Zugl.: Karlsruhe, Univ., Diss., 2009 / Hergestellt on demand

Many patients suffer from dermatological diseases throughout the world. Literature about this problem is emphasizing that it is getting worse. Factors such as poor hygiene, poverty and diseases such as HIV/AIDS, have increased the prevalence of dermatological diseases in developing countries such as Namibia. Understanding the different dermatological diseases and studying their prevalence will aid in ensuring patients better quality of life. The aim of the study was to investigate the prevalence and medicinal treatment patterns of dermatological diseases in the private healthcare sector of Namibia, with special reference to Windhoek. The research methodology was divided into two sections, namely a literature analysis and an empirical study. The literature analysis has been done to ensure knowledge about dermatological conditions before the empirical study was started. The empirical study was divided into two phases and data were collected from the community pharmacy environment (Phase 1) and a dermatologist (Phase 2). A total number of 507 patients participated in this study. In the community pharmacy environment, data were gathered from dermatological prescriptions of general practitioners (Phase 1A) and from pharmacist-initiated therapy prescriptions (Phase 1B). The data collected from the dermatologist (Phase 2), were collected from patients files at the dermatologist‘s practise. Phase 1A indicated that urticaria (n=36) had the highest prevalence followed by eczema (n=28) and contact dermatitis (n=28). 49% of the patients that participated in this phase were seeking treatment for the same condition the second time. In Phase 1B, contact dermatitis (n=15) showed the highest prevalence with eczema (n=14) and urticaria (n=8) second and third respectively. 77% of the patients participating in this phase of the research study did not have a family history of the same dermatological diseases. Phase 2 indicated that the highest prevalence of dermatological diseases was acne vulgaris (n=30) and melasma (n=19). The treatment duration that occurred most often in this phase was 180 days. Over all, the data indicated that eczema was the dermatological disease with the highest incidence of 11.2% (n=57). Other diseases that played a significant part were acne vulgaris (10.5%), urticaria (9.0%), contact dermatitis (8.6%) and melasma (7.1%). Rare dermatological diseases such as Kaposi sarcoma showed relatively high prevalence (n=9). It was concluded that this could be due to the fact that the dermatologist consulted, had been the only dermatologist claiming directly from the government medical aid, and that most of the patients diagnosed with Kaposi sarcoma during this research study were government employees. Many dermatological diseases were not specifically defined or diagnosed, but still treated with topical corticosteroids which may suggest that the term eczema is undefined and easily used by different healthcare practitioners for dry-skin related conditions. It is concluded in this research study that the three most prevalent dermatological diseases in the private healthcare sector of Namibia are eczema, acne vulgaris and urticaria. These conditions are not considered to be life-threatening, but they do have a significant effect on the quality of life of patients. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

Many patients suffer from dermatological diseases throughout the world. Literature about this problem is emphasizing that it is getting worse. Factors such as poor hygiene, poverty and diseases such as HIV/AIDS, have increased the prevalence of dermatological diseases in developing countries such as Namibia. Understanding the different dermatological diseases and studying their prevalence will aid in ensuring patients better quality of life. The aim of the study was to investigate the prevalence and medicinal treatment patterns of dermatological diseases in the private healthcare sector of Namibia, with special reference to Windhoek. The research methodology was divided into two sections, namely a literature analysis and an empirical study. The literature analysis has been done to ensure knowledge about dermatological conditions before the empirical study was started. The empirical study was divided into two phases and data were collected from the community pharmacy environment (Phase 1) and a dermatologist (Phase 2). A total number of 507 patients participated in this study. In the community pharmacy environment, data were gathered from dermatological prescriptions of general practitioners (Phase 1A) and from pharmacist-initiated therapy prescriptions (Phase 1B). The data collected from the dermatologist (Phase 2), were collected from patients files at the dermatologist‘s practise. Phase 1A indicated that urticaria (n=36) had the highest prevalence followed by eczema (n=28) and contact dermatitis (n=28). 