The purpose of this study was to investigate physical activity (PA) engagement among older adults (OA) following discharge from a medically supervised group exercise program and to explore the facilitators and barriers that influenced maintained PA engagement. While facilitators and barriers to PA among OA in general have been well documented, facilitators and barriers particular to maintaining PA after discharge from a supervised exercise program have not been widely explored with qualitative methods or a mixed method design. Data for this mixed method, case study approach were collected in two phases. In Phase I, questionnaires were used to investigate PA engagement as well as semi-structured qualitative interviews were completed (n = 12; Mage = 80.0 years) to explore facilitators and barriers that influenced PA engagement. In Phase II, reviews of medical charts were conducted retrospectively to gather further information on PA engagement and barriers (n = 12). All 12 individuals in Phase I remained engaged in PA activity 2 – 48 months post completion of the medically supervised exercise program. This particular group of OA identified facilitators for and barriers to maintaining PA that were personally-, socially-, and program-based, and also provided suggestions to alleviate cited barriers. Four themes identified in regards to PA engagement were: (1) Personal drive: highly aware of the need to keep moving; (2) Social connections and support: we all need people; (3) Program components matter; and, (4) Convenient, Affordable, Relevant: suggestions to improve program access. The power of multi-level, multi-sector approaches that consider the broader determinants of health was highlighted in this study. Participants identified the need for health care providers (HCP) and PA instructors to continue to communicate the benefits of PA, the importance of ongoing HCP support, and the necessity of working across sectors to reduce program related barriers to promote PA engagement among OA discharged from a medically supervised exercise program. / Graduate / melodyburgoyne@hotmail.com

Background: Social participation is essential to well-being for adolescents with and without disabilities. Adolescents with a disability, however, often have fewer friendships and experience social isolation compared to their peers without disability. Telecommunications play a vital role in facilitating social participation for adolescents yet those with a disability experience reduced access. Based on the World Health Organisation’s framework of the International Classification of Functioning, Disability and Health (ICF) this study aimed to identify environmental factors (barriers and facilitators) that impact on participation in telecommunication use, as perceived by adolescents with cerebral palsy and their communication partners. Method: A qualitative research design was adopted using observations and in-depth interviews with five dyads of adolescents with cerebral palsy and significant communication partners. Data from interviews was analysed using qualitative content analysis to identify barriers and facilitators. Results and Conclusions: A total of 66 facilitators and 72 barriers to telecommunication use were identified. These were divided into four categories; people-related, equipment-related, support/training-related and ‘other’. A large number of interrelated people and equipment related factors were identified. Participants also identified the need for further training and support. In order to improve social participation for adolescents with disabilities, future research must investigate the development of assessment tools that accurately identify environmental barriers to telecommunication use and contribute to the development of strategies to over come these barriers.

Background: Social participation is essential to well-being for adolescents with and without disabilities. Adolescents with a disability, however, often have fewer friendships and experience social isolation compared to their peers without disability. Telecommunications play a vital role in facilitating social participation for adolescents yet those with a disability experience reduced access. Based on the World Health Organisation’s framework of the International Classification of Functioning, Disability and Health (ICF) this study aimed to identify environmental factors (barriers and facilitators) that impact on participation in telecommunication use, as perceived by adolescents with cerebral palsy and their communication partners. Method: A qualitative research design was adopted using observations and in-depth interviews with five dyads of adolescents with cerebral palsy and significant communication partners. Data from interviews was analysed using qualitative content analysis to identify barriers and facilitators. Results and Conclusions: A total of 66 facilitators and 72 barriers to telecommunication use were identified. These were divided into four categories; people-related, equipment-related, support/training-related and ‘other’. A large number of interrelated people and equipment related factors were identified. Participants also identified the need for further training and support. In order to improve social participation for adolescents with disabilities, future research must investigate the development of assessment tools that accurately identify environmental barriers to telecommunication use and contribute to the development of strategies to over come these barriers.

Background Posttraumatic stress disorder (PTSD) brings with it diagnostic symptoms that can be debilitating and persist for years. Left untreated, PTSD can have far-reaching and damaging consequences – for the individual, families, communities, and society at large. While early detection and intervention is recognized as key to the effective treatment of PTSD, many who suffer from PTSD do not seek essential health services. The aim of this study was to answer the research question: based on existing literature, what are the barriers and facilitators to help-seeking for individuals with PTSD? Methods A systematic review, modeled on the Joanna Briggs Institute (JBI) methodology for systematic reviews, examined studies cited in PsycINFO, Medline, Embase, CINAHL and PILOTS published from January 2000 to November 2015. Eligible studies measured barriers and facilitators to help-seeking for adults with PTSD. Two reviewers independently screened citations and double data extraction was exercised. Results Of 1,759 potentially relevant citations, sixteen studies were included, published between 2003 and 2015 and based in five countries, predominantly within the United States (n=12). Thirteen studies focused on military as a target population. Eight principal barrier themes and seven principal facilitator themes were identified, under which supportive subthemes were categorized. Conclusions In identifying prominent barriers and facilitators to help-seeking for individuals with PTSD, this review highlights opportunities to inform policies and programs that educate and promote PTSD knowledge and recognition, reduce public and personal stigma, improve access and availability of care, and encourage social support for patients and families living with PTSD.

