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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
111

Sjuksköterskors erfarenheter av att arbeta kliniskt med Comprehenssive Geriatric Assessment- CGA på en geriatrisk akutvårdsavdelning : En empirisk studie

Estehag Johannesson, Anna January 2015 (has links)
Syftet var att granska sjuksköterskans dokumentation avseende intagningsorsak, andra identifierade problem/behov utefter CGA och vilka åtgärder det ledde till samt beskriva sjuksköterskans erfarenheter av att använda instrumentet CGA. Metod: Studien har en beskrivande design med kvantitativ och kvalitativ ansats. Totalt granskades 50 bedömningsinstrument och datajournaler. Frågeformulär utformades och 13 sjuksköterskor valde att delta. Journalgranskningarna utfördes med kvantitativ retrospektiv analys och frågeformulären analyserades enligt kvalitativ manifest innehållsanalys. Resultat: Under journalgranskningen framkom 11 olika intagningsorsaker där försämrat allmäntillstånd var den största gruppen. Totalt identifierades 205 problem/behov och 186 initierade åtgärder varav 7 åtgärder/person var högsta antal. Flest initierade åtgärder fanns inom nutrition, social bakgrund och fallrisk. Sjuksköterskornas erfarenheter av att använda CGA var att det fanns behov av tydliga arbetsrutiner gällande CGA, att CGA fungerade bra som checklista men var tidskrävande. De upplevde att CGA gav dubbelarbete men viljan fanns att använda CGA men däremot svårt att få det att fungera i arbetet samt att sjuksköterskorna identifierade problem/behov utan att använda CGA. Sjuksköterskorna upplevde inte att omhändertagandet förändrades men däremot fick teamet helhetsperspektiv på patientens livssituation. Samverkan med anhöriga och kommunen var viktigt. Slutsats: Studiens resultat visade att förutom inskrivningsorsak fanns även andra identifierade problem/behov utefter CGA som hade stor betydelse för att den äldre skulle uppleva hälsa. Sjuksköterskorna upplevde brister inom rutinen runt CGA samt erfor att sjuksköterskornas omhändertagande av den geriatriska patienten inte förändrades efter implementeringen av CGA. / Aim was to examine nurses documentation regarding admission cause, other identified problems/needs by the CGA and the actions that led to and describe nurses experiences of using the instrument CGA. Method: The study has a descriptive design with quantitative and qualitative approach. Total audited 50 assessment instruments and data records. Questionnaires were designed and 13 nurses chose to participate. Journal audits performed by quantitative retrospective analysis and the questionnaires were analyzed by the inspiration of qualitative manifest content analysis. Results: In the journal audit identified 11 different admission causes which reduced general condition was the largest group. Total identified 205 problems/needs and 186 initiated measures which 7 action/person was the highest number. Most measures were initiated in nutrition, social background and risk of falling. Nurses experiences of using the CGA was that there was a need for clear work procedures regarding the CGA, the CGA worked well as a checklist but was time consuming. They felt that the CGA gave duplication but the desire was to use the CGA but hard to make it work at work and the nurses identified problems / needs without using the CGA. The nurses did not feel that the care was changed but got the team holistic view of the patients life situation. Collaboration with families and the municipality was important. Conclusion: The study results showed that in addition the cause enrollment were other identified problems/needs along the CGA that had great importance for the elderly would experience health. The nurses experienced deficiencies in routine around the CGA and required that the nurses taking care of the geriatric patient did not change after the implementation of CGA.
112

Lucro abrangente e o risco de companhias brasileiras de capital aberto / Comprehensive income and the risk of Brazilian public companies.

