The transformative process of personal growth following suffering and challenges, or posttraumatic growth (PTG), is limited in persons with acquired disability. The dimensions of acquired disability, as outlined by the World Health Organization, include impairments in body functions, body structures, and growth restrictions in activities and participation. The 5 domains of PTG include personal strength, new possibilities, relating to other people, appreciation of life, and spiritual change. Using discriminant function analysis, the purpose of this quantitative study was to identify a discriminant analysis of the dimensions of acquired disability on the domains of posttraumatic growth. The first research question focused on investigating the number of statistically significant uncorrelated linear combinations. The second research question reviewed the multivariate profile (or profiles if there is more than one statistically significant function) of the Posttraumatic Growth Inventory domains that discriminant the dimensions of acquired disability. A cross-sectional survey design was used to gather data from 161 individuals with acquired disability who were over 18 years of age and were at least 1 year postdiagnosis. Participants were invited to participate using a Facebook page and targeted advertising, as well as personal invitations to online support groups advocating for persons with acquired disability. This study and analysis only found 1 significant pairwise connection between impairment in body structure and growth, activity, and participation with the PTG domain of personal strength. Results may be used to guide the planning and implementation of aftercare programs for individuals diagnosed with an acquired disability to help promote PTG.

Nosocomial infections are acquired in health care settings and they can lead to catastrophic health care consequences for patients. These infections can also pose significant financial burdens on society and health care systems. Educating nurses on hand hygiene is essential to reducing infection rates. The research question for the study examined the effectiveness of hand hygiene among nurses in reduction of nosocomial infections and how can health care organizations develop educational strategies to reduce nosocomial infections to improve public confidence in health care systems. The purpose of this study was to educate nurses on how to reduce the incidence of nosocomial infections. The evidence-based practice model for this project was Florence Nightingale's environmental theory. The health belief model was used to identify the reasons for health care culture and how they inspire change. In this study, 2 licensed practical nurses and 2 registered nurses were educated on how to reduce nosocomial infections in acute care settings. Participants then completed a questionnaire to assess their knowledge of hand hygiene as a means of reducing nosocomial infections when caring for patients. All participants agreed that hand hygiene; reduces the risk of contracting a nosocomial infection, suggesting that the incidence of nosocomial infections within acute care settings maybe reduced through this education. This project has potential positive social change by educating first and second year nursing students on the importance of hand hygiene in reduction of nosocomial infections and preventing patients from sustaining further injuries while admitted in acute care settings.

A stroke is a life-changing event for a patient and his or her family. The acute stroke patient is at risk for developing aspiration pneumonia, whether silent or overt. Prevention of pneumonia in this population requires timely completion and documentation of the bedside swallow screen to identify those patients at risk for aspiration pneumonia; however, anecdotal data from the emergency department at the site of this project suggested that completion and documentation of the screening were inconsistent. Guided by the quality caring model adopted by the project site as well as the logic model, the aim of this project was to evaluate emergency room nurses' compliance with documentation after completing a modified bedside swallow screening. To facilitate documentation compliance, the current bedside screening tool was modified to make it user friendly. Electronic records of stroke patients (n = 104) admitted to the emergency room were monitored for a period of 6 months after implementing the modified bedside swallow screening tool. The findings indicate that implementing the modified bedside swallow screening tool achieved 93% documentation compliance in the electronic records and 100% documentation in patient charts over this 6-month period and clearly identified patients at risk for developing aspiration pneumonia. Further study is recommended to determine the relationship between the results of the modified bedside swallow screening and the development of hospital-acquired pneumonia. Implementation of this modified bedside swallow screening tool can initiate therapeutic measures to reduce the incidence of aspiration pneumonia in the acute stroke patient, resulting in shorter length of hospitalization and reduced health care costs.

