This study set out to determine the extent to which educational psychologists in South Africa are familiar with and use dynamic assessment. The study also covered issues such as the dynamic assessment training that educational psychologists receive as well as their attitudes towards dynamic assessment. A review of the literature revealed that only international studies have been done on the use of dynamic assessment by school psychologists. The findings of international studies can, however, not summarily be generalised to the South African context. The only national study that has been done on the use of dynamic assessment by educational psychologists was a qualitative study. The present study endeavoured to address this research hiatus by conducting a national cross-sectional online survey that was sent to all educational psychologists in South Africa. The study sought to find an answer to the following primary research question: "To what extent are South African educational psychologists familiar with and use dynamic assessment?" The sample was selected initially through purposive sampling and later through snowball sampling. The study found that of the 173 respondents who responded to the survey, 69,90% were familiar with dynamic assessment. However, this picture changed dramatically when they were asked to what extent they were familiar with dynamic assessment. A total of only 25,40% of the respondents indicated that they were quite familiar with dynamic assessment, and only 20,80% reported that they used dynamic assessment. Furthermore, only 8,10% had used dynamic assessment once a week during the past six months. / Dissertation (MEd)--University of Pretoria, 2016. / Educational Psychology / MEd / Unrestricted

Background: As the diabetes (DM) epidemic in Canada continues to grow, the need to provide diabetes self-management education (DSME) becomes increasingly important. Research has shown that DSME can improve both physiological and behavioural outcomes in individuals with DM. Diabetes educators (DE) play an essential role in providing DSME to individuals with DM. Although considered an important role in the care of individuals with DM, the DE role is not well described in Ontario. Building a province-wide description of DEs’ role would outline the role of DE in Ontario is enacted, and suggest possible areas for improvement. The specific objectives of this study are: a) To describe the demographic characteristics of DEs in Ontario; b) To identify the structures, processes, and outcomes associated with the role of DEs; c) To identify the facilitators and barriers to providing DSME in Ontario; d) To identify the association between key characteristics of DEs (profession, education, certification, practice-setting, and DM-specific training) and the structures, processes and outcomes of this role. Methods: This cross-sectional study used an online questionnaire, the Diabetes Educator Questionnaire (DEQ). The DEQ was developed using the International Standards for Diabetes Education and Donabedian’s framework to examine the structures, processes and outcomes associated with the role of DEs. The study consisted of three sequential phases: (1) pre-testing the questionnaire in a tertiary care diabetes program, (2) pilot testing the questionnaire to a single Diabetes Educator Section (DES) chapter of the Canadian Diabetes Association (CDA), and (3) administering the DEQ to the remaining DES chapters across Ontario. The online questionnaire was created using LIME survey, an open source survey program housed at McMaster University. Data were downloaded, cleaned, and analyzed using statistical and geographical mapping software. Results: The DEQ demonstrated both face and content validity. A total of 178 out of an estimated 600 DEs across Ontario responded to the DEQ, for an overall response rate of 30%. The respondents consisted of 61 registered nurses, 94 registered dietitians, 18 pharmacists, and 4 nurse practitioners, and 1 undescribed. The majority (85%) of respondents were CDEs. Insufficient time, and organizational/management support were the two most common barriers to implementation of the role of the DE. Significant differences (p value greater than 0.05) in how DSME was provided and the use of outcomes were observed for profession, level of education, and practice setting. Limitations: With a low response rate, conclusions cannot be drawn from this study. Being an anonymous study, intra-rater reliability could not be performed. Conclusions: This study shows that the DEQ serves as a feasible tool to explore the role of DEs in Ontario, however, improved recruitment strategies are necessary before further research is performed. The study provides a foundational description of DEs across Ontario, generating possible hypotheses for future research. / Thesis / Master of Science in Nursing (MSN)

