Thesis (M.S.)--University of Michigan, 1983.

Thesis (M.S.)--University of Michigan, 1991.

Thesis (MTech (Nursing))--Cape Peninsula University of Technology, 2015. / The most common cancer in women worldwide is breast cancer. It is also the leading cancer affecting women in South Africa. When breast cancer is detected early, it improves the outcome of the disease and reduces mortality. The aim of this study was to determine the knowledge, beliefs, attitude and practice of breast self-examination among female university students. The objectives were, to explore the levels of knowledge of female university students on breast cancer and breast self-examination; to ascertain the beliefs of female university students on breast cancer and breast self-examination; to examine the attitudes of female university students toward breast cancer and breast self-examination and to determine if female university students regularly practice breast self-examination. A Mixed method descriptive design was used for this study. The selected site for this study was a higher education institution in the Western Cape. The population included all female university students in the Western Cape. The sample was female university students studying in the selected higher education institution who reside on the institution’s campus. Convenience sampling was used to select the sample. Two methods were used to collect data; these were questionnaires and face-to-face interviews. Questionnaires were analysed by the use of Microsoft Excel and Statistical Package for Social Sciences. Frequency Distribution was used to analyse descriptive statistics. Interviews were transcribed and analysed by using coding and thematic analysis. Participants lacked knowledge on breast cancer risk factors, as majority of them only knew about family history being a risk factor. Majority of the participants had never been educated by their healthcare provider on breast cancer and its screening. Most of the participants had never examined their breast before. Most of the participants who did not examine their breast did not have any knowledge on how to do BSE. Education on breast cancer and cancer as a whole should be initiated in high schools and higher institutions of learning as part of their curriculum. Posters on breast cancer screening and breast self-examination should be put up at public places and campuses. Breast awareness campaigns must be done every month not only in October which is the breast cancer awareness month. Health care professionals should give information on breast cancer to women when they visit the hospital or health centre

With the advancement in information technology, online assessments are getting more attention and online examinations are regarded as important parts of online learning. Online examinations can be easily taken by remote students, help the students get exam results quickly and save their time; online examinations also aid instructors in collecting students' exam answers and generating the exam reports effectively. In addition, online examinations can help reduce cost and save trees for our world. Multimedia elements like images, graphics, video and audio have been widely integrated into online learning environments. They not only help instructors design more engaging online learning content, but also help provide more interactive and pleasant learning experience for learners. However, integrating multimedia elements into online examination systems is rarely reported. Multimedia elements generally consume amounts of computing resources in a separated software system running on a single computer. "Software-as-a-Service (SaaS)" has become a new software paradigm and cloud-based software systems are becoming more attractive due to their dynamic scalability and effective usage of computing resources. Yet, how to effectively integrate multimedia elements into a cloud-based software system for online examinations is not significantly investigated. Although a variety of online-assessment tools have been developed, few of them adopt the "Software-as-a-Service (SaaS)" paradigm and most of them focus on the assessment in a specific domain or an application area with short of multimedia elements. There is a lack of a comprehensive software solution for online multimedia examinations. This thesis tries to utilize the "Software-as-a-Service (SaaS)" paradigm, design and develop a cloud-bAsed softwaRe systEm for oNline multimediA examinationS (ARENAS), and explore a comprehensive software solution for the online assessment field. ARENAS employs a multi-tiered client-server architecture and includes five subsystem modules: user module, question repository module, exam module, exam report module and configuration module. The developed cloud-based software system can present online questions with multimedia elements, and also support a myriad of question types, flexible accounts to the exam-takers, randomized question order in an online exam, flexible grading mechanisms, and analytical exam reports. For instructors, the developed system can help design more engaging online questions; for exam-takers, the developed system can help provide more user-friendly experience; for other educators and researchers, the design and development processes of ARENAS can be taken as a reference to designing and developing other large-scale cloud-based educational software systems. / Master of Science

