Changes in demogaphics, employment and shopping habits, triggered by urbanisation and increasing mobility are important factors influencing Swedish countryside. Answering the changing conditions is especially important in the northermost counties, with very low population density and large distances between settlements. Within the peripheries of V.sterbotten the availability of basic social and commercial services is decreasing, as the economic viability of such businesses is too low and the former commercial model became unsustainable. Most of the service functions are associated to local grocery stores, and when one is forced to close down, the village loses not only its access to basic services, but most of all a meeting point for the community. The supply of food and errands is not a problem for the inhabitants, but the need for social activities and access to a neutral ground to meet the neighbours remains unresolved. This thesis is investigating possible alternatives and proposing new models of hybrid service centres for rural communities of V.sterbotten, that are capable of uplifting the countryside by focusing on the most important aspect: the people.

Worldwide, drowning is the third leading cause of death among children. In Asia it is the first leading cause of death and a major public health threat. The objective of this paper was to develop a drowning prevention program including swimming training, CPR and lifesaving methods for children and to evaluate it. This intervention was provided and evaluated in Thailand where drowning is the first leading cause of death among children. The study used observations, quantitative and qualitative methods. In total 20 children in the age of seven to ten, from Nan Province in northern Thailand were participating.The result of this intervention is that the children are highly capable to learn swimming, CPR and lifesaving activities within 10 days. Out of 20 participants all have successfully completed the swimming, CPR and lifesaving programs.The conclusion of this intervention study can be sum up by both the interventions result, the questionnaires and the independent evaluators is that swimming program as this one is highly needed for saving lives. Support from the local as well as the central authority is also needed. Therefore such swimming program shows the importance of swimming knowledge and water security to prevent drowning in near future.

Autism spectrum disorders (ASD) are neurodevelopmental disorders that affect social, communication, and behavioral development. Social impairments have been implicated as primary symptoms of ASD and communication impairments are often cited as initial concerns among parents. Yet there is an inconsistency in the literature regarding the existence of restricted interests and repetitive behaviors (RR) in very young children (i.e., those younger than 4 years) with ASD and the association between RR and sensory dysfunction. The purpose of the current project was to identify social deficits that most distinguish very young children with ASD, assess whether RR are present in very young children diagnosed with ASD, and explore the relationship between RR and sensory dysfunction. Results support the hypothesis that social impairments are primary symptoms of ASD. Stereotyped patterns of thought and behavior were present in this sample and were correlated with sensory dysfunction. Implications for theory, diagnosis, and research are discussed.

Background Obesity is increasing worldwide and is a major contributor to morbidity and mortality. Notably, abdominal (central) obesity carries a high risk of obesity-related diseases, while peripheral fat accumulation can act in a protective manner. A redistribution of fat from peripheral to central depots is seen after the menopause and is associated with an increasing prevalence of diabetes and cardiovascular disease. A key mediator may be ectopic fat accumulation in the liver. Our hypothesis was that a Palaeolithic-type diet (PD) consumed ad libitum improves body composition and metabolic risk markers, including liver fat and insulin sensitivity, in obese postmenopausal women. Methods In study I the study subjects (n=10) used a PD during 5 weeks. In study II and III (n=70) the effect of a Palaeolithic-type diet (PD) was compared to a diet according to the Nordic Nutrition Recommendations diet (NNR) during a 2-year randomized clinical trial (RCT). Food records and nitrogen excretion in urine validated food intake. Anthropometric measurements were performed in a standardized manner. Body composition was calculated using Dual Energy X-ray Absorptiometry (DXA). Total energy expenditure was calculated by accelerometry (Actiheart®) in combination with indirect calorimetry. Liver and muscle fat content was estimated by magnet resonance spectroscopy (1H-MRS). Insulin sensitivity was measured either with hyperinsulinemic euglycemic clamps (paper I) or oral glucose tolerance tests (OGTTs) (paper III). Results In study I a significant weight loss, linked to improved lipid and blood pressure levels, was associated with a 49% decrease in liver fat. Concomitantly, hepatic insulin sensitivity improved, while peripheral insulin sensitivity (and muscle fat) was unaltered. In study II/III both groups had a significant and sustained weight loss after 2 years. The PD was more effective than the NNR diet regarding loss of weight and fat mass after 6 months, but not after 24 months. Serum triglyceride levels were significantly lower at 24 months in the PD group. Liver fat decreased throughout the study in both groups. Hepatic insulin sensitivity improved during the first 6 months of the study, while peripheral insulin sensitivity did not change. Hepatic insulin sensitivity was associated with liver fat at baseline, but not during the diet intervention. Energy expenditure did not change in any of the study groups. Conclusion Ad libitum diets can have sustained beneficial effects on weight and body composition in obese postmenopausal women, a PD being more effective on short-term than a diet according to the NNR. This is associated with a reduction in liver fat that may reduce the risk of future diabetes and cardiovascular disease. Further studies are needed in order to explore the association between liver fat and metabolic dysfunction, including insulin sensitivity.

