Bakgrund God vårdhygien kan reducera antalet vårdrelaterade infektioner med en tredjedel och med dagens kunskaper går det med enkla medel att iaktta de förhållningsregler som är nödvändiga för att säkerställa en god vårdhygien. Ändå följs ofta inte hygienrutiner. Syfte Att belysa vilka faktorer som underlättar att vårdpersonal på vårdavdelningar på sjukhus följer basala hygienrutiner. Metod Studiens design är en deskriptiv litteraturstudie. Denna metod valdes för att utforska det aktuella kunskapsläget inom området. Metoden beskriver det nuvarande kunskapsläget inom ett område genom att granska, analysera och beskriva valda vetenskapliga studier. Resultat Analysen av data från studierna gav sju teman: ansvarskänsla, arbetsbelastning, attityder och beteende, kunskap och utbildningens inverkan, ledningens ansvar i hygienfrågan, återkoppling samt tillgänglighet. De viktigaste faktorerna är ”attityder och beteende” och ”ledningens ansvar i hygienfrågan”. Slutsats Ett tydligt ledarskap med motiverade chefer och en uppmuntrande miljö ger störst möjlighet till att påverka attityder och beteenden hos personalen. För att förbättra följsamheten till hygienrutiner behöver dock alla sju underliggande faktorer beaktas. Därigenom kan patienters lidande undvikas genom en minskning i antal vårdrelaterade infektioner (VRI) och vårddygn. / Background Good healthcare hygiene can reduce the number of healthcare associated infections by one-third and with current knowledge we can with simple means observe the precautions necessary to ensure good healthcare hygiene. Yet these hygiene rules are often not followed. Aim To elucidate the factors that facilitate for nursing staff in hospital wards in to follow basic hygiene procedures. Methods The study design is a descriptive literature study. This method was chosen to get an idea of the current state of knowledge in the field. The method describes the state of knowledge of a field by reviewing, analyzing and describing selected scientific studies. Results Analysis of data from the articles gave seven themes: sense of responsibility, workload, attitude and behaviour, knowledge and education, responsibilities with regard to hygiene, feedback and availability. The most important factors are “attitudes and behaviour” and “management’s responsibility considering the hygiene”. Conclusion A clear leadership with motivated managers and an encouraging environment gives the best opportunity to change the staffs' behaviour and attitudes. However, to improve compliance with hygiene routines all seven factors need to be considered. Thus patients suffering can be avoided through a reduction in health care associated infections and days of care.

