Com o objetivo de estudar o processo de referência de pacientes que procuram um Hospital Universitário, pela primeira vez e analisar algumas características destes pacientes e as inter relações entre a localização do domicílio, a utilização de outros serviços, as dificuldades e facilidades apresentadas pelos pacientes, para procurar o Hospital, foram investigados todos os pacientes que procuraram um Hospital Universitário. O trabalho foi realizado no período de cinco semanas de outubro e novembro de 1983, a saber: de 3 a 7, 17 a 21 e 24 a 27 de outubro e de 7 a 11 e 21 a 25 de novembro. Através de entrevistas foi preenchido um formulário com questões sobre características do paciente tais como: sexo, idade, nível de instrução; ocupação, local de residência, gravidade dos sinais e sintomas que os levaram a procurar o Hospital, motivo da demanda, distância do domicílio ao Hospital, utilização de outros serviços, tipos de encaminhamento. A hipótese diagnóstica foi obtida do prontuário do paciente, após a consulta. Foram estudados 1.601 pacientes, sendo 59,53 por cento do sexo feminino e 40,47 por cento do sexo masculino. A maior concentração de pacientes pertence ao grupo etário de 15 a 24 anos (24,49 por cento ), seguido pelo de 25 a 34 anos (17,86 por cento ). O nível de instrução mostrou-se bastante baixo, uma vez que, 54,63 por cento tinha o primeiro grau incompleto e 30 por cento analfabetos. A ocupação que apareceu com maior freqüência foi as donas de casa (43,94 por cento ), seguida pelos agricultores (15,51 por cento ), trabalhadores dos serviços dos desportos e das diversões (13, 64 por cento ). Como Hospital Regional 46,34 por cento dos pacientes procedem da região de Ribeirão Preto e 37,48 por cento do próprio município, onde está localizado. A procedência de pacientes na zona rural aumenta proporcionalmente, em relação à urbana a medida que se afasta do município de Ribeirão Preto. De maneira geral, os pacientes da zona urbana procuram mais precocemente o Hospital, quando residem mais próximo dele. A maioria dos pacientes que residem próximo e procuram o Hospital é portador de sinais e sintomas considerado leve, aumentando a proporção de sinais e sintomas graves entre os pacientes que residem mais distantes do Hospital. 32,57 por cento dos pacientes portadores de sinais e sintomas leves e 25,12 por cento dos portadores de sinais e sintomas graves não procuraram outro serviço, antes de demandarem ao Hospital e informaram não ter procurado outro serviço, por falta de recursos para pagar assistência médica e não confiar no Centro de Saúde. Dentre os pacientes que procuram outros serviços antes, apenas 54,4 O por cento foram referidos para o Hospital e 87,36 por cento destes não receberam orientação para, após o atendimento no Hospital, retornarem a seu serviço de origem. O fluxo de pacientes ao Hospital diminuiu paulatinamente, no decorrer da semana. As doenças do sistema nervoso e dos órgãos dos sentidos ocupam o primeiro lugar entre as hipóteses diagnósticas dos pacientes que procuram o Hospital, pela primeira vez. Dos 1601 pacientes atendidos, 14,74 por cento não foram registrados, conforme rotina estabelecida pelo Hospital, podendo gerar estatísticas imperfeitas. O estudo do processo de referência ao Hospital mostrou-se importante para o conhecimento das características dos pacientes, das inter relações com os outros serviços e das peculiaridades própria do Hospital, como subsídio para organização da assistência à saúde. / With the objective to study the process of referral of patients who look for a University Hospital for the first time and to analyze some characteristics of these patients and the interrelationships between the location of their homes, the use of other services and the difficulties or the facilitation met by the patient to contact the hospital, all the patients who looked for a University Hospital were investigated. The study was conducted over a period of five weeks from October 3 to 7, 17 to 21 and 24 to 27 and from November 7 to 11 and 21 to 25, 1983. Each patient was interviewed and a form was filled out with answers to questions of the characteristics of the patient