La thèse de doctorat a pour objectif, d'abord, de déterminer la portée de trois obligations imposées par les institutions européennes aux États membres en ce qui concerne leur organisation administrative, de déterminer, ensuite, sur quels points l’autonomie et les particularités des États ont été protégées lors de l’édiction de ces obligations, et d’évaluer, enfin, la conformité de ces dernières aux dispositions des traités garantes de l’autonomie et des spécificités nationales. La thèse qui est soutenue est celle selon laquelle les avancées du droit européen du marché intérieur dans le domaine de l’organisation administrative nationale qui sont analysées ne sont que partiellement conformes aux dispositions des traités qui protègent l'autonomie et les spécificités nationales. La méthode adoptée pour la recherche relève, pour l'essentiel, de la technique juridique. / Doctorat en Sciences juridiques / info:eu-repo/semantics/nonPublished

L’Union européenne conduit une ambitieuse politique de développement des énergies renouvelables, visant à porter à 20 % la part de ces dernières dans la consommation énergétique européenne à l’horizon 2020. A cet effet, le législateur européen sollicite des Etats membres qu’ils mettent en œuvre des soutiens nationaux à la production d’électricité renouvelable, susceptibles de relever du champ de l’interdiction des entraves et des aides d’Etat. Parallèlement, la politique de réalisation du marché intérieur de l’énergie impose aux Etats membres de libéraliser le secteur économique dans lequel s’inscrit l’électricité renouvelable. Par l’observation des règles du marché intérieur, la thèse évalue l’articulation entre ces objectifs visiblement contradictoires. Si la finalité environnementale qui sous-tend le développement de l’électricité renouvelable justifie une inflexion des règles du marché intérieur, elle favorise les cloisonnements nationaux et fait naître une concurrence normative entre les Etats membres. Chacun d’eux use de l’attractivité de son droit pour inciter les opérateurs économiques à exploiter des sources d’énergie nationales, indépendamment de leur répartition naturelle à l’échelle européenne. L’observation empirique de ce phénomène met en évidence les risques qu’il fait peser sur la cohérence globale de l’action de l’Union dans le domaine des énergies renouvelables. En prenant appui sur certaines évolutions du droit positif et de la pratique des acteurs privés sur le marché, la thèse évalue les hypothèses de renouvellement des mécanismes du marché afin qu’il devienne un instrument à part entière de promotion de l’électricité renouvelable dans l’Union européenne. / The European Union is pursuing an ambitious policy to develop renewable energy aimed at increasing its share to 20% in the European energy consumption by 2020. To that extent, the European legislator requests from all Member States that they implement national support for the production of renewable electricity, which may fall within the scope of the ban on restrictions and State aids. In parallel, the policy of achieving the internal energy market requires the Member States to liberate the economic sector in which renewable electricity is used. By observing the rules of the internal market, the thesis evaluates the articulation between these objectives that seem contradictory. While the environmental goal underlying the development of renewable electricity justifies an inflexion of the rules of the internal market, it promotes national separation and gives rise to normative competition between the Member States. Each of them uses the attractiveness of its own laws to persuade the economic operators to exploit national energy sources, independently of their natural distribution on a European scale. The empirical observation of this phenomenon highlights the risks it poses to the overall coherence of the European Union’s action in the field of renewable energies. By using some developments of the positive law and the practice of private actors in the market, the thesis evaluates the hypotheses to renew the market mechanisms so that the market becomes a full instrument for promoting renewable electricity in the European Union.

