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Disney, Tom. "Between care and control? : orphan geographies in the Russian Federation." Thesis, University of Birmingham, 2015. http://etheses.bham.ac.uk//id/eprint/6298/.
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While many countries in the West have been broadly pursing policies of deinstitutionalisation since the latter half of the 20th Century, orphanages remain the norm for many countries. Orphanage research has often tended to be conducted through a bio-psychological lens, and there remains little qualitative research to reveal the nuances of micro-scale practices taking place within these institutions. This thesis employs a multi-sited ethnography and explores the orphanage as a complex institution influenced by Soviet and Post-Soviet practices of childcare. In particular, this research draws upon an ethnography conducted in an orphanage for children with severe intellectual disabilities. The thesis considers the multiscalar nature of this institution and explores childhood mobilities, agency and elements of discipline and control within the institution, destabilising the notion of the orphanage as an environment of care. This research addresses significant empirical lacunae in human geography and studies of post-socialism through an ethnographic study of Russia's disability orphanages. This research also challenges understandings of mobility in children's geographies by drawing upon theories of coerced and disciplined mobility. Finally, in highlighting the vulnerability of these children, this thesis develops the concept of 'contingent agency' to provide a more nuanced understanding of agency in children's geographies.
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Hanrahan, Kelsey B. "Living Care-fully: Labor, Love and Suffering and the Geographies of Intergenerational Care in Northern Ghana." UKnowledge, 2015. http://uknowledge.uky.edu/geography_etds/40.
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Care is socially constructed, shaped by expectations embedded within particular relationships and the culturally-specific understandings of what it means to work, love and suffer. In this dissertation, I conceptualize care as a fundamental component of everyday life in which individuals are oriented towards the needs of others. Drawing on ethnographic fieldwork in a rural Konkomba community in northern Ghana, I explore the geographies of care shaping the everyday experiences of women engaged in intergenerational relationships as they encounter emerging dependencies associated with ageing. Dependencies emerge when an individual requires support and care from another, and in turn the struggles for, and the provision of this support has material and emotional implications for those involved. I make three primary contributions. First, I examine the potential for a feminist ethics of care within livelihoods approaches in order to destabilize notions of independence and material outcomes, arguing that livelihood strategies are characterized by interdependencies within families and communities. Second, I contribute to an understanding of the politics of care by considering women's mobility in the face of competing demands on their labor and resources. Despite responsibilities to provide a 'good death', women experience social and material hurdles to negotiate their mobility in order to provide end of life care to a parent. Third, I explore the embodied emotional experiences of elderly women as they experience dependencies and struggle to engage in material exchange and caring relationships. As a result of these emergence of dependencies, women's everyday lives are deeply shaped by experiences of love and suffering. In northern Ghana, as in other rural agrarian communities in developing regions, the elderly population is growing and a weak formal care infrastructure is ill-prepared to face the pressures of an ageing population. Through this dissertation, I highlight the complex geographies of care shaping everyday life experiences and contribute to an understanding of the particular issues faced by communities where intergenerational relationships are key to lives lived with care.
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Cole, Edward. "Handle with care : historical geographies and difficult cultural legacies of egg-collecting." Thesis, University of Glasgow, 2016. http://theses.gla.ac.uk/7800/.
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This thesis offers an examination of egg-collecting, which was a very popular pastime in Britain from the Victorian era well into the twentieth century. Collectors, both young and old, would often spend whole days and sometimes longer trips in a wide variety of different habitats, from sea shores to moorlands, wetlands to craggy mountainsides, searching for birds’ nests and the bounty to be found within them. Once collectors had found and taken eggs, they emptied out the contents; hence, they were really eggshell collectors. Some egg collectors claimed that egg-collecting was not just a hobby but a science, going by the name of oology, and seeking to establish oology as a recognised sub-discipline of ornithology, these collectors or oologists established formal institutions such as associations and societies, attended meetings where they exhibited unusual finds, and also contributed to specialist publications dedicated to oology. Egg-collecting was therefore many things at once: a culture of the British countryside, from where many eggs were taken; a culture of natural history, taking on the trappings of a science; and a culture of enthusiasm, providing a consuming passion for many collectors. By the early twentieth century, however, opposing voices were increasingly being raised, by conservation groups and other observers, about the impact that egg-collecting was having on bird populations and on the welfare of individual birds. By mid-century the tide had turned against the collectors, and egg-collecting in Britain was largely outlawed in 1954, with further restrictions imposed in 1981. While many egg collections have been lost or destroyed, some have been donated to museums, including Glasgow Museums (GM), which holds in its collections over 30,000 eggs. As a Collaborative Doctoral Award involving the University of Glasgow and GM, the project outlined in this thesis aims to bring to light and to life these egg collections, the activities of the collectors who originally built them, and the wider world of British egg-collecting. By researching archival material held by Glasgow Museums, published specialist egg-collecting journals and other published sources, as well as the eggs as a material archive, this thesis seeks to recover some of the practices and preoccupations of egg collectors. It also recounts the practical activities carried out during the course of the project at GM, particularly those involving a collection of eggs newly donated to the museum during the course of this project, culminating in a new temporary display of birds’ eggs at Glasgow Museums Resource Centre.
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Chubachi, Natsuko. "Geographies of nisei Japanese Canadians and their attitudes towards elderly long-term care." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0001/MQ42599.pdf.
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Williams, Andrew. "Geographies of faith, welfare and substance abuse : from neoliberalism to postsecular ethics." Thesis, University of Exeter, 2012. http://hdl.handle.net/10036/3751.
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The increasing prominence of faith-based organisations (FBOs) in providing welfare in the UK has typically been regarded as a by-product of neoliberalism, as the gaps left by shrinking public service provision and the contracting out of service delivery have been filled by these and other Third Sector organisations. In this way, FBOs have been represented as merely being co-opted as inexpensive resource providers into the wider governmentalities of neoliberal politics – a process that allows a particular secularised form of religion in the public realm. In contrast FBOs working outside the financial and regulatory frameworks of government are understood to resist co-option and maintain the integrity a faith-motivated approach - an approach commonly assumed to be ideologically coercive and tainted by proselytising self-interest. This thesis challenges these conventional accounts of FBOs and the bifurcation of third sector welfare providers into “insiders” and “outsiders”. Drawing upon in-depth ethnographic research with FBOs providing drug rehabilitation services in the UK – and with the clients of these services – this thesis illustrates how neoliberalism can be co-constituted through the involvement of FBOs, which can offer various pathways of resistance in and through the pursuit of alternative philosophies of care and political activism. I critically question the difference faith makes in the processes of care and welfare in FBOs, critiquing the varied ethics of care derived in part from theological belief, and emphasise the relationships of care embodied and performed within organisational spaces as to complicate oversimplified stories of neoliberal co-option, proselytisation and social control. Equally, I argue that some accounts of secularisation of FBOs overlook a broader rapprochement between secular and faith-based ethical motivations, which can solicit new political and ethical spaces that run counter to, and sometimes actively resist, neoliberal (and religious) governmentalities. By drawing attention to the ethical agency of staff and clients in these spaces of care and regulation, this thesis paves the way for a more nuanced understanding of the geographies of faith, welfare and neoliberalism.
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Pinfold, Vanessa Anne. "Community connections : geographies of rehabilitation amongst people with long term and enduring mental health problems in Nottingham." Thesis, University of Nottingham, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.324061.
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MARI, VIOLA. "Unpacking female marginality. Entangled dimensions of care in a female shelter in Turin." Doctoral thesis, Politecnico di Torino, 2022. http://hdl.handle.net/11583/2966327.
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Orchel, Katharine Anne. "'Value added'? : faith-based organisations and the delivery of social services to marginalised groups in the UK : a case study of the Salvation Army." Thesis, University of Exeter, 2016. http://hdl.handle.net/10871/33193.
