Background: Since 1849, Catholic religious have provided health services in South Africa. They have established hospitals, clinics, and have provided community-based preventive and curative services throughout the country. Today faith-based organizations (FBOs) continue to play an important role in healthcare delivery and are crucial to the goal of providing universal access to antiretroviral therapy (ART). In order to scale up HIV care and treatment, there is a need to describe and analyze ART models of care (MOC) that address the challenges faced by developing countries. The South African Catholic Bishopsâ Conference (SACBC) manages twenty ART clinics in medically underserved South African communities, where the need is great, but the resources limited. These SACBC managed ART clinics operate on different MOC. A study to describe, analyze and compare the different MOC can inform future directions in healthcare delivery in resource-constrained settings. Method: A single case-study design was used to describe, analyze and compare four different MOC (managed by the SACBC) for ART delivery, as embedded units of analysis. A mixed method approach was used, incorporating qualitative and quantitative information. Data were collected using structured interviews (n=1,006 adult ART patients), file audits (n=1,006 files of the respondents), semistructured interviews (n=27 healthcare workers) and nominal groups (n=12 groups with Home Based Care-workers). Descriptive and inferential data analyses were conducted by a biostatistician from the Department of Biostatistics at the University of the Free State and the researcher. Findings: In the study, patients accessed care late (CD4=119 cells/mm3). Decentralized care provided better access. Family members are a potential source of support because disclosure rates to relatives and others were high (95.63%). Nurse-driven, doctor supported care was not inferior to doctor-driven care. Task-shifting to registered nurses and HBC-workers can be implemented successfully with support. Differences exist between the South African Government (SAG) -managed model and the FBOâmanaged models. Partnership between the SAG and FBO strengthened the SAG-managed MOC, while capitalizing on the sustainability of the government services. Functional information systems, developed by the FBO, were implemented at all the MOC in 2009. All the MOC focused on acute care. Conclusions: Nurse-driven decentralized service can most effectively and appropriately address the chronic nature of HIV and strengthen the healthcare system by a paradigm shift to a chronic care model. Based on the findings, a chronic care model was adapted for South Africa that has seven elements: (1) an integrated, decentralized chronic care system based within a primary health setting; (2) partnerships with NGOs; (3) an effective information management system; (4) patients and their families; (5) self-management support to patients; (6) provider decision support and (7) delivery system redesign. Implications for the nursing profession include adaptation of focus and training, as well as the recognition of the nurse practitioners/specialist role in South Africa.

The researcherâs observation that patients do not always understand what they are consenting to was confirmed by various sources. According to Northouse and Northouse (1998: 270) and the South African Department of Health (2006: 11) patientsâ lack of comprehension in the process of informed consent is a general phenomenon taking place in every hospital setting due to factors such as lack of interpersonal relationships between the health care professional and the patient cultural practices as well as language. A quantitative, descriptive study design was used to describe the process of obtaining informed consent prior to a surgical procedure in a hospital in the Northern Cape. Specific objectives were to: (1) describe the current practice of obtaining informed consent prior to a surgical procedure or an operation; and (2) make recommendations to relevant stakeholders for the purpose of improving the process of informed consent for an operation or procedure and thus the quality of health care. A structured interview, based on a questionnaire, was used to gather information using convenient sampling as the primary sampling method because it was feasible and affordable. A pretest was done before the main data collection process, but the results were not included in the final results. Data collection took place over a period of 90 days and included 150 participants who all met the inclusion criteria determined by the researcher. The researcher was assisted by a biostatistician who made use of Statistical Analyses Software (SAS) in order to analyze the data. Descriptive statistics namely means and standard deviations or medians and percentiles were calculated for continuous data. Frequencies and percentages were calculated for categorical data, and the analysis was done by a biostatistician. The researcher organized the study results according to tenets of capacity to consent to give meaning to the data and make it easy to understand. Figures and tables were used to present the large amount of detailed information concisely and clearly. More than one third of the sample was vulnerable due to their low educational level and unawareness of their rights as patients. Unfortunately no effort was made to ensure that they fully comprehended what they were consenting to. Recommendations focused on strategies to improve understanding by patients and to inform patients of their rights and responsibilities.

