Reports of people with mental disorders without access to treatment are a major occurrence in prisons outside and within Africa. An estimated 450 000 000 people worldwide suffer from mental or behavioural disorders. The disproportionately high rate of mental disorders in prisons is due to several factors. The factors include the widespread misconception that all persons with mental disorders are a danger to the public; the general intolerance of many societies to difficult or disturbing behaviour, the failure to promote treatment, care and rehabilitation, and above all the lack of or poor access to mental health services in many countries. Many of these disorders may be present before admission to prison and may be further exacerbated by the stress of imprisonment. However mental disorders may develop during imprisonment itself as a consequence of prevailing conditions. / Thesis (LLM (Human Rights and Democratisation in Africa)) -- University of Pretoria, 2011. / http://www.chr.up.ac.za/ / nf2012 / Centre for Human Rights / LLM

Thesis (MPH.) -- University of Limpopo, 2021 / Background: Chronic illnesses, including non-communicable diseases (NCDs), continue to be a public health concern, globally, and contribute to the high burden of diseases. These health challenges have led to the introduction of community health workers (CHWs) in both developed and developing countries as a way of dealing with these challenges. It is more than five years since ward-based outreach teams (WBOTs) were introduced into the Julesburg area in order to respond to the needs of the community, based on the government’s focus on quadruple burden of diseases. The researcher is aware of the increasing workload, unclear roles and responsibilities, different approaches to CHWs’ work taken, and the ever-changing focus of their work, based on the community needs and diseases that the community faces at a particular time. It is for this reason that the researcher is interested in understanding the CHWs’ experiences and the manner in which they cope with challenges when working in their ever-changing environment, workload, work focus and roles and responsibilities. Methods: A qualitative exploratory, descriptive and contextual study approach was used; data was collected using focus group discussions with CHWs and one-on-one interviews with key informants, using their supervisors to gather more information that could not have been shared by CHWs. Result: The findings from the focus group discussions revealed that the CHWs have a high workload, while receiving stipend and are not permanently employed. CHWs have had experiences that make them feel unimportant and not needed, as well as enduring poor working conditions without sufficient personal protective equipment (PPE). Even though they experience dissatisfaction, they are passionate about continuing with their community-based work for many years, evidenced by those who have up to 22 years of service.

Homosexuality is something which has been a part of almost every society throughout history. In western society this has been a subject of secrecy and taboo. Throughout our history homosexuals have been persecuted and forced to hide their sexual identity. The effects of this on an individual should be something of concern to professionals in the mental health field. While in the past there has been little knowledge of homosexuality, and no self-expression on the part of homosexuals, there has, in recent years, been growing information and expression. The effect of this change on mental health workers is what this paper will examine. An historical survey will present the forces which shaped the current attitude of the mental health profession about homosexuality. I will present a general examination of the social ideology toward homosexuality in western society. I will also review the history of those homosexuals who have banded together for companionship, reform, and protest. This will be a context against which I will examine the attitudes of a specific group of people who care for the mentally ill--nurses and aides at a state mental hospital. The questionnaire I used to examine their attitudes surveys a broad range of possible attitudes about homosexuality. The responses will demonstrate what changes have occurred in society’s attitudes toward homosexuality. It will show, specifically, what the attitudes are of those who care for economically disadvantaged, severely disturbed homosexuals.

School recess can be a problematic setting due to inadequate safety, supervision, and structure. Peer praise notes (PPNs) is a school-wide positive behavior support strategy that was implemented during recess to address these concerns at a Title I elementary school. An ABAB reversal design across all students was employed to evaluate the effectiveness of PPNs. Overall changes in office disciplinary referrals (ODRs) in each phase of the design, an effect size that reflects a highly effective treatment, and a moderately strong and statistically significant negative correlation suggest that PPNs decreased ODRs. Results from social validity surveys completed by eight recess aides and 88 students indicated that participants had positive perceptions of PPNs improving student behavior and peer relations, communicating playground rules, extending supervision responsibilities, and offering structured activity to peer praisers. Students' perceptions were overall more positive than the recess aides' perceptions. Limitations, future research, and implications are addressed.

