Few mental health studies have explored the prevalence of disorders, risk factors, and availability of services in Antioquia, especially in urban children and adolescent populations. However, access studies have never been developed. Despite growing interest in access, researchers, bureaucrats and interest groups have not come to any consensus about which specific factors may be considered in order to improve access for children and adolescents, especially in provinces with high levels of violence, displacement and inequality. This thesis aims to generate such a consensus among a diverse group of mental health stakeholders around Antioquia. Consensus suggests that predisposing, enabling, need and behaviour factors simultaneously influence access. Additionally, social capital is the resource upon which several mental health programs focus for the development and promotion of mental health services. Finally, stakeholders have identified effectiveness criteria that should be used to evaluate their efficacy as a network in order to improve their work.

The purpose of this study was to assess planning and delivering agricultural extension activities in the Kurdistan region of Iraq for future program implementation. The study was a descriptive research and used a modified Delphi technique to identify needed improvements and highlight barriers in planning and delivering extension activities by the willingness of extension workers. The population of the study was 50 MOAWR purposely selected government employees consisted of 10 extension experts, 15 extension administrators, and 25 extension agents. The study used three rounds web-based survey questionnaires. In Round I, the panelists were responded to two open ended questions to identify needed improvements and barriers in planning and delivering extension activities. The gathered information from Round I was examined, organized, and combined to create the second questionnaire for Round II. In Round II, the panelists were indicated their levels of agreement or disagreement about each needed improvement and barrier. The study employed a six-Likert scale with 1=”Strongly Agree”, 2=”Agree”, 3=”Somewhat Agree”, 4=”Somewhat Disagree”, 5=”Disagree”, and 6=”Strongly Disagree”. The needed improvements and barriers that received two-thirds of agreement (numbers 1 and 2 in the six-point Likert scale) were used to create the third questionnaire for Round III. In Round III, panelists were developed consensus by rating the statements that received two-third agreement in Round II. Equally, the same Round II six-point Likert scale was used in Round III. The result findings of the study were revealed to the demands of extension policy implementation in the region. The results of the study were summarized in three overall implementation theme areas: community based program development, building capacity program, and institutional structuring and three distinct research areas: leadership in extension, personal traits of extension agents, and external communication. Furthermore, the results of the study provided key points and details for each implementation theme and distinct research area.

Few mental health studies have explored the prevalence of disorders, risk factors, and availability of services in Antioquia, especially in urban children and adolescent populations. However, access studies have never been developed. Despite growing interest in access, researchers, bureaucrats and interest groups have not come to any consensus about which specific factors may be considered in order to improve access for children and adolescents, especially in provinces with high levels of violence, displacement and inequality. This thesis aims to generate such a consensus among a diverse group of mental health stakeholders around Antioquia. Consensus suggests that predisposing, enabling, need and behaviour factors simultaneously influence access. Additionally, social capital is the resource upon which several mental health programs focus for the development and promotion of mental health services. Finally, stakeholders have identified effectiveness criteria that should be used to evaluate their efficacy as a network in order to improve their work.

Given the complexity of medicines use in elderly patients, structures and processes of medicines management are key to deriving best outcomes. This research was conducted in hospitals in the United Arab Emirates (UAE) and focused on the patient journey from admission to discharge. The overall aim was to explore the structures and processes of medicines management in elderly hospitalised patients in the UAE, conducted in three phases. Phase 1. Following a review of systematic reviews of aspects of medicines management (e.g. reconciliation), this phase focused on a specific, emerging tool (the Drug Burden Index (DBI)) relating to anticholinergic/sedative agents, which are problematic in the elderly. The aim was to critically appraise, synthesize and present evidence of DBI use. The review protocol was registered with the Joanna Briggs Institute and conducted according to best accepted practice. The key finding was the lack of evidence of DBI use prospectively to identify potentially inappropriate prescribing. Phase 2. Phase 2 employed a qualitative phenomenological design to explore health professionals’ views and experiences of medicines management. Semi-structured interviews were conducted with 27 professionals and analysed using Normalization Process Theory (NPT) and the Theoretical Domains Framework (TDF). Findings revealed little evidence of coherence, cognitive participation, collective action and reflexive monitoring (NPT). TDF domains dominant were: professional role, identity; beliefs about capabilities; beliefs about consequences; environmental context, resources; and knowledge. Phase 3. The Delphi technique in phase 3 aimed to determine consensus around medicines management using an expert panel of policy makers, educators and lead health professionals. Phase 1 and 2 findings were used in construction of validated statements. A high level of consensus (≥70% strongly agree/agree) was obtained for statements other than those for targeting medicines management (rather than all elderly admissions) and tasks linked to professions (rather than trained staff). Overall, this research has generated original findings focused on the entire inpatient hospital journey, particularly the need to more clearly define, refine and agree on healthcare structures and processes across the entire patient journey from admission to discharge. The use of the NPT and TDF has highlighted those individual practitioners and organisational issues which require consideration.

