A medicina de viagem (MV) surgiu em resposta ao crescente deslocamento populacional, com o objetivo de prevenir os agravos à saúde relacionados às viagens. No Brasil teve inicio no final da década de 90, momento em que reformas socioeconômicas levaram a melhorias das condições de vida dos brasileiros. O Núcleo de Medicina do Viajante (NMV), do Instituto de Infectologia Emilio Ribas (IIER), foi o primeiro serviço de atenção à saúde do viajante criado na cidade de São Paulo, em maio de 2000. O presente estudo visa: descrever a população de viajantes que procuraram orientação pré-viagem no Núcleo de Medicina do Viajante (NMV) do Instituto de Infectologia Emilio Ribas (IIER) no período de janeiro de 2006 a dezembro de 2010; descrever as medidas de prevenção recomendadas em relação às doenças infecciosas; descrever as atividades de ensino realizadas e a participação do serviço na discussão de diretrizes em políticas públicas em medicina de viagem. No período estudado, 2744 viajantes procuraram orientação pré-viagem no NMV do IIER. Foram realizados 2836 atendimentos de orientação pré-viagem, 92 viajantes procuraram o serviço mais de uma vez. A faixa etária entre 18 e 34 anos (54,2%), o sexo feminino (51,1%) e grau de educação superior (75,5%) foram as principais características demográficas desses viajantes. Os destinos mais procurados foram: África (24,5%), Europa (21,2%), Ásia (16,6%) e Brasil (19,2%). O turismo (35,7%) e o trabalho (35,7%) foram os motivos de viagem mais referidos. O tempo de permanência menor ou igual a 30 dias foi referido pelos viajantes em que o objetivo de viagem foi o turismo, enquanto os viajantes que referiram o trabalho ou estudo apresentaram maior tempo de permanência (p < 0,001). O meio de transporte mais referido foi o aéreo (62,8%). Os viajantes relataram durante a consulta pré-viagem dificuldade de acesso ao serviço. As fontes de informação mais referidas foram: informação a partir de amigos, indicação por profissional da saúde e mídia eletrônica. As medidas de prevenção recomendadas variaram conforme o destino. O tratamento autoadministrado para diarreia foi mais recomendado aos viajantes com destino à Ásia. As vacinas de febre amarela, poliomielite e antimeningocócica A e C foram mais recomendadas aos viajantes com destino à África, assim como a quimioprofilaxia para malária, que foi recomendada para 26,4% dos viajantes para esse destino. A quimioprofilaxia (QPX) para malária foi recomendada em 10,3% de todas as orientações. Houve diferença com significância estatística na recomendação segundo a finalidade (p < 0,30), o destino (p < 0,001) e a duração da viagem (p < 0,001). Das 422 orientações realizadas aos viajantes com destino ao Brasil, a QPX foi recomendada somente para 30 (7,1%). Dos 2744 viajantes atendidos, 664 (24,2%) relataram pelo menos uma morbidade prévia; 66 (2,4%) eram menores de 10 anos de idade; e 157 (5,7%) tinham 60 anos ou mais. Em relação às atividades de ensino, no período do estudo, 83 médicos residentes estagiaram no NMV e foram orientadas onze monografias de conclusão de residência médica. O NMV participou de 12 reuniões para discussão de diretrizes sobre a saúde do viajante e de iniciativas como a Carta de São Paulo (documento em defesa da saúde do viajante elaborado por acadêmicos e profissionais de saúde participantes do SUS). Da criação da Sociedade Brasileira de Medicina de Viagem e da criação do Comitê Estadual de Saúde do Viajante, pela Secretaria de Estado da Saúde de São Paulo. Essas atividades foram passos decisivos para corroborar a implementação de políticas públicas em saúde do viajante no Brasil / Travel medicine (TM) arose in response to the growing population displacement and its objective is the prevention of health problems related to travel. Began in Brazil in the in the late 1990s, at which socioeconomic reforms have led to improvements in of life of Brazilians. Travel Medicine Center (TMC) at \"Instituto de Infectologia Emilio Ribas\" (IIER) was the first health of traveler service created in São Paulo city in May 2000. The present study aims: to describe the traveler population who sought pre-travel guidance in TMC at IIER from January 2006 to December 2010; to describe the recommended preventive measures to travelers concerned with infectious diseases; to describe the teaching activities performed and the service involvement in debating guidelines about public policies in travel medicine. In the time period studied, a total of 2744 travelers sought pre-travel guidance in TMC of IIER, but 2836 assistances were provided for pre-trip orientation since 92 travelers sought the service more than once. The age group between 18-34 years (54.2%), female (51.1%), and university level degree (75.5%) were the main demographic characteristics. The more