Abstract: Introduction: To explore the information seeking behavior of Internationally Educated Nurses (IENs) and to investigate their exposure to libraries and library training in both their home countries and after being hired in Saskatchewan. Methods: This two-phase multi-method project was carried out in Saskatchewan, Canada. A questionnaire was developed based on survey instruments used in previously conducted studies on the topic. Librarians in two academic institutions assisted with validation of the survey. In Phase 1, data were collected via an online questionnaire from IENs in three health regions: Saskatoon, Regina, and Sunrise. In Phase 2, the study was expanded to IENs in all the health regions in the province. The same questionnaire from Phase 1 was used during telephone interviews with participants. Results: A total of 17 IENs responded (Phase 1, n = 9, Phase 2, n = 8). Results show that IENs, although interested in looking for information for their practice, are hindered by a lack of knowledge of how and where to seek relevant clinical information as well as a lack of library training. As a result, their main source of information is the Internet (Google). Discusion: Despite barriers such as time to information seeking, results revealed that given the opportunity IENs would like to receive library training to enhance their information seeking skills.

Pulmonary Tuberculosis (TB) is a significant cause of morbidity in Uganda. TB control in the Ugandan district of Butaleja remains poor, characterised by TB case detection and cure rates below national targets. A qualitative exploratory and descriptive study was conducted to identify factors associated with health-seeking behaviour of TB patients in Butaleja district; with an aim to present recommendations for promoting positive health-seeking behaviour amongst the patients. Data was collected through individual in-depth interviews with seven diagnosed TB patients and analysed using Creswell’s (2009:186) analytic spiral steps. The findings revealed three major themes, namely; the nature of health-seeking behaviour, factors associated with the health-seeking behaviour and advice to others experiencing similar symptoms. The health-seeking behaviour of participants was generally poor, characterised by delay in seeking proper medical treatment for TB. Health system, individual and social factors contributed to poor health-seeking behaviour among the participants. The study recommends health system and community interventions targeted at individuals to improve health-seeking behaviour for Pulmonary TB / Health Studies / M.A. (Public Health)

Magister Public Health - MPH / Background: Globally, neonatal mortality (i.e. deaths occurring during the first month of life) accounts for 44% of the 11 million infants that die every year (Lawn, Cousens Zupan, 2005). Early detection of illness and referral of mothers and infants during the peri-natal period to higher levels of care can lead to substantial reductions in maternal and child mortality in developing countries. Establishing effective referral systems from the community to health facilities can be achieved through greater utilization of community health workers and improved health seeking behaviour. Study design: The Good Start Saving Newborn Lives study being conducted in Umlazi, KwaZulu-Natal, is a community randomized trial to assess the effect of an integrated home visit package delivered to mothers during pregnancy and post delivery on uptake of PMTCT interventions and appropriate newborn care practices. The home visit package is delivered by community health workers in fifteen intervention clusters. Control clusters receive routine health facility antenatal and postpartum care. For any identified danger signs during a home visit, community health workers write a referral and if necessary refer infants to a local clinic or hospital. The aim of this study was to assess the effectiveness of this referral system by describing community health worker referral completion rates as well as health-care seeking practices and perceptions of mothers. A cross- sectional survey was undertaken using a structured questionnaire with all mothers who had been referred to a clinic or hospital by a community health worker since the start of the Good Start Saving Newborn Lives Trial. Data collection: Informed consent was obtained from willing participants. Interviews were conducted by a trained research assistant in the mothers home or at the study offices. Road to Health Cards were reviewed to confirm referral completion. Data was collected by means of a cell phone (mobile researcher software) and the database was later transferred to Epi-info and STATA IC 11 for analysis. Descriptive analysis was conducted so as to establish associations between explanatory factors and referral completion and to describe referral processes experienced by caregivers. Significant associations between categorical variables were assessed using chi square tests and continuous variables using analysis of variance. Results: A total of 2423 women were enrolled in the