The purpose of this study was to ascertain the current status of healthcare delivery on American Indian reservations. In particular, the study sought to determine if the Indian Health Service was actually meeting its goals in delivering healthcare to American Indians, and if not, were there alternatives to public medicine for healthcare? The Indian Health Service has not met its own goals in delivering healthcare, and private medicine in the form of private practicing physicians and other medical personnel have filled the void left by the Indian Health Service. The study also discusses the possibility of private medicine being the only realistic alternative in the future for Indian healthcare delivery.

The purpose of the study was to examine the career paths of women managers in the service area of higher education and women managers in the hospital industry service area. A secondary purpose was to identify factors that influence the advancement of women managers in those areas.This research outlined the career paths of women managers in the service industry in educational and in non-educational organizations. It identified encouragements and impediments to the promotion of qualified women in the areas of management within the service industry.Findings from the study show that there is no significant difference between the career paths of women managers in higher education and women managers in the hospital industry. There are no differences between the education, training, length of tenure, motivation for employment, mentoring, emotional support or career impediments of women managers in service area of both higher education and the hospital industry.The following conclusions were drawn from the study:1. Women in the service field of higher education and the hospital industry face very similar histories.2. Entry into the profession can be found through a variety of sources and it is through the investigation of these sources that a woman will find entry into this field.3. Very few women reported career impediments and many reported having the emotional support of family and friends.4. The true reason why the experienced, educated, trained woman manager has not progressed up the career and salary ladder until the past several years has not been found. Both groups are being motivated by opportunity for advancement and salary.5. Most women managers in the service have been the determinants of their own career advancement. The women desiring to become managers in the service field must realize that the future of her career and its advancement lies with her own decisions and her own initiative. The woman manager must be responsible for her own future. / Department of Educational Leadership

Official-language minorities in Canada may face specific issues in accessing health care services that can lead to negative consequences on their health, utilization of health care services and satisfaction with the health care system. A secondary data analysis of the 2006 Survey on the Vitality of Official-Language Minorities revealed significant differences between the Anglophone minority (n=5,161) and the Francophone minority (n=12,029) with regards to general health, and access to and use of health care services. Important predictors of these outcomes included age, education level, household income, marital status and place of residence (urban/rural). Access to health care services in the minority language was associated with self-perceived health in the Anglophone minority only. Health policy recommendations elaborated in light of the findings include working on both the supply and the demand of health care services offered in the two official languages, while taking into consideration important contextual differences between regions.

The term E-health - describes the use of information and IT, to satisfy needs of citizens, patients, and healthcare specialists, providers of healthcare services, managers and politics. Development of e-health structure and the use of patient healthcare services just in the beginning in Lithuania, so there is a need of work and solutions are made in this direction. The object of research – the spreading of e-health services, development and management solutions of healthcare institutions. The purpose is to investigate problems of management, describe the changes in e-healthcare development process. The second aim to investigate diffusion of e-health services in Lithuania and compare with situation in the world.

In 1996, Lithuania was one of the first countries in the East and Central Europe that established the Law on the Rights of Patients and Compensation of the Damage to Their Health, and the rights of patients became the subject of discussions between lawyers and citizens. However, there are only few studies on this subject, even it is very relevant for improving of work planning in the health care institutions. From the 1st till 19th of August 2005 the research has been done with the purpose to examine the status of the rights of the patients that were using stationary services in the hospital of Vilnius University “Santariškių klinikos” (VUL SK) and considering the received information to propose how to prevent breach of the patients’ rights.

This thesis is based on a journey towards developing team working within a primary healthcare setting which enabled the NHS agenda for primary care service delivery to keep pace with the government modernisation agenda. (Department of Health, 1997). Initially the focus was on the development of an integrated nursing team which enabled all disciplines of nurses to work towards a patient focussed healthcare service, but it soon became evident that all staff involved in delivering the primary healthcare service were essential to the process and developments of the enquiry if the objective was to be achieved. An action enquiry approach based on collaborative and participative action research (Carr and Kemmis, 1986; Lincoln and Guba, 1989; Cayer, 1997) was discussed and was the prime method of enabling changes to occur in the healthcare practice. This is represented by the interrelated four main cycles of enquiry that have emerged from the data, and discussed in this thesis. Key to the success of the developments was an understanding of team working and leadership as it applied within a healthcare setting and also the underlying dynamics, which are evident when different professional groups from different traditions and knowledge base work together. (Schon, 1983) This was explored within the context of a systems approach to organisational development and through reflective dialogue along the principles advocated for creating a learning organisation. (Senge, 1990) This thesis will demonstrate how confidence developed in myself and the practitioners, especially those from marginalised groups, and how the wider healthcare system made an impact on the developments within the practice. The area of leadership will be discussed from multiple perspectives and recognition that as a concept all stakeholders had a poor understanding of leadership. The key finding from this study identifies the need for a holistic approach to manage and sustain change, and indeed everyday productive working relationships. This especially identifies the importance of giving attention to the preparation of future healthcare workers, the appropriateness of organisational structures in which services are delivered and support structures available to those in team leadership positions.

This thesis was undertaken to assess the characteristics of individuals who smoke crack cocaine and to examine the health-related risks and healthcare needs of this population. A literature review of 147 published articles was conducted to synthesize evidence regarding behaviours associated with crack use and to assess the risks of disease transmission through crack smoking behaviours. Qualitative interviews were subsequently conducted with thirty Ottawa residents who smoke crack to learn about their experiences with healthcare and harm reduction services. Results identified barriers related to accessing primary healthcare and drug treatment programming among people who smoke crack and gaps within existing harm reduction services. Individuals who smoke crack represent a marginalized population who are often missed through traditional health promotion and harm reduction programming. There is a need for increased coverage of current programming and a reduction of factors which currently hinder the delivery and effectiveness of crack-specific harm reduction programs.

This qualitative study investigates the evolving role of Divisions of General Practice (Divisions) in linking general practitioners (GPs) and general practice with the wider health sector in Australia. The work draws on boundary role theory within organisations, integration theories, empirical research on service integration involving general practice, and structural interests theory to develop the conceptual framework on which the research was based. The data for the research came from both documentary and interview sources that gave voice to Divisions in the state of Victoria, Australia. The documents used represented the core working documents of Divisions, and the semi-structured interviews involved 30 key informants, these being leaders in all Victorian Divisions.

Diss. (sammanfattning) Uppsala : Univ., 2003. / Härtill 4 uppsatser.

Thesis (Ph.D.)--University of Wollongong, 2006. / Typescript. Includes bibliographical references: leaf 180-201.