Thesis (M.Sc. (Pharmacology)) --University of Limpopo, 2014 / Consult the document

Problematisering: Företagsförvärv är en populär strategi bland företag runt om i världen, trots det faktum att närmare 70 % av alla förvärv misslyckas. Tidigare forskning har pekat på integrationsfasen som den kritiska processen för förvärvets framgång. Oavsett om ett uppköpt företag absorberas eller konserveras, är flertalet forskare överens om att ledningen i det uppköpta företaget har en betydande roll för den sammanslagna organisationen och bör därmed involveras i integrationsprocessen. Trots detta, tenderar forskningen att belysa fenomenet ur det förvärvande företagets perspektiv och sällan ur det uppköpta företagets synvinkel. Syfte: Syftet är att beskriva hur ledningen i ett uppköpt företag hanterar och leder förvärvsprojektets integrationsfas, internt. Metod: Med ett induktivt angreppssätt och kvalitativ ansats har studien utgått från ett enskilt fall; det förvärvade företaget Sunne Software. Genom ett “Quick and Dirty” fältarbete där ledningen utgör den undersökta gruppen, blir fallstudien etnografiskt inspirerad vilket resulterar i en detaljerad och innehållsrik empiri och analys. För att uppnå syftet med studien har åtta semistrukturerade intervjuer genomförts med samtliga i ledningen på Sunne Software. Slutsats: Studiens resultat visar att ledningens arbete med integrationsfasen kan anses vara cirkulärt, där arbetet med konservering, anpassning och förändring av organisationen sker simultant. Ledningen har hanterat och lett dessa delar genom att bevara sin identitet, att tydligt kommunicera samt att genomföra olika anpassningar i förhållande till den nya målbilden. / Background: Acquisitions are a popular strategy among companies around the world, even though almost 70 % of all acquisitions fail. Earlier research has pointed at the integration phase as the most critical process for the success of the acquisition. Regardless of whether an acquired company is absorbed or preserved, most researchers agree that the top management team of the acquired company has a significant role for the merged organization and should therefore be involved in the integration process. Despite this, researchers have mainly focused on discussing acquisitions from the buyers’ perspective and not from the acquired company. Aim: The purpose is to describe how the top management team of an acquired company, internally manage the acquisitions integration phase. Methodology: The study has an inductive approach and is based on a single case study of the acquired company Sunne Software. To achieve the purpose of the study, the approach is qualitative and eight semi-structured interviews have been conducted with the top management team of Sunne Software. Because this specific group has been studied in its natural environment through a “Quick and Dirty” fieldwork, resulting in detailed descriptions of the case, the design of the study is therefore ethnographically inspired. Conclusion: The result of this study shows that the management of the integration phase from the acquired company’s perspective, can be considered to be circular; all parts of the integration phase are simultaneously managed. Based on the empirical data from Sunne Software, the three main parts of the integration phase have been identified as conservation, change and adaptation. The top management team has managed these parts by maintaining their identity, through clear communication and by implementing various adaptations according to the new objective.

