South African institutions of higher learning remain unfriendly and hostile environments for queer students who reportedly continue to experience homophobia, biphobia and transphobia in these spaces. This qualitative enquiry explored the experiences of Lesbian, Gay, Bisexual, Transgender, and Intersexed (LGBTI) students in accessing healthcare in a contact higher education institution. The findings suggest that LGBTI issues are silenced within the university spaces and this blocks the availability of a targeted and strategic approach to deal with the healthcare issues of queer students. Furthermore, it was found that the healthcare services are heterocentric in nature, mainly targeting heterosexual students and deliberately excluding LGBTI students from accessing these services. In addition, the heteronormative attitudes held by healthcare professionals create added barriers for LGBTI students to access healthcare services. Religiously motivated stigma and discrimination prevented healthcare professionals from providing culturally appropriate healthcare services to LGBTI students, thereby excluding them from accessing these services. This research concludes that university management should take decisive action in supporting a human rights framework in order to protect the rights of LGBTI students. Sensitization training as well as the training curriculum of healthcare professionals should include aspects of sexual orientation and gender identity. / Health Studies / M.A.(Social Behaviour Studies in HIV-AIDS)

As the public sector and specifically the health sector, undergo reform throughout the Western world in order to find systems that work better and cost less, the phenomenon of accountability is of increasing concern to policy-makers. Although the public administration concept of accountability is ancient, and has been debated and described in the languages of many diverse disciplines, little academic work is available on its meaning or application to the Canadian Health System. Without a clearer understanding of the concept, the basis for improving accountability in the Canadian Health System will remain unknown. This dissertation seeks to clarify the concept of health system accountability and elucidate the issues related to improving accountability in the system. This is accomplished through a concept analysis methodology using two qualitative data collection strategies: a structured review of Canadian literature on accountability from the domains of health policy/administration, professional and popular literature sources; and an interview process whereby 24 health system leaders from five Canadian provinces were interviewed. The findings reveal that the concept of accountability, in its current explicit, performance-based form, is relatively new to Canadian health system policy discussions, its use only beginning in the 1980’s. Prior to this, accountability was implicit in the delegation of health matters to self-regulating professions. The concept evolved from public administration theory and continues to evolve as a health concept. An attempt is made to disentangle the concept of health system accountability from its many related concepts and references. The defining attributes of accountability are: a performance assessment according to standards/goals; an obligation to render an account; and an answerability to the community served. Antecedents or pre-requisites to accountability include a renewed culture, strategic direction, citizen engagement, information management, performance measurement and reporting. Consequences of accountability are: a sustainable health system, increased public confidence, improved health outcomes and quality services, added bureaucracy and uncertainty. Although there is a majority view on the defining attributes, there are several conceptions of accountability: as a theoretical or ethical construct; as gesture; as a formal system or set of practices; as an on-going political process; and as desired outcomes or results. Likewise several normative modes or models exist: the historical professional model, the emerging managerial model and the potential citizen participation model. These are all encompassed within the broader political framework. Also, accountability is a multi-level construct: personal, organizational and political. There are several policy issues related to accountability and democratic governments in today’s modem societies. Within the health sector, the key issues identified, by health system leader research participants, as problematic to improving accountability included: a lack of direction and role definition, cultural issues, a lack of citizen engagement, and a lack of appropriate measurement and information with which to evaluate organization and system performance. Although the purpose of this dissertation is not to answer or provide prescriptions to policy issues, several health policy questions are generated. I trust that the conceptual analysis presented here will assist to clarify our language and understanding of accountability as it continues to evolve in health care, provide a helpful reference point from which to discuss health system policy issues, and prompt further research in an area that has largely been ignored by Canadian academics. We need to get clear about our language, (so that), our intelligence is not bewitched by our language. (Hodgkinson, 1996, p.144) / Graduate

No description available.

