services, but this policy was not implemented. During 2002, the Department of Health produced a strategic plan for the reshaping of public health services in the Western Cape. This initiative, Healthcare 2010, the Future for Health in the Western Cape 2020, mapped the way forward to improve substantially the quality of care provided by the health service. This plan was based on the primary healthcare approach and aimed to shift patients to more appropriate levels of care. It became evident that in order to move forward with the 2020 vision, there needed to be a greater understanding of the current situation. This study focused primarily on the aspect of rehabilitation, with a specific focus on systematic review and three dimensions of the process of care, namely patient information; service provider information; and realised access. These dimensions assisted in evaluating the rehabilitation service in order to understand what was happening in the delivery of rehabilitation services, focusing on the experiences of patients with physical disabilities, as well as service providers and caregivers, and realised access that included satisfaction of all participants in the rehabilitation centres. Hence the aim of this study was to evaluate the process of care at three selected rehabilitation centres in the Western Cape Province within the contextual framework of the National Rehabilitation Policy (NRP) and the United Nations Convention Rehabilitation Policy for People with Disabilities (UNCRPD). To assist in achieving this aim, objectives were developed as follows: to determine the reported barriers and facilitators to rehabilitation services through a systematic review; to determine the profile of patients with disabilities accessing rehabilitation services at three rehabilitation centres in the Western Cape Province; to determine the profile of service providers providing rehabilitation service to patients with disabilities attending rehabilitation centres in the Western Cape Province; to explore clients’ perceptions of and satisfaction with the rehabilitation services; to explore caregivers’ perceptions of and satisfaction with the rehabilitation services; to explore the experiences of service providers with the rehabilitation services; and to map the links between the experiences and perceptions of the key stakeholders. This was an evaluation study, which was primarily descriptive, with the focus on process evaluation. Process evaluation provides an indication of what happened, and why. The study was conducted at three rehabilitation centres in the Western Cape Province. Voluntary participation of patients, service providers and caregivers was gained by signing a consent form. Both qualitative and quantitative methods of data collection were used in this study. Questionnaires were used for quantitative data collection and SPSS version 17 and 21 was used to analyse the data. Focus group discussions and in-depth interviews, which were based on interview guides and tape recorded, were used to gather information on experiences and perceptions of all the participants. Quantitative data capturing was checked for errors by using excel spread sheets, where data was entered twice in two different spread sheets and checked for differences, as responses were coded by using numbers. Qualitative data was checked for errors by following the trustworthiness process where data was transcribed verbatim, and where necessary translated by two different translators to ensure accuracy. The researcher consulted with the supervisors during data analysis to enhance quality in the coding process and identification of themes and relevant quotations. Results showed that barriers to rehabilitation outnumbered facilitators of the rehabilitation process. There was a gap identified in the profile of the patients with regards to their rehabilitation needs. Records of the patients had missing information posing a challenge to data collection and possible presenting a distorted picture of service provision. However, records showed that not all rehabilitation professionals were not consulted during the rehabilitation process of care. Ninety-five percent (95%) of the clients consulted with physiotherapists, whereas only 4% consulted social workers. Rehabilitation service providers did not reflect a rehabilitation team. There was a shortage of rehabilitation service providers, in that some centres had full time staff while other centres only had sessional rehabilitation professionals. Service providers were negligent with some of the processes to be followed when consulting clients, such as getting consent to treat the patient and educating patients regarding their ailments, which then affected satisfaction of the patients. However, there were also positive aspects like treating patients with respect and allowing patients to ask questions during consultation. Caregivers on the other hand were satisfied with the rehabilitation process, as they found the centre easily accessible for their family members and were involved in the rehabilitation of the patients. In conclusion, the rehabilitation process was satisfying to the participants of this study. The main challenge that patients and caregivers experienced was financial constraints. Staffing remains a problem in rehabilitation centres in the Western Cape Province, as there were not enough staff for rehabilitation service delivery at these selected rehabilitation centres. Other staff members were not utilised during the rehabilitation process. These findings raise issues for the Western Cape Department of Health to consider regarding rehabilitation, as people with disabilities are not receiving optimal care. The study makes recommendations to the Department of Health in the Western Cape Province regarding the improvement of the rehabilitation process of care.

