<p> Caregivers&rsquo; compliance with polio vaccine regimens and timely receipt of the recommended 4 doses of polio vaccine are pivotal to eliminating polio. This cross sectional study, conducted in Lagos State, Nigeria, examined polio vaccine compliance and demographic attributes of caregivers&rsquo; for statistically significant associations. Using an adapted health belief model theoretical framework, 1,200 participants were recruited from well-baby clinics in 8 local government areas in Lagos State. Participants completed a brief demographic survey providing data on caregivers&rsquo; age, gender, residence (rural or urban), and their level of education as well as records from their children&rsquo;s immunization cards. Data obtained were tested for associations between caregiver&rsquo;s demographic information and their children&rsquo;s receipt of polio doses within specified timelines using chi-square and logistic regression analysis. Fisher&rsquo;s exact analysis were conducted for variables with frequencies less than 5. The only significant association recorded was between the receipt of Polio Dose A and location of caregivers&rsquo; residence: Rural dwelling caregivers were less likely to receive the first dose of polio. Results showed Polio Dose D to be the dose most likely received in an untimely manner as well as most likely missed of the 4 doses. Logistic regression analysis did not show any variable to be of greater odds in predicting completion of the 4 doses or compliance with timelines of their receipt. Study&rsquo;s results may inspire polio program planners to develop interventions that broaden the immunization coverage for rural dwellers to include nontraditional maternity locations. Positive social change will ensue by the improvement caregivers&rsquo; compliance with full polio dose receipts with timelines, maximizing immunity. </p><p>

As long as governmental institutions have existed, efforts have been undertaken to reform them. This research examines a particular strategy, coercive controls, exercised through a particular instrument, executive orders, by a singular reformer, the president of the United States. The presidents studied- Johnson, Nixon, Ford, Carter, Reagan, Bush, and Clinton-are those whose campaigns for office were characterized to varying degrees as against Washington bureaucracy and for executive reform. Executive order issuance is assessed through an examination of key factors for each president including political party affiliation, levels of political capital, and legislative experience. A classification typology is used to identify the topical dimensions and levels of coerciveness. The portrayal of the federal government is analyzed through examination of public, media, and presidential attention. The results show that executive orders are significant management tools for the president. Executive orders also represent an important component of the transition plans for incoming administrations. The findings indicate that overall, while executive orders have not increased in the aggregate, they are more intrusive and significant. When the factors of political party affiliation, political capital, and legislative experience are examined, it reveals a strong relationship between executive orders and previous executive experience, specifically presidents who served as a state governor prior to winning national election as president. Presidents Carter, Reagan, and Clinton (all former governors) have the highest percent of executive orders focusing on the federal bureaucracy. Additionally, the highest percent of forceful orders were issued by former governors (41.0%) as compared to their presidential counterparts who have not served as governors (19.9%). Secondly, political party affiliation is an important, but not significant, predictor for the use of executive orders. Thirdly, management strategies that provide the president with the greatest level of autonomy-executive orders redefine the concept of presidential power and autonomous action. Interviews of elite government officials and political observers support the idea that executive orders can provide the president with a successful management strategy, requiring less expenditure of political resources, less risk to political capital, and a way of achieving objectives without depending on an unresponsive Congress.

The major purpose of this study was to ascertain how needs assessment findings and methodologies are accepted by public decision makers in the U. S. Virgin Islands. To accomplish this, the following five different needs assessments were executed: (1) population survey; (2) key informants survey; (3) community forum; (4) rates-under-treatment (RUT); and (5) social indicators analysis. The assessments measured unmet needs of older persons regarding transportation, in-home care, and sociorecreation services, and determined which of the five methodologies is most costly, time consuming, and valid. The results of a five-way comparative analysis was presented to public sector decision makers who were surveyed to determine whether they are influenced more by needs assessment findings, or by the methodology used, and to ascertain the factors that lead to their acceptance of needs assessment findings and methodologies. The survey results revealed that acceptance of findings and methodology is influenced by the congruency of the findings with decision makers' goals and objectives, feasibility of the findings, and credibility of the researcher. The study also found that decision makers are influenced equally by needs assessment findings and methodology; that they prefer population surveys, although they are the most expensive and time consuming of the methodologies; that different types of needs assessments produce different results; and, that needs assessment is an essential program planning tool. Executive decision makers are found to be influenced more by management factors than by legal and political factors, while legislative decision makers are influenced more by legal factors. Decision makers overwhelmingly view their leadership style as democratic. A typology of the five needs assessments, highlighting their strengths and weaknesses is offered as a planning guide for public decision makers.