Early computerized health information systems supported applications in hospital records and laboratory data collection. Since that time, software has been developed for a number of health care providers such as doctors and pharmacists. Although local area networks are installed at larger institutions, only a few small-scale, special-purpose, wide-area networks are installed for external providers. To be adopted, wide-area networks should provide greater functionality than, and be cost-competitive with, conventional communication methods. Several projects are underway in Health Information Science to develop and evaluate generic, wide-area networks. This dissertation describes the design, analysis, development, implementation and evaluation of a prototype health care network which would be accessible to providers using existing computer equipment and the public switched telephone system. The network software, Health Link, supports reliable, automatic, store-and-forward messaging of medically-sensitive information. Encrypted messages can be authenticated and the software features registered delivery. An application programming interface formats messages in accordance with the HL7 data interchange standard. Simulation studies have been conducted which demonstrate the steady state characteristic behaviour of a node in a uniform cluster. Further studies have investigated a realistic, dynamic, large scale network. A peer-to-peer model and client-server model were analyzed and both were found to be feasible with respect to certain performance and cost criteria. The client-server model was found to be less costly to operate than the peer-to-peer model. The peer-to-peer model can transfer messages in a shorter time than the client-server model. The network software was verified in a field test involving four clinics, one medical laboratory, and one hospital. Data collected in the test provide performance benchmarks, an estimate of message sizes and frequencies, network reliability statistics, and a wealth of observations. Performance benchmarks and message traffic measurements were used to calibrate the simulation models. Results from this and other research indicate that, although most of the technical networking problems can be readily overcome, consensus on standards, health care applications, and initiatives should be promoted before a wide-spread, production network is implemented. / Graduate

Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2007 / Understanding the use of information and communication technology (ICT) in the Namibian's health sector is important in the global information society It is not clear how ICT is being deployed to support the delivery of health services to the Namibian patients. Health service providers (HSP) in both private and pUblic health sector must be aware of ICT use patterns because this may influence how they deliver services to their patients in the future. This study thus seeks to investigate how ICT have been used in the delivery of health services to patients in the Khomas and Oshana regions of Namibia. Based on the literature review and data collected from the HSP and patients, a 'generic' health service delivery landscape for Namibia was developed and regional landscapes for the Khomas and Oshana regions were further derived from it. The landscapes depicted health service provision to patients in the different health sectors in Namibia. After mapping the health landscapes primary data was collected from the health service providers (HSP) in private, mission and public health institutions using a questionnaire A second structured questionnaire was administered on the patients A total of 21 and 134 HSP patients respectively, responded to the survey questionnaire. Results from the descriptive analysis indicate a relatively high ICT use by both HSP and patients.

Radiography is a constantly changing environment that is continuously evolving with new technology and new techniques on how to image human anatomy. This has led to cheaper and easier ways of imaging that present an opportunity for radiographers to practice independently from radiologists. The increase in the number of radiographers going into private practice since 2006 has led to a number of private radiography practices failing due to competition and other management and financial factors. This study seeks to provide insight into the changing environment of private radiographic practice and the level of success it can bring to radiographers. This will enable radiographers to better determine their personal and professional development needs, which will effectively improve their ability to manage and sustain private radiographic practices. This approach stems from the researcher’s belief that with the right skill and knowledge radiographers can run successful private practices and in so doing be able to empower others to do the same. The researcher has chosen to carry out a qualitative, exploratory, descriptive and contextual research design in order to explore and describe the detailed recommendations and views of private radiographic practice owners and how they manage their practices. The chosen method of data collection for this study is individual one-on-one interviews supported by a literature control. The one-on-one interview was used to collect the data from participants who meet the inclusion criteria. The researcher purposively selected participants to ensure that their ideas and opinions will benefit the study. The chosen method of data analysis is Tesch’s data analysis approach as it follows the qualitative way of data analysis which occurs in three phases: description, analysis, and interpretation. This research made use of Guba’s trustworthiness model to establish the validity and reliability of the qualitative research. The four criteria in this model for trustworthiness are truth-value by using the qualitative approach of credibility; applicability determined by using transferability; consistency determined by using the qualitative approach of dependability and, finally, neutrality determined by the qualitative approach to confirmability. The following six (6) ethical principles were followed to ensure no harm came to the participants: beneficence and non-maleficence, autonomy, justice, veracity, confidentiality and privacy. On completion of the study, the researcher made recommendations based on the findings for inclusion in basic radiographic training and continuous professional development. These recommendations are: Complete reviewing of the management training syllabus in radiography education. Compilation of literature that deals with private practice radiography. Inclusion of private practice radiographers in radiography societies. Further research into the subject of private practice radiography. This will allow for the knowledge contained in the study to be accessible to those who need it. It is also important to note that a study of this nature has never been conducted and therefore sharing of this information will allow for radiographers to know and understand what sustaining a private radiographic practice involves. The findings will be disseminated in seminars, conferences and publications.