Carlos de Lima Silva 02 October 2015 (has links)
A presente pesquisa objetivou verificar se medidas contábeis calculadas por meio do lucro abrangente e de seus componentes são relevantes na explicação do risco das empresas. Para isso, analisou-se amostra composta por 105 companhias brasileiras de capital aberto com ações negociadas na BM&FBovespa. Foram selecionadas empresas não financeiras com dados disponíveis no período compreendido entre o primeiro trimestre de 2011 e o primeiro de trimestre de 2015, sendo excluídas empresas com ações de baixa liquidez. Inicialmente, avaliou-se por meio de análise de estatísticas descritivas e do Teste de Wilcoxon se o lucro abrangente é mais volátil que o lucro líquido. Esta primeira hipótese de pesquisa não foi refutada e se constatou que, para as empresas que compõem a amostra estudada, a volatilidade do lucro abrangente foi 30,84% superior à volatilidade do lucro líquido, evidenciando que a análise focada única e exclusivamente no lucro líquido induziria o usuário da informação contábil a ignorar possíveis fontes de risco da empresa. Para a análise da relevância do lucro abrangente e de seus componentes na explicação do risco, foi feita análise de regressão com dados em painel por meio de oito modelos estimados, cada qual com diferentes variáveis explicativas e abordagens de risco, estimado por meio da volatilidade dos retornos das ações (risco total) e do beta de mercado (risco sistemático). Os resultados apresentados evidenciaram que a relação entre a volatilidade do lucro abrangente e o risco da empresa é superior àquela observada entre a volatilidade do lucro líquido e o risco, porém tal relação não se mostrou estatisticamente significante. Todavia, verificou-se que a volatilidade do valor referente a outros resultados abrangentes possui relação negativa e estatisticamente significante com seu risco sistemático. Ganhos e perdas com hedges de fluxo de caixa e com ativos financeiros classificados como disponíveis para venda apresentaram relação negativa e estatisticamente significante com o risco da empresa, o que, de acordo com estudos anteriores, deve-se ao fato de que resultados não realizados estariam além do controle dos gestores. As evidências apresentadas pelo presente estudo corroboram a importância do assunto, fornecendo insumos para discussões sobre políticas contábeis relacionadas ao lucro e para o desenvolvimento de métricas contábeis para a avaliação do risco das empresas. / This research aimed to verify if the comprehensive income and its components are relevant in explanation of the firm risk. Thus, it analyzed sample of 105 Brazilian public companies listed on the BM&FBovespa. Non-financial companies with available data from the first quarter of 2011 to first quarter of 2015 were selected, being excluded companies with low stock liquidity. Initially, it was evaluated by analysis of descriptive statistics and the Wilcoxon test if the comprehensive income is more volatile than net income. This first research hypothesis was not refuted and found that for the companies in the sample, the volatility of comprehensive income was 30.84% higher than the volatility of net income, showing that an analysis focused exclusively on net income induce the accounting information user to ignore possible sources of firm risk. For the analysis of the relevance of comprehensive income and its components in risk explanation, regression analysis was done with panel data through eight estimated models, each with different explanatory variables and risk approaches, estimated by the volatility of stock returns (total risk) and market beta (systematic risk). The results showed that the relationship between the volatility of comprehensive income and the company\'s risk is greater than that observed between the volatility of net income and risk, but this relationship was not statistically significant. However, it was found that the volatility of the value related to other comprehensive income has negative and statistically significant relationship with its systematic risk. Gains and losses from cash flow hedges and financial assets classified as available for sale showed a negative and statistically significant relationship to the risk of the firm, which, according to previous studies, is due to the fact that unrealized results would be beyond the control of managers. The evidence presented in this study confirm the importance of the subject, providing inputs for discussions on accounting policies related to income and to the development of accounting metrics for risk assessment of companies.
113

Sexuality health programs curricula assessment

Shaughnessy, Erin January 1900 (has links)
Master of Science / Department of Programs in General Human Ecology / Karen S. Myers-Bowman / The alarming incidence of sex-related health problems among American adolescents has health educators searching for effective curricula-based programs aiming at behavioral changes. Such desire and urgent need to find or create programs and curricula that work have generated different approaches, philosophies, and educational strategies. However, this also may have produced a number of programs that have not benefited from a careful and thorough evaluation: neither evaluation of content, message, and cognitive and/or behavioral effect. The focus of this paper is on the curricula utilized in sexuality health programs in middle and high schools. Questions arise about the impact of these programs. Currently, abstinence-based programs are the only ones funded by the government. Research data does not convincingly show that abstinence-only sexuality education significantly decreases the number of adolescents engaging in sexual intercourse prior to marriage. This paper attempts to review current research about abstinence and comprehensive curricula. I begin by discussing the different approaches and their supporters. The importance of adolescent development and theory will be incorporated into my review. Effectiveness of each approach, as well as evaluation studies will be examined. From this review, I composed my own assessment of one abstinence-based curriculum and one comprehensive based curriculum.
114

Bemästra, bistå eller både och? : En kritisk studie av Provincial Reconstruction Teams roll och agerande i Afghanistan

