An historical analysis of the solid waste management collection practices was undertaken. The analysis attempted to examine and evaluate the current private contract collection system which is being used by the City, and to determine whether the City needs to convert to a public collection system. Based on the findings of the study, the writer recommended that the City of Daytona Beach should go into public collection.

Public Law 131-336, Americans With Disabilities Act (ADA), is comprehensive legislation created with the intention of integrating the disable into the work place and every segment of society. Forty-three million Americans are disabled. Of these, twenty-three million seek employment, but because of discrimination are unable to find work. The law provides requirements for access to public accommodations. All disabled Americans deserve the opportunity to enjoy the same public services as the non-disabled. Businesses are now required to provide reasonable accommodations to a disabled employee if these accommodations will allow the employee to perform the essential functions of the job. Businesses are also required to make necessary renovations to their facilities to allow the disabled to move freely about and enjoy the services and amenities of the facility. This researcher attempts to compile the costs of complying with the ADA in one hospital. The analysis is limited to one facility. However, the findings may be beneficial to other facilities because severe civil penalties can be levied on facilities which do not comply. The study involved surveying a healthcare facility using points from Title I of the ADA determined by the researcher to be necessary for compliance. Title III compliance was accomplished using a facility survey from developed by the American Hospital Association. The researcher complied total expenditures by The Medical Center at Bowling Green, Bowling Green, Kentucky, to comply with Titles I and III of the ADA as well as projected costs associated with recommendations to resolve deficiencies. The findings support the hypothesis that practical approaches and inexpensive solutions are readily available so facilitates can fully comply with the intent of the law and avoid undue hardship.

The primary objective and intent of this paper is to explain the problem of continuous high turnover among the employees of the City of Atlanta workforce, and identify the factors and major variables that are responsible for this problematic situation. The City of Atlanta has been burdened with high turnover among its employees in the past several years and that problem has continued to the present time. Findings from this research indicate significantly that employees are not motivated by economic factors alone; other factors, socio-psychological in nature, have much impact on workers' motivational behavior. Research method for this paper consisted of informal interviews (primary data) and exit interviews (secondary data). The main sources of information were documents, records, and materials collected from the Bureau of Personnel and Human Resources, City of Atlanta. Other sources of information included magazines, periodicals, and books. Research findings indicated the following significant factors. 1. A perennial, persistent employee turnover. 2. A very high mark of resignations in good standing. 3. Dissatisfaction with the city employment. Based on the findings of this research, it is conclusive that the city must arrest this problematic situation in order to improve employee performance, productivity, and retention. To achieve this, the city must change some aspects of its personnel policies. Some important recommendations have been made which if implemented, will help to arrest the situation.

This study utilizes the Longitudinal Study of the Vocational Rehabilitation Program to examine the impact of state-federal vocational rehabilitation services on the quality of life of consumers. The theory that guides this study is an amalgam of theories of Allardt, Halpern, Campbell, and Cummins which indicate that quality of life is made up of various domains which parallel Maslow’s Hierarchy of Needs. The study followed the theory that improvement in the individual domains of life would improve its overall quality. The domains of physical functioning, self-esteem, community integration and productivity were assessed prior to and after the receipt of vocational rehabilitation services. Results indicate that consumers who obtain an employment outcome obtain higher scores on measurements of self-esteem, physical functioning and activities of daily living and productivity than do consumers who do not obtain an employment outcome. The linkages that specific VR services have on individual life domains were also explored. Consumers who receive more education and training services show an increase in community integration scores. Suggestions for state-vocational rehabilitation services change are provided based on a socio-ecological model.

