The purpose of the study was to describe the support services available for nurses who care for patients with human immunodeficiency virus / acquired immune-deficiency syndrome (HIV/AIDS) in Pretoria urban pubic hospitals. Problems faced by nurses in HIV/AIDS care support preferences were also investigated. The study was conducted between March and April 2003, using a descriptive design. Respondents comprised eighty-seven (87) nurses who were conveniently selected from five (5) hospitals. Results reveal that support available is inadequate in both quality and coverage of nurses. Other significant findings are inadequate job preparation, shortage of nurses and that nurses prefer to receive support from both within and outside the hospital. It has been recommended that management should work with nurses to design support interventions that match the identified problems/needs. Nurses need to take an active role in caring for themselves and more in-service training opportunities need to be created for nurses. / Health Studies / MA (Health Studies)

Self-injurious behaviour (SIB) is recognised as a difficult behaviour to work/deal with and Community Support Workers (CSW‟s) who work with this behaviour may not have any formal training in the field of SIB. This study was therefore aimed at assessing the needs of CSW‟s working in the field of self-injurious behaviour amongst adolescents. A qualitative approach was used, the study was of an explorative nature and the researcher made use of purposive non-probability sampling to select respondents who were willing to participate in one-on-one semi-structured interviews with the researcher. This data was then analysed by the researcher making use of Creswell‟s spiral of analysis. The data collected was sorted into themes, sub-themes and categories and interpreted according to literature. The study identified that there are specific needs amongst CSW‟s who work with adolescent SIB in the specific areas of support and education/training. / Social Work / M. Diac. (Play Therapy)

Text in English / In Swaziland, family nurse practitioners (FNPs) are professional nurses who have undergone preparation as general nurse, midwife and FNP. These nurses play an important role in the delivery of primary health care (PHC). Family nurse practice is an evolving concept introduced in Swaziland in 1979. It is a means of exploring nursing roles and primary health care services for deployment in under-served areas and to enable nurses to serve as the primary providers of health care services in clinics, health centres and in the outpatient departments of hospitals. Changing responsibilities within the health care setting require different skills and more knowledge. The expansion and extension of the nurses' role, including the techniques of diagnosing and treating, was a priority of the Ministry of Health and Social Welfare (MOH&SW) in Swaziland's five-year development plan for 1978-1983. It was regarded as a necessary component for raising the quality and effectiveness of PHC services. Some of the major and urgent challenges that confront FNPs today are the advent of the human immune virus/acquired immuno-deficiency syndrome (HIV/AIDS) scourge and the re-emergence of the tuberculosis epidemic. Both these health problems require proficient diagnosis and case management skills as well as new approaches. If FNPs are to remain relevant and to continue to provide quality services in spite of prevailing challenges, they have to engage in continuing education (CE). The main aim of this study was to investigate the perceptions of the FNP role, CE needs and issues relevant to the current practice of FNPs in Swaziland. A further aim was to establish a structure or framework for a CE programme that would contribute to the strengthening of CE for FNPs and identify enabling factors and barriers in the practice and education ofFNPs. Both quantitative and qualitative research methods were used for data collection. A survey was conducted to collect data from 5 7 FNPs and 11 nurse managers and nurse educators. The transcript from the questionnaires was subjected to quantitative-based content analysis. A total of thirty nurse managers, nurse educators and MOH&SW nurse executives participated in the focus group interviews. The collected data was subjected to qualitativebased content analysis. The findings identified the role of the FNP as manager, clinical practitioner, educator and researcher. The analyses highlighted the CE needs of FNPs, and the question of updating and upgrading the skills of practising FNPs. The identified enabling factors and barriers, although perceived as issues that are peripheral and auxiliary to the curriculum, appeared to have a strong bearing on programme planning. The findings from this study have implications for a structured CE programme for FNPs at the University of Swaziland. / Health Studies / D. Litt et Phil. (Nursing Sciences)