BACKGROUND: Complementary and alternative medicine (CAM) use has steadily increased globally over the past two decades and is increasingly playing a role in the healthcare system in the United States. CAM practice-based effectiveness research requires an understanding of the settings in which CAM practitioners provide services. This paper describes and quantifies practice environment characteristics for a cross-sectional sample of doctors of chiropractic (DCs), licensed acupuncturists (LAcs), and licensed massage therapists (LMTs) in the United States. METHODS: Using a cross-sectional telephone survey of DCs (n = 32), LAcs (n = 70), and LMTs (n = 184) in the Tucson, AZ metropolitan area, we collected data about each location where practitioners work, as well as measures on practitioner and practice characteristics including: patient volume, number of locations where practitioners worked, CAM practitioner types working at each location, and business models of practice. RESULTS: The majority of practitioners reported having one practice location (93.8% of DCs, 80% of LAcs and 59.8% of LMTs) where they treat patients. Patient volume/week was related to practitioner type; DCs saw 83.13 (SD = 49.29) patients/week, LAcs saw 22.29 (SD = 16.88) patients/week, and LMTs saw 14.21 (SD =10.25) patients per week. Practitioners completed surveys for N = 388 practice locations. Many CAM practices were found to be multidisciplinary and/or have more than one practitioner: 9/35 (25.7%) chiropractic practices, 24/87 (27.6%) acupuncture practices, and 141/266 (53.0%) massage practices. Practice business models across CAM practitioner types were heterogeneous, e.g. sole proprietor, employee, partner, and independent contractor. CONCLUSIONS: CAM practices vary across and within disciplines in ways that can significantly impact design and implementation of practice-based research. CAM research and intervention programs need to be mindful of the heterogeneity of CAM practices in order to create appropriate interventions, study designs, and implementation plans.

Effective nursing care can be threatened when nurses are not culturally attuned with their patients. Associate degree nursing (ADN) students receive information about diverse ethnicities in the nursing curriculum, but it may not be sufficient to provide the expertise necessary to care for patients of various cultural backgrounds. The purpose of this quantitative study was to explore the 2nd year ADN students' levels of cultural competence and their perceptions of self-efficacy in working with Caucasian, African American, Native American, Hispanic, and Asian ethnicities. The study used a cross-sectional survey design to determine if a relationship existed between the students' reported cultural competencies and their self-efficacy scores while providing care to patients of these diverse cultures. The process of cultural competence in the delivery of health care services was used as the theoretical framework for this study. A volunteer convenience sample of 64 2nd-year ADN students completed the Nurse Cultural Competence Scale and the Cultural Self-Efficacy Scale. The Pearson-Product Moment correlation revealed a significant negative, moderate relationship between self-efficacy and the students' perceptions of cultural competence. A project was designed to enhance skills and knowledge to improve the students' cultural competency while caring for patients of Asian, Native American, and Hispanic cultures because minimal familiarity of those cultures contributed most to the negative correlation. Research on methods to improve cultural competence among health care professionals should be continued. Positive social change will occur as nursing students gain proficiency in their abilities to provide culturally appropriate care to patients of diverse ethnic backgrounds.

<p>A cross- sectional descriptive study using a self-administered close-ended questionnaire was conducted with pupils in standards four to seven (aged 10 &ndash / 17 years) in ten government primary schools in Meru District. The sample of 400 school pupils was obtained by a simple random sampling technique. Data analysis was done using Statistical Package for Social Sciences SPSS (version 15) computer software and the results were presented in frequencies using simple percentages, tables and graphs. The Chi-square test was used to assess the significance where a p-value of &lt / 0.05 was considered statistically significant. In conclusion, Primary school pupils in Meru district engage in several risky sexual behaviors including substance use, sexual coercion, early sexual debut and engaging in various sexual practices. This calls for a more comprehensive approach in the fight against HIV among primary school children in Tanzania, which could include life skill training at an early age, behaviour change communication interventions, advocacy activities to influence policy formulation, condom promotion and incorporating key stakeholders in the rollout of school based HIV programmes such as parents, community leaders and faith-based organizations leaders.</p>

