Violence is a leading cause of morbidity and mortality amongst young people. Public health approaches are now being increasingly utilised to reduce the risk of young peoples' involvement in violence. One such programme is Medics Against Violence (MAV), which aims to reduce pro-violent attitudes and enhance empathy in secondary school pupils. This thesis aims to investigate whether this approach can be effective in tackling youth violence in secondary school pupils. A mixed-methods approach was adopted to conduct both an outcome and process evaluation of MAV. Four schools took part in the outcome evaluation, which examined whether there was a change in attitudes towards violence or empathy in pupils receiving the MAV programme. The process evaluation consisted of focus groups with school pupils, and open-ended questionnaires and semi-structured interviews with MAV volunteers. There was a small but significant reduction in pro-violent attitudes immediately post-intervention. However, this was not sustained at three months and there was no significant increase in empathy scores. Pupils generally demonstrated anti-violent attitudes, although were more likely to support the use of reactive violence. The pupils appeared to enjoy and generally engage well with the programme. In particular, the use of real footage, interviews with those affected by violence and the Glasgow setting provided a sense of realism for the pupils. Moreover, pupils valued the opportunity to discuss the issues raised by MAV with the volunteers. Volunteers felt engagement was occasionally an issue in the most affluent areas. However, some volunteers adapted the programme to focus on victimisation prevention in the most affluent schools. Further development is therefore needed in terms of establishing who the programme is aimed at (i.e. potential victims or perpetrators), focusing on reactive violence and increasing the sustainability of its effects.

This study of the South African prevention programme titled Human Rights Club aims to explore the participating adolescents experience. The method being used is qualitative focus groups interviews. Four focus groups interviews were conducted in different townships around East London, in total 21 respondents participated in the focus groups. The theoretical framework that was used to analyze the result was the concept of socialization, gender and empowerment. The results indicate that the participants experience that the program has contributed to their own personal development, social affiliation, and the ability to help others. The participants experience a change in their views on women's human rights and gender roles. Through advocacy they are spreading the knowledge they have gained to their families, friends, schools and communities. This turns former participants into activists and helps Human Rights Club to reach beyond their participants only.

Background: The negative side of rugby participation is the danger it presents to health in the form of injuries. Most school coaches, advocates of talent development and selectors put a high priority on implementing programmes to develop bigger, stronger, faster and more skilful rugby players who can excel at their sport. These programmes however, do not place enough emphasis on the prevention of injuries. Aims: The primary aim of the study was to determine the effect of an approved injury prevention programme on the incidence (injuries per 1000 player hours) of n~gbyin juries (overall, intrinsic and extrinsic injuries) of 15- and 16 year-old schoolboys, over a two-year period. A further aim was to measure the effect of an approved injury prevention programme on the selected anthropometric, physical and motor and biomechanical and postural variables of all the groups involved in this study over a period of two years. Originating from these aims, a sub-aim of this study was to use information from this study to provide modifications - if necessary - to the current prevention programme in order for it to be effectively applied at high-school rugby level. Design: A non-equivalent experimental-control group design with multiple post-tests was used for the investigation. Subjects: The subjects were 120 schoolboy rugby players. The subjects came from two secondary schools in the North West province of South Africa. Both schools were schools wit11 a tradition of excellence in rugby. Players who participated in the experimental injury prevention programme were the year 2004, 15- and 16-year old elite A teams. The B teams acted as controls. Method: Players were tested over