published_or_final_version / Law / Master / Master of Laws

This investigation used a one-group pretest-posttest design to examine the relationship between a tier three reading intervention program (i.e., a program designed for students that have failed to respond to regular (tier one) and resource (tier two) supports), and grade-level reading gains, as measured using the Fountas and Pinnell Benchmark Assessment System (Fountas & Pinnell, 2010), for 140 students between grades two and four. All students included in this study began well-below their expected grade-level in reading (i.e., two or more grade-levels below). In order to describe the gains made in grade-level reading ability, the Fountas and Pinnell Benchmark Assessment System (Fountas & Pinnell, 2010) was used pretest and posttest to track reading gains. Results from descriptive statistics, Kruskal-Wallis H tests, Mann-Whitney U tests, t-tests, and a multiple regression were indicative of positive reading gains. Approximately 74% of participants achieved grade-level reading gains that had the potential to close the reading gap (i.e., 0.75 grade-levels or more as measured using the Fountas and Pinnell Benchmark Assessment System (Fountas & Pinnell, 2010)). These results were similar for all participants regardless of gender, diagnosis status (i.e., garden-variety poor reader, physical disability, and learning/attentional disability) or first language status (i.e., English as an additional language or English). This study provides preliminary evidence that this intervention is improving reading outcomes for tier three students. Moving forward, stakeholders of this division would be encouraged to develop a well-designed, structured mixed-methods research study with standardized assessment measures and planned follow-up.

The purpose of this study was to examine the similarity of outcomes from three different treatment integrity (TI) methods, and to identify the method which best corresponded to the assessment of a child’s behavior. Six raters were recruited through individual contact via snowball sampling. A modified intervention component list and 19 video clips were derived from Stahr’s (2005) study, “An Intervention for Children with Autism Spectrum Disorders (ASD) who Have Food Selectivity.” The raters, randomly and evenly assigned to three dyads. Each dyad received an average of six hours training and reached 85% interobserver agreement (IOA) with a 0.60 kappa score. After training, each dyad watched 5 video clips per day and measured both the child’s behavior and TI. The percentages of IOA, kappas, and indices of dependability for assessment of the child’s behavior and TI were analyzed. The data revealed that all raters reached over 80% IOA and the whole interval (WI) and yes/no (Y/N) dyads reached .60 kappa, but the two raters in the Likert-type (LIK) dyad could not reach .60 kappa. The indices of dependability indicated that the six raters consistently observed and rated both the child’s behavior and TI, but there was a discrepancy in scores (i.e., percentages of TI) between the two raters in the two indirect measure dyads (i.e., Y/N and LIK). An analysis of the percentages of total variance showed that the two indirect TI methods may affect the discrepancy between the two raters’ rating scores. A comparison of the three different TI methods and correlation between the child’s behavior and TI were examined using the PASW Statistics 18 software program. There was no significant difference between the WI and the Y/N dyads, while the assessments from the LIK dyad indicated a significant difference from the other two dyads. Both the WI and the Y/N dyads showed correlations between the degree of the child’s behavior and the degree of TI, but there was no significant difference between the two correlation coefficients. Questions about reliability with the indirect TI measures suggest one should be careful in considering these results.

