Risk management strategy is a broad discipline aimed at identifying, evaluating and handling risks by both physical and financial means. The medical aid industry in South Africa has experienced a disproportionate increase in expenditure relative to the overall economic growth. These cost pressures have placed restraints on their ability to obtain new members, which is vital when subsidizing higher risks with younger healthier members, and has resulted in losses for many schemes. Compounding the problem has been political and regulatory health care reforms as well as technological advances, which have initiated a complete restructure of the industry. This dissertation reviews the risk management strategies implemented by medical insurers in South Africa. An analysis of alternate risk management strategies is taken with the view of recommending a tentative means of making medical aids more efficient in an increasingly difficult market. / Business Management / M. Comm. (Business Management)

Summaries in Afrikaans and English / Die tradisionele benadering tot bestuur het die Suid-Afrikaanse korrektiewe sisteem sedert sy ontstaan gedomineer. Die vraag wat ontstaan, is of daar enige praktiese, werkbare altematiewe is, veral omdat die huidige strategiese ingesteldheid, argitektuur en menslike hulpbronne onder verdenking is. Hierdie navorsing bevestig die vermoede dat 'n nuwe benadering tot strategie, struktuur, kultuur, bestuursfilosofie, werkspraktyke en mense te voorskyn kom en dat dit alleenlik gemobiliseer kan word deur organisasievernuwing. 'n Penologiese sisteem wat 'n deelnemende bestuursbenadering aanvaar, sal as 'n wereldleier geklassifiseer word. / The traditional approach to management has dominated the South African correctional system since its conception. The question arises whether there are any practical workable alternatives, especially as the present strategic intent, architecture and human resources are under suspicion. This research confirms the supposition that a new approach to strategy, structure, culture, management philosophy, work methods and people is emerging and that this approach can be enabled only by organisational renewal. A penological system that adopts a participative management approach would be classified as a world leader. / Penology / M.A. (Penology)

Les territoires et les paysages littoraux sont soumis à des risques naturels de mieux en mieux identifiés et croissants (tempêtes, submersions…), notamment sous les effets du changement climatique, dont les manifestations, pas seulement eustatiques, auront d’autres conséquences sur les paysages. Comment, dans une logique proactive, tirer parti des modifications de paysages tout en limitant, contrôlant, voire corrigeant les dérives induites par la hausse du niveau marin sur les littoraux ? L’objectif est de montrer qu’il est possible de s’ajuster à ces risques par la prise en compte des paysages et par la pratique d’une gestion plus douce et raisonnée des aménagements côtiers. Après avoir établi un bilan argumenté sur la prise en compte du paysage dans les stratégies aujourd’hui mises en œuvre pour réduire les risques d’inondation et de submersion, la thèse évalue comment le projet de paysage, processus holistique de conception et de partage de visions à long terme, peut-il être un outil de réduction de la vulnérabilité du territoire et de sa société. Puis, la thèse se focalise sur la Camargue, territoire deltaïque emblématique dont les processus naturels et sociaux ont permis d’inventer une société et des paysages créateurs de richesses dans un équilibre dynamique face aux risques permanents d’inondation et de submersion. Cependant, avec, entre autres causes, celle du changement climatique, cet équilibre stratégique est remis en question et nécessite d’élaborer les hypothèses d’une autre Camargue. Ainsi, dans une dimension exploratoire, la thèse propose une illustration argumentée de nouveaux modèles de développement et d’ajustement du système camarguais. La double prise en compte du paysage et du changement climatique et les premiers résultats de l’étude de dépoldérisation des Bas-Champs Picards, nous amènent à revendiquer la mise en œuvre d’une politique de renouvellement littoral en tant que réponse aux problèmes des territoires côtiers d’aujourd’hui et plus encore de demain. / Coastal territories and landscapes are submitted to increasing yet better identified natural risks (storms, flooding, etc.), especially under the effects of climate change. Its reflections, the eustatic ones among others, have various consequences on the landscape. How is it possible, in a proactive reasoning, to take advantage of the lanscape alterations at the same time as limitating, controling and why not correcting the excesses due to the sea level rise on the coasts ? The aim is to show that it is possible to adjust to these risks upon taking landscapes into account and managing the coastal structures a lighter and better thought-out way.An argued assessment on the way the landscape is taken into account in current strategies used to reduce the flooding risks, is followed with an evaluation of the way the landscape project, a holistic process of designing and sharing long term visions, can be used as a tool to reduce the vulnerability of both the territory and its society. Then, the thesis focuses on the emblematic Camargue delta, a territory which natural and social processes allowed to develop a society together with lanscapes creators of wealth in a dynamic balance considering the permanent flooding risks. However, keeping in mind, among other causes, that of climate change, this strategic balance is being questioned and needs the elaboration of hypotheses for another form of Camargue. Thus, in an exploratory dimension, the thesis suggests an argued illustration of new models of development and adjustment for the system of Camargue. Taking into account both the landscape and climate change, the first results of a study on managed realignment in Bas-Champs, Picardie, lead us to a demand for the implementation of a coastal regeneration policy as the answer to the issues of coastal terriories for today, and even more for tomorrow.