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This thesis explores the ways in which Christian faith ‘adds value’ to the ‘carescape’ and ‘caringscapes’ of statutory hostels for people experiencing homelessness in the United Kingdom. The ways that a distinctively Christian organisational ethos is created and experienced through the material, regulatory and performative dimensions of space, place and subjectivity, are explored through a case study of the Salvation Army’s contemporary statutory accommodation services for single homeless people. Drawing upon Cloke’s notions of ‘theo-ethics’ and Conradson’s concept of ‘therapeutic landscape experience’, the links between spirituality, care and ‘value added’ are examined from the perspective of staff, volunteers and service users. This analysis extends the debate on the potential for faith-based organisations to make a distinctive and valuable contribution to care for people experiencing homelessness, by foregrounding the spiritual and emotional dimensions that texture these organisational landscapes of care. A feminist epistemological approach is taken to illuminate the nuances of care-giving and care-receiving, with particular attention paid to the emotional and spiritual sensitivities underpinning social interactions, and how these dimensions are perceived, narrated and experienced from a variety of perspectives. Using an ethnographic methodology, this study involved the undertaking of 91 semi-structured interviews, a six-week period of participant observation in a specific Salvation Army Lifehouse, and attendance at four professional social service and chaplaincy conferences run by the Salvation Army UK. The research findings suggest that Christianity adds value to these institutional spaces of care in a highly nuanced way, dependent on one’s subjectivity. A second observation is that the potential for faith to add value within statutory arenas of care for the homeless is being compromised due to the pressures associated with the incumbent neoliberal contract culture within which Lifehouses are embedded. A third contribution concerns the potential for a faith-based organisation to act as a crucible for the emergence of postsecular rapprochement: it is suggested that an intersectional approach to analysing this socio-spatial process is necessary, due to the strategic role that gender, age, sexuality and race were revealed to play in fostering, or dissipating, the affective relationships that underpinned fragile moments of rapprochement.
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Gustafsson, Cecilia. ""For a better life..." : a study on migration and health in Nicaragua." Doctoral thesis, Umeå universitet, Kulturgeografi, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-97493.
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This thesis explores and analyses the manifold relations between migration and health, what I call the migration-health nexus, in the contemporary Nicaraguan context. The study is based on fieldwork in León and Cuatro Santos and a mixed-methods approach combining qualitative in-depth interviews and quantitative survey data. In the thesis health is “traced” within the migration process; i.e. in places of origin, during travel, at the destination and after return, including the situation and consequences for both migrants and family members to migrants (“left-behinds”). The study shows that migration-health relations in Nicaragua are connected to broader economic, social and political factors and to the country’s historical experiences of colonization, neo-colonization and structural adjustments. Contemporary Nicaraguan migrations are primarily related to the strategies of making a living and the struggle for a better life (i.e. a practice of mobile livelihoods). In the study setting health concerns were both indirectly embedded in people’s mobile livelihoods, as well as directly influencing decisions to move or to stay, and migration involved both advantages and disadvantages for health. Through migration, women could see an end to physical violence and sexual abuse. Internal migrants could improve their access to health care and medicine. Vulnerabilities related to the unpredictable nature conditions could be avoided through moving. And, through the money made from migrant work people’s everyday lives and health could be improved, in terms of better nutrition, housing, and access to education, health care and medicine. However, remittances do not necessarily lead to development, as they are used to compensate for the lacking public sector in Nicaragua. Under these circumstances, I argue that the Nicaraguan population is not guaranteed their social rights of citizenship. I also argue that the negative aspects surrounding migration must be taken into account when discussing the development potentials of migration and remittances. Both internal and international migrants in this study experienced stress while moving to a new place. International migrants had difficulties accessing health care in the destination, particularly those lacking documentation. The separation within families due to migration often caused emotional pain. Family members left behind did not rate their physical health as good as often as non-migrant families. The vulnerability, stress experiences and sufferings of migrants and left-behinds varied, however. I therefore conclude that social differences (in terms of e.g. gender, class, skin colour, and legal immigration status) are key for the enactment of the migration-health nexus, and that an interplay of individual, social and structural factors influence the outcome.
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Ritterbusch, Amy E. "A Youth Vision of the City: The Socio-Spatial Lives and Exclusion of Street Girls in Bogota, Colombia." FIU Digital Commons, 2011. http://digitalcommons.fiu.edu/etd/432.
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This dissertation documents the everyday lives and spaces of a population of youth typically constructed as out of place, and the broader urban context in which they are rendered as such. Thirty-three female and transgender street youth participated in the development of this youth-based participatory action research (YPAR) project utilizing geo-ethnographic methods, auto-photography, and archival research throughout a six-phase, eighteen-month research process in Bogotá, Colombia.
This dissertation details the participatory writing process that enabled the YPAR research team to destabilize dominant representations of both street girls and urban space and the participatory mapping process that enabled the development of a youth vision of the city through cartographic images. The maps display individual and aggregate spatial data indicating trends within and making comparisons between three subgroups of the research population according to nine spatial variables. These spatial data, coupled with photographic and ethnographic data, substantiate that street girls’ mobilities and activity spaces intersect with and are altered by state-sponsored urban renewal projects and paramilitary-led social cleansing killings, both efforts to clean up Bogotá by purging the city center of deviant populations and places.
Advancing an ethical approach to conducting research with excluded populations, this dissertation argues for the enactment of critical field praxis and care ethics within a YPAR framework to incorporate young people as principal research actors rather than merely voices represented in adultist academic discourse. Interjection of considerations of space, gender, and participation into the study of street youth produce new ways of envisioning the city and the role of young people in research. Instead of seeing the city from a panoptic view, Bogotá is revealed through the eyes of street youth who participated in the construction and feminist visualization of a new cartography and counter-map of the city grounded in embodied, situated praxis. This dissertation presents a socially responsible approach to conducting action-research with high-risk youth by documenting how street girls reclaim their right to the city on paper and in practice; through maps of their everyday exclusion in Bogotá followed by activism to fight against it.
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Hodge, Alison. "Farm animal welfare and sustainability." Thesis, University of Exeter, 2010. http://hdl.handle.net/10036/3674.
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This thesis is concerned with acknowledging farm animals and their co-presence in the more-than-human space of the livestock farm, and with accounting for them responsibly in sustainability debates. The enrolment of farm animals as actors in political agendas for environmental sustainability, and farm animal welfare suggests that there are new ways of seeing and being with farm animals that permit their relational presence and recognise their subjectivity. Indeed geographers have in recent years acknowledged animals and their relations with humans, and they have begun to recognise the nature of animal subjectivies. However, within the fundamental rethinking of animals that has been provoked by these discussions, I suggest that farm animals have remained relatively invisible. Occupying ethically confusing terrain, farm animals have nonetheless been visible in a set of philosophical positions regarding their moral status, yet these debates present a rather confusing picture in which the farm animal as an individual is conspicuous by its absence. In seeking to redress the invisibility of farm animals within these debates, and recast them in relation to humans and the broader farm ecology, this thesis attempts to set out an epistemological and methodological framework through which farm animals might become visible as individual fleshy beings. Drawing on the concept of agricultural stewardship and new agendas in farm animal welfare science, it makes use of new methodological tools that have emerged in the social sciences to conduct a relational study of the livestock farm; a study in which farm animals themselves participate. It also considers how the divisions that have been constructed between humans, farm animals and the environment can be reconfigured as a more unified political science of the livestock farm.
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Chege, Eunice Nyambura. "Geographic Variations in Antenatal Care Services in Sierra Leone." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5062.
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Despite antenatal care presenting opportunities to identify and monitor women at risk, use of recommended antenatal care services remains. Barriers preventing use of antenatal services vary between countries, and limited knowledge exists about the link between geographical settings and antenatal service use. The objective of this cross-sectional quantitative study was to explore geographical variations and investigate how social demographic characteristics affect use of antenatal care for women in Sierra Leone using the Andersen behavioral model. The data used were from the 2016 maternal death surveillance report of the whole counrty (N =706). Logistic regression analysis was used to determine the individual predictor effects on antenatal care, including geographical location, the age of women, marital status, parity, and institution of birth impact. Southern, Northern, and Eastern women had significantly lower odds of attending the recommended antenatal services compared to women in the Western region (OR = .517, p = .019; OR = .497, p = .021; OR = 0.014, p = .041, respectively). The odds of married women attending the recommended antenatal services was 7.3 times more than that of the single women (OR = 7.397). Also, significantly associated with less uptake of recommended antenatal visits was lower education level among women (OR = .517). This study will contribute to positive social change by highlighting inequities in antenatal care use among women, thus allowing for accurate targeting of health promotion programs and ultimately saving lives of mothers and children of Sierra Leone through more inclusive policies.
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Lavergne, Miriam Ruth. "Understanding geographic variation in health care costs in British Columbia." Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/52302.
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Amidst concerns about escalating health spending, examining variation in health care delivery may reveal opportunities for improved efficiency. Influential research in the United States (US) has concluded that health care spending and service use vary substantially from place to place, and this cannot be explained by differences in the health status of populations or by better outcomes of care in higher-spending regions. Whether similar patterns exist in Canada is not clear.