SNL study and 148 had received a referral for a sick infant by a CHW by June 2010. The majority (95%) of infants were referred only once during the time of enrolment, the highest number of which occurred within the first 4 weeks of life (62%) with 22% of these being between birth and 2 weeks of age. Almost all mothers (95%) completed the referral by taking their child to a health facility. Difficulty in breathing and rash accounted for the highest number of referrals (26% and 19% respectively). None of the six mothers who did not complete referral recognised any danger signs in their infants. In only 16% of cases did a health worker give written feedback on the outcome of the referral to the referring CHW. Conclusion: This study found high compliance with referrals for sick infants by community health workers in Umlazi. This supports the current primary health care re-engineering process being undertaken by the South African National Department of Health (SANDOH) which will involve the establishment of family health worker teams including community health workers. A key function of these workers will be to conduct antenatal and postnatal visits to women in their homes and to identify and refer ill children. Failure of mothers to identify danger signs in the infant was associated with non-completion of referral. This highlights the need for thorough counseling of mothers during the antenatal and early postnatal period on neonatal danger signs which can be reinforced by community health workers. Most of the referrals in this study were neonates which strengthens the need for home visit packages delivered by community health workers during the antenatal and post-natal period as currently planned by the South African National Department of Health.Recommendations: This study supports the current plans of the Department of Health for greater involvement of CHWs in Primary Health Care. Attention should be given to improving communication between health facilities and CHWs to ensure continuity of care and greater realization of a team approach to PHC. / South Africa

Problématique : Dans les pays africains où les soins de santé sont encore payants au point de service, la barrière financière est un des obstacles majeurs au recours aux soins. Les indigents, qui sont les plus démunis, en sont les plus affectés. Pour faire face à ce défi, certains pays ont entrepris l’élaboration de programmes de santé ciblant les indigents pour leur permettre d’avoir un meilleur recours aux soins de santé par l’intermédiaire d’une exemption du paiement. Mais il existe un réel défi à identifier les indigents. De plus, peu d’études ont évalué l’impact de programmes d’exemption du paiement sur leur recours aux soins. Les indigents sont en majorité des personnes âgées avec des besoins importants en santé. Les personnes âgées en Afrique consultent très peu les professionnels de santé et les déterminants de leur recours aux soins sont peu connus. Pourtant, leur proportion est en augmentation dans les pays à faibles et moyens revenus. Ils sont en perte d’autonomie, ont de faibles revenus et présentent une prévalence élevée de maladies chroniques et d’incapacités fonctionnelles. Ces affections surviennent de façon précoce surtout chez les femmes. Objectifs : Cette thèse a pour objectifs : i) de déterminer le caractère équitable d’un processus de sélection communautaire des indigents au Burkina Faso qui vise à les faire bénéficier d’une exemption du paiement des soins; ii) de mesurer l’impact de ce programme d’exemption sur le recours aux soins de santé des indigents ; iii) d’analyser les facteurs associés au recours aux soins de santé par les personnes âgées au Nigéria. Méthode : Le cadre conceptuel de cette étude est le modèle d’Andersen et Newman qui regroupe les déterminants de l’utilisation des soins de santé en facteurs prédisposants (âge, sexe, état matrimonial, occupation), en facteurs facilitants (revenu, existence d’un recours à une aide financière, alimentaire ou instrumentale, cohabitation) et en besoins (présence de maladies chroniques et de limites de la vision, de la force musculaire et de la mobilité). Dans un premier temps, pour déterminer le caractère équitable d’une sélection communautaire des indigents, nous avons réalisé une étude transversale en 2010 dans le district de Ouargaye au Burkina Faso. Au cours de cette enquête, 1687 indigents ont été interrogés. La variable dépendante est la possession de la carte d’exemption du paiement des soins. Des analyses bivariées et une régression logistique ont été réalisées. Dans un deuxième temps, à partir d’un devis quasi expérimental pré/post, nous avons évalué les effets de ce programme d’exemption du paiement des soins sur le recours aux soins de santé des personnes en situation d’indigence au Burkina Faso. Au cours de cette recherche, 1224 indigents ont été interrogés en 2010 sur leur recours aux soins de santé. Parmi eux, 540 ont été sélectionnés et ont reçu une carte d’exemption du paiement des soins. Un an plus tard, un suivi a été réalisé avec un taux de rétention de 55,3%. Des analyses bivariées et une