Many Information and Communication Technologies for Development (ICTD) projects are established with the overall aim of positively developing the communities they are implemented in. However, the solutions that are provided are often commonly developed without the needs of these communities being sufficiently investigated beforehand. As a result the ICTD strategy of the project ends up not well aligned with the aims and targets of the needs of the community. As a result of this, an appropriate programme theory for the project and relevant impact indicators fail to be adequately developed. Consequently, when an impact assessment is conducted it is often found that the intended effects are not directly linked to the needs of the community or what the community had hoped to gain from the ICTD initiative. The purpose of this research serves to develop a needs-ICTD strategy alignment foundation that supports the identification and formulation of impact assessment indicators. Through this research, a framework is developed to support the alignment of ICTD strategy, the development and the promotion of contextual needs of rural communities and other frequently marginalized areas. The Needs-ICTD strategy alignment framework is composed of eight main components that describe the process that can be used to align ICTD strategy with community needs. These components include: collaboration between the internal and external stakeholders, the development of the community, conducting baseline studies, the needs assessment, the ICTD strategy, linking of the needs-ICTD strategy, and lastly the identification of impact indicators. An interpretive research approach is used to explore and inform the framework through a multi-case study investigation of the Siyakhula Living Lab and two projects in the Systems Application Products (SAP) Living Lab. Two main case study questions drive the exploration of the framework, that being: 1) How are the needs of the community elicited and how is the ICTD strategy aligned to the needs of the community? 2) And, why were the selected approaches chosen for aligning the needs of the community and ICTD strategy? Data for this research was collected qualitatively through interviews, document analysis and participant observation. Key findings indicate that the involvement of internal (local) stakeholders in the development and alignment of ICTD strategy to the needs of the community is still lacking. As a consequence, many community members end up not fully understanding the project objectives and how these objectives aims are to be achieved. The research also finds that ‘solution specific’ projects also fail communities as they focus specifically on one target group and repeatedly fail to assist the community holistically in supporting their information and their community development needs.

Since the Department of Correctional Services has been transformed into an institution of rehabilitation and the promotion of corrections has become a societal responsibility, there is a new dimension to the classification system whereby offenders are separated according to their potential for treatment and training programmes. Research into offender classification as a tool to rehabilitate offenders in corrections was necessitated by the way in which assessment was used for classification. Corrections uses offender files as the only determinant of classification assessment. Simply investigating offender files and observing classification hearings does not reveal the full aspects of the character of the offender as an individual. Corrections does not use qualitative research to gain an understanding of real issues faced by the offender. The problems with classification are also quantity assessments that are too narrow. Most correctional institutions believe that better data and statistical analysis will in one way or the other improve the situation for offenders and correctional officials. Staffs have limited skills and lack the appropriate training to support the rehabilitation of offenders. This remains an obstacle to the delivery and transformation of the department and implies that there is ineffective treatment of offenders. The increasing dissatisfaction with treatment and rehabilitation services available to offenders in South African prisons can result in an increase in recidivism. All of the above are reasons why this research became important. The investigation contributes largely to scientific knowledge regarding the importance of classification for each individual within corrections. In this research the extent to which classification treatment rehabilitation arrangements are based on the concept of differential treatment is studied. This implies that offenders' needs and problems must be specific and treated on an individualised basis. This study focuses on classifying offenders as a means to rehabilitate them effectively. Particular emphasis will be placed on philosophical approaches, theoretical frameworks and the effectiveness of offenders' treatment through the utilisation of reliable assessment tools. This research was conducted through an extensive literature study by examining offender classification as a rehabilitation tool from a Penological perspective. International and national approaches as well as standards for the treatment of offenders and a range of rehabilitation programmes were also studied. / Department of Penology / M.A. (Penology)

Das Working Paper Nr. 1 basiert auf der Studie „Ergebnisse der Situationsanalyse“, welche von der Technischen Universität Dresden, Fakultät für Erziehungswissenschaften, Institut für Berufspädagogik, Professur für Didaktik des beruflichen Lernens (Prof. Dr. paed. habil. Hanno Hortsch, Dipl.-Berufspäd. Marcel Köhler, Lars Leidl M.A., M.Sc.) im Auftrag der Staatlichen Studienakademie Breitenbrunn durchgeführt wurde. Die vollständige Studie, die für den vorliegenden Bericht durch die Herausgeberin gekürzt und redaktionell weiterverarbeitet wurde, wird nicht als eigene Publikation der Öffentlichkeit zugänglich gemacht. Diese Studie und das Working Paper sind Bestandteil des Projektes „Zusatzqualifikation zur Förderung der interkulturellen Kompetenz von Studierenden der Berufsakademie Sachsen“, welches aus Mitteln des Europäischen Sozialfonds (ESF) und des Freistaates Sachsen gefördert wird.:1 Ziele und Inhalte der „Zusatzqualifikation Interkulturelle Kompetenz“ 2 Gegenstand und Methode der Situationsanalyse 3 Ergebnisse der Situationsanalyse 3.1 Vorhandene Unternehmensstrukturen 3.2 Stellenwert und Bedeutung von interkulturell qualifiziertem Personal 3.3 Anforderungen an interkulturell qualifiziertes akademisches Fachpersonal 3.4 Inhalte der Zusatzqualifikation Interkulturelle Kompetenz 3.5 Zielländer/-kulturen/-regionen in der Konzeption der Zusatzqualifikation 3.6 Didaktisch-methodische Empfehlungen für die Konzeption 3.7 Befragung der Studierenden des Studiengangs Industrie 4 Fazit