This thesis uses administrative health data to examine how and why health care use and costs vary within the Canadian province of British Columbia (BC). We developed networks of patients, physicians, and hospitals that correspond to actual service use, in order to ensure that observation of variation was not obscured by unit of analysis. We also identified areas of the province representing distinct health service environments, as an improvement over existing urban/rural classifications in understanding the role of geographic context. Access to individual-level data allowed more complete adjustment for population characteristics than is typically possible.
In contrast to the US, this thesis suggests that variation in costs of physician and hospital services in BC is largely explained by population health status. The very different environments for health services that exist among metropolitan, non-metropolitan, and remote regions of the province also explained some area-level variation. Despite modest variation in total costs, there are clear differences in patterns of service use across the province due to substitution between categories of care (such as inpatient and outpatient, or generalist and specialist services). Though differences in costs are modest, marked differences in health outcomes are evident, and require further scrutiny.
Results show there are no areas with systematically higher volume or more intensive service provision for populations with similar health needs. However, this does not mean that important variation does not exist and cannot be uncovered. It may be that examining variation at the level of provider, among population groups, or in treatment for specific diseases or conditions will yield more actionable results. Ultimately policy reforms aimed at system-wide quality and efficiency, rather than targeted at high-spending regions, will likely prove most promising.Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
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Hepburn, Robert Cameron. "Environmental epidemiology in primary care using a geographic information system." Thesis, University of Aberdeen, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.268876.
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Boettcher, Walter Eric. "Carl Ritter's early geographic thought (1779-1817)." Thesis, University College London (University of London), 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.344052.
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Dillman, Jennifer L. "Geographic Distance, Contact, and Family Perceptions of Quality Nursing Home Care." Thesis, University of North Texas, 2010. https://digital.library.unt.edu/ark:/67531/metadc28412/.
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The effect of frequency of nursing home contact on family perceptions of quality care is the focus of this research. A family member characteristic, such as geographic distance from the nursing home, affects his or her frequency of contact with the nursing home. Frequency of contact, in turn, affects family perceptions of the care his or her loved one receives in the nursing home. The theoretical framework for this study is based on Allport's intergroup contact theory, which posits that when four contact conditions - institutional support, equal status, common goals, and intergroup cooperation - are present in an intergroup situation, a reduction in anxiety between groups is likely to occur. Regression analysis tested the stated hypotheses using survey data collected from 275 family members of residents in 10 Dallas-Ft. Worth area nursing homes. This study is among the first to quantify family geographic distance, finding that family geographic distance is a significant negative predictor of nursing home contact. Additionally, results build on Allport's theory by extending its' usefulness to nursing home organizations in two distinct ways. First, findings support Allport's premise that contact alone between groups - i.e., family members and nursing home staff - is insufficient for increasing or decreasing family perceptions of nursing home care. Second, three of the four contact conditions included in Allport's theory were statistically supported by the data. In sum, findings of this research provide nursing homes with an empirically tested model for improving family perceptions of quality nursing home care.
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Shortt, Niamh Maura Kelly. "Defining regions for locality health care planning : a multidimensional geographic approach." Thesis, University of Ulster, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.232848.
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Wang, Chunxiao. "Trends in geographic disparities in health workforce and hospital-beds in Guangdong Province." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B4171197X.
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Roth, Caryn. "The Geographic Distribution of Cardiovascular Health in SPHERE." The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1397559331.
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王春曉 and Chunxiao Wang. "Trends in geographic disparities in health workforce and hospital-bedsin Guangdong Province." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B4171197X.
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Watkins, Alexandra. "Sonic Apartheid: ecoracism, apartheid geographics and noise pollution in Cape Town's Blikkiesdorp." Master's thesis, University of Cape Town, 2020. http://hdl.handle.net/11427/32488.
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In Sonic Apartheid: Ecoracism, Apartheid Geographies, and Noise Pollution in Cape Town's Blikkiesdorp, Alexandra Downing Watkins begins a project of mapping geographies of dispossession and abandonment in Blikkiesdorp (Afrikaans for "Tin Can Town"), a Temporary Relocation Area on the margins of Cape Town created in 2007 following a wake of mass evictions for the 2010 World Cup. After being created as a "temporary" solution, Blikkiesdorp remained a site of abandonment where evicted peoples, refugees, and other "undesirables" were sent to live. Seven years later, the City of Cape Town and the Airports Company of South Africa signed a Memorandum of Understanding agreeing to realign one of the airport's runways, which would serve to relocate the community. Following the story of strategic organising by the Blikkiesdorp community to be included in the Environmental Impact Assessment that was being instrumentalized to further displace them, this work examines the community's struggle against conditions of abandonment through complicating the division of humans and the environment. This project engages with the mechanics of bio-, necro-, and geontopower, in contemporary South African environmental governance as an afterlife of apartheid spatial planning. The project features environmental research that was completed in cooperation with community members who shared their experiential environmental knowledge through interviews and diary entries as well as compiling decibel readings of excessive noise pollution. This data along with noise pollution diaries, photographs, and interviews has been compiled and placed in a digital archive in the form of an open-source ArchGIS Story Map. Combining theory and research contributed by the Blikkiesdorp community with the contemporary theoretical language of new materialism and critical race theory, this work engages with the porosity of bodies, the co-imbrication of bodies and landscape, how the creation of an "alternative social project" can serve to disturb and resist evidence-based technoscience and processes of ecoracist governance.
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Samuel, Cleo Alda. "Essays on Health Care Quality and Access: Cancer Care Disparities, Composite Measure Development, and Geographic Variations in Electronic Health Record Adoption." Thesis, Harvard University, 2014. http://dissertations.umi.com/gsas.harvard:11583.
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Racial/ethnic disparities in cancer care are well documented in the research literature; however, less is known about the extent and potential source of cancer care disparities in the Veterans Health Administration (VA). In my first paper, I use logistic regression and hospital fixed effects models to examine racial disparities in 20 cancer-related quality measures and the extent to which racial differences in site of care explain VA cancer care disparities. I found evidence of racial disparities in 7 out of 20 cancer-related quality measures. In general, these disparities were primarily driven by racial differences in care for black and white patients within the same VA hospital, rather than racial differences in site of care.
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Murage, Peninah. "Geographic variations in access to cancer services and outcomes along the cancer care pathway." Thesis, University of East Anglia, 2017. https://ueaeprints.uea.ac.uk/66588/.
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The poorer cancer survival in England in comparison to countries of comparable wealth may be explained by variations in diagnostic and treatment practices, and in disease stage. This highlights the importance of General Practitioners (GPs) in facilitating earlier diagnosis and access to secondary care. Poor access to secondary care has been associated with poorer cancer outcomes. As GPs are the first point of contact with health services for most patients, it is possible that some problems associated with access in secondary care originate from poor GP access. Despite this, there is little evidence describing the relationship between access to GPs and cancer outcomes. This research examines the association between geographical accessibility and cancer outcomes along the cancer care pathway, with a focus on access to the GP. The research begins by reviewing policies on improving access to cancer services, and finds some trade-offs that result when meeting contrasting policy goals. For example, centralisation may improve efficiencies, but may increase inequities in access. One study found that cancer services in England may not be located according to need, but are more likely to be concentrated in urban areas where incidence rates are lower. The other studies examine how geographical access associates with outcomes related to primary care, secondary care and the interface between these two. These studies found that longer travel to primary care has an opposite association on outcomes in rural compared to urban areas, and, has important implications on the mode of cancer diagnosis in secondary care. Additionally, longer travel to both primary and secondary care, and living in an urban area is associated with worse survival, furthermore, times delays and disease stage may be important mediators for these associations. This research generates original evidence showing that geographical access to primary care for diagnosis may have important consequences for cancer outcomes. The findings suggests that rural areas may not necessarily experience poorer outcomes, warranting future research on access issues amongst patients living in urban areas.
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Bivens, Laura R. "Individual and Geographic Predictors of Formal and Informal Care Patterns and Nursing Home Placement Risk among Rural Appalachian Elders." Diss., Virginia Tech, 2016. http://hdl.handle.net/10919/73752.