<p> The purpose of this quantitative study was to examine considerations that a sample of parents identified as influential when deciding to open enroll their children into a specific Wisconsin school district. Under Wisconsin Act 27, parents have the right to choose their children's public school through so-called open enrollment. This act also provides for state funding of public schools based in part on student enrollment. If a public school district's student enrollment increases, state funding increases. In recent years the district in this study experienced significant net loss in student enrollment and funding. As a result, programming, salaries, curriculum, facilities, and more were adversely affected. A survey was administered to a convenience sample of 64 families out of a target population of 117. Results indicated school culture and relationships were reportedly primary influences on parents' decisions to open enroll into the study district. Additionally, quality of academics was reported as an influential consideration. Stakeholders may incorporate these considerations when planning marketing and public relations strategies. Findings from this study may provide stakeholders with ways to attract and maintain students in the study district, and may also assist policymakers.</p>

Children do not acquire adequate amounts of physical activity (PA), there for it is important to identify opportunities to increase PA. The purpose of this thesis is to characterize PA during the school day, and to determine the effectiveness of a short term recess PA intervention. Children from two schools (N=75, ages 7-10) wore pedometers for five days. A subset of subjects (N=17) also wore accelerometers. Step counts were recorded 9-10 times/day to obtain PA information for six daily periods. Males were more active than females (P<0.001, 12.331, 9439 step/day respectively). Recess contributes 30.6% of daily step counts, while PE contributes 17.2%. Sex, period duration, weather and location of PA period all were factors for PA. The intervention was effective in increasing PA by a mean 985 (±1808) steps/day (P<0.05). Recess is window of opportunity in which to improve on PA and pedometer interventions are effective in this area.

This thesis examined the relationship of six factors related to the growing problem of missed copy submission deadlines in high school yearbook programs. These factors were: a) the historical tendency for companies to deliver books on time despite missed deadlines, b) the ability of extra-curricular programs to meet deadlines vs. intra-curricular programs, c) the relationship of adviser training to missed deadlines, d) the relationship of complex pages to missed deadlines, e) the relationship of student involvement outside of school to missed deadlines, and f) the relationship of staff motivation to missed deadlines.Six states were identified to represent national trends in the yearbook industry--California, Florida, Indiana, Michigan, New Jersey, and Pennsylvania. These states offered a regional balance as well as one inadviser training and in programs delivering books during different seasons. They also reflected the national shares of the major yearbook companies. Surveys were mailed to 1,200 advisers, 200 in each state. Surveys were mailed to all sales representatives in these states from the six major companies. In addition, each company received a survey requesting statistical information used to define the problem in the study. Follow-up phone interviews were conducted with 13 advisers and 15 representatives. Interviews were also conducted with 12 company employees at three yearbook plants and three company executives by phone.The conclusions of the study showed that missed yearbook deadlines are most directly related to the adviser, his or her attitude toward deadlines, and his or her education and training. It is apparent that while other factors are involved in the issue of missed deadlines, the adviser is the key element in meeting those deadlines. The adviser provides staff motivation and education and is the common link from year to year. It is therefore concluded that adviser training and education is a responsibility of the school system in hiring trained advisers. Having trained advisers is also to the advantage of publishing companies.

There is no abstract available for this dissertation.

There is no abstract available for this dissertation.

There is no abstract available for this dissertation.

