M & A indeed is one of speedy growing methods for enterprise. But not every one enterprise can get its effectiveness as expectation after conducting merger. There is usually a huge organizational change is hidden behind M & A. The retained employees after the merger face the new company, seems like new employees that just inaugurated, filled with strange and a sense of uncertainty. In 1998, Watson Wyatt Company made a survey and found most of the merger failed to achieve the strategic target as expectation, M & A will ultimately lead to failure or poor performance, in addition to cultural differences, "people" issues can not be integrated effectively by the system is a major key factors, such as the leave of excellent talents, staff remaining in the low efficiency, So triggered the human resources issues discussed after M & A. The purpose of this study was to research successful key factor of human resources integration in the process of M & A which through an interview with qualitative, considering the time appropriateness and the difficulties of backtracking information validity to avoid making poor effectiveness. Especially to choose a case of retailer Taiwan in 2006 as example, French Carrefour merged with British Tesco to study. Also considering the impact of mergers and acquisitions on the acquired employees are greater than the acquiring ones, especially the employees under the middle management level, we selected the remained employees under the middle management level in the acquired corporation as the sample. This empirical study found that the unmet expectation of acquired employees not only from job regulations and benefit, but also from the person-organization fit of the acquiring corporation. The unmet expectation may both affect the psychological and behavioral stress of acquired employees. It also affects the organizational commitment of acquired employees to the acquiring corporation. The unmet expectation has a direct effect on the job stress and organization commitment. It also has an indirect effect on the performance positively through the perceived organizational support. The purpose of this study is to explore the human resources integration challenges under merger and acquisition of the pharmaceutical company A. The findings are from focused interview with employees of different backgrounds including acquired company employees, acquiring (A) company employees and top management team of the A company. The research results indicate that¡G 1.Under M&A, the internal integration team with outsider consulting firm¡¦s professional assistance will minimize the resistances. 2.Under M&A, the specific HR integration structure is needed. 3.Under M&A, the comprehensive communication plan is needed to erase the rumors and gossips. 4.Under M&A, the talent deployment must retain all the talents from both-side companies and eliminate the poor performers in the acquiring company. 5.Under M&A, for ensuring every colleague in the new company move forward to the same goals, the enterprise has to review the performance appraisal and management system.

Background: The School Health Program (SHP) in the Republic of Panama includes preventive healthcare services delivery and referral issuing at elementary schools nationwide. Despite these early prevention efforts, a majority of referrals are apparently not achieving their desired outcome. This idea is supported by the SHP data showing preventable diseases on the rise. Thus, learning the outcome rates of particular referral outcomes may provide a basis for appropriately targeted action. Methods: Three focus groups were conducted with health workers, medical records staff, and teachers, respectively. Following systems thinking and framework analysis, a pilot plan for referral tracking and referral outcome rates obtainment was developed. Finally, the SHP team was surveyed for their perception on the effectiveness and feasibility of the plan, for future implementation. Results: Themes related to referral tracking led directly to the development of a referral tracking pilot plan (RTPP). Survey data analysis revealed that the SHP team perceived the RTPP as an effective way to obtain complete referral tracking and referral outcome rates, and they also found it feasible to implement. Conclusion: Keeping referral records and tracking the SHP referrals is perceived, by those that will be involved in its delivery, as achievable by implementing a RTPP developed from their own recommendations. Once implemented, the resulting obtainment of referral outcome rates may allow them to know if the SHP preventive objective for issuing these referrals is being properly achieved, and to prioritize for targeted action where needed.

The objectives of this thesis were to examine (1) associations between primary care type (team-based versus non-team based) and access problems (difficulty in access and self-reported unmet need), and (2) if socioeconomic variations in access problems were less graded for team-based than non-team-based primary care. Data came from a nationally representative cross-sectional survey, the 2008 Canadian Survey of Experiences with Primary Health Care. Using logistic regression, we examined the associations between primary care type and access problems, adjusting for demographic, health status, socioeconomic, and health care supply factors. We then stratified by primary care type to compare steepness of socioeconomic associations with access problems. Primary care type had no statistically significant, independent associations with access problems. No statistically significant socioeconomic gradients in access problems were observed regardless of primary care type, except that difficulty in access was statistically significantly and positively graded by education for non-team-based primary care.