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A variety of individual and geographic factors influence the mix of formal and informal services utilized by older adults and their families along the continuum of care. This study focuses on a specific rural population in the United States - Central and South Central Appalachia, which experiences the triple jeopardy of vulnerable people (older adults) in vulnerable places (rural Appalachia), with cultural views and beliefs that may negatively impact the care they receive. Using Andersen’s behavioral model of service utilization, Soldo’s supplementation model of care, and Bronfenbrenner’s ecological theory as the theoretical frameworks, data from the Older Families in Rural Communities: Personal and Social Influences on Service Use project and the United States 2000 Census were used to examine the utilization of informal and formal care services and nursing home placement risk in a rural Appalachian population. The main goals of this research were to (a) examine the relationships among individual and geographic characteristics and determine how those relationships affect the utilization of informal-formal care-mix, and (b) determine how the informal-formal care-mix is associated with nursing home placement risk in older adults living in rural southwest Virginia. Two separate analyses were completed in order to address the research objectives. First, a multinomial regression model, including both individual and geographic data, was used to predict care-mix. Second, after calculating the outcome variable “nursing home placement risk” via a derived logistic regression equation, a log-linear analysis with a 3×4 contingency table was computed in order to understand the association between care-mix and nursing home placement risk. Results indicate that disparities in sex and poverty level in an area that already suffers from healthcare disparities significantly affect the type of care an older adult receives. When formal care was utilized, it was more often added to existing informal care systems, supplementing them, rather than replacing them. The type of care-mix individuals received was also associated with nursing home placement risk. Specifically, when informal support was the only source of care, nursing home placement risk was significantly higher than when informal-formal care-mix was received. Research and policy implications for disparity-ridden areas are discussed.Ph. D.
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Liu, Constance Wei-fang. "Evaluating Measures of Geographic Accessibility to Health Care In Urban Diabetics Living in Cuyahoga County." Case Western Reserve University School of Graduate Studies / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=case1200713083.
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Pezzulo, Carla <1983>. "Reproduction and maternal health care among young women in Kenya: geographic and socio-economic determinants." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2012. http://amsdottorato.unibo.it/5039/1/PEZZULO_CARLA_TESI.PDF.
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Many factors influence the propensity of young women to seek appropriate maternal healthcare, and they need to be considered when analyzing these women’s reproductive behavior. This study aimed to contribute to the analysis concerning Kenyan young women’s determinants on maternal healthcare-seeking behavior for the 5 years preceding the 2008/9 Kenya Demographic and Health Survey. The specific objectives were to: investigate the individual and contextual variables that may explain maternal healthcare habits; measure the individual, household and community effect on maternal healthcare attitudes in young women; assess the link between young women’s characteristics and the use of facilities for maternal healthcare; find a relationship between young women’s behavior and the community where they live; examine how the role of the local presence of healthcare facilities influences reproductive behavior, and if the specificity of services offered by healthcare facilities affects their inclination to use healthcare facilities, and measure the geographic differences that influence the propensity to seek appropriate maternal healthcare. The analysis of factors associated with maternal healthcare-seeking behavior for young women in Kenya was investigated using multilevel models. We performed three major analyses, which concerned the individual and contextual determinants influencing antenatal care (discussed in Part 6), delivery care (Part 7), and postnatal care (Part 8). Our results show that there is a significant variation in antenatal, delivery and postnatal care between communities, even if the majority of variability is explained by individual characteristics. There are differences at the women’s level on the probability of receiving antenatal care and delivering in a healthcare facility instead of at home. Moreover, community factors and availability of healthcare facilities on the territory are also crucial in influencing young women’s behavior. Therefore, policies addressed to youth’s reproductive health should also consider geographic inequalities and different types of barriers in access to healthcare facilities.
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Pezzulo, Carla <1983>. "Reproduction and maternal health care among young women in Kenya: geographic and socio-economic determinants." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2012. http://amsdottorato.unibo.it/5039/.
Full textAbstract:
Many factors influence the propensity of young women to seek appropriate maternal healthcare, and they need to be considered when analyzing these women’s reproductive behavior. This study aimed to contribute to the analysis concerning Kenyan young women’s determinants on maternal healthcare-seeking behavior for the 5 years preceding the 2008/9 Kenya Demographic and Health Survey. The specific objectives were to: investigate the individual and contextual variables that may explain maternal healthcare habits; measure the individual, household and community effect on maternal healthcare attitudes in young women; assess the link between young women’s characteristics and the use of facilities for maternal healthcare; find a relationship between young women’s behavior and the community where they live; examine how the role of the local presence of healthcare facilities influences reproductive behavior, and if the specificity of services offered by healthcare facilities affects their inclination to use healthcare facilities, and measure the geographic differences that influence the propensity to seek appropriate maternal healthcare. The analysis of factors associated with maternal healthcare-seeking behavior for young women in Kenya was investigated using multilevel models. We performed three major analyses, which concerned the individual and contextual determinants influencing antenatal care (discussed in Part 6), delivery care (Part 7), and postnatal care (Part 8). Our results show that there is a significant variation in antenatal, delivery and postnatal care between communities, even if the majority of variability is explained by individual characteristics. There are differences at the women’s level on the probability of receiving antenatal care and delivering in a healthcare facility instead of at home. Moreover, community factors and availability of healthcare facilities on the territory are also crucial in influencing young women’s behavior. Therefore, policies addressed to youth’s reproductive health should also consider geographic inequalities and different types of barriers in access to healthcare facilities.
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Field, Kenneth Spencer. "Modelling health care utilization : an applied Geographical Information Systems approach." Thesis, University of Northampton, 1998. http://nectar.northampton.ac.uk/2708/.
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This research has emanated from the geographical concerns raised by organisational change in the British National Health Service (NHS), namely the ongoing debate relating to health and health care inequalities. This thesis develops a flexible, portable and predictive model of health care utilization capable of assisting improved health care planning and analysis. In so doing it contributes to the current resurgence in medical geography. An applied approach to this research is identified which builds upon methods of modelling spatial patterns and processes in geography and the upsurge of interest in Geographical Information Systems (GIS) technology. In these terms, the use of GIS is central to the research; it supports construction and application of the model; facilitates a wide range of analyses; and provides a basis for visualisation and interpretation of model results. The value of modelling in analysing relationships between health inequalities and the location and allocation of health care is identified through a discussion of previous NHS policy initiatives and previous research. From this, a conceptual model of utilization is developed which incorporates components of need, accessibility and provision. A patient survey of asthmatics and diabetics informs the development of the model and validates the choice of indicators used to measure utilization. Indicators of need, accessibility and utilization are thus defined and subsequently measured using a signed chi-square scoring method. The model was developed and tested for primary care General Practitioner services in the Northampton District Health Authority area and outcome measures are proposed and evaluated. Rigorous testing of the model’s sensitivity and robustness is undertaken and potential for its simplification explored. Components are critically evaluated through a comparison with alternative methods of determining spatial inequalities in disadvantage. The potential of the model of utilization for health care planning and analysis is extensively demonstrated through the application of a variety of modelled scenarios. Emergent issues from the research are considered and potential for future geographical research in this area of study, and the impact upon research agendas more generally, is explored
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Beere, Paul. "The Fast and the Spurious: Geographies of Youth Car Culture in Hamilton, New Zealand." The University of Waikato, 2007. http://hdl.handle.net/10289/2489.
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quot;Boy racersquot; or quot;hoonsquot; attract extensive media attention and are often the focus of public concern. Discourses about quot;hooningquot; often focus on notions of public safety and illegal behaviour. What is largely absent from these debates is alternative explanations as to why young people choose to engage in quot;hooningquot; behaviour, what drives them to congregate in public spaces and why they choose to express themselves through an quot;autocentricquot; culture. When these issues are addressed it is usually within broader policy frameworks which seek ways of dissipating youth activities in spaces constructed as quot;trouble spotsquot;. This thesis represents an attempt to provide a reverse discourse about youth car culture and young people's presence in public spaces. Criminal activity not withstanding, youth car culture behaviour in this context is treated as a legitimate form of cultural expression that has the same social validity as other non-mainstream phenomena. Through feminist and poststructuralist understandings of identities, landscapes and place, the complexities of youth car culture will be unpacked in an attempt to expose quot;concernsquot; which may turn out to be little more than moral panic.
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Benwell, Matthew Charles. "Social geographies of childhood : outdoor spaces, mobility and 'growing up' in post-apartheid suburban Cape Town, South Africa." Thesis, Royal Holloway, University of London, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.479372.
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Azzam, Yousri Abdel-Kader. "Caractéristiques et problèmes urbains du Caire par rapport au Nil." Paris 12, 1986. http://www.theses.fr/1986PA120006.