The ability to think critically is considered an essential skill of nursing graduates and competent nursing practice. Yet, the literature reports that teachers are having difficulty teaching for critical thinking and that critical thinking is lacking in new nursing graduates. This research study sought to identify barriers to the implementation of critical thinking teaching strategies by nursing faculty currently teaching in generic baccalaureate programs in Tennessee. Surveys were mailed to 262 nursing faculty; 194 were returned, and 175 were usable. Students' attitudes and expectations represented the single greatest barrier to the implementation of critical thinking teaching strategies, followed by time constraints and the perceived need to teach for content coverage. Recommendations to support and encourage faculty to teach for critical thinking are outlined.

[ES] Los Cuidados Paliativos (PC) son cuidados médicos especializados cuyo objetivo esmejorar la calidad de vida de los pacientes con enfermedades graves. Históricamente,se han aplicado a los pacientes en fase terminal, especialmente a los que tienen undiagnóstico oncológico. Sin embargo, los resultados de las investigaciones actualessugieren que la PC afecta positivamente a la calidad de vida de los pacientes condiferentes enfermedades. La tendencia actual sobre la PC es incluir a pacientes nooncológicos con afecciones como la EPOC, la insuficiencia de funciones orgánicas ola demencia. Sin embargo, la identificación de los pacientes con esas necesidades escompleja, por lo que se requieren herramientas alternativas basadas en datos clínicos. La creciente demanda de PC puede beneficiarse de una herramienta de cribadopara identificar a los pacientes con necesidades de PC durante el ingreso hospitalario.Se han propuesto varias herramientas, como la Pregunta Sorpresa (SQ) o la creaciónde diferentes índices y puntuaciones, con distintos grados de éxito. Recientemente,el uso de algoritmos de inteligencia artificial, en concreto de Machine Learning (ML), ha surgido como una solución potencial dada su capacidad de aprendizaje a partirde las Historias Clínicas Electrónicas (EHR) y con la expectativa de proporcionarpredicciones precisas para el ingreso en programas de PC. Esta tesis se centra en la creación de herramientas digitales basadas en ML para la identificación de pacientes con necesidades de cuidados paliativos en el momento del ingreso hospitalario. Hemos utilizado la mortalidad y la fragilidad como los dos criterios clínicos para la toma de decisiones, siendo la corta supervivencia y el aumento de la fragilidad, nuestros objetivos para hacer predicciones. También nos hemos centrado en la implementación de estas herramientas en entornos clínicos y en el estudio de su usabilidad y aceptación en los flujos de trabajo clínicos. Para lograr estos objetivos, en primer lugar, estudiamos y comparamos algoritmos de ML para la supervivencia a un año en pacientes adultos durante el ingreso hospitalario. Para ello, definimos una variable binaria a predecir, equivalente a la SQ y definimos el conjunto de variables predictivas basadas en la literatura. Comparamos modelos basados en Support Vector Machine (SVM), k-Nearest Neighbours (kNN), Random Forest (RF), Gradient Boosting Machine (GBM) y Multilayer Perceptron (MLP), atendiendo a su rendimiento, especialmente al Área bajo la curva ROC (AUC ROC). Además, obtuvimos información sobre la importancia de las variables para los modelos basados en árboles utilizando el criterio GINI. En segundo lugar, estudiamos la medición de la fragilidad de la calidad de vida(QoL) en los candidatos a la intervención en PC. Para este segundo estudio, redujimosla franja de edad de la población a pacientes ancianos (≥ 65 años) como grupo objetivo. A continuación, creamos tres modelos diferentes: 1) la adaptación del modelo demortalidad a un año para pacientes ancianos, 2) un modelo de regresión para estimarel número de días desde el ingreso hasta la muerte para complementar los resultadosdel primer modelo, y finalmente, 3) un modelo predictivo del estado de fragilidad aun año. Estos modelos se compartieron con la comunidad académica a través de unaaplicación web b que permite la entrada de datos y muestra la predicción de los tresmodelos y unos gráficos con la importancia de las variables. En tercer lugar, propusimos una versión del modelo de mortalidad a un año enforma de calculadora online. Esta versión se diseñó para maximizar el acceso de losprofesionales minimizando los requisitos de datos y haciendo que el software respondiera a las plataformas tecnológicas actuales. Así pues, se eliminaron las variablesadministrativas específicas de la fuente de datos y se trabajó en un proceso para minimizar las variables de entrada requeridas, manteniendo al mismo tiempo un ROCAUC elevado del modelo. Como resultado, e / [CA] Les Cures Pal·liatives (PC) són cures mèdiques especialitzades l'objectiu de les qualsés millorar la qualitat de vida dels pacients amb malalties greus. Històricament, s'hanaplicat als pacients en fase terminal, especialment als quals tenen un diagnòstic oncològic. No obstant això, els resultats de les investigacions actuals suggereixen que lesPC afecten positivament a la qualitat de vida dels pacients amb diferents malalties. Latendència actual sobre les PC és incloure a pacients no oncològics amb afeccions comla malaltia pulmonar obstructiva crònica, la insuficiència de funcions orgàniques o lademència. No obstant això, la identificació dels pacients amb aqueixes necessitats éscomplexa, per la qual cosa es requereixen eines alternatives basades en dades clíniques. La creixent demanda de PC pot beneficiar-se d'una eina de garbellat per a identificar als pacients amb necessitats de PC durant l'ingrés hospitalari. S'han proposatdiverses eines, com la Pregunta Sorpresa (SQ) o la creació de diferents índexs i puntuacions, amb diferents graus d'èxit. Recentment, l'ús d'algorismes d'intel·ligènciaartificial, en concret de Machine Learning (ML), ha sorgit com una potencial soluciódonada la seua capacitat d'aprenentatge a partir de les Històries Clíniques Electròniques (EHR) i amb l'expectativa de proporcionar prediccions precises per a l'ingrés enprogrames de PC. Aquesta tesi se centra en la creació d'eines digitals basades en MLper a la identificació de pacients amb necessitats de cures pal·liatives durant l'ingréshospitalari. Hem utilitzat mortalitat i fragilitat com els dos criteris clínics per a lapresa de decisions, sent la curta supervivència