The main aim of this thesis is to assess the institutional arrangements shaped with a perspective of &ldquo / good governance&rdquo / in provision of urban services with reference to the shift of the World Bank&rsquo / s approach to the problem of poverty after 1990s. In spite of the change in the World Bank&rsquo / s perspective, there remain significant problems related with the expected reflection of these institutional arrangements to the practice through certain process and stages of the implemented projects. Regarding this fact, thesis seeks to determine not only the reasons of these problems but also ways for solving them to attain effective provision of urban services. In this thesis, also, as an institutional comparative assessment, some implemented service projects of the World Bank in Turkey are examined by stressing on the institutional dimension of the project objectives. At last, thesis makes suggestions about the unsuccessful dimensions and reveals the roles of institutions in the achievement of projects by using the institutional assessment method for the institutions whose institutional capacity has been developed or the institutions created within the World Bank projects implemented in Turkey. This will be achieved by the evaluations on projects with the outputs of institutional assessment and the research on factors for the achievement of the projects. The results obtained with this thesis study are noteworthy for the evaluation with a new perspective of the projects implemented in Turkey not only by the World Bank but also by other international institutions quite increased in number in recent years.

The purpose of this dissertation is to explore whether rehabilitation counselor/consumer racial similarity is related to rehabilitation services provided and employment outcomes achieved. This research contributes additional information to the research base on how to educate and train practicing vocational rehabilitation counselors to support culturally and linguistically diverse (CLD) consumers more effectively. Information regarding racial dyads may help to articulate whether CLD counselors are more effective with CLD consumers. Utilizing the RSA-911 data file submitted by California for fiscal year 2006 as well as 189 Multicultural Counseling Inventory (MCI) surveys collected on practicing vocational rehabilitation counselors, ANOVA, MANOVA, ANCOVA and chi-square analysis were used to measure relationships among counselor and consumer dyads that were either similar or dissimilar in ethnicity and case service variables and outcome variables. Additional analysis focused on the influence of high versus low cultural competency of rehabilitation counselors and the same consumer case service and outcome variables. Study results revealed statistically significant differences on MCI total scores between counselor ethnic groups, with Hispanic counselors demonstrating the highest mean scores overall on the MCI. In addition, significant differences existed between counselor ethnic groups on MCI total scores, as well as all four subscale scores. Chi-square was used to investigate the effect of counselor ethnicity and cultural competency scores on the case service variables of job search, rehabilitation technology, maintenance and college training, as well as outcome variables of competitive employment. MANOVA and ANCOVA were used for the continuous outcome variables of cost of services, wages at closure and weekly earnings at closure. Significant chi-square results were found for some of the service and outcome variables for both the matched counselor/consumer dyads and the counselor competency score groups. More significant findings existed in the ANCOVA analysis for cultural competency scores than for matched ethnicity groups. Implications of the findings and suggestions for future research are discussed. / text

Efforts to commercialize water supply and sanitation in Dhaka, Bangladesh, have been pushed vigorously by internal and external proponents of neo-liberalism. The thesis takes a critical look at these developments and analyzes the role of multinational finance institutions in this process. In particular, it looks into the role of these finance institutions in funding reform projects to corporatize Dhaka Water Supply and Sewerage Authority (WASA), examining the impacts on end users, especially marginalized sections of society. The thesis describes how, in the process of corporatization, Dhaka WASA is and will continue to be more assertive in its commercial orientation than it was previously. The paper also studies a highly touted ‘successful’ co-operative model for revenue management called Program for Performance Improvement (PPI), seen by some as an alternative to privatization. I argue that the model in fact emerged as a consequence of the commercialization efforts of neoliberal reforms and that the revenue management model has created an isolated business unit with a reclusive management that undermines the egalitarian objectives of the water utility as a public service entity. / Thesis (Master, Environmental Studies) -- Queen's University, 2009-01-06 12:06:45.901

No description available.