Medical education is changing. Physicians have less time for teaching clinical skills and for direct observation of medical students, due to sicker patients in the hospital, shorter hospital stays, competing demands of research and patient care, and implementation of the eighty hour work week for residents. The consumer movement increased awareness of medical errors, patient safety and quality of healthcare. Teaching the pelvic examination is ethically complex. Questions have arisen about medical students learning to conduct the pelvic examination on actual patients. This study utilizes the pelvic examination simulator and genital teaching associates (GTAs) to teach pelvic exam skills to optimize limited resources, as well as address safety and ethical concerns. The purpose of the study was to provide medical students with more practice in pelvic examination skills, to test a pelvic examination simulator, and to explore a new model for teaching pelvic examination skills to second year medical students. After IRB approval, one hundred sixty eight second year medical students at Virginia Commonwealth University School of Medicine participated in the study. A two-armed trial design provided all medical students with pelvic exam training on the pelvic exam simulator and genital teaching associate. Data were gathered via an experience and demographic questionnaire, blood pressure readings, the Fear of Pelvic Examination Scale scores and performance scores after the training. Data analysis consisted of descriptive statistics, paired and independent sample t-tests and the linear mixed model. Statistical tests determined the relationship between fear, blood pressure and performance. The findings revealed that the GTA training group had significantly more fear than the pelvic exam simulator group and significantly higher performance scores than the simulator group. The gender analysis indicated that males had significantly more fear than females. Prior experience with pelvic exam simulators did not appear to reduce anxiety among medical students when first conducting pelvic exams with humans. Completion of pelvic exam training with a GTA may reduce fear substantially and make later training with the pelvic exam simulator the optimal first experience. Use of simulation in medical education reduces ethical concerns, optimizes limited resources and reduces patient safety issues.

In recent years there has been a growing interest in the relationship between religion and the environment. The purpose of this project is to explore the environmental practices and attitudes of Christian churches in two Virginia Communities. The two communities; the Northern Neck and Eastern Shore are located on the Chesapeake Bay and have a shared history of dependence on the Bay. The results of the dissertation demonstrate the prevalence of environmental programs in the population, the nature of these programs and the respondents’ attitudes towards a host of environmental issues. These results can be used by environmental professionals and policy makers seeking to form partnerships with the religious community and hence promote sustainability within religious institutions and their followers. It will also prove useful to religious organizations which are concerned with environmental issues.

States have historically used Certificate of Need (CON) regulations to regulate cost, quality, and access to healthcare services. Federally mandated in 1974, the regulation required the states to review requests for new healthcare construction and services. In theory, community-level planning backed by the state-level CON review and health planning process would prevent unnecessary duplication of services and the accompanying costs (Smith-Mellot, 2004). However, none of the published studies have examined the association of CON regulation on volume and outcomes of solid organ transplants. In 1984, the federal mandate ended, and each state was allowed to determine whether or not to maintain its CON programs; more than one-third of the states eliminated them (Altman & Ostby, 1991). Currently, 37 states including the District of Columbia have CON programs (American Health Planning, 2010). Of those states, 21 include organ transplant as a reviewable, regulated service. Although several studies have investigated whether CON regulation has affected healthcare cost, to date very little has been written about the impact of CON on volume and quality of care; the data that does exist is contradictory. In 1988, investigators studied the effects of CON regulation on mortality and observed that greater regulatory stringency was a positive and significant predictor of hospital mortality rates (Shortell & Hughes, 1988). In contrast, DiSesa et al (2006) found no significant difference in risk-adjusted mortality for cardiac surgery patients in states with and without CON regulations. The gap between evidence and decision-making and the large number of states that use CON to regulate healthcare services indicate a need for a study on the quality of healthcare services. Solid organ transplantation is a complex, high-cost treatment that was performed over 27,000 times in 2008. The purpose of this study is to assess the association of solid organ transplant CON regulations using clinically rich data available from the Scientific Registry of Transplant Recipients (SRTR). This study tests the hypotheses that states with solid organ transplant CON regulations have fewer transplant centers, higher volumes of heart and kidney transplants per center, lower graft failure rates and lower patient mortality rates per center. In addition, this study assesses these hypotheses using two different transplant procedures (heart and kidney). This study provides additional information for transplant centers to use in their strategic decision making. Moreover, with the presence of minimum volume standards for transplant procedures mandated by the Centers for Medicare and Medicaid (CMS) now, the policy implications of continuing or repealing CON regulations should be examined.