Burnout, characterised by feelings of emotional exhaustion, depersonalisation and reduced personal accomplishment can prove detrimental to both the individual employee and the organisation. These negative effects can significantly affect the service culture of client service organisations, since research has shown that burnout amongst front-line service employees can result in these employees displaying negative feelings and behaviour towards their clients and co-workers (Yagil, 2006: 259). Research into antecedents of burnout has primarily focused on organisational and job variables, such as role conflict, role ambiguity, work overload and lack of social support. The present study departed from this tradition by focusing on the relationship between role identities (subjective perceptions) and burnout amongst 100 client service employees in three client service organisations in South Africa. The research was informed by previous studies that suggest that client service employees who feel subordinate to the client and powerless in their interactions with the client may display higher levels of burnout than those who feel in control of the service relationship (Buunk, Peiro, Rodriguez&Bravo, 2007; Vanheule&Verhaeghe, 2004). By applying a sequential mixed-methods approach consisting of a quantitative and a qualitative phase, the research explored the differences in role identities of client service employees who measure higher on burnout with the role identities of client service employees who measure lower on burnout. In the quantitative phase, a survey questionnaire incorporating the Maslach Burnout Inventory – Human Services Survey (Maslach&Jackson, 1996) and a modified version of the Burke-Tully role-identity measurement (Burke&Tully, 1977) was used. The quantitative phase was followed by a qualitative phase consisting of semi-structured interviews with eight higher burnout and nine lower burnout employees. The quantitative data were analysed by means of Maximum Likelihood Factor Analysis (MLFA) with Direct Quartimin rotation, analysis of variance (ANOVA) and Pearson and Spearman correlation analysis. The analysis of qualitative data proceeded through a process of open, axial and selective coding as suggested by Miles and Huberman (1994). Both the quantitative and qualitative data are interpreted within the conceptual framework developed, and a number of findings are presented. Analysis of the quantitative data shows that the Maslach Burnout Inventory (MBI) items load on two, instead of the three factors as conceptualised by Maslach and Jackson (1986). One of the two factors corresponds to the reduced personal accomplishment subscale. The other factor comprises items from both the emotional exhaustion and depersonalisation subscales. The two subscales derived from the factor analysis were then correlated with client service employees‟ descriptions of self in role, counter-role and self in relation to the client descriptions on the bipolar adjective scales. This analysis revealed a number of significant correlations − suggesting a difference in the role identities of client service employees who measure higher on burnout when compared with client service employees who measure lower on burnout. For instance, higher levels of burnout are associated with feeling weak, powerless, unhelpful, inconsiderate, not respected and unimportant. The more rigid, impatient and inconsiderate the client is perceived to be, the higher the levels of experienced burnout. The qualitative data reveal that the role identities of higher burnout employees differ from the role identities of lower burnout employees. While higher burnout employees regard themselves as subordinate to and powerless against the client, lower burnout respondents define themselves as superior to and more knowledgeable than the client. Lower burnout employees are able to exert a level of control and power over the client, while higher burnout employees feel controlled by the client. The qualitative research also illustrates how role identities inform behaviour which may contribute to the development of burnout. The role identities of lower burnout employees also enable self-verification, while the role identities of higher burnout client service employees inhibit self-verification. The study introduces the concept of role identity as an important variable to consider in the development of burnout and links the development of client service role identities to organisational client discourse. In so doing, the study has provided organisational theorists and practitioners with a further point of intervention with which to reduce burnout in client service settings. The study has also developed a conceptual framework, derived from the literature and supported by both qualitative and quantitative findings, that shows how role identity can contribute to role-related attitudes and behaviours that could lead to or inhibit the development of burnout. The study is therefore not merely descriptive in nature, but provides a tentative explanatory framework linking burnout and role identity and exploring the mechanisms by virtue of which this relationship exists. The dissertation concludes with recommendations as to how organisational client discourse may be framed so as to facilitate the creation of role identities which empower the employee in relation to the client. By facilitating the development of empowered client service employees, organisations could greatly reduce levels of experienced burnout. As a result, organisational performance will improve, since lower levels of burnout are associated with reduced absenteeism, increased job satisfaction and commitment to the organisation and improved relationships with clients. / Thesis (PhD)--University of Pretoria, 2010. / Human Resource Management / unrestricted