régression logistique ont été réalisées. Dans un troisième temps, à partir des données d’une étude transversale nationale, le General Household Survey de 2012-2013 du Nigéria qui couvre toutes les régions du pays, nous avons étudié le recours aux soins de 3587 personnes âgées dont 850 ont déclaré avoir été malades. Nous avons tenté d’identifier les facteurs qui y sont associés. Des analyses pondérées bivariées et une regression de Poisson pondérée ont été effectuées. Résultats : Au Burkina Faso, l’exemption du paiement des soins a été accordée en majorité aux veufs (ves) (OR=1,40 IC 95% [1,10-1,78]), à ceux qui ne bénéficient pas d’aide financière de leur ménage pour recourir aux soins de santé (OR=1,58 IC 95% [1,26-1,97], qui vivent seuls (OR=1,28 IC 95% [1,01-1,63]), qui vivent avec leurs époux/se (OR=2,00 IC 95% [1,35-2,96], qui ont des troubles de la vision (OR=1,45 IC 95% [1,14-1,84]), qui ont une faible force musculaire et une bonne mobilité (OR=1,73 IC 95% [1,28-2,33]). Le processus de sélection communautaire des indigents n’est pas parfaitement équitable, car très restrictif, bien qu’il ait permis de sélectionner les plus démunis. Il existe des différences de genre concernant les déterminants du recours aux soins chez les indigents. Être veufs (OR=0,53 IC 95% [0,33-0,81]) et avoir des troubles de la vision (OR=0,42 IC 95% [0,28-0,63]) freinent le recours aux soins chez les hommes, mais pas chez les femmes. Les maladies chroniques demeurent un obstacle commun aux hommes (OR=4,05 IC 95% [2,84-5,77]) et aux femmes (OR=2,14 IC 95% [1,54 – 2,97]). Le fait d’être exempté du paiement des soins n’est pas associé à l’augmentation de l’utilisation des services de santé (OR=1,1 IC 95% [0,80-1,51]). Qu’ils aient bénéficié ou pas de l’exemption du paiement des soins, les indigents qui ont un âge supérieur à 69 ans (OR=1,66 IC 95% [1,05-2,64]), qui appartiennent au genre masculin (OR=1,44 IC 95% [0,99-2,08]), qui appartiennent à un ménage à faible revenu (OR=1,71 IC 95% [1,15-2,54]) et ceux qui ont recours à l’aide financière familiale pour accéder aux soins de santé (OR=1,59 IC 95% [1,1-2,28]), sont les plus susceptibles d’augmenter leur utilisation des soins de santé. Au Nigéria, seulement 53% des personnes âgées ont consulté un agent de santé suite à un épisode de maladie. L’absence de scolarisation (PR = 0.73, 95% CI [0.6 0–0.8]), la faiblesse du revenu de ménage (PR = 0.75, 95% CI [0.5–0.9]), et le fait de résider dans les zones du Sud-Sud (PR = 0.59 95% CI [0.4–0.7]) et du Sud-Ouest (PR = 0.60 95% CI [0.4–0.7]), constituent des freins à la consultation d’un agent de santé. Conclusion La sélection communautaire est une des méthodes qui semble avoir permis de sélectionner les indigents avec une prévalence élevée de besoins en santé et d’obstacles économiques au recours aux soins. Cependant, l’exemption du paiement des soins n’est pas suffisante pour améliorer leur recours aux soins. Les déterminants de leur recours aux soins différent selon le genre, mais les maladies chroniques constituent un motif commun. Les personnes âgées et les indigents ont des caractéristiques communes telles que l’âge avancé, mais certains facteurs qui déterminent leurs recours aux soins diffèrent. Le déterminant commun est le facteur financier, soit la capacité contributive de ces personnes dans un contexte où l’utilisateur des services de santé est le payeur. En attendant la couverture universelle de soins, il serait approprié que les interventions pour améliorer le recours aux soins ciblent en premier lieu les populations ayant des besoins importants telles que les indigents et les personnes âgées en ôtant la barrière financière. Pour les indigents par contre, il faudrait y ajouter des mesures additionnelles comme, par exemple l’accompagnement, le transport et les frais d’hébergement. Enfin, les interventions doivent aussi considérer les différences de genre qui existent dans les facteurs qui déterminent leur recours aux soins. / Problem In African countries with point-of-service healthcare user fees, financial barriers are one of the major obstacles to healthcare-seeking behaviour, and the indigent, the poorest members of society, are the most affected. To address this issue, some countries have begun developing health programs targeting indigent people to help them gain better access to healthcare by waiving healthcare fees. Unfortunately, it is a genuine challenge to identify those who are indigent. In addition, few studies have assessed the impact of user fees exemption programs on healthcare-seeking behaviour. The majority of indigent people are older with significant health needs. Older people in Africa do not often consult health professionals. The determinants regarding healthcare-seeking behaviour by older people is little-known, although proportionately, their numbers are increasing in low- and middle- income countries. They are losing their autonomy, have little income and have a high prevalence of chronic diseases and functional disabilities. These problems occur early on, especially among women. Objectives The objectives of this thesis are as