49% of the patients that participated in this phase were seeking treatment for the same condition the second time. In Phase 1B, contact dermatitis (n=15) showed the highest prevalence with eczema (n=14) and urticaria (n=8) second and third respectively. 77% of the patients participating in this phase of the research study did not have a family history of the same dermatological diseases. Phase 2 indicated that the highest prevalence of dermatological diseases was acne vulgaris (n=30) and melasma (n=19). The treatment duration that occurred most often in this phase was 180 days. Over all, the data indicated that eczema was the dermatological disease with the highest incidence of 11.2% (n=57). Other diseases that played a significant part were acne vulgaris (10.5%), urticaria (9.0%), contact dermatitis (8.6%) and melasma (7.1%). Rare dermatological diseases such as Kaposi sarcoma showed relatively high prevalence (n=9). It was concluded that this could be due to the fact that the dermatologist consulted, had been the only dermatologist claiming directly from the government medical aid, and that most of the patients diagnosed with Kaposi sarcoma during this research study were government employees. Many dermatological diseases were not specifically defined or diagnosed, but still treated with topical corticosteroids which may suggest that the term eczema is undefined and easily used by different healthcare practitioners for dry-skin related conditions. It is concluded in this research study that the three most prevalent dermatological diseases in the private healthcare sector of Namibia are eczema, acne vulgaris and urticaria. These conditions are not considered to be life-threatening, but they do have a significant effect on the quality of life of patients. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

The main aim of the study was to determine the prescribing patterns of antibiotics with an emphasis on fluoroquinolones in the private health sector of South Africa. The empirical study followed a quantitative, descriptive, observational method using retrospective, longitudinal medicine claims data provided by a nationally representative Pharmaceutical Benefit Management company (PBM) from 1 January 2005 to 31 December 2012. Penicillins, cephalosporins, carbapenems, aminoglycosides, chloramphenicol, fluoroquinolones, macrolides, tetracyclines, sulphonamides and trimethoprim were considered in the study. A total of 5 155 262 (44.8%) patients received at least one antibiotic prescription out of the total number of registered beneficiaries included in the database. The average number of antibiotic prescriptions per patient per year ranged from 2.22 ± 1.89 (95% CI 2.22-2.22) in 2005 to 1.98 ± 1.62 (95% CI 1.98-1.99) in 2012. The number of antibiotics per prescription per year remained fairly constant at 1.05 ± 0.19 (95% CI 1.05-1.05) in 2005 to 1.06 ± 0.21 (95% CI 1.06-1.06) in 2012. The prevalence of patients receiving antibiotic prescriptions decreased from 46.1% (n = 789 247) in 2005 to 38.2% (n = 480 159) in 2012. Antibiotics were mostly prescribed for females (54.9%, n = 2 831 686) and in patients aged 0 to 18 years (26.5%, n = 1 366 824) and least in patients above 65 years (9.5%, n = 490 496). The prevalence of patients receiving antibiotic prescriptions was highest in Gauteng (41.9%, n = 2 159 360) and lowest in the Northern Cape (1.7%, n = 87 720). Antibiotics were mostly prescribed during the winter period. Penicillins were the most prescribed antibiotics (43%) and carbapenem the least (0.1%) out of the total number of antibiotics claimed. No practically significant association was found between antibiotic prescribing and gender, age, province and season. A total of 1 983 622 prescriptions for fluoroquinolones were claimed in patients older than 18 years. The average number of fluoroquinolone prescriptions per patient per year ranged from 1.45 ± 0.92 (95% CI 1.44-1.45) in 2005 to 1.31 ± 0.71 (95% CI 1.31-1.32) in 2012. The highest prevalence of fluoroquinolone prescribing was observed in females (64.1%, n = 850 253) and in patients between 45 and 65 years (38.6%, n = 511 542). The total fluoroquinolone use by the study population decreased from 2.85 DID in 2005 to 2.41 DID in 2012. Norfloxacin was the only first-generation fluoroquinolone prescribed. The second-generation fluoroquinolones accounted for more