Thesis (Ph.D.)--University of California, San Francisco, 2008. / Source: Dissertation Abstracts International, Volume: 69-09, Section: A, page: 3767. Adviser: Carroll L. Estes.

Thesis (Ph.D.)--Indiana University, Dept. of Sociology, 2009. / Title from PDF t.p. (viewed on Jul 12, 2010). Source: Dissertation Abstracts International, Volume: 70-12, Section: A, page: 4860. Adviser: Elizabeth A. Armstrong.

Thesis (Ph.D.)--Indiana University, Dept. of Sociology, 2009. / Title from PDF t.p. (viewed on Jul 6, 2010). Source: Dissertation Abstracts International, Volume: 70-10, Section: A, page: 4073. Adviser: Clem Brooks.

Thesis (Ph.D.)--Indiana University, School of Public and Environmental Affairs, 2009. / Title from PDF t.p. (viewed on Jul 7, 2010). Source: Dissertation Abstracts International, Volume: 70-10, Section: A, page: 4046. Adviser: David A. Reingold.

This thesis explores definition of five concepts central to international health intervention, participation, efficiency, equity, scaling up and sustainability, within the case study of the Tanzanian Essential Health Interventions Project (TEHIP). Developed in response to the 1993 World Development Report and implemented in Tanzania during the era of health sector reform under structural adjustment, TEHIP offers an especially pertinent case within which to explore the language and health practices resulting from this particular history and ideology. Using key informant interviews and literature review, conceptual and applied definitions of the concepts were analyzed. A theoretical framework of health equity as social justice, offered by Amartya Sen, Fabienne Peter, and Thomas Pogge, was employed to examine assumptions and biases inherent in these concepts and their application. Despite significant health gains achieved by TEHIP, this theoretical analysis raises important questions and concerns about the rationale, design and implementation of the project. Keywords. Participation, efficiency, equity, sustainability, scaling up, health intervention, health system reform, Tanzania.

CSR may be a means of dealing with human rights abuses and negative environmental and socio-economic impacts associated with mining in developing nations. Little research has been published on how "host" and "home" governments can help make CSR initiatives in this industry more effective. This study obtained perspectives on their roles through a study of the academic and secondary literature on CSR and its application in exploration and mining. Four literature case studies of exploration projects and mines in Peru (Tambogrande, Tintaya, Rio Blanco, and Antamina) were followed up with field studies of the Rio Blanco project and Antamina mine through interviews with community members, authorities at various levels of government, NGOs and industry representatives. The study showed the effect of mining cycle stage and regional differences on dynamics, power relations, and perspectives; and the importance of governments as players. It presents a list of options for their action.

This study intended to discover whether there was consensus among Canadians about the state's responsibility for health care and education from an analysis of the 1996 International Social Survey Programme, Role of Government. The weighted sample size was 1239. Ornstein's and Stevenson's 1977--81 study was also partially replicated. Results showed that welfare state retrenchment in health care and education during the '90s and state ruling by coercion led to dissent among Canadians about government intervention in health care and education. Drawn upon the competing region-class struggle theories, findings indicated that high public support for government intervention in health care was an interaction of regional---Prairie and Alberta---and class struggle---lower, working and middle classes, differences. Quebec showed the lowest increase in support for government role in health care over time. Women favoured much greater government role in health care than men. Younger and low-income people were more favourable to government intervention in education.

Background. In Ontario, the 1994 Tobacco Control Act allowed municipalities to legislate on second-hand smoke in public places. Public health departments were then mandated to promote the passage of smoke-free bylaws in various municipalities. Their efforts have met with varying degrees of success. However, in 2001, the city of Ottawa public health department successfully promoted the adoption of one the cornerstone 100% smoke-free bylaw in Canada. Objective. The purpose of this study was to examine the factors that influenced the process of municipal councillors' adoption of the Ottawa smoke-free bylaw. Methods. This mixed-methods case study focused on the public participation aspect of the case through the analysis of interviews, public opinion surveys and newspaper articles using qualitative, quantitative and triangulation methods. Findings. The study identified four critical elements in the passage of the smoke-free bylaw: (1) Initiation of the bylaw development process, (2) Municipal councillors' position before the final vote, (3) Municipal councillor's final vote and (4) Municipal councillors' position after the final vote. Five lever factors (1) Perceptions of public opinion, (2) Public participation, (3) Dynamics of the democratic process, (4) Context of the smoke-free bylaw development and (5) Context of newness were found to have influenced the critical elements, each in a particular way. Lever factors are presented as characteristics of the context of the bylaw adoption that increased the effect of the strategies and interventions conducted by the groups supporting the passage of the bylaw. Discussion. This case study identifies conditions that enhance the leverage of tobacco control strategies and highlights how the convergence of factors is key to successful tobacco control policy change at the municipal level.

The purposes of the study were to investigate homeless men's experiences of taking medications while living in a homeless shelter and the factors that affect medication adherence; and to describe medication adherence, as it pertains to homeless men residing in a shelter, from the perspective of the shelter staff. This is a manuscript-based thesis. The first manuscript provides a description of a proposed ecological model, based on clinical experience of the author and from the literature. The second paper is a summary of the findings of the qualitative research on medication adherence and homeless men's shelters. The third manuscript, directed at pharmacists, offers recommendations and strategies based on results of the qualitative study, to improve medication adherence. This thesis suggests that when health professionals view adherence to medications as an individual, cognitive choice, it does not take into account the challenges imposed by a homeless individual's environmental context.

Essay One: Genetic Health Risks: The Case for Universal Public Health Insurance. This paper examines the appropriate role for the public sector in providing genetic and health insurance when health risks are genetically determined at conception. The ex ante efficient outcome (when individuals are ignorant about their health risks) is characterized. It is demonstrated that this outcome cannot be achieved by private health insurance markets or by a government which cannot commit to a once-and-for-all transfer policy. In contrast, the desired outcome is attained through public provision of universal health insurance and of genetic testing, coupled with a public pension scheme. Essay Two: Fee-for-Service vs. Capitation: Anything You Can Do - I Can Do Better (and Cheaper). This paper recasts the analysis of optimal physician remuneration - generally presented as a contest between prospective (capitation) and retrospective (fee-for-service) schemes - as a problem in price theory. This approach abstracts from problems of asymmetric information and concentrates on the design of the price mechanism. It demonstrates that when the demand for health care is price-inelastic, the appropriately designed fee-for-service and capitation schemes both lead to Pareto efficient outcomes. When a patient's demand for care is uncertain, or the risk of poor health outcomes depends on the preventive care provision, standard arguments concerning risk bearing are used to prove that paying physicians on a fee-for-service basis can deliver socially-optimal outcomes at a lower cost than if they are paid under a capitation scheme. Essay Three: Comparative Efficiency Assessment of Primary Care Models Using Data Envelopment Analysis. This paper compares the productive efficiency of four models of primary care service delivery in Ontario, Canada, using the methodology of Data Envelopment Analysis. Particular care is taken to include quality of service in the output measure. The influence of the delivery model on productive efficiency is disentangled from patient characteristics using regression analysis. The traditional fee-for-service arrangement ranks highest and the Community Health Centre model (which involves a multidisciplinary team of health care professionals paid on a salary basis) the lowest in efficiency scoring. The reliance of input measures on the costs of running a practice and on the number of patients favours the fee-for-service model.