The aim of the study was to investigate the knowledge and utilisation of antenatal care (ANC) services by pregnant women at a clinic in Ekurhuleni. A quantitative, descriptive correlational study was carried out on 90 eligible pregnant women. Data were collected with a self-administered questionnaire and analysed with the help of a statistician using the Epi Info version 7 computer program. The results of the study indicate that most women initiated ANC later than the recommendations by the World Health Organization (WHO). Over half of the respondents had overall good knowledge of ANC, but lacked knowledge of medication and screening tests done during pregnancy, some danger signs during pregnancy and of exclusive breastfeeding. Factors that were identified as associated with late initiation of ANC were current employment status, number of children, transport costs to clinic and number of antenatal visits. / Department of Health Studies / M.A. (Public Health)

Includes publications published as a result of ideas developed in this thesis, inserted at end. / "April 2005" / Includes bibliographical references (leaves 210-242) / 242 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Examines goal setting in people with diabetes as part of chronic disease management in a rural setting. The studies were performed in Eyre Peninsula with a significant (10-20%) Aboriginal population. / Thesis (M.D.)--University of Adelaide, Dept. of General Practice, 2005

This research project focuses on the Walla Walla River Basin located on the east side of the states of Oregon and Washington, USA. With the support and collaboration of the Walla Walla Basin Watershed Council, this work embraces four research topics. The first topic includes the feasibility study of artificial aquifer recharge in the Walla Walla Basin. Through development and application of a regional hydrological model, a methodology for evaluating locations of artificial aquifer recharge is presented with a test case. The second research topic evaluates the recharge rates observed from pilot test studies of artificial aquifer recharge. Scale dependence of recharge rates should be considered when excessive induced groundwater mounding forms beneath the infiltrating basins. The third topic utilizes groundwater tracers and simulation models to evaluate the hydraulic connection of springs to infiltrating basins of artificial aquifer recharge. Finally, the fourth topic as a proof of a technique, utilizes distributed temperature sensing technology with a pair of black and white coated fiber optic cables to estimate the effective exposure to solar radiation over the Walla Walla River. / Graduation date: 2013

Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2008.

No description available.

No description available.

The most frequent intervention performed by physicians is the writing of a prescription. Modern medicine has been remarkably effective in managing diseases. Medicines play a fundamental role in the effectiveness, efficiency and responsiveness of health care systems. However, health care expenditure is a great cause for concern and many nations around the world struggle to contain rising health care costs. Pharmaceutical benefit management programmes such as pharmacoeconomics, drug utilisation review (DUR) and disease management have emerged as control tools to ensure cost effective selection and use of medicine. These managed care instruments are often used to determine whether new strategies or interventions, such as the implementation of a managed medicine reference price list, are appropriate and have "value". The general objective of this study was to investigate the influences of the implementation of a managed medicine reference price list on the usage and cost of antibiotic medicine in the private health care sector of South Africa. The research design used in this study was retrospective, non-experimental and quantitative. The data used for the analysis were obtained over a two-year study period (1 May 2001 to 31 April 2003) from the central medicine claims database of Medschem&. Data was analysed according to prevalence, cost and original (innovator) or generic medicine items. For the purpose of this study antibiotics referred to beta-lactams (penicillins, cephalosporins and "others"), erythromycin and other macrolides, tetracyclines, sulphonamides and combinations, quinolones, chloramphenicol and aminoglycosides. The results of the empirical investigation showed the total number of medicine items claimed during the study period amounted to 49098736 medicine items having a total expenditure of R7150344897.00. There was a decrease in the prevalence of original (innovator) products during the two-year period. The prevalence of generic products increased from 25.87% to 32.47%. A total of 4092495 antibiotic medicine items were claimed with a total cost of R526309279.43 representing 7.36% (n = R7150344897.00) of all pharmaceutical products purchased during the two-year period. Original antibiotics had a prevalence of 42.32%, while generic antibiotics constituted 57.68% of all antibiotic products claimed (n = 4092495). However, original (innovator) products contributed 62.32% and generic products 37.68% to the total cost of all antibiotics claimed. It was concluded that the beta-lactam antibiotics represented 56.99% of all antibiotics claimed (n = 4092495) and contributed 52.51% to the total antibiotic expenditure (n = R526309279.43) for the two-year period. The average cost of beta-lactam items ranged between R112.88 * 69.95 and R122.18 + 81.42. The Medschema Price List (MPL) was implemented in May 2001. The aim of this reference pricing system was to allocate a ceiling price to a group of drugs, which are similar in terms of composition, clinical efficacy, safety and quality, with the ultimate goal to reduce medicine expenditure. During the year of implementation of the MPL 62.24% of beta-lactam antibiotics claimed (n = 1303464) were MPL listed. These products contributed 43.25% to the total cost of all beta-lactam antibiotics (n = R157142778.38). Medical aid companies reimbursed R61649211.86 for penicillins claimed and MPL listed. If all penicillin products were claimed at the ceiling price set by the MPL, a cost saving of 2.79% could have been achieved. Cost analysis indicated that it is possible to reduce health care costs by implementing strategies with the aim to reduce medicine cost. Further research, however, is necessary and in this regard recommendations for further research were formulated. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2005.