popular destinations were: Africa (24.5%), Europe (21.2%), Asia (16.6%) and Brazil (19.2%). Tourism (35.7%) and work (35.7%) were the main purposes of trip for travelers. For tourism purpose travelers would stay 30 or less days, while for work or study they stayed for a longer time (p <0,001). Commercial air travel was the preferred alternative (62.8%). The main sources of information were friends, health professionals, and electronic media. The recommended preventive measures varied according to the destination. The self-treatment for diarrhea was more recommended for travelers to Asia. Vaccination against yellow fever, polio, and anti-meningococcal (A and C) was more recommended for travelers to Africa, as well as chemoprophylaxis (CP) of malaria was recommended for 26.4% of travelers to the same country. The CP of malaria was indicated for 10.3% of all assistances. There was statistically significant difference in the recommendation according to purpose (p < 030), destination (p < 0.001) and trip duration (p < 0.001). From 422 assistances to travelers to Brazil, CP was only recommended for 30 (7.1%) travelers. From the 2744 travelers assisted, 664 (24.2%) reported at least one previous morbidity; 66 (2.4%) were under age 10; and 157 (5.7%) were 60 years or older. During the research period and relating to study activities, 83 residents were interns in TMC, and eleven monographs for completion of the Medical Residency were supervised. TMC participated in 12 meetings to discuss guidelines in travel medicine, and participated in initiatives such as \"Carta de São Paulo\" (a document in defense of traveler health prepared by academics and health professionals participating in the Unified Health System); in the institution of the Brazilian Society of Travel Medicine, and of the São Paulo State Travel Medicine Committee by the Secretariat for Health of São Paulo State. These were decisive steps to support implementation of public policies in traveler health in Brazil

INTRODUÇÃO: Em 1999 e 2000, a ocorrência de surtos de rubéola, com maior acometimento entre adultos jovens, refletiu no aumento da síndrome da rubéola congênita. Como estratégia de controle da doença, foram realizadas campanhas de vacinação contra a rubéola em mulheres em idade fértil em vários Estados do País. Em razão das controvérsias existentes na literatura geradas quanto ao emprego da vacina de vírus vivos atenuados em gestantes, não se recomendou sua utilização durante a gravidez e até um mês após a aplicação da vacina. No entanto, 6.473 mulheres foram inadvertidamente vacinadas no Estado de São Paulo, sendo encaminhadas a serviços de referência para acompanhamento dessas gestações, dentre eles, o HCFMUSP. OBJETIVO: Este estudo buscou descrever as características clínicas e epidemiológicas das gestantes atendidas no HCFMUSP e obter os resultados dessas gestações. MÉTODO: Foi realizado um estudo epidemiológico descritivo, utilizando-se como fonte de dados as notificações das gestantes inadvertidamente vacinadas contra a rubéola e atendidas no HCFMUSP entre novembro de 2001 a dezembro de 2002. Para obter o desfecho das gestações, utilizou-se a base de dados dos nascidos vivos do Município de São Paulo (SINASC). RESULTADOS: No HCMFUSP, foram atendidas e notificadas 409 gestantes. Destas, 49,1% foram vacinadas no primeiro mês de gravidez e 26,2% engravidaram até um mês após a vacinação. Em relação a condição sorológica durante o pré-natal, 16,9% das gestantes apresentaram sorologia reagente para rubéola. Do relacionamento com a base de dados do SINASC, foram localizados os dados do parto de 63,3% das gestantes, sendo detectadas duas malformações congênitas no SINASC e um abortamento, porém, não se pode atribuir estes resultados à vacina, pois, as sorologias das mães não permitem determinar se estas mulheres eram realmente suscetíveis. CONSIDERAÇÕES FINAIS: O estudo apresentou o fluxo de informação estabelecido frente a um evento inusitado. Além disso, o uso de bases de dados secundárias contribuiu para o aprimoramento dos dados coletados, resultando na melhora da qualidade das informações. Os Núcleos de Epidemiologia Hospitalar são fundamentais na articulação entre a equipe assistencial e o Sistema de Vigilância e colaboram para discussão na padronização de Sistemas de Informação para permitir melhor integração entre as informações geradas pelos Serviços de Saúde. / INTRODUCTION: In the years 1999 and 2000, rubella outbreaks reaching mostly young adults resulted in an increased number of cases of Congenital Rubella Syndrome in Brazil. State Vaccination Campaigns aiming at women at childbearing age were promoted around the country to control the disease, recommending that vaccination of pregnant women should be avoided and pregnancy should be postponed for