No description available.

This thesis explores the historical roots of scientific medicine in an effort to highlight the lack of humanist intersubjectivity within the contemporary medical model. The study notes that contemporary medicine is overtly scientific and that its scientific framework is upheld and furthered by a medical model which draws legitimation from the irrefutability of what is referred to variously within this work, as its scientific "regime". It is shown that in terms of the humanist tradition people, not science, constitute the epicentre of meaningful experiential participation in the defining of human social reality. This, it is argued, implies a radically different ontology from other sociological perspectives on medicine. The thesis suggests that the contemporary medical model loses sight of the patient's ability to cognitively participate in the defining of illness, diagnosis and treatment in terms of his/her experience thereof , and argues that contemporary medicine, by advancing the idea that it alone has the correct and only answer to such problems, has led to a situation which promotes an overmedicalisation of society . The study gives an indication of the way in which this overmedicalisation has led to areas of human life becoming conceived of only in relation to medical expertise. In this respect it is noted that medicine has so successfully infiltrated the human consciousness (involving areas as diverse as childbirth, genetic engineering, transplant surgery and death), that decisions on health are invariably taken from a foundation of scientific legitimation which seems to exclude the patient as subject. It is argued that this way of making decisions reinforces the requirement for a scientific medical model which as it negates the human element insidiously amplifies its power over human life; thereby devaluing the very people it seeks to serve. The thesis suggests that in terms of a humanist reading of the Oath of Hippocrates, medical decisions can only be taken within a framework of experiential involvement which includes both medical expertise and lay understanding. It is indicated that when this happens, social reality functions in terms of a symbolic participation which fosters a commitment to equalise the conditions of human existence, and promotes a dialogical negotiatory process which is both intersubjectively and ongoingly produced.

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This thesis explores the difficulties of talking about cancer. Conversational interviews with 17 people diagnosed with cancer are analysed from the perspective of discursive psychology which treats accounts and the description of events as discourse practices and categories. Cancer is considered a mysterious and frightening disease associated with myths and taboos. It is a sensitive topic and talking about it can be a delicate and difficult thing to do for all concerned. If a person with cancer (PWC) is not seen or heard to be 'being positive' or 'adopting a fighting spirit, they could be left with a sense of blame, guilt or failure. It is proposed that not only do they have to contend with managing to live with a life threatening illness but the metaphorical descriptions attributed to cancer, the 'heroic model' and its accompanying discourses and expectations construct the ill person as being morally accountable. Narrative themes of discovery, diagnosis, doctors and delay, social relationships, the indignities of treatment and talk of death and dying are analysed. The analysis reveals some of the problems and interactional difficulties that participants have to manage, and it considers some of the dilemmas and problems produced in cancer narratives and how discursive Practices, such as laughter, are displayed. It considers the way participants discursively construct notions such asdoing being responsible, 'complaining and blaming' and 'doing being positive' and it reveals how participants' concerns of identity and moral accountability are rhetorically accomplished and managed. The findings of this thesis emphasise how PWC work to maintain the identity of someone who is bearing their illness 'patiently", without complaining and are seen to be a 'good patient'. The analysis reveals that participants construct their identity as someone who is being positive and that they not only have to manage the interactional problems that their illness poses for others and their inadequacies to cope with people with cancer, but additionally they have to manage the moral restrictions on not being able to admit that they are not coping. It is suggested that an increased awareness of the psychological burdens and interactional difficulties people with cancer report in their accounts can contribute to a better understanding of what and how people with cancer manage these additional burdens in their social lives.