a two-year period. During each of the two years there were three testing occasions where all players were tested: pre-season, during the mid-season break and at the end of the season. The results of these tests were used to monitor changes in anthropometric, physical and motor and biomechanical and postural variables in various stages of the training programme. At the end of every evaluation, deficits were identified in the performance of all players in the experimental group and the prevention programmes were planned accordingly. Players in the experimental group received exercises to address the specific deficits identified. Rugby injuries were screened and injury data collected through the use of weekly sports. medical clinics. Results: Differences and changes in extrinsic injury incidences in this study could not be attributed to the effect of the prevention programme, and as a result injury trends related to overall injury incidences were inconsistent when the experimental groups were compared to the matching control groups. However, the prevention programme did have a positive effect on the intrinsic injury incidence of both experimental groups during the study period. The following moderate or highly practically significant anthropometric changes occurred when inter-group comparisons for the two year period were considered: triceps skinfold (d=0.8 among 16-year olds), subscapular skinfold (d=0.5 among 16-year olds, midaxillary skinfold (d=1.3 among 15-year olds), calf skinfold (d=1.3 among 16-year olds), humerus breadth (d=1.4 among 15-year olds), femur breadth (d=0.5 among 15-year olds), fat percentage (d=0.5 among 16-year olds) and mesomorphy (d=1.3 among 15-year olds). However, these anthropometric changes may be due to other factors, such as the natural growth phase of boys, rather than the effect of the prevention programme. During the inter-group comparisons of physical and motor components, moderately or highly practically significant improvements were recorded in the vertical jump (d=0.8 for 15-year olds and d=1.5 for 16year olds), bleep (d=0.7 for 16-year olds), pull-ups (d=0.6 for 15-year olds) and push-up tests (d=1.5 for 15-year olds and d=1.1 for 16 year-olds) of the experimental groups considering the total two year period. From the results it was clear that in practice, the prevention programme significantly improved only four of the 11 physical and motor components over the two-year period and that these improvements often occurred in only one of the age groups involved. The inter-group comparison of biomechanical and postural variables revealed numerous moderately and highly practically significant improvements in both age groups. over the total two-year period. All in all the prevention p r o v e provided the experimental groups with a more balanced (closer to ideal) dynamic mobility, core stability and postural symmetry. Conclusion: It could be concluded that the present prevention programme did not have a practically significant effect on the incidence of overall rugby injuries and extrinsic rugby injuries of 15- and 16-year old schoolboys over a two-year period. However, in practice, the prevention programme did have a significantly positive effect on the incidence of intrinsic rugby injuries of 15- and 16-year old schoolboys over a period of two years. It could be concluded that the prevention programme did not have a practically significant effect on the anthropometric components of 15- and 16-year old schoolboys over a two-year period. Seeing that the prevention programme had a moderately or highly practically significantly effect on only four of 11 physical-and-motor components over the two-year period, and that these improvements often occurred in only one of the age groups involved, it could be concluded that the prevention programme did not significantly affect the physical and motor variables of 15- and 16-year old schoolboys over a two-year period. Finally the conclusion could be drawn that in practice the prevention programme significantly improved the biomechanical and postural variables over a period of two years. This improvement in biomechanical and postural status may be responsible for the decrease in intrinsic injury incidence. Information from this study was used to provide modifications to the tested prevention programme in order for it to be effectively applied at high school rugby level. / Thesis (Ph.D. (Movement Science Education))--North-West University, Potchefstroom Campus, 2006

Thesis (Ph.D. (Movement Science Education))--North-West University, Potchefstroom Campus, 2006.

