Background: Compliance with CPAP treatment for OSA is not reliably predicted by the severity of symptoms or physiological variables. I conducted a series of studies to examine a range of factors that may affect compliance with CPAP. Methods: I performed a retrospective study examining association of demographic factors and OSA severity with long-term CPAP compliance. In a prospective study, I looked at the correlation of short and long-term CPAP compliance with socio-economic status, education, type D personality, demographics, disease severity, mood and clinician's prediction. I undertook a prospective, cross-over trial comparing the impact of Bi-level PAP therapy in individuals with low tolerance of CPAP. Results: In a retrospective analysis, an improvement in subjective daytime somnolence was correlated with optimal compliance. In the prospective study, median compliance with CPAP at 6 months was 5.6 (3.4- 7.1) hours/night with 73% of subjects using CPAP ≥ 4 hours/night. Compliance with CPAP was not found to be associated with socio-economic class for people in work, type D personality, education, sex, age, baseline sleepiness (ESS score) or disease severity (ODI). The clinician's initial impression had no predictive value for individual patients. Subjects who were long-term unemployed or reporting mood disorders (High Beck's Depression Index scores) were likely to have poor compliance and sub-optimal CPAP usage (OR 4.6, p = 0.011 and OR 1.4. p=0.04 respectively). Subjects experiencing side effects after the first night on treatment showed lower acceptance and subsequent compliance. In the cross-over trial, changing to Bi-level PAP in individuals with suboptimal compliance due to pressure related intolerance, did not lead to an improvement in CPAP compliance. In post-hoc analysis, compliance and comfort were better in the subgroup that complained of difficulty with exhalation on CPAP. Conclusion: My research as presented in this thesis, did not find an association between disease severity (ODI), socio-economic status (for people in employment), education or personality type and CPAP compliance. My research demonstrated that subjects with long-term unemployment, mood disorders and those experiencing side effects on the first night of treatment were likely to have sub-optimal compliance. Changing to Bi-level PAP is only likely to be useful for a sub-group of subjects experiencing pressure related intolerance. More research is needed to explore whether intensive support to individuals with OSA and long term unemployment, as well as mood disorders, may improve compliance.

Magister Chirurgiae Dentium - MChD / Oral ulcers and oral thrush could be indicative of serious illnesses such as oral cancer, HIV and other sexually transmitted infections (STIs), among others. There are many different health care workers that can be approached for advice and/or treatment for oral ulcers and oral thrush (sometimes referred to as mouth sores by patients), including pharmacists. In fact, the mild and intermittent nature of oral ulcers and oral thrush may most likely lead the patient to present to a pharmacist for immediate treatment. In addition, certain aspects of access are exempt at a pharmacy such as long queues and waiting times, the need to make an appointment and the cost for consultation. Thus pharmacies may serve as a reservoir of undetected cases of oral cancer, HIV and other STIs. Aim: To determine how community pharmacists in the Western Cape manage oral ulcers and oral thrush. Objectives: The data set included the prevalence of oral complaints confronted by pharmacists, how they manage oral ulcers, oral thrush and mouth sores, their knowledge about these conditions, and the influence of socio-economic status (SES) and metropolitan location (metro or non-metro) on recognition and management of the lesions. Method: A cross-sectional survey of community pharmacists in the Western Cape was conducted. A random sample of pharmacies was stratified by SES (high and low), and metropolitan location. A structured questionnaire was used to conduct a telephonic interview. The questionnaire was faxed to pharmacists 24 hours prior to the interview. Pharmacists were also telephoned 24 hours prior to the interview, but after the questionnaire was faxed, in order to gain informed consent for participation in the study, and to confirm a convenient time to conduct the interview. Results: Two thirds (63%) of pharmacists managed oral problems nearly everyday, and 30% managed these more than once a week. More pharmacists in high SES (73%) areas managed oral problems nearly everyday (Fisher Exact, p=0.0005). Just over half (56%) and 49.2% of pharmacists said that ulcers and thrush, respectively, was the most common oral problem that they encounter. The prevalence of oral thrush was significantly higher in non-metro areas (58%) (RR=0.7 (0.5-1.0) ChiSquared=4.0, p=0.04), and it was also significantly lower in low SES areas (RR=1.6 (1.1-2.4), Chi Squared=6.5, p=0.01). Half the pharmacists reported that they would manage the patient comprehensively. Most would take a history but the quality of the history is poor, thereby compromising their ability to manage these cases appropriately. Only a third would refer a simple oral ulcer, thrush or mouth sore to a doctor/dentist but all pharmacists would have referred a longstanding ulcer to a doctor/dentist. In terms of knowledge, only 33% of pharmacists were aware that oral ulcers and thrush could be indicative of HIV infection, and only 8% linked oral ulcers with oral cancer. There was no discernable pattern of management of oral ulcers and thrush, or of knowledge of the link between these lesions with underlying diseases, by SES and metropolitan locations (Chi Squared, Fisher Exact, p>0.05). Conclusion: The result of this study strengthens the current view of pharmacists as oral health advisors as they encounter oral problems regularly, most commonly oral ulcers and oral thrush. Therefore, the pharmacist can play an important role in the early detection of HIV and oral cancer. However many pharmacists fail to refer these cases to a dentist. Most pharmacists lacked specific knowledge about the relationship of oral ulcers and thrush with underlying conditions, which may explain why many pharmacists are not managing these cases correctly. There is a definite need to train pharmacists at both an under- and post-graduate level with specific emphasis on the proper management of oral ulcers, oral thrush and mouth sores, as well as comprehensive training that outlines why vigilant management of oral ulcers and oral thrush is necessary. / South Africa

