BACKGROUND: More than 70% of the global premature mortality from NCDs occurs in low- and middle-income countries. These countries, including Nigeria, also have varied but mostly limited health system capacity to respond to cardiovascular disease and diabetes mellitus. Substantial gaps exist in our understanding of the subnational capacity to respond to these conditions in Nigeria. This encompasses a variety of issues, perhaps most importantly the readiness of facilities to provide care and the quality of care provided to patients with these conditions. As the Lagos State government accelerates the rollout of its mandatory state-based health insurance scheme, the number of patients with diabetes and hypertension receiving care will increase, poor management of which can threaten the scheme's financial sustainability. This mixed-methods study was conducted as part of the baseline activities of an impact evaluation of the health insurance program and was designed to answer three questions: 1) What is the capacity and readiness of health facilities in Lagos State to provide hypertension (HTN) and diabetes (DM) care? 2) What is the level of the quality of care provided to patients with HTN and DM, and how does it vary by patient and facility characteristics? 3) What are the barriers to providing diabetes and hypertension care from providers' perspectives? METHODS: The data for this study were collected using three approaches. We conducted a facility survey among public and private facilities (n=84) in Lagos State to assess facility readiness and the functionality of systems required for diabetes and hypertension care. Linear mixed-effects models were used to determine the level and factors associated with the process quality of care provided to patients in 2019 by analyzing clinical data collected via medical chart abstraction. Finally, in-depth interviews were conducted with health care providers (n=20) to explore their practices and the barriers faced in providing care to patients with diabetes and hypertension. RESULTS: The essential inputs needed for diabetes and hypertension care were mostly available; the mean HTN readiness score was 66%, and the DM readiness score was 68.9%. At the same time, systems to facilitate longitudinal care were mostly lacking; 35% had a mechanism for tracking patients who missed appointments, and 52% assigned unique patient identification numbers to NCD patients. Based on the clinical records, the quality of care provided to patients was very low; overall, patients with diabetes and hypertension received less than 30% of recommended care processes. Less than a third of the patients had their blood pressure or blood glucose controlled. There was substantial variation in the mean quality score by patient and across care processes, with lifestyle modification counseling (LSM) counseling the least likely to be delivered. According to providers, the inability to pay for laboratory tests and medications and non-compliance with medications and clinic visits are key barriers to delivery of high-quality services. Barriers at the organizational level included poorly functioning two-way referrals, non-availability of LSM counseling materials, and lack of recall and follow-up systems. CONCLUSION: While the service readiness scores for diabetes and hypertension are moderately high among these health facilities, there are critical deficits in their ability to provide long-term, integrated care of high quality to patients. Addressing these deficits will require the implementation of a comprehensive model of care co-created by providers, health system managers, patients, and insurers. Lessons can be drawn from the implementation of other chronic disease programs to kick start this process. / 2024-08-30T00:00:00Z

This dissertation increases our understanding of information system project success by investigating how software development team members define the success of an information system development effort. The theoretical model of ISD success is developed and tested. ISD success is measured through the eyes of the software development team members—since they are the most influential stakeholders during the development of the system. This dissertation was conducted in two phases: 1) theory building and 2) theory testing. The theory building phase began with a thorough literature review. Semi-structured interviews were conducted and the data analyzed to add emergent concepts to the model. The result of the theory building phase is the theoretical model of ISD success. The theory testing stage began with the development and validation of a survey instrument to measure the constructs and subconstructs found within the theoretical model of ISD success. Data was collected and the model tested using partial least squares regression. The findings indicate that software development team members view ISD success as being composed of process quality, functional product quality, non-functional product quality, team member benefits, and team member satisfaction. Team member satisfaction is highly influenced by team member benefits, moderately influenced by functional product quality and slightly influence by non-functional product quality and process quality. Software development team members view process quality as being composed of within budget and process maturity; non-functional product as being composed of reliability, usability, testability, and efficiency; team member benefits as being composed of learning and teamwork; and team member satisfaction as being composed of product satisfaction, process satisfaction, and personal satisfaction. Software development team members do not view on time as a significant contributor to their definition of process quality; they do not view modifiability, portability, or reusability as significant contributors to their definition of non-functional product quality; and they do not view recognition as a significant contributor to team member benefits. / Ph. D.

