Thesis (Ph. D.)--University of Wisconsin--Madison, 1984. / Typescript. Vita. Includes bibliographical references (leaves 357-380).

Thesis.

Thesis (Ed.D.) -- Central Connecticut State University, 2006. / Thesis advisor: Carol Carter-Lowery. "... in partial fulfillment of the requirements for the degree of Doctor of Education, Department of Educational Leadership." Includes bibliographical references (leaves 162-170) Also available via the World Wide Web.

Thesis (M.Ed.)--Regis University, Denver, Colo., 2006. / Title from PDF title page (viewed on Sept. 7, 2006). Includes bibliographical references.

Thesis (Ph. D.)--University of Washington, 1986. / Vita. Bibliography: leaves 146-160.

Thesis (Ph. D.)--University of Auckland, 1966. / Includes bibliographical references (leaves 419-445).

C. ABSTRACT Introduction: Medical pluralism is a worldwide phenomenon. The reality in South Africa is that healthcare is provided by both orthodox and traditional healthcare providers. There is a great reliance on traditional medicine (TM) especially in rural communities. The complex interplay between patient centeredness and empowerment, health economics, failure of the biomedical approach and many other factors has resulted in an increasing prevalence of medical pluralism. Aim: The aim of the study was to explore the existence and extent of medical pluralism in my practice population, to quantify the prevalence of use and to qualify the determinants of choice. Methods: A cross sectional community household survey was conducted in the Makwarela Township of the Thulamela municipality (which forms part of the Vhembe district in the Limpopo Province in South Africa) using systematic sampling based on interval numbers. Interviewer administered questionnaires were used to obtain information from 65 households. Information was collected regarding the dependent variables (illness episodes, consultation behaviour, choice of primary health care provider) and the independent variables (socio-demographics, characteristics of illness, characteristics of health services). These were then analysed to assess prevalence of use and to elucidate significant associations. Results: Only 48 households representing 73,8% of the sample agreed to be interviewed. The total household members numbered 242. There were 364 illness episodes experienced by the household members in the 6 months prior to the survey. The ever use of TM in the sample was 70,8% (57,9% - 83,7%, 95% CI), whereas the ever use of orthodox medicine was 100%. The percentage of respondents who feel that they would probably use TM in future was 50%. The only significant correlates of TM use were highest education, household size, health belief model, waiting times at OM practitioner and past utilisation of TM. Conclusion: The study confirms the hypothesis of the existence of a pluralistic primary healthcare system and high prevalence of use of TM in the sample. The pattern of use of TM is that of an adjunct rather than as exclusive therapy. The study also confirms the complex interplay of a myriad of factors in healthcare choice. Despite the limitations of the study it can serve as a preliminary investigation prompting further studies to elucidate healthcare utilisation in the province and nationally. There are many ensuing implications for healthcare providers, funders and health system planners.

Resumo: Ao longo da história da humanidade, a família tem-se mantido como instituição social permanente devendo ser fortalecida. Mas, para definir família, é necessário compreender uma série de fatores, contextos e realidades e para conhecer famílias, é necessário ter uma visão das relações entre familiares, vizinhos, parentes e da rede de suporte. A família tornou-se foco de pesquisa e objeto de investigações após a implantação do Programa de Saúde da Família pelo Ministério de Saúde em 1994. A enfermagem assume um importante papel em criar vínculos com a família na construção de um novo paradigma de saúde. Nesta oportunidade, priorizou-se desenvolver o estudo sobre o enfoque de risco familiar a agravos ou danos a saúde, com o objetivo de avaliar o instrumento "Critério UFES" para identificação e classificação de risco familiar no âmbito da Estratégia Saúde da Família, adaptado pela Universidade Federal do Espírito Santo, da Escala de Coelho. Os dados foram coletados após atualização dos cadastros das famílias, por meio da Ficha A1 do Sistema de Informação da Atenção Básica, complementadas pelos agentes comunitários de saúde. Os dados foram lançados em planilha Excel para processamento dos escores. E, para analisar a consistência e coerência do instrumento, foi calculado o Coeficiente α de Cronbach. As famílias foram classificadas: 20% em Risco Zero; 63% como Risco 1; 8% como Risco 2 e 7% como Risco 3. As sentinelas de risco mais frequentes foram baixas condições de saneamento e higiene, uso de drogas lícitas e ilícitas e doenças crônicas. O instrumento em foco permite classificação de risco familiar, porém apresenta alguns limites, principalmente relacionados às definições das sentinelas, sendo que na área rural o Coeficiente α de Cronbach apresentou resultados considerados de regulares a discretos; sendo necessário a sua ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Over human history, the family has been a permanent social institution that must be strengthened. But, in order to define family, it is necessary to understand a number of factors, contexts and realities. And, in order to know families, it is necessary to have a view of the relationships among relatives, neighbors and members of the support network. The family became an object of investigation after the implantation of the Family Health Program by the Health Ministry in 1994. Nursing then assumes an important role in creating bonds with the family for the construction of a new health care paradigm. In this scenario, this study aimed at investigating family risk for health aggravations and damage, with the purpose to evaluate the instrument "UFES Criterion" for family risk identification and classification in the realm of the Family Health Strategy, adapted from the Coelho Scale by Espiríto Santo Federal University. The data were collected after updating families' records by means of SIAB Form A1, complemented by community health agents. Hence, the data were entered on an Excel sheet for score processing. In order to analyze the consistency and coherence of the instrument, Cronbach's α Coefficient was calculated. The families were classified as: 20% under Zero Risk; 63% under Risk 1; 8% under Risk 2 and 7% under Risk 3. The most frequent risk sentinels were poor sanitation and hygiene conditions, use of licit and illicit drugs and chronic diseases. The focused instrument classifies family risk; however, it has some limits particularly in relation to the definitions of sentinels, and, in the rural area, Cronbach's α Coefficient showed results that are considered to be regular and discreet. Well-defined criteria are necessary for its application or for inclusion of specific sentinels in the rural area / Orientador: José Eduardo Corrente / Coorientador: Vera Lúcia Pamplona Tonete / Banca: Ethel Leonor Nóia Maciel / Banca: Antonio Luiz Caldas Júnior / Banca: Carmem Maria Casquel Monti Juliani / Banca: Maria José Bistafa / Mestre