The overall aim of the study was to examine relapse among participants in the DWI Prevention Programme and those who get prison sentence after driving when influenced by alcohol and to examine the participants’ attitudes towards drunk – driving, risk behavior and traffic safety. A direct evaluation of the sentence and penal accomplishment is also examined. The sample of the survey study (see article 1) was 44 from the DWI – sample and 44 from the prison – sample that completed a questionnaire answering about their attitudes towards drunk – driving, risk behavior and traffic safety. The results presented in article 2 are based on transcripts of criminal convicts that participated in the DWI Prevention Programme during the period of 1998 – 2002 in the Salten District ( n = 68) and a sample of convicts to an unconditional sentence for drunk - driving in the same time periode (n = 112). The 1st analysis revealed that the DWI – sample had more ideal attitudes towards drunk – driving, risk behavior and traffic safety. There were also significant differences in how they evaluated their sentence and penal accomplishment. The DWI - sample were generally more satisfied with the penal accomplishment, the way they was treated and how the relationships around them were. They were also more satisfied with the contents of the penal accomplishment. Multivariate analysis, Kaplan – Meier and Cox regression was used in the 2nd analysis calculating if there were significant differences between the samples, survival time and to investigate effects of several variables upon the time a specified event takes to happen. In this study the relapse time was shorter for men than for women and the youngest age – groups had a shorter relapse time than the oldest age – groups. The Kaplan – Meier plot revealed that the prison – group have a shorter relapse time compared to the DWI – group. Based on the results of the two articles we can conclude that the DWI Prevention Programme had a very good effect on the participants compared to those who get traditional prison – sentence. The participants in the programme had the most ideal attitudes and the longest survival time after participating. When it comes to survival time among gender and age, women and the older age – groups had the longest survival time.

Background: The negative side of rugby participation is the danger it presents to health in the form of injuries. Most school coaches, advocates of talent development and selectors put a high priority on implementing programmes to develop bigger, stronger, faster and more skilful rugby players who can excel at their sport. These programmes however, do not place enough emphasis on the prevention of injuries. Aims: The primary aim of the study was to determine the effect of an approved injury prevention programme on the incidence (injuries per 1000 player hours) of n~gbyin juries (overall, intrinsic and extrinsic injuries) of 15- and 16 year-old schoolboys, over a two-year period. A further aim was to measure the effect of an approved injury prevention programme on the selected anthropometric, physical and motor and biomechanical and postural variables of all the groups involved in this study over a period of two years. Originating from these aims, a sub-aim of this study was to use information from this study to provide modifications - if necessary - to the current prevention programme in order for it to be effectively applied at high-school rugby level. Design: A non-equivalent experimental-control group design with multiple post-tests was used for the investigation. Subjects: The subjects were 120 schoolboy rugby players. The subjects came from two secondary schools in the North West province of South Africa. Both schools were schools wit11 a tradition of excellence in rugby. Players who participated in the experimental injury prevention programme were the year 2004, 15- and 16-year old elite A teams. The B teams acted as controls. Method: Players were tested over a two-year period. During each of the two years there were three testing occasions where all players were tested: pre-season, during the mid-season break and at the end of the season. The results of these tests were used to monitor changes in anthropometric, physical and motor and biomechanical and postural variables in various stages of the training programme. At the end of every evaluation, deficits were identified in the performance of all players in the experimental group and the prevention programmes were planned accordingly. Players in the experimental group received exercises to address the specific deficits identified. Rugby injuries were screened and injury data collected through the use of weekly sports. medical clinics. Results: Differences and changes in extrinsic injury incidences in this study could not be attributed to the effect of the prevention programme, and as a result injury trends related to overall injury incidences were inconsistent when the experimental groups were compared to the matching control groups. However, the prevention programme did have a positive effect on the intrinsic injury incidence of both experimental groups during the study period. The following moderate or highly practically significant anthropometric changes occurred when inter-group comparisons for the two year period were considered: triceps skinfold (d=0.8 among 16-year olds), subscapular skinfold (d=0.5 among 16-year olds, midaxillary skinfold (d=1.3 among 15-year olds), calf skinfold (d=1.3 among 16-year olds), humerus breadth (d=1.4 among 15-year olds), femur breadth (d=0.5 among 15-year olds), fat percentage (d=0.5 among 16-year olds) and mesomorphy (d=1.3 among 15-year olds). However, these anthropometric changes may be due to other factors, such as the natural growth phase of boys, rather than the effect of the prevention programme. During the inter-group comparisons of physical and motor components, moderately or highly practically significant improvements were recorded in the vertical jump (d=0.8 for 15-year olds and d=1.5 for 16year olds), bleep (d=0.7 for 16-year olds), pull-ups (d=0.6 for 15-year olds) and push-up tests (d=1.5 for 15-year olds