Introduction: Cancer survivors continue to experience psychological distress and challenges in their daily lives long after the completion of treatment. Caregivers play a pivotal role in the lives of cancer survivors by providing support in various domains of their lives. The cancer experience between support persons and cancer survivors is intertwined. The interdependence theory will serve as a theoretical framework to guide the purposes of this study. Objective:The purpose of this research was to gain a better understanding of unmet needs of caregivers supporting long-term cancer survivors and explore how fulfilling the needs of caregivers influenced the psychological well-being of cancer survivors. Specifically, an emphasis was placed on exploring the level of dependence present in marital relationships, and how this impacted the relationship between caregiver unmet needs and the psychological outcomes of cancer survivors. Method: Data was drawn from The Cancer Support Persons’ Unmet Needs Survey (SPUNS) (Campbell et al., 2009) and The Cancer Survivors’ Unmet Needs Survey (SUNS) (Campbell et al., 2009). Regression models tested for significant interactions between caregiver unmet needs and factors influencing survivor dependence with psychological distress in cancer survivors. Results: Findings revealed main effects between caregivers’ depression, anxiety, and stress with the respective psychological outcomes in cancer survivors. Caregivers’ concerns about the future predicted elevated depression in cancer survivors. Caregivers with needs pertaining to information or emotions predicted higher anxiety in cancer survivors. Information needs, future concerns, and health care access and continuity needs of caregivers predicted higher survivor stress. Conversely, work and financial needs of caregivers predicted lower depression, anxiety and stress in cancer survivors. Significant interactions were found for caregivers’ concerns about the future by recurrence of diagnosis with decreased survivor anxiety, health care needs of support persons by recurrence of illness with increased survivor anxiety, caregivers’ personal needs by severity of illness with higher survivor anxiety, support persons’ emotional needs by severity of illness with lower survivor anxiety, caregivers’ emotional needs by severity of illness and decreased survivor stress, and finally, support persons’ health care needs by severity of illness with higher survivor stress. Conclusion: Findings did not fully support the hypotheses of this present study. Nonetheless, the significant results revealed in the findings would be useful to generate alternative hypotheses in future studies regarding interdependence, unmet needs and psychological well-being. The findings for the present study will also provide direction towards improvement in treating caregivers and cancer patients as a conglomerate, and inform programs, services and policies in cancer care.

As the number of cancer survivors continues to rise, there is an increasing need for psychological research to better understand and help individuals cope with their cancer journey. According to Socioemotional Selectivity theory (SST), shortened time perspective and mortality awareness heighten the importance of social and emotional goals. In the present analysis, SST is applied to the unmet needs of cancer survivors. This is done to provide a better understanding of the association between unmet needs of cancer survivors and the impact of such needs on the survivors' psychological well-being, especially in the case of survivor’s awareness of his/her mortality. In keeping with SST theory, we anticipated that for those with higher mortality awareness (e.g., recurrence of cancer, older age, greater mortality ratio), high unmet social and emotional needs, above else, will be associated with lower psychological well-being. Partial support was found for these hypotheses and results are discussed in terms of their contribution to a better understanding of the nature of psychological well-being of cancer survivors.