Birkeland, Jacob January 2011 (has links)
The specific task of this thesis is to illustrate the complexity of a cooperation between civilian and military entities by examining Provincial Reconstruction Teams (PRTs) and their role as an actor among others in the field in a war-torn Afghanistan. By using counterinsurgency strategy as an analytical framework it has been possible to examine the civilian and military contexts closer. Underlying structures concerning the norms and interpretation of reality of the PRTs has been partly revealed. Studies of the PRTs as one significant bearers of "the comprehensive approach", which includes a holistic approach regarding the use of civilian and military capabilities, new conclusions can be drawn on whether a general civil-military approach can be a part of the solution for current and future conflicts. Based on the counterinsurgency strategy, the author has identified three themes as bearing and thus appears through the thesis as a foundation. These are Coordination, Development and Security. The empirical material is filtered through these themes as they are central to counterinsurgency and there by affect the PRT-concept. This study leads to five conclusions regarding the integration of the civilian and military contexts. In summary the conclusions states that it seems to be no starting points for creating a robust culture for cooperation. The absence of common objectives regarding operation, competition between different narratives as well as parallel processes of development and security risks causing a counterproductive outcome. A single resonance must be allowed to emerge from a convergence of civil and military powers as to what should be the civilmilitary mission. With mutual trust and dialogue improved conditions can be shaped to build common ground and goals for what needs to be done in countries with similar problems like Afghanistan.
115

Application of polychlorinated biphenyl signatures for environmental fingerprinting

Megson, David Peter January 2014 (has links)
Polychlorinated Biphenyls (PCBs) are a group of 209 ‘man-made’ chlorinated organic compounds that were widely used in the 20th century for a variety of industrial uses. PCBs were first commercially produced in the 1929 and were manufactured until the 1980s when their use was phased out due to environmental and human health risks. However, due to their widespread use and persistence they are ubiquitous in the environment and remain a contaminant of concern. The structural properties that determine the persistence of PCBs in humans were therefore elucidated by statistical analysis of data from the National Health and Nutrition Examination Survey (NHANES). PCBs with chlorine bonding in the 2,5-and 2,3,6- positions (and 2- in di- and tri-chlorinated congeners) were rapidly biotransformed and so can be classed as episodic congeners whereas PCBs with chlorine bonding in the 2,3,4-, 2,4,5-, 3,4,5-, and 2,3,4,5- positions were more resistant to biotransformation and can therefore be classed as steady state congeners. A fundamental requirement of using PCB signatures for environmental fingerprinting is an effective analytical method capable of producing high resolution signatures from biological samples. An extraction and clean-up method was developed that was successfully applied to different biological matrices (blood and tissues). A two dimensional gas chromatography with time of flight mass spectrometry (GCxGC-ToFMS) method was designed and optimised to provide a congener specific method capable of identifying 200 out of the 209 PCBs, with detection limits in human serum in the range of 1 to 10 ng g-1 lipid. The extraction and detection methods were used to determine the source of PCB contamination and age date exposure in workers at a transformer dismantling plant. A total of 84 different PCB congeners were identified in the sera of 30 workers with concentrations of the 7 indicator PCBs ranging from 1.2 - 39 μg g-1 lipid. Analysis of PCB signatures was able to distinguish recent from prolonged exposure and also identified an additional source of inhalation exposure in a subgroup of workers. Analysis of 12 different tissue types obtained from the common guillemot (Uria aalge) suggested a high degree of perpetuation between the PCB signature in different tissue types. This shows that comparative assessments can be undertaken between animals using different tissue types and that small (1 g) samples of blood can be used as a non-lethal sampling technique. The regional provenance of 25 wrecked Leach’s storm petrels (Oceanodroma leucorhoa) was also determined using PCB signatures. Results from GCxGC-ToFMS analysis revealed distinctively different PCB signatures in birds from Canada and Europe. The findings reported in this thesis enhance our understanding of PCB signatures in the environment and show how they can be used effectively to age date and identify the source of exposure in humans and animals.
116