and d=1.1 for 16 year-olds) of the experimental groups considering the total two year period. From the results it was clear that in practice, the prevention programme significantly improved only four of the 11 physical and motor components over the two-year period and that these improvements often occurred in only one of the age groups involved. The inter-group comparison of biomechanical and postural variables revealed numerous moderately and highly practically significant improvements in both age groups. over the total two-year period. All in all the prevention p r o v e provided the experimental groups with a more balanced (closer to ideal) dynamic mobility, core stability and postural symmetry. Conclusion: It could be concluded that the present prevention programme did not have a practically significant effect on the incidence of overall rugby injuries and extrinsic rugby injuries of 15- and 16-year old schoolboys over a two-year period. However, in practice, the prevention programme did have a significantly positive effect on the incidence of intrinsic rugby injuries of 15- and 16-year old schoolboys over a period of two years. It could be concluded that the prevention programme did not have a practically significant effect on the anthropometric components of 15- and 16-year old schoolboys over a two-year period. Seeing that the prevention programme had a moderately or highly practically significantly effect on only four of 11 physical-and-motor components over the two-year period, and that these improvements often occurred in only one of the age groups involved, it could be concluded that the prevention programme did not significantly affect the physical and motor variables of 15- and 16-year old schoolboys over a two-year period. Finally the conclusion could be drawn that in practice the prevention programme significantly improved the biomechanical and postural variables over a period of two years. This improvement in biomechanical and postural status may be responsible for the decrease in intrinsic injury incidence. Information from this study was used to provide modifications to the tested prevention programme in order for it to be effectively applied at high school rugby level. / Thesis (Ph.D. (Movement Science Education))--North-West University, Potchefstroom Campus, 2006

Philosophiae Doctor - PhD / Background: The Human Immunodeficiency virus (HIV) has become a global public health challenge amid the growing concern of adolescent risky sexual behaviour, influenced by biological and psycho-social factors. There is an increasing demand for adolescent sexual risk reduction interventions, especially in sub-Saharan Africa which remains the hub of HIV epidemic worldwide. Sport-based HIV prevention programme has been identified as one of the interventions, in addition to other approaches to provide young people with appropriate HIV knowledge and skills to either delay or reduce risk-taking behaviour. Despite the potential of sport-based programme for sexual risk reduction, there is limited information on how to adapt it to meet adolescent needs in terms of design, contents, and delivery. This information is necessary to provide sufficiently strong evidence to support widespread implementation of sport-based programme, especially in rural African schools. Therefore, the study aimed to measure the impact of a sport-based HIV prevention intervention in the reduction of HIV related sexual risk behaviour among rural high school learners aged 13-18. Method: The overall study design was a concurrent mixed method, utilizing both the quantitative and qualitative approach. The population for the quantitative and the qualitative studies was made up of two high schools in a predominantly “Coloured” community in Ceres. Two classes each were randomly selected from grades 8-10 in both intervention and control school. The intervention was developed through a process of focus group discussions with the Grassroot Soccer (GRS) staff and it was guided by the Social Cognitive Theory. The intervention was delivered to grade 8-10 learners by GRS peer facilitators using the GRS generation skillz curriculum that consists of 12-week sessions in the intervention school. Quantitative data were analysed with multivariate statistical techniques and qualitative data with thematic analysis approach. Results: The data that assessed the behavioural and protective factors to understand why learners in rural schools engage in risky sexual behaviour showed that about 27.2% of the learners reported being sexually active. Of the sexually active learners, 48.7% reported engaging in sex by 14 years or younger and nearly 42.2% reported multiple sexual partners with significant higher proportion of boys than girls. Nearly 55.2% of the sexually active learners reported irregular condom use and 46.3% did not use a condom at the last sexual encounter. The majority of the learners (87%) did not know their HIV status. Being male (OR = 6.60;95% C I = 1.62 – 26.84) and peer influence (OR = 3.01; 95% CI = 1.97-4.60) were the strongest predictors of reporting sexual intercourse and early sexual activities before the age 15 respectively. Though the knowledge of HIV was low, those with greater knowledge of HIV were more likely to use a condom at last the sexual encounter (OR = 1.22; 95% C I =1.03-1.44). The learners who participated in sport-based intervention were 1.43times likely to report higher self-efficacy to refuse sex compared to the control group (OR = 1.43; 95% C.I =1.07-1.92).The process evaluation indicated that the sport-based intervention was well received among the learners as it gave them free space to freely express themselves. Conclusion: The findings have shown that sport-based intervention can be successfully implemented in school and is a promising approach to reduce risks associated with risky sexual behaviour in learners. However, the quality of the programme delivery was hampered by irregular session‟s schedule and language of instruction. The process suggests for a longer exposure period and because of social-cultural diversity, learners must be provided with the ownership of the programme in schools.