Stigma and discrimination are now recognised as major factors in the spread of Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS). To date, research has focused on how to change individual responses to stigma and discrimination without exploring the social and structural dimensions. Complex community and societal dimensions, such as culture, power and difference need to be explored if progress is to be made in coping with stigma and discrimination. India now has HIV/AIDS prevalence figures to rival sub Saharan Africa. The disease has spread from high-risk populations such as intravenous drug users and commercial sex workers into the general population. Married, monogamous, heterosexual women in slum communities are highly vulnerable. Factors such as caste, class, ethnic group, poverty and social expectations present formidable layers of stigma for these women. They have also faced discrimination since before their birth. HIV/AIDS imposes yet another layer of stigma and discrimination upon their shoulders. The aims of the study were firstly to investigate whether stigma and discrimination existed for these women by documenting and analysing literature on the individual, societal and cultural situation of Indian women living with HIV/AIDS (IWLWHAs). Secondly, the study aimed to identify, evaluate and explore the psychosocial needs and coping strategies of IWLWHAs, to determine the barriers to accessing health services, and describe community perceptions as they were experienced by the participants. / This qualitative research study examined the multiple layers of stigma and discrimination experienced by women infected and affected by HIV/AIDS in a low socio-economic area of Mumbai, India. This was achieved by interviewing women who were benefiting from a home-based service - Positive Living - An integrated home-based care programme for people living with HIV/AIDS under the auspices of the KJ Somaiya Hospital in Mumbai. This programme provides a nutrition and home-based service to the nearby community slums. The conceptual framework used for this study was developed to evaluate the effects of natural disasters such as tsunamis, floods and earthquakes. HIV/AIDS is no less of a tragedy for individuals, families and communities. Within this framework, human capacity or the ability of individuals to cope is linked to social ecology - the relationship between individuals and their community. This dimension overlaps with culture and values. Three other dimensions affect humans - economic status, the environment and living conditions, and physical health. I have developed this framework further to examine threats and strengths which arise from these dimensions, and which affect human resilience. An exploratory case study was considered the most suitable approach to explore these areas, as it permits more sensitivity and richer data, and enhances rigour. In-depth interviews of 45 women in three different age groups, home visits and observations, focus group discussion, key informants, narratives, vignettes and photographs were supported by documentary data collection in triangulation of the data. A reflective journal recorded observations and perceptions in the field during three months in India. / Results from the combined data indicated that IWLWHAs experienced discrimination in their families, communities and health care settings. Fear of future discrimination ensured secrecy which, in turn, prevented them accessing community services which would provide emotional and physical support. A range of reactions was demonstrated by the affected women, half of whom were also infected which added to their burden. Women who could not disclose their condition were extremely isolated, lacked family and community support, feared the future and felt hopeless. Despite their appalling living conditions of poverty, overcrowding, prevalence of disease and pollution, the women displayed a sense of pride, dignity and resilience. Culturally appropriate strategies are necessary to address the lack of education and awareness as only two of the 45 women had any knowledge of HIV/AIDS before their own diagnosis which often followed their husbands' positive status. In addition, the social and cultural dimensions which affect these women have to be explored and examined in order to strengthen the 'shock absorbers' of the family. The community health workers and co-ordinator of the home-based service were vital in providing emotional support and health information to the women. Finally, no change is possible unless men take responsibility for their sexual mores. Policy makers and programmes have to look further for strategies which would engage men in the process to change their attitudes and thus protect vulnerable women and children.