Bank holding companies (BHC) that sustain significant losses without adequate capital can become insolvent and pose a systemic risk to the U.S. economy, yet 6 BHCs' had losses higher today than they were prior to 2008 recession. BHCs continue to experience significant losses as senior managers lack effective practice towards capital regulation. The research question for this study was, what is the level of consensus among banking finance experts across the U.S. on how to recognize a senior manager's effective practice towards capital regulation in BHCs. The purpose of this qualitative e-Delphi study was to build consensus among banking finance experts across the U.S. on how to recognize a senior manager's effective practice towards capital regulation in BHCs. The conceptual framework for this study was Compliance and Ethics Group's standard that improves quality and performance, principal-agent theory and goal theory. This e-Delphi study built consensus among 10 finance experts who are: employed a minimum of 10 years in banking; possessed an MBA in Finance; and, currently employed as a consultant to a large bank in the U.S. Data were collected from 3 electronic questionnaires submitted through Qualtrics. Data were analyzed using theoretical triangulation, coding, and thematic analysis. The data analysis revealed consensus on 33 activities constituting a senior manager's effective practice towards capital regulation in BHCs, with the highest agreement on internal control activities. The identification of these effective practices towards capital regulation in banks can effect social change by providing senior bank managers in BHCs with uniform principles that can reduce the level of risk behavior while meeting capital regulation requirement and shareholder objectives.

The preparation of prospective music educators is a very complex undertaking that culminates with the student teaching practicum. However, the music student teaching experience may have less predictable expectations and results than the curriculum that precedes the event. The two-fold purpose of this study was (a) to investigate the music student teaching practicum in the State of Texas in an effort to establish current levels of success as perceived by the music educators involved in the process and (b) to identify any potentially problematic areas which might be in need of attention or revision. Thirty-six music educators (12 university supervisors, 12 cooperating teachers and 12 student teachers) who were recently involved in the music student teaching practicum in Texas were chosen as the sample in this two-round Delphi study. The first round Delphi survey, based on related literature, achieved consensus on 79% of the 108 item responses, and 15 of the 22 unresolved items reached consensus in round two of the Delphi process. The 34 sample members who completed the study ranked a final item in the second Delphi round concerning suggestions for the improvement of student teaching. The respondents showed a very high opinion of the music student teaching practicum. However, the cooperating teachers' responses were often lower, hence the recommendation that collaborative efforts between universities and public schools be strengthened. Recommendations for improvement were also made advocating: (a) adequate rehearsal time to be afforded the student teacher, (b) expectations to be clearly defined and articulated, (c) classroom management, measurement and media, and content area reading classes to be taught by music faculty, (d) videotaping to be used in the teacher-training and student teaching process, and (e) the length of the student teaching practicum to be extended. Five additional recommendations for improvement were made in areas deemed less urgent.

The purpose of this study was to examine academic department chair perceptions about the future influence of web-based distance education on departmental operations and their changing role as academic leader. Using a rating, modified-policy Delphi method, the researcher worked with 22 department chairs employed at public, urban universities in the United States to develop 76 factor statements about the opportunities, pressures, changing relationships, and role of the chair. In a three-step process, the chairs reduced the 76 factors into 29 predictive statements. Furthermore, the researcher merged the predictions into six themes covering topics such as the importance of external agencies to the successful implementation of web-based education and concerns about future funding. Based on the findings, the researcher argued that the most efficient strategies to promote web-based distance education are through the efforts of the department chair due to the closer proximity of the department to external markets.

