Magister Commercii - MCom / The aim of this mini-thesis is to investigate the factors linked to access in the South African public health sector - using General Household Survey Data - in order to contribute to a better understanding of the role of access in achieving the National Department of Health’s primary goal of universal coverage. Even though the multi-dimensional interpretation of health system performance has gained acceptance and traction in recent years, much of the research linked to it remains supply-focused. The implicit truth is that demand-side health issues are largely ignored, under-researched and ominously absent from health policies. This is particularly true with regard to the access dimension of health performance, where research and policy focus almost exclusively on availability and affordability perspectives of access while neglecting demand-side aspects of health-seeking behaviour, such as acceptability. The study, therefore, pursues an in-depth exploration of access across its three dimensions - availability, affordability and acceptability - in the South African public health sector and aims to empirically investigate access to public health care from 2002 to 2012. It also identifies the underlying reasons for the observed trends, supplementing and reorienting the current understanding of access to public health care. The empirical findings reveal mixed results: it supports current literature by suggesting that equity has been achieved in terms of making public health care services more affordable, especially for the most vulnerable groups of South African society. However, acceptability and availability issues persist. It is safe to say that the availability of public health care – mainly a supply-side issue – is being addressed in the South African context with Government taking steps to address it. Unfortunately the same attention has not been given to issues of acceptability on the demand-side. Failure to fully understand the demand-side dimension of access and the role health-seeking behaviour plays in public health issues threatens to weaken health policies aimed at improving access. It is imperative that demand-side aspects of health-seeking behaviour and institutional responsiveness to health-demand occupy a more prominent role in South African public health debates, research and policy.

Magister Artium - MA / The extent of a community experiencing social vulnerability depends on the community’s ability to access resources that may contribute to coping mechanisms (either within the household or provided externally by a responsible authority) that decrease the impacts and effects of a disaster. Therefore, the purpose of this research was to identify the existence of social and institutional mechanisms that aim to reduce experiences of water inaccessibility and the causes of social vulnerability, and increase coping mechanisms within Kayamandi. Kayamandi is a low income residential community on the north-westerly periphery of the greater Stellenbosch town in the Western Cape. The research attained responses through questionnaires and surveys from residents,community organisations and responsible personnel. These surveys allowed the researcher to produce raw attribute data for each household that assisted in spatially representing vulnerable households and informing the five priority areas of the Hyogo Framework for Action. Contributing to this method of attaining information, secondary geographic data collection was obtained through the Stellenbosch Local Municipality, the National Geospatial Information Directorate and the National Demarcation Board. The findings of this thesis established that household and public water infrastructure contribute to the risk of experiencing social vulnerability that affects economic standings and quality of health within the community. Contributing to this and due to Kayamandi’s politically sensitive and historically fractioned community, social cohesion has also been noted as an area of vulnerability. Although these vulnerabilities are experienced, residents are able to implement technical, social and municipal reliant coping mechanisms. However, although efforts from Stellenbosch Local Municipality do respond to most of the key indicators within the Hyogo Framework for Action, the study found no concrete efforts within the Stellenbosch Local Municipality that illustrate integrated mechanisms to reduce the impacts of disasters and compound effects.

The purpose of the study was to assess the level of patient satisfaction with service provided in the Buffalo City sub-district following the implementation of the down-referral chronic medication distribution system between the tertiary(ELHC) and primary (clinics) levels of health care. The intervention was aimed at improving accessibility and availability of medication to the chronic patients. Research Design: A non-experimental descriptive quantitative research methodology was used. The sampling method for the study was the non-probability purposive sampling. Data was collected using a self-administered questionnaire that was given to respondents as they arrived at the facilities, and who, after completing the questionnaire, gave it back to the researcher. Findings: The results of the study revealed that the patients were generally satisfied about the down-referral chronic medication distribution system. However the patients were not satisfied about the services that they receive from the primary health care facilities when they go to collect their down-referred medication. Lack of communication to the patients regarding their medication by the hospital staff (pharmacists in particular) was a concern for patients. Conclusion: The down-referral chronic medication distribution system can benefit both the patients and the hospitals. Patient will receive their medication closer to their homes and save on the cost of transport. The hospital will have less patient congestion in the outpatient dispensaries and queues and waiting times will be reduced. Some strategies must be sought to improve the services at the primary health care facilities. The hospital should explore various communication methods to put into place, that will save pharmacists time and satisfy the needs of the patients. This would require the health services management from both the hospitals and the primary health care facilities to work together to ensure continued support for the patients.

