Thesis (M.P.H.)--University of Michigan, 1945.

Thesis (M.S.P.H.)--University of Michigan, 1940.

Thesis (M.P.H.)--University of Michigan, 1945.

Thesis (M.A.)--Carleton University, 1985. / Also available in electronic format on the Internet.

Thesis (M. S.)--Public Policy, Georgia Institute of Technology, 2010. / Committee Chair: Susan E. Cozzens; Committee Member: Barbara D. Lynch; Committee Member: Marilyn A. Brown. Part of the SMARTech Electronic Thesis and Dissertation Collection.

Primary health care is pivotal to the growth of a country’s economy by improving the health and social well-being of its people. Several efforts and structures have been put in place to ensure that all South Africans have access to health facilities as well as representation in the health facilities, just as community members are represented in schools and other boards. Health committees play an important and integral role to the community and health facilities by being mediators between the community and the health facility (Padarath &Friedman, 2008). The Eastern Cape is one of the provinces that has health committees that are fully functional and a number of factors including the collaboration of key stakeholders (facility managers, community members, clinic staff and ward councillors) contribute to why health committees have been operational in the Eastern Cape(Padarath &Friedman , 2008). It becomes critical to investigate factors that sustain health committees in Nelson Mandela Bay. This chapter introduces the research topic, purpose, rationale and background as well as the objectives of the study. The research focuses on investigating the sustainability of health committees in Nelson Mandela Bay therefore making it critical to define the term sustainability. Conceptualizing sustainability has been ongoing with various definitions from learners from different backgrounds. Sustainability as a concept emanates from different dimensions namely, scientific, political economic and indigenous dimension. Sustainability has been described by scholars as a state of well-being and as an evolutionary process (Dimitrov, 2010). Sustainability is regarded as a state of well being whereby humans can live in co-exist with the natural world, this definition takes into account issues to do with good health , cultural identity, personal security and freedom of choice. Sustainability- well being brings out a lot of questions and problems in identifying the fundamentals values of sustainability. It is continuously debated amoung scholars if sustainability of well being pertains only to the health conditions of human beings or it should be extended to others (Dimitrov, 2010) “Sustainability that is restricted to the well being of humans is related to Notions about security of individual/community health together with financial security together with financial security; the planet is regarded as a resource to further this end (Dimitrov, 2010:4) If however well-being definitions of sustainability are construed to preserving and protecting the environment as well as biodiversity of other species (plant and animals) then the normative definitions of sustainability from this viewpoint are tendered with notions of global Environmental stability, ecological considerations and security of ecosystems” (Dimitrov, 2010:4).

The purpose of this study was to examine the relationships between perceived organizational support, perceived coworker support, and debriefing on the one hand, and compassion satisfaction, burnout, and secondary traumatic stress on the other hand in Florida law enforcement, fire, emergency medical services, and dispatch public safety workers. In order to explore the relationships between these constructs, the research questions examined the relationships of the work environment of Florida public safety by administering surveys gauging perceived organizational support, perceived coworker support, psychological resilience, and debriefing activities that the personnel participate in. The Professional Quality of Life: Compassion Satisfaction and Compassion Fatigue Version 5 was also sent out to establish the self-reported levels of compassion satisfaction, burnout, and secondary traumatic stress. The study found that there were differences in the levels of compassion satisfaction, burnout, and secondary traumatic stress between the public safety fields. It also found that there was a positive relationship between the presence of perceived organizational support, perceived coworker support, psychological resilience, and debriefing activities on at least one of the constructs of compassion satisfaction, burnout, or secondary traumatic stress within the different public safety fields. This study furthers the literature by being the first study to compare the four different public safety fields in the state of Florida and with regards to those constructs.

The implications of rising healthcare expenditures are of great concern nationally and internationally. Performing procedures in the outpatient setting can be one solution to this crisis. However, there is a lack of research on systematic approaches for transitioning procedures to the outpatient setting. Unicondylar knee arthroplasty (UKA) presents an opportunity, as it is already in the early stages of transitioning to the outpatient setting. The key step in facilitating an effective transition to the outpatient setting is comparing outpatient UKAs with inpatient UKAs with a focus on process time, quality outcomes, and patient satisfaction. This study retrospectively compares 400 UKA patients in the outpatient setting with 675 UKA patients in the inpatient setting. The primary analytical tools for this study are Ordinary Least Squares Regression, Logistic Regression, and Ordinal Regression adjusting for comorbidity, social history, demographics, and surgery related characteristics. Outpatient UKAs outperformed inpatient UKAs across 11 of 18 variables analyzed. Process Time will be less for outpatient UKAs in all phases with the exception of Surgery Breakdown Time. The risk-adjusted quality outcomes of UKAs in the outpatient setting were better across Non-Surgery Related Complications, Follow-Up Pain, and Follow-Up Functional Range of Motion Limitation. Patient Satisfaction was higher for outpatient UKAs. There was a lack of consistent and appropriate information to conduct a substantial statistical analysis of the costs. These findings point towards outpatient UKAs being a viable option in the future. This research serves as a platform to launch a system-wide effort of transitioning procedures to the outpatient setting across different specialties.

American hospitals have made serious efforts to implement and expand their health information technology capabilities and to integrate different specialized care or high-tech services in order to maximize the efficiency and quality of care. In providing a variety of HIT-related services, these hospitals expanded their national reputation in line with integrated care goals. As a result, hospitals are encouraged to establish effective communication channels to facilitate patient-physician sharing of the patient care experience, to enhance effective pain management, and to transform patient-centered care modalities to solidify the adequacy of patient care processes. By analyzing national data sets publicly available, this investigation explored the relationship of acute-care hospitals' performance to the contextual, organizational and patient characteristics, using a cross-sectional study design. This study developed and evaluated the quality and efficiency of hospitals with respects to the structural complexity, process adequacy, efficiency, and quality of care. The structure-process-outcome theory in quality of care developed by Donabedian (1980), is adopted for this investigation. Statistical methods such as confirmatory factor analysis (CFA) and covariance structure model are employed. The population surveyed by the American Hospital Association (AHA) are acute care hospitals throughout the United States, including more than 3000 acute care hospitals of all types of ownership. The data provided by HIMSS Analytics and AHA are available for 2015 and the data provided CMS quality indicators are available for 2016. The key finding of this research is that process adequacy mediates the relationship between hospital structure and performance variables. The efficiency variable played an important role in shaping quality. The location and hospital teaching status have a moderate impact in determining hospital performance by affecting the structure and process of hospitals.

<p>The purpose of this thesis is to describe a research strategy for evaluating the efficacy of a reduced dose maternal tetanus immunization schedule in reducing neonatal tetanus deaths in Sierra Leone.</p> <p>Neonatal tetanus has been demonstrated to be a major cause in infant death in areas where sanitary midwifery is unavailable. A review of the literature reveals evidence for reduction in neonatal tetanus deaths by maternal immunization using a conventional three dose adsorbed tetanus toxoid.</p> <p>In Sierra Leone, as in many developing countries, the resources are unavailable to maintain a three-dose schedule in the relatively inaccessible interior of the country. A two-dose schedule of a concentrated adsorbed toxoid has been recommended as an alternative by the World Health Organization. Research on simplified immunization schedules has been reviewed; the results are inconclusive.</p> <p>A double-blind randomized placebo-controlled design has been selected to address the research questions. Various aspects of this design are discussed with respect to methodologic and ethical issues.</p> <p>Procedures for carrying out the trial and for the assessment of neonatal tetanus death in a remote chiefdom in Sierra Leone are proposed. A procedure for the analysis of outcome data is presented.</p> / Master of Science (MS)