at least a month after vaccination. Despite the recommendations, 6.473 pregnant women were accidentally vaccinated in the State of São Paulo and therefore sent to reference obstetrical services for prenatal care. A study was conducted to describe the cases assisted at the University of São Paulo, School of Medicine, General Hospital and notified to Public Health and also to obtain information on the pregnancy outcomes. METHODS: This descriptive epidemiological study used notification by the Hospital Epidemiology Service as source of information on pregnant women accidentally vaccinated against rubella that received care from November 2001 to December 2002 at the School of Medicine, General Hospital. The City of São Paulo Newborn Database was searched for pregnancy outcomes. RESULTS: Among the 409 notified cases, 49,1% were women accidentally vaccinated during fist trimester of pregnancy and 26,2% women that became pregnant within less than a month after vaccination. Positive serological tests were found in 16,9% of women during prenatal care. Newborn data base search yielded pregnancy outcome for 63,3%. The findings of 2 cases of Congenital Rubella Syndrome and 1miscarriage cannot be surely attributed to vaccination because immediate previous immunization status was unknown. CONCLUSIONS: The study described the information flow established for an unexpected adverse event and the use of secondary data to improve quality of information. Hospital Epidemiology Services have a fundamental role in connecting health assisting professionals to Public Surveillance Systems and in setting standards for information generated by Health Assistance.

Introdução: Por se tratar de uma falha médica com potencial implicação jurídica, a retenção inadvertida de corpos estranhos continua sendo subnotificada, o que dificulta o seu estudo e a sua compreensão. Como resultado, ainda se enfrenta um problema recorrente. Este estudo explorou a experiência de cirurgiões brasileiros em relação à retenção de corpos estranhos, analisando as suas características e consequências. Métodos: Foi enviado um questionário de preenchimento voluntário, confidencial e anônimo, por correio eletrônico, aos cirurgiões membros de nove sociedades brasileiras, durante um período de três meses. As questões analisaram a vivência dos entrevistados com os corpos estranhos, seus tipos, manifestações clínicas, diagnóstico, fatores de risco ou de proteção e implicações jurídicas. Resultados: Das 2872 submissões elegíveis, 43% dos médicos teriam deixado e 73% retirado corpos estranhos em uma ou mais ocasiões. Destes, 90% eram têxteis, 78% foram descobertos no primeiro ano e 14% eram assintomáticos. A maioria das retenções ocorreu no início da carreira profissional, em procedimentos eletivos (54%) e rotineiros (85%), porém complexos (57%). Emergência, ausência de contagem, pacientes obesos, fadiga do cirurgião e problemas relacionados às equipes cirúrgicas e aos processos foram tidos como os principais facilitadores. Os pacientes foram alertados sobre a retenção em 46% das vezes e, destes, 26% processaram os médicos ou a instituição. Conclusões: A maioria das retenções inadvertidas ocorreu nos primeiros anos de atividade profissional, em intervenções eletivas e rotineiras. Os corpos estranhos foram diagnosticados nos primeiros meses de pósoperatório, tendo sido os têxteis os mais frequentes. Os fatores de risco referidos pelos entrevistados são comuns em seus locais de trabalho, como emergências e equipes cirúrgicas incompletas, por exemplo. Menos de metade dos operados ficou ciente do evento adverso, sendo que a minoria acabou processando as instituições e/ou cirurgiões envolvidos / Background: Although there is an international mobilization to deal with unintentionally retained foreign bodies (RFB), since it is medical malpractice with potential legal implications, the cases are underreported, hindering the understanding and study of the problem. As a result, we face a recurrent and poorly understood event. This study explored the experience of brazilian surgeons on RFB and analyzed their characteristics and consequences. Study Design: In a three-month period, questionnaire was sent to surgeons members of nine brazilian societies, by electronic mail. Answering the questionnaire was volunteer. Answers were kept confidential and anonymous. The questions explored their experience with foreign bodies, FB types, clinical manifestations, diagnosis, risk and protection factors, and legal implications. Results: In 2872 eligible questionnaires, 43% of the doctors said they had already left FB and 73% had removed FB, in one or more occasions. Of these foreign bodies, 90% were textiles, 78% were discovered in the first year after the surgery and 14% remained asymptomatic. The occurrence