i la major fragilitat els nostres objectiusa predir. Després, ens hem centrat en la seua implementació en entorns clínics i hemestudiat la seua usabilitat i acceptació en els fluxos de treball clínics.Aquesta tesi se centra en la creació d'eines digitals basades en ML per a la identificació de pacients amb necessitats de cures pal·liatives en el moment de l'ingrés hospitalari. Hem utilitzat la mortalitat i la fragilitat com els dos criteris clínics per ala presa de decisions, sent la curta supervivència i l'augment de la fragilitat, els nostresobjectius per a fer prediccions. També ens hem centrat en la implementació d'aquesteseines en entorns clínics i en l'estudi de la seua usabilitat i acceptació en els fluxos detreball clínics. Per a aconseguir aquests objectius, en primer lloc, estudiem i comparem algorismesde ML per a la supervivència a un any en pacients adults durant l'ingrés hospitalari.Per a això, definim una variable binària a predir, equivalent a la SQ i definim el conjuntde variables predictives basades en la literatura. Comparem models basats en Support Vector Machine (SVM), k-Nearest Neighbours (kNN), Random Forest (RF), Gradient Boosting Machine (GBM) i Multilayer Perceptron (MLP), atenent el seu rendiment,especialment a l'Àrea sota la corba ROC (AUC ROC). A més, vam obtindre informaciósobre la importància de les variables per als models basats en arbres utilitzant el criteri GINI. En segon lloc, estudiem el mesurament de la fragilitat de la qualitat de vida (QoL)en els candidats a la intervenció en PC. Per a aquest segon estudi, vam reduir lafranja d'edat de la població a pacients ancians (≥ 65 anys) com a grup objectiu. Acontinuació, creem tres models diferents: 1) l'adaptació del model de mortalitat a unany per a pacients ancians, 2) un model de regressió per a estimar el nombre de dies desde l'ingrés fins a la mort per a complementar els resultats del primer model, i finalment,3) un model predictiu de l'estat de fragilitat a un any. Aquests models es van compartiramb la comunitat acadèmica a través d'una aplicació web c que permet l'entrada dedades i mostra la predicció dels tres models i uns gràfics amb la importància de lesvariables. En tercer lloc, vam proposar una versió del model de mortalitat a un any en formade calculadora en línia. Aquesta versió es va di / [EN] Palliative Care (PC) is specialized medical care that aims to improve patients' quality of life with serious illnesses. Historically, it has been applied to terminally ill patients, especially those with oncologic diagnoses. However, current research results suggest that PC positively affects the quality of life of patients with different conditions. The current trend on PC is to include non-oncological patients with conditions such as Chronic Obstructive Pulmonary Disease (COPD), organ function failure or dementia. However, the identification of patients with those needs is complex, and therefore alternative tools based on clinical data are required. The growing demand for PC may benefit from a screening tool to identify patients with PC needs during hospital admission. Several tools, such as the Surprise Question (SQ) or the creation of different indexes and scores, have been proposed with varying degrees of success. Recently, the use of artificial intelligence algorithms, specifically Machine Learning (ML), has arisen as a potential solution given their capacity to learn from the Electronic Health Records (EHRs) and with the expectation to provide accurate predictions for admission to PC programs. This thesis focuses on creating ML-based digital tools for identifying patients with palliative care needs at hospital admission. We have used mortality and frailty as the two clinical criteria for decision-making, being short survival and increased frailty, as our targets to make predictions. We also have focused on implementing these tools in clinical settings and studying their usability and acceptance in clinical workflows. To accomplish these objectives, first, we studied and compared ML algorithms for one-year survival in adult patients during hospital admission. To do so, we defined a binary variable to predict, equivalent to the SQ and defined the set of predictive variables based on literature. We compared models based on Support Vector Machine (SVM), k-Nearest Neighbours (kNN), Random Forest (RF), Gradient Boosting Machine (GBM) and Multilayer Perceptron (MLP), attending to their performance, especially to the Area under the ROC curve (AUC ROC). Additionally, we obtained information on the importance of variables for tree-based models using the GINI criterion. Second, we studied frailty measurement of Quality of Life (QoL) in candidates for PC intervention. For this second study, we narrowed the age of the population to elderly patients (≥ 65 years) as the target group. Then we created three different models: 1) for the adaptation of the one-year mortality model for elderly patients, 2) a regression model to estimate the number of days from admission to death to complement the results of the first model, and finally, 3) a predictive model for frailty status at one year. These models were shared with the academic community through a web application a that allows data input and shows the prediction from the three models and some graphs with the importance of the variables. Third, we proposed a version of the 1-year mortality model in the form of an online calculator. This version was designed to maximize access from professionals by minimizing data requirements and making the software responsive to the current technological platforms. So we eliminated the administrative variables specific to the dataset source and worked on a process to minimize the required input variables while maintaining high the model's AUC ROC. As a result, this model retained most of the predictive power and required only seven bed-side inputs. Finally, we evaluated the Clinical Decision Support System (CDSS) web tool on PC with an actual set of users. This evaluation comprised three domains: evaluation of participant's predictions against the ML baseline, the usability of the graphical interface, and user experience measurement. A first evaluation was performed, followed by a period of implementation of improvements and corrections to the pla / Blanes Selva, V. (2022). Clinical Decision Support Systems for Palliative Care Referral: Design and Evaluation of Frailty and Mortality Predictive Models [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/190993