Commercial nonylphenol ethoxysulphonate (NPEOS), octylphenol ethoxysulphonate (OPEOS) surfactant formulations and mixtures of alkyl aryl sulphonate and NPEOS surfactant formulations, are used for enhanced oil recovery (EOR). The surfactants have been analysed by liquid chromatography (LC), liquid chromatography-mass spectrometry (LC-MS) and matrix assisted laser desorption ionization mass spectrometry. Mixedmode C1 8/SAX and C8/SAX columns were used for both liquid chromatography and liquid chromatography-mass spectrometry analyses of NPEOS and OPEOS. NPEOS and alkyl aryl sulphonate surfactant mixtures were separated using a mixed-mode C4/SAX column. Matrix assisted laser desorption ionization mass spectrometry (MALDI-MS) spectra were obtained using either alpha-cyano-4-hydroxycinnamic acid or 2,5-dihydroxybenzoic acid as matrix with the addition of lithium chloride to simplify the mass spectra obtained. Data obtained from each method indicate that the NPEOS formulation has an ethoxymer chain length ranging from 2-13 units with average of 6.26. This is in broad agreement with earlier studies, although the range was reported as 2-15. However, the data obtained suggest that the OPEOS formulation has an ethoxymer chain length ranging from 1-8 ethoxymer units with an average chain length of 3.67. This is in contrast to earlier studies carried out by LC only, which suggested that the chain length ranged from 2 to 6 ethoxymer units with an average of 3.6. A method for the extraction of NPEOS and OPEOS from sea-water and reagent water, and alkyl aryl sulphonate from sea-water only, using graphitised carbon black (GCB) solid phase extraction (SPE) cartridges has also been developed. In the last section of this thesis the chemical oxidation of NPEOS used Fenton's reagent and biological oxidation of NPEOS using a microorganism (Paracoccus halodenitrificans) is reported. The intermediate products formed in the chemical oxidation have been identified and characterized by LC, LC-ES-MS and MALDI/MS techniques. The major products formed are dicarboxylic acids and single carboxylic acids. The aerobic biodegradation of NPEOS was carried out over five days. Theoxygen uptake was measured each day. The biodegradation intermediate products were analysed by LC and data indicate that the same products were formed as those from the chemical oxidation of NPEOS.

The study aimed to develop, monitor and explore the process and outcomes of guided reflection and its impact on enabling practitioners to achieve desirable and effective caring practice. A secondary focus of the study was to monitor and explore the process and outcomes of guided reflection as a form of critical action research which may generate theoretical insights regarding its use in clinical supervisory practices. The process referred to as 'guided reflection' was developed and used to guide this study. Guided reflection represents a form of social action research which was framed within an ontology and process of critical and reflexive phenomenology of experience between practitioners and their supervisors over a period of four years. Whilst each guided reflection relationship was written as a critical narrative to illuminate the reflexive development of effective practice, these narratives became a secondary level of analysis to construct meta-narratives of the nature of effective work and dynamics of guided reflection. Various frameworks were developed and tested within a reflexive process that was appropriately informed and juxtaposed with extant theory to adequately interpret and present the process and ou.tc omes of the study. The method and process of guided reflection generated two major empirical and theoretical insights. • 'The 'Being available' framework to know effective caring practice, presented as one major exemplar of 'Pru'. • Meta-reflection of methods and process of guided reflection. Three frameworks in particular are significant: . • 'Being available' as a parallel framework for effective supervision practice. This parallel framework supports the coherence between developmental and research processes. • The Model for Structured Reflection as an heuristic device for knowing reflection. • 'Framing perspectives' as a series of integrated lenses to focus on discrete layers of learning within reflection. The insights gained through the study have considerable significance for informing and guiding the future development of reflective practice within nursing curriculum, clinical supervision within practice, and the future development of nursing knowledge. The development of nursing knowledge is of particular significance in understanding the meaning and nuances of holistic nursing as a lived reality and have significantly contributed to the reflexive development of the Burford NDU Model: Caring in Practice. The study has become a springboard for research to gain further insight into the factors that facilitate or constrain the efficacy of guided reflection in enabling practitioners to know and realise desirable practice within everyday practice.