Introduction: In recent year, the role of the pharmacist has evolved from product-focused to patient-focused activities. Following this evolution, new professional pharmacy services were simultaneously developed by researchers and started to be legally implemented and remunerated for community pharmacists around the world. Implementation, essential to ensure a good programme delivery and therefore its effectiveness, was seen as a passive process for which diffusion and dissemination were sufficient to translate research into practice. However, the transition from theory to practice is often difficult as different factors hinder or facilitate the implementation of such services. In consequence of that, implementation research started to be developed in the community pharmacy field to understand and fil the gap between theory and practice.Objectives of the thesis: Three projects were conducted in Belgium and Switzerland; (1) to understand the implementation of an existing programme in Belgium; the isotretinoin pregnancy prevention programme (PPP) (Chapter IV, point 4.1), and (2) to study the implementation of two new developed pharmaceutical services, which include an interview between the pharmacist and the patient and require interprofessional collaboration; the medication adherence program in Switzerland and the medication review in Belgium (Chapter IV, point 4.2). Methods: To understand the implementation of the isotretinoin PPP, two studies were conducted. The first study was a survey sent to health care professionals (pharmacists, general practitioners and dermatologists) and patients. The outcomes of the survey were the PPP awareness and compliance to safety recommendations related to the teratogenic risk of isotretinoin. The second study was cross-sectional and analysed the reimbursed prescription data of the Belgian population taking isotretinoin between January 2012 and August 2015. The outcomes were medication adherence to isotretinoin and to contraception, and the concomitant use of contraception and isotretinoin. Medication adherence was measured using the medication possession ratio (MPR), dividing the total days of medication supplied within the refill interval by the number of days in the refill interval. The concomitant use of isotretinoin and contraception was realised in combining prescription database of both isotretinoin and contraception of women between 12 and 21 years old, who received at least one prescription of isotretinoin during the study period.To study the implementation of the medication adherence program in Switzerland and the medication review service in Belgium, two prospective and observational studies were conducted with a mixed method approach (quantitative and qualitative outcomes). The defined outcomes, based on the RE-AIM model, were; reach of the target patients, adoption of the service by health care professionals providing the service, implementation (facilitators, barriers and fidelity or the extent to which the intervention is delivered as intended), and maintenance (the extent to which the intervention become institutionalized or part of the routine activity). Outcomes were collected through web platforms for quantitative data, and interviews and focus groups for qualitative data.Results and discussion: The study of the isotretinoin PPP implementation showed that two safety recommendations related to the teratogenic risk were particularly poorly applied by interviewed health care professionals. These two recommendations were the use of a second contraceptive method (like condoms) and the monthly pregnancy test. They considered these two recommendations as unnecessary for women taking an effective contraceptive method. Through the prescription refill data analysis, we observed that 46.1% of patients were adherent to isotretinoin (MPR ≥ 0.8) and 74.0% of women taking isotretinoin to their prescribed contraception (oral contraceptive, rings and patches). Lastly, 83.4% of women between 12 and 21 years taking isotretinoin did not receive an effective contraceptive method one month before, during and one month after isotretinoin treatment. However, the proportion of women receiving at least one prescription of contraception during (74.1%) and after (72.1%) isotretinoin treatment was higher than one month before isotretinoin treatment (35.7%). Regarding