M.Cur. (Community Nursing) / The emphasis has moved from curative to services in South Africa, therefore the assurance mechanisms is now essential primary health care establishing of quality with the announcement of the devolution of primary health care services to the local authority, by the Minister of Health in 1991, the role fulfillment and accountability of the community health nurse becomes much more complex and greater demands are continuously made. The need for standards in child health nursing in a local authority led to this study. Relevant literature was explored in respect of the main variables and concepts of the child health nursing practice, whereby theoretical validity is confirmed for the formulation of the nursing standards in this respect. Nursing standards for child health nursing as rendered by the community health nurse in the local authorities on the Witwatersrand, were formulated. These standards were validated by a representative group of experts on regional level. The validation process consisted of a two-stage research technique. The statistical validity was calculated by means of a content validity index for each standard. All the standards (N=86) were considered valid, but sixteen (19%) require reformulation standards form the basis of the quality assurance process. These should equip the community health nurse with valuable guidelines to promote quality nursing care in respect of child health in the local authority. It is recommended that these standards should serve as optimum standards for the community health nurse concerned with child health nursing in the local authority.

M.Tech. (Homoeopathy) / Atopic dermatitis (atopic eczema) is a chronic, relapsing, allergic inflammatory skin disease (Hauk, 2008). The prevalence of atopic dermatitis has increased significantly over the past few decades, with highest rates of 45 – 64% occurring amongst preschool children (Butler, 2009), and 40% amongst older children and adults (Manjra, 2005). This increase in prevalence is attributed to environmental factors such as microbial exposure and poor nutrition, which can all lead to atopic dermatitis (Schnopp, 2006). The quality of life of patients suffering from atopic dermatitis and their family members are significantly affected (Manjra, 2005). Atopic dermatitis is characterized by active skin lesions that are red, flaky, dry and itchy and in children commonly occurs in the flexural areas of the body (Fölster-Hols et al., 2007, Schnopp, 2006). Conventional treatment potions for atopic dermatitis are associated with adverse effects in children (Kalicharan et al., 2005). Homoeopathic remedies may offer an alternative option for this condition. This study aimed to assess the effect of a homoeopathic complex consisting of Graphites 6cH, Histaminum 9cH, Psorinum 6cH and Sulphur 6cH, on atopic dermatitis in children. All the participants of the study received the homoeopathic complex. The atopic dermatitis was evaluated using the SCORAD index (Scoring of Atopic Dermatitis) (Appendix F) and the Children’s Dermatology Life Quality Index (CDLQI) (Appendix E). Thirty four participants who met the inclusion and exclusion criteria were recruited to participate in this pre-test – post-test single group study by means of advertisements (Appendix A) placed in and around primary schools in the Gauteng area (with relevant permission given) and in the local newspaper. Participants were also recruited via word of mouth. Once participants were accepted into the study they were allocated into the treatment group which received the homoeopathic complex containing Graphites 6cH, Histaminum 9cH, Psorinum 6cH and Sulphur 6cH. The study was completed over a four week period. The percentage of the area affected, the intensity of the symptoms, the pruritus and the loss of sleep as well as the quality of life of the participants suffering from atopic dermatitis were aspects of the condition evaluated on a weekly basis. The results for the CDLQI showed improvements in the participant’s perception of itching/ pain of the affected area, as well as their quality of sleep. These improvements were shown to have occurred gradually over the study period. There were however no statistically significant changes noted in the mental and emotional quality of life of the participants.

Class of 2013 Abstract / Specific Aims: The purpose of this study was to assess risk factors that are associated with inpatient charges and mortality rates with methicilin-resistant Staphylococcus aureu (MRSA), Aspergillus, and Candida in children with leukemia. The hypotheses is MRSA and opportunistic fungal infections are associated with higher inpatient charges and worse outcomes relative to those without. Children with leukemia are especially at risk due to underdeveloped and compromised immune systems. The rational is that identifying the risk factors that affect mortality and inpatient charges of these infections should add to the current knowledge of treating and preventing these infections in immune compromised patients. Methods: Retrospective cohort study using the Agency for Healthcare Research Quality (AHRQ) KIDS 2009 database. Inclusion criteria was defined as 17 years of age or younger and a ICD-9 code for an active infection with MRSA, Aspergillus, or Candida. Regression analysis's were performed to identify factors that had an impact on mortality, length of stay, and direct patient charges. Main Results: Values that were significant (p≤0.05) for predicting an increase in mortality were Age (year), MRSA, Aspergillus, Candida, and Deyo-Charlson comorbidity scores. Significant predictors of increased Inpatient Charges (p≤0.05) was Age (year), MRSA, Aspergillus, Candida, Female Sex, Deyo-Charlson comorbidity scores, Urban Hospitals, and the Southern Region. Significant predictors of Increased Length of Stay (p≤0.05) MRSA, Aspergillus, Candida, Female Sex, Deyo-Charlson, Urban Hospitals, Teaching Hospitals, and the Southern Region. Conclusion: Although uncommon in leukemia cases involving pediatrics or young adults, statistically significant and large risks of higher mortality, length of stay, and inpatient charges were noted in cases involving MRSA, aspergillus, and candida. Increasing Deyo-Charlson comorbidities scores were also consistently important predictors for poor outcomes in these leukemia patients and, with certain outcomes, increasing age and female sex.