such as sex, age, level of education, occupation, place of residence, seriousness of the signs and symptoms that led him to look for the Hospital, reason for the demand, distance of the residence from the Hospital, type of referrals. The diagnostic hypothesis was taken from the patient\'s medical record after his medical visit. A total of 1601 patients were studied; 59.53 per cent were women and 40.43 per cent were males. Most patient were concentrated in the 15 to 24 year age range (24.49 per cent ), followed by the 25 to 34 year age range (17.86 per cent ). The level of education was quite low, since 54.63 per cent had not completed elementary school and 30 per cent were illiterate. The most frequent types of occupation were: housewife (43.94 per cent ), followed by rural workers (15.51 per cent ) and by workers in suports and amusement services (13.64 per cent ). Since this is a Regional Hospital, 46.34 per cent of the patients were from the Ribeirão Preto region and 37.48 per cent from the town itself in which the Hospital is located. The origin of patients from the rural zone increased proportionally in relation to the urban zone with the distance from Ribeirão Preto. In general, the patients from the urban zone look earlier for the Hospital when they live closer to it. Most of the patients living close to the Hospital had signs and symptoms considered mild, with an increase in the proportion of serious signs and symptans anong the patients who live farther away from the Hospital. 32.57 per cent of the patients with mild signs and symptoms and 25.12 per cent of the patients with serious signs and symptoms did not look for any other service before contacting the Hospital and informed that they had not lookes for other services because of lack of money to pay for medical assistance and because they did not trust the health center. Among the patients who had previously looked for other services, 54.40 per cent were referred to the Hospital and 87.36 per cent of these did not receive guidance to return to the original service after being attended at the Hospital. The flow of patients to the Hospital decreased little by little with each passing week. Diseases of the nervous system and of the sensory organs occupied first place among the diagnostic hypotheses for the patients who looked for the Hospital for the first time. Of 1601 patients attended, l4.74 per cent were not registered according to the routine established by the Hospital, a fact that may give rise to imperfet statistics. The study of the process of referral to the Hospital proved to be important in terms of learning about the characteristics of the patients, the interrelationships with the other services and the peculiarities of the Hospital, as an aid in organizing health assistance.

This dissertation aims to use a system thinking approach to describe and evaluate the Lead-Acid Battery Recycling Program in British Columbia, compare it with other provincial regulated recycling programs and identify strategies on how it can be improved. The research is presented in the manuscript based format, comprised of four interrelated chapters. Following the introduction, chapter 2 describes a multiple regression analysis to assess how various factors identified by informed stakeholders have contributed to recycling rate in 14 transportation zones from 1995 to 2005. This study demonstrates that the existing recycling scheme ineffectively promotes recycling as it has achieved an average of 75% over the past 13 years with large fluctuations among transportation zones. The regression also shows that recycling rate of transportation zones are not highly influenced by LME lead prices and Transportation Incentive (which can be explained by the strong market power of the recycling plants responsible for setting up the price of scrap lead to which the collectors respond). Chapter 3 identifies key components that influence the performance of varied recycling systems based on a comparative analysis of provincial recycling systems informed by expert interviews. In chapter 4, comprehensive evaluation criteria for the lead-acid battery recycling program