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Le schema directeur d'amenagement et d'urbanisme du grand-caire en 1981 qui tend a l'adapter aux besoins de notre epoque, a grossierement sousestime le fleuve et son corridor. . En effet, la remise en valeur relatif au secteur du fleuve et aux quartiers riverains presente une necessite toute urgente; car parmi tous les projets d'amenagements des eaux en milieu urbain, le rapport "nilo-caire" est certainement un des plus importants par sa dimension spatiale et la masse de population cairote. C'est en particulier sur le fondement de cette consideration que cette these a tente d'etudier et d'analyser la relation entre la ville et le fleuve. . . Un nil beaucoup plus large que de nos jours, avec davantage d'iles, debordant davantage, explique les sites successifs du caire. . Il a influence jusqu'a la mentalite cairote. . Dans ce pays desertique qu' est l'egypte, le nil joue un role vital, y compris pour expliquer le caire: sa situation, son site, son organisation spatiale, son evolution, ses problemes et ceci depuis les origines de la ville. . Les fonctions economiques du nil furent aussi toujours essentielles: eau pour l'irrigation, l'approvisionnement, navigation fluviale, evacuation des eaux usees, espace d'aeration, de loisirs, de promenade. . Mais esthetiquement, on a pu parler de "carnaval architectural" le long du nil. Toutefois, dans le centre, le fleuve a ete relativement protege des activites industrielles et de leur pollution. . Cette these analyse les problemes actuels et la necessite d'une remise en valeur du site du nil prenant en compte les problemes d'environnement: la proprete des berges, la creation et l'amenagement d'espace verts, la renovation architecturale, la limitation des hauteurs, l'amelioration de l'epuration des eaux et de l'assainissement, les transports en commun fluviaux et le tourisme le long et sur le fleuve. . Cette these est un cadre general dans lequel les problemes urbains, dans les rapports nilo-caire, ont ete envisages de maniere globale; aussi, c'est une base de depart d'un projet d'amenagement (livre bleu) dans la region du grand-caireVery few planners are aware of the eminent potentiality of water and the role it plays in the development of cities. . The nile river and his corridor, has not seriously estimated in the long range urban development scheme for greater cairo region of 1981. . One of the major tasks undertaken was the analysis of urban relation between the city of cairo and nile. . . This study begins with a general analysis of past evolution of the city site, main features of the natural site and the urban development of city due to nile. . . The study will then go into the detailed components of the present urban problems, in the relation cairo nile, such as socio-economic conditions (components of population change in the g. C. R. , population structure, social patterns, industry, commerce and tourism). . . This study recognizes, not only the vital need of a reorganisation of river banks and an architectural renovation, but also takes cognizance of infrastructure problems such as water supply, waste water and transport. . . This thesis is a base of an urban development scheme for nile river in greater cairo region
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Wheeler, Anthony J. "Procedural Rates, Economic Costs, and Geographic Variation of Primary and Revision Lumbar Total Disc Replacement." DigitalCommons@USU, 2013. https://digitalcommons.usu.edu/etd/1764.
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Lumbar degenerative disc disease is a remarkably common condition among patients presenting with chronic low back pain and physical disability. When a surgical treatment option is warranted, patients now have the option of undergoing lumbar total disc replacement (TDR), a relatively new procedure that is designed to replace lumbar fusion, the traditional surgical intervention for degenerative disc disease. The lumbar TDR procedure has demonstrated clinical efficacy equivalent to that of lumbar fusion, although concern remains about the longevity, safety, and costs related to the procedure. These issues were addressed in three separate observational studies using administrative claims data. The first study estimated the revision burden and economic revision burden of lumbar TDR. The second study examined the lumbar TDR hybrid procedure, where both a lumbar TDR and lumbar fusion are performed simultaneously. No observational data have been reported on the frequency, cost, and diagnostic indications related to the TDR hybrid procedure. The third study mapped the geographic variation of procedural rates of lumbar TDR. Previous research has found substantial geographic variation in lumbar spine surgery rates and a similar analysis of lumbar TDR variation has yet to be reported. The present series of studies found the revision burden and economic revision burden of lumbar TDR to be similar to data reported for this procedure from the mid-2000s, though the overall occurrence of the procedure appears to have declined. The economic revision burden made this a lower-cost procedure than lumbar fusion, with a tradeoff in terms of revision burden being higher for lumbar TDR. The lumbar TDR hybrid procedure was found to make up approximately 16% of the total number of TDR procedures, involving much higher costs than a single-level TDR procedure. Finally, geographic variation of the procedural rate of lumbar TDR varied dramatically across the U.S., surpassing the variation observed in lumbar fusion surgery. Limitations of the observational data used in these studies are described. Recommendations for future observational research are offered as well. Finally, implications for these studies on practice guidelines and reimbursement policies are provided.
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Nyangiwe, Nkululeko. "The geographic distribution of ticks in the eastern region of the Eastern Cape Province." Diss., Electronic thesis, 2007. http://upetd.up.ac.za/thesis/available/etd-05122008-095145/.
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Bratsch, Mary E. Vernon-Feagans Lynne. "Rural African American families' child care placement examined through child age, economic, education, social support, and geographic isolation measures /." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2008. http://dc.lib.unc.edu/u?/etd,1833.
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Thesis (M.A.)--University of North Carolina at Chapel Hill, 2008.Title from electronic title page (viewed Dec. 11, 2008). "... in partial fulfillment of the requirements for the degree of Master of Arts in the School of Education Early Childhood, Intervention and Literacy." Discipline: Education; Department/School: Education.
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Kinkade, Marion Carlton. "Geospatial Analysis of Care and Mortality in the 2014 Liberia Ebola Outbreak." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6344.
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The Ebola outbreak in West Africa in 2014 to 2016 had more than 28,000 suspected, probable, and confirmed cases. It was the largest Ebola outbreak in history. Of the 28,000 cases in the three Ebola-affected countries, Liberia had 10,000 cases with almost 5,000 deaths. The Ebola Virus Disease (EVD) entered Liberia along the border of Guinea and moved to the capital city of Monrovia where the virus spread. Ebola Treatment Units (ETUs) were constructed throughout the response in locations where there were available facilities versus distance to care challenges. This study examined the association of distance from villages to ETUs and mortality. Using Geographic Information System (GIS) and statistics framed within the Social Ecological Model and the GIS Framework, this study geolocated the Ebola cases by village, mapped the travel routes and calculated the distance to the ETU. A logistic regression was then used to determine if there was an association between distance and mortality, with and without controlling for age and gender, and, to calculate the odds ratio. A logistic regression model showed there is an association between distance and mortality and that Ebola patients living within 12 kilometers of the ETU were 1.8 times less at risk of mortality (OR = 1.778, 95% CI [1.171 - 2.7]) than those living more than 12 kilometers. In addition, males had a 1.4 times lower risk of death due to EVD. This understanding can inform future outbreak responses and placement of treatment units. In addition, this information can lead to social change with respect to individual understanding of access to care, community expectations, and national health care planning.
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Dietrich-Jones, Natalie. "The ma(r)king of complex border geographies and their negotiation by undocumented migrants : the case of Barbados." Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/the-marking-of-complex-border-geographies-and-their-negotiation-by-undocumented-migrants-the-case-of-barbados(ca2236a6-0905-4512-ab27-a881362febda).html.
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The University of ManchesterNatalie Dietrich JonesPhD Development Policy and ManagementThe ma(r)king of complex border geographies and their negotiation by undocumented migrants: The case of Barbados2013ABSTRACTUsing Barbados as a case study, this thesis examines the relationship between agency, undocumentedness and borders. The relationship between these three concepts has been debated in a well-established European and North American literature; however, there is no similar body of work for the Caribbean, a space which since its genesis has been shaped by b/ordering practices. Through a stratified view of the border, it explored the discursive and non-discursive (material) factors which constrained migrants’ existence, and migrants’ agentic response to these constraints. The timing of fieldwork meant that the location’s geography, as well as migrants’ narratives, was marked by a recent amnesty exercise. In addition to ‘talk’ the research also relied on text, in the form of government and other legal documents relating to the management of migration. The research is therefore based on a combination of narrative and critical discourse analysis, espousing the methodological eclecticism that is encouraged in critical realist methodology. The study makes an important contribution to the field of border studies, based on its exploration of the relationship between a complex border ontology and migrant agency. The principal finding is that borders create complex geographies, which operate at varying spatial scales. The thesis thus provides an enhanced theorization of border(s), in particular as it relates to conceptualizations of space, suspect status, governmentality, and agency.
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Odendaal, Lizelle Janine. "Geographic variation in the echolocation calls of the endemic Cape horseshoe bat, Rhinolophus capensis (Chiroptera: Rhinolophidae)." Master's thesis, University of Cape Town, 2009. http://hdl.handle.net/11427/8976.