The aim of this paper is description of the accreditation process in a healthcare facility, mapping out the possible problems related to the implementation of accreditation standards and the influence of accreditation on the quality of health care in a healthcare facility. The basic conditions of the healthcare facility readiness for the national SAK-ČR accreditation are the same as for any other quality management system. The point is to look at the individual processes from a different viewpoint and to find a way of engaging all employees in the entire process. It is necessary for them in particular to understand the programme philosophy, the process management, the term client, the strategy of solving problems, the rules of implementation and the organizational structure of the healthcare facility. The most demanding job is to motivate the employees and keep them aware of the continuous improvement. This paper consists of a theoretical part, a practical part and a proposal for improvement of observed shortcomings.

The purpose of this dissertation is to investigate auditors' judgments and decisions in the presence of an explicitly stated client preference. This investigation considers two factors. First, the temporal placement (i.e., timing) of the client preference is varied to allow for an examination of differential effects associated with the receipt of an early client preference and a late client preference. Second, client trustworthiness is varied so that participants may have a basis upon which to evaluate the client's representations (i.e., preferences). Practicing auditors, who were either managers or senior managers at a national accounting firm, participated in the study by completing two audit tasks in which the two factors were manipulated. Findings indicate that explicitly stated client preferences resulted in significantly different decision processes, but did not significantly influence auditors' judgment processes. However, further analysis indicated that there was no significant client preference (CP) effect observed for auditors' final decisions. Therefore, it appears that the influence of the client's preference was transitory. Taken together, these findings suggest that the CP did not result in a loss of auditors' objectivity. Auditors' judgments and decisions were sensitive to the client's relative trustworthiness. This finding suggests that auditors are responsive to a client's credibility when evaluating the client's representations. This result is expected given since generally accepted auditing standards require auditors to consider a source's credibility. However, it is surprising that auditors' evidence evaluation efforts were not differentially sensitive to the client's trustworthiness. Such a finding may indicate that the participating auditors' evidence evaluation efforts are more influenced by firm policy than individual judgment. / Ph. D.

This thesis analyzes various alternatives of SIP protocol implementation on Java Micro Edition devices. This analysis is especially concentrated on SIP protocol, SIP API (JSR-180) and the development in contemporary mobile data networks. I design a midlet for a mobile phone SIP client on the basis of this analysis. The design is especially concentrated on communication, registration and text mesage transfer.

This diploma thesis describes a possibility of application protocol implementation in OPNET Modeler simulation environment. It presumes that this application protocol is going to use TCP protocol for their communication on transport layer. The first part of thesis is focused on a description of TCP. It is a connection oriented, reliable and confirmed protocol which maintains sequence of transmitted data. This data is after receiving positively confirmed. In the second chapter are described the main functions of OPNET Modeler simulation environment. OPNET is hierarchical divided into four editors. Each editor has a specific function by creating a network and setting his behavior. There is also focused on the two lowest layers of OPNET Modeler and their components in detail, which are participating at usage TCP on transport layer to communication. Implemented applications communicate by sockets, which are created and destroyed on request. Communication is controlled by manager process, whose function is maintenance particular connections and redirect dataflow into relevant process. This manager put in action as well a process, which simulates a single TCP. In the practical part I made two applications: one is a client type and a second one is a server type. Both applications are using TCP on transport layer. The establishment of connection initiates a client, who is sending a request to the server for a data. Then server sends back data in desired quantity. After sending the entire data, client terminates the connection. The result of simulation is statistics, where we pictured the size of the transferred data, a number of transferred packets and other parameters typical for TCP.