To date, only a small number of studies have examined the results of physical literacy (PL) assessments using the Canadian Assessment of Physical Literacy (CAPL). Among these studies, none have evaluated the correlations between the four domains of PL assessed within the CAPL, nor have they evaluated whether these correlations differ depending on weight status. The current study aimed to determine the strength of associations between the four domains of PL, and compare the correlation coefficients between healthy weight and overweight/obese children. Children aged 8-12 years (n=456) were assessed using the CAPL protocol and partial correlations (controlling for age, sex, and other domain scores) were calculated between domains, for healthy weight (n=275) and overweight/obese children (n=181) separately. The results of this study show that the domains of physical competence, daily behaviour, and motivation and confidence correlate significantly with one another at similar low-to-moderate levels in both body weight groups examined (r = 0.15 to 0.38). The domain of knowledge and understanding did not correlate significantly with other domains in healthy weight participants, and only correlated significantly with physical competence in overweight/obese children (r = 0.22). Overall, the low level of correlations seen between domains in this study lends support to the psychometric architecture of the CAPL and suggests that the four domains of CAPL measure different constructs. Furthermore, the results of this study suggest that interventions aimed at improving PL in children should assess multiple domains, and do not necessarily need to be tailored based on a child’s weight status.

Objectives: 1) To describe the state of the evidence for interventions in pediatric migraine, 2) to survey experts regarding non-inferiority margins in migraine research and 3) to design a clinical trial in this area of research. Methods: A systematic review was carried out to identify randomized, placebo-controlled trials of pharmaceutical and nutraceutical interventions used to prevent migraine in children and adolescents, using Cochrane methods. Secondly, neurologists with expertise in Headache Medicine were invited to participate in a survey regarding their opinions on non-inferiority margins for outcomes used in clinical trials of migraine interventions. Thirdly, a protocol was written for a three-arm, parallel-group, randomized trial comparing the efficacy and safety of topiramate, levetiracetam and placebo for the prophylaxis of pediatric migraine. Results: The systematic review identified 19 articles of 12 interventions for pediatric migraine. The quality of the evidence was poor and few conclusions could be made. Ninety-nine eligible respondents completed the survey and non-inferiority margins for six outcomes were determined. A randomized controlled trial protocol was developed to determine if topiramate and levetiracetam are superior to placebo, and if levetiracetam is non-inferior to topiramate for the prevention of migraines in children and adolescents. Conclusions: It is hoped that the results of this thesis can be applied to further the evidence in this area of clinical research.

The purpose of this study was to investigate the effect of a nursing intervention on the mother's postpartum adjustment and perception of her infant. The intervention was designed to give information about infant behaviour patterns; and to assist the mother in identifying the behavioural responses and reflex behaviours characteristic of her infant. A quasi-experimental design was utilized with random assignment of the twenty-five married primiparous participants to either an experimental or a control group. The subjects in the experimental group took part in the nursing intervention approximately twelve days following their infants' births; the fathers of the infants were also present during the intervention. All participants completed the Neonatal Perception Inventory and the Postnatal Research Inventory one month postpartum. Data were also obtained from the mothers' hospital records. Statistical analysis comparing the scores for the two groups indicated that experimental group mothers had a more positive perception of their infants. In addition, they reported less depression and irritability and fewer negative feelings towards caring for their babies. There were no differences between experimental and control group mothers on seven other scales of maternal adjustment. Correlations between the perception scale and maternal adjustment inventory across all subjects showed that positive perception of the infant was associated with low scores on scales of depression, irritability, fear or concern for the baby, and the mother's need for reassurance. These findings were discussed in relation to their implications for clinical practice. Suggestions for further research into other variables that may be influential in the postpartum period were also outlined. / Applied Science, Faculty of / Nursing, School of / Graduate

No description available.

Obesity is a substantial public health concern. One subgroup that has shown a large increase in prevalence of obesity is adolescents (12 - 19 years) (CDC, 2014; Altman & Wilfley, 2014; Odgen et al., 2010; Ogden, et al., 2012; Ogden, et al., 2014). This is concerning for two reasons: (a) the strong likelihood of obesity persisting into adulthood (CDC, 2014) leading to co-occurring medical and psychosocial problems (Altman & Wilfley, 2014; Kelsey et al., 2014), and (b) there are few studies demonstrating successful reductions in obesity in children and even fewer successful demonstrations in adolescents (Altman & Wilfley, 2014; Tsiros et al., 2008). One way to evaluate the behaviors related to obesity is through an individual’s choice-making behavior between foods and exercises. Behavior Economic Theory (BET) is an operant methodology used to assess choice making and to describe relationships between choices. The purpose of this study was to describe the relationship between diet and exercise, through the BET framework, in adolescent females who are obese within a single case design. Participants’ recorded daily perceived calories consumed and expended with a concurrent schedules design using an electronic self-monitoring program for baseline (Phase 1). After Phase 1, the researcher presented a choice between diet and exercise and developed a behavioral contract with goals addressing that choice for Phase 2. A subsequent behavioral contract was developed to target the changes in diet or exercise in Phase 3. The participants continued to record daily consumption and expenditure during Phases 2 and 3. IOA was collected by two researchers who independently reviewed the recorded consumed and expended calories on at least 30% of days that the participant self-monitored. For all participants, IOA was calculated across 35.8% of days with an average 96.6% agreement. The results showed that 3 of 5 participants preferred to develop a behavioral contract which targeted exercise, but only one showed weight loss. Two of the 5 participants chose to target diet with the contracts. Similar to the exercise group, weight loss occurred for only one participant. Using the BET methodology to analyze the participant’s engagement in reducing calories, only participants that simultaneously worked on increasing exercise and reducing their calorie intake lost weight, showing a complementary relationship between diet and exercise. Regardless of intervention strategy, these results suggest that adolescent females may have to develop a complementary relationship between diet and exercise to achieve successful outcomes. These results suggest that further analysis of the relationship between diet and exercise are warranted.

No description available.

No description available.