of RFBs is more frequent in early professional career, in elective (54%) and routine (85%), but complex (57%) procedures. The main causes were emergency, lack of counting, inadequate work conditions, change of plans during the procedure and obese patients. Patients were alerted about the retention in 46% of the cases, and of these, 26% sued the doctors or the institution. Conclusion: The majority of unintentionally retained foreign bodies occurred at the beginning of the professional career, during routine surgical procedures. In general, foreign bodies caused symptoms and were diagnosed in the first year of the post-operative period. Textiles predominated. Inadequate work conditions were listed as RFB risk factors, as well as emergency surgery, for example. Less than half of the patients were aware of the adverse event and 26% sued the surgeons or the institutions involved in the procedure

No description available.

Thesis (M. Tech.) -- Central University of Technology, Free State, 2008 / Blood transfusions carry a number of risks, one of which is transmitting HIV/AIDS from an infected donor. Since HIV is sexually and parenterally transmitted, the initial HIV risk management of donated blood in the early 1980‟s consisted of screening by visual assessment and completion of a lifestyle questionnaire, followed by deferral of practicing homosexual and bisexual male donors and intravenous drug addicts. The visual assessment was replaced by tests for antibodies directed against HIV, from the middle 1980‟s. In the early 1990‟s HIV was increasingly found in the black population of South Africa, particularly among black women. By 1998 0.26% of the received donations returned a positive test for HIV-1. In 1999 the South African Blood Transfusion Service (SABTS) Blood Safety Policy was introduced, including a donation HIV-risk categorization model which used the donor ethnic group, gender and donation history as indicators of the risk of exposure to HIV. The unacceptable use of the donor ethnic group as an indicator was the motivation to seek a suitable alternative donation risk categorization model which excludes the donor‟s ethnic group. The use of a more acceptable model with a high level of accuracy in predicting the risk of exposure to HIV has the potential of contributing to the reduced risk of HIV transmission through blood transfusion in South Africa. The aim of this study was to compare the suitability of four alternative models based on the information obtained from donors. Donations from new and lapsed donors were categorized in the highest applicable risk category in each model. The study was divided into two phases to achieve the aim. The first phase needed to determine suitable parameters for a model which uses the donor‟s age as an indicator. For this phase the ages of the regular donors returning an HIV-positive test result, were analysed. The second phase was to evaluate the effectiveness of the four suggested alternative blood donation risk categorization models against the model introduced by the SABTS in 1999. During this phase the donor demographic data and donation histories of donors who made donations at the Bloemfontein branch of the South African National Blood Service (SANBS) between October 2004 and September 2005, were analysed statistically. This phase honed in on two aspects to evaluate the effectiveness of the alternative models. Firstly the percentages of HIV-positive donations found in each risk category of each model, were determined as indicators of the residual risk of HIV-positive donations within the window period. Secondly the percentages of the collected blood donations allocated to each risk category within each model, were analysed to give an indication of the availability of “safe” blood associated with each of the models. The first phase of the study highlighted the difference in the age-group prevalence between male and female regular donors who returned an HIVpositive test result. Potentially suitable parameters for an Age-based Model were formulated by comparing this data with the ages of the donors who donated in Bloemfontein during the twelve months covered by this study. The second phase compared a Donation Interval Model, a Combination Model (using donation interval, gender and ethnic group as indicators), the SANBS 2005 Model (using age and gender as indicators) and an Agebased Model (using age and gender as indicators) with the SABTS 1999 Model (using gender and ethnic group as indicators). This study has shown that each of the models analysed has its advantages and disadvantages. The SANBS 2005 Model proved the best model without an ethnic indicator, for SANBS. Several recommendations regarding further investigation emanating from the results of this study were made.