<p>A cross- sectional descriptive study using a self-administered close-ended questionnaire was conducted with pupils in standards four to seven (aged 10 &ndash / 17 years) in ten government primary schools in Meru District. The sample of 400 school pupils was obtained by a simple random sampling technique. Data analysis was done using Statistical Package for Social Sciences SPSS (version 15) computer software and the results were presented in frequencies using simple percentages, tables and graphs. The Chi-square test was used to assess the significance where a p-value of &lt / 0.05 was considered statistically significant. In conclusion, Primary school pupils in Meru district engage in several risky sexual behaviors including substance use, sexual coercion, early sexual debut and engaging in various sexual practices. This calls for a more comprehensive approach in the fight against HIV among primary school children in Tanzania, which could include life skill training at an early age, behaviour change communication interventions, advocacy activities to influence policy formulation, condom promotion and incorporating key stakeholders in the rollout of school based HIV programmes such as parents, community leaders and faith-based organizations leaders.</p>

Background: Chronic pain is a major public health problem. The impact of stages of chronic pain adjusted for disease load on societal burden has not been assessed in population surveys. Methods: A cross-sectional survey with 4360 people aged ≥ 14 years representative of the German population was conducted. Measures obtained included demographic variables, presence of chronic pain (based on the definition of the International Association for the Study of Pain), chronic pain stages (by chronic pain grade questionnaire), disease load (by self-reported comorbidity questionnaire) and societal burden (by self-reported number of doctor visits, nights spent in hospital and days of sick leave/disability in the previous 12 months, and by current unemployment). Associations between chronic pain stages with societal burden, adjusted for demographic variables and disease load, were tested by Poisson and logistic regression analyses. Results: 2508 responses were received. 19.4% (95% CI 16.8% to 22.0%) of participants met the criteria of chronic non-disabling non-malignant pain. 7.4% (95% CI 5.0% to 9.9%) met criteria for chronic disabling non-malignant pain. Compared with no chronic pain, the rate ratio (RR) of days with sick leave/disability was 1.6 for non-disabling pain and 6.4 for disabling pain. After adjusting for age and disease load, the RRs increased to 1.8 and 6.8. The RR of doctor visits was 2.5 for non-disabling pain and 4.5 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.7 and 2.6. The RR of days in hospital was 2.7 for non-disabling pain and 11.7 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.5 and 4.0. Unemployment was predicted by lower educational level (Odds Ratio OR 3.27 [95% CI 1.70-6.29]), disabling pain (OR 3.30 [95% CI 1.76-6.21]) and disease load (OR 1.70 [95% CI 1.41-2.05]). Conclusion: Chronic pain stages, but also disease load and societal inequalities contributed to societal burden. Pain measurements in epidemiology research of chronic pain should include chronic pain grades and disease load.

Improving the effectiveness and efficiency of medication error reporting is key to enhancing patient safety. The aim of this research was to explore medication error reporting in the United Arab Emirates (UAE), examining the attitudes, beliefs, behaviors and experiences of health professionals. The first phase was a Joanna Briggs Institute registered systematic review of the beliefs, attitudes and experiences of health professionals relating to medication error reporting. Findings indicated the need for original research employing a mixed methods approach to quantify and generate in-depth information, grounded in theories of behaviour change. In the second phase, a cross-sectional survey of health professionals in the UAE was conducted to determine the behavioural determinants and facilitators and barriers of medication error reporting. Principal component analysis of responses from 294 health professionals identified six components: knowledge and skills related; feedback and support related; action and impact related; motivation related; effort related; and emotions. Responses were neutral for the motivation and effort related components, but negative for the emotions component. Comparison of component scores identified that, nurses, females, those with greater experience and being older were more likely to be positive in their responses (p<0.05). In terms of emotions, the component with the lowest scores, older respondents with greater experience gave more positive responses (p<0.05). In the final phase, face-to-face semi-structured interviews with 29 health professionals explored in-depth the behavioural determinants of medication errors reporting in the UAE. The theoretical domains framework was employed in constructing the interview schedule and interpreting the findings. ‘Goals’ and ‘intentions’ were determinants which acted as facilitators while ‘beliefs of the consequences’, ‘emotions’,’ ‘social influences and environmental context’ were barriers. This doctoral research has generated original findings which can support the development of interventions, based on behaviour change techniques, to enhance medication error reporting. These changes could impact at the levels of the organisation, health professional and patient.