The new age, the "Information Age" (Davenport and Prusak 1997) has increased society's and businesses' reliance on Information Technology (IT). Hence, there is an increasing focus on the management of IT, not only from a technological perspective but also from a business perspective. This research, sponsored by REALTECH and the Australian Research Council, applies one of the modern management approaches, business process management (Hammer 1990), to the domain IT service provision, by designing a business process reference model for IT Service Provision. A reference model is an abstracted depiction of reality that serves as a standardised or suggestive conceptual basis for the design of enterprise specific models, usually within a like domain. They are one method of improving the efficiency and effectiveness of enterprise modelling and can also be used to standardise communication or capture knowledge. There is a general lack of theory regarding the classification, design and quality of reference models. The first part of this thesis attempts to fill these gaps, by presenting a reference model classification scheme, outlining 7 philosophies for the design of reference models and detailing 2 case studies on the user-perceived quality of business process reference models. Reference models and the Business Process Management Lifecycle (Rosemann 2000) are integrated to show how reference models can be applied to improve the efficiency and effectiveness of business process improvement projects. This reference model theory was then applied to produce a model for domain of IT Service Provision. Investment in IT has increased to become the largest single element of capital expenditure (Thorp 1998). Gartner predicted that organisations will spend over 10% of revenue on IT by 2005 (Haines 2000). A major input for this model is the ITIL best practice documents (CCTA 2000). The reference model focuses on Incident Management and used focus groups with participants from several large IT service providers to validate the models. The designed reference model is then tested in two case studies to determine its accuracy and usefulness. The thesis finishes with a discussion of the designed model, the effectiveness of the procedural model and provides suggestions for the design of other reference models. The final chapter provides a summary and an outlook for further research into the area.

Research has shown that a high number of South Asian people suffer with mental health problems and that South Asian women specifically, are at high risk of attempting self -harm or suicide. However, there seems to be a low uptake of the mainstream services offered by the South Asian community as a whole, compared to their white counterparts. Furthermore, the existing literature in this area is scarce and focuses on identifying barriers that South Asian women face in accessing help. This mixed methods study explored the mental health help seeking experiences of British born South Asian women. For the first part of the study, six (N=six) women who had successfully accessed therapy were interviewed and the qualitative data was analysed using Braun and Clarke’s (2006) framework for thematic analysis. The main superordinate themes identified included: therapy as a positive experience, perseverance and persistence, need to know basis, fears about being judged, the need for more publicising and awareness, recovery as an ongoing process, medical professionals needing to be more proactive, developing autonomy and putting your own needs first, developing understanding and the importance of the first step. Various subordinate themes were identified for some of these main superordinate themes. The second part of this study involved delivering a psycho educational workshop (which was partly based on the qualitative data generated in the first part of the study) to a group of South Asian women (N=25). Their attitude towards help seeking was measured before, immediately after and four weeks after the workshop using Fischer and Farina’s (1995) Attitudes toward Seeking Professional Psychological Help Scale. An ANOVA Test indicated a statistically significant difference in attitudes to help seeking before, immediately after and four weeks after the workshop. This study helped to get a better understanding of the experiences of a marginalised group and demonstrated how such information can be used to develop new and innovative interventions that can be used with a client group that appear to have low levels of engagement with and referral to mental health services.

Cancer is emerging as a major problem globally and effective cancer care services are needed to lessen its burden on the community. In Greece, oncology health service provision is not located efficiently, resulting in only few patients receiving high quality care. Furthermore, shortages of health professionals and underdeveloped services such as primary care, home care and palliative care in the Greek NHS have aggravated the problem. The limited resources for healthcare have led to the absence of a national cancer registry, thus the extent of cancer incidence cannot be evaluated effectively. The dissatisfaction of the population regarding the Greek NHS is well established, despite the numerous reforms proposed by consecutive Greek governments. It remains that limited research exists in the area of oncology, especially on cancer services and cancer care. The aim of this study was to identify the key areas of cancer care and services that needed to be developed or improved in Greece and their prioritisation within the Greek healthcare system. Once identified, these areas of improvement could be used in a policy making context for the provision of effective services to cancer patients and might provide areas for further research A new Delphi technique (Q-Delphi) was introduced as an extension of the classical Delphi and implemented in two settings to collect data from a sample of 30 healthcare providers and 30 healthcare users. This was to reduce the potential subjectivity that may be introduced by the researcher in generating themes as an essential part of a successful Delphi outcome. The Q-Delphi of healthcare providers consisted of three rounds while that of the healthcare users was based on two rounds. The response rates for all rounds in both Q-Delphi studies were over 77%. The priorities for healthcare providers were focused on staff shortages, working conditions, pain management, home care, day units and communication. Healthcare users' highest priorities included the provision of and research on effective treatment, lessening the financial costs involved and the organisation of cancer services. Despite the separate Delphi studies, there were areas that both healthcare providers and users identified and prioritised. However, for the areas that both panels shared, there was a significant difference between their prioritisation. The World Health Organisation (WHO) suggestions for controlling cancer were used to triangulate, explain and discuss the results from this study (WHO 2002). The areas identified by healthcare providers and users were within those recommended by WHO. Based on the priorities provided by the participants and the suggestions by WHO, the establishment of a national cancer registry, the employment of nurses in order to develop primary care, home care, day care and palliative care services, education in communication skills and redistribution of the bio-medical technology are recommended in order to reduce the burden of cancer hi Greece. More research is needed to validate the actual level of cancer services provided in Greece. In addition, Q-Delphi is suggested as a valid and objective research method. For the benefit of Greek researchers, copies of documents used in conducting the research are also presented in Greek (Appendices 3 to 13 and 15).