This dissertation examines the correlation between incivilities, indicators of urban blight, and single-family residential property values in the City of Richmond, Virginia. Through the utilization of a mixed methods research methodology, this dissertation assesses whether specific incivilities, structural characteristics of properties, or community demographics have an adverse influence on property values. Three separate methodologies were utilized in this research including a time series assessment, focus group and individual interviews, and a cross sectional design. The findings from the time series analysis indicate that property values increased every year over a five year period and that there were variances in property values throughout the City. The qualitative interviews suggested that the location of a property and features of the area heavily influence its value. Higher quality of life amenities tend to have a positive influence on property values and lower quality of life amenities tend to have a negative influence on property values. Incivilities, poverty, and crime were considered attributes of an area that adversely influence property values. The cross sectional analysis suggested that the socio-economics of the area tended to have a stronger correlation to property values than incivilities. Indicators of a high socio-economic status generally had a strong, positive correlation to property values and indicators of a low socio-economic status tended to have a strong, negative correlation to property values. Incivilities, in general, tended to have a moderately weak, negative correlation to property values. The research argues to not overlook but to assess multiple structural and neighborhood factors when examining community conditions. Such an assessment should be conducted at an intimate geographic level rather than a broad, city wide level. From an academic perspective this dissertation fills a hollowness in the empirical literature on the correlation of incivilities to property values. From a practical standpoint, the research provides a renewed lens in which to conceptualize and assess urban conditions and its impressions on communities. Together, this dissertation aids in assessing incivilities and other socio economic conditions to one of the most pervasive challenges facing municipalities in the 21st century - the economic stagnation and decline of residential property values.

This paper assessed factors that delayed the passage of the annual budget bill specifically in Virginia and also in 13 structurally similar states including: Arizona, Connecticut, Indiana, Kentucky, Maine, Minnesota, Montana, New Hampshire, North Carolina, North Dakota, Texas, Washington, and Wyoming. Virginia was the core focus of this study, but the variables detailed below were also measured for all thirteen states in an effort to broaden the scope of the study, and determine which political and economic factors affected the budget passage rates in Virginia and the 13 other states. Political and economic explanations were tested to examine their relationship with the passage of the state’s budget bills including: divided governments, election cycle of the Governor, economic conditions, and political party influence. Through the use of a general linear model, the relationship between these political and economic factors and the time that it takes to pass an annual budget was assessed from 1980 to 2010. The findings in this study revealed that split branch governments have an impact on the time that it takes to pass a state budget bill. The findings in this study helped deepen our understanding of factors that influenced state budget bill passage rates and suggested recommendations for future legislative sessions that will benefit state agencies, legislators, and citizens in the Commonwealth of Virginia.

Abstract EXAMINING CRIMINAL JUSTICE PROFESSIONALS’ ATTITUDES AND RESPONSIVENESS TOWARDS INTIMIDATED WITNESSES ON THE LOCAL LEVEL: AN EXPLORATORY ANALYSIS By Michon J. Moon, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2011 Major Director: Laura J. Moriarty, Ph. D, Professor and Vice Provost of Academic and Faculty Affairs L. Douglas Wilder School of Government and Public Affairs The study explored criminal justice professionals’ attitudes and responsiveness toward witness intimidation on the local level based on their occupation and region of employment. Intimidated witnesses are vulnerable individuals that have fallen victim to competing social and civic expectations to which neither allow much consideration for the witness’ safety. This problem is evident in that too many local criminal justice agencies have yet to formulate substantive plans and dedicated sufficient resources to effectively address the growing problem of witness intimidation. A total of 59 major crime detectives, 52 prosecutors and 5 executive administrators from two regions of Virginia participated in the study. Major crime detectives and prosecutors were administered an online survey to gage their attitudes about intimidated witness issues and the administrators who are responsible for the allocation of resources and policy mandates for their respective agencies participated in interviews. Overall, 39 percent of prosecutors and 45 percent of detectives indicated that intimidation was more likely to occur in cases involving homicide, rape, aggravated assault, drug activity, gang activity, robbery, and domestic violence. On average 38 percent of detectives and 31 percent of prosecutors agreed that relocation assistance was warranted in circumstances such as, perceived threats, threatening calls, assault on witness, assault of family member, drive-by shootings, vandalism, stalking, domestic violence. Conversely, on average only 18 percent of prosecutors and 22 percent of detectives indicated that their agencies’ would more than likely provide relocation assistance to intimidated witnesses in these same cases. Appended are details of study, methodology, quantitative and qualitative analyses, as well as, demographic characteristics of study participants.