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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.

Identifying health education competencies for primary health care nurses in Saudi Arabia : a Delphi Consensus Study

Alsaleh, N. S. M. January 2016 (has links)
Research Aim: The primary aim of this Saudi-based study is to identify health-education competencies (knowledge, skills & attitudes) for Primary Health Care (PHC) nurses. Although the Saudi Ministry of Health (MOH) has highlighted the importance of health education provided in PHC by nurses, there have been no studies into the required competencies in the Saudi context. Methods: The Delphi technique was employed with a sample of sixty PHC nurses who matched the study’s inclusion criteria and they took part in a three-round questionnaire. A consensus criterion of 60 per cent was adopted for the study. The first round asked participants’ opinions about what items should be included within health education competencies for PHC nurses by selecting (Yes, No, Uncertain). In the second round, participants were asked to rank the competencies on which there had been no initial consensus, using a five-point Likert scale. In the final round, participants selected agree or disagree for each of the remaining competencies. Following the Delphi technique an interactive workshop was undertaken with primary health care nurses and service users, to consider the next steps and practical piloting and testing of the competencies. Principal Findings: The expert Delphi panellists eventually reached consensus on 45 of the 48 competencies for PHC nurses to engage in health-education practice. These competencies were classified into three domains: knowledge (22), skills (10) and attitudes (13). Three competencies related to knowledge did not reach consensus in the three rounds. The main outcomes of the interactive workshop suggest that service users would welcome the introduction of technology within the delivery of health education, and the PHC nurses confirmed the need for more training courses in order to improve their practice of health education. Importance and Relevance: This is the first study to identify health-education competencies for PHC nurses in S.A. The results from this study represent a contribution to knowledge in a PHC setting and they can assist the MOH by being an initial step on the road to developing a national competency and curriculum framework for PHC nurses’ practice. Also, it is the first study to involve service users.

Understanding healthcare staff's hand hygiene adherence : a theory-driven approach

Brackett, Andrew January 2016 (has links)
Literature Review: Healthcare staff’s hand hygiene adherence has been associated with reduced healthcare-associated infection rates. Addressing poor adherence is therefore imperative. The use of psychological theory in hand hygiene research is lacking. A systematic review was conducted of the application and efficacy of the theory of planned behaviour to understanding healthcare staff’s hand hygiene. Five databases were searched yielding nine relevant articles. The amount of variance accounted for across studies varied widely, explaining 35-70% of intention and 15-79% of actual behaviour. Current methodological limitations and heterogeneity of research aims limit the conclusions that can be drawn and inhibit an overall goodness-of-fit statistic being calculated. A revised model of the theory in relation to hand hygiene is proposed and salient issues discussed. Research Report: Despite a wealth of research, our understanding of hand hygiene adherence and how to improve it remains poor. Reasons for this may lie in an overreliance on self-report methodologies and a lack of reference to psychological theory (Edwards et al. 2012). Therefore a theory-informed, mixed-methods investigation was undertaken to identify key factors influencing nursing staff’s hand hygiene adherence within Critical Care. Three methodologies were triangulated and used concurrently: a) a quantitative questionnaire; b) a Delphi consensus approach; and c) ward observations. ‘Memory, Attention and Decision Processes’ were clearly highlighted as key to staff’s hand hygiene across all three methodologies, whilst ‘Environmental Context and Resources’ were highlighted across the two self-report methodologies. Findings suggest that interventions should prioritise addressing factors related to ‘Memory, Attention and Decision Processes’. ‘Environmental Context and Resources’ were also deemed important but appeared to reflect staff’s perception of busyness and difficulties prioritising hand hygiene rather than externally visible factors. Limitations and implications are discussed. Critical Appraisal: The researcher’s account of the research process, reflections, learning points and critique are offered.