than 50% of the total DID, with ciprofloxacin being the most used active ingredient in this generation. Moxifloxacin was the most prescribed third-generation fluoroquinolone; its use ranging from 0.51 DID in 2005 to 0.44 DID in 2012. Between 2005 and 2012, a total of 57 325 prescriptions for fluoroquinolones were claimed by patients 18 years and younger. The prevalence of patients receiving fluoroquinolone prescriptions decreased from 3.6% (n = 8 329) in 2005 to 2.9% (n = 3 310) in 2012. Fluoroquinolones were mostly prescribed to females and in patients between 12 and 18 years. In all age groups, prescribing was mainly done by general medical practitioners. Ciprofloxacin was the most prescribed fluoroquinolone, followed by levofloxacin. In conclusion, this study established estimates on the prevalence of antibiotic prescribing covering an eight-year period. Secondly, baseline estimates for fluoroquinolone prescribing in adults using the ATC/DDD methodology were determined. Fluoroquinolone prescribing patterns in children and adolescents were determined, with specific reference to the comparison between the prescribed daily and recommended daily dosages in the different age groups and by prescribers’ specialties. / MPharm (Pharmacy Practice), North-West University, Potchefstroom Campus, 2015

The main aim of the study was to determine the prescribing patterns of antibiotics with an emphasis on fluoroquinolones in the private health sector of South Africa. The empirical study followed a quantitative, descriptive, observational method using retrospective, longitudinal medicine claims data provided by a nationally representative Pharmaceutical Benefit Management company (PBM) from 1 January 2005 to 31 December 2012. Penicillins, cephalosporins, carbapenems, aminoglycosides, chloramphenicol, fluoroquinolones, macrolides, tetracyclines, sulphonamides and trimethoprim were considered in the study. A total of 5 155 262 (44.8%) patients received at least one antibiotic prescription out of the total number of registered beneficiaries included in the database. The average number of antibiotic prescriptions per patient per year ranged from 2.22 ± 1.89 (95% CI 2.22-2.22) in 2005 to 1.98 ± 1.62 (95% CI 1.98-1.99) in 2012. The number of antibiotics per prescription per year remained fairly constant at 1.05 ± 0.19 (95% CI 1.05-1.05) in 2005 to 1.06 ± 0.21 (95% CI 1.06-1.06) in 2012. The prevalence of patients receiving antibiotic prescriptions decreased from 46.1% (n = 789 247) in 2005 to 38.2% (n = 480 159) in 2012. Antibiotics were mostly prescribed for females (54.9%, n = 2 831 686) and in patients aged 0 to 18 years (26.5%, n = 1 366 824) and least in patients above 65 years (9.5%, n = 490 496). The prevalence of patients receiving antibiotic prescriptions was highest in Gauteng (41.9%, n = 2 159 360) and lowest in the Northern Cape (1.7%, n = 87 720). Antibiotics were mostly prescribed during the winter period. Penicillins were the most prescribed antibiotics (43%) and carbapenem the least (0.1%) out of the total number of antibiotics claimed. No practically significant association was found between antibiotic prescribing and gender, age, province and season. A total of 1 983 622 prescriptions for fluoroquinolones were claimed in patients older than 18 years. The average number of fluoroquinolone prescriptions per patient per year ranged from 1.45 ± 0.92 (95% CI 1.44-1.45) in 2005 to 1.31 ± 0.71 (95% CI 1.31-1.32) in 2012. The highest prevalence of fluoroquinolone prescribing was observed in females (64.1%, n = 850 253) and in patients between 45 and 65 years (38.6%, n = 511 542). The total fluoroquinolone use by the study population decreased from 2.85 DID in 2005 to 2.41 DID in 2012. Norfloxacin was the only first-generation fluoroquinolone prescribed. The second-generation fluoroquinolones accounted for more than 50% of the total DID, with ciprofloxacin being the most used active ingredient in this generation. Moxifloxacin was the most prescribed third-generation fluoroquinolone; its use ranging from 0.51 DID in 2005 to 0.44 DID in 2012. Between 2005 and 2012, a total of 57 325 prescriptions for fluoroquinolones were claimed by patients 18 years and younger. The prevalence of patients receiving fluoroquinolone prescriptions decreased from 3.6% (n = 8 329) in 2005 to 2.9% (n = 3 310) in 2012. Fluoroquinolones were mostly prescribed to females and in patients between 12 and 18 years. In all age groups, prescribing was mainly done by general medical practitioners. Ciprofloxacin was the most prescribed fluoroquinolone, followed by levofloxacin. In conclusion, this study established estimates on the prevalence of antibiotic prescribing covering an eight-year period. Secondly, baseline estimates for fluoroquinolone prescribing in adults using the ATC/DDD methodology were determined. Fluoroquinolone prescribing patterns in children and adolescents were determined, with specific reference to the comparison between the prescribed daily and recommended daily dosages in the different age groups and by prescribers’ specialties. / MPharm (Pharmacy Practice), North-West University, Potchefstroom Campus, 2015

