Thesis (Ph. D.)--Ohio State University, 2006. / Title from first page of PDF file. Includes bibliographical references (p. 64-67).

Thesis (D.Clin.Psych) - University of Queensland, 2006. / Includes bibliography.

Situated cognition argues that learning takes place in an embedded social and physical environment, and through a social process, reality takes on meaning. This dissertation investigated if a link exists between learners’ participation and advancement within a sociocultural community of practice as specifically evidenced by higher rates of tracheal intubations on live patients and scores on the national certifying examination by paramedics. During 2006, paramedic students taking the national certifying examination were asked to answer a post-examination questionnaire quantifying the number of intubations performed during training. For intubation experience, significant odds ratios (relative to none performed) were observed for 4 to 9 performed [OR = 1.66, 95% c.i. = (1.24, 2.23)] and 16 or more performed [OR = 1.76, 95% c.i. = (1.21, 2.56)]. The male to female odds ratio [OR = 1.25, 95% c.i. = (1.04, 1.52)] was significant. For age category, significant odds ratios (relative to 40 and over) were observed for 20 to 24 [OR = 1.70, 95% c.i. = (1.27, 2.28)] and 25 to 29 [OR = 1.32, 95% c.i. = (1.00, 1.73)]. For education, the bachelor’s degree to high school odds ratio [OR = 2.56. 95% c.i. = (1.95, 3.35)] was significant. For ethnicity, significant odds ratios (relative to African-Americans) were observed for whites [OR = 1.69, 95% c.i. = (1.04, 2.74)] and others [OR = 2.33, 95% c.i. = (1.15, 4.72)].The multivariable logistic regression model results suggest that the number of tracheal intubations, sex, ethnicity and education level are all associated with greater odds of passing the certifying examination. In addition to traditional classroom lectures and activities, paramedic students also learn in clinical situations with varying levels of supervision culminating in near independent practice. Theories of situated cognition provide insight into these clinical learning situations that break from traditional models. When context, content, and community merge, knowledge is generated in new and meaningful ways. By participating in communities of practice, knowledge is transferred, created, and altered along with the learner through active engagement with all the illstructured, dynamic, and unpredicted opportunities the ‘real world’ offers. The students’ exposure to live tracheal intubations during training serve as an example of situated learning environments and its influence can be observed through the national certifying examination. The findings provide guidance for paramedic educators in creating situative learning affordances and specifically, determining the number of tracheal intubations performed during paramedic training.

Breastfeeding support for mothers and their babies historically was the informal work of family and community members. In the United States today, breastfeeding support is embedded in the biomedical system, and is provided by a new allied health professional: the International Board Certified Lactation Consultant (IBCLC). This dissertation explores this professionalization of breastfeeding support and the origins of this new profession. It studies how IBCLCs working in the U.S. cultural context perceive and practice the profession and examines the relationship between the profession of lactation consulting and the medicalization of breastfeeding. Oral history interviews with 17 founders of the profession, which was established in 1985, and a content analysis of the professional journal (the Journal of Human Lactation) from 1985 to 2010, allowed me to build the story of how and why breastfeeding support became professionalized and how experiential breastfeeding knowledge entered the domain of expert knowledge. While constrained by the biomedical system in which they created the profession, the founders exhibited a both agency and creativity in their production and reproduction of professional values and practices. Interviews with 30 currently certified IBCLCs and observations of the clinical practice of 3 IBCLCs provided insight into the daily practice of IBCLCs working in different settings--hospitals, WIC clinics, pediatric offices, and private practice. The data collected from these ethnographic methods demonstrated how the medical knowledge base of IBCLCs translates into clinical practice with patients, and allowed me to understand the relationship between the profession of lactation consulting and the medicalization of breastfeeding. While IBCLCs' draw on medicalized knowledge and evidence about breastfeeding and human lactation, their interactions with clients are best described as empathetic and humanistic, and are derived from nursing and mother-to-mother breastfeeding support models rather than from a technocratic, biomedical approach to care. While the appropriation of certain biomedical values and standards helped to legitimize the professionalization efforts of the founders, in practice, lactation consultants apply their medical knowledge and clinical experience in a way that reflects the compassionate, empowering care approach of mother-to-mother breastfeeding support and that thus resists the overt medicalization of breastfeeding.

This study aimed to explore how the experience of previous mental-health problems affects clinical and counselling psychologists’ approach to practice. Semi-structured interviews were conducted with six clinical and four counselling psychologists who had experienced mental-health difficulties. Data was analysed using Interpretative Phenomenological Analysis. Analysis of the interviews highlighted five master themes: Use of the personal-self of psychologist; Ambivalence; Identity as a psychologist; Psychologists as agent of change; and Finding meaning in suffering. The results of this research showed that psychologists with a history of mental-health problems actively draw upon their experience. In managing their dual identity of service-user and professional, they reported a degree of ambivalence which influenced the way that they viewed themselves and their practice. Their personal experiences seemed to be closely tied up with their professional-identity, which either conflicted with their sense of self or complemented it through highlighting how fortunate they were compared to others. The interviews frequently highlighted how psychologists’ experiences can provide an impetus to speak out for patients’ rights to ensure that they are treated with respect and dignity. A number of psychologists with an experience of mental-health difficulties felt that they might not have pursued their career had they not had previous mental-health difficulties. There appeared to be mixed findings concerning whether the participants felt that their mental-health difficulties had helped or hindered their practice.

