Introduction. Road traffic injuries are the eighth leading cause of death globally and the leading cause of death among young people aged 15-29. Of individuals killed or injured in road traffic injuries, a large group comprises occupants sustaining a thorax injury in frontal crashes. The elderly are particularly at risk, as they are more fragile. The evaluation of the frontal crash performance of new vehicles is normally based on barrier crash tests. Such tests are only representative of a small portion of real-life crashes, but it is not feasible to test vehicles in all real-life conditions. However, the rapid development of computers opens up possibilities for simulating whole populations of real-life crashes using so-called stochastic simulations. This opportunity leads to the aim of this thesis, which is to develop and validate a simplified, parameterized, stochastic vehicle simulation model for the evaluation of passive restraint systems in real-life frontal crashes with regard to rib fracture injuries. Methods. The work was divided into five phases. In phase one, the geometry and properties of a finite element (FE) generic vehicle buck model were developed based on data from 14 vehicles. In the second phase, a human FE model was validated for oblique frontal crashes. This human FE model was then used to represent the vehicle occupant. In the third phase, vehicle buck boundary conditions were derived based on real-life crash data from the National Automotive Sampling System (NASS) and crash test data from the Insurance Institute for Highway Safety. In phase four, a validation reference was developed by creating risk curves for rib fracture in NASS real-life crashes. Next, these risk curves were compared to the risk of rib fractures computed using the generic vehicle buck model. In the final phase, injury mechanisms in nearside oblique frontal crashes were evaluated. Results. In addition to an averaged geometry, parametric distributions for 27 vehicle and boundary condition parameters were developed as guiding properties for the stochastic model. Particular aspects of the boundary conditions such as pulse shape, pulse angle and pulse severity were analyzed in detail. The human FE model validation showed that the kinematics and rib fracture pattern in frontal oblique crashes were acceptable for this study. The validation of the complete FE generic vehicle buck model showed that the model overestimates the risk of rib fractures. However, if the reported under-prediction of rib fractures (50-70%) in the NASS data is accounted for using statistical simulations, the generic vehicle buck model accurately predicts injury risk for senior (70-year-old) occupants. The chest injury mechanisms in nearside oblique frontal crashes were found to be a combination of (I) belt and airbag loading and (II) the chest impacting the side structure. The debut of the second mechanism was found for pulse angles of about 30 degrees. Conclusion. A parameterized FE generic passenger vehicle buck model has been created and validated on a population of real life crashes in terms of rib fracture risk. With the current validation status, this model provides the possibility of developing and evaluating new passive safety systems for fragile senior occupants. Further, an injury mechanism responsible for the increased number of outboard rib fractures seen in small overlap and near-side oblique frontal impacts has been proposed and analyzed. / Vinnova Project: Real Life Safety Innovations

Increasing health care costs is an international problem from which South Africa is not excluded. Prescription medication contributes most to these high health care costs, and methods to reduce their costs to society are implemented worldwide. In South Africa, such a method is a managed care reference medicine price list, as introduced by a PBM (pharmacy benefit management) company. This step had some cost implications in the private health sector in South Africa, and these implications were investigated in this study. Central nervous system (CNS) medicine items are among the top ten medicine items claimed and represent a substantial amount of the costs of all medicine items claimed during the study period. Antidepressants, a subdivision of the CNS agents, comprise the largest share of CNS agents claimed and CNS costs, and were therefore investigated more closely. The objective of this study was to analyse the usage patterns and costs of central nervous system medicine items, and more specifically, the antidepressants, against the background of the implementation of a managed care reference medicine price list in the private sector of South Africa. This study was conducted as a retrospective, non-experimental quantitative research project. The study population consisted of all medicine items claimed as observed on the database over the two-year study period of May 2001 to April 2002 (pre-MPL) and May 2002 to April 2003 (post-MPL). Data were provided by MedschemeTM/lnterpharm, and the Statistical Analysis System® SAS 8.2® was used to extract the data from the database. The central nervous system agents had a prevalence of 8.10% (N=49098736) and a total cost of R757576976.72 over the two-year study period. The cost per CNS item increased by 5.98% or R11.50 per CNS item in the year after MPL implementation, and the cost per prescription containing CNS medicine items increased by 4.09% or R9.07 per prescription. CNS agents are classified into ten sub-pharmacological groups, according to the MIMSC3 (Snyman, 2003:13a). One of these sub-pharmacological groups, antidepressants, comprised 33.97% of all CNS medicine items claimed (N=3978364) and 45.53% of all costs associated with CNS medicine items (N=R757576976.72) over the study period. The number one antidepressant claimed was amitriptyline, a tricyclic antidepressant. Of the antidepressants with generic substitutes, all with the exception of clomipramine, were prescribed at generic substitution rates of more than 50%. After the MPL implementation, generic antidepressant products were more frequently prescribed (16.48% increase, N=617190), although patient co-payments did not decrease immediately. Some innovator products had price reductions after the implementation of the MPL. This study indicates that cost minimisation analyses and retrospective drug utilisation reviews are valuable tools in the evaluation of managed care medicine price lists. / Thesis (M. Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2005.