The study aims to investigate what constitutes quality in municipal supported housing for young people (16-21 y/o). The study examines organizational conditions and what working methods are used in the work with the youths. Qualitative interviews have been conducted with unitmanagers, coordinators and employees who work at various municipal supported housing inSweden (10 interviews; 6 supported housing). The interviews have been processed using athematic analysis method and analyzed with self-determination theories combined with a theoretical framework based on implementation science and quality residential care. The resultsshowed some central quality aspects for the supported housing facilities. Related to structurequality, the importance of internal trustworthy relationships in the workplace, opportunities for competence supplies, flexibility, good professional collaborations, and access to resources werehighlighted. For process quality, it depended on how the caregivers produced and contributedto the youth’s goal to independency. The coworkers mainly used practical and emotional support efforts, inspired by Motivational Interviewing approaches. Since the employees mainly used themselves as a working tool, the study concludes that they would need continuous support for their professional and personal development, to maintain a good quality.

Made available in DSpace on 2016-08-10T10:40:19Z (GMT). No. of bitstreams: 1 Denes Magalhaes Soares.pdf: 1106480 bytes, checksum: 8fdf922cbdd5c110f9e94dc17578558e (MD5) Previous issue date: 2013-04-29 / In the present work is a study of the system quick tool changing, Taguchi, Toyota system, Ishikawa method to minimize or solve problems involved in the production, in particular in industry packaging paper, motivated by the need to improve the system production company, aiming to reduce losses of raw materials and also the costs of production. Quality tools Ishikawa, Taguchi, fall into this prospect of improvement, and can evaluate the applicability of these tools in a medium-sized industry, producer of paper packaging. Through its application, aims to remove some of the losses existing in the process, improving their productivity and the quality of the final product. Application of Taguchi aims to evaluate the best settings and patterns of operation of the equipment to meet the demands of consumers, owners and employees of the company. / No presente trabalho realizou-se um estudo do sistema troca rápida de ferramenta, método Taguchi, sistema Toyota, método Ishikawa, para minimizar ou resolver problemas envolvidos na produção, em específico, em indústria de embalagem de papel, motivado pela necessidade de melhorar o sistema produtivo da empresa, com vistas a reduzir as perdas de matéria prima e também os custos da produção. As ferramentas de qualidade Ishikawa, método Taguchi, enquadram-se nessa perspectiva de melhoria, e pode-se avaliar a aplicabilidade destas ferramentas em uma indústria de médio porte, produtora de embalagens de papel. Através da sua aplicação, pretende-se eliminar algumas das perdas existentes no processo, melhorando sua produtividade e a qualidade do produto final. A aplicação do Taguchi tem como objetivo avaliar as melhores regulagens e padrões de operação do equipamento para atender às exigências dos consumidores, proprietários e colaboradores da empresa.

Many early childhood learners enter kindergarten not academically and social-emotionally prepared. This qualitative study explored teachers' perceptions of what constitutes high-quality learning concerning kindergarten readiness and parents' understanding and support of kindergarten readiness. The conceptual framework is based on recent studies by early childhood researchers on how and what early learners should experience during their pre-k years. The research questions focused on teachers' understanding of structural quality and process quality, kindergarten readiness, and age- appropriate curriculum. In addition, parents' understanding of kindergarten readiness and what types of learning opportunities they offer their children were examined. Through purposeful sampling, 16 teachers and 17 parents were interviewed from an early childhood site. Interview data were analyzed using a thematic analysis. The data were analyzed by coding and observing for recurrent categories and themes. Key findings indicated that teachers demonstrated a lack of understanding of structural quality and process quality and believed that the current curriculum is outdated and should be replaced to significantly impact student learning. Parents perceived that academics were far more important than social-emotional development and that affording their children learning opportunities outside of school was important. As a result of this study, a professional development program was developed for teachers intended to enhance their instructional practices in preparing early learners towards kindergarten success. Parents will also receive training from teachers to support social-emotional learning opportunities. The training could enable both teachers and parents to better support the cognitive and social-emotional growth of children.

