Die vorliegende Arbeit beschäftigt sich mit der Tätigkeit konsiliarpsychiatrischer Dienste am Allgemeinkrankenhaus. In einem historischen Abriß wird zunächst die Integration des psychiatrischen Fachgebiets in die Allgemeinkrankenhäuser als wesentliche Bedingung für die Entwicklung der Konsiliarpsychiatrie am Beispiel der USA dargestellt, gefolgt von europäischen Perspektiven und der Entwicklung in Deutschland, unter besonderer Berücksichtigung der Psychiatrie-Enquête. Anschließend werden Aspekte somatopsychischer Komorbidät als Grundlage der Konsiliarpsychiatrie und ihre Implikationen für Diagnostik und Therapie skizziert. Vorschläge zur Bestimmung des Bedarfs der konsiliarpsychiatrischen Versorgung werden diskutiert. Das Spektrum konsiliar-liaisonpsych-iatrischer Versorgungsmöglichkeiten wird dargestellt, Interventionsmöglichkeiten mit ihren differentia specifica im Setting des Allgemeinkrankenhauses am Beispiel von supportiver Psychotherapie und Psychopharmakatherapie bei körperlich kranken Patienten werden verdeutlicht. Im empirischen Teil wird auf Grundlage einer Längsschnittstudie über einen 10jährigen Be-obachtungszeitraum eines amerikanischen, sowie einer Vergleichsstudie der Tätigkeit eines deutschen und eines amerikanischen Konsildienstes über einen einjährigen Beobachtungszeitraum versucht, einen Kernbereich konsiliarpsychiatrischer Tätigkeit am Allgemeinkrankenhaus zu definieren. In der Längsschnittuntersuchung wurde ein zeitüberdauernder Bereich konsiliarpsychiatrischer Tätigkeit identifiziert, der im Vergleich mit ähnlichen, allerdings weniger detaillierten Studien (Lipowski & Wolston 1981, Paddison et al. 1989) ebenfalls überwiegend Gemeinsamkeiten deutlich werden läßt. Auch die vergleichende Querschnittsuntersuchung zeigte, daß psychiatrische Konsiliartätigkeit über nationale Grenzen hinweg eine Reihe von Gemeinsamkeiten aufweist. Auch dies konnte im Vergleich mit anderen Studien bestätigt werden (vgl. Übersichten bei Hengeveld et al. 1984, Diefenbacher 1999, Huyse et al. 1997). Anschließend werden Veränderungen im Gefolge der Tätigkeit eines neu beginnenden psychiatrischen Konsiliars über einen einjährigen Beobachtungszeitraum untersucht und im Hinblick auf die Implementation eines Konsildiensten auf für die konsiliarpsychiatrische Praxis bzw. Interventionsforschung wichtige Parameter wie z.B. Zusammenarbeit mit den Stationsteams und Beeinflussung von Krankenhausverweildauer und Zeitintervall zwischen stationärer Aufnahme und Konsilanforderung diskutiert. Zusammenfassend wird ein Kernbereich konsiliarpsychiatrischer Tätigkeit beschrieben, von dem erwartet wird, daß er für die nahe Zukunft konstant bleibt und somit als Orientierungshilfe für administrative und evaluative Zwecke dienen kann. Abschließend werden Perspektiven weiterer Forschung in der Konsiliarpsychiatrie diskutiert und auf Aspekte der Fort- und Weiterbildung im psychiatrischen Konsiliar-Liaisondienst in der psychiatrischen Facharztweiterbildung, sowie auf Schnittstellen für eine mögliche Zusammenarbeit mit dem hausärztlichen Bereich eingegangen. / Psychiatric consultation-liaison (c-l) service delivery in the general hospital is the topic of this study. In the first part, an historical outline of the development of psychiatric c-l-services in the USA is presented, followed by recent developments in Europe and Germany, with special emphasis - for the latter - of the impact of the so-called "Psychiatrie-Enquête" (1975) on the implementation of psychiatric departments in general hospitals since the 1980s. The issue of somato-psychic comorbidity of general hospital inpatients, the very reason of existence of c-l-psychiatry, is discussed, as are its implications for diagnosis and treatment. Proposals for the evaluation of need for such services are presented, as is the scope of c-l-psychiatric interventions and their special nature with the example of supportive psychotherapy and psychopharmaco-therapy in the medically and psychiatrically ill inpatient. The second empirical part consists of a 10-year-longitudinal study of a c-l-psychiatric service in New York City, and a comparative cross-sectional study (over a 1-year-period) of a German and an American c-l-psychiatric service in order to delineate a common core of psychiatric c-l-service delivery in the general hospital. In both studies, a cross-national common core and a time stable course over time, respectively, are identified and then discussed in comparison to other less detailed studies (e.g. Lipowski & Wolston 1981, Hengeveld et al. 1984, Huyse et al. 1997). In addition, the implementation phase of a newly started psychiatric c-l-service is studied over a 1-year-period with regard to variables important for c-l-psychiatric intervention studies, such as influence on length of stay in hospital, lagtime between admission to hospital and day of consultation request, and cooperation with staff. In conclusion, a core field of psychiatric c-l-service delivery in the general hospital is identified, that is expected to remain stable in years to come and thus might help as an orientation for administrative and evaluative purposes. Finally, perspectives for further research in the field, for training and education, and for the cooperation with primary care doctors are discussed.