Discursive designing theory : towards a theory of designing design

Faust, Juergen January 2015 (has links)
Motivated by the immature theoretical framework of design, this thesis employs transdisciplinary discourse to provide a contemporary and forward-looking model of design and design theory, as well as the linkages between the two, along with the necessary methodology. The discourse involves research into the current understanding of design, its principles, its practice and conceptual framework. The methodology developed and employed in this thesis can be outlined in five steps: 0. Design briefing 1. Developing a conceptual model based on the writings of Michel Foucault and Helmut Krippendorff. 2. Presenting the model in a written form. 3. Using accounts of conferences as tools for Designing Design and building monuments. 4. Interrogating the theory through an expert system. 5. Summarising and evaluating the findings. Design Briefing The present study delves into design, and into the design of theory. In Chapter A.1.6, a summary of Chapter A.0−A.1.5 is given, highlighting the underlying discourse. As shown, the theory behind this work is based on a hypothesis, which cannot be proved experimentally, or deduced from experimental data, at least at the time of its construction. Therefore, it needs to be understood that the case studies (A.3.2−A.3.5) in this thesis are not intended to serve as experiments that were conducted in order to prove the theory; rather, these case studies are design cases—products and artefacts—and should be viewed as discourse frameworks that can be adopted to design design. As described in Chapter 3.1, these are elements of monuments—in reference to Raichman (1988)—that have resulted from the discursive strategies and were designed within a community of designers, allowing the design understanding to be shaped. Methodologically, the theory is created through an indication of differences. These differences were elaborated on in the literature review, and can be explained using either logic-based or hermeneutical metaphors. As the latter approach is more flexible, it might be more applicable to the design environment. The generated knowledge can be located in three areas—design knowledge, epistemology, methodology (the process to get there), and phenomenology (the composition of the artefacts). While the main focus of this thesis has been on theory design, it was also important to delineate how to get there, as well as analyse the questionable differences between theory and practice, since they are ideal types that mark the extreme ends of a continuum (Jonsen and Toulmin 1988, p.36). The work presented in this thesis was conducted in a circular manner, like a design process, in order to encapsulate the instance. Therefore, essential topics reappear, allowing them to be reframed and newly contextualised. Chapter 0.0 to 0.7 reperesent the introductory part of this work. Thus, the content presented could be referred to as ‘the briefing’—as a parallel to a design case—to provide the background. It shows the motivation, a first hypothesis, some methodological considerations, and the research design and decisions. The aim is to provide insight into the phenomenon of interest and discuss some preconceptions. Thus, these introductory chapters provide orientation through locating some statements of the provided (design) discourse. Developing a conceptual model based on the writings of Michel Foucault and Helmut Krippendorff. As a follow up, Section A consists of several key components, and encompasses the research methodology specificity, its theoretical underpinning, and its connection to design, a reframing and contextualisation. This section also provides the means to overcome the discrepancy between researching and designing. Therefore, in Chapter A1−A1.6, a more substantial discourse of design is provided, along with the theory and the essential knowledge. Here, we can see the method in operation, as a patching of discursive statements—akin to an additive process of designing. Clearly, the attempt made here belongs to the constructivist epistemology, as the idea of design is a mental construct. Nonetheless, the aim is to provide a broad perspective of what can be presently observed in the design field. The employed methodology strategically aims to overcome the divide between designing and researching—between acting and reflecting—in order to provide a conceptual model. Still, it also makes the designing practice a conscious process, whereby theory is designed through discourse. Such discourse is revealed within the discovery of textual statements based on an extensive literature review, as well as through the discovery of textual statements from organised interactive conferences. The theory developed here is, in fact, a theory derived from theory, and is shaped through finding patterns and the simplification of the overall structure they form. In A.2, the concept of discourse and its designing quality is revealed. It shows how discourse, as the guiding method, is ‘excavated’ from the writings of Michel Foucault and Helmut Krippendorff. Methodologically, Michel Foucault’s ‘Archeology of Knowledge’ was analysed against and parallel to Helmut Krippendorff’s ‘Semantic Turn’, as these sources are complementary to each other. The goal of this process is a comparison of statements, yielding reasoning towards discourse and design discourse. In sum, this analysis helped reveal that it is a matter of design how the discourse is provided. The outcome of the aforementioned comparison is very interesting and satisfying. The findings revealed a difference in discourse, because engineering and design discourses are informed by rhetoric of design, rhetoric of deliberation, in opposite to humanistic discourse, which consumes textual objects (Perelman 1999). The discursive designing process within these chapters reveals some important elements, such as the conceptual frame of politics, referred to in Foucault’s discourse explorations. According to the author, power is a generating force in shaping discourse (Faucault 1980, p.119). In contrast, Krippendorff (1995b) sees power as emanating from language, which can be overcome through avoiding the construction of certain language. In the research presented, the designing practice that took place during the conferences, as well as the aforementioned notions, play a role, as was shown in Chapter 3. Power, as it was experienced, is unavoidable. Yet, rather than seeing it as a problem, it should be viewed as a generating force. A second more substantial question arises around the notion of discontinuity (A.2.3), which is essential in Foucault’s concept. According to Krippendorff, knowledge is not partitioned; it rather provides continuity through the various disciplines. As this research shows, this view should not be seen as an opposite to Foucault’s concept of discontinuity, because statements can refer to the same object, but coming from a discontinuous field, from various disciplines. In other words, as design discourse can be viewed as a discourse hosted by various disciplines, it is discontinuous! With respect to Foucault’s concern of grasping of statements, the main goal of this thesis is to provide support for this perspective. As the author noted, the grasping of the statements needs to follow the exact specificity of their occurrence (Foucault 1972). The prudence and success of dissociating statements from their original context to place them in a new context is questionable, since no discontinuity can be ignored (Foucault 1972). Often, rather than paraphrasing the text so that it reflects one’s own understanding of it, the result is a mere citation of the original texts and con-texts. The awareness of discontinuity does not allow for this thesis to be presented according to the positivistic paradigm.
117

