In partial fulfilment of the degree of MSc Med (Bioethics & Health Law) Steve Biko Centre for Bioethics, Faculty of Health Sciences, University of the Witwatersrand. Johannesburg, December 2011 / ‘Whistle blowing’ means to blow a whistle calling attention to practices which an individual considers as immoral or illegal and harmful to the public. Some people think whistle blowing is a good or right act; others consider it wrong. There are numerous reports concerning blowing the whistle in scientific research. I place whistle blowing in the context of institutions, focusing on good clinical practice and Research Ethics Committees. Many research activities take place resulting in monetary and personal gain which may influence research conduct. I explore some issues in the development and organization of Research Ethics Committees, discuss the nature of whistle blowing and whistle blowers, and examine some whistle blowing incidents in scientific research. I conclude that although the function of Research Ethics Committees does not necessarily include mechanisms for whistle blowing, that this idea has merit and should be considered.

research report submitted to the Faculty of Health Sciences, University of the Witwatersrand in partial fulfilment of the requirements for the degree of Master of Public Health in the field of Hospital Management MAY 2014 / BACKGROUND: One of the key challenges facing the Limpopo Department of Health and Social Development in the area of Casualty Care is the lack of trained personnel and the inappropriate referral and utilisation of these services. There has been no known study conducted in this area in the South African context and therefore this study was undertaken to evaluate the services rendered within the Casualty Department at the Polokwane Mankweng Hospital Complex with specific reference to material and human resources as well as efficiency of the unit. AIM: To evaluate the Hospital Casualty Department in the Polokwane Mankweng Hospital Complex in terms of caseload, influencing factors and implications on resource utilisation during a one year study period. METHODOLOGY: A cross sectional study design was employed in this study. A retrospective record review was done and information was extracted from various sources of hospital information systems. No primary data was collected for this study. The setting of this study was the Casualty Departments at Polokwane Mankweng Hospital Complex. The two hospitals constituting this complex are situated 30 km apart in Polokwane and Turfloop respectively. Data was collected on various variables that are relevant to the functioning of, and resource utilisation in the Casualty Unit of this Complex. Variables including that of caseload, patient profiles, service costs and workload on human resources were measured. RESULTS: This study based on retrospective review of records of 250 patients’ records selected by a simple random sample from a cohort of 14,113 patients who attended the Casualty Department of the Polokwane Mankweng Hospital Complex during one year study period. One fifth of the patients were referred from other health facilities and more than 60% of the patients were discharged after receiving treatment which implied that these patients could be managed at a regional or district hospital. More patients with medical aid bypassed the referral system. Almost half of the patients arrived after-hours (from 18h00 to 6h00). This is the first study in the Limpopo Province which looked at the direct cost per patient at the Casualty Department. In 2008/09, overall expenditure was R 10,321,401.42 (including R 954,168.45 for pharmacy products, other consumables R 177,261.16 and Laboratory tests R 1,866,233.25). Overall the Department accounts for an estimated R 7,323,804 in personnel annual expenditure of the hospital. Unit personnel cost per patient was estimated at R518.94 (70.96% of total recurrent cost), while the unit costs for the Pharmaceuticals, Stores and Laboratory tests were; R67.23 (9.24%), R12.56 (1.72%) and R132.24 (18.08%) per patient respectively. Overall the combined unit cost was estimated at R731.34 per single emergency care patient excluding the capital costs. CONCLUSION: The results of the study will be used to guide the allocation of appropriate resources, and to highlight the need to implement an effective referral system, which will assist in reducing the workload.

Thesis (M.A.) -- University of Texas Southwestern Medical Center at Dallas, 2006. / Vita. Bibliography: pp. 123-133

The primary health care (PHC) model is being actively promoted as an effective and lower-cost alternative to conventional health care delivery systems in many developing countries. Despite the fact that over 300 PHC projects of varying scale have been implemented and reported on throughout the Third World over the past two decades, there appears to be little evidence available to support the popular hypothesis that the availability and utilization of primary health care services necessarily results in significant improvements in health. The objective of this thesis is to identify alternative strategies for evaluating PHC projects which will establish credible and useful results. The thesis reviews the evolution of both the PHC model and evaluative research methodologies, and then presents a critical analysis of a set of PHC project evaluations. The aim of this exercise is to identify some of the major factors which have limited the validity, utility and significance of the evaluation results. The thesis suggests that less rigorous evaluative research designs and evaluative techniques which use a combination of quantitative and qualitative data be used to enhance the credibility and utility of evaluation results. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

Thesis (M.H.S.A.)--University of Michigan, 1979.

Thesis--University of Oklahoma. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan.

Thesis (M.H.S.A.)--University of Michigan, 1979.

Thesis (M.S.)--University of Michigan.

One of the major obstacles to performance evaluation studies is the definition of a representative or accurate workload. User scripts, a detailed description of user activities to specify an interactive workload, can be used as input for remote terminal emulators as well as a representation of an interactive workload the users impose on a system. User scripts are often based on the widely accepted user behaviour model 'LIST-MODS-RUN'. A method of analysis is described which suggests that this user behaviour is not realistic. More accurate models are given to describe user behaviour at system command language level. It is also studied how different users groups adapt to different loads. The results are then used to define a workload model. An automatic workload genrator is described to generate workload models in form of user scripts ready for execution 'on ERTE which is a system designed to exert interactive workloads on a multiaccess system. Experimental runs with ERTE demonstrate the accuracy of the model and provide the basis for more realistic performance measures on EMAS and the development of ERTE.