South African prescribers have a large choice of combination analgesic preparations available for prescribing. According to Desmeules et al. (2003:8) the advantages of combining analgesics include increasing the duration of analgesia, widening the spectrum of efficacy, improved patient compliance and reduced parenteral abuse potential. According to McMahon (1975:13) one of the principle arguments against fixed-dose combinations is that the physician surrenders flexibility in managing his patient. Combination analgesics may expose patients to ingredients not necessary for pain relief in their particular condition (Beaver, 1984). Rigas (1997:454) explains that the value of pharmaco-economics in providing cost-effective pharmacologic treatment for pain must not only be seen as a containment effort, but rather as a valuation effort. Meaningful economic analyses based on empiric information about cost and a range of subjective and objective outcomes are needed to minimise cost without compromising care. The objective of this study was to review and interpret the prescribing patterns of combination analgesics and the cost associated with their usage for the period 2001-2006 in a section of the private healthcare sector in South Africa. This research can be classified as a quantitative, retrospective drug utilisation review study. Data were obtained from a medicine claims database, and the study population consisted of all combination analgesic prescriptions (Mims® category 3.3) for the period 1 January 2001 to 31 December 2002 and 1 January 2004 to 31 December 2006. Prescribing Patterns of Combination Analgesics in the Private Health Care Sector. Firstly pain and the treatment thereof with combination analgesics were investigated from the literature to understand the disease and to determine the prevalence and treatment thereof. Secondly, managed health care, drug utilisation review, pharmacoeconomics and pharmaco-epidemiology were investigated from the literature to understand these concepts. The influence of the South African government on the medicine pricing regulations was discussed. Thirdly, through the empirical investigation the utilisation patterns of combination analgesics were reviewed, analysed and interpreted. It was determined that combination analgesic drugs represented 8.87% (n=261 907) of all medicine claimed during 2001 (N=2 951 326), decreased to 7.20% (n=381 809) during 2004 (N=5 305 846) after which it increased to 7.92% (n=187 745) in 2006 (N=2 370 572). Between 2001 (N=R379 708 489.00) and 2006 (N=R279 160 832.00) the cost percentage of the combination analgesic drugs decreased from 4.95% (n=R18 798 202.42) to 3.15% (n=R8 791 228.57). The average cost per combination analgesic drugs decreased from R71.77 ± 61.67 to R46.83 ± 43.41 between 2001 and 2006. This decrease was of no practical significance (d<0.8). The average number of combination analgesics per prescription stayed relatively constant varying between 1.01 ± 0.11 in 2001 and 1.02 ± 0.13 in 2006. The percentage generic combination analgesic drugs claimed increased from 29.63% (n=77 608) in 2001 to 66.37% (n=124 600) in 2006 (N=261 907 for 2001 and N=187 745 for 2006) even though generic medicine items claimed by the total database only increased from 26.79% (n=790 548) in 2001 to 40.27% (n=954 561) during 2006 (N=2 951 326 for 2001 and N=2 370 572 for 2006). The combination of ibuprofen 200mg, paracetamol 250mg and codeine phosphate 10mg (e.g. Myprodol® capsules, Mybulen® capsules, Gen-payne® capsules and Ibupain Forte® capsules) represented the active ingredient combination with the highest prevalence for the entire study period, increasing from 28.44% (n=74 483) in 2001 to 33.08% (n=62 100) in 2006 of all combination analgesics prescribed (N=261 907 for 2001 and N=187 745 for 2006). Generic substitution influenced the prevalence of the innovator medicine item, Myprodol® Capsules dramatically, causing a decrease from 23.16% (n=60 631) in 2001 to 3.77% (n=7 084) in 2006 representation of all combination analgesic prescribed. In 2006, the generics of Myprodol® Capsules e.g. Dentopain Forte®, Mybulen® Capsules, Gen-payne® and Ibupain Forte® represented 23.79% (n=44651) of all combination analgesics claimed. Recommendations were derived regarding certain aspects of the clinical and economical management of pain e.g. the implication of generic substitution with regard to cost and prescribing patterns, and the decreasing cost of combination analgesics which might encourage abuse, needs further investigation. South African prescribers