Magister Scientiae (Physiotherapy) - MSc(Physio) / In South Africa, the Education White Paper 6 on Special Needs Education (2001) Building an inclusive education and training system stated that the special schools would be resource centres for ordinary schools that admit learners with disabilities. Occupational therapists,physiotherapists, speech and language therapists (collectively called therapists) had previously been employed in special schools, but under the new structure, would form part of the district-based support teams to provide their support to ordinary and full service schools.Therapists working in an inclusive education system would need to change the focus of their model of support from a medical model of direct support to a health-promoting model of indirect support. The aim of the current study was to determine whether therapists are changing their model of support in building inclusive and health-promoting schools and also to determine the barriers and facilitators they experience in providing their support in an inclusive education system. This study used both qualitative and quantitative methodology.The quantitative component was a non-experimental, descriptive, cross-sectional design,using one questionnaire in a survey. The questionnaire was used to determine the type of support provided to schools. In total, 97 therapists, who worked at special schools in the Western Cape, participated in the study by completing the questionnaire. The test-retest results of the questionnaire indicated that most of questions (63%) showed perfect agreement (Kappa 0.81-1.0). Quantitative data analysis was done by descriptive statistics, using SPSS.The results indicated that therapists were using the medical model of support combined with a more holistic approach using the principles of the health-promoting framework. The qualitative component involved three group interviews, which were held at three different special schools, in three different education districts, with a total of 12 therapists. The group interviews were used to determine the barriers and facilitators that either prevent or promote provision of support. Qualitative data analysis was done by using content analysis with codes and themes to determine barriers and facilitators. The barriers included the following: therapists’ uncertainty about roles; lack of networking, lack of certain competencies and training; delayed response from district; lack of policy;autocratic leadership styles; exclusion from the district-based support team; concern to support learners at special school; therapists being based at the special school; lack of human resources; insufficient time; cost of therapists’ training; education department circuit boundaries affecting communication;negative attitudes of principals and educators; and parents’ non-involvement. The facilitators included therapists’ competencies to fulfil roles; educators’ positive attitude; meetings; training to improve therapists’ skills; the co-ordinating role of the district-based support team;and the supportive role of learner support educator and the principal. This study provides evidence concerning therapists’ roles and the barriers and facilitators which therapists experience regarding their support provision in an inclusive education system.

No description available.

Sammanfattning Bakgrund: Äldre är en allt mer växande grupp i samhället då medellivslängden i Sverige har ökat. En stor del av världens äldre population är fysiskt inaktiv och drabbas av kroniska sjukdomar med ökad ålder. Detta har resulterat i en ökad belastning på sjukvården som kunde minska om fler äldre skulle delta i fysisk aktivitet. Syfte: Syftet var att undersöka vilka faktorer som upplevs påverka deltagande i fysisk aktivitet hos äldre som regelbundet tränar på Träffpunkter samt hur de upplever träningen som erbjuds där. Metod: En kvalitativ intervjustudie genomfördes. Informanterna bestämdes med ett strategiskt urval. Kvalitativ innehållsanalys har använts vid databearbetning.  Resultatsammanfattning: Individuella faktorer som obehagskänslor kopplade till fysisk aktivitet och nedsatt kroppsfunktion nämndes som utmaningar för deltagande. Informanterna beskrev att det krävs flexibilitet och anpassningsförmåga utav individen samt att det krävs att samhället anpassar utbud och resurser till den äldre populationen. Informanterna i studien motiverades av positiva effekter av träning samt uppskattade den anpassningsbara träning och det sociala utbytet som Träffpunkten erbjuder. Slutsats: Äldres deltagande i fysisk aktivitet påverkas av faktorer på individnivå som obehagskänslor, funktionsbegränsningar och flexibilitetsförmåga. Dessa faktorer samspelar med faktorer på samhällsnivå som anpassad träning, lokalutformning och transportmöjligheter. Träningen på Träffpunkter anses vara anpassningsbar och bidra till en social samvaro som underlättar deltagandet i fysisk aktivitet. Ett större utbud av träningsformer skulle kunna öka motivation för deltagande i fysisk aktivitet. Mer forskning inom området behövs. / Abstract Background: Older adults are a growing population in society as the life expectancy increases in Sweden. Many are physically inactive and are exposed to chronic diseases. This has resulted in a considerable load on healthcare which could be decreased if this group would increase their physical activity. Aim: The aim of this study was to explore factors that affects participation in physical activity for older adults that are exercising regularly at Träffpunkter and their experience of the exercise provided. Method: A qualitative interview study was used. Participants were selected using a strategic sample procedure. A qualitative content analysis approach was used for data analysis. Results: Individual factors such as negative feelings linked to physical activity and reduced bodily function, were mentioned as challenges to participation. Participants expressed that they need to be flexible to overcome barriers and that the society need to provide accessible and adjustable exercise. The motivators were similar for all participants such as the positive effects of exercise and they appreciated the adjustable training and the social climate at Träffpunkten. Conclusion: Factors that affects participation in physical activity are factors relating to the individual such as negative feelings, physical limitations and flexibility. They interact with environmental factors such as facility- and exercise design and transportation. Träffpunkter are viewed to provide adjustable training and a positive social climate. A increased variety of exercise could motivate participation in physical activity. More research in the field is needed.