these results, less adopted recommendations should be reviewed by an expert committee and interventions focused on the improvement of the use of contraception during isotretinoin treatment could be developed.The two studies related to two new developed pharmaceutical services showed that their implementation was feasible in community pharmacy practice. Most of pharmacists participating in both projects had positive attitude regarding the implementation of these services in their daily practice. They considered it as professionally satisfying and important for patients and perceived the benefits of the programs. However, similar barriers were observed; difficulties to include patients and lack of interprofessional collaboration, and lack of time (related to lack of staff, administrative burden and lack of team adoption). According to participating health care professionals, the development of new strategies to overcome these barriers is necessary to anticipate the future implementation and the maintenance of these services at the national level. Following these results, the proposed strategies are for example the development of broad based media campaigns (for health care professionals and patients), or the development of specific trainings focusing on interprofessional collaboration, service-process, practice change management and leadership. Conclusion: The legal evolution of the pharmacists’ role is a positive progress but insufficient to ensure a full implementation in practice. Implementation strategies should be considered at different implementation stages (exploration, preparation, testing, operation and maintenance) and levels (individual, pharmacy, local setting, and system). The use of implementation science would allow a quicker and more effective implementation of these new professional pharmacy services. The anticipation of change and the selection of appropriate strategies would allow a higher fidelity level to the different components of the service by health care professionals and therefore a higher effectiveness, e.g. clinical and economic outcomes. Health care professionals, professional associations, academics and policy makers should be aware of implementation science and integrate it in the development of the new pharmacists’ role. As shown in our results, it should also be considered for existing programmes such as the isotretinoin PPP. / Doctorat en Sciences biomédicales et pharmaceutiques (Pharmacie) / info:eu-repo/semantics/nonPublished

Thesis (MCur)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: The Joint Commission International Accreditation (JCIA) has included a patient safety goal as part of the standards for the accreditation of hospitals. Goal number six states the need to “reduce the risk of patient harm resulting from falls”. An acute care hospital setting in Abu Dhabi, United Arab Emirates had implemented a multifaceted, multidisciplinary fall prevention programme (FPP) in preparation for accreditation by the JCIA. The achievement of the above goal is dependent on compliance with JCIA standard requirements and the hospital’s FPP. This study was undertaken to identify the factors preventing the successful implementation of the existing FPP in an acute care setting. The FPP is recognised to be in its development stages and therefore has opportunities for improvement for better patient safety outcomes, more so by reducing the incidence of falls and the severity of injuries from falls. Literature studies by Gowdy and Godfrey (2003:365) and Hathaway, Walsh, Lacey and Saenger (2001:172) suggests that the most successful approach to reducing falls and the severity of injuries from falls among patients in an acute care setting is that of a multifaceted, multidisciplinary approach. The nurses, who were primarily responsible for completing the initial fall risk assessment, expressed feelings of being overwhelmed by more safety standards being required for the JCIA. Patients with a high risk for falls were not referred to the physicians and physical therapists, nor were they referred to the clinical pharmacists for the review of high-risk medications. In addition, fall risk assessments were sometimes not done in the afternoon and during the night shift. The existing programme also did not consider bedbound, long-term patients, who require less