Magister Artium (Development Studies) - MA(DVS) / In South Africa, since 2000, an increase of awareness in community involvement has become apparent, owing to the response from people to the need to be more engaged in decisions pertaining to their community. This positive move echoes an increasing acknowledgement by those in authority that community participation is essential to the main demands of renewing democracy, expanding service provision and constructing robust communities. The development of innovative patterns of participation development means that local communities should be empowered to participate in decision making, whilst government establishments need to have the determination and ability to respond to various community needs. The Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) pandemic has placed an enormous responsibility on public health services, such as South African hospitals, which are already functioning with limited resources. This has shifted the load of nursing to family members and communities as public health services are often stretched beyond their limits. Several community or home-based care programmes and facilities have materialised in reply to this necessity. In the context of participation of communities, the duty of community involvement in health plays a vital role in the future of public health in South Africa. Accordingly, this research was conducted to explore the nature and extent of community participation within the HIV/AIDS context in the Dunoon suburb in the Western Cape. An empirical research design, which consisted of qualitative methods, was used in this exploratory study to investigate the nature and extent of home-based care as an alternative strategy to institutional care. The research population was comprised of community members at the Dunoon informal settlement, the home-based workers employed at Heavenly Promise NGO, as well as staff and management of the Caltex/Chevron Refinery, members of Project Management 4 Africa (PM4A) and representatives of the Department of Social Development (DSD), which together constitute the partnership that is dedicated to combating the spread of HIV/AIDS in Dunoon. In general, the research findings demonstrate that home-based caregivers displayed strong levels of participation right from the outset of the project. The findings also established that participation among the community members was a combination of passive, weak and non-participatory, whereas home-based carers displayed a level of active participation. Furthermore, home-based care staff played a key role in decision making, while carers essentially undertook the work in the community. Hence, home-based care and communities participating in health matters are considered to be substantial as home care focuses primarily on palliative care of the patient at home, with the support of the family and the immediate community. Consequently, it is hoped that this research will prove significant and will enhance the existing knowledge of the potential benefits of home-based care as an alternative strategy to institutional care.

Philosophiae Doctor - PhD (Physiotherapy) / Stroke is a debilitating medical and neurological condition. It is the leading cause of adult disability worldwide. Disability from stroke covers the three key classifications of the WHO-ICF framework on human function centred on health and health related issues, implying that the disability in stroke involve structural and activity limitations to participation restriction. Rehabilitation remains the hallmark of managing the plethora of neurological deficits accompanying stroke. Currently, the key advocacy in neuroscientific studies for stroke rehabilitation is that therapy should be directed towards task specificity. Task Specific Training most recently, the form of Circuit Class Therapy and the intensity of multiple repetition of the task has been identified as physiological mechanisms behind sustained motor learning following stroke.Circuit Class Therapy (CCT) is a form of Task Specific Training (TST) that involves the practice of structuring tasks in a circuit or series of workstations. It offers the patient the ability to practice multiple tasks in a conducive environmental because of its three key features of utilisation of different workstations that allow people to practice intensively in a meaningful and progressive way to suit their respective needs; the efficient utilisation of therapists'/trainees' time; and the group dynamics such as peer support and social support. Although these features are attainable following CCT challenges remain in selecting the most efficient intensity that could produce these benefits in stroke survivors. This study investigated the effectiveness of differing intensities of CCT in the rehabilitation of stroke survivors using the ICF framework to guide patients� response assessments after training.