Bakgrund: Omkring 10-15 % av befolkningen, oftast i arbetsför ålder, riskerar att någon gång drabbas av njursten. Nationella riktlinjer för njurstensbehandling saknas, men studier stödjer behandling inom 48 timmar för snabb symtomlindring och minskade besvär för patienten. Inom studerad verksamhet var tiden från diagnos till behandling lång och återinläggningarna var många, varför ett förbättringsarbete initierades. Syfte: Syftet med förbättringsarbetet var att halvera tiden från diagnos till behandling för patienter med akut behandlingskrävande uretärsten, samt minska negativa effekter relaterade till obehandlad uretärsten. Vidare syftade studien av förbättringsarbetet till att beskriva ett tvärprofessionellt teams erfarenheter av aktuellt förbättringsarbete gällande patienter med uretärsten. Metod: Ett tvärprofessionellt team bedrev förbättringsarbetet med stöd av Nolans modell för förbättringsarbete, vilket studerades genom en deskriptiv fallstudie med induktiv ansats. Effekterna av förbättringsarbetet utvärderades med Statistical Process Control (SPC). Vidare studerades teamets erfarenheter genom gruppintervjuer, och skriftliga berättelser vars data analyserades och sammanställdes genom kvalitativ innehållsanalys. Resultat: Målet med behandlingstiden uppnåddes inte, men positiva effekter för patienterna uppmättes. ESWL-behandling inom 48 timmar minskade tiden från diagnos till sista behandling. Planering, samarbete, information var nödvändigt för att lyckas med ett förbättringsarbete, men i kontexten fanns motsättningar, vilket försvårade arbetet, så som hög arbetsbelastning och bristande rutiner. Vidare beskrevs en bristande helhetssyn inom verksamheterna kring patienter med njursten, vilket ledde till varierande drivkrafter hos medarbetarna. Slutsatser: ESWL inom 48 timmar förkortade tiden från diagnos till behandling, även hos de patienter som behövde ombehandlas. Utmaningarna i ett förbättringsarbete finns inom olika nivåer, inom en komplex organisation. Riktlinjer och en gemensam målsättning är viktigt för att erbjuda patienterna ändamålsriktig vård i rätt tid. Kommunikation är grundläggande för att lyckas med ett förbättringsarbete. / Background: About 10-15% of the population, mostly at working age, has the risk that at some point be affected by kidney stones. There is a lack of national guidelines for kidney stone treatment, but several studies suggest treatment to start within 48 hours for rapid symptom relief and reduced discomfort for the patient. Within the studied context, the time from diagnosis to final treatment was too long, and the readmission rate was high, why a quality improvement project was initiated. Purpose: The aim of the Quality Improvement project was to halve the time from diagnosis to final treatment for the patients suffering from urethral calculi, and to reduce negative impacts related to an untreated urethral stone. Furthermore the aim of the study was to describe a multi-professional teams’ experiences of actual Quality improvement project. Method: Nolans model for Improvement was used by the team. The effects of the quality improvement were evaluated with Statistical Process Control (SPC). A case study with inductive approach was used. The teams’ experiences was studied through group interviews, and written stories and the data were conducted through qualitative content analysis Results: The goal considering time to final treatment was not achieved, but positive effects for the patients were noted. Extracorporeal Shock Wave Lithotripsy (ESWL) treatment within 48 hours reduced the time from diagnosis to final treatment. Planning, cooperation and communication was the key factors for success for quality improvement. Several barriers was identified in the context, such as; high work load and indistinct routines, which complicated their work. Furthermore a lack of holistic view, considering patients with kidney stone was described, which led to a variation in the driving forces among the employees. Conclusions: ESWL in 48 hours shortened the time from diagnose to final treatment, even if a retreatment was necessary. In a complex organization, the challenges conducting a quality improvement project is on several levels. Well known guidelines and a shared goal for the entire process are important to be able to offer patients appropriate care at the right time.  Communication is fundamental to achieve success.

The high prevalence of sexual abuse suffered by women as children is well documented, both internationally and in South Africa. The life outcomes of women who had experienced childhood sexual abuse are generally reported as adverse, yet some of these survivors manage to overcome the abusive relationship and experience positive changes in themselves and their lives. Emerging trauma literature thus supports a philosophical shift from a pathogenic to a autogenic paradigm in which the focus is on positive and adaptive post trauma outcomes. Previous trauma models, which were based on a pathogenic model, are now shifting to a positive psychology trend by incorporating a salutary component, which includes a spiritual and existential dimension as well as an area of potential emerging growth. Information on the constructive coping behaviours, posttraumatic growth and psychological well-being of women who had experienced childhood sexual abuse can lead to the formulation of guidelines with strategies for an intervention programme that can facilitate and enhance coping, posttraumatic growth and psychological well-being in survivors of childhood sexual abuse. This research investigated the coping behaviours, posttraumatic growth and psychological well-being of women who had experienced childhood sexual abuse. The research was carried out in South Africa in the greater Gauteng Province and surrounding areas, with women who had experienced sexual abuse in childhood. A mixed method research design was used in which: the first phase was quantitative research conducted with validated psychometric instruments measuring coping behaviour, posttraumatic growth and psychological well-being. These instruments were the COPE (Coping Self-efficacy Scale), the Posttraumatic Growth Inventory, the Mental Health Continuum, Rosenberg’s Self-esteem Scale and the General Health Questionnaire. The second phase was of a qualitative nature, and explored the stories and experiences of women identified as coping constructively, manifesting posttraumatic growth and psychological well-being, by using semi-structured interviews. Lastly, the data obtained was used to formulate guidelines with specific strategies, which can be used by helping professionals in a group context to facilitate and enhance constructive coping, posttraumatic growth and psychological well-being in survivors of childhood sexual abuse. The results of this research were as follows: prevalence of constructive coping, posttraumatic growth and psychological well-being was determined, and indicated that 58% of participants manifested constructive coping, 60% manifested posttraumatic growth and 42% manifested psychological well-being. Semi-structured interviews conducted with the women scoring in the upper range of coping constructively, growing after the trauma and emerging psychologically well were transcribed and analysed by means of interpretative phenomenological analysis, and the following broad themes emerged: psycho-socio spiritual resources, the healing process and positive strengths. These themes and sub-themes produced data which could be used in the formulation of guidelines with strategies for an intervention programme aimed at enhancing and facilitating constructive coping, posttraumatic growth and psychological well-being thereby improving the therapeutic services available to childhood sexual abuse survivors. Finally the study was evaluated and conclusions and recommendations were made. / PhD, Psychology, North-West University, Vaal Triangle Campus, 2012

