Thesis (M. Arch.)--University of Hong Kong, 2004. / Includes special report study entitled: Study of high density housing typology: architecture & infectious disease. Also available in print.

Thesis (M. Arch.)--University of Hong Kong, 2004. / Includes special report study entitled: Cinema and architecture: learning from cinema. Also available in print.

Thesis (M. Arch.)--University of Hong Kong, 2004. / Includes special report study entitled: The end of architectural ideology & new architecture. Also available in print.

Thesis (M. Phil.)--University of Hong Kong, 2005. / Title proper from title frame. Also available in printed format.

Thesis (M. Hous. M.)--University of Hong Kong, 2006.

<p> Adequate access to primary care is an integral part of any health care system. One indicator for access outcomes is potentially preventable hospitalizations (PPH), i.e., a hospitalization that occurs when a patient is hospitalized for an ambulatory care sensitive condition (ACSC). PPHs are of interest because the additional costs of caring for a patient in a hospital with an ACSC, as opposed to in a primary care setting, are substantial, for patients, payers, and hospitals. Identifying the factors associated with PPH will aid in policymaking, improve access to care, and reduce the burden on the health care system. To address the gaps in the literature, I analyze how community-level access to care resources and state policies are associated with PPH using nationally representative data, while controlling for individual patient characteristics and community-level demographics. Multiple publicly available and restricted use data sources are linked to create a comprehensive data set that is used to investigate the relationship between PPH rates and community access to care factors. The dissertation addresses the following three objectives: (1) To determine the association between state Medicaid policies and the odds of a potentially preventable hospitalization; (2) To assess how primary care capacity and the odds of a potentially preventable hospitalization varies across the urbanization spectrum; and (3) To assess how primary care capacity and the odds of PPH varies for chronic and acute ACSCs. The findings are summarized below: - An analysis of state Medicaid policies does not find any significant associations between the odds of PPH and Medicaid generosity index and managed care penetration. - Primary care physician supply and the presence of a federally qualified health center are associated with a lower odds of PPH across the urbanization spectrum. - Physician supply, primary care and specialist, is associated with a lower odds of PPH for chronic ACSCs, while nurse practitioner and physician assistant supply is associated with a lower odds of PPH for acute ACSCs. The presence of a federally qualified health center is associated with lower odds of PPH for both chronic and acute ACSCs.</p>

La pénalisation apparente de la responsabilité des agents publics constitue depuis 2004 l'un des traits marquants de l'actualité nationale. Pourtant, derrière ces pseudos condamnations se cache un océan d'impunité. Impunité parfois voulue et encouragée par les pouvoirs publics au point où, certains auteurs, ont qualifié cette attitude de « réinstitutionnalisation des infractions par l'Etat » pour montrer que par son action la puissance publique finit par donner le caractère légal à ce qui est illégal. Partant de ce constat, nous nous sommes proposé de répondre à la question : existe-t-il encore une responsabilité pénale pour les agents publics au Cameroun ? A l’observation, s’il est vrai que cette dernière est perceptible à bien des égards ; il est tout aussi vrai qu’elle est perfectible à bien d’autres égards. / One of the most important thing in cameroon actuality since 2004, is the apparent penalisation of public agents responsibility. However, these appearences appear just to be the tree hiding a forest of impunity. That impunity, which sometimes can be considered as encouraged by authorities, led some authors to speak about "the reinstitutionalisation of infractions by the STATE" to demonstrate how, the STATE with his power can make something illegal seen as legal.Thus, the question "do a penal responsability for public agents still exist in Cameroon ?" seems to be a logic confusion which the present work should try as possible to clarify and understand. Nevertheless, let us mention that the Cameroonian law clearly forbid and condemn all the responsibles, even public agents, of infractions. By then and as a matter of fact, all the public agents are penaly responsible. But although there exist a law for it, many things can be done in order to improve that law for the Cameroon to become more rightious.

<p> Understanding federal managers&rsquo; use of evidence (performance measurement data and evaluation results) to inform decision-making is an important step to develop concrete strategies to remove barriers to use and increase use. The goals of this research are to: 1) explain the extent to which senior level managers and executives in federal agencies use performance measurement data and evaluation findings and results to inform decision-making; 2) understand the factors that influence use of evidence to inform decision-making; and 3) explore strategies to enhance the use of evidence. </p><p> The study employs a case study approach focusing on four federal agencies whose managers&rsquo; exhibit varying degrees of success in utilizing evidence (e.g., performance measurement data and program evaluation results). The four case study agencies that are the subject of the study are: United States Agency for International Development (AID), Department of Treasury (Treasury), the Small Business Administration (SBA), and Department of Transportation (DOT). The study relied on publicly available secondary data sources that were supplemented by document reviews and interviews with a small number of key informants. </p><p> The findings indicate that performance measurement use occurs within the four case study agencies, however, it&rsquo;s use declined from 2007 to 2017 for SBA, DOT and Treasury. Although a decline in use for some categories was evident in AID, other types of use increased. The results indicate that nearly 40% or more of respondents for the case study agencies use performance measurement data to inform decisions related to program strategy, problem identification and improvements and personnel performance related issues. </p><p> The data also suggest an important distinction and nuance associated with different levels of management who use performance information, as well as specific types of use. For example, the agency&rsquo;s top leaders and first line supervisors are more likely to use performance measurement data. However, an organization&rsquo;s middle management tends to be less likely to use data to inform decisions regarding changes to the program. </p><p> The most common factors that influence performance information use across the four case study agencies include: manager perceptions about who pays attention to performance information, the lack of incentives and the perceived authority (or lack of) to make changes to improve the program. In addition, access to timely and readily available data, information technology and or systems capable of providing the needed data, access to training, and staff knowledge and expertise to develop performance measures and conduct evaluations were found to influence the use of performance measurement. </p><p> In general, there is an overall decline in the percentage of managers who report an evaluation of their program was conducted from 2013 to 2017 in all four case study agencies. Despite this decline, over 50% of AID managers were aware of an evaluation that was conducted within the past five years. The lower responses reported by DOT (28%), SBA (32%) and Treasury (34%) is consistent with the absence of robust program evaluation efforts. In 2017, managers at AID, SBA and Treasury report using program evaluation results to implement changes to improve program management or performance, while AID, DOT and Treasury managers report using program evaluation to assess program effectiveness, value or worth.</p><p>