SANTANA, H. S. Compreensão da prática médica na perspectiva de usuários do Programa de Saúde da Família Rural de Sacramento/MG. Ribeirão Preto (2008). Dissertação (Mestrado). Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Estudo de abordagem qualitativa realizado junto aos usuários de famílias adscritas a uma equipe rural do Programa de Saúde da Família (PSF) de Sacramento/MG que teve por objetivo geral compreender a prática profissional a partir da identificação de crenças e representações das famílias das comunidades rurais sobre as relações que estabelecem com o profissional médico, no contexto das vivências de atendimento e participação no Programa Saúde da Família. A compreensão da prática médica é balizada através da vinculação da medicina com os componentes políticos e ideológicos que se moldam em seu entorno. Partese do pressuposto que a prática médica não é neutra ou desinteressada mesmo que seus agentes não tenham disso consciência. A medicina, e seu exercício, a prática médica, conformam um dos processos de reprodução da estrutura da sociedade que torna os cidadãos socialmente desiguais. Trabalhamos com três grupos focais compostos por 8 a 12 representantes das famílias de três comunidades rurais microáreas da área de abrangência do PSF Rural. Utilizamos a análise temática com a identificação de três categorias temáticas: Disponibilidade, Legitimidade e Contexto Geral do Trabalho Médico. Na Categoria I Disponibilidade - a compreensão da prática médica foi marcada pela concepção do Rapport enquanto facilitador do vínculo com o usuário, pela disponibilidade para a atenção e tato nas relações. Ainda nesse tema, foram identificadas representações que avaliaram o Interesse e a Empatia em atender demandas não especificamente médicas como um elemento que estabelece certa identidade entre o médico e o usuário/ comunidade; a Eqüidade enquanto critério que garante o acesso às práticas de saúde sem discriminação, e o Tempo como categoria importante que garante o acessar adequado do médico. Na Categoria II Legitimidade os conteúdos foram marcados por representações que expressam Conflito nas relações com o profissional médico, especialmente a partir de maior acesso da população à informação sobre a medicina, que já não aceita pacificamente certas determinações do profissional; também as crenças foram marcadas por conteúdos que expressam o Convívio com as populações atendidas e a Competência que está relacionada aos aspectos técnicos da prática médica. Na Categoria III Contexto do Trabalho Médico - identificou-se o tema Politização em que os conteúdos referem a outro nível de determinação acima do trabalho médico; e nas Condições de Trabalho a referência é feita ao contexto de vida e trabalho do profissional da medicina como critério de compreensão da prática médica. Esses temas trazem questões interligadas, mas que não se superpõem exatamente umas às outras conquanto constituam indagações específicas e cuja compreensão requer considerá-las separadamente. Destacamos com relevância a amplitude dos temas retratados nas crenças e representações da população usuária do PSF Rural habilitando-o o usuário - como um interlocutor privilegiado ao tratar-se dessa temática, de modo que seria legítimo e prudente que as políticas públicas do setor saúde e da formação do profissional médico não ficassem restritas aos muros das universidades. / SANTANA, H.S. Comprehension of medical practice in users perspective of Rural PSF of Sacramento/MG. Ribeirão Preto (2008). Dissertação (mestrado). Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. This qualitative study was developed with users of enrolled families by a rural group of Family Health of Sacramento/MG which intended to understand the professional practice despite of the identification of beliefs and representations of families from rural communities about the relationships that establish with the professional doctor, in the context of the experiences of consideration and participation in Family Health. The comprehension of the medical practice is done through the link of medicine with the political and ideological components that adapt themselves according to their surroundings. It is presumed that medical practice is not neuter or disinterested even with its agents do not have in mind their conscience. The medicine, and its duty, the medical practice, conform one of the process of reproduction of the societys structure that makes the citizens be socially unequal. We worked with there focused group compound of 8 to 12 families representants of three rural communities micro areas of rural Health Familys reached area. We used the thematic analyzes with the identification of three thematic categories: Availability, Legitimately and General context of medical wok. In Category I Availability the comprehension of medical practice was set by the conception of Rapport while easy element that makes way to entail the user, by availability for the attention and feeling in the relationships. In this issue yet, it was identified representations that tested the Interest and the Empathy in answering requests not specifically medical as an element that establishes certain identity between doctor and user/community; the Equity while subject that guarantees access to health practices without discrimination and, the Time as an important category that assures the direct contact with the doctors. In Category II Legitimately the researches were set by representations which express Conflict in the relationships with the doctors, especially despite the moment bigger access of population to information about medicine, that is not already accepted peacefully in certain doctors requirements; The beliefs were also set by subjects that the Acquaintance with the answered populations and the Competence that is related to technical aspects in the medical practice. In Category III Context of Medical Work, it was identified the issue Politicization which refers to another level of determination over medical work; and, in Work conditions, the reference is done according to the doctors life and work context as a way to understand the medical practice. These issues arouse interconnected questions, however, these ones are not exactly supposed to each other while these interrogate specific questions whose understanding demands consider them apart. We demonstrated with relevance the amplitude and pertinence of the shown subjects in the beliefs and representations of the population that use the Rural Family Health making way the user to privileged agent when this issue is demonstrated. In doing so, it would be legitimate and prudent that the building up and test of the health sectors public policies and medical professional formation do not get closed inside the universities.