The study substantiates common strategies and theories regarding the teaching of sight-reading. The literature study done on sight-reading at the keyboard consists of opinions and recommendations resulting from empirical findings of well-known piano pedagogues. Seven beginner courses were analysed in order to assess their presentation of a well-structured development of piano sight-reading against the opinions and recommendations of well-known piano pedagogues and authors in this field as well as the personal experience of the researcher. During this process it was discovered that insufficient attention was paid to the development of the association between a note symbol and its corresponding key on the piano. However no attention was paid to the act of playing while reading ahead. The researcher compiled additional progressive exercises for the 7 to 9 year old beginner, to address the above-mentioned discrepancies. The exercises and their individual purposes are clearly explained with instructions regarding their performance. / Hierdie studie bevestig algemene strategieë en teorieë aangaande die ontwikkeling van vaardighede om musieknotasie te lees en te speel. Die literatuur wat in hierdie studie bestudeer is, handel oor opinies en aanbevelings van vooraanstaande klavierpedagoë wat voortspruit uit die resultate van hulle empiriese navorsing. Sewe aanvangskursusse is ontleed en die aktiwiteite en metodes waarvolgens vaardighede onderrig word om musieknotasie te leer lees en speel, is gemeet aan die aanbevelings van vooraanstaande klavierpedagoë, navorsers op die gebied, asook die navorser se eie ervaring met die boeke. Gedurende die studie is daar ontdek dat daar meesal nie aandag geskenk word aan die ontwikkeling van 'n assosiasie tussen 'n toonhoogtesimbool en ooreenstemmende klawer op die klavier nie en glad nie aan die proses van vooruitlees nie. Om hierdie tekortkominge te oorkom het die navorser 'n stel aanvullende en progressiewe oefeninge saamgestel wat maklik genoeg uitvoerbaar is vir die 7- tot 9-jarige beginner. Duidelike beskrywings van die oefeninge, elkeen se spesifieke doel, en aanwysings vir effektiewe uitvoering daarvan word verskaf. / Art History, Visual Arts & Music / M.A. (Musicology)

Text in Afrikaans / Die objek van studie in hierdie proefskrif is ietwat ongewoon. Die studie is outobiografies en is gegrond op die aanname dat daar tussen die psigoterapeut, sy geskiedenis, die wetenskap (etnografie en tweede-orde kubernetika) en die klient(e) 'n unieke patroonverband bestaan. Die psigoterapeut in die platteland het weens afstand of finansies nie altyd die voorreg om supervisie van 'n eksterne supervisor te ontvang nie. In so 'n situasie kan selfsupervisie, deurdat dit 'n proses van selfontdekking is, 'n belangrike rol in die psigoterapeut se selfontwikkeling speel. Selfsupervisie plaas die klem op die psigoterapeut as persoon en as terapeut; oor wie hy is, waar hy vandaan kom en waarheen hy binne die psigoterapeutiese proses op pad is. Vir enige psigoterapeut is dit belangrik om na 'n hoer vlak van psigoterapie te streef. Hierdie strewe impliseer 'n proses van selfondersoek, delwing, selfevaluasie en disseksie. Hierdie proses is aan die hand van dagboekinskrywings gedoen, waar die psigoterapeut sy daaglikse ervarings en gebeurtenisse vanuit die verlede interpreteer het. Dit plaas die psigoterapeut as hoofspeler, met sy familiegeskiedenis en huidige interpersoonlike opset as inherente deel van sy mondering, op die voorgrond. In hierdie proses word die psigoterapeut sentraal geplaas met die klem op eie verantwoordelikheid met betrekking tot die proses van selfsupervisie. Die probleme wat deur hierdie persoonlik gekleurde, wetenskaplike studie aangespreek word, is probleme wat die psigoterapeut deur middel van sy selfsupervisie ge1dentifiseer het. So 'n selfondersoek lei tot 'n diepere selfkennis wat die psigoterapeut tot voordeel van homself, sy gesinsisteem en klientsisteem kan gebruik. Hierdie studie is 'n poging om 'n nuwe wyse van navorsing te identifiseer. Dit is omvattend en lei tot persoonlike vervulling asook diepere selfkennis en is 'n man waardeur ander psigoterapeute ook