This study focuses on the identification of didactic guidelines for presenting values education in secondary schools. The studied literature sends a clear message that values education is of cardinal importance in education, teaching and training. In 2000 the National Department of Education of South Africa assembled a task team to identify a set of values in particular relevant to education and training. In the report Manifesto on Values Education and Democracy (DOE, 2001) six core values are singled out as of primary importance to the new dispensation in South Africa: equality, equal rights, tolerance, multilingualism, transparency, accountability, and social responsibility. The Report focuses only on national, political and social values, however. From research performed by Rens (2005), Hattingh (1999) en Bagarette (1995), it is clear that an individual needs to be educated as a holistic being and all life values thus need to be addressed integratively . A literature study was undertaken to clarify the concepts values, value orientation and values education, and also to determine how adolescents experience values education. Consequently, different values education programmes currently implemented in foreign countries were analysed . It was found that the 'Cornerstone-waardes" programme of John Heenan, applied in New Zealand, could reasonably easily be adapted for the South African context. From the discussion of the curriculating process as applicable to values education, didactic guidelines could be formulated for values education in South African schools. To identify the current orientation to values as manifested by learners, teachers and school principals in South Africa, the values questionnaire compiled by Vreken and Rens (2001) for research on the values orientation of university learners, was adapted and completed by the population involved in this study. Principals were subjected to partly-structured interviews to gain their opinions on values education in schools. Interviews on possible guidelines for values education in South Africa were also conducted by e-mail with international experts. Since the primary aim of the study was to determine the values orientation of secondary school learners and to recommend didactic guidelines for values education, the aim was mainly attained by means of the empirical study. Noteworthy is, however, that there is no symmetry between learners' views on important values and those that the Department of Education finds it necessary to be promoted. / Thesis (Ph.D. (Education))--North-West University, Potchefstroom Campus, 2005.

The focus of this study is to suggest guidelines for the implementation of a character education program in high schools. It has become clearly evident, from the literature that character education is of cardinal importance for instruction and education. The breakdown of values in South Africa is leading to an increase in crime in the country, which will have far-reaching consequences if learner crime is not addressed. Character education could offer a possible solution and make learners realise the difference between "right" and "wrong" as well as to say "no" to drugs, alcohol, sex, gangs and other social problems. A literature study was done to highlight the nature and scope of behaviour problems in overseas schools as well as South African schools. There was also looked at the impact of violence on the culture of instruction and learning as well as the external and internal factors that can play a role in violence within schools. Furthermore, the concept of character education was investigated as well as character education as possible solution to behavioural problems in high schools. There was also looked at whether character education does indeed produce positive results. Different character education programs that have already been implemented successfully abroad were investigated. Smart & Good High Schools seem suitable for the South African situation and could easily be adapted to the circumstances of individual schools. This program ascribes to the view that the best high schools have two main objectives in common, namely: to help learners to become smart - in the multi-dimensional sense of intelligence - and to help them become good - in the multi-dimensional sense of moral maturity. It is, therefore, about excellence and ethics. Lickona and Davidson (2005) mention schools that are committed to both these objectives, Smart & Good High Schools. Guidelines for the implementation of a character education program arose from discussing the program. In order to determine in what areas character education are needed with learners; how parents evaluate the character education of the learners of the school; what teachers are presently doing to promote character education; and how the learners' values changed within the scope of six months, questionnaire surveys were used. Questionnaires were given to learners wherein they had to judge their own values and that of their fellow learners. Questionnaires were given to parents asking their opinions on the values currently displayed by learners of the relevant school; what parents would like see with the learners; the character traits of the learners; and which traits the school should promote. Questionnaires were also distributed to the teachers of the school to determine to what extent particular promising practices are being pursued to promote character education with learners. A test sample of Grade 8 to 12 learners also filled out a revised questionnaire to determine to what extent these practices were indeed being applied in the classroom. The primary objective of the survey was to determine the character education practices of a particular high school in the North-West Province and to suggest guidelines for the implementation of a character education program. The empirical survey aided in achieving this objective. Findings of some concern, within the scope of six months, related to the general deterioration in the behaviour/habits of the learners at the school, inter alia the number of learners who smoke, drink, are aware of those who use drugs as well an increase in learners who tested positive for HIV/AIDS. In addition, almost half the learners indicated that they find it difficult to say "no" to negative peer pressure. It has been concluded that character education in schools offer a definite solution and that such a program can be integrated effectively into the existing curriculum. / Thesis (Ph.D. (Education))--North-West University, Potchefstroom Campus, 2008.