This study compared the effectiveness of two group treatment procedures in reducing adolescent anxiety in a school setting. The interventions included group cognitive-behavioral treatment, group relaxation training, and study skills (control group). Participants were students in Grades 5-12 who were parent, teacher, or school personnel nominated. The adolescents had to exhibit T scores of > 60 on an anxiety scale of the Youth Self Report for ages 11-18 or Multidimensional Anxiety Scale for Children (MASC), self-report rating scales, a parent rating scale or teacher report form for ages 6-18 of the Child Behavior Checklist (CBCL). Measurements were collected at preintervention, postintervention, and a 6-week follow up for the treatment groups. The control group was assessed at preintervention and postintervention only. The data gathered consisted of an overall student anxiety scale score from the MASC, and anxious/ depressed, anxiety problems, and internalizing problems scale scores from the student, teacher, and parent CBCL rating scales.All three groups exhibited lower scores from preintervention to postintervention on the student self-reported MASC. No differences were found among the groups in the reduction of teacher or parent reported anxiety levels from preintervention to postintervention except on the parent ratings of the CBCL anxious/depressed scale. A statistically significant group by time interaction indicated that the students in the CBT group showed significantly lower posttest scores than the relaxation and study skills groups. The significant interaction of group by time from preintervention to postintervention on the parent CBCL anxious/depressed scale score was expanded to the follow-up measure; however, no significant interaction between group and time was found. The main effect of time was significant and post hoc comparisons of the anxious/depressed scale found that the CBT and relaxation groups were significantly lower at postintervention than at preintervention and significantly lower at follow up than at preintervention. However, the sample was not significantly different from postintervention to follow up.The results were discussed in relation to the research literature on cognitive-behavioral treatment of fears and related anxieties in children and adolescents.

Pathogens on surfaces in child care centers can contribute to illness among attendees and may thereby contribute to medical visits as well. This intervention study was conducted to assess the effect of using specific sanitizing products and cleaning protocols in child care centers on the incidences of lower respiratory infections, diarrheal illness, antibiotic use, and medical visits among children attending the centers and on the levels and antibiotic resistance of indicator bacteria in those centers. During the ten-week study period, children from twelve centers were observed. Six of the centers were randomly assigned to the intervention. The other six were controls. Intervention centers were given cleaning protocols and sanitizing products. Control centers were asked to retain their original procedures and products.Acute illness was determined from records kept by the center directors and telephone calls made to parents of ill children. A call was also made to one randomly selected healthy child's parents for every two ill children recorded. Parents were given a questionnaire requesting information including bedroom sharing status, environmental tobacco smoke exposure, and chronic illnesses.After controlling for within-center clustering and zero-inflation, statistically non-significant trends of reduction were seen in the weeks of lower respiratory infections, diarrheal illness, and medical visits. Multivariable zero-inflated Poisson regression revealed that the number of weeks intervention center children were using antibiotics was 32% lower than among the control center children. This was a statistically significant reduction (95% CI = 0.54-0.86; p = 0.001).Bacterial samples were collected from ten sites within each center at the beginning and the end of the study period to determine the effect of the intervention on the microbial population. The study determined the heterotrophic plate count bacteria numbers and the rates of resistance to ampicillin and cephalothin. Neither heterotrophic bacterial concentrations nor antibiotic resistance rates significantly changed over the course of the study.

The increasing tendency of youth getting involved in crime, globally as well as in South Africa is an indication of the comprehensive problem and the duty that is resting upon professionals dealing with the youth. It is therefore important that in South Africa attention will be given to the young first offender. Various intervention methods such as drama-based intervention can be used as service delivery for the young first offender. Drama based intervention hold various therapeutic values for the young first offender. This program can make use of various methods for intervention such as, dance, movement and theatre. The objectives of the program, the need of the participants as well as the background of each individual participant are determining the choice of the intervention method. A drama-based intervention program was used for the study. The aim of this study was to examine the nature of a drama-based intervention for young first offenders. The aims were to: • Through an intensive literature study the various intervention methods was studied. The finding of the literature study was that the involvement of the first young offender within any creative activity has a lasting effect on the social development of the client resulting in a decrease in anti-social behaviour such as crime. Experimental exercises that is based on social learning-; role- and cognitive-behavioural theory are very effective in working with young people • To develop, implement and evaluate a drama-based intervention program through an intensive literature study and empirical research. This program needs to focus on the decreasing and prevention of recidivism with young first offenders. This goal was achieved as the program was developed according to guidelines of the GEESE theatre, which was adapted for South-African circumstances. The program was implemented and evaluated with a group of seven young first offenders. The research showed that the most effective intervention program for young first offenders should be more experimental and based upon creative arts, rather than a structured goal-oriented program, creating opportunities for in-depth exploration of the inner self. The program would then also help the respondent to develop resiliency by building on protective factors, identifying risk factors and developing skills to manage factors such as low self esteem, family relations, peer pressure and poverty. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2005.