Compulsory community service programmes have been initiated in many countries to recruit health care professionals to provide services in rural and under-served areas. However, the success or failure of the Community Service Programme depends largely on the attitudes of the professionals, their understanding of the programme's objectives, their preparedness for working in these areas and their ability to adapt to a new and challenging experience. Aim The aim ofthis study was to assess therapist's perceptions and attitudes about the compulsory Community Service Programme in KwaZulu-Natal in 2005 and to assess whether these changed during the year. Methods An observational cross sectional study with a descriptive and analytic component was conducted on commencement and after completion of community service. The therapists completed a self-administered questionnaire before and after their community service. Results A total of 126 (89% of 142) therapists responded to the initial questionnaire, 59 (42%) completed the exit questionnaire of which 47 (33%) completed both the questionnaire at commencement and completion of community service. Despite the poor response rate, similarities in perceptions and attitudes were noted with other studies conducted nationally and internationally. At onset 50% indicated that they would work in the public sector in the future and this proportion declined to 35% by exit. Even fewer (24%) said they would work in a rural area in the future. Only 16% reported that they would stay on at the same institution the year after community service. There was also no significant association between therapists collecting a rural allowance and expressing an interest to work in a rural area in the future (p=0.78) or staying at the same institution in the years after community service (p=0.32). However, therapists working in urban areas were more likely to say they would work in a rural area in the future (p=0.018). The comparisons between the occupational catergories showed that for support and supervision, the Speech Therapy and Audiology Forum was considered significantly (p=O.OOI) supportive compared to the Physiotherapy Forum. There was no significant difference within the occupational catergories in their perceptions of support, mentoring and supervision, attitude, psychological coping, personal and professional gains, safety issues and the amount of community outreach conducted. All groups were similarly resource constrained. Language was a barrier for 50% of all community service therapists and impeded their professional functioning. Discussion Despite the challenges experienced by community service therapists the majority felt that they had made a difference in the community in which they have been placed. The obligation to work in rural and under-served areas was personally and professionally rewarding. Particular concerns centred on support, supervision, training, resources and language barriers in providing better service delivery. Recommendations To achieve its objectives in relation to compulsory community service, which is to ensure an improved provision of health services to all citizens ofthe country, the Department ofHealth should consider multiple strategies including financial incentives such as rural allowances and non-financial incentives to retain health care personnel in rural and under-served areas. A long-term strategy that addresses human resources in a comprehensive manner needs to be developed to improve staffing and quality health services in these areas. / Thesis (MMed.)-University of KwaZulu-Natal, Durban, 2009.

Dissertation submitted to the Faculty of Health Sciences at The Durban University of Technology in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, 2008. / Objective: To determine the current knowledge and perceptions of biokineticists with respect to the chiropractic profession in South Africa. Design: A descriptive design was utilized in a qualitative questionnaire in order to evaluate, in a structured manner, the knowledge and perceptions of biokineticists with respect to Chiropractic. Subjects: The total population size used in the study was 657 (response rate n=78; 11.87%). Outcome Measures: These were based on a questionnaire which addressed biokineticists knowledge of Chiropractic, interaction with Chiropractic, Chiropractic terminology and scope of Chiropractic practice. Results: Of the 657 questionnaires that were mailed, only 78 questionnaires were returned and this gave a response rate of 11.87%. The most frequent view or attitude towards chiropractic was that it had a valuable role in the health care system (64%). About 50% of the respondents believed chiropractors to be greatly competent in examination and diagnosis whilst 40% felt that chiropractors were moderately competent in examination and diagnosis. Nevertheless, the rate of communication between biokineticists and chiropractors was found to be quite high, in this study. All together, 67% of biokineticists had communicated with chiropractors. Of those that had communicated, the communication was rated as positive (94.4%). Of those who had referred patients to chiropractors, 41.8% had received treatment feedback reports and of those who had received reports, 68.8% said they were concise and valuable. Conclusion: The results of this study show that the mean knowledge score was 60%. Thus the overall knowledge of chiropractic was high. The only factor that significantly affected respondents’ knowledge was their self reported knowledge of chiropractic. In congruence with this, the most common attitude towards chiropractic was that it had a valuable role to play in the health care system (64%).

There are many choices of specialists to be utilized in a sport medicine support staff. The effectiveness of any athletic training program depends on the organization and utilization of these specialists. The purpose of this investigation was to review current practices of accessibility, utilization, and compensation of sports medicine support staff at NCAA Division I, II, and III institutions. A random sample of 225 NCAA institutions equally stratified by level (Division I, II, 111) was obtained from the National Association of Collegiate Directors of Athletics (NACDA) directory. A questionnaire was sent to 75 head athletic trainers in each of three NCAA divisions levels. Of the 225 questionnaires mailed, 178 were returned representing a 79% response rate.The accessibility and utilization of support staff was equally distributed with respect to gender and sports at all division levels. When examining the support staff, Division I had consistently higher accessibility and utilization rates than Division II and Ill. This study may assist athletic trainers to evaluate or update their program by reviewing current practices of accessibility utilization, and compensation of support staff. / School of Physical Education

Typescript. / Thesis (Ed. D.)--University of Hawaii at Manoa, 1981. / Bibliography: leaves 231-243. / Photocopy. / xvii, 243 leaves, bound 29 cm

This thesis endeavours to explore, describe and portray the author's attempt to work with the people of Vanuatu, a small island nation in the South Pacific, establishing a preventative eye care project. The goal of this study is to offer a contribution to the understanding of cross-cultural health work in Vanuatu. / Thesis (PhD)--University of South Australia, [2000]