is developed based on objectives and performance measures elicited through an extensive stakeholder consultation process with various individuals and organizations. Fundamental objectives identified by stakeholders include: reduce environmental impacts, reduce occupational health impacts, reduce net costs, increase equity in resource consumption patterns and increase systematic learning. In chapter 5, we use multiple criteria decision analysis (MCDA) to design and assess effective recycling strategies to meet societal objectives previously identified in the chapter 4. Recycling strategies were compiled using the results of chapter 3. The results reveals that the optimal policy for the lead-acid battery recycling system combines a return to retailer program financed through an advanced disposal fee included in the battery price in combination with increased plant or recycling capacity domestically. This research also provides relevant contributions to the refining and application of value-focused thinking and decision analysis methodologies. / Applied Science, Faculty of / Mining Engineering, Keevil Institute of / Graduate

Cette thèse interdisciplinaire analyse la manière dont des citoyens débattent lors d’une consultation publique organisée sur des questions éthiques controversées. Elle s’intéresse plus spécifiquement à la « présentation de soi » que des individus construisent à travers leurs écrits dans le but de crédibiliser leurs discours sur l’euthanasie. Sur ce sujet, ces voix citoyennes n’ont jusqu’ici que peu retenu l’attention des chercheurs. Le cas étudié concerne la consultation publique québécoise organisée en 2010-2011 par la « Commission spéciale sur la question de mourir dans la dignité ». Nous analysons à l’aide des outils de la rhétorique et de « l’argumentation dans le discours », les mémoires écrits (n= 149) envoyés par des citoyens à la Commission spéciale. Devant la taille et le nombre important de documents (de 1 à plus de 250 pages, 5 pages en moyenne), nous utilisons la formule « mourir dans la dignité », tout à fait centrale dans le débat québécois, comme un point d’accès à ce débat. Nous partons de cette formule pour comprendre comment les participants argumentent, avant de regarder dans les autres parties de ces mémoires. Quatre types moyens de présentation de soi se dégagent de l’analyse, à savoir l’expert (n=40), le témoin (n=40), l’opinant (n=52) et l’amateur (n=17). Là où l’expert se présente professionnellement de manière détaillée, là où le témoin développe son récit, l’opinant, lui, dit très peu de choses sur lui-même. Il se distingue des autres figures moyennes par la faible présence – et parfois l’absence – d’informations personnelles ou professionnelles. L’amateur se situe ici entre l’opinant et l’expert ou le témoin : les faits biographiques (personnels ou professionnels) tiennent généralement sur quelques lignes. Celui-ci se présente implicitement comme amateur lorsque, ayant la possibilité de s’appuyer sur une expertise ou expérience personnelle, choisit plutôt de dire ce que ne dit jamais l’expert et qui pourrait se résumer ainsi : « les personnes ordinaires comme moi ». À de très rares exceptions, toutes les personnes engagées politiquement dans cette consultation publique, aussi différentes soient-elles, affichent une grande certitude dans leurs croyances éthiques. À la question qui leur est notamment posée – faut-il légaliser l’euthanasie? – les participants ne montrent guère de doutes. Chacun fait comme si les convictions de l’adversaire étaient inférieures aux siennes qu’ils présentent souvent comme universelles. Concernant la formule « mourir dans la dignité », les participants prétendent implicitement à l’objectivité de leur définition. Ils agissent même comme s’il existait une seule définition de la formule « mourir dans la dignité » et une seule vérité éthique. Nous soutenons que ces manières d’argumenter sont efficaces pour masquer la fragilité des croyances éthiques et maintenir l’adversaire à distance. Notre conclusion suggère pourtant qu’une éthique plus humble, complexe et sociale pourrait fonctionner en dehors d’un système fortement polarisé.