Wheat is the most economically important crop forming one quarter of Australian farm production. The wheat industry is severely affected by diseases, with fungal pathogens causing the most important economic losses in Australia. The application of fungicides and chemicals can control crop diseases to a certain extent, however, it is expensive and public concern for the environment has led to alternative methods of disease control to be sought, including the use of microorganisms as biological control agents. Microorganisms are abundant in the soil adjacent to plant roots (rhizosphere) and within healthy plant tissue (endophytic) and a proportion possess plant growth promotion and disease resistance properties. Actinobacteria are gram-positive, filamentous bacteria capable of secondary metabolite production such as antibiotics and antifungal compounds. A number of the biologically active endophytes belonging to the Actinobacteria phylum were isolated in our laboratory. A number of these isolates were capable of suppressing the wheat fungal pathogens Rhizoctonia solani, Pythium sp. and Gaeumannomyces graminis var. tritici, both in vitro and in planta indicating the potential for the actinobacteria to be used as biocontrol agents. The aim of this research was to investigate the molecular mechanisms underlying this plant-microbe interaction. The indigenous microbial populations present in the rhizosphere and endophytic environment are critical to plant health and disruptions of these populations are detrimental. The culture-independent technique Terminal Restriction Fragment Length Polymorphism (T-RFLP) was used to characterise the endophytic actinobacteria population of wheat roots under different conditions. Soils which support a higher number of indigenous microorganisms result in wheat roots with higher endophytic actinobacterial diversity and level of colonisation. Sequencing of 16S rRNA gene clones, obtained using the same actinobacteria-biased PCR primers that were used in the T-RFLP analysis, confirmed the presence of the actinobacterial diversity, and identified a number of Mycobacterium and Streptomyces species. It was found that the endophytic actinobacterial population of the wheat plants contained a higher diversity of endophytic actinobacteria than reported previously, and that this diversity varied significantly among different field soils. The endophytic actinobacteria have previously been shown to protect wheat from disease and enhance growth when coated onto the seed before sowing. As the endophytes isolated were recognised as potential biocontrol agents, the impact on the indigenous endophytic microbial population was investigated. Utilising the T-RFLP technique it was established that the use of a commercial microbial inoculant, containing a large number of soil bacterial and fungal strains applied to the soil, disrupts the indigenous endophyte population present in the wheat roots. The hypothesis is that non-indigenous microbes proliferate and dominate in the soil preventing a number of endophytic-competent actinobacterial genera from access to the seed and ultimately endophytic colonisation of the wheat roots. This dramatically reduces diversity of endophytes and level of colonisation. In contrast the use of a single endophytic actinobacteria endophyte inoculant results in a 3-fold increase in colonisation by the added inoculant, but does not significantly affect this indigenous population. Colonisation of healthy plant tissues with fungal endophytes has been shown to improve the competitive fitness with enhanced tolerance to abiotic and biotic stress and improved resistance to pathogens and herbivores. In this study the fungal endophyte population of wheat plants grown in four different soils was analysed using partial sequencing of 18S rRNA gene sequences. Sequence anlaysis of clones revealed a diverse range of fungal endophytes. In this diverse range of fungal endophytes a number sequences were highly similar to those of previously known fungal phytopathogens. A number of sequences detected were similar to fungal species previously identified in soil or plant material but not as endophytes. The remaining sequences were similar to fungal species without a known relationship with plants. Plants have developed an inducible mechanism of defence against pathogens. In addition to local responses plants have developed a mechanism to protect uninfected tissue through a signal that spreads systemically inducing changes in gene expression. In the model plant Arabidopsis thaliana activation of the Systemic Acquired Resistance (SAR) pathway and the Jasmonate (JA)/Ethylene (ET) pathway is characterised by the production of pathogenesis-related (PR) and antimicrobial proteins resulting in systemic pathogen resistance. Endophytic actinobacteria, isolated from healthy wheat roots in our laboratory, have been shown to enhance disease resistance to multiple pathogens in wheat when coated onto the seed before sowing. Real Time RT-PCR was used to determine if key genes in the SAR and JA/ET pathways were induced in response to inoculation with endophytic actinobacteria. Inoculation of wild-type Arabidopsis thaliana with selected strains of endophytic actinobacteria was able to �prime� the defence pathways by inducing low level expression of SAR and JA/ET genes. Upon pathogen infection the defence-genes are strongly up-regulated and the endophyte coated plants had significantly higher expression of these genes compared to un-inoculated plants. Resistance to the bacterial pathogen Erwinia carotovora subsp. carotovora was mediated by the JA/ET pathway whereas the fungal pathogen Fusarium oxysporum triggered primarily the SAR pathway. Further analysis of the endophytic actinobacteria-mediated resistance was performed using the Streptomyces sp. EN27 and Arabidopsis defence-compromised mutants. It was found that resistance to E. carotovora subsp. carotovora mediated by Streptomyces sp. EN27 occurred via a NPR1-independent pathway and required salicylic acid whereas the jasmonic acid and ethylene signalling molecules were not essential. In contrast resistance to F. oxysporum mediated by Streptomyces sp. EN27 occurred via a NPR1-dependent pathway but also required salicylic acid and was JA- and ET-independent. This research demonstrated that inoculating wheat with endophytic actinobacteria does not disrupt the indigenous endophytic population and may be inducing systemic resistance by activating defence pathways which lead to the expression of antimicrobial genes and resistance to a broad range of pathogens.