The perception of patients regarding comprehensive care rendered by Clinical Nurse Practitioners in the West Coast rural district in the Western Cape

Van Heerden, Petro 03 1900 (has links)
Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Primary Health Care (PHC) provide a quality, comprehensive health service to the community, based on the principles of equity, affordability, accessibility and community participation. It is a nurse driven service with the Clinical Nurse Practitioner (CNP), a registered nurse specialising in the clinical elements of primary, secondary and tertiary prevention at the forefront. It is against this background that this study was endeavored to investigate the community’s perceptions and lived experiences of the quality of care being rendered by CNPs in the West Coast rural district of the Western Cape. The objectives of this study included the following: - To explore and describe the perceptions of patients in the West Coast rural community regarding the attitudes, knowledge and skills of CNPs. - To provide policy makers with feedback and possible recommendations with regards to the implementation of this nurse driven PHC service. - To provide recommendations for improvement of the existing curricula at nursing education institutions based on whether the current training meets patients’ needs and thereby possibly influence curricular change. A qualitative, descriptive, research design was used. The guideline by Colaizzi (as cited in Streubert & Carpenter, 1999:14) was used for data collection and analysis. Twenty-six participants took part in five different group interviews. Semi-structured, open ended questions were used to encourage the participants to actively partake. Each interview was audio taped and field notes were taken. Thematic analyses was performed to highlight three main themes, i.e. the attitudes of the CNPs, the knowledge and skills of CNPs, and the impact of the current training programmes on the quality of care being rendered by these CNPs. Written approval from the Ethics Research Committee, University of Stellenbosch, as well as from the Research unit of the Western Cape Department of Health was obtained. Prior informed consent was further obtained from each participant, after being assured of voluntary participation, confidentiality and anonymity. Credibility, dependability and transferability were ensured by returning to two participants who validated that the transcripts were a true reflection of their experiencesand opinions. This study concluded that patients perceived CNPs as being unfriendly, uncompassionate and unprofessional. Dissatisfaction with the prevalence of unjust practices due to family members and certain race groups being attended to first by CNPs, were expressed. Participants found the competency levels of CNPs more than adequate when assessing, examining and providing health information and medicine. However, they expressed the need that CNPs should be able to prescribe a greater variety of medicines and perform more diagnostic tests than currently permitted by the scope of practice as set out by the South African Nursing Council. Therefore, these views of the participants indicated that the current postgraduate training programme do fulfill their health needs, although the need for expansion of the role and function of the CNP were expressed. Recommendations made included: - An in-depth investigation into the alleged rude attitudes of CNPs should be undertaken, soas to improve the professional behavior of CNPs towards patients. - Applicable policy makers should consider expanding the roles and functions of the CNP. - Enforcing continuous, professional competency through adequate and productive in-service training programmes. In conclusion, this study showed that CNPs need to be constantly aware that they work with human beings, with feelings and with health needs. The need for a therapeutic environment is thus crucial to the rendering of a quality, comprehensive service to the