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Includes bibliographical references (leaves 63-84).Several intrinsic (body size) and extrinsic (foraging ecology and communication) factors are suggested to influence call frequency divergence in high duty-cycle bats. Investigating these factors within the framework of established hypotheses would contribute to understanding evolutionary changes leading to speciation in bats. Here, acoustic divergence between populations of the endemic Cape horseshoe bat, Rhinolophus capensis was investigated at both inter- and intraspecific levels. No previous study has investigated geographic variation in echolocation calls of R. capensis. Body size, wing morphology and skull parameters associated with diet and echolocation call production and reception, were compared between populations. Adult R. capensis were sampled at three sites: De Hoop situated in the centre of the species distribution in the Fynbos biome; Steenkampskraal and Table Farm were ecotone populations situated in the western and eastern limits of the distribution, respectively. Interspecific analysis revealed that the two ecotone populations deviated slightly from the allometric relationship between body size and peak frequency for the African clade. In fact, the expected inverse relationship between body size and peak frequency was not evident across populations. Ecotone populations had significantly larger mean body sizes than the population at De Hoop (10.28 ± 1.08 g; 84.60 ± 0.82 kHz). However, one population in the ecotone had the highest frequency (Table Farm: 13.88 ± 0.87 g; 85.84 ± 0.73 kHz) while the other had the lowest (Steenkampskraal: 13.15 ± 0.95 g; 80.66 ± 0.50 kHz). Several hypotheses were considered to explain the patterns of echolocation and morphological variation observed. The larger body size of the ecotone populations may be explained by James' Rule or it may be an adaptation to the intrinsic habitat heterogeneity of ecotones as it affords these bats a greater niche width and possibly larger home ranges to access spatially separated resources. On the other hand, neither climatic (humidity hypothesis), habitat (foraging habitat hypothesis) nor dietary differences (prey detection hypothesis between populations were responsible for the observed peak frequency differences between populations. Nasal chamber area was the best predictor of peak frequency and there was no relationship between the area of the nasal chamber and body size. Thus, selection may have acted directly on peak frequency altering skull parameters directly involved in echolocation independently of body size. Within each population, females were larger and used higher frequencies than males, which implies a potential social role of peak frequency for R. capensis. Observed differences in peak frequency may be because R. capensis interacts with separate rhinolophid species at either end of its distribution (Steenkampskraal: R. swinnyi; Table Farm: R. darlingi) in addition to R. clivasus, which results in the evolution of local dialects to facilitate intraspecific communication. These local dialects, possibly brought about by differences in local ambient noise characteristics (e.g. chorusing insects), could be maintained via cultural transmission. However, the role of gene flow for the evolution of these local dialects between populations cannot be discounted without adequate genetic analyses.
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Fortuin, Mildred. "A geographic information systems approach to the identification of Table Mountain group aquifer "type areas" of ecological importance." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&.
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The Table Mountain group aquifer system has the potential to be an important supply of water. Although the aquifer system is used to some extent, a number of aspects relating to the aquifer system are poorly understood and unquantified. This study aimed to take into consideration the importance of differenct ecosytems, which is essential in predicting the effects of groundwater abstruction. However, the ecological requirements of systems that depend on groundwater are poorly understood. This project identified "type areas"
for further detailed research into the impacts of large-scale groundwater abstraction from the Table Mountain group aquifer system based on the nature and functioning of ecosystems across groundwater dependent ecosystem boundaries of a regional scale.
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Perez, Martinez Oscar. "GIS based models for optimisation of marine cage aquaculture in Tenerife, Canary Islands." Thesis, University of Stirling, 2002. http://hdl.handle.net/1893/21881.
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This study focused on the optimisation of offshore marine fish-cage farming in Tenerife, Canary Islands. The main objective was to select the most suitable sites for offshore cage culture. This is a key factor in any aquaculture operation, affecting both success and sustainability. Moreover, it can solve conflicts between different coastal activities, making a rational use of the coastal space. Site selection was achieved by using Geographical Information Systems (GIS) based models and related technology, such as satellite images and Global Positioning System (GPS), to support the decision-making process. Three different cage systems were selected and proposed for different areas around Tenerife. Finally, a particulate waste distribution model (uneaten feed and faeces) was developed, also using GIS, for future prediction of the dispersive nature of selected sites. This can reduce the number of sites previously identified as most suitable, by predicting possible environmental impacts on the benthos if aquaculture was to be developed on a specific site. The framework for spatial multi-criteria decision analysis used in this study began with a recognition and definition of the decision problem. Subsequently, 31 production functions (factors and constraints) were identified, defined and subdivided into 8 sub-models. These sub-models were then integrated into a GIS database in the form of thematic layers and later scored for standardization. At this stage, the database was verified by field sampling to establish the quality of data used. The decision maker's preferences were incorporated into the decision model by assigning weights of relative importance to the evaluation under consideration. These, together with the thematic layers, were integrated by using Multi-criteria Evaluation (MCE) and simple overlays to provide an overall assessment of possible alternatives. Finally, sensitivity analysis was performed to determine the model robustness. The integration, manipulations and presentation of the results by means of GIS-based models in this sequential and logical flow of steps proved to be very effective for helping the decision-making process of site selection in study. On the whole, this study revealed the usefulness of GIS as an aquaculture planning and management tool. Cage systems that can withstand harsh environments were found to be suitable for use over a broader area of Tenerife's coastline. Thus, the more robust self-tensioned cage (SeaStation®) could be used over a greater area than the weaker gravity cages (Corelsa®). From the 228 km2 of available area for siting cages in the coastal regions with depth of 50 m, the suitable area (sum of scores 6, 7 and 8) for siting SeaStation® cages was 61 km2, while the suitable area for SeaStation® and Corelsa® cages was 49 and 37 km2 respectively. Most of the variation between these three cage systems was found among the intermediate suitability scores. It was concluded that the biggest differences in suitable area among cage systems are between Corelsa® and SeaStation® systems, followed by differences between Corelsa® and OceanSpar® cages, and OceanSpar® and SeaStation® respectively. This variability was mostly located on the N and NNW of the island, where waves, both long and short-term, are higher.
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Matoti, Andiswa. "Assessing the groundwater resources within the Table Mountain Group using remote sensing and geographic information system." Thesis, Stellenbosch : Stellenbosch University, 2003. http://hdl.handle.net/10019.1/53298.
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Thesis (MSc)--Stellenbosch University, 2003.ENGLISH ABSTRACT: The Cape Town metropolitan area has limited water supply due to rapid population and urban growth. In many instances, surface water is the only source in water supply schemes. There is a need for additional water supplies to supplement the existing water sources. Groundwater systems can be used as primary or supplemental water supply sources especially in areas where there is high demand for water resources. The aim of this study is to evaluate the groundwater potential within the Table Mountain Group (TMG) with the assistance of remote sensing and Geographical Information System (GIS). Previous hydrogeological studies have found the TMG to be the second largest hydrogeological unit in South Africa with extensively fractured and multi-porous rock. The study area is 5660 km2 with TMG covering 1336 km". In this study a Landsat Enhanced Thematic Mapper Plus (ETM+) image was used to identify lineaments. The identified lineaments were overlaid with vegetation, drainage patterns, faults and fractures digitized from 1:250 000 geological maps and borehole yields to show areas with promising groundwater resources. The results did not show correlation between vegetation and lineaments. Most of the lineaments intersected drainage lines at some points, and a few were parallel to the drainage lines. Forty five percent of the digitized faults and fractures overlap with the Landsat lineament. The most dominating lineaments are oriented in a NW-SE direction. High yielding boreholes with average yield of about 12 lIs were found within the distance of 150m from the lineaments. The lineaments were further analysed to locate areas that could be suitable for groundwater exploration. These areas were identified using Landsat lineaments, boreholes and a Digital Elevation Model (DEM). The results showed that the most favourable lineaments and geological features were oriented in a 135-180° and 0-45° direction and areas with slopes of less than 40% were found to be suitable for drilling boreholes. The amount of available groundwater within the TMG was also investigated by looking at both volume of recharge and amount that could be held in storage. Rainfall data was used to estimate recharge. Groundwater recharge was calculated to be 5% of the total precipitation that falls on this area. Based on the average rainfall of 600mm per annum, the results show that TMG has an average recharge value of 30mm per annum. The total recharge for the area covered by TMG, which has an area of 1336km2 , is 160 million nr'. Geological profiles and cross sections were drawn to determine the storage capacity of the TMG, which was estimated to be 525 million m.3 According to a study done by the Department of Water Affairs and Forestry (DW AF) in 1996, the anticipated water demand in the Cape Town metropolitan area will increase from 243 million m3 in 1990 to 560 million m3 in 2020. The estimated volume of water that can be stored within the TMG can meet the current demand for the next 10 years and supplement the existing surface water sources. Groundwater vulnerability of the TMG to contamination was assessed and mapped by using the DRASTIC index. The results demonstrate that the TMG area is at low risk to contamination.