follows: (i) to determine the equitable nature of a community-based selection process for indigent people in Burkina Faso that aims to exempt them from paying healthcare user fees; (ii) to measure the impact of this user fees exemption program on healthcare-seeking behaviour among indigent people; (iii) to analyze the factors associated with healthcare-seeking behaviour by older people in Nigeria. Method The conceptual framework of this study is based on the model developed by Andersen and Newman, which groups healthcare use determinants into predisposing factors (age, gender, marital status, occupation), enabling factors (income, means and know-how to access financial, food or instrumental assistance, social relationships), and needs (presence of chronic disease and vision, muscle strength and mobility limitations). To determine the equitable nature of a community-based selection of indigent people, we carried out a cross-sectional study in 2010 in the Ouargaye District of Burkina Faso, in which 1687 indigent people were interviewed. The dependent variable was possession of an exemption card. Bivariate analyses and logistic regression were performed. Next, using a quasi-experimental before/after approach, we assessed the effects of this user fees exemption program on healthcare-seeking behaviour by indigent people in Burkina Faso. To that end, 1224 indigent people were interviewed in 2010 about their healthcare-seeking behaviour. Among them, 540 were selected and received an exemption card. One year later, a follow-up was conducted, with a 55.3% retention rate. Bivariate analyses and logistic regression were performed. Finally, using data from a national cross-sectional study, the Nigerian 2012–2013 General Household Survey, which covers all the country’s regions, we studied healthcare-seeking behaviour by 3587 older people, of whom 850 stated that they were ill. We attempted to identify the associated factors. Weighted bivariate analyses and a weighted Poisson regression were performed. Results In Burkina Faso, healthcare payment waivers were mainly granted to widows or widowers (OR=1.40 IC 95% [1.10–1.78]), to those who do not receive financial support from their household for healthcare (OR=1.58 IC 95% [1.26–1.97], or those who live alone (OR=1.28 IC 95% [1.01–1.63]), or with their spouse (OR=2.00 IC 95% [1.35-2.96], who have vision impairment (OR=1.45 IC 95% [1.14–1.84]), who have limited muscle strength and good mobility (OR=1.73 IC 95% [1.28–2.33]). The community-based selection process of indigent people is not completely equitable, although it did enable the most needy to be selected. There are gender differences concerning healthcare-seeking behaviour determinants among indigent people. Being a widower (OR=0.53 IC 95% [0.33–0.81]), and having vision impairment (OR=0.42 IC 95% [0.28–0.63]) were factors limiting healthcare-seeking behaviour among men but not among women. Chronic diseases remain a common obstacle among men (OR=4.05 IC 95% [2.84–5.77]) and women (OR=2.14 IC 95% [1.54–2.97]). User fees exemption is not associated with an increased use of healthcare services (OR=1.1 IC 95% [0.80–1.51]). Whether they received or did not receive exemption cards, indigent people over the age of 69 (OR=1.66 IC 95% [1.05–2.64]), who were male (OR=1.44 IC 95% [0.99–2.08]), who belong to a low-income household (OR=1.71 IC 95% [1.15–2.54]), and those who had financial assistance from family to access healthcare (OR=1.59 IC 95% [1.1–2.28]), are more likely to increase their use of healthcare. In Nigeria, only 53% of older people consulted a health practitioner after an episode of illness. Lack of education (PR = 0.73, 95% CI [0.60–0.8]), low household income (PR = 0.75, 95% CI [0.5–0.9]), and residence in Nigeria’s South South (PR = 0.59 95% CI [0.4–0.7]) and South West zones (PR = 0.60 95% CI [0.4–0.7]) constituted limitations to consulting a health practitioner. Conclusion Community-based selection is one method that appears to have made it possible to select indigent people with a high prevalence of health needs and obstacles to seeking healthcare. Healthcare payment waivers are not sufficient to increase their healthcare-seeking behaviour. Healthcare use determinants differ according to gender, but chronic disease constitutes a common theme. Elderly and indigent people have common characteristics, such as advanced age, but some factors that determine their healthcare-seeking behaviour differ. The common determinant is the financial factor, i.e., the contributory capacity of these people in a context where the user pays. Until there is universal healthcare coverage, it would be appropriate to ensure that activities to improve healthcare-seeking behaviour primarily target populations with significant needs, such as indigent and elderly people, by removing financial barriers. For indigent people, however, additional measures must be included, such as accompaniment, transportation and accommodation expenses. And activities must also take existing gender differences into account among the factors determining their healthcare-seeking behaviour.