Thesis (Ph.D.(Curriculum Studies)) -- University of Limpopo, 2020 / Community education has driven change in societies for time immemorial. The successes of educational services in influencing socio-economic issues in societies across the globe are captured through empirical studies. There are community education services conducted in the Gravelotte community, but they seem not to address socio-economic needs. The level of illiteracy and joblessness is not abated. The purpose of the study was to investigate the extent to which community education services in the Gravelotte community influences socio-economic issues. Qualitative study approach was employed in the study to investigate the subject. The research paradigm engaged was Interpretive within a case study. I used three methods to collect data which were in-depth individual interviews, document analysis and participant observation. Ten participants were interviewed individually using open-ended interview guides. Minutes, journals and related documents were analysed for data triangulation. I participated and observed public meetings and stakeholders’ gatherings within the area under study. The study was conducted in the small semi-urban area of Gravelotte community in Ba-Phalaborwa municipality with a population of about 500 residents of mixed races. The sampling was done purposively as the participants were requested to respond to a matter relative within the community. The generated data was thematically analysed. I interpreted the data generated from informants to make conclusions on answering the main research question. The study brought forth the following findings. There is no secondary school in the Gravelotte community which is detrimental for socio economic development in the area. Community education programmes offered in Gravelotte have significant successes. Several graduates from the TVET college can find employment and some of them start their businesses. The ABET centre in Gravelotte Primary assists mine workers to earn better salaries. There is evidence of success in the education programmes provided in the Gravelotte community. However, the study discovered that the programmes were offered amidst challenges. Planning, participation and partnership were identified as obstacles to proper implementation of education programmes. The use of common planning to deal with educational goals is most required to enhance the success of educational programmes. There is an increased appreciation by the local community to participate in educational matters. Partnerships are being forged between the local community, the municipality and the mines to address the successful implementation of educational programmes. The study recommends that one primary school in the area be empowered to proceed to include a secondary school or provide education up to grade 9. Additionally, that more research is directed into the gap between provision and demand in the future such that the challenges can be extensively investigated. Likewise, that further researches be encouraged to investigate the ability of TVET colleges to collaborate with local communities with intent to find solutions on educational challenges. In conclusion, the study clearly outlines the effects that education has on the socio-economic issues within the Gravelotte community. There are diverse opinions that support each other in areas that are very important for socio-economic development