This thesis deals with creating application for PDA for multimedia stream presentation and processing. Introduction of the thesis is devoted to the theoretical explanation of terms such as PDA (Personal Digital Assistant) and Windows Mobile 6.0. Readers will be acquainted with the technology of .NET Framework and also with its version for mobile equipment .NET Compact Framework. Advantages as well as disadvantages of .NET technology are dealt with in this section together with the same phenomena of C# programming language, which is the basic language used for running our application. Next chapters of the thesis deal with my own design of multimedia application, especially from the point of view of classes. For better orientation and understanding UML diagram is used. UML (Unified Modeling Language) is a graphic language intended for visualization and documentation of programming systems. Except of general description of the classes there is also a detailed explanation of individual attributes and application methods. Their function and purpose are explained here as well. In the next part of the thesis attention is paid to the network communication of the application, both in terms of individual multimedia files transmission and stream transmission. Principles of connection and disconnection between client and server are analyzed in this part. Client’ s part of the application is designed for the mobile equipment with Microsoft Windows Mobile 6.0 operation system and server’s part of application is designed for computers, where Microsoft Windows XP operation system is installed. A concise manual for operating both the applications is included. This part also describes some exceptions which may occur in case of problems with connection. Last chapters describe synchronization of mobile equipment or emulator with a desktop computer and provide the reader with the summary of supported audio formats in multimedia application. All achieved results are summarized in the concluding part of the thesis.

This diploma thesis is devoted to a modern attitude of desktop computer usage, that uses operating system and applications virtualization. The paper describes theoretical principles of virtualization techniques and selection of the proper solution for the organization. Diploma thesis also describes the project implementation.

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Bibliography: leaves 67-69. / The Narrative Therapy approach has been developed in Australia, and is therefore refreshingly southern hemispheric in contrast to most psychological theories which have originated in northern hemisphere countries. However, its application has mostly been in first-world, white, middle- class, English-speaking contexts. Questions therefore arise as to the appropriateness and applicability of this approach with people from working-class, politically disempowered, and multi-language contexts. The context for this study is the broader African culture which has traditionally privileged the oral tradition in the sense of the shared telling of stories. A narrative or story approach to therapy recognises the client's story as a story and privileges the telling of it. The respect for the other and their story, implicit in the narrative approach, greatly facilitates cross-cultural exchange. This research illuminates the process and appropriateness of applying Narrative Therapy in order to facilitate the client's preferred, alternative story of her life and her relationships in a South African setting of racial, cultural and economic refraction and ,diversity. Light is shed on the cross-cultural sensitivity of the narrative approach and on restraints inherent in the author-therapist's and the client's contexts and in the site of study, namely a South African university. The story of co-authoring a client's life and relationships is presented via a qualitative, exploratory design and single case study methodology. Data was collected from the author- therapist's session notes and transcripts of audio tape recordings. Data processing analysis and interpretation were informed by the characteristics and concepts of Narrative Therapy theory. Summarizing statements and recommendations suggest modifications to and extensions of the Narrative Therapy approach in the specified context. These include suggestions for cross-cultural training in the context of peer-group supervision, generation of a thesaurus of modified questions by practitioners for use in multi-language settings, and further research with regard to application of the narrative approach to groups and families in settings which are similar to that of this study. Exchange across the spectrum of human sciences and social services is recommended to enlighten and enliven the narrative conversation in South Africa in order to move forward with regard to empowering and just practices.