In recent years, the legalization of medical marijuana in states has been a controversial topic. Despite conflicting with the federal government ban on marijuana use, 28 states and D.C. have legalized medical marijuana by the year 2016 and other states are currently considering adopting the law every year. Why do some states adopt medical marijuana laws and others do not? This study lays out an approach that explains what and how the predictors of the adoption of medical marijuana laws affect legalizing medical marijuana in a state, using a mixed methods approach. In the quantitative research, this study examines the diffusion of medical marijuana laws by analyzing policy adoption from a morality and economic development perspective through three policy typologies such as morality policy, economic policy and multidimensional policy. For the qualitative research, this study uses short case studies of three states (California, Colorado, and Illinois) based on news reports to draw out the politics surrounding the issues and reasons why the policies were adopted. This study finds that the morality policy characteristics as policy diffusion factors -- religious groups, citizens’ liberal ideology, and a ballot initiative process -- have a significant effect on the adoption of a medical marijuana law. Economic indicators -- fiscal capacity growth, incarceration, and cost of justice system -- also have a significant effect on the adoption. As internal characteristics, a major proponent group (number of marijuana users) and state regulatory environment (mandatory minimum sentences for drug offenses and the size of the regulatory bureaucracy) are important predictors of diffusion. Overall, this study shows that the diffusion of a medical marijuana law is mainly determined by the citizens’ opinion rather than elected officials’ political ideology or government's fiscal health conditions. Also, we demonstrated that a multidimensional policy model provides a superior explanation for predicting when a state will adopt medical marijuana policy; policy typologies are still a useful framework for clarifying and understanding characteristics of each policy type and its unique politics pattern. These findings contribute to the literature of diffusion, and they have important implications for the diffusion of multidimensional policies that transcend classical typological boundaries. Moreover, in terms of practical implication, this study provides policy makers and American civil society useful information about which factors impact medical marijuana adoption and why. / A Dissertation submitted to the Askew School of Public Administration and Policy in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Fall Semester 2016. / October 24, 2016. / Economic policy, Medical marijuana law, Morality policy, Multidimensional policy, Policy innovation and diffusion, Policy typology / Includes bibliographical references. / Frances S. Berry, Professor Directing Dissertation; William G. Weissert, University Representative; Ralph S. Brower, Committee Member; Keon-Hyung Lee, Committee Member.

A Utah State Agriculture Extension Department was created by the Utah State Agricultural College in 1907 to be supported by state appropriations. Its purpose was to bring the information being gained by the College Experiment Station, and other knowledge applicable to agriculture, to the rural population of the State in order to improve the quality of Utah agriculture and the conditions of the farm population. The program began with college instructors holding Farmers' Institutes and schools and expanded into a state-wide system of agricultural and home extension work carried on by specially appointed county agents in each county. The purpose of the agent was to demonstrate to the farmer improved farm methods and help in any way the situation of the farm family. In 1914 the Smith-Lever Act was passed by the Congress of the United States which appropriated federal funds for county agent work. This made the extension program a joint government undertaking with funds appropriated by state, federal, and local governments. This also linked the Extension Service to the Federal Government through the United States Department of Agriculture and in times of national crisis it was called upon to assist in putting government programs into effect. The Utah Extension Service can be said to have rendered valuable service to the people of Utah. It has provided information, has been available for consultation in farm and home problems, and has helped unite the rural population by encouraging farm bureau organizations, cooperative associations, and community projects. Through programs involving both adults and young people it has, in one way or another, either directly or indirectly, affected the lives of most Utah citizens. It has become involved in every facet of farm living including economic, social, and political. The object of the Utah Extension Service has been improvement and progress through extending education.