We compare the health needs between children and young adults with CL/P. Patient-reported experiences about the impact of a cleft are described. A service delivery model integrating quality of life into the ICF framework is presented. Lastly, transition of care for the young adult with CL/P is highlighted.

As a child approaches adulthood, many transitions take place; physically and psychosocially. There are new roles and responsibilities. For the young adult with cleft lip and palate (CLP), one of the most significant transitions is moving from the pediatric interdisciplinary team to the adult-centered health care system. There is a shift in focus from the cleft itself and clinician-reported outcomes to patient self-report about the perceived impact of the cleft on quality of life. Transition also befalls the parents and team providers who, through the course of some 18 years, were active participants in the young person's care. Their roles, too, have changed. The International Classification of Functioning, Disability, and Health (ICF; World Health Organization, 2001, 2004) is a conceptual framework for considering the totality of the cleft by addressing the interaction between the person and their personal and social environment. This model is suitably applicable to the transition of care of the young adult with CLP. In this paper, we propose an evidence-based person-centered delivery model of care using the concepts of the ICF to facilitate the transition of care for this population. A case example is presented highlighting the use of these concepts for the speech-language pathologist.

Thesis (M.Dev.) --University of the North, 2001 / Refer to document

Thesis (MPA.) -- University of Limpopo, 2008 / Refer to document

Thesis (MPA.) -- University of Limpopo, 2018 / This study analyses the national election manifestos of the African National Congress on the subject of service delivery between 1994 and 2014. One of the arguments advanced in this thesis and corroborated in the theory of democratization by elections is that elections play an important role in the struggle for better governance and democracy. The election manifestos, in this regard, serve as instruments of ensuring accountability to the voters as well as gauging the performance of those in government. The party in government must implement its election manifestos; otherwise it must face electoral consequences through a democratic election process. However, there is a view aptly sustained in the study that elections are at times not a reliable or credible measure of a democratic outcome because many voters do not have the necessary knowledge to make rational choices in order to counteract the effects of poor or lack of implementation of election manifestos regarding service delivery. Therefore, as cautioned in the thesis, conscious public participation will remain an empty slogan if the majority of the electorate is left and forgotten languishing in poverty and arrogance. The sustainability of participation by citizens is hugely compromised in an environment infested with rampant corruption and runaway impunity. The study followed an interpretivist paradigm with a qualitative approach. ANC members in four villages –Duthuni, Tshisaulu, Ha-Mushavhanamadi and Ha-Ratshiedana (ward 35, Thulamela Municipality) were purposively targeted as the research population for the study. For practical reason, not all members of the ANC in the villages were reached to participate in the study. Ultimately, 42 members of the ANC in the villages formed the research sample. Data collection techniques used were face-to-face interviews, semi-structured questionnaire and document review (data triangulation). The rationale for using data triangulation in the study was to ensure that the weaknesses of a single data collection strategy were minimized and to ensure that the strategies complemented and verified one another. A total of 12 interviews were conducted, 30 questionnaires were administered and five ANC national election manifestos were perused. Three qualitative data analysis strategies were adopted, namely, conversation analysis, discourse analysis and content analysis. Analysis and interpretation of qualitative data consisted of words and observations and not numbers or statistics because the researcher did not want to quantify nor generate numerical data for purposes of statistical analysis.