The modern superintendent is a key figure in the administrative process of the public school system. In fulfilling his role, he must consider performing numerous functional tasks which involve the many facets of the educational program.It was the purpose of the study to: (1) identify the functional tasks of the superintendent, (2) to determine if the performance of the identified functional tasks varied according to the pupil enrollment of the school corporation, and (3) to determine whether or not the functional tasks were totally accepted, partially delegated, or totally delegated by the superintendent.As a result of a review of the research and literature related to the superintendency, and consultation with professional educators, a list of 150 functional tasks ascribed to the superintendent was developed. The functional tasks pertained to eight areas of educational administration: (1) finance and business management, (2) instruction, (3) pupil personnel, (4) school plant, (5) school-community relations, (6) staff personnel, (7) relations with board of education, and (8) general.The functional tasks were incorporated into a questionnaire, which was mailed to 280 Indiana superintendents in August, 1970. The superintendents were asked to respond to each functional task in one of four ways: (1) did he "totally accept" the performance of the functional task, (2) did he "partially delegate" the performance of the functional task, (3) did he "totally delegate" the performance of the functional task, or (4) was the functional task "not performed" in the school system. Two hundred and thirty-two (232) or 82.8 per cent of the superintendents returned questionnaires.The data derived from the questionnaires were analyzed in four ways: (1) The functional tasks performed and not performed by the superintendents were summarized according to the functional categories in which they were placed and by school corporations of specified pupil enrollment. (2) The rank order of the functional categories was compared among school corporations of specified pupil enrollment. (3) The functional tasks not performed were identified according to the size of the school corporation. (4) A comparison was made of the degrees of delegation of the functional tasks among school corporations of specified pupil enrollment.The analyzed data indicated the following, in terms of functional tasks of superintendents in the State of Indiana: (1) In general, as the pupil enrollment of the school corporations increased, the degrees of delegation of the functional tasks tended to shift from totally accepted to partially delegated to totally delegated. (2) Functional tasks making up the functional category relations with board of education tended to be totally accepted by the majority of superintendents regardless of the size of the school corporations. (3) In school corporations with small pupil enrollments, the superintendent generally totally accepted the majority of the functional tasks in the functional categories finance and business management, school plant, and general; while superintendents in school corporations with larger pupil enrollments tended to partially delegate and/or totally delegate the performance of these functional tasks. (4) The majority of the responding superintendents, regardless of the size of the school corporation, either partially delegated or totally delegated the functional tasks involving pupil personnel. (5) In general, the superintendents and the professional staff tended to share the responsibility for the performance of the majority of functional tasks in the functional categories instruction, school-community relations, and staff personnel. (6) The smaller the school corporation, the greater the number of functional tasks indicated as not performed. The functional tasks most effected in this way were in the areas of instruction, school plant, school-community relations, and staff personnel.

The purpose of this study was to investigate various role-definer groups' perceptions of the school psychologist's role with regard to real behavior and ideal behavior. The role-definer groups were: special education teacher, special education director, elementary school teacher, elementary school principal and school psychologist. An instrument was developed and piloted on randomly selected members from each role-definer group throughout the states of Indiana and Michigan. Upon revision, the 15-item instrument in questionnaire form was sent to 50 randomly selected members from each role-definer group in each state. A total of 325 completed questionnaires (65%) were returned for inclusion in the analyses. The subjects responded to each of the 15 items with a Likert-type response on a 7-point scale.An analysis of variance with contrast was utilized to test for any differences between the school psychologist and each of the other role-definer groups in how they perceived the real role functions and the ideal role functions of the school psychologist. There were some significant differences, primarily related to direct service activities vs. consultant-type activities.A one way analysis of variance was utilized to test for any differences between the Indiana role-definer groups and the Michigan role-definer groups in how they perceived the real role functions and the ideal role functions of the school psychologist. There were some significant differences, primarily related to the specialization of expected services from the school psychologist. It appeared that less specialization was expected from the Michigan school psychologist than from the Indiana school psychologist, possibly due in part to the difference in administrative models utilized by the states.A correlated t-test was utilized to test for any differences in how each role-definer group perceived the school psychologist's real behavior compared to the school psychologist's ideal behavior. Significant differences were found for 70 of the 75 possible hypotheses (i.e., 15 items x 5 role-definer groups). It appeared that, for the most part, role-definer groups preferred that the school psychologist function differently.