Philosophiae Doctor - PhD / The major objective of this study was to investigate the nature of the relationship between achievement motivation, autonomous and social achievement values, study habits and attitudes, locus of control and socio-economic status (SES) as independent variables on the one hand and the level of achievement as dependent variable on the other. The subjects were 548 second and third year social science students who were studying in seven different directions at the University of the Western Cape during 1990. The following measuring instruments were used in the investigation: The Ray-Lynn (1980) Achievement Orientation questionnaire; Strumpfer's (1975) questionnaire for the measuring of autonomous and social achievement values; Rotter's (1966) internal/external locus of control scale, as adapted by Collins (1974); The study habits and attitudes subscales of the Brown and Holtzman (1955) Survey of Study Habits and Attitudes (SSHA) questionnaire, as adapted for South African conditions; A brief biographical questionnaire The achievement criterion consisted of the average achievement point, which is constituted of a proportion of achievement obtained in continuous evaluation, and a proportion of achievement obtained in the final examination. The following findings were made: Achievement motivation plays a much smaller role in achievement than can be expected and its influence is gender specific. It explains only about 5% of the variance in the achievement of males, and non in the case of females. Academically successful and unsuccessful students could also not be distinguished from each other in terms of level of achievement motivation. The measuring instrument for achievement motivation, although valid and reliable, probably does not succeed in measuring aspects of achievement motivation which are related to a specific situation such as the academic. While social achievement value is not related to achievement, autonomous achievement value explains 4,8% of the variance in achievement of males but none in the case of females. Successful and unsuccessful students also do not differ from each other with regard to their achievement value orientation. Study habit and attitude do not differ in their ability to predict the achievement criterion and explain 4,1% and 5,3% of the variance in achievement of males respectively, but none in the case of females. Successful and unsuccessful students can be distinguished in terms of their study habits and attitudes. Socio-economic status has a differential influence on achievement. While higher SES females achieve at a higher level than low SES females, males do not differ in this regard. The subjects are predominantly internally orientated as far as locus of control characteristic is concerned. Although internal individuals display more "positive" characteristics compared to external individuals, the two groups do not, however, differ as far as level of achievement is concerned, irrespective of gender or socio-economic status. African students have a more positive attitude towards study compared to English and Afrikaans speaking, as well as bilingual (English and Afrikaans speaking) students. Females in this study are generally more homogenous than males. It is recommended that: The suitability of the average achievement point as a criterion of achievement be studied; A broad investigation be launched into practices and problems which might centre around the system of continuous evaluation at uwc, with specific reference to possible problems that students, lecturers and big departments may experience; The nature of differences which might exist between higher and low SES female, and low SES female and low SES male students be investigated; The nature of debilitating factors which affect the achievement of low SES female students be investigated; The tendency towards greater homogeneity among female influence thereof on university study; The adjustment of African students at uwc be studied with the objective of identifying factors that obstruct their academic progress

<p> The conflict between native people and resource development in the Canadian north is considered within the framework of a colonial model of development. It is hypothesized that the origins of contemporary land use conflicts in the north can be attributed to the colonization of native people, and that the growing discontent among native people can be viewed as a response to the perpetuation of their colonial status. </p> <p> Two phases in the historical relationship between native people and the Canadian government, traditional colonialism and nee-colonialism, are defined and the impacts of these forms of colonialism upon native people, and their role in the future development of the north, are examinedo Alternative native responses to colonial status are identified and each option is discussed in terms of its likelihood as a choice and the effects of that choice upon the native community. Government control over native people is identified as a major constraint on response choice. Various means of government control and their effectiveness are considered. </p> <p> Two alternatives are presented for the future control of political space in northern Canada: continuation of colonial domination or increasing control by natives. It is concluded, on the basis of recent experiences in native communities, that increasing control by natives is the only means through which the political and socio-economic status of native people will be improved. </p> / Thesis / Master of Arts (MA)

A substantial body of research has shown worse health conditions for East- vs. West-Germany in the wake of reunification. In the present study, we investigate how these differences between the two formerly divided regions developed and what maintains them. Specifically, we consider the associations between health status, income satisfaction, and health-related locus of control. In a quasi-experimental and longitudinal study design, we are particularly interested in the differences between individuals who stayed in East-Germany and those who were born in the East but migrated to West-Germany. To this end, we examined data from seven waves of the Saxony Longitudinal Study (2003–2009). Specifically, we tested a cross-lagged panel model with random effects, which evinced very good model fit. Most parameters and processes were equivalent between individuals who stayed in East-Germany vs. moved to West-Germany. Crucially, there was the expected pattern of positive correlations between health, income, and locus of control. In addition, we found substantially lower values for all three of these variables for the individuals who stayed in East-Germany (vs. moved to West-Germany). A possible explanation is the increase in socio-economic status that the internal migrants experienced. These findings present an important contribution of research in order to foster a better understanding on the social dynamics in Germany related to internal/domesticmigrants and implications in the context of health outcomes (e.g., significantly more unemployment in East vs. West-Germany), especially since almost 20–25% of East-German citizens migrated to West-Germany. Until now, there are no similar studies to the Saxony longitudinal project, since the data collection started in 1987 and almost every year an identical panel has been surveyed; which can be particularly useful for health authorities. The study mainly focuses on social science research and deals with the phenomenon of reunification, approaching several subjects such as mental and physical health, quality of life and the evaluation of the political system. Yet even though many people have experienced such a migration process, there has been little research on the subjects we approach. With our research we deepen the understanding of the health consequences of internal migration.