Thesis (MScMedSc (Pathology. Medical Microbiology))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: INTRODUCTION Mycobacterium tuberculosis (MTB) and Cryptococcus neoformans are the most common causes of chronic meningitis in South Africa. Conventional microbiology has limited utility in diagnosing these pathogens due to the paucibacillary nature of cerebrospinal fluid (CSF) and the diagnostic delay associated with culturing methods. This study aimed to evaluate the utility of an in-house polymerase chain reaction (PCR) method for the detection of the etiological agent of chronic meningitis. METHODS CSF samples (where volume exceeded 5ml) were submitted to the Medical Microbiology diagnostic laboratory of the Tygerberg Hospital from patients with suspected tuberculosis meningitis (TBM). Following routine bacteriology, the sample was used to inoculate two mycobacterial growth indicator tubes (MGIT A and B) and subsequently incubated in the BACTEC 960 automated system. MGIT A followed standard operating procedures and the time to culture positivity was noted. Weekly aliquots (up to 6 weeks) were removed from MGIT B. These samples were boiled to inactivate the bacteria and then the DNA was extracted using the Promega Wizard SV Genomic DNA kit. The DNA was then speciated by PCR and high-resolution melting analysis (HRM) by using primers specific to either the RD9 region of MTB complex or primers specific to the partial internal transcribed spacer 1 (ITS1), 5.8S rRNA gene and partial ITS2 sequence of C. neoformans. RESULTS Routine CSF microscopy indicated that 14 of the 78 patients (17.9%) had typical CSF findings of TBM (lymphocytes predominant, increased protein levels and decreased glucose levels). IV Ziehl-Neelsen (ZN) stains were positive for 12 (15.4%) samples, and MTB was cultured from 19 samples (24.4%). Our optimized PCR and HRM method was able to detect M. tuberculosis in 17 of the 19 culture positive specimens with a sensitivity of 89.5% and a specificity of 62.7%. The sensitivity of this method was higher than that of direct microscopy. In all of the PCR positive samples, the time to detection, compared to culture, could be shortened by 1 to 2 weeks. Only one sample was positive for Cryptococcus culture and another sample was positive with a Cryptococcus latex test. PCR for Cryptococcus was positive in 2 cases (n=78), sensitivities and specificities could not be reported due to the low number of positive cases. CONCLUSION We demonstrated that a short culture period and the use of commercial DNA extraction kit on CSF samples increases the sensitivity of molecular tests to diagnose tuberculosis. Furthermore, the molecular techniques could significantly reduce the time to positivity of results, when compared to culture. Due to the low occurrence of Cryptococcus in the samples included in our study, we could not comment on the diagnostic utility of PCR in the diagnosis of Cryptococcal meningitis, when compared to the conventional methods. / AFRIKAANSE OPSOMMING: INLEIDING Mycobacterium tuberculosis (MTB) en Cryptococcus neoformans is die mees algemeenste oorsake van kroniese meningitis in Suid-Afrika. Routine mikroskopie dra beperkte waarde in die diagnose van hierdie patogene as gevolg van die klein hoeveelhede organismes wat in die SSV (serobrospinale vog) voorkom en die lang tyd wat dit benodig om hierdie organisms te kweek. Hierdie studie beoog om die diagnostiese waarde van ‘n polymerase ketting reaksie (PKR) metode wat intern ontwerp is te evalueer vir die identifikasie van patogene verantwoordelik vir kroniese meningitis. METODES SSV monsters (waarvan die volume 5ml oorskry) en waar daar ‘n kliniese vermoede van tuberkulose meningitis (TBM) was, is na die diagnostiese Mediese Mikrobiologie laboratorium van Tygerberg hospitaal gestuur vir roetine bakteriologiese ontleding. Die oorblywende monsters is gebruik om twee mikobakteriële groei-indikasiebuise (MGIT A en B) te innokuleer en hulle is geïnkubeer in ‘n BACTEC 960 geautomatiseerde sisteem. MGIT A is volgens roetine diagnostiese metodes geanaliseer en die tyd tot ‘n positiewe resultaat is aangeteken Weeklikse monsters (tot en met week 6) is uit MGIT B verwyder en die monsters is gekook om sodoende die bakterië te inaktiveer. Die Promega Wizard SV Genomiese DNS ekstraksiemetode is gebruik om die DNS te versuiwer. Spesiëring van die DNS is deur middel van ‘n intern ontwerpte PKR en hoëresolusiesmeltingsmetode (HRS) gedoen met inleiers wat spesifiek is tot die RD9 gedeelte van die MTB kompleks en inleiers spesifiek tot die gedeeltelike interne getranskribeerde spasieerder 1 (ITS1), 5.8S rRNS geen en die gedeeltelike ITS2 DNS volgorde van C. neoformans. VI RESULTATE Roetine SSV mikroskopie het aangedui dat 14 uit 78 (17.9%) pasiënte tipiese SSV bevindings van TBM (oorwegend limfosiete, verhoogde proteïene en verlaagde glukose) gehad het. Ziehl- Neelsen (ZN) kleurings was positief vir 12 (15.4%) monsters, en MTB is gekweek in 19 (24.4%) van hierdie monsters. Ons geoptimaliseerde PKR en HRS metode het daarin geslaag om M. tuberculosis in 17 van die 19 kultuurpositiewe monsters aan te toon met ‘n sensitiviteit van 89.5% en ‘n spesifisitiet van 62.7%. Die sensitiwiteit van die direkte PKR was hoër in vergelyking met mikroskopie. In al die PKR positiewe monsters was die tyd tot aantoning, in vergelyking met kultuur, verkort met 1 tot 2 weke. Slegs een monster het C. neoformans gekweek en ‘n ander monster was positief met die kriptokokkale latekstoets. PKR vir C. neoformans was positief in 2 gevalle (n=78). Die sensitiwiteit en spesifisiteit van die C. neoformans PKR kon nie bepaal word nie weens te min gevalle. GEVOLGTREKKINGS Ons het aangetoon dat ‘n verkorte inkubasieperiode en die gebruik van ‘n kommersiële DNS ekstraksiemetode op SSV monsters die sensitiwiteit van die molekulêre tegniek vir die diagnose van tuberkulose verhoog en dat hierdie metode die tyd na positiwiteit aansienlik verkort in vergelyking met kultuur. Weens die lae getalle van kriptokokkale meningitis in ons studie kon ons nie kommentaar lewer op die akkuraatheid van PKR in die diagnose van kriptokokkale meningitis, in vergelyking met meer konvensionele metodes, nie.