The objectives of this research firstly is to assess and establish the guidelines in respect of the medium of instruction as a determinant of the forms of the educational system in South Africa. Subsequently, the researcher wishes to establish the precise policy in respect of the instructional medium in South Africa. Thirdly, the researcher wishes to establish which languages are preferred as instructional media by South African learners, and why. Finally, the researchers wishes to establish the learners' approach and attitude in respect of a particular instructional medium. The research method followed, focuses in the first place on an extensive literature study to primarily establish the guidelines in respect of the instructional medium as a determinant of the educational system, as well as to acquire information in respect of the instructional medium in South Africa. In addition, empirical research was done to determine which languages are preferred in practice by learners as media of instruction, and why attempts at assessing attitudes in respect of a specific instructional media were also made. By using a questionnaire as measuring instrument, quantitative research was done in respect of 28 % of the grade eleven learners in Vanderbijlpark. Qualitative research was also done by way of personal interviews using a structured questionnaire with the aid of teachers. The findings briefly indicate that the Afrikaans -speaking learners in South Africa realize the value of mother tongue instruction, consequently also then preferring it as the instructional medium. Both English -speaking and African language users in South Africa prefer English as a medium of instruction as they believe their entrance into the job market will then be assured. Only a small percentage of users of African languages prefer their mother tongue as instructional language. The literature study revealed that mother tongue instruction is indispensable in respect of academic performance. Learners perform better academically should they for a period receive instruction in their mother tongue, even should it be up to the fourth grade when basic skills such as reading, writing and arithmetic are acquired. It was finally established, that South African legislation indeed provides for mother tongue instruction for all, but that the policy is not applied in practice. It is the considered opinion of the researcher that mother tongue instruction in South Africa is a treasure to be cherished and preserved by both Afrikaans and English speaking learners, also that it should be extended to users of African languages, as only mother tongue instruction for all in South Africa would indeed mean real equal educational opportunities. / Thesis (M.Ed.)--North-West University, Vaal Triangle Campus, 2009.

The objectives of this research firstly is to assess and establish the guidelines in respect of the medium of instruction as a determinant of the forms of the educational system in South Africa. Subsequently, the researcher wishes to establish the precise policy in respect of the instructional medium in South Africa. Thirdly, the researcher wishes to establish which languages are preferred as instructional media by South African learners, and why. Finally, the researchers wishes to establish the learners' approach and attitude in respect of a particular instructional medium. The research method followed, focuses in the first place on an extensive literature study to primarily establish the guidelines in respect of the instructional medium as a determinant of the educational system, as well as to acquire information in respect of the instructional medium in South Africa. In addition, empirical research was done to determine which languages are preferred in practice by learners as media of instruction, and why attempts at assessing attitudes in respect of a specific instructional media were also made. By using a questionnaire as measuring instrument, quantitative research was done in respect of 28 % of the grade eleven learners in Vanderbijlpark. Qualitative research was also done by way of personal interviews using a structured questionnaire with the aid of teachers. The findings briefly indicate that the Afrikaans -speaking learners in South Africa realize the value of mother tongue instruction, consequently also then preferring it as the instructional medium. Both English -speaking and African language users in South Africa prefer English as a medium of instruction as they believe their entrance into the job market will then be assured. Only a small percentage of users of African languages prefer their mother tongue as instructional language. The literature study revealed that mother tongue instruction is indispensable in respect of academic performance. Learners perform better academically should they for a period receive instruction in their mother tongue, even should it be up to the fourth grade when basic skills such as reading, writing and arithmetic are acquired. It was finally established, that South African legislation indeed provides for mother tongue instruction for all, but that the policy is not applied in practice. It is the considered opinion of the researcher that mother tongue instruction in South Africa is a treasure to be cherished and preserved by both Afrikaans and English speaking learners, also that it should be extended to users of African languages, as only mother tongue instruction for all in South Africa would indeed mean real equal educational opportunities. / Thesis (M.Ed.)--North-West University, Vaal Triangle Campus, 2009.