AFRIKAANSE OPSOMMING: 'n Vinnig groeiende bevolking en stedelike uitbreiding plaas toenemende druk op Kaapstad se water voorraad. Addisionele waterbronne sal benodig word om bestaande bronne aan te vul. Oppervlakwater is in die meeste gevalle die enigste waterbron, maar grondwater het die potensiaal om te dien as 'n primêre of aanvullende voorsieningsbron, veral in areas waar groot water tekorte bestaan. Die doel van hierdie studie is om die grondwaterpotensiaal van gesteentes van die Tafelberg Groep (TBG) te evalueer deur van afstandswaarneming en geografiese inligtingstelsels gebruik te maak. Geohidrologiese studies het getoon dat die TBG gesteentes met sy veelvuldige nate en breuksones, die tweede grootste geohidrologiese eenheid in Suid Afrika is. Die studiegebied beslaan 5660 km", waarvan 1336 km2 deur Tafelberg Sandsteen beslaan word. Vir hierdie studie is 'n "Landsat Enhanced Thematic Mapper Plus (ETM+)" beeld gebruik in die identifisering van breuksones (lineamente). Verdere analises is uitgevoer om areas geskik vir grondwater ontginning te identifiseer. Geïdentifiseerde verskuiwings op Landsat beelde is met plantegroei, dreinerings patrone en bekende verskuiwings en fraktuur sones vanaf gelogiese kaarte vergelyk in 'n poging om areas met belowende grondwaterbronne uit te wys. Bekende boorgat posisies en lewerings volumes was 'n primêre databron vir die berekening van groundwater reserves. Die studie het egter geen korrelasie tussen plantegroei en die voorkoms van lineamente gevind nie. Die riviere in die studiegebied word op verskeie plekke deur verskuiwings gekruis. Slegs 'n paar van die verskuiwings lê parallel met die dreinering. Daar is gevind dat vyf-en-veertig persent van bekende verskuiwings en fraktuursones met die geïdentifiseerd op Landsat beelde oorvleuel. Die mees prominente lineamente het 'n NW-SO oriëntasie. Boorgate met lewerings van gemiddeld 12 lis is binne 'n 150m afstand van die verskuiwings gevind. Die verskuiwings is ook geanaliseer om die mees produktiewe areas vir grondwater ontginning te identifiseer. Landsat beelde, boorgate en 'n Digitale Elevasie Model (DEM) is gebruik om moontlike boorposisies te identifiseer. Die mees produktiewe verskuiwings en geologiese verskynsels het 'n N 135-180W en NO-450 oriëntasie, terwyl areas met 'n helling < 40% vir die boor van boorgate geskik is. Berekeninge oor die hoeveelheid water wat binne die TBG gesteentes beskikbaar is, is gemaak deur die hoeveelheid aanvulling en stoorkapasiteit van die TBG gesteentes te beraam. Grondwater aanvulling, soos bereken vanaf reënval data, is 5% van die totale presipitasie van 'n gegewe area. Met 'n gemiddelde jaarlikse reënval van 600mm in die studie gebied is die TBG se jaarlikse aanvulling ongeveer 30mm. Daar word beraam dat die totale aanvulling in die 1336km2 TBG area 160-miljoen m3 per jaar is. Geologiese profiele en dwarsnitte is gemaak om die stoorvermoë van die TBG te bepaal, en is beraam op 525-miljoen rrr'. 'n 1996 navorsing studie deur die Departement van Waterwese en Bosbou toon dat waterverbruik in die Kaapse Metropolitaanse gebied sal toeneem vanaf die 1990 vlak van 243-miljoen m3 tot 560 miljoen m3 teen 2020. Die berekende volume water wat binne die TBG gestoor word, kan die water aanvraag oor die volgende 10 jaar bevredig en as aanvulling dien vir oppervlak waterbronne. Die kwesbaarheid van die TBG akwifer vir besoedeling is met behulp van die DRASTIC indeks geëvalueer en gekarteer. Die resultate toon dat die TBG 'n lae risiko vir besoedeling het.
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Mendez, Ortiz Laura F. "The Role of the Built Environment and Public Transit in Geographic Access to Primary Health Care: A Study of Hamilton County, Ohio." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1595847536869522.
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Wan, Shaowei. "Investigating age varying effect of access to cancer care on immediate choice of chemotherapy among elderly women with metastatic breast cancer." Diss., University of Iowa, 2010. https://ir.uiowa.edu/etd/759.
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Geographic access to cancer care is an important dimension of quality of cancer care. Previous studies have shown that the more uncertain medical evidence is, the more geographic variation is observed in the medical care utilization that is attributable to local care health care system capacity and local area patient/physician preferences. Chemotherapy for metastatic breast cancer (MBC) is such a case. Although clinical trials have proven the efficacy of chemotherapy in treating MBC, whether to treat elderly MBC patients with chemotherapy is uncertain because of the underrepresentation of elderly patients in the clinical trials. As age advances, uncertainties increase due to competing causes of death, limited life expectancy, and higher risk of toxicities. As a result, geographic access may matter more in chemotherapy choice for older patients than for younger patients. Literature has shown that older patients are less likely to be treated with chemotherapy. In this study, we examined the effect of access to cancer care on age-related difference in chemotherapy use for elderly MBC patients. Access to cancer care is measured by four variables, including travel time to the nearest oncologist practice, local area per capita number of oncologists among stage IV cancer patients, local area per capita number of hospices among stage IV cancer patients, and local area chemotherapy percentage among stage IV cancer patients.
The retrospective cohort study used the 1992-2002 SEER-Medicare database. Chemotherapy use was defined as at least one chemotherapy-related claim within 6 months post diagnosis. To examine the age variant effect of access on chemotherapy choice, the analysis adopted both interaction term approach and subgroup analysis. In interaction term analysis, product term between age and access dummy variables were specified in the multivariate logistic regression model controlling for other covariates; in subgroup analysis, age subgroups were specified consistently with interaction term approach. For each age subgroup, we used multivariate logistic regression to estimate the effect of access to cancer care on immediate chemotherapy use controlling for covariates.
Among 4533 elderly patients with MBC, 30.16% used chemotherapy. Chemotherapy rate decreased with age. Interaction term approach did not show significant interaction between age and access in each specification. Both interaction term and subgroup analysis showed that the local area treatment rate was positively associated with immediate chemotherapy use across patient age. In addition, subgroup analysis showed among patients who were 85+ years old, the local area oncologist supply was negatively associated with chemotherapy use. This effect was not observed among younger age groups. Our results suggest that estimating all patients in one equation with dummies and interactions can hide results. By estimating each group separately, subgroup analysis showed that provider access is paramount for age subgroup 85 years or older.
Our access measures suggest that access to cancer care affects chemotherapy choice among elderly patients whose clinical evidence is uncertain. This can be attributable to local practice style and physician concern of real benefits of chemotherapy. The local area chemotherapy practice styles affect chemotherapy choice for patients across age except patients aged between 80 to 84 years old; provider access plays an important role for patients 85 years or older. The more certain the evidence with age, the more access may affect chemotherapy choice.
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Surles, Malvina. "Associations, cadre de vie et urbanisme : l'exemple toulousain et le cas du quartier reynerie au mirail." Toulouse 2, 1987. http://www.theses.fr/1987TOU20068.
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La recherche ici presentee, consiste en une analyse du mouvement associatif du cadre de vie a toulouse. La methodologie s'organise autour de la confrontation des analyses quantitatives (analyse multifactorielles) et des analyses qualitatives. L'objectif principal est d'essayer d'esquisser une typologie des associations et de cerner les possibilites et les limites d'une politique de participation. Cette recherche s'articule autour de trois axes: un axe qui dresse le bilan des acquis c'est a dire, l'approche theorique du mouvement associatif (histoire recente: depuis 1970, a travers l'etude des mouvements sociaux urbains. Un axe qui analyse le mouvement associatif local, les differents themes developpes sont: l'evolution des associations, leurs motifs de creation, leurs modes de fonction nement et le profil de leurs adherents. Un axe qui represente une etude exhaustive des associations dans un quartier populaire d'habitat social (rehabilite dans le cadre d'une operation developpement social des quartiers)The argument elaborated in this proposition is based on the analysis of the social associative movement in the urban frame life of toulouse. The methodology makes clear the confrontation between quantitative analysis (multifactorial analysis) and qualitative analysis. The main purpose intends to introduce the association's outline having regard to the possibilities and the limits of a politic of participation. The investigation is based upon three main lines: the first axes strikes the balance of the acquired knowledge that is to say the theorical approach of the associative movement (recents events: the urban social movement since the seventy's). The following axis studies the local associative movement, whose various concerned topicsare: the association's evolution, their creative motivation, their working methods and the adherent's profile. The last axis presents a detailed research on the association life in a popular district of the city (rehabilited by a state procedure: "developpement social des quartiers")
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Rayner, Chrisleen Ann. "The effects of fluoride levels in potable water: case studies in the Northern Cape and Mitchell's Plain." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_3297_1190379480.