The purpose of this study was to examine Residential Care Aides’ (RCAs) experiences of good quality dementia care provision. Informed by a political economy perspective, I sought to understand how RCAs conceptualize quality dementia care, whether such conceptualizations are reflected in their daily care practice and how the organizational care context impedes or facilitates such care provision. Drawing on a focused ethnographic approach, I utilized in-depth interviews, participant observation and the review of selected documents to contextualize RCAs’ experiences within the organizational care environment. Over a 12-month period, in-depth interviews with 29 staff (21 RCAs, 3 LPNs and 5 managers) and 239 hours of participant observation were conducted in four small-scale dementia units in two nursing homes in British Columbia, Canada. In-depth interviews yielded information-rich data about RCAs’ care experiences and their relationships with residents, while participant observation afforded the opportunity to strategically link RCAs’ actions and interactions with what was said, a feature missing from much of the previous research examining staff perceptions of quality dementia care. A select review of facility documents and provincial licensing regulations provided additional insight regarding the relevance of the larger structural context for RCAs’ care experiences. In general, RCAs conceptualized, and exhibited in their daily physical care provision, quality dementia care as that which focused on tangible care outcomes (i.e., keeping residents clean, comfortable, calm and happy), on their care approach (i.e., delivering care in a compassionate, patient and affectionate manner) and was guided by family ideology (i.e., invoking of family metaphors). Inherent in their care provision was a sense of role tension, as they sought to incorporate social interaction with task completion and their co-workers’ conflicting expectations. Study findings also illustrated how, in the face of continued disempowerment and organizational constraints, RCAs sought to provide quality dementia care by negotiating their peer and supervisory relationships and selectively breaking formal and informal policies/procedures. Salient to RCAs’ experiences of personhood was the limited recognition and appreciation they received from management and the manner in which work-life balance, staffing coverage, human resource management practices and limited information sharing further devalued them and their work. Study findings draw attention to the importance of: acknowledging the role of structural constraints in the pervasiveness of a task-oriented work culture; attending to (and facilitating) staff personhood; facilitating supportive peer and supervisory relationships and; fostering effective management practices as a means of potentially improving care quality. As such, the study sheds important light on what RCAs require within their work environments to help facilitate resident well-being, reinforcing the assertion that residents’ care conditions are inextricably linked to RCAs’ care work conditions. / Graduate / 0351

M.Cur. (Nursing Management) / Information technology is the management of a computer-based information system, particularly software applications and computer hardware, which are used to handle all aspects of information storage, retrieval, transmittal, protection, and processing information securely. The lack of reliable health information is one of the major obstacles to the effective planning of the health services in South Africa. The existing information systems are fragmented and incompatible; most systems are manually driven with minimal computerisation which results in inadequate analysis, interpretation and the use of data at PHC level. The use of computer information technology in the health facilities will improve service delivery; reduce the cost of providing health care; and enhance the management and control of service. Yet, it seems that nurses are insufficiently using computer information technology at the PHC clinics in the eastern part of Ekurhuleni. It has been observed that nurses do not use Computer Information Technology (CIT) to the benefit of the clients. It was unclear what the perceptions of PHC professional nurses about CIT were. The purpose of this study was to explore and describe the perceptions of primary health care nurses with regard to the use of Computer Information Technology (CIT) with the purpose of recommending the actions to be taken by the nurse manager about computer information technology. In this study a quantitative, exploratory and descriptive design was used in order to obtain factual reasoning and information from professional nurses working at five (5) primary health clinics in the eastern part of Ekurhuleni. The total sample of professional nurses was n = 150. The method of data collection was a self-administered and structured survey- questionnaire that took 30 minutes to complete. Descriptive statistics were compiled by using the Statistical Package of the Social Sciences (SPSS) Version 20 software program. Validity and reliability were ensured by the judgments of the researcher and experts about whether the research instrument had covered the comprehensive set of facets that encompassed the concepts (the use of information technology at primary health care clinics). It also included pre-testing of the instrument to establish the consistency with which participants understood, interpreted and responded to all the carefully formulated questions in the survey-questionnaire. Ethical principles and standards for nurse researchers were adhere to. The findings indicated that there were aspects that need to be addressed in respect of the use of information technology in primary health care clinics. Limitations of study and the recommendations for nursing practice, management and research were discussed. This study determined the perceptions of nurses with regard to the use of computer information technology at the PHC clinics that lead to recommendations on the actions to be taken by the nurse managers about the use of computer information technology at PHC clinics.