Background: Persistently elevated hospitalization rates in the home healthcare setting indicate the need to prioritize patients with undertreated conditions that can lead to negative outcomes. Urinary incontinence affects approximately 40% of older adults in home healthcare, yet often remains unaddressed. This leaves older adults with urinary incontinence at risk for potentially serious complications that can lead to emergency department visits, hospitalizations, and mortality. Multiple comorbidities, co-occurring symptoms, and disparities in care fuel the complexity of older adults in the home healthcare setting. The overall purpose of this dissertation was to leverage natural language processing to understand symptom clusters and factors associated with acute care utilization among older adults with urinary incontinence in home healthcare to improve comprehensive assessment, treatment, and outcomes. The aims of this dissertation were to: 1) identify relevant comorbidities among community-dwelling older adults with urinary incontinence; 2) develop and test a natural language processing algorithm to extract symptom information from home healthcare free-text clinical notes for older adults with urinary incontinence and analyze differences by race or ethnicity; 3) identify symptom clusters among older adults with urinary incontinence in home healthcare and examine differences by sociodemographic and clinical correlates; and 4) determine factors associated with the risk of emergency department visits or hospitalizations among older adults with urinary incontinence in home healthcare, including the impact of symptom clusters. Methods: This dissertation comprised four studies: 1) a scoping review of the literature to identify comorbidities to broadly characterize community-dwelling older adults with urinary incontinence, 2) a secondary analysis of cross-sectional electronic health record data using natural language processing to extract symptoms from free-text clinical notes and analyze differences by race or ethnicity using Chi-square tests and logistic regression models, 3) a secondary analysis of cross-sectional electronic health record data using hierarchical clustering to analyze the natural language processing-extracted symptom variables and examine differences in sociodemographic and clinical correlates using Chi-square tests, and 4) a retrospective secondary analysis of electronic health record data to identify factors, including symptom clusters, associated with emergency department visits or hospitalizations using Chi-square tests and backward stepwise logistic regression. Results: In the scoping review, we synthesized findings from 10 studies that identified comorbidities among community-dwelling older adults with urinary incontinence across neurologic, cardiovascular, respiratory, endocrine, genitourinary, musculoskeletal, and psychologic systems. In the natural language processing study, we identified eight symptoms of older adults with urinary incontinence (i.e., anxiety, constipation, dizziness, syncope, tachycardia, urinary frequency/urgency, urinary hesitancy/retention, and vision impairment/blurred vision) that were extracted from free-text clinical notes from approximately 29% of home healthcare episodes. Compared to White patients, home healthcare episodes for Asian/Pacific Islander, Hispanic, and Black patients were less likely to have any symptoms documented in clinical notes. In the clustering analysis, we identified five distinct symptom clusters: Cluster 1 (anxiety), Cluster 2 (broadly symptomatic), Cluster 3 (dizziness and anxiety), Cluster 4 (constipation, anxiety, and dizziness), and Cluster 5 (no symptoms) that correlate with sociodemographic and clinical characteristics. Finally, in the retrospective analysis, we found that Clusters 1-4 had higher odds of emergency department visits or hospitalizations, in addition to home healthcare episodes for Black and Hispanic patients, males, patients with an unhealed skin ulcer, and patients with a urinary tract infection 14 days prior to home healthcare admission. Conclusion: Older adults with urinary incontinence in home healthcare have complex physical and psychosocial needs, increasing the risk of negative outcomes. Improving comprehensive assessment and treatment for older adults with urinary incontinence is an urgent priority, given high hospitalization rates in home healthcare. Leveraging natural language processing, this dissertation identified key symptom clusters and factors associated with emergency department visits or hospitalizations, providing valuable insight for multidimensional interventions. Findings provide preliminary evidence to inform improvements in clinical practice, healthcare policies, and future research to enhance the care of older adults with urinary incontinence and reduce negative outcomes in the home healthcare setting.