Thesis (MPA.) --University of Limpopo, 2005 / Refer to the abstract

The educational rights of students with disabilities are supported through federal mandates, as the Individuals with Disabilities Education Act (IDEA) safeguards a free and appropriate public education (FAPE) in the least restrictive environment (LRE). Special education students encompass a wide range of individual and unique learning needs, thus the creation of educational environments that utilize fluid and flexible service delivery models is warranted. Furthermore, students with moderate to severe disabilities (MSD) require specialized academic instruction that promotes advancements across several developmental areas, which includes cognition, adaptive skills, communication, and emotional awareness. Exploring educational service delivery models that proficiently address the unique needs of students with MSD is essential, as limited research exists in this specific area. Utilizing a qualitative phenomenological research methodology, this study sought to explore an informal class reassignment program that provides educational instruction to students with MSD. Additionally, the intent behind this study was to explore how the informal class reassignment program influenced the special education teachers’ perspectives regarding learning outcomes for students with MSD, if at all. Moreover, this study sought to explore how moderate to severe special education teachers experience, define and describe an informal class reassignment program specifically designed to target the individual earning needs of students with MSD. This inquiry incorporated semi-structured interviews combined with reflective field notes to gain a deeper understanding of the participants’ lived experiences. Consequently, the findings shed light on factors that relate to optimal service delivery models for students with MSD.

The productivity of Trinidad and Tobago's public sector workplaces is related to their absorptive capacity for technological adoption. Guided by the technology acceptance model, which suggests that individuals' and institutions' use of technology increases in relation to perceived ease of use and apparent value, this case study explored how Trinidad and Tobago used information and communications technology from 2001 - 2010 to improve public sector workplace productivity. Study data were collected from 22 individual interviews with senior executives from the government of Trinidad and Tobago, members of the e-business roundtable, and local industry experts, and from reviewing the archives of the Ministry of Public Administration and Information. The data were analyzed using keyword frequency comparison, coding techniques, and cluster analysis. The resulting themes include e-legislation, e-infrastructure, e-readiness, government e-services, and e-business. The study findings showed that Trinidad and Tobago's technology agenda centered primarily on connecting government ministries and agencies. It also ushered in a period of telecommunication liberalization, which provided sustainable and cost effective options for government, citizens, and businesses to access broadband technology services. The results of the study showed that this access to low-costs broadband technology provides a platform for digital inclusion by improving workplace productivity, providing access to additional opportunities for education via an online platform, and increasing employment opportunities.

Thesis (M.Dev.) -- University of Limpopo, 2012 / The study seek to analyze the role of the Local Government in distribution of equitable and basic needs to its community through efficient and effective service delivery through the utilization municipal infrastructure grant. Municipal service delivery is still a major concern in South Africa. In terms of the Constitution of South Africa (Act 106 of 1996), municipalities are the only spheres of government that are mandated for delivery of basic services such as water, sanitation, electricity, refuse removal, development and maintenance of community infrastructure, storm water, primary health and provision of better housing to the poorest of the poor. The new dispensation in 1994, necessitated the transformation of the municipalities towards service delivery. The apartheid system was characterized by inequities in terms of provision of sustainable needs to its communities. The service delivery was fragmented along racial lines. Blacks were largely excluded from better services, while the minority enjoyed the services of municipalities around the country. Various laws, policies were enacted to find ways of ensuring that municipalities are responsive to community’s demands and needs in an equitable manner. The White Paper on Local Government in 1998, outlined some strategies that needs to be followed for the Local Government to achieve its objective. The background of the study, problem statements highlighted the historical imbalances in the system and how it can be redressed to provide good governance at the local government. The research questions form the basis of the study. The questionnaire for data gathering were formulated in line with the research questionnaire. Municipalities are characterized by service backlog, lack of skills (administratively and technically), lack of transparency and accountability that contribute to major challenges faced by municipalities in service provision. The research methodology used in this study focused more on the qualitative to allow participants to express their feelings in a descriptive manner and less on the iv quantitative approach wherein figures were reflected in a form of tables and graphs . The provision of service, as a social phenomena focused on human beings as object of study. Ethical considerations were taken into account. Questionnaires were distributed to executive directors and officials in strategic positions of service delivery of City of Tshwane Metropolitan Municipality and also to SALGA, CoGTA and National Treasury. The aim of the questionnaire was to find out and assess the challenges faced by municipal officials on their day to day activities regarding the management and utilization of MIG in a responsible and accountable manner. Extensive literature review covered a range of books, journals, African National Congress (ANC) Manifesto, Reconstruction and Development Programme (RDP), White Paper, Discussion Documents and City of Tshwane’s Annual Reports, Service Delivery Strategies Reports and other related documents that advocate for service delivery challenges and its impact. The findings revealed that municipalities faced common challenges that impede on the progress of service delivery. Some of the challenges are beyond their control like the non-availability of government owned land. Most of municipalities are characterized by lack of funding, under-spending or over-spending. Media news regularly covers negative aspects such as corruption that occurs in municipalities and not positive issues of delivery of service. In the City of Tshwane Metropolitan Municipality, housing is still a major challenge. The ever increasing demand from communities also impact on the budget of the municipality. Immigration in Tshwane area have negative effect on service delivery, particularly the housing backlog and proper sanitation.