have a large choice of combination analgesic preparations available for prescribing. According to Desmeules et al. (2003:8) the advantages of combining analgesics include increasing the duration of analgesia, widening the spectrum of efficacy, improved patient compliance and reduced parenteral abuse potential. According to McMahon (1975:13) one of the principle arguments against fixed-dose combinations is that the physician surrenders flexibility in managing his patient. Combination analgesics may expose patients to ingredients not necessary for pain relief in their particular condition (Beaver, 1984). Rigas (1997:454) explains that the value of pharmaco-economics in providing cost-effective pharmacologic treatment for pain must not only be seen as a containment effort, but rather as a valuation effort. Meaningful economic analyses based on empiric information about cost and a range of subjective and objective outcomes are needed to minimise cost without compromising care. The objective of this study was to review and interpret the prescribing patterns of combination analgesics and the cost associated with their usage for the period 2001-2006 in a section of the private healthcare sector in South Africa. This research can be classified as a quantitative, retrospective drug utilisation review study. Data were obtained from a medicine claims database, and the study population consisted of all combination analgesic prescriptions (Mims® category 3.3) for the period 1 January 2001 to 31 December 2002 and 1 January 2004 to 31 December 2006. Prescribing Patterns of Combination Analgesics in the Private Health Care Sector. Firstly pain and the treatment thereof with combination analgesics were investigated from the literature to understand the disease and to determine the prevalence and treatment thereof. Secondly, managed health care, drug utilisation review, pharmacoeconomics and pharmaco-epidemiology were investigated from the literature to understand these concepts. The influence of the South African government on the medicine pricing regulations was discussed. Thirdly, through the empirical investigation the utilisation patterns of combination analgesics were reviewed, analysed and interpreted. It was determined that combination analgesic drugs represented 8.87% (n=261 907) of all medicine claimed during 2001 (N=2 951 326), decreased to 7.20% (n=381 809) during 2004 (N=5 305 846) after which it increased to 7.92% (n=187 745) in 2006 (N=2 370 572). Between 2001 (N=R379 708 489.00) and 2006 (N=R279 160 832.00) the cost percentage of the combination analgesic drugs decreased from 4.95% (n=R18 798 202.42) to 3.15% (n=R8 791 228.57). The average cost per combination analgesic drugs decreased from R71.77 ± 61.67 to R46.83 ± 43.41 between 2001 and 2006. This decrease was of no practical significance (d<0.8). The average number of combination analgesics per prescription stayed relatively constant varying between 1.01 ± 0.11 in 2001 and 1.02 ± 0.13 in 2006. The percentage generic combination analgesic drugs claimed increased from 29.63% (n=77 608) in 2001 to 66.37% (n=124 600) in 2006 (N=261 907 for 2001 and N=187 745 for 2006) even though generic medicine items claimed by the total database only increased from 26.79% (n=790 548) in 2001 to 40.27% (n=954 561) during 2006 (N=2 951 326 for 2001 and N=2 370 572 for 2006). The combination of ibuprofen 200mg, paracetamol 250mg and codeine phosphate 10mg (e.g. Myprodol® capsules, Mybulen® capsules, Gen-payne® capsules and Ibupain Forte® capsules) represented the active ingredient combination with the highest prevalence for the entire study period, increasing from 28.44% (n=74 483) in 2001 to 33.08% (n=62 100) in 2006 of all combination analgesics prescribed (N=261 907 for 2001 and N=187 745 for 2006). Generic substitution influenced the prevalence of the innovator medicine item, Myprodol® Capsules dramatically, causing a decrease from 23.16% (n=60 631) in 2001 to 3.77% (n=7 084) in 2006 representation of all combination analgesic prescribed. In 2006, the generics of Myprodol® Capsules e.g. Dentopain Forte®, Mybulen® Capsules, Gen-payne® and Ibupain Forte® represented 23.79% (n=44651) of all combination analgesics claimed. Recommendations were derived regarding certain aspects of the clinical and economical management of pain e.g. the implication of generic substitution with regard to cost and prescribing patterns, and the decreasing cost of combination analgesics which might encourage abuse, needs further investigation. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2008.