Recognizing characteristics that improve inclusion in general education classrooms allows educators and parents to make conscious decisions regarding how students with Autism Spectrum Disorder (ASD) can be included most appropriately. The purpose of this qualitative Delphi study was to understand the opinions of individuals with expertise in the fields of autism and inclusion as to the characteristics and behaviors within the environmental constellation that support or inhibit inclusion of elementary students with ASD. The conceptual framework was based on tenets of applied behavior analysis, multiple intelligences, and ecosystem characteristics. Research questions addressed characteristics and behaviors of general and special education teachers, other school personnel, students, and their families. Sixteen international experts responded to semistructured interviews and follow-up questions. Data were coded and distilled across three rounds. Knowledge of disabilities and effective behavior management were agreed to be important for all adults, and a sense of humor and willingness to collaborate were agreed to be important for students and adults. Participants agreed that cognitive abilities were important for students. There was no consensus on the unconditional inclusion of all students. Specific types of support and training for adults and more research by educators, parents, and professionals who work with students with ASD were recommended. Specific characteristics and behaviors of all involved are important in the development of the child. A suggested resource was created as part of this study. Being knowledgeable of how to work together support children in the general education classroom is a start for those students to become more included in the larger world.

Introduktion: Specialiserad palliativ vård finns i hela landet, men är olika organiserad. Det finns uppskattningsvis 100 arbetsterapeuter inom denna vårdform i Sverige. Arbetsterapeut är inte en obligatorisk profession i teamet runt dessa patienter trots att tidigare studier visat att arbetsterapeuter är viktiga då arbetsterapi i den specialiserade palliativa vården skiljer sig från den traditionella.  Syfte: Att kartlägga och beskriva arbetsterapi i den specialiserade palliativa vården i Sverige. Metod: Studien var en Delphistudie i tre ronder för att nå konsensus kring ett antal påståenden om arbetsterapi i palliativ specialiserad vård. Urvalet av deltagare var målinriktat och expertpanelen bestod av 28 arbetsterapeuter som representerade hela landet. Resultat: Experterna nådde konsensus kring att patientens energibesparing tillhör deras främsta arbetsuppgifter redan i rond 2. I rond 3 nåddes konsensus i mer än hälften av påståendena. Konsensus nåddes ej till exempel kring användning av modeller eller bedömningsinstrument. Konklusion: Arbetsterapeuter i specialiserad palliativ vård är samstämmiga i mycket gällande utövandet av arbetsterapi, trots organisatoriska skillnader. Implikationer: Studien visar att arbetsterapeuten borde vara en obligatorisk profession i teamet i den specialiserade palliativa vården i Sverige. / Introduction: Specialized palliative care is available throughout the country but is organized differently. There are estimated 100 occupational therapists in this form of care in Sweden. Occupational therapist is not a mandatory profession in the team around these patients, despite previous studies showing that occupational therapists are important since occupational therapy in specialized palliative care differs from the traditional. Aim: To map and describe occupational therapy in specialized palliative care in Sweden. Method: The study was a Delphi study in three rounds to reach consensus around several statements about occupational therapy in specialized palliative care. The selection of participants was purposeful and the expert panel consisted of 28 occupational therapists representing the entire country. Results: The experts reached consensus that “Saving the patient's energy is one of their main tasks” already in round 2. In round 3, consensus was reached in more than half of the statements. Consensus was not reached, for example, around the use of models or assessment instruments.  Conclusions: Occupational therapists in specialized palliative care agree on much regarding the practice of occupational therapy, despite organizational differences. Significance:  The study shows that the occupational therapist should be a mandatory profession in the team in specialized palliative care in Sweden.

All engineering careers require some level of programming proficiency. However, beginning programming classes are challenging for many students. Difficulties have been well-documented and contribute to high drop-out rates which prevent students from pursuing engineering. While many approaches have been tried to improve the performance of students and reduce the dropout rate, continued work is needed. This research seeks to re-examine what items are critical for programming education and how those might inform what is taught in introductory programming classes (CS1). Following trends coming from accreditation and academic boards on the importance of professional skills, we desire to rank knowledge and professional skill areas in one list. While programming curricula focus almost exclusively on knowledge areas, integrating critical professional skill areas could provide students with a better high-level understanding of what engineering encompasses. Enhancing the current knowledge centric syllabi with critical professional skills should allow students to have better visibility into what an engineering job might be like at the earliest classes in the engineering degree. To define our list of important professional skills, we use a two-group, three-round Delphi survey to build consensus ranked lists of knowledge and professional skill areas from industry and academic experts. Performing a gap analysis between the expert groups shows that industry experts focus more on professional skills then their academic counterparts. We use this resulting list to recommend ways to further integrate professional skills into engineering programming curriculum.