Introdução: Os modelos de gerência centralizados e descentralizados utilizados pela administração pública no Brasil é tema bastante discutido em razão da busca por um atendimento de qualidade prestado à sociedade, não sendo diferente na área da saúde. Nesse sentido o Estado do Acre fez a opção de implementar um modelo de gerência de unidades de saúde que pudesse efetivar a descentralização das unidades de saúde estaduais e estabelecer a participação da comunidade. Objetivos: Analisar o modelo de gerência de unidades de saúde de média e alta complexidade, implementada pelo Estado do Acre, por meio da Lei de Gestão Democrática do Sistema Público de Saúde do Estado do Acre (Lei n.1912/07) e da Lei de Autonomia Financeira das Unidades de Saúde Estaduais (Lei n.1.910/07), no período de 2007 a 2011. Métodos: A pesquisa de natureza qualitativa e descritiva foi realizada no período de 2013 a 2016, utilizando como técnica de coleta de dados secundários a análise de documentos, e de dados primários as entrevistas individuais com informantes-chave. Trata-se de um estudo de caso cuja análise buscou compreender o modelo adotado pelo Estado do Acre. Resultados: A partir do modelo de gerência implementado pelo Estado do Acre, as unidades de saúde sob a gestão estadual passaram a ser geridas por um Conselho Gestor, constituído por gestores, profissionais de saúde e usuários de saúde. O modelo proporciona a descentralização da gerência das unidades de saúde com autonomia para o conselho gestor planejar e executar os recursos financeiros cujo repasse se efetiva com o termo de compromisso. O modelo implementado com a participação da comunidade no conselho gestor executivo apresenta aspectos inovadores e controversos, e sua legalidade fora questionada pelo Tribunal de Contas do Estado do Acre. No entanto, analisando as normas que permitiram a implementação do modelo, verifica-se o cumprimento das normas do Sistema Único de Saúde. Considerações finais: O modelo implementado pelo Estado mostrou ser uma alternativa de gerência de unidades de saúde descentralizado e participativo de modo a incentivar a organização e realização dos conselhos gestores / Introduction: The centralized and decentralized management models used by public administration in Brazil is a topic that is much discussed because of the quest for quality care provided to society, and is not different in the health area. In this sense, the State of Acre made the option of implementing a model of health unit management that could effect the decentralization of state health units and establish community participation. Objectives: To analyze the model of management of health units implemented by the State of Acre through the Law of Democratic Management of the Public Health System of the State of Acre (Law n.1912 / 07) and the Financial Autonomy Law of the Units of State Health (Law n.1.910 / 07) in the period from 2007 to 2011. Methods: The qualitative and descriptive research was carried out in the period from 2013 to 2016, using as secondary data collection technique the analysis of documents and data Primary interviews with key informants. It is a case study whose analysis sought to understand the model adopted by the State of Acre. Results: Based on the management model implemented by the State of Acre, health units under state management were managed by a Management Council, made up of managers, health professionals and health users. The model provides the decentralization of health unit management with autonomy for the managing board to plan and execute the financial resources whose transfer is effective with the term of commitment. The model implemented with the participation of the community in the executive management council presents innovative and controversial aspects and its legality was questioned by the Court of Accounts of the State of Acre. Final considerations: The model implemented by the State has shown to be an alternative for the management of decentralized and participatory health units in order to encourage the implementation of the model. Organization and implementation of management councils

Thesis (M.Dev) --University of Limpopo, 2011 / Projects will do well, sustain and function effectively if the people and communities for whom they are established understood them better and took charge of their implementation. The integrated development planning is, by its nature and purpose appropriate and proves a better tool for community development. It is already showing some fruits and will, undoubtedly continue serving the purpose as long as its implementation is based on the peoples' own analysis of their own problems and perceived solutions. The aim of this research was to evaluate on the level of community participation in the integrated development planning conducted by the Molemole municipality in the villages, more especially, Mokomene which is under Kgosi Ramokgopa. It has also been the objectives of the research to assess and measure the level of participation by members of the community in this area.lnterviews, questionnaires and observations were used to carry out the research.While many people in this area supported the introduction of the IDP in the communities, these recommended strongly for its correct implementation. The results of the research indicate a substantial number of people who still believe education and orientation on IDP matters should be given to the communities.