Humans and dogs have been living close for over 15,000 years, resulting in a unique relationship. The dog-owner relationship can affect stress, and could be affected by contact-seeking behaviour, personalities, and behavioural synchronization. Due to Covid-19, an increase in registered dogs could be observed. This could lead to more dogs being rehomed once the restrictions are eased and people go back to their workplaces, hence the importance of more knowledge concerning rehomed dogs and their behaviour, stress, and the relationship to its new owner. Thirty rehomed dogs (26 owners) and 31 control dogs (28 owners) participated. Dogs and their owners were tested in an unsolvable problem task to observe contact-seeking behaviour, and a behavioural synchronization test was conducted. Afterwards, dogs were equipped with activity collars to measure physical activity and dog-hair was collected to assess long-term stress. In addition, owners completed three questionnaires to assess the dog-owner relationship, and the personalities of the dogs and their owners. The results revealed no significant differences in behavioural synchronization, contact-seeking behaviour, stress, physical activity, or the dog-owner relationship between rehomed and control dogs. However, owners owning a rehomed dog potentially scored higher on the personality trait “agreeableness”, and rehomed dogs were potentially scored as more fearful of handling and less playful than control dogs. In conclusion, there is potentially a difference in personality traits in both dogs and owners between the groups, however, rehomed dogs are similar to control dogs in terms of behavioural synchronization, contact-seeking behaviour, long-term stress, and the dog-owner relationship.

The study aimed to examine high school student usage of licensed databases available through public libraries in Atlanta-USA. A descriptive quantitative survey was conducted via a web-based questionnaire among 135 East Cobb high school students. The findings revealed that most students are aware of these licensed databases, but their usage is low (1:10) compared to Google. However, as students advance in grade levels, their database usage increases and GALILEO is the most-used licensed resource. Factors that influence student database usage include: specific academic needs; teacher instruction to use specific databases and frequent Digital Information Literacy (DIL) instruction. Most students receive DIL instruction at school, but their DIL skills are still inadequate. To increase usage of licensed databases as reliable information resources, the study recommends collaboration between public libraries and high schools, including incorporation of Generation Y's digital information preferences such as Google-type simplified interfaces, cutting-edge technology and time-saving search features. / Information Science / M.A. (Information Science)

The aim of this study was to describe mothers’ knowledge, attitudes and practices regarding malaria in children under five years old. A descriptive cross-sectional study design was used. A structured questionnaire was administered by face-to-face interviews during data collection. The study population of this research composed of mothers of children under five years old suffering from malaria in Thyolo district. Economic-demographic characteristics that were significantly associated with mothers’ knowledge were age (p=0.018), formal education (p=0.001), income (p=0.005), and type of a house (p=0.002). Sources of malaria information that were significantly associated with mothers’ knowledge included television (p=0.004), radio (p=o.005), and posters (p=o.00019). Treatment-seeking behaviour was significantly associated with education (p=0.017). Treatment prior to hospitalisation was significantly associated with mothers’ education (p=0.0001), number of children that passed away (p=0.015), distance to the health facility (p=0.013), lack of money (p=0.019), and time taken at the hospital to get treatment (p=0.016). Recommendations were made to improve mothers’ malaria knowledge for further research / Health Studies / M.A. (Public Health)

This study is focused on the dopamine D2 receptor and the linkage between TaqIA and - 141C Ins/Del polymorphisms in DRD2 gene and novelty seeking behaviour, as well as the linkage between Val158Met polymorphism in COMT gene and novelty seeking behaviour. Novelty seeking behaviour is characterized as a personality trait with a tendency to look for novel stimulation and extravagances at any cost of legal, physical and social risk to reward cues. DRD2 and COMT genes are associated with the function of dopamine, which is essential for motoric function and reward-motivated behaviour. Therefore, the aim of this study is to ascertain the potential linkage among the three studied polymorphisms and novelty seeking behaviour.