Background: In Canada, Aboriginal women are disproportionately impacted by HIV and are tested later in disease progression, resulting in poorer health outcomes and increasing the risk of onward transmission. Methods: Using purposive sampling, 13 self-identified Aboriginal women participated in in-depth, qualitative interviews exploring women’s experiences with HIV testing and their ideas for improving the process. Thematic analysis was conducted in conjunction with constant comparison to identify emergent themes and to direct future interviews and analyses. Results: Women identified several barriers to HIV testing converging on the subjects of insufficient knowledge of HIV and HIV transmission, lack of perceived relevance of HIV testing, unwillingness or inability to confront the need for testing, and judgment from self and others regarding engagement in HIV-related risk-behaviours. The women also described their acceptable and unacceptable testing experiences, presented recommendations for increasing HIV testing uptake, and suggested ways to create the ideal testing experience. The findings demonstrate a clear need for stronger engagement of Aboriginal women surrounding their HIV-related testing needs and increased access to educational opportunities, culturally appropriate care, and initiatives aimed at reducing societal stigma around HIV.

This diploma thesis is dedicated to the field of Human-Computer Interaction (HCI), which covers user friendliness, usability and further aspects of interaction between computer and a human. According to the assumptions of author this field is not favourably promoted during the educational process of the Czech IT experts at Czech universities. Knowledge of HCI is one of the crucial factors of development of effective information systems. The first key part of this thesis contains evaluation of education in HCI at Czech universities. In the second key part the author proposes a subject of HCI, which could be thought at Czech universities. Finally the reached goals are compared with the set ones.

Within the project Maps without Barriers realized under Charta 77 Foundation - Barriers Account, in 2015 we intend to map accessibility of buildings and its premises from the perspective of people with limited mobility. We plan to inspect nearly 600 castles, palaces and other tourist attractions in the Czech Republic. The acquired data will be gathered and published as an on-line map in form of open and machine-readable data. It will also appear as Linked Open Data. However, the project will not end with mapping premises, the main objective is to provide a solid foundation for a unified database of accessibility of buildings and its premises. Negotiations with institutions and organizations interested in mapping are in progress and we try to offer them our project platform for publication of their data. The required RDFS vocabulary will be designed and carried out as part of this diploma thesis. It will be tested on the data from a number of forms describing existing objects. The data will be gathered by means of services designed in terms of this theses and provided for purchasers and users equally.

Research on urban travel represents an important area in geography, transportation planning and urban studies. Compared to the traditional trip based approach, the activity based approach offers a better understanding of the motivations underlying travel, that is, activity participation. Urban activity-travel is complex as it takes place both in space and time. Building upon the time geography framework, this study provides new ways to characterize urban activity-travel and examine the association with accessibility. A new optimization model incorporating complex urban travel is also proposed for service provision planning. Activity space represents an important concept for understanding human activity-travel. The geometry based approaches widely used for delineating activity spaces are limited in fully characterizing real-world travel behavior. To address the issue, Chapter 2 proposes a new time geography based approach to more accurately portray urban activity spaces. The proposed approach takes into account the full complexity of real-world travel and underlying urban structures. Results of an empirical study are presented based on the 2008 Add-on National Household Travel Survey conducted in Tucson, Arizona. Activity spaces of 1,164 sample travelers are delineated and analyzed. Results show the effectiveness of the new approach in more realistically depicting urban activity-travel. Understanding the impact of the built environment on travel is important for formulating effective travel reduction policies. In Chapter 3, a study is presented to examine the relationship between accessibility to urban opportunities and urban travel. Activity spaces are drawn to characterize the spatial extent of activity-travel, and a new accessibility measure is introduced to account for the complexity of urban travel. An empirical study based on a travel survey dataset in Tucson, Arizona shows that improved accessibility is generally associated with reduced travel, but such an effect varies across different activity types. In addition, employment status and trip-chaining behavior can be used to explain the varying influences on the accessibility-travel relationship. In Chapter 4, a new multi-objective location model is developed with the goal of accessibility maximization. The model extends the classic p-median problem (PMP) to account for accessibility in a more realistic manner. Trip chaining and activity space are incorporated into the location model. In addition to fixed home locations, stops along chained trips are allowed for potential service site visits. The model is applied to locate service facilities in Tucson, AZ. Alternative versions of the objective function are solved exactly with the resulting sets of optimal facility locations displayed and analyzed. Decision makers are given flexibility to determine the relative importance for each of three sub-objective, based on the type of services being located, their preferences and practical needs.

