This study examines clients' reports of aspects of a single child health clinic visit and of a home visit by the health visitor. There are two foci of the thesis. First: recall; value and use of the advice/information selected by the client as the most important; second, an exploration of the meaning of support identified by some clients.Seven health visitors participated in the research, which incorporated two studies. In the first study, the researcher observed the content of discussions between 100 clients and the health visitor in child health clinics. These clients were then interviewed at home and asked questions about the advice/information received from the health visitor during theirprevious visit to the child health clinic.For the second study, information was recorded by the health visitor describing the content of 149 home visits. Clients were interviewed at home and asked similar questions regarding advice/information received from the health visitor. In addition, those clients who described receiving support were asked to describe the meaning to them of this aspectof the visit.Data analysis for both studies included descriptive and inferential statistics and content analysis.Findings from both studies indicate that recall of advice/information is related to the amount of advice/information given to the client. This may have implications for the amount of advice/information that health visitors are encouraged to provide.Advice/information received from the health visitor was generally valued and used by the mothers in both studies. Clients appeared most likely to be dissatisfied when topics had been raised which they had no interest in discussing. It is suggested that that there may be correspondence between some clients' descriptions of support, and taxonomies of social support found in social support literature. An exploration of health visiting work employing the concepts of social support is recommended.

The aim of the study was to understand how and why medical technologies (devices, pharmaceuticals and surgical procedures) are produced (innovated and developed) and consumed (adopted and utilised).Medical technologies are linked to the expansion of health care provision and costs. Policy makers encourage technology assessment to ensure the value of medical technologies (absolute technological efficacy and relative cost effectiveness). This policy, which is underlain by a model of technological determinism, may be ineffective if other factors influence decision making.Three international (UK and USA) comparative case studies were undertaken, analysing the innovation, development and diffusion of specific medical technologies. Annual statistics were gathered on adoption and utilisation rates of Magnetic Resonance Imaging (a device), Laparoscopic Cholecystectomy (a surgical procedure) and Prozac (a drug). Literature review supported interviews with parties involved in decision making processes.The widespread adoption of Magnetic Resonance Imaging has been motivated by professional and institutional competition, despite its often inappropriate utilisation, uncertain efficacy and extremely high costs.Laparoscopic Cholecystectomy (keyhole surgery for gallbladder stones) has diffused rapidly, being driven by general surgeon's concerns over their control of the gallbladder. The ease of the surgery has enabled total surgical volumes to almost double.The diffusion of Prozac (an expensive antidepressant) was influenced by high profile uncertainties regarding its safety and efficacy. Subsequently its range of applications have grown, but many of these are unproven, whilst its long term safety profile is unknown.The study concludes that the decision making surrounding the innovation and diffusion of medical technologies is only vaguely related to their clinical efficacy or their cost effectiveness. lntra professional competition is central to the production and diffusion of medical technologies. Technology assessments, being largely reactive, and dependent on clinical reports, are unlikely to prove effective in achieving cost effectiveness. This finding has significant implications for future health care policy making.

The provision of health services to all the population is one of the highest priorities in many governments' agenda, because the health system, education and social security are important indicators of the level of development of a state. However, the provision of health services to cover all the population is not easy, particularly in many developing counnies, which lack human and financial resources. In 1978, at Alma - Ata WHO and UNICEF jointly declared the primacy of the primary health care ( PHC) approach for achieving the WHO's social goal, " health for all the people by the year 2000". Since then, PHC has become a major concern on national and international levels. Saul Arabia one of the countries which has adopted and implemented the PHC approach.This study explores the implementation of the PHC approach, the utilisation of health services delivered at the health centres and health awareness in Jeddah, a major urban centre in Saudi Arabia, where public and private health services co-exist and compete, and where traditional medicine is still used and practised. A sample comprising both utilisers of the PHC centres and non- utilisers were questioned about their health practices, beliefs and attitudes, and an attempt was made to determine whether socio- economic and demographic characteristics were significantly related to utilisation and health awareness. No single pattern of attitude or behaviour was found to be consistently related to socio-economic or demographic characteristics. However, the findings indicate the general significance of education.The nature of service provision was found to affect satisfaction and a need was found to improve the quality of the health service and to remove bureaucratic barriers which impede utilisation. Although many aspects of PHC are successfully implemented, there is evidence of misunderstandings of the approach by both consumers and providers, which limits both utilisation and satisfaction. In particular providers and users still prioritises curative above preventive medicine, health education is still neglected, and the potential of the media in this respect is under-exploited.Finally, traditional medicine was found to be used and practised, but the finding; indicate there is not necessarily a conflict between the two systems. They appear to be used in a complementary way, and them may be scope for integration.

Thesis (M. P. H.)--University of Hong Kong, 2007.

Thesis (M. P. H.)--University of Hong Kong, 2007. / Also available in print.

Thesis (M. Res.(Med.))--University of Hong Kong, 2007.

Thesis (Ph.D.)--Australian National University, 2001.

Thesis (M.A.)--Texas State University-San Marcos, 2008. / Vita. Appendices: leaves 106-107. Includes bibliographical references (leaves 108-111). Also available on microfilm.

Thesis (M.S.)--Virginia Polytechnic Institute and State University, 1994. / Vita. Abstract. Includes bibliographical references (leaves 112-117). Also available via the Internet.

Thesis (M.H.S.A.)--University of Michigan, 1980.