Thesis (M. Pharm.)--North-West University, Potchefstroom Campus, 2008.

INTRODUCTION The intention of this study was to formulate guidelines for the implementation of Performance Management System (PMS) regarding line managers (LM) and employees (E) in a level 2 public hospital in the North–West Province. From a preliminary evaluation it was evident that the implementation of performance management as outlined in the NWPG policy No. 13, was not effective. The results of the research was to provide baseline data of the current policy implementation by the line managers and employees; an indication of the ability of the PMS to reach its goal of improved performance between line managers and employees in the long term; and the barriers to the policy implementation discovered over the course of the study. RESEARCH QUESTIONS Based on the statement of the problem, the following research questions were asked: * How is PMS implemented from the perspective of line managers in a level 2 public hospital? * How is PMS implemented from the perspective of employees in a level 2 public hospital? * What guidelines can be formulated for line managers and employees regarding PMS? AIM AND OBJECTIVES OF THE STUDY The principal aim of this study was to formulate guidelines for implementation of PMS by line managers and employees. The objectives below of the research which are derived from the principal aim were: * To describe the implementation of the PMS from the perspective of line managers in a level 2 public hospital. * To describe the implementation of the PMS from the perspective of employees in a level 2 public hospital. * To formulate guidelines for line managers and employees regarding PMS? RESEARCH DESIGN A quantitative, explorative, descriptive, and contextual design was used in this study to reach the overarching aim and respective objectives. RESEARCH METHOD The researcher firstly conducted a literature review to understand implementation of PMS and related constructs. Thereafter the researcher used two similar structured questionnaires for both LM and E to collect data. The questionnaires were developed to measure the perceptions of both LM and E in the implementation of PMS in a level 2 public hospital. The questionnaires were based on the six steps (performance planning, developing performance criteria, performance monitoring, performance review and assessment, annual performance assessment and performance assessment outcomes) of the current PMS policy used in a level 2 public hospital. The study is based on transformational leadership whereby the line managers (LM) as nurse leaders with transformational characteristics are assumed to be empowering the employees (E) and creating enthusiasm for nursing practice. Minor adaptations were made to the questionnaires prior to administration to the nursing personnel in a level 2 public hospital in North West Province. An all inclusive sample was taken, representative of a larger population and this amounted to twenty four line managers (n=24) and fifty five employees (n=55) that participated in the study. RESULTS There were problems identified from both the line managers (LM) and employees (E) in performance planning, developing performance criteria, and monitoring performance, organizing and the process of performance review and assessment and lastly the annual performance assessment. The main two main findings are: * The effect size of all the questions indicates a practically visible and thus significant difference with regard to LM and E perceptions of the implementation of PMS. * There is statistical evidence of improper implementation of PMS from both groups regarding some of the performance implementation items. Based on the empirical evidence and the problems identified from the results, guidelines for the implementation of PMS were formulated. It is suggested that these be used and implemented to streamline the PMS in level 2 public hospitals. Keywords: Key result areas (KRAs), Generic assessment factors (GAFs), reward, work plan, Performance Agreement (PA), Performance Management System (PMS). / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012.