<p>The aim of the present thesis was to examine possible cognitive consequences of acquired hearing loss and the possible impact of these</p><p>cognitive consequences on the ability to process spoken language presented through visual speechreading or through a cochlear implant.</p><p>The main findings of the present thesis can be summarised in the following conclusions: (a) The phonological processing capabilities of</p><p>individuals who have acquired a severe hearing loss or deafness deteriorate progressively as a function of number of years with a complete or partial auditory deprivation. (b) The observed phonological deterioration is restricted to certain aspects of the phonological system. Specifically, the phonological representations of words in the mental lexicon are of less good quality, whereas the phonological system in verbal working memory is preserved. (c) The deterioration of the phonological representations has a negative effect on the individual's ability to process speech, either presented visually (i.e., speechreading) or through a cochlear implant, as it may impair word recognition processes which involve activation of and discrimination between the phonological representations in the lexicon. (d) Thus, the present research describes an acquired cognitive disability not previously documented in the literature, and contributes to the context of other populations with phonological disabilities by showing that a complete or partial deprivation of auditory speech stimulation in adulthood can give rise to a phonological disability. (e) From a clinical point of view, the results from the present thesis suggest that early cochlear implantation after the onset of an acquired severe hearing loss is an important objective in order to reach a high level of speech understanding with the implant.</p>

<p>Bakgrund: Varje dag smittas i genomsnitt cirka 14 000 personer av HIV i världen. Ny behandling har gjort att dessa patienter idag lever längre. Sjukdomsförlopp samt komplikationer går inte att förutsäga utan är individuellt. Eftersom personer med HIV/AIDS-diagnos nu lever längre kommer behovet av arbetsterapeutiska insatser att öka. Syfte: Syftet med studien är att beskriva arbetsterapeutiska insatser för personer med HIV/AIDS samt vilken roll arbetsterapeuten har i arbetet kring dessa personer. Metod: En systematisk litteraturstudie gjordes för att få svar på syftet. Resultat: Vi har kommit fram till att arbetsterapeutiska insatser för personer med HIV/AIDS kan delas in i fem teman; Handledning, Hjälpmedel och anpassning, Undervisning, Förhållningssätt samt Existentiella frågor och andlighet. Arbetsterapeuten hjälper patienten att formulera målsättningar och att uppnå ökad självständighet genom att bland annat tillhandahålla hjälpmedel och bedriva utbildning. HIV/AIDS-patienters bakgrund är viktig att tänka på då den kan visa hur mottaglig en patient är för olika arbetsterapeutiska behandlingsmetoder. Slutsats: Arbetsterapeutiska insatser som används i arbetet med HIV/AIDS-patienter skiljer sig inte mot insatser riktade till andra patientgrupper.</p>

<p>The quantitative findings indicated high levels of HIV/AIDS knowledge, self-concept and self-efficacy. Risky sexual behaviour was measured in terms of condom use and the number of sexual partners in the 12 months prior to the study with males reporting significantly more risky sexual behaviour. More males (70% vs. 43 % females) reported no condom use when engaging in sex. More males (62 % vs. 28 % females) reported having had two or more sexual partners in the 12 months prior to the study. Results also suggested that an increase in knowledge of HIV/AIDS would predict an increase in the use of condoms particularly for males. Lower self-efficacy seemed to predict an increase in the number of sexual partners for males. The focus group discussions highlighted students' views of HIV/AIDS knowledge in relation to their sexual practices, attitudes and sexual decision-making. Influences such as personal factors (self-concept and self-efficacy), social factors (e.g. peer influences, gender, and status) and environmental factors (e.g. media) were investigated. Participants also commented on the effectiveness of HIV/AIDS campaigns and the adequacy in provision of health services at college and community level. From the findings, guidelines were developed which may be used to reflect on current intervention programmes and may be considered when developing future interventions programmes, policies, or campaigns in promoting safer sexual practices amongst youth as a means of addressing the HIV/AIDS pandemic.</p>