frequent assessment. There furthermore was observer evidence to suggest that the existing FPP was not being implemented correctly. The aim of this study was to describe factors preventing the successful implementation of the existing FPP. The objectives were to identify areas being implemented successfully, to identify any barriers to successful implementation and to identify aspects of the existing FPP that may need revision. A quantitative descriptive approach was applied. The population was healthcare providers (HCPs), including both registered and practical nurses, physicians, physical therapists and pharmacists, working in an acute care setting in the United Arab Emirates. The respondents were 118 (86%) from a stratified sample of n = 137 (20%) from 684 HCPs. A specifically developed structured questionnaire was used for data collection. Reliability and validity were assured through the use of experts in questionnaire design and statistical consulting, in addition to pre-testing of the questionnaire. Ethical approval was obtained from the University of Stellenbosch Committee for Human Research and the Ethics Committee of the hospital where the study was undertaken. The respondents’ completion of the questionnaire served as voluntary consent to participate. The data were analysed and are presented in frequency tables. The mean and standard deviation were used for the statistical analysis. Correlational analyses were not done because of the descriptive approach to the study. It was considered most practical to focus on the professional groups and not on the variables, as the initial analysis indicated weak correlations. The results show those aspects of the FPP that were successfully implemented and those areas that need improvement if the JCIA requirements are to be met. Policy revision to include a clearly defined referral process for the high-risk patients, in addition to consistency of the environmental safety rounds and greater involvement and support of the unit managers/supervisors, will contribute to the greater success of the FPP. The hallmark of a successful FPP is staff education, which should be the key step in addressing the identified barriers. The human need for safety and the patient’s right to safe care and a safe environment must be integrated into staff orientation, and education and safety training programmes for all HCPs. Increased compliance may occur when HCPs are more aware of the hospital’s commitment to the patient’s right to safety. Compliance with JCIA standards and the FPP will contribute in the achievement of the accreditation. / AFRIKAANSE OPSOMMING: Die Joint Commission International Accreditation (JCIA) het ’n pasiëntveiligheidsdoelwit as deel van die standaarde vir die akkreditasie van hospitale ingesluit. Doelwit nommer ses lui: “verminder die risiko vir leed aan die pasiënt as gevolg van val”. ’n Akute sorg hospitaal in die Verenigde Arabiese Emirate het ’n veelvuldig gefasetteerde, multidissiplinêre program vir die voorkoming van val (fall prevention programme (FPP)) geïmplementeer ter voorbereiding vir akkreditasie deur die JCIA. Die bereiking van bogenoemde doelwit is afhanklik van nakoming van die standaardvereistes van die JCIA en die hospitaal se FPP. Hierdie studie is onderneem om die faktore wat die suksesvolle implementering van die bestaande FPP in die akute sorg omgewing verhinder, te identifiseer. Daar word erken dat die FPP nog in die ontwikkelingstadium is en dat daar dus geleenthede vir beter pasiëntveiligheidsuitkomstes is, veral deur die aantal valvoorvalle en die erns van beserings as gevolg van val te verminder. Literatuurstudies deur Gowdy en Godfrey (2003:365) en Hathaway, Walsh, Lacey en Saenger (2001:172) stel voor dat die suksesvolste benadering tot die vermindering van val en die erns van die gevolglike beserings onder pasiënte in ’n akute sorg omgewing ’n veelvuldig gefasetteerde, multidissiplinêre benadering behels. Verpleërs, wat die primêre verantwoordelikheid vir die voltooiing van die aanvanklike assessering van die risiko vir val het, het daarop gewys dat hulle oorweldig voel deur bykomende veiligheidstandaarde wat vir die JCIA vereis word. Pasiënte met ’n hoë risiko vir val is nie na die geneeshere en fisiese terapeute verwys nie, en ook nie na die kliniese aptekers vir die beoordeling van hoë-risiko medikasie