South African prescribers have a large choice of combination analgesic preparations available for prescribing. According to Desmeules et al. (2003:8) the advantages of combining analgesics include increasing the duration of analgesia, widening the spectrum of efficacy, improved patient compliance and reduced parenteral abuse potential. According to McMahon (1975:13) one of the principle arguments against fixed-dose combinations is that the physician surrenders flexibility in managing his patient. Combination analgesics may expose patients to ingredients not necessary for pain relief in their particular condition (Beaver, 1984). Rigas (1997:454) explains that the value of pharmaco-economics in providing cost-effective pharmacologic treatment for pain must not only be seen as a containment effort, but rather as a valuation effort. Meaningful economic analyses based on empiric information about cost and a range of subjective and objective outcomes are needed to minimise cost without compromising care. The objective of this study was to review and interpret the prescribing patterns of combination analgesics and the cost associated with their usage for the period 2001-2006 in a section of the private healthcare sector in South Africa. This research can be classified as a quantitative, retrospective drug utilisation review study. Data were obtained from a medicine claims database, and the study population consisted of all combination analgesic prescriptions (Mims® category 3.3) for the period 1 January 2001 to 31 December 2002 and 1 January 2004 to 31 December 2006. Prescribing Patterns of Combination Analgesics in the Private Health Care Sector. Firstly pain and the treatment thereof with combination analgesics were investigated from the literature to understand the disease and to determine the prevalence and treatment thereof. Secondly, managed health care, drug utilisation review, pharmacoeconomics and pharmaco-epidemiology were investigated from the literature to understand these concepts. The influence of the South African government on the medicine pricing regulations was discussed. Thirdly, through the empirical investigation the utilisation patterns of combination analgesics were reviewed, analysed and interpreted. It was determined that combination analgesic drugs represented 8.87% (n=261 907) of all medicine claimed during 2001 (N=2 951 326), decreased to 7.20% (n=381 809) during 2004 (N=5 305 846) after which it increased to 7.92% (n=187 745) in 2006 (N=2 370 572). Between 2001 (N=R379 708 489.00) and 2006 (N=R279 160 832.00) the cost percentage of the combination analgesic drugs decreased from 4.95% (n=R18 798 202.42) to 3.15% (n=R8 791 228.57). The average cost per combination analgesic drugs decreased from R71.77 ± 61.67 to R46.83 ± 43.41 between 2001 and 2006. This decrease was of no practical significance (d<0.8). The average number of combination analgesics per prescription stayed relatively constant varying between 1.01 ± 0.11 in 2001 and 1.02 ± 0.13 in 2006. The percentage generic combination analgesic drugs claimed increased from 29.63% (n=77 608) in 2001 to 66.37% (n=124 600) in 2006 (N=261 907 for 2001 and N=187 745 for 2006) even though generic medicine items claimed by the total database only increased from 26.79% (n=790 548) in 2001 to 40.27% (n=954 561) during 2006 (N=2 951 326 for 2001 and N=2 370 572 for 2006). The combination of ibuprofen 200mg, paracetamol 250mg and codeine phosphate 10mg (e.g. Myprodol® capsules, Mybulen® capsules, Gen-payne® capsules and Ibupain Forte® capsules) represented the active ingredient combination with the highest prevalence for the entire study period, increasing from 28.44% (n=74 483) in 2001 to 33.08% (n=62 100) in 2006 of all combination analgesics prescribed (N=261 907 for 2001 and N=187 745 for 2006). Generic substitution influenced the prevalence of the innovator medicine item, Myprodol® Capsules dramatically, causing a decrease from 23.16% (n=60 631) in 2001 to 3.77% (n=7 084) in 2006 representation of all combination analgesic prescribed. In 2006, the generics of Myprodol® Capsules e.g. Dentopain Forte®, Mybulen® Capsules, Gen-payne® and Ibupain Forte® represented 23.79% (n=44651) of all combination analgesics claimed. Recommendations were derived regarding certain aspects of the clinical and economical management of pain e.g. the implication of generic substitution with regard to cost and prescribing patterns, and the decreasing cost of combination analgesics which might encourage abuse, needs further investigation. South African prescribers have a large choice of combination