Volunteer home-based caregivers are critical role players in South Africa‘s health care system and in the South African government‘s strategy to fight HIV and AIDS. In order to achieve the aims that the government seeks to attain, it is important that the care and treatment provided to patients receiving community home-based care (CHBC) be of a high quality. While the need for quality care is supported by government and civil society, research indicates that it is not clear whether quality care is indeed being provided and therefore there is a need for research into the quality of CHBC. The research aimed to undertake a critical assessment of CHBC programmes to determine the quality of care provided by volunteer caregivers using social capital theory as a theoretical framework. The study examined the quality of CHBC by analysing the context of CHBC, by investigating the support that volunteer caregivers and their clients receive and by discussing the support that volunteer caregivers and their clients still need. The study used one-on-one in-depth interviews and focus groups to obtain relevant data. The participants included volunteer caregivers, clients and supervisors who took part in the one-on-one interviews. The focus groups consisted of key informants and supervisors respectively. The quantitative data consisted of descriptive statistics which helped describe the participants. The qualitative data was coded and themes and sub-themes were developed. The data was also analysed by an independent coder. The results showed that poverty, and the related problems of poor living conditions and a lack of food security affects the quality CHBC. In addition, unemployment and the problem of stipends also affect quality CHBC. Certain socio-economic factors were also found to lead people to choose to become volunteer caregivers and unemployment was found to be an important driving force behind the choice to undertake volunteer caregiving. Furthermore, the volunteer caregivers in the sample received organisational support from their supervisors and their fellow caregivers or peers. They also received social support from their families and their communities. Regarding the clients of the volunteer caregivers, it was found that they received a number of types of support including psycho- iv social counselling, spiritual counselling and care of a holistic nature. In addition, the study found that there is a need for standardised quality training of volunteer caregivers, which will equip them with multiple skills. It was also found that volunteer caregivers require mentoring and quality supervision in order to be able to provide quality CHBC to their clients. Government has the ability to put the necessary systems and structures in place, such as a scope of practice for volunteers, standardised training and monitoring and evaluation, to enable CHBC and its relevant role players to operate at optimum levels. It also has the authority to make the changes and to enforce rules. Furthermore, it has the ability to unite CHBC organisations and can create the necessary conditions that can lead to increased social capital. Furthermore, the study recommends that two additional dimensions of quality care be added to existing dimensions of quality in health care. The first is the holistic approach to caregiving and the second is social support systems, namely supervisor/mentor and peer support and family and community support. This second dimension is also closely linked to social capital and the networks that make up CHBC.

A la fois phénomène social et institution juridique, il n’est d’organisation familiale qui échappe à la règle de droit. La place de chacun de ses membres est fixée en fonction d’un statut identifié. De singulière, la famille peut, dans ses rapports avec l’enfant, être plurielle. L’enfant et ses familles, nucléaires et élargies, n’existe que par ses liens familiaux. Son statut hétéroclite l’amène à coexister avec le groupe familial. Les schémas d’existence et de coexistence de l’enfant, de sa naissance à son décès, ne sont pas neutres juridiquement, tant les enjeux extrapatrimoniaux que patrimoniaux sont marqués. / At the same time social phenomenon and legal institution, it is not of family organization which escapes the legal provision. The place of each one of its members is fixed according to an identified statute. Of singular, the family can, in her relationship with the plural child, being. The child and his families, nuclear and widened, exist only by his family ties. Its heteroclite statute leads it to coexist with the family group. The diagrams of existence and coexistence of the child, of his birth to its death, are not neutral legally, as well the extrapatrimonial challenges as patrimonial are marked.

La presbyacousie est une maladie qui concernerait plus de 12 millions de Français mais qui reste peu connue. Si elle n'est pas traitée tôt, elle peut entraîner de graves complications comme des troubles de la communication, de la dépression et des troubles cognitifs. Le constat actuel est que très peu de presbyacousiques sont traités, et lorsqu'ils le sont, le résultat semble insuffisant. L'objet de cette thèse est de proposer à partir des connaissances actuelles, des solutions adaptées aux besoins de ces patients, du dépistage à la réadaptation. Trois études ont été menées : l'étude « AcoumAudio », déclinée en trois volets a montré que l'acoumétrie vocale était un bon test de dépistage de la surdité chez les personnes âgées, d'évaluation du degré de perte auditive et de mesure du gain auditif fonctionnel après réhabilitation ; l'étude 1 intitulée « Privation sensorielle auditive et fonctionnement cognitif chez le sujet âgé (ACADem) » a montré que le port d'un appareillage auditif pouvait préserver d'une dégradation cognitive ; et l'étude 2 intitulée « Faisabilité d'une Réhabilitation Conjointe Audioprothétique et Orthophonique pour les Presbyacousiques (FRéCAOP) » a montré qu'il était possible de proposer une prise en charge plus complète et efficiente de la presbyacousie, dans un circuit de l'audition du GRAPsanté, incluant nécessairement un Aidant / Presbycusis is a disease that occurs in more than 12 million French people, but which is still not well known. If it is not treated early, it can lead to serious complications such as communication disorders, depression and cognitive impairment. The current situation is that very few presbycusic patients are treated, and when they are, the result seems insufficient. The purpose of this thesis is to propose using current data, solutions tailored to the needs of these patients, from screening to rehabilitation. Three studies were conducted: the "AcoumAudio" Study, available in three components showed that the vocal acoumetry was a good hearing test to screen elderly people, to evaluate the degree of hearing disorders and to measure functional auditory gain after rehabilitation; Study 1 entitled "Auditory deprivation and cognitive functioning in the elderly" showed that wearing hearing aids could preserve from cognitive deterioration; and Study 2 entitled "Feasibility of a Conjoint Rehabilitation involving audiology and speech therapy for presbycusis (FRéCAOP)" showed that it was possible to offer a more complete and efficient management of presbycusis, in the hearing circuit of GRAPsanté, necessarily including a caregiver