Change in any form can become painful if individuals are not equipped with the necessary coping mechanisms. The transformation in the educational arena over the last few years has resulted in increased stress levels for school principals. This study investigates the role and impact of a stress intervention programme, the Art of Living workshop, using controlled breathing techniques, on the functioning of primary school principals in the Phoenix Circuit, Durban. A combined quantitative and qualitative research approach employing structured questionnaires and semi-structured individual interviews was used to compare the principals’ stress levels before and after the stress intervention programme. The findings revealed that the intervention programme was successful in reducing principals’ stress levels. A lack of resources, increased workloads, learner discipline, educator attitudes, indifferent parents and resolving conflicts created stress for principals. Benefits of the Art of Living workshop included the ability to remain calm and relaxed; and improved sleep patterns, increased energy levels and improved human relation skills. / Educational Leadership and Management / MED (ED MNG)

Résumé : L’Ordre des infirmières et infirmiers du Québec (OIIQ) a créé en 2011 une spécialisation pour les infirmières en PCI qui doivent maintenant suivre une formation de 2e cycle pour l’obtention de leur titre d’infirmière clinicienne spécialisée en PCI. Au sein de cette formation figure un cours de microbiologie et infectiologie (MI) qui vise à parfaire les connaissances et l’expertise en la matière. Jusqu’à présent, aucune étude n’avait été réalisée pour évaluer l’influence de ce cours sur le savoir infirmier des infirmières en PCI. Cette étude vise à décrire l’évolution du savoir infirmier des infirmières en PCI qui participent au cours de MI du programme de 2e cycle en PCI. Un devis qualitatif descriptif a été utilisé au cours de cette étude pour décrire l’évolution du savoir infirmier. Le modèle de réflexion structurée (MRS) de Johns (1995) a servi à l’élaboration d’entrevues semi-dirigées individuelles avant et après le cours de MI, afin de permettre l’identification du savoir infirmier selon un processus déductif. La méthode de codification de Miles et Huberman (2003) a ensuite favorisé un processus semi-inductif. Une analyse horizontale a finalement permis de repérer les récurrences ou les changements dans le savoir infirmier entre les entrevues de chaque participante ainsi qu’entre les participantes elles-mêmes. Des manifestations des dimensions du savoir infirmier telles que définies par Johns et influencées par Carper (1978) sont décrites, ainsi que l’évolution du savoir infirmier suite à la participation au cours de MI. Les thèmes qui ont découlé des entrevues sont : le développement d’un vocabulaire favorisant la communication dans l’équipe, la capacité d’aller au-delà des protocoles, une meilleure confiance en leurs capacités et l’élargissement d’une vision éthique qui comprend tous les acteurs de la communauté. Les retombées de l’étude se retrouvent au plan de la formation par la mise en valeur de la perspective infirmière dans le cours de MI et par l’évolution du savoir infirmier après avoir suivi ce cours. Sur le plan de la recherche, cette étude présente une nouvelle approche, pour de futures recherches, permettant d’évaluer la contribution d’un cours universitaire. / Abstract : As the Ordre des infirmières et infirmiers du Québec (OIIQ) has created in 2011 a specialty, making it possible for nurses to develop their expertise in infection prevention and control (IPC). In order to become an IPC clinical nurse specialist, nurses must fulfil a graduate program, which includes a course in microbiology and infectious diseases (MID), among others. Until now, there has been no study evaluating the influence of this training or course on patterns of knowing in nursing for IPC nurses. The goal of this study was to determine the evolution of the patterns of knowing in nursing for IPC nurses who have completed an MID course as part of a graduate program in IPC. A qualitative descriptive evaluation made it possible to determine the evolution of the patterns of knowing. Johns’ model (1995) for structured reflection (MSR) which was used in semi-structured, individual interviews before and after an MID course, helped identify patterns of knowing through a deductive process. Furthermore, Miles and Huberman’s (2003) codification method ensured a semi-inductive process. A horizontal analysis allowed for the detection of recurrence or change in patterns of knowing between each participant’s interviews, as well as between participants. The illustration of the scope of the patterns of knowing in nursing, as defined by Johns and influenced by Carper (1978), as well as the evolution of the patterns of knowing after completing an MID course, were described. The topics that surfaced during the interviews were: the development of a vocabulary fostering team communication, the capacity to go beyond protocols, a greater confidence in their abilities, and the expansion of an ethical view that includes all stakeholders in the community. The benefits of the study are at the level of training and research. Training is represented by the development of nursing perspective in the MID courses and the development of nursing knowledge after completing a course in MID. Finally, towards the research, this has put forward a new approach to assess the contribution of a university course.