The writing of this thesis was inspired by a chance remark I had with a friend from the Dutch Reformed Church. I had made the point that having been through such a difficult time of apartheid in South Africa we shall not cross the same river twice. His response to me was that it may be true but cautioned that we needed to be careful not to cross a different river the same wrong way. It was then that I decided on a hypothesis that the Kairos Document could still be a guide to the present day events in a new democratic dispensation. I then embarked on a study to revisit the Kairos Document to research whether it could assist the Church once more as it grappled with the question of how to relate to this new government that has been elected by the majority of the people of South Africa. The rationale behind all this was twofold: one, fighting apartheid was a hard struggle but clear-cut, it was the apartheid enemy as represented by an easily identifiable National Party and a compliant church, the Dutch Reformed Church (DRC); two, the temptation to repeat what the DRC did during apartheid was highly likely. The Church today needs to learn from past mistakes so as not to repeat them. The DRC had an opportunity to positively shape events in South Africa but chose to take the wrong path of leading the State into the disastrous policy of apartheid. The thesis traces a brief history of the Dutch Reformed Church and how it had failed the entire Church and the country by promoting State Theology, as described by the Kairos Document. Profuse source documents on the history of the DRC have already been written and from which I got my information. Among the writers on the history of the DRC were Cecil Ngcokovane and Colleen Ryan who wrote Demons of Apartheid and Beyers Naude: Pilgrimage of Faith respectively, and who gave excellently researched material on the history of the DRC in respect of the rise and fall of apartheid. My research led me to another insight, namely, that there were also other Afrikaner prophets apart from Beyers Naude who suffered greatly within the DRC, and that they have gone mainly unnoticed. What followed was the history of the Church with its fight against apartheid. The leading light in the fight was the leadership of the South African Council of Churches (SACC) with its programmes. There were other strong organisations such as the Black Sash whose work was invaluable, but these did not fall within my scope of research. In addition to my own knowledge of and experience within the SACC, as Director of Faith and Mission, and before this having been Organising Secretary of the Western Province Council of Churches (WPCC), my observer-participant status had been greatly enhanced. For further information I used the South African History Archives (SAHA) at the Cullinan Library, Witwatersand University, for my primary sources, and other relevant books and documents written by SACC stalwart and theologian, Wolfram Kistner, by Archbishop Emeritus Desmond Tutu and by Bernard Spong who was for years in the Communications department of the SACC. I traced briefly the history of the struggle for liberation in South Africa from the general perspective, especially from 1912 when the African National Congress was started through to the Pan African Congress’ 1960 march which led to the Sharpeville shootings, to the efforts of the Black Consciousness Movement from 1968 to the 1976 Students Uprising until the advent of the new South Africa. The oppressed people of South Africa did a lot to revive pride among themselves as a downtrodden people with many efforts from a number of initiatives. The Trade Unions, COSATU in particular, also shook the foundations of apartheid in an effective targeting of the economic situation and big business. The thesis shows how South Africans attacked apartheid from different angles. The production of the Kairos Document seemed to overshadow a number of other efforts that had been undertaken by the Church and yet the KD was a comment on the lackluster contribution of the Church with a view to making it true to its calling. There had been a series of initiatives, including many other publications, which tried to challenge the apartheid government to change its ways. The government then always responded with more repressive laws. Among the series of attempts at destroying apartheid was the establishment of the Wilgespruiit Fellowship Centre to promote friendship and training against a government policy that thrived on racial separation. After the Sharpeville massacre there was the Cottesloe Consultation in 1960 which was sponsored by the World Council of Churches, another church body that was very active in its support for the victims of apartheid. There was also the Christian Institute which became so reputable that it got banned by the government. The Message to the People of South Africa in 1968 made some inroads in terms of raising the level of the debate among white people especially. Many white people at that time enjoyed the insulation against the sufferings of the black masses which they enjoyed through the policy of isolation. The Belhar Confession in 1982 shook the DRC because it contained elements which were directly in opposition to the teachings of the DRC regarding the separation of races. Other catalysts towards change were the Soweto Students’ Uprisings against Afrikaans as a language of instruction at schools in line with Bantu Education. There were also rent boycotts and boycotts of businesses to force the government to change. By the early eighties repression had escalated so much that a group of Christian activists met, first in Cape Town and then in Johannesburg, to chart what is now known as the Kairos Document (Speckman and Kaufmann 2001:18ff). My research dealt with the three types of