Coping and adjustment in paediatric chronic pain : the role of child and parent pain beliefs

Masterson, Ciara January 1999 (has links)
There is wide variation in psychological and functional adjustment to paediatric chronic pain. This study aimed to explore predictors of adjustment that are amenable to intervention. Relationships between children's and parents' causal and control beliefs were examined, as well as the relationships between these beliefs and coping and adjustment measures. The study had a correlational design. Participants were 40 children aged 11-17 with non-pathological chronic pain, and their parents. Attributions and control beliefs were elicited by semi-structured interviews. Pain coping strategies, functional adjustment, and psychological adjustment were assessed by standardised questionnaires. Associations between measures were examined using non-parametric statistics. The findings show that paediatric pain patients and their parents make attributions about the cause of the pain, and that there are associations between children's and parents' pain beliefs. As predicted, children who made attributions to their own behaviour had higher beliefs in their ability to control pain. Children's attributions to their own behaviour also influenced coping and adjustment as predicted, but these associations were not statistically significant. Parents' attributions to the child's behaviour were also associated with the use of effective coping and good adjustment in the child, and had more associations with coping and adjustment than the children's attributions had. Children's attributions to pathological causes had several associations with control, coping, and adjustment measures as predicted. However, parental attributions to pathology were not found to have a clear relationship with children's coping and adjustment. The study found that children's and parents' beliefs about pain were moderately related, which supports the use of family-based intervention in the treatment or paediatric chronic pain. In addition, the results suggest that intervention should focus on beliefs about the pain and on increasing the child's use of active coping strategies.

Towards an understanding of walking groups as a health promoting intervention

Hanson, Sarah January 2016 (has links)
Low levels of physical activity are a major cause of disease burden. This presents a serious health challenge. Despite the benefits of physical activity being widely promoted, inactivity remains pernicious. This is compounded by physical activity interventions tending to be placed in more affluent areas and taken up by those who are more educated and in better health. Outdoor group walks have the potential to be a useful health intervention as they increase physical activity and are cost effective. However, a more extensive understanding is needed before they can be more widely promoted. This thesis sought to address this. Using mixed methods, it assessed any health benefits from group walking. It then evaluated their potential to influence health inequity. Finally, it sought to make recommendations to more effectively promote, and recruit to, walking groups for those people in poorest health. This thesis demonstrates the wide ranging psychological and physiological benefits from walking groups. With good adherence and virtually no adverse effects they can be safely and confidently recommended by clinicians. Their potential to increase inequity has also been demonstrated. Firstly, they may not be set up in those areas in greatest need. Secondly, the lack of a ‘bottom-up’ community partnership approach precludes reach into deprived communities and long term sustainability. Thirdly, without effective partnerships and promotion of walking groups by health professionals, targeted recruitment of the most inactive and those in poorest health remains problematic. Finally, promoting the social element of group-based interventions creates a barrier to those who find such expectations inhibiting; rather better to give clear tangible advice about their health promoting benefits. Outdoor walking groups are a safe and effective health promoting intervention but they should be developed and promoted judiciously to target those who would benefit the most and avoid potentially increasing intervention based inequity.

Studies in medical selection methods applied to Royal Air Force recruits

Reid, D. D. January 1949 (has links)
No description available.

Exploring health-related uses of mobile phones : an Egyptian case study

Mechael, Patricia N. January 2007 (has links)
No description available.

Essays on the empirical modelling of the determinants of health and lifestyle

de Preux Gallone, Laure January 2012 (has links)
The thesis comprises two essays in health economics. The first examines the impact of health insurance on lifestyle. The ex ante moral hazard (EAMH) postulates that health insurance reduces prevention effort (healthy lifestyle) since the cost of ill health to the insured individual is reduced. There is little evidence to support this hypothesis. I extend the standard model of EAMH by allowing for the fact that the consequences of a more healthy current lifestyle take some time to affect health. This extended model predicts that anticipated future insurance can alter current behaviour. I test this prediction by using as a natural experiment the granting of Medicare at age 65 to all individuals, including the large proportion who have no insurance when under age 65. I first use classical parametric and semi-parametric empirical methods. Then, these methods are combined into a more robust estimator to compare the changes in lifestyle between ages 59 and 68 for individuals with different amounts of insurance before age 65. The results suggest reductions in physical activity by the uninsured two years before being covered by Medicare. Anticipation of Medicare has no effect on alcohol consumption or smoking behaviour. The second essay investigates the role of maternal parenting style on child health. The analysis is innovative in using econometric methods that allow for possible biases arising from unobservable family circumstances and from parenting style being influenced also by child health. Using two waves from the Millennium Cohort Study I also develop a set of measures of parenting style and allow for potential reporting bias and for the role of the father. I find that maternal parenting style mainly influences the mental health of the child, rather than the physical health. Parenting style and socio-economic factors do not appear to interact in their effect on child health.