Syftet med denna studie är att undersöka om det finns några mönster och samband i hur förskolepedagoger upplever förutsättningar för barns lärande beroende på ålderssammansättningen i gruppen. Studien är kvantitativ med webbenkät som metod för insamling av data från pedagoger. Undersökningen omfattar alla förskolor inom en kommun i Värmland, totalt 55 kommunala avdelningar och 144 pedagoger. Följande ålderssammansättningar ingår i studien: åldersindelade grupper, småbarnsavdelningar (1-3), avdelningar för äldre barn (3-5) och syskonavdelningar (1-5). Studien har sin utgångspunkt i interaktionistiska teorier, vilket innebär att förskolans verksamhet studeras utifrån olika samspelade aspekter, faktorer och nivåer. I studien ses förutsättningar för barns lärande i förhållande till förskolans kvalitet, vilken i sin tur tolkas som ett komplext fenomen som skapas i samspel mellan olika faktorer på struktur-, process- och resultatnivåer. Studien fokuserar på samband mellan ålderssammansättning som en faktor för förskolans strukturkvalitet och flera aspekter av processkvalitet, nämligen utformning av pedagogiska miljön, pedagogernas sätt att organisera och genomföra verksamheten och pedagogernas samspel med barnen. Undersökningen visade att det finns betydelsefulla skillnader mellan grupperna med olika ålderssammansättningar i utformning av den pedagogiska miljön och även i pedagogernas samspel med barnen. Däremot är denna påverkan inte entydig och kan även förklaras med andra orsaker och faktorer, så som gruppens storlek, barnens ålder och pedagogiskt arbetssätt. Gruppens ålderssammansättning i sig är således inte avgörande för verksamhetens kvalitet, utan behöver ses i relation till andra påverkande faktorer. / The purpose of this study is to investigate whether there are some patterns and connections between the teachers’ experiences of the conditions for children’s learning and age settings at preschool groups. The study is quantitative, and a web survey is used to collect the data from the teachers. The study includes all preschools in a municipality in Värmland, Sweden. 144 preschool teachers from 55 municipal preschool groups participated in the study. Following age settings are represented in the study: same-age preschool groups, groups with children between 1-3 years old, groups with children between 3-5 years old and groups with children between 1-5 years old. The study is based on interactionistic theories, which means that the preschool is examined from various interacting aspects and dimensions. Conditions for children’s learning are seen in the study in relation to preschool quality, which is a complex phenomenon constituted in the interaction between dimensions of structure, process, and outcome. The study focuses on age setting as a structural aspect of preschool quality and following aspects of process quality: organizing of the pedagogical environment, teachers’ approach to organizing of daily activities and teachers’ interplay with children.  The results of the study show that there are important differences between groups with different age settings regarding organizing of the pedagogical environment and interplay between teachers and children. However, these differences are rather ambiguous and can be explained by other aspects and factors such as group’size, children’s age, and pedagogical approach. Therefore, age setting as such is not the key to preschool quality but must be seen in relation to other aspects and dimensions.

Previous research has shown how home and parental characteristics support or hinder the development of children’s self-regulation in the family context. There have only been limited attempts to understand these mechanisms in early childhood education settings. This study used the NICHD Study of Early Child Care (when participating children were 36-months old) to examine the relations among various aspects of the early childhood education setting, the interactions in the setting, and children’s self-regulation in center-based and home-based settings. Structural equation modeling was used to test a model proposing the deconstruction of early childhood education quality into structural (i.e., environmental and caregiver characteristics) and process quality components (i.e., positive and negative interactions) and to examine these as predictors of three-years old children’s self-regulation abilities. A meditational model was tested in which positive and negative interactions in the classroom mediated the relations between the structural characteristics and self-regulation. There were three important findings. First, although there were no consistent patterns of associations between structural features and self-regulation across the two types of care, there were more significant relationships in home-based care compared to center-based care. These findings showed that the home-based caregiver characteristics were more closely tied to the processes in the classroom than those characteristics of caregivers in center care. Second, both positive and negative caregiving were associated with children’s compliance, which suggested that compliance may have been influenced differently by process quality compared to other self-regulation measures, such as self-control and emotion-, behavior-, and attention-regulation. It may be that high rates of compliance may be markers of highly restrictive caregiving rather than the result of good quality caregiving. Third, there were very few significant relationships between process quality measures and children’s self-regulation measures, which suggested that commonly used process quality measures may not be capturing the processes that are most important for the development of self-regulation. / text