nie. Assessering van die risiko vir val is soms ook nie in die middag en tydens die nagskof gedoen nie. Die bestaande program het ook nie bedlêende, langtermyn pasiënte wat minder gereelde assessering benodig, oorweeg nie. Daar is verder ook waargeneem dat die bestaande FPP nie korrek geïmplementeer word nie. Die doel van hierdie studie was om die faktore te beskryf wat die suksesvolle implementering van die bestaande FPP verhoed. Die doelwitte was om areas wat suksesvol geïmplementeer word, te identifiseer, sowel as hindernisse tot suksesvolle implementering en aspekte van die bestaande FPP wat hersiening benodig. ’n Kwantitatiewe beskrywende benadering is gebruik. Die populasie was gesondheidsorgverskaffers, insluitend beide geregistreerde en praktiese verpleërs, geneeshere, fisiese terapeute en aptekers wat in ’n akute sorg omgewing in die Verenigde Arabiese Emirate werk. Daar war 118 (86%) respondente uit ’n gestratifiseerde steekproef van n = 137 (20%) uit 684 gesondheidsorgverskaffers. ’n Spesiaal ontwikkelde, gestruktureerde vraelys is vir dataversameling gebruik. Betroubaarheid en geldigheid is verseker deur die gebruik van kundiges in vraelysontwerp en statistiese raadgewing, sowel as die vooraftoetsing van die vraelys. Etiese goedkeuring is van die Universiteit Stellenbosch se Komitee vir Menslike Navorsing, en die Etiekkomitee van die hospitaal waar die studie onderneem is, verkry. Die voltooiing van die vraelys deur die respondente het gedien as vrywillige toestemming om deel te neem. Die data is geanaliseer en in frekwensietabelle voorgesit. Die gemiddelde en standaardafwyking is vir die statistiese analises gebruik. Korrelasie-analises is as gevolg van die beskrywende benadering nie onderneem nie. Daar is besluit dat die mees praktiese benadering sou wees om op die professionele groeperinge te fokus en nie op die veranderlikes nie, aangesien die aanvanklike analise swak korrelasies aangedui het. Die resultate identifiseer daardie aspekte van die FPP wat die suksesvolste geïmplementeer is, sowel as dié gebiede wat verbetering benodig om aan die JCIA-vereistes te voldoen. Faktore wat sal bydra tot die groter sukses van die FPP is beleidshersiening wat ’n duidelik bepaalde verwysingsproses vir hoë-risiko pasiënte insluit, sowel as konsekwentheid in die omgewingsveiligheidsrondtes, en meer betrokkenheid en ondersteuning deur die eenheidsbestuurders/toesighouers Die waarmerk van ’n suksesvolle FPP is personeelopvoeding, wat die belangrikste stap in die aanspreek van die geïdentifiseerde hindernisse moet wees. Die menslike behoefte aan veiligheid en die pasiënt se reg op veilige sorg en ’n veilige omgewing moet in personeeloriëntering, personeelopvoeding- en veiligheidsopleidingsprogramme vir alle gesondheidsorgverskaffers ingesluit word. Verhoogde nakoming sou moontlik plaasvind indien gesondheidsorgverskaffers meer bewus was van die hospitaal se verbintenis tot die pasiënt se reg op veiligheid. Nakoming van JCIA-standaarde en die FPP sal bydra tot die verkryging van die akkreditasie.

The diploma thesis deals with risk behavior of pupils of SOŠ and SOU Kralupy nad Vltavou. The aim of this work is primarily to find out what risk behavior is actually occurring at SOŠ and SOU Kralupy nad Vltavou, whether pupils themselves are aware of how the school attempts to prevent the occurrence of this undesirable behavior, and what is used to eliminate the risk behavior of pupils. It reveals how risk behaviors are treated in the school's basic documents and how this behavior is being prevented. It deals with the functioning of the school counseling center and the work of class teachers. Methods used for this work are document study, focus group and interviews. Observation is an additional method. Research shows that the most common risk behaviors are truancy, substance abuse, bullying and cyberbullying, aggression in the form of vandalism and vulgarism. Based on the study of school documents, it recommends possible ways of making the work of the school counseling center more effective, primary and secondary prevention at school, class teacher's work, and class lessons. The conclusion of the thesis is to recommend the school how to promote the elimination of pupils' risk behaviors. Key words: Risk behaviour, school methodologies of prevention, educational consultant, form teacher, minimum...