Understanding how participation in groups promotes health-related psychological and behaviour change

Borek, Aleksandra Jolanta January 2016 (has links)
Groups are commonly used to deliver interventions to promote health and prevent illness through facilitating psychological and behaviour change. The research reported in this thesis aimed to further our understanding of how group-based diet and physical activity interventions work. The thesis consists of six chapters: Chapter 1 provides an introduction to the thesis, Chapter 6 is an overall discussion, including strengths, limitations and implications, whereas Chapters 2 to 5 include four empirical studies. Chapter 2 is a conceptual overview of concepts and models that explain group dynamics and change processes in groups. This chapter highlights the importance of a better understanding of research al")d theories concerned with change processes in groups in order to optimise design, delivery and evaluation of group-based interventions. Chapter 3 is a systematic review and meta-analysis of group-based diet and physical activity interventions. This shows that groups can be effective in facilitating about 3 kg weight loss at 6, 12 and 24 months, and that explicitly targeting weight loss, using menonly groups and providing feedback may enhance effectiveness. However, the research also highlights large, unexplained, between-study variations in effectiveness, and deficiencies in reporting of group-specific elements of intervention design and delivery. Chapter 4 presents a checklist to improve reporting of group-based behaviour-change interventions. It addresses the problem of incomprehensive reporting of group interventions and lack of consideration of group processes and characteristics in such reports. The checklist defines 26 reporting elements that could help designing and replicating effective group-based interventions. Chapter 5 is a qualitative study of participants' experiences of group participation in a diet and physical activity intervention for prevention and control of diabetes. The results show that participants perceived individual as well as group-specific change processes as beneficial, and highlight the role of the group context and optimal facilitation in promoting participants' engagement with the programme and behaviour change. Overall, this programme of research demonstrates that group-based diet and physical activity interventions can be effective in facilitating weight loss and that participation in groups can be helpful in promoting behaviour change. A series of recommendations for design and evaluation of group-based health interventions are provided.

Effects of the fibre component of Irish sourced Laminaria digitata on the gut microbiota and its effects on bone health and lipid metabolism in mice

Strain, Conall Reamonn January 2016 (has links)
This thesis investigated the bioactivity of a crude and depolymerised polysaccharide rich extract from summer harvested Irish Laminaria digitata (LD). An in vitro human colonic model was employed to test the extracts in comparison with cellulose and fructooligosaccharides as respective negative and positive controls, on the composition (16S rDNA sequencing) and metabolic activity (short chain fatty acids (SCFA)) of the gut microbiota (GM). Furthermore, the effect of the crude LD extract on the composition and metabolic activity of the GM along with its effect on markers of bone health were assessed using murine models. Both extracts demonstrated fermentability by human faecal bacterial populations with significant increases in Lachnospiraceae and Parabacteroides and Dialister species, acetate, propionate, butyrate and total SCFA noted. In-vivo supplementation with the crude LD extract (5%) in the standard diet mouse model resulted in significant changes to the composition of the GM including: increased diversity, significant reductions in the Firmicutes to Bacteroidetes ratio, with division wide reductions in Firmicutes and a number of increases in Bacteroidetes, including Prevotella, Bacteroides and Parabacteroides species. Modulation of bone remodeling (increases in osteocalcin, reductions in TRACP-5b), reduced body weight and reduced serum cholesterol was also found with LD supplementation. In the diet induced obese murine model, LD (5%) increased the proportion of Akkermansia species by 150 fold, reduced Firmicutes to Bacteroidetes ratio, increased colonic and caecal butyrate concentrations in young adult mice and reduced total SCFA in mature adult mice. Anti-obesogenic effects were found including: significantly reduced fat mass, serum cholesterol, leptin and lipopolysaccharide binding protein concentrations. These results highlight the potential of the fibre component of LD as a beneficial GM modulating functional food ingredient to promote bone health and protect against obesity. Further work is required to assess whether such effects occur in humans.

Studies on Coffee from the Viewpoint of Heart Disease

Al-Samarrae, W. A. H. January 1976 (has links)
No description available.

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