community they serve. / AFRIKAANSE OPSOMMING: Primêre Gesondheidsorg (PGS) voorsien ’n kwaliteit, omvattende gesondheidsdiens aan die gemeenskap, gebaseer op die beginsels van gelykheid, bekostigbaarheid, toeganklikheid en gemeenskaps-betrokkenheid.Dit is `n verpleegaangedrewe diens met die Kliniese Verpleegspraktisyn (KVP) wat gespesialiseerd is in die kliniese elemente van primêre, sekondêre en tersiêre voorkoming, aan die voortou. Dit is teen hierdie agtergrond wat hierdie studie aangepak is, ten einde ondersoek in te stel aangaande die gemeenskap se persepsies en geleefde ervarings van die kwaliteit van sorg wat deur KVPs in die plattelandse Weskusdistrik van die Wes-Kaap gelewer word. Die doelwitte van hierdie studie het die volgende ingesluit: - Om die persepsies van pasiënte, rakende die ingesteldhede (gedrag), kennis en vaardighede van KVPs te ondersoek. - Om toepaslike beleidsmakers metterugvoer en moontlike aanbevelings te voorsien aangaande die implimentering van verpleegaangedrewe, PGS. - Om aanbevelings te maak vir die verbetering van bestaande kurrikula aan verpleegopleidingsinstellings op grond van óf die huidige opleiding in pasiëntbehoeftes voorsien, en sodoende kurrikulumverandering moontlik te beïnvloed. ’n Kwalitatiewe, beskrywende navorsingsontwerp is gebruik. Die raamwerk van Colaizzi (soos beskryf in Streubert & Carpenter, 1999:14) is tydens datainsameling en analiese gebruik. Ses-en-twintig deelnemers het aan die vyf verskillende groepsonderhoude deelgeneem. Semi-gestruktureerde, oop-einde vrae was gebruik om die deelnemers aan te moedig om aktief aan die besprekings deel te neem. Elke onderhoud is op oudio band opgeneem en veldnotas is gemaak. Tydens analiese is drie hooftemas geïdentifiseer, nl die houdings van KVPs, die kennis en vaardighede van die KVPs sowel as die impak van die opleidingsprogram op die kwaliteit van sorg wat deur KVPs gelewer word. Skriftelike toestemming vir die studie is by die Etiese Navorsingkommittee, Universiteit van Stellenbosch, asook die Navorsingseenheid van die Wes- Kaapse Departement van Gesondheid verkry. Voorafgaande toestemming is voorts vanaf elke deelnemer verkry, nadat hulle verseker is van vrywillige deelname, konfidensialiteit en anonimiteit. Geloofwaardigheid, afhanklikheid en oordraagbaarheid is verseker, deur na twee van die deelnemers terug te gaan wat die transkripsies geverifieër het as juis en korrek. In hierdie studie is tot die slotsom gekom dat pasiënte KVPs as onvriendelik enongevoeligervaar het. Onbillike praktyke kom steeds voor, deurdat familielede en sekere rassegroepe voorkeur behandeling kry. Deelnemers se ervarings aangaande die bevoegdheid van KVPs was as toereikend beskryf aangaande die assessering, ondersoek en voorsiening van gesondheidsinligting en medisyne. Hulle het egter ook die behoefte uitgespreek dat die KVP’s `n groter verskeidenheid medisyne behoort voor te skryf en meer diagnostiese toetse behoort te kan uitvoer as wat tans binne die bestek van praktyk, soos neergelê deur die Suid-Afrikaanse Raad op Verpleging, moontlik is. Hierdie persepsie van die deelnemers impliseer dat die huidige nagraadse opleidingsprogram voldoende is en hul gesondheidsbehoeftes aanspreek. Die behoefte vir die uitbreiding van die rol en funksie van die KVP is egter uitgespreek. Die aanbevelings wat gemaak is sluit in: - ’n In-diepte ondersoek oor die onbeskofte ingesteldhede van KVPs behoort uitgevoer te word, ten einde die professionele gedrag van KVPs teenoor pasiënte te verbeter. - Beleidmakers behoort die uitbreiding van die rolle en funksies van die KVP te oorweeg. - Benadruk voortgesette, professionele bevoegdheid deur toepaslike en produktiewe indiensopleidingsprogramme. Ter aflsuiting: hierdie studie het aangetoon dat KVPs voortdurend bewus moetbly dat hulle met mense werk wat gevoelens het en wat gesondheidshulp benodig. Dit is uiters belangrik om aan die behoeftesvan ’n terapeutiese omgewing te voorsien, ten einde ’n kwaliteit, omvattende diens aan die gemeenskap te lewer.
118