La question du contexte occupe une place centrale dans l’observation et l'étude de tout phénomène. Associée à la recherche d’information, la notion de contexte est de plus en plus mobilisée dans les domaines des sciences de l’information, de l’ingénierie des connaissances, des sciences cognitives et de l’informatique. En effet, le sens d'une expression linguistique, la lecture d’un document la stratégie mise en œuvre dans l’activité de recherche d’information, le raisonnement adopté dans l’opération de classement d’un document, le choix d’avoir recours à tel dispositif, varient fortement d'un contexte à l'autre. Mais que faut-il entendre exactement par contexte ? Comment le définir ? Le contexte est-il assimilable à la notion de situation ? À la notion d'usage ? Voici quelques-unes des questions qui sont traitées dans ce travail, qui cherche à appréhender l’environnement informationnel d’un groupe professionnel donné : les ingénieurs-chercheurs d’une équipe d’EDF-R&D. Pour ce faire, nous cherchons à cartographier cet environnement, à le comprendre, en interrogeant notamment la construction du sens en contexte. Notre contribution cherche ainsi à éclairer l’environnement informationnel de ce groupe d’acteurs et propose quelques axes de réflexion pour accompagner la construction d’une démarche instrumentée de gestion de l’information en entreprise. Ce travail associe différents acteurs (chercheurs et ingénieurs) et participe à un projet de recherche appliquée (ANR MIIPA-Doc). Il accompagne ainsi la conception d’une solution logicielle qui explore l’approche de la classification et de la navigation par facettes, et s’inscrit dans la mouvance des outils collaboratifs, dont le principe consiste à impliquer l’acteur dans les opérations de classification et de "marquage" des documents qu’il produit, manipule et classe dans le cadre de ses activités professionnelles. / Assuming that workplace significantly affects information seeking and information management patterns,this study explores accessibility and management of information sources among a group of research engineers.The study explores how these engineers, who belong to the R&D entity of a major energy group,require, search and manage information sources in given professional contexts. Furthermore, it strives toidentify the contextual factors that shape information practices. This empirical study is based on a qualitativeapproach: following exploratory inquiries, semi-structured interviews and observations were conducted witha small group of actors in their proper workplace. Our integration within the team facilitated the participantobservation stance. The study provides an analytic cartography of the various components of the organizationaland informational environments whereby the activities and tasks of the above mentioned actors takeplace. A wide range of practices has been identified via interviews but also through the activities and workrhythms observed. An appreciative framework has been developed to analyze the practices of access to informationproduced and used in professional contexts; it underlines the contextual factors that may becomedriving dimensions to support an innovative perspective on information management structures. The studyattempts to provide an innovative approach for the analysis of information practices in contexts, orientedtoward the design of a facetted and collaborative information management system.

The study aimed to examine high school student usage of licensed databases available through public libraries in Atlanta-USA. A descriptive quantitative survey was conducted via a web-based questionnaire among 135 East Cobb high school students. The findings revealed that most students are aware of these licensed databases, but their usage is low (1:10) compared to Google. However, as students advance in grade levels, their database usage increases and GALILEO is the most-used licensed resource. Factors that influence student database usage include: specific academic needs; teacher instruction to use specific databases and frequent Digital Information Literacy (DIL) instruction. Most students receive DIL instruction at school, but their DIL skills are still inadequate. To increase usage of licensed databases as reliable information resources, the study recommends collaboration between public libraries and high schools, including incorporation of Generation Y's digital information preferences such as Google-type simplified interfaces, cutting-edge technology and time-saving search features. / Information Science / M.A. (Information Science)