由於現代企業面臨之風險是多變的，許多有關之法令規定已過時，企業組織可用之資源、成本和效益會產生變化，故企業要能適應未來的變局更需落實風險管理。 企業實施風險管理之重要目標，是為了在損失發生前能以節約的原則，減少憂慮，符合外界規定，並善盡社會責任；在損失發生後能生存，繼續營運，維持收益穩定，以求繼續成長等。然而企業往往會多角化擴充經營範疇，甚至在各處實施特定的經營活動，如此其風險管理將更形複雜。 本文擬以風險管理與損害防阻的實務經驗，佐以理論基礎，說明導入風險管理與損害防阻之目標、策略、程序、計畫、績效評核等，期能使各企業認識、衡量風險，藉由選擇並執行最符合經濟效益之風險管理方法，達到企業永續經營的目標。 其次，以個人在集團內執行安全管理系統和損害防阻安全查勘服務計畫的個案，說明企業損害防阻管理意義、風險的確認、分析與評估、損害防阻管理的執行與考核、績效評估等。最後再以身為企業推動風險管理與損害防阻的一份子，檢視以往歷程提出建議，期能拋磚引玉，讓更多的組織、企業和相關人士重視並推動主動式的風險控制及損害防阻管理。 / Since the risks faced by the modern enterprises are changeable, the laws and stipulations are obsolete and outdated, the resources, costs and benefits used by the enterprises organizations are subject to change, and therefore the enterprises have to carry out the risk management in order to be able to adapt the future changes in situations. The major targets for the enterprises to implement the risk management are for the purposes of reducing the anxiety, conforming to the outside stipulations and fulfilling the social responsibilities sincerely before the losses occur; surviving, operating continually, maintaining the incomes and continuing to grow, etc. if the losses should occur. However, the enterprises often run their business diversified and even operate the specific business activities everywhere, that will make their risk management more complex. This article intends to be written in the view of practical experiences to engage in the risk management, loss prevention and control as well as the assists of theory foundations, depicts the implementations of goals, strategies, procedures, plans and performance evaluations, etc. in risk management, loss prevention and control, anticipating various enterprises to identify and measure the risks by means of selecting and executing the risk management methods which conform to the utmost economical benefits for the goals of running businesses continually. Next, in the case where the writer personally carried out the safety management systems and safety survey service plans of loss prevention and control in group enterprises illustrates the meaning of loss control management, the identification, analysis and evaluation of risk, and the implementation, the verification and performance evaluation of loss control management, etc. Finally, as the member of implementing enterprises risk management and loss prevention and control, the writer examines the past working processes and experiences to offer some recommendations, expecting to throw stones and bring back jade to let much more organizations, enterprises and the parties concerned think highly of and enforce the proactive risk control and loss control management.