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The aim of this study was to evaluate employee commitment to achieve the primary objective, which was to evaluate employee commitment towards product and process quality. Employees who are engaged in their work and committed to their organisations give companies crucial competitive advantages – including higher productivity, better quality products and lower employee turnover. A thorough literature study was conducted by using the views of different authors and combining them. The concept of quality was defined by making use of the five quality gurus; Deming, Juran, Feigenbaum, Crosby and Ishikawa. The fourteen principles of quality, developed by Deming, were presented in Table 2.1. These principles had the goal of increased productivity, with less rework, less waste of manpower and material resources, resulting in a reduction of costs, to in turn give the organisation greater market share and ultimately better competitive position, by improving the overall quality of an organisation’s work processes. The concept of employee and organisational commitment was defined, and from this study it is evident that employee commitment towards the company is positive and therefore should have a positive effect on their operating environment. The product process flow for this manufacturing concern were discussed to give an overall view of the production processes used in this organisation. An empirical study was completed using a questionnaire survey to determine employee commitment at a manufacturing concern in Gauteng. The questionnaire used for this study was designed to focus on commitment towards internal quality only, to specifically evaluate employee perspective towards product quality, as well as the commitment towards the organisation. Analysis of the responses showed the questionnaire to be reliable and valid. Respondents indicated that they are committed towards the organisation in general across all constructs, but a lack in management trust was a predominant sentiment. The quantitative analysis showed that after a factor analysis was done on the two sections of the questionnaire, four factors for each section were considered as meaningful. These factors were: Affinity, quality awareness, autonomy and corporate image (employee commitment - section B) and employee commitment, task performance, job satisfaction and contextual performance (company relationship – section C). This indicated strong employee commitment towards the organisation. The qualitative results had four areas that all respondents felt needed some attention, and loaded negative towards the organisation. These were HR (trust in management, competency, communication and company culture), skills development, employee development and BBBEE. Thus, drawing conclusions from quantitative results alone could give a company a false sense of employee commitment towards the company and therefore overlook the importance of the roles that employees play in executing strategic plans. Conclusions regarding the findings of the research study were presented and recommendations for this organisation were made. These recommendations are merely a guideline that correlates directly to the empirical analysis made. The research study was evaluated against the primary and secondary objectives with the conclusion that both were achieved. / Thesis (MBA)--North-West University, Potchefstroom Campus, 2013.

The aim of this study was to evaluate employee commitment to achieve the primary objective, which was to evaluate employee commitment towards product and process quality. Employees who are engaged in their work and committed to their organisations give companies crucial competitive advantages – including higher productivity, better quality products and lower employee turnover. A thorough literature study was conducted by using the views of different authors and combining them. The concept of quality was defined by making use of the five quality gurus; Deming, Juran, Feigenbaum, Crosby and Ishikawa. The fourteen principles of quality, developed by Deming, were presented in Table 2.1. These principles had the goal of increased productivity, with less rework, less waste of manpower and material resources, resulting in a reduction of costs, to in turn give the organisation greater market share and ultimately better competitive position, by improving the overall quality of an organisation’s work processes. The concept of employee and organisational commitment was defined, and from this study it is evident that employee commitment towards the company is positive and therefore should have a positive effect on their operating environment. The product process flow for this manufacturing concern were discussed to give an overall view of the production processes used in this organisation. An empirical study was completed using a questionnaire survey to determine employee commitment at a manufacturing concern in Gauteng. The questionnaire used for this study was designed to focus on commitment towards internal quality only, to specifically evaluate employee perspective towards product quality, as well as the commitment towards the organisation. Analysis of the responses showed the questionnaire to be reliable and valid. Respondents indicated that they are committed towards the organisation in general across all constructs, but a lack in management trust was a predominant sentiment. The quantitative analysis showed that after a factor analysis was done on the two sections of the questionnaire, four factors for each section were considered as meaningful. These factors were: Affinity, quality awareness, autonomy and corporate image (employee commitment - section B) and employee commitment, task performance, job satisfaction and contextual performance (company relationship – section C). This indicated strong employee commitment towards the organisation. The qualitative results had four areas that all respondents felt needed some attention, and loaded negative towards the organisation. These were HR (trust in management, competency, communication and company culture), skills development, employee development and BBBEE. Thus, drawing conclusions from quantitative results alone could give a company a false sense of employee commitment towards the company and therefore overlook the importance of the roles that employees play in executing strategic plans. Conclusions regarding the findings of the research study were presented and recommendations for this organisation were made. These recommendations are merely a guideline that correlates directly to the empirical analysis made. The research study was evaluated against the primary and secondary objectives with the conclusion that both were achieved. / Thesis (MBA)--North-West University, Potchefstroom Campus, 2013.