hulself en hul werelde kan ontdek. Dit is 'n stadige en pynlike proses. Hoofstukke 1 tot 4 is die teoretiese, wetenskaplike beredenering van die studie en hoofstukke 5 tot 12 is 'n uitbeelding van die geskiedenis van die psigoterapeut. Hoofstuk 13 plaas selfsupervisie as selfevalueringsmetode binne die psigoterapeutiese beroep. / The object of this study somewhat unusual. The study is an autobiography based on the assumption that there exists an unique patterned connection between the psychotherapist, his history, science (ethnography and second-order cybernetics), and his clients. Due to distance or financial problems, a rural psychotherapist cannot experience the privilege of supervision with an external supervisor. In such a situation selfsupervision could play an important role in the self-development, because it includes a search of self that will lead to more effectiveness in psychotherapy. Self-supervision focuses on the psychotherapist as a person and therapist, who he is, where he comes from, and in what direction he, as a psychotherapist, is developing within the psychotherapeutic process. It is important to any psychotherapist to strive towards a higher level of psychotherapy. This implies a process of selfinvestigation, dissection and self-evaluation. This process was conducted by means of diary entries in which the psychotherapist interpreted his daily experiences and events in terms of his past. This places the psychotherapist, with his family history and current interpersonal situation, as intrinsic parts of himself, in the foreground. In this process the psychotherapist takes centre stage with emphasis on his responsibility concerning the process of self-supervision. The problems addressed by this personally coloured, scientific study, are problems that the psychotherapist identified through the process of self-supervision and introspection. Such introspection leads to a deeper personal knowledge which the psychotherapist can use to his own benefit but also to the benefit of his family and client system. This study is an attempt to identify a new way of research. It is comprehensive and leads to personal fulfilment and deeper self-knowledge and is also a method by which other psychotherapists could discover themselves and their worlds. It is a slow and painful process. Chapters 1 to 4 comprise of the theoretical rationale of the study and chapters 5 to 12 depict the history of the psychotherapist. Chapter 13 situates self-supervision as a method of self-evaluation in the profession of psychotherapy. / Psychology / D. Litt. et Phil.

The study substantiates common strategies and theories regarding the teaching of sight-reading. The literature study done on sight-reading at the keyboard consists of opinions and recommendations resulting from empirical findings of well-known piano pedagogues. Seven beginner courses were analysed in order to assess their presentation of a well-structured development of piano sight-reading against the opinions and recommendations of well-known piano pedagogues and authors in this field as well as the personal experience of the researcher. During this process it was discovered that insufficient attention was paid to the development of the association between a note symbol and its corresponding key on the piano. However no attention was paid to the act of playing while reading ahead. The researcher compiled additional progressive exercises for the 7 to 9 year old beginner, to address the above-mentioned discrepancies. The exercises and their individual purposes are clearly explained with instructions regarding their performance. / Hierdie studie bevestig algemene strategieë en teorieë aangaande die ontwikkeling van vaardighede om musieknotasie te lees en te speel. Die literatuur wat in hierdie studie bestudeer is, handel oor opinies en aanbevelings van vooraanstaande klavierpedagoë wat voortspruit uit die resultate van hulle empiriese navorsing. Sewe aanvangskursusse is ontleed en die aktiwiteite en metodes waarvolgens vaardighede onderrig word om musieknotasie te leer lees en speel, is gemeet aan die aanbevelings van vooraanstaande klavierpedagoë, navorsers op die gebied, asook die navorser se eie ervaring met die boeke. Gedurende die studie is daar ontdek dat daar meesal nie aandag geskenk word aan die ontwikkeling van 'n assosiasie tussen 'n toonhoogtesimbool en ooreenstemmende klawer op die klavier nie en glad nie aan die proses van vooruitlees nie. Om hierdie tekortkominge te oorkom het die navorser 'n stel aanvullende en progressiewe oefeninge saamgestel wat maklik genoeg uitvoerbaar is vir die 7- tot 9-jarige beginner. Duidelike beskrywings van die oefeninge, elkeen se spesifieke doel, en aanwysings vir effektiewe uitvoering daarvan word verskaf. / Art History, Visual Arts and Music / M.A. (Musicology)