Mental illness is often associated with social isolation, unemployment and limited community participation. Mental health rehabilitation services aim to decrease these psychosocial effects of illness and encourage better community integration for mental health consumers. Volunteer work is one avenue in which consumers can become actively involved with their local communities. However whilst often supported clinically, limited empirical evidence exists which supports the use of volunteer work as a potential mode of rehabilitation for consumers. The overall aim of this study was to document consumer perceptions and experiences with volunteer work and to identify if participation in volunteer work has a positive impact on their mental health. Phase one of this study involved in-depth interviews with nine consumers currently volunteering. Themes identified from these interviews supported the notion that volunteer work is a meaningful occupation for consumers and one which promotes community integration and supports consumer recovery. Findings from the interviews also guided the development of a volunteer scale for later use within the study. Phase two involved the development and pilot testing of a volunteering questionnaire which measured consumer attitudes and experiences with volunteer work. This scale was combined with other standardised tests which measured the mental health variables of personal empowerment and quality of life. Phase three involved the administration of the questionnaire battery developed in phase two. The battery was distributed and completed by thirty consumers, including both those who were and were not volunteering. Analysis conducted identified that overall consumers held a positive view of volunteer work, believing it was a way of developing work skills, friendships and promoting positive mental health. / Analysis comparing the volunteering to the non volunteering group indicated that those volunteering experienced better quality of life, specifically within the psychological health, social relationships and personal environment domains. This provides support for the hypothesis that participation in volunteer work promotes consumer recovery. However, age was identified as a potential confounding variable and so the significant results should be viewed with caution. Cost, stigma and becoming unwell during volunteering were identified as barriers to consumer participation. It is argued that mental health services are in a good position to support consumers not only to access but also to maintain ongoing volunteer participation. To date minimal evidence has existed that supported this intervention. This study has begun to fill this research void, however, small study numbers and the cross-sectional, descriptive design make establishing a cause and effect relationship impossible. It would thus be beneficial to conduct a larger study investigating the impact further, including measuring the influence of any interventions that promote consumer participation in volunteer work, such as supported volunteering.

PhD / People with a chronic illness, such as Parkinson’s disease, often live in the community for many years while the illness becomes progressively more debilitating. Little is known about how such people control the impact the disease has upon their various roles in life. This study employed naturalistic qualitative research methods to investigate how people with Parkinson’s disease and their partners continue to actively participate as members of their social community. Using in-depth semi-structured, focused interviews, participants with Parkinson’s disease and their partners were asked to name and describe roles that occupied their daily activity. They were asked about their most significant occupational roles, what they did in these roles, the knowledge or strategies they employed to deal with barriers to occupational role performance, and the personal meaning such roles held. Four basic themes evolved from the data: the impact of the disease on occupational role performance, or ‘doing’, secondary personal limitations to occupational role performance, secondary social limitations to occupational role performance and cumulative barriers to occupational role performance. Loss of control over choice and manner of engagement in occupational roles was a significant element of all four themes. Sense of self and sense of social fit were identified as major elements that informed participants’ perceptions of control. Participants described a range of diverse responses that they used to actively restore personal control of occupational performance in the face of degenerative illness. Learning new coping styles appeared to be underpinned by a personal set of rules or ‘blueprint’, despite professional input. This blueprint was actualised through a problem identification, problem solving and active engagement cycle that was termed a cycle of control. A conceptual model of a cycle of control was proposed as the final stage of the research. The model represented a way of describing how participants acted to restore a sense of personal control once a specific barrier to occupational role performance had been perceived. The findings of this study support the notion that people with chronic illness, such as Parkinson’s disease, are active and knowledgeable participants in health care, and have occupational histories and experiences that they harness when dealing with barriers to performance. Moreover, the findings demonstrate that people with chronic illness work in tandem with significant role partners to constantly maintain the valued partnership in meaningful occupational roles as the disease progresses. A greater understanding of how people with chronic illness and their partners strive to maintain a sense of personal control can enable occupational therapists to work effectively as ancillary partners in care. A greater understanding of the way in which role partners work together to maintain occupational integrity in their lives would be central to assessment and intervention for community programs for people with chronic illness.