Central management of local performance : a comparison of England and Korea

Lee, Dong-Ok January 2009 (has links)
Since the 1980s, New Public Management (NPM) has deeply influenced the public sector across the world, and thus measuring or managing performance has become a principal element of government reform. In terms of borrowing models and techniques from the private sector, performance measurement has been significantly extended into government, but differences between the two sectors have led to difficulties and criticism of this practice with a wide inconsistent variety of different theoretical explanations about it. In this context, this thesis investigates the effectiveness of performance measurement and theoretical explanations of conditions for its success in the public sector. It focuses through a comparative methodology on Comprehensive Performance Assessment and Joint Performance Assessment that have recently been introduced between the levels of government in England and Korea for the improvement of local government performance and accountability. Extensive analysis of literature and case studies have allowed the thesis to find firstly, that the introduction of such unique assessment systems, by which the centre assesses localities, was deeply affected by the environmental commonalities of both countries such as centralisation in inter-governmental relations and enthusiasm for NPM. Second, the empirical evaluation of both tools shows that they have in practice been valid for accurate assessment, and directly functional for improvement and indirectly for accountability to the public. Their high validity and functionality proved to be mainly attributable to two characteristics. One was institutionally that both frameworks were based on a balanced approach to performance and the disclosure of assessment results to the public for facilitating competition between localities. The other was that both had impacted on internal management of local government which led to change in organisational culture with more focus on performance. However, it identified a necessity for local authorities to participate in the development process of those tools to ensure legitimacy of central management of local performance since they enjoy their own electorally based political support. The research has also found the importance of assessors’ expertise for accurate assessment and a possibility that performance measurement can contribute to the resolution of political tension and cooperation between central and local government when it focuses more on outcomes than input and process. A deeper theoretical and practical understanding of these successful experiences and important policy elements in contemporary public management contributes significantly to knowledge in the three settings of evaluation of policy instruments, comparison between countries and central-local relations. Finally, the study assists each country and others to draw lessons from each other.
119

An examination of the monitoring unit of the Comprehensive Employment Training Act summer youth employment program 1979

Ogbonna, Evelyn D. 01 July 1981 (has links)
No description available.
120

Investigations into Background Correction and Retention Time Alignment to Enhance Quantitative Chemometric Analysis of Comprehensive Two-Dimensional Liquid Chromatography-Diode Array Detection Data

Allen, Robert 20 November 2012 (has links)
The focus of the projects presented here was to develop possible solutions to three issues commonly encountered during chemometric analysis of comprehensive two-dimensional liquid chromatography diode array detector (LCxLC-DAD) data. The focus of the first project was to determine a means of performing background correction that removed two background ridges. The methods of simply subtracting out a mean blank sample, singular value decomposition based background correction (SVD-BC) and asymmetrically weighted least squares (AWLS) were compared. AWLS was found to be the only background correction technique to fully remove the ridges. However, AWLS was also found to attenuate the peak intensity by approximately 25% due to over fitting of the background at the lower wavelengths. The focus of the second project was the investigation of five common interpolation strategies for the reconstruction of the sampled first dimension peak. The interpolation strategy that best reproduced the original first dimension retention time was Gaussian fitting. This was expected given that the simulated data set was generated using a Gaussian model for the peak shape. An algorithm, semi-automated alignment method (SAAM), was then developed that allowed for each peak to be aligned independently of the other peaks in the data set. SAAM was validated using both simulated and experimental data. The simulated results indicated that SAAM produced percent recoveries close to 100%. SAAM was also compared to iterative key set factor analysis-alternating least squares (IKSFA-ALS) for the analysis of phenytoin in a waste water treatment plant effluent. SAAM produced a concentration of 26±3 ppb compared to 39±9 ppb from IKSFA-ALS. While these results are very different, the result produced by SAAM is still within the experimental error of the reference 2D-LC/MS/MS method, 42±19. Finally, SAAM was compared to two existing literature methods. A mixture of simulated and experimental data sets was used to measure the accuracy and precision of the results. SAAM was found to be impacted less by intra- and inter-sample retention time shifting then PARAFAC2. SAAM and shifted candecomp/PARAFAC were found to produce very similar results. However, SAAM was found to experience some difficulty producing accurate and precise results with some of the experimental data sets.

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