Des orientations de travail, issues du régime politique démocratique d’interaction et de la dynamique de la différenciation sociale s’inscrivent et traversent tous les procès de prises en charge des assistés, faisant qu’il est tout à la fois impossible de les sacraliser et de les déshumaniser. L’articulation de ces orientations faisant que ces derniers sont déqualifiés en tant qu’humain. Cette déqualification démontre que les politiques sociales individualisantes placées sous l’égide de l’humanisme ne solutionnent aucunement le problème de la pauvreté. Cela questionne dès lors l’utilité de telles politiques demandant de lourds investissements pour des résultats sociaux mitigés. La réinscription de cette problématique dans son développement historique permet d’éclairer ce paradoxe : les politiques sociales de lutte contre la pauvreté ont été des facteurs de richesses pour la modernité. Loin des analyses en terme de « crise », l’institutionnalisation desdites politiques témoigne d’un développement exponentiel, bien que dynamique, des possibilités de croissance économique. L’action sociale et médico-sociale est en quelque sorte le déversoir de la modernité, véritable marché artificiel, pour ne pas dire centre de recyclage, du surplus humain. / Working orientations, resulting from the democratic political system of interaction and dynamics of the social differentiation are registered and cross all the institutionalization of assisted, making that it is all at the same time impossible to sacrilize them and to dehumanize them. The joint of these orientations making that these last ones are dequalified as human being. This deskilling demonstrates that the new individualisantes social policies placed under the aegis of the humanism resolve not at all the problem of the poverty. It questions from then on the utility of such policies asking for heavy investments for reserved social results. The re-registration of this problem in its historic development allows to light this paradox: the social policies of struggle against poverty were factors of wealth for the modernity. Far from analyses in term of "crisis", the institutionalization the aforementioned policies testifies of an exponential development, although dynamics, possibilities of economic growth. The social and medical social action is in a sense the overflow of the modernity, the real artificial market of the human surplus.

Thesis (MPH)--University of Limpopo, 2009. / BACKGROUND AND AIM: Hepatitis B virus (HBV) is the major cause of hepatitis in South Africa (SA), with an estimated 4 million carriers. It is transmitted by infected blood and other body fluids, placing health care workers (HCWs) at high risk of infection. The SA Department of Health strongly recommends that all HCWs be vaccinated against HBV, but studies have shown that uptake of the vaccine is sub-optimal. This study aimed to estimate HB vaccination coverage levels among nurses, and describe the demographics and characteristics of the HB vaccination policies associated with different levels of coverage, at private and public hospitals in Tshwane. METHODS: This was a questionnaire-based cross-sectional study on 300 randomly selected nurses and 12 chief infection control officers (CICOs) from 13 hospitals (6 public and 7 private) in Tshwane performing high risk procedures. CICOs were asked questions about HB vaccination policies and coverage, while nurses were asked about demographics, HB vaccination status, and the HB vaccination policies of their institutions. RESULTS: The response rate was 84.3% (253/300) for nurses, and 75% (9/12) for CICOs. Of the nurses, 68.0% (172/253) were vaccinated, and logistic regression analysis found that those statistically significantly most likely to be vaccinated were: 30 years and younger (odds ratio [OR]=2.9; 95% CI: 1.11–7.59); employed in private hospitals (OR=3.0; 95% CI: 1.24–7.32); and graduated after 1990 (OR=2.6; 95% CI: 1.10–6.19). Also, logistic regression analysis found two statistically significant policy-related predictor for vaccination uptake, which was the presence of HB vaccination program (OR=4.6; 95% CI: 2.11-10.06); and compulsory HB vaccination (OR=2.8; 95% CI: 1.37-5.70. CONCLUSION: There is a need for a national policy on HB vaccination of HCWs which should include compulsory vaccination, to increase the vaccination coverage level amongst nurses.