研究發現在台北市方面,若要實現福利社區化,仍有結構上的障礙,中央集權的國家機器,在行政體系與運作上,從未將社區概念落實在實施或推動層面. 在萬芳社區方面,發現:1.福利需求無社經地位差異,且定義傾向包括生活需求與福利需求2.福利資訊網路以社區為單位有其可行性 3.應以社區福利作為社區參與凝聚的目地與手段 4.居住時間,居民同質性及活動內容為參與的基礎5.社區中的少數更應被關心6.社區認同應被強化7.社區組織的重要8.女性力量的發揮9.社區內各區域的分離影響社區中各區域的關係10.善用社區居民'購物行為'與'休閒行為'的公共空間11.既有公共空間的維護與管理12.社區內出租國宅疏離來自居民對其環境無自主能力13.地緣影響參與與認同14.善用社區特殊資源.

In recent years, there has been an increasing interest in Australia in structures which allow community participation in the governance of schools. The introduction of a new Education Authority in the Australian Capital Territory, beginning in 1974, brought with it a substantial commitment to such structures as school boards, a relatively new phenomenon in Australian school systems. However, there has been substantial experience of lay or community participation in governing bodies of post-secondary institutions in Australia. This study examines both the general experience of lay participation in such governing bodies and the specific experience of lay members of the governing bodies of three institutions in the Australian Capital Territory, the Australian National University, the Canberra College of Advanced Education and the Canberra College of Technical and Further Education. The principal collection of data was from structured interviews with lay or community members of the councils of these three institutions, designed to produce a picture of their attitudes towards participation in governance. It was found that lay members are most commonly "middleaged, middle-class, males", although women are more frequently found in college councils. Lay members believe that they are chosen because of their successful backgrounds, their administrative skills, and their ability to reflect general community values. They do not believe they are constrained in their participation by specific community interests. They act as independent critical, individuals. Some areas of difficulty were identified, particularly the problem of finding sufficient time to learn thoroughly the nature of complex institutions, and to participate on an equal footing with staff members of councils. It is asserted that the assumptions underlying lay participation remain broadly unquestioned, even at a time of significant change in the wide process of planning and control of post-secondary education. The relevance of this to the innovations in the A.C.T. school system is suggested.

<p>The aim of this study was to evaluate the impact of community involvement on management of water tanks in the Arkavathi sub-basin in the state of Karnataka, South India. Water management was analysed from a socio-environmental perspective, with emphasis on village-level stakeholders’ roles and perceived responsibility. The efficiency of community participation was investigated by comparing two villages having undergone the same World Bank launched program to restore water bodies traditionally used to sustain the livelihood of the rural population. In one village there was a resistance towards how the implementation of the tank rejuvenation project had been performed, in the other there was no local involvement.</p><p>A minor field study was conducted by visiting the two villages. Qualitative interviews were held with village-level stakeholders of three age groups, to analyse changes over time in knowledge and attitudes. Additionally, ocular observation and photo documentation were made of the study areas. Some informal interviews were carried out with members of an external non-governmental organisation and locals in the study villages. The collected data were analysed by comparing the results for the two villages, as well as the results of the different age groups and genders.</p><p>There were significant differences in awareness and sense of responsibility, but not knowledge, between the two villages. In the village with a community involvement resisting the governmental scheme for tank renovation, this involvement had proved to be of some advantage to the local community. Contrary to the guidelines, the governmental implementation of the water management strategy did not include local stakeholders’ participation, nor were the tanks restored. Overall, the villagers considered the tank management to be the responsibility of external authorities. There were generally no significant differences between the age groups or men and women, though there were indications of a lower level of knowledge and awareness in women. Absence of effective institutions for water management on all levels as well as difficulties in mainatining efficient village level leadership for community participation are factors causing a major gap between planning and implementation.</p>