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Dental caries is a multi-factorial disease that affects everyone irrespective of race, class or gender, however, the burden of the disease is often found in children from lower socio-economic backgrounds. The nature of the disease is such that it can be prevented. Various international studies on fluoride have shown a reduction in the prevalence of dental caries. By using geographical information systems, oral health data can be linked to the fluoride levels and further analysis could be done to identify areas at risk of dental caries as well as show patterns in the distribution of dental caries. The aim of this study was therefore to assess the effects of different levels of fluoride on the prevalence of dental caries in selected towns in the Northern Cape and Westen Cape. It also examined the application of Geographical Information Systems (GIS) to oral health data.
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Almudaris, Sami M. "Measuring Accessibility to Primary Care Physicians in the Nashville Metropolitan Statistical Area." TopSCHOLAR®, 2011. http://digitalcommons.wku.edu/theses/1125.
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The growing concern for the shortage of primary care physicians (PCPs) prompted a government legislation to designate areas where shortage in the delivery of primary care services occurs. The implemented systems (e.g., HPSA, MUA, and MUP) analyze utilization of health services within confined administrative units and fail to account for spatial interactions that occur across administrative borders. This research examines the spatial accessibility to PCPs and the underlying demographic and socioeconomic settings. With the Nashville Metropolitan Statistical Area (MSA) as a study area, this study utilized data from the U.S. Census 2000 and 2010, as well as the known locations of (PCPs) collected in 2010. Geographic Information Systems (GIS) provided the tools by which the processing and analysis of the data was carried out. Specifically, network analysis was applied to estimate travel time and service area coverage. A Two-Step Floating Catchment Area (2SFCA) method was implemented to measure spatial accessibility to PCPs. This method was applied to measure accessibility at the level (census block) that most accurately represents the spatial population of the Nashville MSA. In addition, this research implemented several distance-decay functions in addition to the dichotomous function of the standard 2SFCA method. This research has found that the majority of the population residing in the Nashville MSA enjoyed good spatial accessibility to PCPs. However, the highest percentages of those resided in areas of low accessibility were located in periphery rural areas as well as isolated areas poorly connected to the roadway network due to certain physical barriers such as lakes and streams. Moreover, this research has found that, in general, non-spatial factors intensified the most where there was good accessibility to PCPs.
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Munch, Zahn. "Assessment of GIS-interpolation techniques for groundwater evaluation : a case study of the Sandveld, Western Cape, South Africa." Thesis, Stellenbosch : University of Stellenbosch, 2004. http://hdl.handle.net/10019.1/16400.
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Thesis (MSc)--University of Stellenbosch, 2004ENGLISH ABSTRACT: The Sandveld, a potato growing area of the Western Cape is subject to significant groundwater abstraction for both municipal and agriculture purposes. The climate is arid and sensitive and important ecosystems in the area are showing varying degrees of impact. Management measures are needed to ensure ongoing sustainable development of the area. In this study, different interpolation techniques were evaluated to calculate values for unsampled variables rainfall and groundwater elevation. Local deterministic techniques as well as geostatistical techniques were used. It was found that geostatistical techniques, especially with collateral information, such as topography, provided a more accurate result. For environmental studies of this nature, Kriging is recommended as interpolation technique. The underlying data will determine the selection of the particular type of Kriging. Data was extracted from a customized relational database, geoMon, used for data capture, retrieval, processing and reporting. Ease of data extraction facilitated analysis. The interpolated grids were applied in two scenarios: Recharge calculations and quantification as well as a new classification approach according to Resource Directed Measures (RDM). Management classes were defined based on GIS-derived data.
AFRIKAANSE OPSOMMING: Die Sandveld, ‘n aartappelverbouingsgebied in die Wes-Kaap, ondergaan aansienlike grondwateronttrekking vir beide munisipale sowel as landbou doeleindes. Die klimaat is dor en droog en sensitiewe en belangrike ekosisteme in die area ondervind wisselende impakvlakke. Bestuursmaatreëls word benodig om volhoubare ontwikkeling van die area te verseker. In hierdie studie is verskillende interpolasie tegnieke om onbekende waardes vir veranderlikes gebruik in grondwater evaluasie te bereken, evalueer. Lokale deterministiese tegnieke sowel as geostatistiese tegnieke is gebruik. Geostatistiese tegnieke, veral gebruik saam met addisionele inligting soos topografie, bereken meer akkurate resultate. Vir omgewingsstudies van hierdie aard, word Kriging aanbeveel as interpolasie tegniek. Eienskappe van die onderliggende data word gebruik om die tipe Kriging aan te dui. Data is onttrek uit ‘n gebruikersaangepaste databasis, geoMon, wat gebruik is vir datavaslegging, onttrekking, prosessering en verslaggewing. Die gemak waarmee data onttrek kon word het analise vergemaklik. Geïnterpoleerde data is gebruik vir grondwateraanvullingsberekeninge en -kwantifisering sowel as ‘n nuwe benadering tot klassifikasie volgens hulpbron gerigte maatreëls. Bestuursklasse gebaseer op GIS-afgeleide data, is gedefinieer.
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Webster, Michael S. "The development of a Geographic information system for environmental monitoring on the Cape Peninsula, and an assessment of the use of spot imagery for vegetation mapping." Master's thesis, University of Cape Town, 1991. http://hdl.handle.net/11427/22272.
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This thesis concerns the establishment of a Geographic Information System for the Cape Peninsula and the use of SPOT satellite imagery to map land cover classes. The former is seen as a necessary tool to promote judicious conservation management decisions for the fragile "Fynbos" ecosystem, and the latter as a convenient means of acquiring up-to-date information concerning the environment, and to monitor change.
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Liao, Hsin-Chung. "The Association of Spatial Accessibility to Health Care Services with Health Utilization and Health Status Among People with Disabilities." Cleveland State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=csu1295035743.
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McMaster, Alistair. "GIS in participatory catchment management : a case study in the Kat River Valley, Eastern Cape, South Africa." Thesis, Rhodes University, 2002. http://hdl.handle.net/10962/d1007602.
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In water resources management in South Africa, there is an emphasis on public participation. On a river catchment basis, one of the mechanisms for such participation is the establishment of catchment forums. However, members of catchment forums, particularly those coming from poor or rural communities, cannot be expected to engage in catchment management without having been enabled to do so. This thesis considers the use of GIS in the process of enabling the Kat River Valley Catchment Forum to better participate in catchment management. The research focus is on the use of GIS to facilitate an understanding of the Kat River Catchment and associated catchment concepts, and constructive communication and sharing, among the Catchment Forum. The GIS is used in the context of "GIS for Participatory Research", an outgrowth of Public Participation GIS (PPGIS), which focuses on GIS as a tool for empowerment within participatory processes. The study has used Action Research, situated in the Critical paradigm, as a methodology. The research has included seven Forum workshop processes and one series of in-village meetings. These engagements have involved map-based appraisals, issues and resource mapping, map-based planning, and the use of on-screen GIS for presentation and sharing. The use of GIS has facilitated the creation of customised maps, the integration of village-scale mapping into a catchment scale product, the presentation of synthesised data in digital and hardcopy format and, in so doing, has allowed catchment-scale appraisal. Outcomes enabling participation in catchment management have included developed mapping skills and an enhanced understanding of the catchment as a whole, and developed conceptual access to a decision-making language (or way of thinking), among participants. Furthermore, the Forum as a whole has identified common needs, and has developed a set of map-based action plans. The research process has yielded a number of lessons regarding "GIS for participation" and the participatory framework within which it takes place. Chief among these is that the GIS operator should take on the role of a participatory practitioner.
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Ford, Francois Yorke. "A geographical information system for fire management by the Western Cape Nature Conservation Board /." Link to the online version, 2006. http://hdl.handle.net/10019/1641.
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