Health policy reforms have dominated health systems in African countries for over three decades. However, the impacts of these policies on nurses’ work, as well as the extent to which the nurses are involved in the policy decisions, have not been well documented. As the largest group of health professionals in the workforce, nurses’ services are necessary to achieve population health outcomes. Thus, nurses’ work concerns related to the reform of national policies should be identified and addressed. This study was carried out to examine how the national policy reforms have impacted on nurses’ work in Kenyan district health care systems and how nurses have been involved in policy processes in the health care system. Critical theory and feminist critical policy analysis perspectives guided the study. The study was implemented in two phases. The first phase involved qualitative interviews with 32 decision makers and nurses in the public health care system. The second phase involved a comparative quantitative survey of nurses and nurse managers in two districts. A sample of 169 nurses was interviewed in two district hospitals to generate data for this second phase of the study. This thesis contains three manuscripts. The first manuscript presents a qualitative analysis of the impact of policies on nurses’ work (Chapter 2). The second manuscript presents qualitative results of how nurses were involved in policy processes at various levels of the health care system (Chapter 3). The third manuscript presents results of a quantitative survey of frontline nurses’ experiences with the policy reforms, comparing two districts (Chapter 4). An integrative discussion of key findings from all these manuscripts forms the last chapter of the thesis. The findings revealed that policies meant to enhance access to services like decentralization and primary health care were more enabling to nurses’ work while those aimed at enhancing efficiency like structural adjustment programs were more constraining. The constraints included poor work environments, unchanging work conditions, increased responsibilities and dilemmas in providing care. These constraints were experienced more by nurses in the district that was poorly resourced and had poor health indicators than the district that had better resources and better health indicators. The results suggest that inadequate involvement of nurses in policy processes is a reason why their work concerns have not been addressed. There are recommendations to improve nurses’ work in the context of policy reform and to improve nurses’ abilities to participate in policy processes.

Health policy reforms have dominated health systems in African countries for over three decades. However, the impacts of these policies on nurses’ work, as well as the extent to which the nurses are involved in the policy decisions, have not been well documented. As the largest group of health professionals in the workforce, nurses’ services are necessary to achieve population health outcomes. Thus, nurses’ work concerns related to the reform of national policies should be identified and addressed. This study was carried out to examine how the national policy reforms have impacted on nurses’ work in Kenyan district health care systems and how nurses have been involved in policy processes in the health care system. Critical theory and feminist critical policy analysis perspectives guided the study. The study was implemented in two phases. The first phase involved qualitative interviews with 32 decision makers and nurses in the public health care system. The second phase involved a comparative quantitative survey of nurses and nurse managers in two districts. A sample of 169 nurses was interviewed in two district hospitals to generate data for this second phase of the study. This thesis contains three manuscripts. The first manuscript presents a qualitative analysis of the impact of policies on nurses’ work (Chapter 2). The second manuscript presents qualitative results of how nurses were involved in policy processes at various levels of the health care system (Chapter 3). The third manuscript presents results of a quantitative survey of frontline nurses’ experiences with the policy reforms, comparing two districts (Chapter 4). An integrative discussion of key findings from all these manuscripts forms the last chapter of the thesis. The findings revealed that policies meant to enhance access to services like decentralization and primary health care were more enabling to nurses’ work while those aimed at enhancing efficiency like structural adjustment programs were more constraining. The constraints included poor work environments, unchanging work conditions, increased responsibilities and dilemmas in providing care. These constraints were experienced more by nurses in the district that was poorly resourced and had poor health indicators than the district that had better resources and better health indicators. The results suggest that inadequate involvement of nurses in policy processes is a reason why their work concerns have not been addressed. There are recommendations to improve nurses’ work in the context of policy reform and to improve nurses’ abilities to participate in policy processes.

Inaug.-Diss.--Basel. / Bibliography: p. [154]-155.