<p> Over 59 million US residents live in rural areas where they cannot easily access healthcare services. Well-documented disparities between rural and urban healthcare access led the federal government to certify and financially support Critical Access Hospitals (CAHs), which offer rural healthcare services and 24/7 emergency care. Many CAHs are in dire financial distress, and some are looking to increase their patient population volume to improve financial health and ensure continued operations. It is a well-known business truism that satisfied customers are return customers. Today many patients' first encounter with a hospital is with the emergency department (ED). Thus, it is likely that increasing patient satisfaction with their ED visits in a CAH can be expected to increase the chance that they will return for additional care. </p><p> All hospitals engage in quality improvement (QI) activities. Many papers outline efforts by QI teams to implement one or a few predetermined interventions with mixed results. Because patients in an ED are subject to a variety of processes in the ED and other hospital departments, improving patient satisfaction in the ED demands a comprehensive approach. This paper focuses on the QI processes and tools used by the QI team in a CAH that developed a comprehensive list of (56) short- and long-term interventions to take place over five years to improve patient satisfaction in the ED. For this hospital, two aspects of the project deserve mention: </p><p> 1. The use of Failure Mode and Effects Analysis (FMEA): The FMEA is a QI tool developed by the military to address complex problems. Although it has been adapted for use in healthcare QI, in the author's experience, it has not always been fully implemented. The QI team completed a traditional, full, two-part FMEA. In completing both parts of a traditional FMEA, the team first identified and individually analyzed each known or potential failure in the care of an ED patient and potential interventions that could prevent each failure. Then, after careful analysis of all potential interventions, the QI team chose those most likely to succeed and began implementing a sequenced schedule of interrelated interventions deemed most likely to improve care and patient satisfaction. </p><p> 2. Learner-Centered Teaching: QI projects typically use learner-centered teaching methods that, according to Social Cognitive Theory, improve participants' general self-efficacy, which is the likelihood of choosing difficult problems to solve and persisting when faced with challenges. The hospital's project team members' self-efficacy scores increased after participating on the team. Post-project interviews with team members indicate they feel better equipped to solve other problems and have begun to plan other QI projects because they understand other areas' processes, they know who should participate on projects, and they better understand QI processes and tools.</p><p>

Civil Service reform has swept through all levels of government during the last decade. These reforms call for greater managerial flexibility at the expense of civil servant employment security and tenure. This work examines the effects of these reforms on the psychological contract of various generations working in Florida's state government. The psychological contract can be defined as an exchange agreement of promises and contributions between two parties, the employee and employer, and includes an individual's beliefs regarding mutual obligations (Rousseau, 1990, 1995). Psychological contract theory is believed by many to be the most accurate explanation of the varied, albeit primarily negative, reactions of employees to job insecurity (King, 2000). The psychological contract becomes an important and appropriate framework to study employee perceptions of civil service reforms. In this research, three distinct literatures were reviewed to build a theory of worker perceptions based on generational cohort. First, a brief account of the civil service reform efforts taking place. From there, the work outlined streams of research associated with the psychological contract and generational differences. From there, gaps in the literature were identified and hypotheses proposed. The hypotheses fell into four groups: psychological contract obligations, job security, self-reliance, and loyalty/commitment levels. Age (birth year) was converted to generational cohort variables which were used in the exploration of generational differences. Analysis of Variance was used to identify the differences in means. The predicted theory of this research was that various generations hold differences in psychological contract perceptions, self-reliance factors, and various career and organizational commitment measures. This theory was only partially supported by the findings. The findings were significant in the area of continuance commitment. There was also significance found between the hypotheses and various control variables. Possible reasons for this are discussed. Employment conditions are changing rapidly in today's public and private work environments. Researchers have attempted to capture the effects of those changes on perceptions, including their effects on the psychological contract. This research contributes to a better understanding of civil service reform, psychological contract, and generational differences. Moreover, it highlights the need for additional research that will illuminate a more accurate conceptualization of the relationship between generation and worker perceptions. / A Dissertation submitted to the Askew School of Public Administration and Policy in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester, 2007. / April 23, 2007. / Motivation, Generation, Civil Service Reform, Psychological Contract / Includes bibliographical references. / Mary Ellen Guy, Professor Directing Dissertation; Pam Perrewe, Outside Committee Member; James Bowman, Committee Member; Kaifeng Yang, Committee Member.