Public transportation is important today due to all the problems connected to the use of cars. To avoid these problems like pollution and traffic jams people need to use the public transportation systems more frequently. Many people today are used to the idea of their cars as a primary way of transportation due to the flexibility it provides. To make them think twice before using the car they need to find a sustainable and flexible substitute to the car, maybe public transportation could be that. This thesis aims to identify possibilities for development in the public transportation system. To do so some inhabitants in the municipality of Österåker have been interviewed about their opinion towards the public transportation. The results from the interviews have been thematically coded to be able to find common themes within the answers. The results show that the public transportation system is sufficient to use when commute to and from work, but not adequate enough within the municipality during leisure time or trips for service. This could mirror the opinions of the interviewed inhabitants that the public transportation is time consuming and lack flexibility. To work around these the municipalities and the public transportation companies need to work together to be able to change people’s views and behavioral towards the public transportations.

A universalização do acesso ao conteúdo disponibilizado em sistemas Web tem se tornado crucial para que todas as pessoas, independente de deficiências ou de outras restrições possam ter acesso a ele. Diversos estudos indicam que, apesar da instituição de leis federais sobre acessibilidade para conteúdo Web em diversos países, muitos sítios ainda apresentam problemas. A falta de conscientização das pessoas envolvidas em projetos de desenvolvimento Web sobre a acessibilidade e a não utilização de técnicas adequadas para desenvolvimento de aplicações têm um impacto considerável sobre a acessibilidade. Levantamentos foram realizados com o objetivo de identificar características dos desenvolvedores sobre o conhecimento e uso de técnicas para acessibilidade. Entretanto, os estudos realizados investigaram somente o uso de um conjunto restrito de técnicas e, além disso, também não investigaram a correlação entre as respostas obtidas pelos participantes e o nível de acessibilidade das páginas desenvolvidas por eles. Neste trabalho, propõe-se efetuar um levantamento sobre a percepção de acessibilidade e uso de técnicas para desenvolvimento de sistemas Web considerando acessibilidade com pessoas envolvidas em projetos de desenvolvimento Web no Brasil de diferentes áreas de atuação. Este levantamento foi acompanhado de avaliações de acessibilidade automatizadas com uso de métricas sobre sítios desenvolvidos pelos participantes, para verificar a influência dos fatores investigados na acessibilidade dos sítios e na percepção de acessibilidade dos participantes. O levantamento realizado contou com a participação de 613 participantes de todo o Brasil. Os resultados indicaram que no Brasil a percepção da acessibilidade por pessoas que participam de projetos de desenvolvimento Web ainda é bastante limitada. Mais do que promover o treinamento das pessoas envolvidas em projetos sobre questões técnicas, é necessário promover maior conscientização sobre a acessibilidade e sobre os problemas que pessoas com diferentes restrições e habilidades enfrentam ao utilizar a Web. / Universal access to content in Web based systems is an essential aspect to enable everyone to have access to it, regardless of disabilities or any other restrictions. Several studies indicate that, although federal legislation regarding to Web accessibility have been promulgated in many countries, accessibility is still an issue for many Web sites. The limited awareness of accessibility by people involved in Web development and the lack of appropriate use of development techniques in the development of applications have a deep impact on accessibility. A few surveys have been carried out to identify the main characteristics of Web developers regarding accessibility concepts and techniques for accessibility. However, the studies reported up to this date have only investigated the use of a restricted set of techniques by developers. Besides, they have not addressed the analysis of the correlation between the answers provided by the subjects and the accessibility level of their Web pages. The proposal of the work presented in this master\'s thesis is the development of a survey on the accessibility awareness and on the use of techniques for accessibility by people involved in the development of Web based systems. Automatic metric based accessibility evaluations on the Web sites developed by the subjects were carried out to support the investigation of the impacts that the issues investigated have on the Web pages accessibility and on the accessibility awareness. The survey was answered by 613 subjects from all Brazilian states. The results show that in Brazil the accessibility awareness is still very limited. Training people involved in Web projects on technical issues alone is not enough. It is necessary to promote a wider awareness of accessibility and of the problems people with different restrictions and abilities deal with when using the Web