This thesis approaches key areas of insurance contract law and their reform from the perspective of Adams and Brownsword’s theory of contract law ideologies. Pursuant to this theory, there are two layers of ideologies underlying contract law. One is the formalist versus realist judicial approaches. The other is that the realist approach being broken down into two limbs, namely market-individualism and consumer-welfarism in contract law. The theory of contract law ideologies is relevant to insurance contract law, because there is substantiated homogeneity between general contract law and insurance contract law, and the relevance consists in the theory’s usefulness both as an interpretive framework and as an evaluative standard. Specifically, from that particular ideological perspective, the thesis interprets the law of disclosure and warranty in insurance, of the requirement of insurable interest, and of the legal rules for insurance payment. Under the theory of contract law ideologies as an interpretative framework, the current law of insurance as far as those three key areas are concerned is found to be much more formalist than realist. The thesis also evaluates the core proposals tentatively put forward by the Law Commission and the Scottish Law Commission for reform in those key areas of insurance contract law. From the theory of contract law ideologies, it can be derived an evaluative standard that, for law reform through legislation, the realist approach is more preferable, and market-individualism should prevail in business insurance whereas consumer-welfarism should prevail in consumer insurance. By this standard, most of the core tentative proposals by the two Law Commissions for reform in the law of disclosure in business insurance and of warranties in insurance are realist and therefore desirable, but two of the proposals need to be amended. The recent proposals in 2011 to retain the requirement of insurable interest are not realist and instead it is better to return to the proposals in 2008. Among the proposals regarding the legal rules of insurance payment, the Scottish approach is preferable for its realist re-characterization of insurers’ primary contractual obligation.

Breastfeeding rates vary considerably among high-income countries who are members of the Organization for Economic Co-operation and Development (OECD). In the 1960's, breastfeeding outcomes, both initiation of breastfeeding and breastfeeding duration, were at an all-time low. Over the past half century, breastfeeding outcomes have increased among all OECD countries, but at very different rates. This dissertation examines both the policy-level and public health-level initiatives that have affected the differential growth of breastfeeding rates among 18 high-income, OECD countries. Using a combination of multiple regression, fuzzy-set qualitative comparative analysis, and small-n methods, I find that countries in the broad Scandinavian welfare regime have combined policy support for women's reproductive and productive labor, along with a strong female representation in government to facilitate positive breastfeeding outcomes. I find that countries who have a strong commitment to the World Health Organization's Baby-Friendly Hospital Initiative have higher breastfeeding initiation rates than countries who do not have a high percentage of hospitals following the WHO protocol. This dissertation adds to the broader understanding of how welfare state policies and public health initiatives operate in tandem to support positive breastfeeding outcomes among high-income countries.

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Following the case study research strategy, this thesis has investigated the implementation of corporate environmental policies in subsidiaries of transnational corporations in Brazil. More specifically, it investigated six subsidiaries from three countries of origin - the United Kingdom, the United States and Germany - operating in the chemical and pharmaceutical sectors. This comparative study has resulted in a theoretical framework to explain transnational corporations' environmental practices. This framework follows an interdisciplinary approach, consisting of four levels. First, at the international level, an overview of the constraints regarding transnational corporations and environmental issues is addressed. The second level is represented by the environmental regulatory policies in the home and host countries. The third level accessed the influences from the industry's structure (in both international and Brazilian contexts). Finally, the fourth level is centred on the companies, which specifically discusses the home-host dilemma in the management of transnational corporations. The most important conclusion is that the main source of pressure over subsidiaries' practices is the environmental regulation of the host country. Nevertheless, there are cases of non-compliance and cases of overcompliance regarding Brazilian environmental legislation. However, these contradictory results are explained by the headquarters-subsidiary relationship. That is, poor environmental performance was explained by lack of control from the headquarters. Otherwise, good performance was explained by tight control from headquarters over subsidiaries' practices in Brazil. Additionally, there is indication that regulation is the main driving force in the home countries. However, attempts at self-regulation are in progress in the chemical industry in order to balance these external pressures for environmental improvements. Finally, there is evidence that the nationality of the selected companies is a relevant aspect of their environmental policies and practices. This is mainly because the legal requirements and management approach of the home countries are incorporated into their environmental management.

No description available.