Master of Philosophy (Medicine) / Health care evaluation serves the purpose of monitoring the quality of health care provided by Health Care Providers (HCP), so that health care services can be provided most effectively and efficiently. Patient satisfaction studies are widely used to assess the quality of outpatient care. A client satisfaction study was conducted at an HIV health care facility in Sydney, Australia during 2007-2008. There were three objectives: 1.) To validate a questionnaire for future determination of client satisfaction in HIV health care facilities. 2.) To identify the levels of satisfaction of clients, and investigate any dissatisfaction and unmet needs towards HIV health care. 3.) To provide recommendations for improving client satisfaction levels in HIV health care. This research used a mixed method approach and consisted of two phases. The first phase was a quantitative survey conducted with 166 clients (both HIV positive and negative) at Albion Street Centre (ASC) using a newly-devised questionnaire. Clients were asked to answer demographic questions, rate their levels of satisfaction with each aspect and each HCP category, and provide suggestions for improvement. Quantitative statistical analysis was conducted to obtain a general view of client satisfaction levels. Dissatisfaction and unmet needs of clients were then investigated in-depth in the second phase of the research through qualitative face-to-face semi-structured interviews. Twenty-two clients (both HIV positive and negative) at ASC were interviewed individually and asked about their attitudes, perceptions, and experiences towards their HCP and the HIV health care services received. Thematic analysis was used to categorise and interpret the qualitative data. More than 90% of the clients were satisfied with most of the aspects covered in the survey, with a mean overall satisfaction score of 84 out of 100. Clients were most iii satisfied with the “technical quality” and “interpersonal manner” of the HCP, and were least satisfied with “waiting time” and “availability of HCP”. The HCP category with which the clients has the highest level of satisfaction was “nurses” (86%), followed by “psychologists” (84%), then “doctors” (83%). Clients who were HIV negative, had a full time job, visited ASC less frequently, or did not possess any type of Health Care Card were more satisfied with the services overall. No common dissatisfaction or unmet needs towards HIV health care service were identified. “Technical quality of HCP” and “the relationship with HCP” were the two most important determinants of client satisfaction, which outweighed the inconvenience contributed by the poor availability of HCP and the location of ASC. The maintenance of “confidentiality/privacy” was shown to be fundamental in HIV health care facilities. The multi-disciplinary nature of ASC increased the degree of convenience and satisfaction level among clients. Suggestions for improvement in client satisfaction levels include increasing the attractiveness of the physical environment and the variety of educational reading materials in the waiting area; introducing beverages, and encouraging clients to be involved in their treatment decisions. Health care administrative staff in particular are reminded not to neglect the importance of the availability of HCP, accessibility, and physical environment when establishing a new HIV health care facility. The mixed method approach (quantitative survey and qualitative interviews) proved beneficial. It increased the validity of the findings by assessing client satisfaction levels using more than one method. This enabled clarification of ambiguities noted in the initial survey through probes used in the interviews, and also allowed investigation of the determinants of client satisfaction through understanding their experiences in HIV health care. Future client satisfaction studies would benefit from using this approach.

abstract: The dissertation examines treatment services received by youth on probation in the Maricopa County, Arizona. The project focuses on three primary issues: 1) the factors associated with receiving treatment services while on probation, 2) the factors associated with receiving treatment services through different funding streams, and 3) whether treatment services and specific characteristics of treatment services, particularly the funding source, influence recidivism outcomes of youth. To answer these questions the research used data obtained from the Maricopa County Juvenile Probation Department from July 2012 thru August 2014. Multivariate regression, along with statistical techniques to control for selection bias, were used to identify the factors associated with receiving treatment services, the factors associated with the funding source of treatment services, and the effect of treatment services on recidivism. The findings from the current dissertation suggest that the receipt of treatment services is not equal across groups, and particularly that minorities are less likely to receive treatment services compared to their White counterparts. Additionally, the findings reveal that certain characteristics of youth and the type of treatment service received influence the funding source, but the source of funding does not influence the effectiveness of the treatment services. Finally, using propensity score matching, the current dissertation found that treatment services were effective in reducing recidivism while under probation supervision and 6 months after probation supervision has ended. Implications for policy and research are discussed in light of these findings. / Dissertation/Thesis / Doctoral Dissertation Criminology and Criminal Justice 2015

Caregivers while, the biggest providers of palliative care for terminally sick patients, are often neglected in the process of providing care, which inadvertently affects their overall health and well-being. This study aims to explore the experiences of the unmet needs of the caregivers in palliative care. The literature review is based on seven quantitative, four qualitative and one mixed methodology approach studies. Results show a shortage of information given to caregivers regarding disease progression, symptomatology, support services and financial services. Furthermore the themes of unmet needs that emerged are physical, psychological, emotional, social and spiritual needs. Caregivers also reported the shortage of standard services provided by healthcare sector.  A healthy relationship scenario, where caregivers are supported to look after themselves as well as their loved ones, would boost the support they render to the patients.  The provision of needed services to caregivers, nurses, and healthcare personnel is required to fulfill a healthy relationship and further develop it by learning from the caregivers’ experiences. In conclusion, effective communication between caregivers and care providers is found to be a prerequisite for building trust and could contribute to satisfy the informational, medical, social and spiritual needs while helping to decrease health strains of caregivers.