Job-related stress occurs as one of the most serious issues in modern era in developed nations. It has direct and negative effects on employees' productivity and it may have negative impacts on employees' health. One of the potential results of prolonged stressors at work place is burnout and this response may lead to physical, emotional, and psychological exhaustion that can occur at both individual and organizational levels. Burnout is a job related threat that provokes social stress and can directly affect an individual's health. Health-related quality of life (HRQoL) is commonly used to measure an individual's overall/global health and quality of life. Another serious issue, mobbing, usually leads to some individual and organizational complications. It affects the organizational commitment, motivation and efficiency of staff, job satisfaction of employee, and may lead to potential burnout of the employees. The primary objective of this study is to determine whether stress and mobbing are directly related to burnout; and, whether burnout leads to an adverse effect on the HRQoL of Turkish territorial state representatives (TSRs). This study examines four specific research questions: 1) Whether and to what extent do the levels of perceived job related stress and mobbing affect the level of perceived burnout syndrome of TSRs? 2) Whether and to what extent is the level of perceived burnout syndrome associated with HRQoL of TSRs? 3) To what extent does the level of perceived burnout mediate the effects of job-related stress on HRQoL of TSRs? 4) What are the mediating factors between job burnout and HRQoL? This study is expected to offer valuable and insightful information about the role of job burnout factors influencing the variability in TSRs' HRQoL. The study utilized two statistical analyses, which were descriptive analysis and Structural Equation Modelling (SEM) which allows for the assessment of the relationships specified in the hypotheses and the SEM was used to validate the theoretically driven model. The findings of the study supported the hypotheses of the study, which asserted that there were correlations between job-related stress and burnout, mobbing and burnout, and burnout and HRQoL. The CFA results established that job-related stress was positively and significantly associated with the burnout of TSRs, while perceived mobbing was positively and significantly related to the burnout of TSRs. Moreover, perceived HRQoL of TSRs was negatively associated with the burnout of TSRs. Further, the findings indicated that the relationship between job-related stress and burnout and the relationship between burnout and HRQoL of TSRs were statistically significant. Thus the variable had a positive effect on burnout and a negative effect on the HRQoL of TSRs. In summary, the findings of the study showed that results and propositions of the theoretical frameworks of the study and literature were consistent with one another.

This study examines the factors that facilitate and hinder the use of performance information by public administrators in local governments in Florida. Acknowledging the incompleteness of many theoretical and conceptual models in previous performance management studies and the absence of theory on the use of performance information; this study utilizes a grounded theory approach to develop and test a model analyzing the use of performance information. The research focuses on cities and counties, members of the Florida Benchmarking Consortium (FBC), and surveys public administrators whose tasks are related with the collection and/or reporting of performance information. The study examines three research questions: First, to what extent and in what capacity do local government administrators use performance information? Second, what are the predictors of the use of performance information among local government administrators? Finally, to what extent does the design adequacy of a performance measurement system (PMS), institutionalization of performance measurement (IPM), organizational support (OS), individual factors (IF) and external influences (EI) impact the use of performance information among local government administrators? To collect data on the above questions, an online survey was administrated to public administrators involved in the 2015-2016 FBC data collection cycle. The data were analyzed with structural equation modeling (SEM). The results of the study demonstrate that institutionalization of performance measurement has the strongest statistically significant positive association with the use of performance information followed by the influence of the design adequacy of the performance measurement system. Organizational support, through institutionalization of performance measurement, has an indirect influence on the use of performance information. Interestingly, in this study individual factors were not found to be significantly associated with the use of performance information.

The cost of healthcare in the United States is on an upward trajectory towards an unsustainable level. In order to address this, Congress and the Obama Administration passed the American Recovery and Reinvestment Act (ARRA) of 2009 to begin the process of controlling these costs. Within the ARRA is the Health Information Technology for Economic and Clinical Health (HITECH) section which creates financial incentives to invest in Health Information Technology (HIT) and to develop a means to measure the Meaningful Use of specific functions of Electronic Health Records (EHRs). This research examines the widely used Joint Commission datasets to determine their suitability as a basis of meeting the government mandated measuring of Meaningful Use. The datasets used for this study consists of hospital level performance measures with a sample size of 370 hospital samples of HIT Use Intensity and Cardiovascular Performance attained from the Veterans Health Administration (VHA). An Organizational Network Theoretical approach was applied to the data in a non-experimental, sample-resample design to data collected in 2007. A Structural Equation Model (SEM) was built to test for the strength of the correlation between HIT Use Intensity and Cardiovascular Performance and a Latent Growth Curve Model (LGM) was built to examine the effect of the trajectory of HIT Use Intensity on the trajectory of Cardiovascular Performance. The SEM found a weak (.18) correlation between HIT Use Intensity and Cardiovascular Performance and the model only captured 12 percent of the variance. The LGM found no convergence between the trajectories of HIT Use Intensity and Cardiovascular Performance. This may have been the result of the data being non-normally distributed and heavily skewed to the high end of the scale. The policy implications of this study indicate that while Joint vi Commission data capture only a small amount of the variance attributed to HIT Use it does show a weak but positive correlation between increases in HIT Use Intensity and Increases in Cardiovascular Performance at the hospital level. Future research into adjustments to Joint Commission data measures (or others) may prove to be valuable in measuring the Meaningful Use of HIT systems in order to help hospitals make educated decisions on which HIT systems to purchase and the potential benefits associated with them.