The purpose of this research is to examine the factors that have influenced political decentralization in Paraguay and Colombia and how the new intergovernmental relations that result in political, fiscal and policy decentralization impact local governments and their capacity to deliver public services. The research, building on institutional theory, places particular emphasis on trying to explain and understand how intergovernmental relations shape the decentralization—and effectiveness—of public service delivery to local and regional governments, particularly in the areas of health and education. The research method is principally a path-dependent within-cases analysis. The analysis traces how the processes of decentralization evolved from 1990 to 2010. Special attention is given to critical junctures, or special political or social circumstances, that have significantly changed the process of decentralization. Data was collected mainly through reviews of documents, journals and newspapers, and most significantly through elite interviews “tailored to the purposes of the study” (Aberbach & Rockman, 2002). Leaders of political parties, unions, non-governmental-organizations and civic movements were interviewed in both countries. The research shows that political parties play a very important role, not only in the design and implementation of decentralization of public service delivery, but also in sustaining and furthering the process. The analysis is based on the assumption that increased decentralization of health and education to local and regional levels should positively impact basic health and education indicators. If decentralization, as argued, helps governments to be more responsive to local needs, and if more health and education programs are decentralized to the local and regional level in response to the demands of many communities, it is predicted that health and education indicators would improve, as people would have easier access to these services. Analysis of health and education indicators in the form of infant mortality rates (deaths of children under one year old, live births) and school enrollment show mixed results for both Colombia and Paraguay.

京都大学 / 0048 / 新制・課程博士 / 博士(地球環境学) / 甲第22104号 / 地環博第190号 / 新制||地環||37(附属図書館) / 京都大学大学院地球環境学舎地球環境学専攻 / (主査)教授 西前 出, 教授 小林 広英, 准教授 鬼塚 健一郎 / 学位規則第4条第1項該当 / Doctor of Global Environmental Studies / Kyoto University / DGAM

Despite the development of an Aboriginal Healing and Wellness Strategy (AHWS), which implemented Aboriginal Health Access Centres (AHACs) to provide integrated healthcare including both mainstream and traditional services, health inequalities persist among the urban Aboriginal population in Ontario. There are multiple social determinants of health (SDOH) besides access to healthcare that affect Aboriginal health. The objectives of this study were to describe the past and current policy strategies to address Aboriginal health in Ontario, and to investigate the ways that service providers perceive health inequalities, demonstrating whether the SDOH are considered in service provision to urban Aboriginal clients. In addition to a document review, interviews were held with representatives from three provincial ministries involved with the AHWS. Through a community engagement research strategy, nine semi-structured interviews were conducted with service providers from various departments within an urban AHAC. Interviews were analyzed using a modified grounded theory, which was guided by the SDOH framework. In understanding policy development, themes included: collaboration with Aboriginal communities and improving access to holistic care. In approaching service provision, themes included: perceived health inequalities and their determinants, what is being done and what must be done to address health inequalities and the use of the SDOH framework in practice. Findings suggest that service providers accurately identify the health needs of their clients, and utilize the SDOH to understand the causes of inequalities, however the SDOH cannot be fully addressed at the service provision level. The SDOH framework must be utilized at the policy level, in order to effectively address the wider determinants of health through intersectoral collaboration between provincial ministries and Aboriginal communities. / Thesis / Master of Arts (MA)