analgesic preparations available for prescribing. According to Desmeules et al. (2003:8) the advantages of combining analgesics include increasing the duration of analgesia, widening the spectrum of efficacy, improved patient compliance and reduced parenteral abuse potential. According to McMahon (1975:13) one of the principle arguments against fixed-dose combinations is that the physician surrenders flexibility in managing his patient. Combination analgesics may expose patients to ingredients not necessary for pain relief in their particular condition (Beaver, 1984). Rigas (1997:454) explains that the value of pharmaco-economics in providing cost-effective pharmacologic treatment for pain must not only be seen as a containment effort, but rather as a valuation effort. Meaningful economic analyses based on empiric information about cost and a range of subjective and objective outcomes are needed to minimise cost without compromising care. The objective of this study was to review and interpret the prescribing patterns of combination analgesics and the cost associated with their usage for the period 2001-2006 in a section of the private healthcare sector in South Africa. This research can be classified as a quantitative, retrospective drug utilisation review study. Data were obtained from a medicine claims database, and the study population consisted of all combination analgesic prescriptions (Mims® category 3.3) for the period 1 January 2001 to 31 December 2002 and 1 January 2004 to 31 December 2006. Prescribing Patterns of Combination Analgesics in the Private Health Care Sector. Firstly pain and the treatment thereof with combination analgesics were investigated from the literature to understand the disease and to determine the prevalence and treatment thereof. Secondly, managed health care, drug utilisation review, pharmacoeconomics and pharmaco-epidemiology were investigated from the literature to understand these concepts. The influence of the South African government on the medicine pricing regulations was discussed. Thirdly, through the empirical investigation the utilisation patterns of combination analgesics were reviewed, analysed and interpreted. It was determined that combination analgesic drugs represented 8.87% (n=261 907) of all medicine claimed during 2001 (N=2 951 326), decreased to 7.20% (n=381 809) during 2004 (N=5 305 846) after which it increased to 7.92% (n=187 745) in 2006 (N=2 370 572). Between 2001 (N=R379 708 489.00) and 2006 (N=R279 160 832.00) the cost percentage of the combination analgesic drugs decreased from 4.95% (n=R18 798 202.42) to 3.15% (n=R8 791 228.57). The average cost per combination analgesic drugs decreased from R71.77 ± 61.67 to R46.83 ± 43.41 between 2001 and 2006. This decrease was of no practical significance (d<0.8). The average number of combination analgesics per prescription stayed relatively constant varying between 1.01 ± 0.11 in 2001 and 1.02 ± 0.13 in 2006. The percentage generic combination analgesic drugs claimed increased from 29.63% (n=77 608) in 2001 to 66.37% (n=124 600) in 2006 (N=261 907 for 2001 and N=187 745 for 2006) even though generic medicine items claimed by the total database only increased from 26.79% (n=790 548) in 2001 to 40.27% (n=954 561) during 2006 (N=2 951 326 for 2001 and N=2 370 572 for 2006). The combination of ibuprofen 200mg, paracetamol 250mg and codeine phosphate 10mg (e.g. Myprodol® capsules, Mybulen® capsules, Gen-payne® capsules and Ibupain Forte® capsules) represented the active ingredient combination with the highest prevalence for the entire study period, increasing from 28.44% (n=74 483) in 2001 to 33.08% (n=62 100) in 2006 of all combination analgesics prescribed (N=261 907 for 2001 and N=187 745 for 2006). Generic substitution influenced the prevalence of the innovator medicine item, Myprodol® Capsules dramatically, causing a decrease from 23.16% (n=60 631) in 2001 to 3.77% (n=7 084) in 2006 representation of all combination analgesic prescribed. In 2006, the generics of Myprodol® Capsules e.g. Dentopain Forte®, Mybulen® Capsules, Gen-payne® and Ibupain Forte® represented 23.79% (n=44651) of all combination analgesics claimed. Recommendations were derived regarding certain aspects of the clinical and economical management of pain e.g. the implication of generic substitution with regard to cost and prescribing patterns, and the decreasing cost of combination analgesics which might encourage abuse, needs further investigation. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2008.

Thesis (M. Pharm.)--North-West University, Potchefstroom Campus, 2008.