The system of care for persons suffering from mental retardation is in a state of upheaval. Considering the mentally handicapped as holistic beings, this study explored and assessed the needs of those residing in the community of District 22 (sub-district 222), KwaZulu-Natal, thus facilitating the planning of care and care facilities for these individuals to enable them to function optimally in the community. To accomplish this purpose, specific objectives were formulated. A quantitative, exploratory and descriptive study based on Maslow's hierarchy of needs theory was carried out, using 167 respondents. The study revealed that despite being mentally retarded, they were still regarded as valuable members of the community, their needs did not differ from the needs of others in the rest of the world and that mental retardation is still rated low in the prioritization of health problems, hence the lack of resources and support needed for the rehabilitation of such persons. / Health Studies / M.A. (Health Studies)

Antiretroviral therapy is an important public health strategy to reduce the risk of HIV vertical transmission. Implementation of such therapy depends on the identification of HIV-infected pregnant women. This study investigated how the biographical characteristics of the pregnant women (16-45 years) influenced their health decision-making in Bulawayo clinics. The study was guided by the theories of health behaviour. The study assumed that the respondents’ demographic characteristics will influence their attitudes towards PMTCT programme. Using a structured questionnaire, forty pregnant women who visited the Bulawayo clinics to have prenatal checkups were interviewed. The majority of respondents came from a poor, high-density township. Most of the respondents were married, but about a third were not married at the time data collection and 5% were separated. The survey items were demographic characteristics, knowledge of PMTCT, HIV risk perceptions and service utilisation. The levels of literacy among the respondents were high; more than 80% had completed primary education. Overall the respondents’ demographic characteristics influenced their attitudes towards PMTCT. Majority of the women knew that a mother with HIV can pass the virus to her child, during pregnancy, delivery and breastfeeding. The pregnant women’s health-seeking behaviour and their attitudes toward reproductive health services are influenced by their demographic situation. / Health Studies / (M.A. (Social Behavior Studies in HIV/AIDS))