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Does ethnicity of the student prevent equal levels of learning at an equal pace? Are schools required to teach all children effectively, no matter what their socio-economic status, gender, or ethnicity? Educators and researchers have longed for the answers to these questions. For years, educators have been looking for ways to teach children in schools that are racially identifiable and have the highest percentages of children on free and reduced lunch. School districts that have choice as a way of assigning students are increasing the number of racially identifiable schools. In Charlotte-Mecklenburg Schools, a choice plan was implemented in June 2001. That plan created more schools of poverty within the district. The district also offered additional resources, teacher incentives, and financial assistance as a way to leverage the student make-up of the school district and the individual schools at all levels. / Ed. D.

Det finns ett kunskapsgap i mellanstadieelevers matematikprestationer mellan elever med låg socioekonomisk status och resterande elever i Sverige. Lärarens förväntningar visar sig även vara en viktig faktor när det kommer till elevers prestationer i matematik och inte minst för skolor med låg socioekonomisk status. Av den anledningen är det intressant att undersöka hur lärarens förväntningar och elevens prestation korrelerar i socioekonomiskt utsatta områden. Syftet med studien är att belysa hur lärarens förväntningar korrelerar med elevens matematikprestationer för årskurs 6, i socioekonomiskt utsatta områden i en svensk medelstor kommun. Syftet besvaras genom frågorna: hur upplever elever lärarens förväntningar i ämnet matematik och hur ser sambandet ut mellan lärarens förväntningar, elevens motivation och elevens matematikprestationer i en svensk skolkontext? Studien använder Expectancy-Value-Theory som teoretisk utgångspunkt för att undersöka hur elevernas prestationer påverkas av lärarens förväntningar, både direkt och indirekt genom motivation. Studien använder en kvantitativ metod och data samlas in via en enkät som besvaras av 67 elever i årskurs 6. Det insamlade materialet analyseras med hjälp av korstabeller och Chi2-test. Resultatet i studien visar att majoriteten av eleverna upplever höga förväntningar, self-efficacy och uppgiftsinriktade mål, oavsett vilket betyg eleven har. Lärarens förväntningar visar inte ett direkt samband med elevernas matematikprestationer, men har ett signifikant samband med elevens self-efficacy och uppgiftsinriktade mål. / There is a knowledge gap in middle school students' mathematics performance between students with low socioeconomic status and other students in Sweden. Teachers' expectations also prove to be an important factor in students' performance in mathematics, particularly in schools with low socioeconomic status. For this reason, it is interesting to investigate how teachers' expectations and students' performance correlate in socioeconomically disadvantaged areas.  The purpose of the study is to highlight how teachers' expectations correlate with students' mathematics performance in grade 6, in socioeconomically disadvantaged areas in a medium-sized Swedish municipality. The purpose is addressed through the following questions: how do students perceive teachers' expectations in the subject of mathematics, and what is the relationship between teachers' expectations, students' motivation, and students' mathematics performance in a Swedish school context? The study uses Expectancy-Value Theory as a theoretical framework to examine how students' performance is influenced by teachers' expectations, both directly and indirectly through motivation. The study employs a quantitative method and data is collected via a questionnaire answered by 67 students in grade 6. The data is analyzed using cross-tabulations and Chi-square tests. The results of the study show that the majority of students perceive high expectations, self-efficacy, and mastery goal orientation. regardless of their grades. Teachers' expectations do not show a direct correlation with students' mathematics performance but have a significant correlation with students' self-efficacy and mastery goal orientation.