A interação com aplicações Web está se tornando cada vez mais presente no dia-a-dia das pessoas, sendo útil para a disponibilização de recursos que permitem a realização de serviços, estudos ou entretenimento. Porém muitos dos recursos disponibilizados apresentam barreiras em relação à acessibilidade, impedindo que usuários finais, com algum tipo de deficiência, possam utilizá-los de forma eficiente. Como solução para esse problema, têm sido propostas diretrizes para o desenvolvimento de aplicações Web acessíveis. Entretanto, apesar da existência dessas diretrizes, o cenário atual ainda mostra que há dificuldades em relação ao desenvolvimento considerando requisitos de acessibilidade. Neste sentido, esta tese está calcada na criação de uma abordagem que permita o apoio efetivo a boas práticas para desenvolvimento Web, a partir da aproximação de tais diretrizes ao ambiente das equipes de desenvolvimento. Para tanto, são definidas atividades separadas em 3 eixos de preocupações: Treinamento em Acessibilidade, Gerência de Decisões e Desenvolvimento e Ferramental. Para validação da concepção inicial da proposta desta tese, estudos de caso são detalhados, demonstrando como o desenvolvimento Web pode ser beneficiado com melhor apoio ferramental, que incluem o uso de técnicas de modelagem e de padrões para geração de código acessível. São ainda verificados os benefícios da colaboração de experiências e treinamento da equipe de desenvolvimento, para tanto foi desenvolvida a ferramenta AccessibilityUtil. Posteriormente é descrita a abordagem e validada em um experimento controlado em que existiram grupos de participantes utilizando a abordagem e outros que não fizeram uso da mesma. Com isso, observou-se que, com a utilização da abordagem, houve melhor apoio a boas práticas de desenvolvimento em relação à aplicação de requisitos de acessibilidade, o que ocasiona em melhores resultados de qualidade para as aplicações Web. / The interaction with Web applications is becoming increasingly present daily, being useful to provide resources that allow the execution of services, education or entertainment. But many of the resources present barriers in relation to accessibility, hindering disabled users use them efficiently. As solution to this problem, guidelines to develop accessible Web applications have been proposed. However, despite the guidelines definition, the current scenario shows that there are difficulties related to the development considering accessibility requirements. Thus, this thesis focus on proposing an approach to support good practices for Web development, based on the use of these guidelines to the development team environment. Therefore, activities are defined on 3 layers: Accessibility Training, Decisions Management, and Development and Tooling. In order to validate the initial design of this thesis proposal, case studies were detailed, presenting how the Web development can be benefited through the tool support, including the use of modeling techniques and patterns for accessible code generation. Additionally, the benefits with the experience collaboration and training of the development team are also verified, to allow this the tool AccessibilityUtil was developed. After this, the approach is described and validated in a controlled experiment, where groups were defined with and without the approach use. As conclusion, we verified benefits using the approach, since that was identified a better support on development best practices regarding to the use of accessibility requirements, which results in a better quality for accessible Web applications