There is a growing phenomenon of employing facilitators in support of learners with learning disabilities in schools offering inclusive education; however there is a scarcity of literature internationally regarding the decision-making models used to make this critical decision. Furthermore, there is also no research done in South Africa regarding facilitators, nor on decision-making models used to determine the need for facilitators or how they should be hired. In spite of the benevolent intentions of parents and teachers who assign facilitators to learners with disabilities, research shows that facilitators are employed according to perceived needs rather than real needs. The research conducted in this study is qualitative in nature; the narrative case study explores the deliberation process of employing facilitators in a manner that provided a deeper understanding of the phenomenon. The study focused on three different schools (Remedial school, Traditional private school and Montessori) that perceive themselves as inclusive primary schools. The purpose of the study was to understand the decision-making process of the various stakeholders (parents, teachers, and facilitators) involved in making the decision to employ facilitators. Through the case the three respective schools were categorised into proactive, reactive or passive, based on their approach to appointing facilitators for special needs learners. It is evident from the case studies that the proactive school (Remedial school) had better success with facilitators than either the reactive (Montesorrri School) or the passive school (traditional private school). The pro-active school displayed a more coherent successful system amongst all stakeholders in the decision to employ a facilitator, while the passive school was somewhat functional mostly because the stakeholders understood the needs of the child. However the system employed by the reactive school was chaotic as all stakeholders were dissatisfied and the learners who were being facilitated suffered the most. / Dissertation (MEd)--University of Pretoria, 2013. / gm2014 / Education Management and Policy Studies / unrestricted

Bakgrund: Underlättande och försvårande faktorer till fysisk aktivitet (FA) är välstuderat inom flera patientgrupper men hos friska vuxna finns inte lika mycket information. Syftet med denna kvalitativa litteraturöversikt var att sammanfatta litteratur gällande underlättande och försvårande faktorer för FA bland friska vuxna.  Metod: Studien var en litteraturstudie där intervjustudier sammanfattades för att få en bild om vilka återkommande teman som finns angående underlättande och försvårande faktorer för FA hos friska vuxna. Varje studie granskades individuellt med Critical Appraisal Skills Programme (CASP) och det sammanvägda resultatets granskades med Confidence in the Evidence from Reviews of Qualitative Research (GRADE- CERQual).  Resultat: Resultatsammanfattningen visar att det finns gemensamma faktorer som lyfts i många studier. Dessa kategoriserades in i fyra olika teman; biologiska, psykologiska, sociala och ekonomiska, samt miljö och samhälle. De främst förekommande underlättande faktorerna var: viktnedgång, njutning, social kontakt och tillgång till platser att träna på. De främsta försvårande faktorerna var: närvaro av sjukdom och rädsla. En majoritet av studierna i litteraturöversikten hade låg risk för snedvridning enligt CASP. Den sammanvägda granskningen med GRADE-CERQual visar inte på några tydliga risker för snedvridning.   Slutsats: Bland dessa kvalitativa intervjustudier fanns en majoritet av psykologiska och sociala faktorer. De ingående intervjustudierna och det sammanvägda resultatet hade låg risk för snedvridning men resultatet bör tolkas utifrån att de granskningsinstrument som används vid kvalitativ litteraturöversikt i sig kan ha stor risk för snedvridning genom att instrumenten lämnar stort tolkningsutrymme. Framtida forskning bör fortsätta undersöka upplevelser av underlättande och försvårande faktorer för FA för att utforska skillnader och gemensamma faktorer mellan populationer.

Magister Psychologiae - MPsych / The inception of the democratic government in 1994 was accompanied by the promulgation of progressive legislature. Chapter Two of the Constitution makes provision for reasonable accommodation for those who are differently-abled due to psychiatric difficulties. Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that impacts functioning adversely. The process to request, access and receive reasonable accommodation for students with ADHD remain inconsistent across various sectors of education. This study aimed to identify barriers and facilitators of reasonable accommodation for students with ADHD registered at the University of the Western Cape (UWC).