Text in English / Monthly breast self-examination (BSE) is an extremely important part of health care for all women in every stage of life as a primary tool in the prevention of breast cancer. The purpose of this study was to determine the knowledge and practice of BSE among women at a private clinic in Zimbabwe. A non-experimental cross-sectional descriptive research design was used. The accessible population was one hundred women admitted to the selected private clinic. Data collection was done using a questionnaire which consisted of three parts: socio-demographic characteristics, knowledge about BSE and practices of BSE. Data obtained was analysed using EPI INFO version 3.3.2. Results showed that respondents were knowledgeable about breast cancer early warning signs and symptoms and BSE. About 28% of the respondents were aware of when to initiate BSE and 74% performed BSE, but their practice was poor. Educational materials should be freely available at hospitals and schools to enhance BSE awareness. / Health Studies / M.A. (Health Studies)

The present study investigated the criterion-based validity of the Mini-Mental State Examination (MMSE), the Cognitive Capacity Screening Examination (CCSE), and the Neurobehavioral Cognitive Status Examination (NCSE) in a sample of older adults with suspected cognitive impairment. As cognitive screening tests, the MMSE, CCSE, and NCSE should predict performance relative to a more thorough testing procedure. In the present study, performance on the Halstead-Reitan Neuropsychological Test Battery (HRNTB) was employed as the criterion measure. Scores on the General Neuropsychological Deficit Scale (G-NDS), a global performance measure computed from the HRNTB, served as the standard by which to judge the presence of cognitive impairment. The sensitivity, specificity, and predictive value of each screening test, as well as how well each screening test correlated with the G-NDS, were investigated. Results of this investigation found that, although the MMSE, CCSE, and NCSE were all significantly correlated with the G-NDS, only the NCSE demonstrated an appropriate balance between high sensitivity and specificity. When a rigorous neuropsychological evaluation was employed as the criterion standard, the NCSE accurately detected the presence of cognitive impairment: in 82% of the cases. The MMSE and CCSE, however, failed to detect cognitive deficits in approximately 80% of the cases. These findings strongly suggest that the MMSE and CCSE may have limited utility in the identification of cognitive impairment in older adults. The heightened sensitivity of the NCSE appears to be the result of several unigue features of the instrument, including a multidimensional scoring system and a graded series of increasingly difficult items within each ability area. Future studies need to examine the utility of the NCSE in other geriatric settings, as well as with more diverse populations suffering from a variety of organic mental syndromes.

Abstract Background: Previous studies show that ADHD is associated with lower educational attainment, lower level of employment and increased risk for stressful life events. No previous studie was found that compared conditions before and after diagnosis was set. The aim of this study was to examin if a neuropsychiatric diagnostic assessment and support afterward had any impact on the life situation for adult persons with ADHD regarding occupational outcome, economical status and social support. Method: A sample of 214 adults participated in the study. Data were collected from the participants’ medical records. Statistical analyses were applied to identify possible changes before and after a neuropsychiatric examination. Results: Changes were seen in occupational outcome, economical outcome and in the help received from the community before and after the examination. Conclusions: Neuropsychiatric examinitions starts a process that could lead to a better socialeconomical situation for the person with ADHD.

A quasi-experimental design was used in this study to determine if guided practice would result in higher breast cancer knowledge scores, higher breast self-examination (BSE) knowledge scores and higher intent to practice scores then modeling alone or teaching without modeling or guided practice. Fifty-eight women participated in the study. There were 19 women in the guided practice group, 22 in the modeling group and 17 in the control group. A pre-test, post-test format was used. ANCOVA was used to statistically control for the variance in pre-test scores. Descriptive statistics were used to analyze demographic data. The results showed that all methods of teaching resulted in higher breast cancer and BSE knowledge scores and in higher intent to practice scores. There were no statistically significant differences between the groups. Nursing research need to continue in this area to find the most effective method of teaching women breast self-examination.

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Fine Arts at Virginia Commonwealth University.