Text in Afrikaans / Die objek van studie in hierdie proefskrif is ietwat ongewoon. Die studie is outobiografies en is gegrond op die aanname dat daar tussen die psigoterapeut, sy geskiedenis, die wetenskap (etnografie en tweede-orde kubernetika) en die klient(e) 'n unieke patroonverband bestaan. Die psigoterapeut in die platteland het weens afstand of finansies nie altyd die voorreg om supervisie van 'n eksterne supervisor te ontvang nie. In so 'n situasie kan selfsupervisie, deurdat dit 'n proses van selfontdekking is, 'n belangrike rol in die psigoterapeut se selfontwikkeling speel. Selfsupervisie plaas die klem op die psigoterapeut as persoon en as terapeut; oor wie hy is, waar hy vandaan kom en waarheen hy binne die psigoterapeutiese proses op pad is. Vir enige psigoterapeut is dit belangrik om na 'n hoer vlak van psigoterapie te streef. Hierdie strewe impliseer 'n proses van selfondersoek, delwing, selfevaluasie en disseksie. Hierdie proses is aan die hand van dagboekinskrywings gedoen, waar die psigoterapeut sy daaglikse ervarings en gebeurtenisse vanuit die verlede interpreteer het. Dit plaas die psigoterapeut as hoofspeler, met sy familiegeskiedenis en huidige interpersoonlike opset as inherente deel van sy mondering, op die voorgrond. In hierdie proses word die psigoterapeut sentraal geplaas met die klem op eie verantwoordelikheid met betrekking tot die proses van selfsupervisie. Die probleme wat deur hierdie persoonlik gekleurde, wetenskaplike studie aangespreek word, is probleme wat die psigoterapeut deur middel van sy selfsupervisie ge1dentifiseer het. So 'n selfondersoek lei tot 'n diepere selfkennis wat die psigoterapeut tot voordeel van homself, sy gesinsisteem en klientsisteem kan gebruik. Hierdie studie is 'n poging om 'n nuwe wyse van navorsing te identifiseer. Dit is omvattend en lei tot persoonlike vervulling asook diepere selfkennis en is 'n man waardeur ander psigoterapeute ook hulself en hul werelde kan ontdek. Dit is 'n stadige en pynlike proses. Hoofstukke 1 tot 4 is die teoretiese, wetenskaplike beredenering van die studie en hoofstukke 5 tot 12 is 'n uitbeelding van die geskiedenis van die psigoterapeut. Hoofstuk 13 plaas selfsupervisie as selfevalueringsmetode binne die psigoterapeutiese beroep. / The object of this study somewhat unusual. The study is an autobiography based on the assumption that there exists an unique patterned connection between the psychotherapist, his history, science (ethnography and second-order cybernetics), and his clients. Due to distance or financial problems, a rural psychotherapist cannot experience the privilege of supervision with an external supervisor. In such a situation selfsupervision could play an important role in the self-development, because it includes a search of self that will lead to more effectiveness in psychotherapy. Self-supervision focuses on the psychotherapist as a person and therapist, who he is, where he comes from, and in what direction he, as a psychotherapist, is developing within the psychotherapeutic process. It is important to any psychotherapist to strive towards a higher level of psychotherapy. This implies a process of selfinvestigation, dissection and self-evaluation. This process was conducted by means of diary entries in which the psychotherapist interpreted his daily experiences and events in terms of his past. This places the psychotherapist, with his family history and current interpersonal situation, as intrinsic parts of himself, in the foreground. In this process the psychotherapist takes centre stage with emphasis on his responsibility concerning the process of self-supervision. The problems addressed by this personally coloured, scientific study, are problems that the psychotherapist identified through the process of self-supervision and introspection. Such introspection leads to a deeper personal knowledge which the psychotherapist can use to his own benefit but also to the benefit of his family and client system. This study is an attempt to identify a new way of research. It is comprehensive and leads to personal fulfilment and deeper self-knowledge and is also a method by which other psychotherapists could discover themselves and their worlds. It is a slow and painful process. Chapters 1 to 4 comprise of the theoretical rationale of the study and chapters 5 to 12 depict the history of the psychotherapist. Chapter 13 situates self-supervision as a method of self-evaluation in the profession of psychotherapy. / Psychology / D. Litt. et Phil.