The Russian invasion of Ukraine in February 2022 has resulted in numerous civilian deaths, damage of transportation and power infrastructure, and forced millions of Ukrainians to seek safety, protection, and assistance abroad. The humanitarian crisis caused by war is beyond the normal capacity of any single agency, institution, or organization and requires collaboration and coordination of various public, private, and nonprofit organizations. Networks connect various organizations and agencies to share and accumulate resources, including financial, human, technological, knowledge, and information, necessary to respond to the changing and uncertain environment and to achieve goals that cannot be accomplished by a single organization. The collaboration of actors within a network is a crucial aspect for service delivery and assistance during the humanitarian crisis caused by war. Even though collaboration among network participants is desirable, the establishment of collaborative ties within the network remains a challenging task for various reasons. This study uses a mixed method approach to answer eight research questions: 1) What is the role of collaborative capacity within interorganizational networks? 2) How do organizations manage the process of collaboration in serving the impacted people in a constantly changing military environment? 3) What is the structure of the humanitarian response network in the response to the crisis caused by war in Ukraine? 4) What humanitarian response partners were involved and what were their roles and responsibilities? 5) What humanitarian response partners were involved and what were their roles and responsibilities? 6) What are the characteristics of the network aiming to respond to the humanitarian crisis? 7) How does network structure impact the collaborative capacity of an interorganizational network during a humanitarian crisis? 8) How do key environmental and organizational factors impact the collaborative capacity of a network during humanitarian crisis? Content analysis (n=229), social network analysis (SNA), and semi-structured interviews (n=14) were used to analyze network collaborative capacity in humanitarian response network in Ukraine. The findings suggest that the network collaborative capacity is influenced by common goals and shared visions, pre-existing ties and relationships between humanitarian response partners, organizational learning, and knowledge sharing. Power asymmetry can both facilitate and hinder network collaborative capacity. The strength of ties, communication, resource dependence, and environmental complexity were also found to play influential roles in building, developing and sustaining the network collaborative capacity. Powerful network members should consider developing better information system that reflects ongoing projects and allow participants to share data and report, and exchange ideas and feedback. Moreover, the efforts should be focused on involving Ukrainian nonprofit organizations in the response because currently they are excluded from the response due to the lack of experience and language barriers.

<p> Human Immunodeficiency Virus (HIV) is a substantial challenge for India. In 2011, India ranked third globally in the number of people living with HIV. While progress has been made in reducing the occurrence of new cases, there has been concern over the emergence of micro-epidemics in rural areas. Surveillance data suggests these micro-epidemics are linked to migration, where migrants serve as a bridge between the high prevalence cities and their low prevalence hometowns. </p><p> However, there appears to be a gap in the research literature when examining the rationale for why HIV is spreading beyond migrants and their partners. One reasonable theory is that the social norms in the source village significantly differ from that of the work destination. To explore this idea, a secondary quantitative analysis was conducted on data collected from 4,294 adult male migrant laborers from multiple sites across India. The Theory of Social Normative Behavior (TNSB) was used to disentangle to role of individual and group norms of the source and destination site on an individual's behavior. </p><p> This study had three major findings. First, the objective prevalence of a behavior (collective norm) had more predictive value than the individual&rsquo;s perceived estimate (descriptive norm). Second, collective norms are not moderators (contrary to TNSB), instead descriptive norms partially mediate the effect of collective norms on risk involvement. Third, the collective norm at the source village had the largest predictive value for risk involvement at both the source and destination sites.</p>