Tableau d’honneur de la Faculté des études supérieures et postdoctorales, 2024. / Ce mémoire se penche sur l'évaluation de l'impact du programme préscolaire Passe-Partout sur la réussite éducative des enfants en se concentrant sur les résultats aux épreuves uniques du ministère de l'Éducation du Québec (MEQ), ainsi que sur le redoublement et la persévérance scolaire. Cette démarche s'inscrit dans le contexte québécois où la réussite éducative est au cœur des priorités ministérielles, compte tenu, notamment, de son impact sur le développement socio-économique. Les recherches antérieures ont mis en lumière l'importance d'intervenir dès le plus jeune âge afin de favoriser le développement des enfants et de promouvoir la réussite scolaire. De plus, les programmes qui encouragent activement la participation des parents ont été associés à des impacts positifs sur la trajectoire éducative des enfants. Ces initiatives préscolaires visent à renforcer les compétences cognitives et non cognitives, qui servent ensuite de fondements essentiels pour la réussite éducative et la vie adulte. Le MEQ a précédemment évalué l'impact du programme préscolaire Passe-Partout sur le développement des aptitudes des jeunes enfants et sur leur transition à la maternelle 5 ans. Le présent mémoire a donc pour objectif d'évaluer si le programme et le développement des compétences contribue à la réussite éducative à moyen et long terme. Afin d'évaluer de tels effets du programme, l'analyse se base sur des données administratives du MEQ ainsi que du recensement de Statistique Canada. L'identification de l'effet causal du programme Passe-Partout a été effectuée par l'application de la méthode économétrique de l'appariement par score de propension. De plus, l'estimation a également été effectuée par la méthode d'apprentissage automatique de forêts aléatoires causales, permettant de valider la robustesse des résultats et d'estimer une distribution des effets de traitement. Passe-Partout démontre des effets positifs et significatifs sur l'obtention d'un diplôme d'études secondaires ou de tout autre diplôme ou qualification ainsi que sur la réduction du redoublement scolaire. L'analyse des résultats aux épreuves ministérielles révèle également des effets bénéfiques et significatifs du programme dans la majorité des domaines. Cependant, cette étude présente des limites, notamment le manque de données sur le parcours des enfants avant l'âge de quatre ans ainsi que sur les résultats aux épreuves de niveau primaire. Malgré ces limites, les résultats suggèrent que Passe-Partout représente une initiative importante afin de favoriser le développement des enfants et, ultimement, la réussite éducative. / This master thesis focuses on evaluating the impact of the Passe-Partout preschool program on children's educational success, with a focus on their performance in the standardized tests administered by the *Ministère de l'Éducation du Québec* (Ministry of Education of Quebec or MEQ), as well as on repetition rates and school retention. This research aligns with the current context in Quebec, where educational success stands as a primary ministerial priority due to its profound socio-economic implications. Prior research has underscored the importance of early intervention to support children's development and promote academic achievement. Furthermore, programs that actively involve parents have been associated with positive impacts on children's educational trajectories. These preschool initiatives aim to strengthen both cognitive and non cognitive skills, which serve as essential foundations for educational success and later adult life.The MEQ has previously assessed the impact of the Passe-Partout preschool program on the development of young children's skills and their transition to kindergarten (*maternelle 5 ans*). Therefore, this master thesis aims to evaluate whether the program contributes to medium and long-term educational success. To assess these program effects, the analysis relies on administrative data from the MEQ and Statistics Canada census data. The program's causal effects were identified through the application of propensity score matching, an econometric method. Moreover, estimations were conducted using the causal random forest machine learning method, providing validation of results' robustness and enabling estimation of the treatment effects' distribution. Passe-Partout demonstrates significant positive effects on high school diploma attainment or any other diploma or qualification, as well as on reducing grade repetition. Analysis of standardized test results also reveals beneficial and significant effects of the program in most domains. However, this study has limitations, including a lack of data on children's trajectories before the age of four and on primary-level test results. Despite these limitations, the results suggest that Passe-Partout represents an important initiative to promote children's development and, ultimately, educational success.

Ce mémoire examine la faisabilité d'une stratégie de maintenance à domicile des aides à la mobilité attribuées à des personnes ayant une déficience physique. Les aides, visées dans ce mémoire, nécessitent des actions de maintenance pour les remettre en état suite à une défaillance (maintenance corrective) ou pour les maintenir en état d'opération, et ce, d'une manière préventive. Au Québec, des centres techniques affiliés à la Régie dAssurance Maladie du Québec (RAMQ) assurent l'évaluation des besoins des personnes, l'attribution et la maintenance de l'aide technique appropriée. Les coûts de ces opérations sont supportés par la RAMQ selon des barèmes préétablis. Les actions de maintenance sont, en grande partie, de type correctif. En cas de défaillance, totale ou partielle, d'une aide technique, l'utilisateur communique avec le centre technique le plus proche pour obtenir un rendez-vous. Il doit ensuite organiser le transport (aller-retour). Cette opération n'est pas toujours simple ni pratique notamment dans le cas où le transport doit être effectué par un véhicule spécialisé et dans le cas où le propriétaire doit respecter d'autres consignes ayant trait à une médication éventuelle. En se basant, notamment, sur les travaux publiés sur l'analyse des différents processus d'attribution et de maintenance d'aides techniques, notamment à l'Institut de Réadaptation en Déficience Physique de Québec (IRDPQ), et sur des travaux récents traitant des soins à domicile, le mémoire traite des différents éléments devant être pris en considération pour l'évaluation des impacts techniques, économiques et sociaux de la mise en place d'un service de maintenance à domicile pour une clientèle ciblée. Il fait état d'outils d'analyse et d'aide à la décision pour la mise en place d'un service de maintenance à domicile. Le contenu de ce mémoire peut servir de base pour la validation de la pertinence d'une stratégie de soin à domicile. S'agissant d'un exercice qui exige une analyse de données concernant des personnes, et dont l'accès est protégé, le mémoire fournit quelques indications sur la façon de procéder.