Source water protection is a key component of the multiple barrier approach to drinking water. The management of contamination within source water ecosystems is associated with many benefits but also several challenges. By its very nature, source water protection is site specific and requires the cooperation of numerous watershed stakeholders to ensure sufficient financial resources and social will. This work focused on two critical aspects of source water protection: 1) The facilitation of effective communication to promote cooperation among watershed stakeholders and aid in public education programs. A drinking source water quality index presents a potential communication and analysis tool to facilitate cooperation between diverse interest groups as well as represent composite source water quality. I tested the effectiveness of the Canadian Council of Ministers of the Environment Water Quality Index (CCME WQI) in capturing expert assessments of surface drinking source water quality. In cooperation with a panel of drinking water quality experts I identified a core set of parameters to reflect common Canadian surface source water concerns. Based upon existing source water guidelines, drinking source water target values were drafted for use in the index corresponding to two basic treatment levels. Index scores calculated using the core parameter set and associated source water target values were strongly correlated with expert assessments of source water quality. Amended with a modified index calculation procedure to accommodate parameters measured at different frequencies within any particular study period, the CCME WQI provides a valuable means of monitoring, communicating, and understanding surface source water quality. 2) The application of source water protection strategies to the appropriate spatial scale in order to manage contaminants of concern in a cost effective manner. Using data gathered from 40 Canadian rivers across 4 western Canadian ecozones I examined the spatial scales at which landuse was most closely associated with drinking source water quality metrics. Linear mixed effects models revealed that different spatial areas of landuse influence drinking source water quality depending on the parameter and season investigated. Microbial risk, characterized using E. coli measures, was only associated with landuse at the local spatial scale. Turbidity measures exhibited a complex association with landuse suggesting that the landuse areas of greatest influence can range from the local to the watershed scale. Total organic carbon concentrations were only associated with landuse characterized at the entire watershed scale. The validated CCME WQI was used to provide a composite measure of seasonal drinking source water quality but did not provide additional information beyond the analyses of individual parameters. These results suggest that entire watershed management is required to safeguard drinking water sources with more focused efforts at targeted spatial scales to reduce identified risk parameters. The source water protection tools and knowledge that I present have immediate application within Canada. Practitioners must be aware of the limitations of the CCME WQI however it provides a validated means of communicating complex source water quality information to non-specialized end users. Combined with the scale dependency of landuse-source water relationships that I elucidated, water quality managers can target contaminant reduction strategies in a more cost-effective manner and relay water quality status and trends to concerned groups. / Graduate

No description available.

The continued growth of waste generation rates and the general concern for its impact on the natural environmental have resulted in a search for solutions to contain the problem before it spirals out of control. One such solution is organised recycling, the practice whereby municipalities require waste generators to set aside post-consumer materials so that they do not enter the mixed waste for collection and delivery to the markets. The practice is popular in developed countries, with municipalities engaging in household waste source separation schemes to meet statutory targets set by higher authorities. In developing countries too, NGOs, municipalities and national governments have started to include source separation in waste management policy and legislation. But this approach will present a new set of challenges to municipalities and waste generators alike, particularly when it is not preceded by a proper analysis of practical constraints on the ground. The purpose of this research is to develop workable recycling guidelines for cities in developing countries with similar characteristics to Gaborone from analysis of such constraints. The study began as an exploratory research process that evolved into a case study. A cross-sectional survey methodology was used including survey techniques such as waste characterisation sampling surveys for household and commercial waste, questionnaire-based interview surveys, semi-structured interviews with key informants representing stakeholders, and market survey for post-consumer materials. The research is directed by the hypothesis that: Despite the projection of organised recycling as an effective means to enhance waste recycling, its practicality as a waste management strategy in developing countries is constrained by the realities on the ground. The research found that, the major constraints to organised recycling are lack of practical official support for recycling, failure of public awareness to translate into participation in recycling initiatives, the attitude of municipal officials that favours maintenance of the status quo and relatively high recovery rates achieved by the existing recycling initiatives. The research concludes that under the prevailing conditions, it would not be practical to organise recycling schemes in the format used in developed countries and proposes guidelines that lake into consideration the established constraints.