theologies as expounded by the KD: State Theology, Church Theology and Prophetic Theology. Again my participant-observer position was activated because I became the next Director of the Institute of Contextual Theology (ICT) and have understood the KD’s importance in the broader history of the Church. The literature I have used had to do with liberation and hope as found in writers such as Moltmann, Jacques Ellul, and liberation theologians such as Albert Nolan, Church and State theologians such as Charles Villa-Vicencio and John de Gruchy and many others. In my research I analysed the situation in the Church today as exposed by interviews and questionnaires with those who had been involved with the KD before, plus a social analysis gleaned from the media and from discussions and relevant writings. The result of my research is that there are principles and ideas contained in the KD and that the three theologies will be applicable for a long time to come. The context has changed remarkably but the Church needs to develop itself to be able to meet a different challenge. The Church can still fall into the same trap as the DRC did during the time of apartheid by doing the reverse and opting out of issues, and by not assisting the government and the country to mobilise its forces to work towards nation building. Furthermore, the Church needs to work more with other religions across the board to fight against the ills within the country which know no borders. I maintain again, as I say in my conclusion, that there is still more to be done in this field of the Research I have undertaken and my intention here is to awaken debate again towards a healthy Church-State relationship with the Church constantly being aware of the imperative preferential option for the poor and oppressed. There is another added kind of “poor and oppressed”. How is the Church going to deal with those who have become poor by the quality of a life of the poverty of consumerism and materialism plus the oppression of a greedy lifestyle. The Church dare not ignore its mandate. / Thesis (PhD)--University of Pretoria, 2010. / Science of Religion and Missiology / unrestricted

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Magister Scientiae (Nutrition Management) - MSc(NM) / The provision of quality nutrition care services is needed to address the national burden of diseases, and to reduce under- and overnutrition in South Africa. Globally, there is a lack of information and data about the perceptions, experience of, and satisfaction with the quality of nutrition care services, both from patients and dietitians. Patients and dietitians are in the best position to provide useful information pertaining to their perception and experience of nutrition care service delivery. The aim of this study was to determine the perceptions of patients and dietitians on the quality of nutrition care service delivery in the Klipfontein/Mitchells Plain Sub-Structure (KMPSS).

The purpose of the study was to create a questionnaire to identify underlying dimensions of athletes' attitudes toward seeking sport psychology consultation. A total of 1138 athletes (625 males, 513 females) representing 36 sports from four levels of participation were used to develop the Sport Psychology Attitudes Questionnaire (SPAQ). In Study I, exploratory factor analysis produced a two-factor solution that accounted for 37.1% of the overall variance: (a) belief in the credibility of sport psychology (14 items) and (b) preference for similarity with a sport psychology consultant (SPC) (7 items). Three items were omitted following item analysis, and nine items were eliminated after failing to load higher than the cut-off value of .40 on either of the factors. In Study II, confirmatory factor analysis supported the two-factor model, and multigroup comparison in Study III demonstrated that the model fit well for both male and female samples. As for validity, the SPAQ factors predictably (a) distinguished between athletes with and without previous experience with a SPC, (b) related to ratings of helpfulness/satisfaction related to a previous experience with a SPC, and (c) correlated with willingness to see a SPC for help in the future. Also, the SPAQ factors were related, as predicted, to (a) belief that practicing sport psychology skills will lead to desirable outcomes, (b) interpersonal openness, and (c) affective prejudice toward identified outgroups but were not related to level of self-concept as hypothesized. Contrary to predictions, Gender X Race X SPC experience MANOVAs revealed no gender or racial differences in attitudes toward sport psychology consultation. It was concluded that the SPAQ is a valid and reliable instrument for assessing a set of important attitudinal dimensions with regard to seeking sport psychology consultation and a useful instrument for research and practice. Theoretical and empirical support for the interpretation of the SPAQ factor structure, directions for future research, and practical implications are discussed.

December, 2006-January, 2007

The problem of this study was to determine how well the public information office of the Dallas Police Department performed in three public relations areas: staff consultation, employee communication, and press relations. Interviews were conducted with the command staff of the Dallas Police Department and with nine mass media representatives who had regular contact with both the police department and the public information office. Their answers were compared with public relations principles taken from literature in both the general public relations and the police public relations fields to see if the public information office was succeeding or failing in performing its staff-consultation, employee-communication, and press-relations functions.