INTRODUCTION The intention of this study was to formulate guidelines for the implementation of Performance Management System (PMS) regarding line managers (LM) and employees (E) in a level 2 public hospital in the North–West Province. From a preliminary evaluation it was evident that the implementation of performance management as outlined in the NWPG policy No. 13, was not effective. The results of the research was to provide baseline data of the current policy implementation by the line managers and employees; an indication of the ability of the PMS to reach its goal of improved performance between line managers and employees in the long term; and the barriers to the policy implementation discovered over the course of the study. RESEARCH QUESTIONS Based on the statement of the problem, the following research questions were asked: * How is PMS implemented from the perspective of line managers in a level 2 public hospital? * How is PMS implemented from the perspective of employees in a level 2 public hospital? * What guidelines can be formulated for line managers and employees regarding PMS? AIM AND OBJECTIVES OF THE STUDY The principal aim of this study was to formulate guidelines for implementation of PMS by line managers and employees. The objectives below of the research which are derived from the principal aim were: * To describe the implementation of the PMS from the perspective of line managers in a level 2 public hospital. * To describe the implementation of the PMS from the perspective of employees in a level 2 public hospital. * To formulate guidelines for line managers and employees regarding PMS? RESEARCH DESIGN A quantitative, explorative, descriptive, and contextual design was used in this study to reach the overarching aim and respective objectives. RESEARCH METHOD The researcher firstly conducted a literature review to understand implementation of PMS and related constructs. Thereafter the researcher used two similar structured questionnaires for both LM and E to collect data. The questionnaires were developed to measure the perceptions of both LM and E in the implementation of PMS in a level 2 public hospital. The questionnaires were based on the six steps (performance planning, developing performance criteria, performance monitoring, performance review and assessment, annual performance assessment and performance assessment outcomes) of the current PMS policy used in a level 2 public hospital. The study is based on transformational leadership whereby the line managers (LM) as nurse leaders with transformational characteristics are assumed to be empowering the employees (E) and creating enthusiasm for nursing practice. Minor adaptations were made to the questionnaires prior to administration to the nursing personnel in a level 2 public hospital in North West Province. An all inclusive sample was taken, representative of a larger population and this amounted to twenty four line managers (n=24) and fifty five employees (n=55) that participated in the study. RESULTS There were problems identified from both the line managers (LM) and employees (E) in performance planning, developing performance criteria, and monitoring performance, organizing and the process of performance review and assessment and lastly the annual performance assessment. The main two main findings are: * The effect size of all the questions indicates a practically visible and thus significant difference with regard to LM and E perceptions of the implementation of PMS. * There is statistical evidence of improper implementation of PMS from both groups regarding some of the performance implementation items. Based on the empirical evidence and the problems identified from the results, guidelines for the implementation of PMS were formulated. It is suggested that these be used and implemented to streamline the PMS in level 2 public hospitals. Keywords: Key result areas (KRAs), Generic assessment factors (GAFs), reward, work plan, Performance Agreement (PA), Performance Management System (PMS). / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012.

In today’s computer age, the numerical simulations are replacing the traditional laboratory experiments. Researchers around the world are using advanced computer software and multiprocessor computer technology to perform experiments, and analyse these simulation results to advance in their respective endeavours. With a wide variety of tools and technologies available, it could be a tedious and time taking task for a non-computer science researcher to choose appropriate methodologies for developing simulation software The research of this thesis addresses the use of Message Passing Interface (MPI) using object-oriented programming techniques and discusses the methodologies suitable to scientific computing, also, propose a customized software engineering development model.

In April 2008, the Ontario government announced its top two healthcare priorities for the next 4 years, one of which is reducing wait time in emergency rooms. To study the wait time in emergency rooms or any other departments in a hospital, one must investigate resource planning, scheduling, and utilization within the hospital. This thesis provides hospitals with a set of simulation and optimization tools to help identify areas of improvement, particularly when there are a number of alternatives under consideration. A simulation tool (a Monte Carlo simulation model) estimates patient demand for beds in a hospital during a typical week. Two optimization tools (an integer programming mathematical model and a heuristics model) demonstrate opportunities for smoothing the patient demand for beds by adjusting the operating room schedule.