Cette recherche qualitative vise à mieux connaître la pratique des travailleurs sociaux dans le contexte de la 3e ligne psychiatrique. La perspective des travailleurs sociaux est centrale dans l’étude, comme le démontre la question de départ : quelles significations les travailleurs sociaux associent-ils à leurs activités professionnelles ? Méthodologie : Des entrevues semi-dirigées ont été réalisées avec dix (10) travailleurs sociaux de l’Institut universitaire en santé mentale de Québec (IUSMQ) d’avril à juin 2015. Ces entrevues comprenaient deux volets : (1) la pratique des travailleurs sociaux en 3e ligne psychiatrique à l’IUSMQ ; (2) un récit de pratique à l’aide d’un exemple clinique concret. Les transcriptions des entrevues ont été soumises à une analyse thématique des contenus fondée sur une grille de codification combinant des catégories prédéterminées et des catégories émergentes du matériel. Résultats et discussion : Le thème central issu de nos analyses est la notion de lien, qui serait au cœur des pratiques de travail social : les liens que les travailleurs sociaux créent, préservent ou rétablissent avec les usagers, les familles, les autres intervenants et les différents partenaires. Les travailleurs sociaux actualisent des rôles différents dans le cadre de leurs diverses activités en 3e ligne psychiatrique. Or, la compréhension de leur rôle dans les diverses équipes interdisciplinaires influence le déroulement de la collaboration ainsi que l’atteinte des objectifs établis avec la clientèle. Les récits de pratique soulignent que la gestion des cas cliniques de 3e ligne nécessite l’intervention de plusieurs partenaires et demandent l’utilisation de nouvelles approches d’intervention. Les collaborations constructives et efficaces ainsi que l’inclusion des familles dans les interventions complexes apportent un grand appui dans l’actualisation du plan d’intervention ou de sortie des usagers. Enfin, les diverses formes de soutien clinique, l’accès aux formations et la flexibilité du travail réalisé facilitent le travail au quotidien. Mots-clés : travail social, troisième ligne, santé mentale, psychiatrie. / This qualitative study aims to extend the knowledge about social work in third line (i.e., hospital-based and specialized) psychiatric services. The outlook of social workers is central in our study as we asked these professionals about the meaning of their duties at work. Interviews were conducted with mental health social workers from the Mental Health Institute of Quebec City. From April to June 2015, 10 social workers were interviewed. They answered a semi-structured questionnaire divided in two sections: (1) social work practice in third line psychiatry; and (2) a practice narrative centered on an actual clinical example. Thematic content analysis based on a codification table with predetermined and emerging categories was conducted. Results and discussion: The central theme of our analysis pertains to the notion of linking, which is viewed as central to social work practices: ties created, preserved, or re-established by social workers, and involving users, families, other practitioners, and other various partners. Social workers enact various roles in third line psychiatric settings. Significantly, the way their role is understood in interdisciplinary teams influences the continuity of the collaboration itself, as well as the achievement of the goals established with clients. The case-centered practice narratives underline that clinical management in third line psychiatric settings need interventions from different collaborators and demand the use of new intervention approaches. Constructive and effective collaborations along with the addition of families in complex interventions provide great support in the realization of the users’ intervention plan or discharge plan. For social workers, the diverse forms of clinical supports, training accessibility and work flexibility facilitate their tasks. Keywords: social work, hospital practice, mental health, psychiatry.

The purpose of this study was to determine the contribution of nursing auxiliaries towards health care services against their scope of practice. Nursing auxiliaries practising within the Elim, Letaba, Malamulele, Nkhensani, Shiluvana and Tintswalo hospitals in the Gazankulu Health Administration, in the Northern Transvaal Province, constituted the target population. The findings revealed that nursing auxiliaries are not functioning strictly according to their scope of practice. They are an essential component of nursing services in Gazankulu by rendering a major contribution towards health care services in fulfilling their scope of practice-role. Apart from their prescribed practice-role, they are also engaged in activities that should be performed by enrolled and professional nurses as well as doctors and general assistants. There appears to be a need for education for all categories of nursing staff regarding the scope of practice of nursing auxiliaries for improving the effective utilisation of this category of nursing personnel / M.A. (Nursing Science) / Health Studies

The purpose of this study was to determine the contribution of nursing auxiliaries towards health care services against their scope of practice. Nursing auxiliaries practising within the Elim, Letaba, Malamulele, Nkhensani, Shiluvana and Tintswalo hospitals in the Gazankulu Health Administration, in the Northern Transvaal Province, constituted the target population. The findings revealed that nursing auxiliaries are not functioning strictly according to their scope of practice. They are an essential component of nursing services in Gazankulu by rendering a major contribution towards health care services in fulfilling their scope of practice-role. Apart from their prescribed practice-role, they are also engaged in activities that should be performed by enrolled and professional nurses as well as doctors and general assistants. There appears to be a need for education for all categories of nursing staff regarding the scope of practice of nursing auxiliaries for improving the effective utilisation of this category of nursing personnel / M.A. (Nursing Science) / Health Studies