隨著台灣民主的多元深化，各種公共政策議題的倡議也愈趨複雜細膩，而利益團體及非營利組織在政策制訂過程的地位也愈趨重要，但實務上，台灣的非營利組織在政策制訂過程中的地位仍屬模糊，特別是在立法過程中的角色扮演與策略選擇，不僅在理論層次的研究中缺少關懷，在實務操作層次上也未獲一般的非營利組織重視，而使得非營利組織在政策立法過程中的未能適切的發揮其應有的功能。因此，本文希望透過非營利組織理論和議題倡導策略分析的結合，建構一個非營利組織在我國立法運作中倡導議題的基本框架，並作為未來相關非營利組織在立法過程中策略選擇的參考依據。 以非營利組織相關理論和公共政策類型區分，可知相關的組織角色和政策類型種類繁多，但本文限於研究範圍，主要將關注於「價值維護者」非營利組織對於「管制性政策」在立法過程中的倡導策略，並選擇以董氏基金會推動「菸害防制法」修訂作為主要的研究個案。本文並以立法過程作為時間的縱面，切割為程序委員會及院會一讀的「立法形成期」、委員會審查的「法案角力期」和黨團協商及院會二三讀的「折衝妥協期」等三個階段，分別分析董氏基金會在不同階段推動「菸害防制法」修訂所採取的各種議題倡導策略，並透過深度訪談等方式蒐集資料，對其所運用的議題倡導策略的利弊得失進行審視評估。 本文研究發現，董氏基金會在歷時兩年半的菸害防制法修法過程中所採取的議題倡導策略，主要有「道德化『困窘策略』的策略主軸」、「結合媒體訴求的行動策略模式」、「單一而執著的直線操作」等幾項特點，而可能忽略了立法院妥協的議事文化、並對於立法院議事技巧不夠熟悉，從而造成菸害防制法修訂的延宕與議題倡導的挫敗。從董氏基金會推動菸害防制法的案例中，本研究認為，有關國內非營利組織進行議題倡導及立法遊說時，最為缺乏而急迫需要的，就是議題倡導及立法遊說的專業化訓練，因此建議我國非營利組織應該加強對於在立法過程中議題倡導策略的專業訓練，使其能夠更為順暢地完成其議題倡導的使命。 關鍵字：非營利組織、議題倡導、立法過程、董氏基金會、菸害防制法 / As the democracy in Taiwan became more intensely diversified, the promotion of various types of bills on public policies turned more complex and more delicate. In addition, the status of both profit-bearing and non-profit organizations in the process of policy establishment also became rather important. However, practically, the status of Taiwan’s non-profit organizations in the process of policy establishment is still blurred especially in the role-play and the strategy selection in the process of the theories of non-profit organizations, bill promotion and strategy analysis, and to use the research findings as a reference for the relevant non-profit organizations in strategy selections in future legislation processes. It is evident that there are various types of relevant organization roles and policies if the categorization is divided into the relevant theories for non-profit organization and the types of public policies. Due to the limitations on the scope of research, this paper mainly focuses on the promotion strategies of the “value guardian”, the non-profit organizations on “control policies” in the legislation processes. Furthermore, the establishment of the “Tobacco Hazard Prevention and Control Act” promoted by John Tung Foundation, is selected as the main case study for the research. This paper then takes the period of legislation process as the timeline and divides the time into 3 stages: the “legislation formation period” for the Procedural Committee and where the 1st Reading is passed by the Legislation Session; the “bill wresting period” where the bills are examined by the Committees; and the “negotiation period” where negotiations take place between the parties and the organizations and the 2nd and 3rd Readings are passed by the Legislation Session. The 3 different stages are used to analyze the various types of bill promotion strategies employed by John Tung Foundation in the promotion for the establishment of the “Tobacco Hazard Prevention and Control Act” in the different stages, where information are collected through in-depth interviews and other methods to undergo examinations and evaluations on the pros and cons in the bill promotion strategies used. It is found in this research that a number of characteristics including the “strategy focus of a moralized ‘impoverished strategy’”, the “mobile strategy model that combines media appeals”, and the “single and persistent linear operation” are the main bill promotion strategies taken by John Tung Foundation in the promotion for the establishment of the “Tobacco Hazard Prevention and Control Act” that took 2.5 years to get through. The bill discussion culture and the compromise of the Legislative Yuan may have been neglected and the unfamiliarity with bill discussion techniques in the Legislative Yuan may have caused the delay and the failure of the bill promotion in the establishment of the Tobacco Hazard Prevention and Control Act. This research feels that from the example of John Tung Foundation’s promotion of the Tobacco Hazard Prevention and Control Act, the most lacking and the most urgently required for local non-profit organizations in bill promotion and legislation persuasion would be the professional training for bill promotion and legislation persuasion. It is therefore recommended that the local non-profit organizations should strengthen their professional training for bill promotion strategies in the legislation processes in order for them to smoothly complete the mission in bill promotion. Keywords: Non-profit Organizations, Bill Promotion, Legislation Processes, John Tung Foundation, Tobacco Hazard Prevention and Control Act.

The overall aim of this study was to evaluate quality of STI services in Umjindi local municipality. A concrete objective was to investigate the health system issues that may have a negative impact in the provision of quality STI service in the local municipality. These include accessibility of the STI services to the community, training of health workers in syndromic management, availability of necessary equipment and supplies for STI management, turn-around time for blood results and infrastructure of the facilities.