Abstract Background: Maternal mortality is one of the most sensitive indicators of the health disparities between poorer and richer nations. It is also one of the most difficult health outcomes to measure reliably. In many settings, major challenges remain in terms of both measuring and reducing maternal mortality effectively. This thesis aims to quantify overall levels, identify specific causes, and evaluate local interventions in relation to efforts to reduce maternal mortality in Tigray Region, Northern Ethiopia, thereby providing a strong empirical basis for decision making by the Tigray Regional Health Bureau using methods that can be scaled at national level.   Methods: This study employed a combination of community-based study designs to investigate the level and determinants of maternal mortality in six randomly selected rural districts of Tigray Region. A census of all households in the six districts was conducted to identify all live births and all deaths to women of reproductive age occurring between May 2012 and September 2013. Pregnancy-related deaths were screened through verbal autopsy with the data processed using the InterVA-4 model, which was used to estimate Maternal Mortality Ratio. To identify independent determinants of maternal mortality, a case-control study using multiple logistic regression analysis was done, taking all pregnancy-related deaths as cases and a random sample of geographical and age matched mothers as controls. Uptake of ambulance services in the six districts was determined retrospectively from ambulance logbooks, and the trends in pregnancy-related death were analyzed against ambulance utilization, distance from nearest health center, and mobile network coverage at local area level. Lastly, implementation of the Family Folder paper health register, and its potential for accurately capturing demographic and health events, were evaluated using a capture-recapture assessment.   Results: A total of 181 deaths to women of reproductive age and 19,179 live births were documented from May 2012 to April2013. Of the deaths, 51 were pregnancy-related. The maternal mortality ratio for Tigray region was calculated at 266 deaths per 100,000 live births (95% CI 198-350), which is consistently lower than previous “top down” MMR estimates. District–level MMRs showed strong inverse correlation with population density (r2 = 0.86). Direct obstetric causes accounted for 61% of all pregnancy–related deaths, with hemorrhage accounting for 34%. Non-membership in the voluntary Women’s Development Army (AOR 2.07, 95% CI 1.04-4.11), low husband or partner involvement during pregnancy (AOR 2.19, 95% CI 1.14-4.18), pre-existing history of other illness (AOR 5.58, 95% CI 2.17-14.30), and never having used contraceptives (AOR 2.58, 95% CI 1.37-4.85) were associated with increased risk of maternal death in a multivariable regression model. In addition, utilization of free ambulance transportation service was strongly associated with reduced MMR at district level. Districts with above-average ambulance utilization had an MMR of 149 per 100,000 LB (95% CI: 77-260) compared with 350 per 100,000 (95% CI: 249-479) in districts with below average utilization. The Family Folder implementation assessment revealed some inconsistencies in the way Health Extension Workers utilize the Family Folders to record demographic and health events.   Conclusion: This work contributes to understanding the status of and factors affecting maternal mortality in Tigray Region. It introduces a locally feasible approach to MMR estimation and gives important insights in to the effectiveness of various interventions that have been targeted at reducing maternal mortality in recent years.

Magister Public Health - MPH / A cross- sectional descriptive study using a self-administered close-ended questionnaire was conducted with pupils in standards four to seven (aged 10 - 17 years) in ten government primary schools in Meru District. The sample of 400 school pupils was obtained by a simple random sampling technique. Data analysis was done using Statistical Package for Social Sciences SPSS (version 15) computer software and the results were presented in frequencies using simple percentages, tables and graphs. The Chi-square test was used to assess the significance where a p-value of <0.05 was considered statistically significant. In conclusion, Primary school pupils in Meru district engage in several risky sexual behaviors including substance use, sexual coercion, early sexual debut and engaging in various sexual practices. This calls for a more comprehensive approach in the fight against HIV among primary school children in Tanzania, which could include life skill training at an early age, behaviour change communication interventions, advocacy activities to influence policy formulation, condom promotion and incorporating key stakeholders in the rollout of school based HIV programmes such as parents, community leaders and faith-based organizations leaders. / South Africa