This thesis examines several nuanced issues, including equitable access, regarding long-distance intercity travel. In the United States, studies of transportation equity focus on affordable access to local destinations and basic services. The limited studies of long-distance intercity travel focus on observed demand, ignoring latent or unmet demand. Both quantitative and qualitative data are used to explore the differences between those who participate in long-distance travel and those with unmet need for it. This thesis found that the ability to participate in long-distance travel plays a role in one’s overall well-being. Undertaking long-distance trips facilitates access to opportunity for cultural and educational experiences, as well as the maintenance and creation of social capital, factors which were indicated by study participants. The first part of the thesis examines equity in access to long-distance travel between individuals by using data from a state-wide survey completed by 2,232 Vermonters for the Vermont Agency of Transportation in 2016. Five ordinal logistic regression models that approximate different levels of realized and unmet travel are used to understand how access to intercity travel differs by socioeconomic, geographic location, and household characteristics. A total of 22 percent of respondents indicated they had unmet demand at least once per year. Furthermore, there was a significant correlation between those who had unmet demand within Vermont and outside of Vermont, proxies for local and intercity travel, respectively. Income level, Internet access, and education level were found to be significant predictors of realized long-distance travel. Household size and composition, household vehicles, age, income, and self-reported urban residence were predictors of both unmet local and long-distance travel need. In addition, full-time employment was significant for local unmet need, while miles to the nearest metropolitan area was a significant predictor for longer travel needs. Models of actual travel were stronger than for unmet demand, indicating that other unmeasured predictor variables may be important, thus requiring qualitative exploration. The second part of the thesis consists of an in-depth examination using semi-structured interviews regarding intercity travel with 24 women living in Chittenden County, Vermont. In addition to the qualitative survey methods, data from a social network geography survey designed specifically for the study and an overall well-being survey were used. Interviews were coded by theme relating to travel type, barriers to travel, and impact on quality of life. A majority of participants felt long-distance travel was very important or essential to their well-being and they wished to increase the amount they did. Additionally, participants felt the need to meet with friends and family in-person, therefore necessitating long-distance travel to those who lived further away. There was also a discrepancy between the desire to meet with friends and family and how often the participants actually were able to do so. Those with higher incomes had less unmet long-distance travel need.

The changing working environment and ageing workforce suggest that many workers will inevitably reach a career plateau, a stage where people regard future promotions as unlikely, or no longer feel challenged at work. Experiencing career plateau is found to be associated with negative job attitudes and performance in the workplace. However, existing studies have been mainly cross-sectional in design and few of them investigate the mechanisms and the conditions that influence the negative relationship. This study follows a quantitative longitudinal research design to further enhance the understanding of the relationships between career plateau and job outcomes. The job outcomes in this research include work attitudes such as job satisfaction, organisational commitment, turnover intentions and three aspects of job performance. Specifically, the three research aims of this thesis are: (1) to understand the causal directions between career plateau and job outcomes, (2) to examine whether employees’ unmet expectations may explain these relations and (3) to investigate whether employees’ age may modify the mediation effects of career plateau on job outcomes via unmet expectations. Three waves of data were collected from working individuals in various industries over an eight-month period. The majority of the participants were working in the UK or in Taiwan. Results showed that unmet expectations partially explain the negative relationship between career plateau and job attitudes over time but not for job performance. Furthermore, age did not affect the strength of the mediation effect of career plateau on the job outcomes through unmet expectations. The significance of this research is three-fold. First, it provides a new explanation for the unfavourable work attitudes of plateaued individuals. The findings that career plateaued employees have lower job satisfaction, lower organisational commitment and higher turnover intentions can partly be explained by unfulfilled expectations in receiving promotions or challenging tasks. Second, the study signals the danger of career plateau at any age, as younger and older workers were found to be equally influenced by career plateau. Finally, this is the first study in the area that seeks to resolve the debate over the directional relationship between career plateau and job outcomes. The implications in theory and in practice, limitations and suggestions for future research directions are discussed.