Reports of people with mental disorders without access to treatment are a major occurrence in prisons outside and within Africa. An estimated 450 000 000 people worldwide suffer from mental or behavioural disorders. The disproportionately high rate of mental disorders in prisons is due to several factors. The factors include the widespread misconception that all persons with mental disorders are a danger to the public; the general intolerance of many societies to difficult or disturbing behaviour, the failure to promote treatment, care and rehabilitation, and above all the lack of or poor access to mental health services in many countries. Many of these disorders may be present before admission to prison and may be further exacerbated by the stress of imprisonment. However mental disorders may develop during imprisonment itself as a consequence of prevailing conditions. / Thesis (LLM (Human Rights and Democratisation in Africa)) -- University of Pretoria, 2011. / http://www.chr.up.ac.za/ / nf2012 / Centre for Human Rights / LLM

Thesis (MPH.) -- University of Limpopo, 2021 / Background: Chronic illnesses, including non-communicable diseases (NCDs), continue to be a public health concern, globally, and contribute to the high burden of diseases. These health challenges have led to the introduction of community health workers (CHWs) in both developed and developing countries as a way of dealing with these challenges. It is more than five years since ward-based outreach teams (WBOTs) were introduced into the Julesburg area in order to respond to the needs of the community, based on the government’s focus on quadruple burden of diseases. The researcher is aware of the increasing workload, unclear roles and responsibilities, different approaches to CHWs’ work taken, and the ever-changing focus of their work, based on the community needs and diseases that the community faces at a particular time. It is for this reason that the researcher is interested in understanding the CHWs’ experiences and the manner in which they cope with challenges when working in their ever-changing environment, workload, work focus and roles and responsibilities. Methods: A qualitative exploratory, descriptive and contextual study approach was used; data was collected using focus group discussions with CHWs and one-on-one interviews with key informants, using their supervisors to gather more information that could not have been shared by CHWs. Result: The findings from the focus group discussions revealed that the CHWs have a high workload, while receiving stipend and are not permanently employed. CHWs have had experiences that make them feel unimportant and not needed, as well as enduring poor working conditions without sufficient personal protective equipment (PPE). Even though they experience dissatisfaction, they are passionate about continuing with their community-based work for many years, evidenced by those who have up to 22 years of service.

Homosexuality is something which has been a part of almost every society throughout history. In western society this has been a subject of secrecy and taboo. Throughout our history homosexuals have been persecuted and forced to hide their sexual identity. The effects of this on an individual should be something of concern to professionals in the mental health field. While in the past there has been little knowledge of homosexuality, and no self-expression on the part of homosexuals, there has, in recent years, been growing information and expression. The effect of this change on mental health workers is what this paper will examine. An historical survey will present the forces which shaped the current attitude of the mental health profession about homosexuality. I will present a general examination of the social ideology toward homosexuality in western society. I will also review the history of those homosexuals who have banded together for companionship, reform, and protest. This will be a context against which I will examine the attitudes of a specific group of people who care for the mentally ill--nurses and aides at a state mental hospital. The questionnaire I used to examine their attitudes surveys a broad range of possible attitudes about homosexuality. The responses will demonstrate what changes have occurred in society’s attitudes toward homosexuality. It will show, specifically, what the attitudes are of those who care for economically disadvantaged, severely disturbed homosexuals.