M.Sc. (Med), Faculty of Health Sciences,University of the Witwatersrand, 2011 / Background: Many factors affect the prescribing of medication to patients with schizophrenia including variables that relate to physicians and may result in marked variance in the choice of drugs, dosages, drug combinations, route of administration and the use of antipsychotic, anticholinergic, sedative and other adjuvant drugs. Clinical practice guidelines were developed to address this variance and for other reasons, including the management of side-effects, drug innovation, rising costs, information overload, changes in treatment goals and the management of medication non-adherence. There are advantages and disadvantages to using clinical practice guidelines including those pertaining to context and cultural norms, but they remain the best method of assessing prescribing quality. Many guidelines are based on the results of randomised clinical trials (with a single drug) or are the consensus of experts in the field. Despite the development and publication of these guidelines over the past two decades, they are frequently not adhered to resulting in much variance in treatment. Aims and objectives: The aim of the study was to determine to what extent the prescribing of psychotropic drugs in the treatment of schizophrenia was consistent with the most recent version of each of five guidelines that originate outside South Africa (two from the United States and one each from Canada, the United Kingdom, and Australia and New Zealand); and one that was developed locally. Methodology: A retrospective, cross-sectional prescription chart review with data sampling at three time points (on hospital admission, at fourteen days thereafter and on hospital discharge) was undertaken. A sample population was drawn over a three year period during which the patients’ physician had access to the same drug formulary. Seventy patients met the study selection criteria in terms of age, diagnosis and receipt of antipsychotic medication during hospital stay and on discharge. Seventy patients met the study selection criteria, and their prescriptions for psychotropic medication (exclusively) were examined for a number of parameters including: drug class, drug name, dose, route of administration and whether the medication was to be administered routinely or ‘as needed’. Findings and discussion: As compared with the recommendations made in some or all of the guidelines, first generation antipsychotic agents were over-prescribed especially early on in the patients’ hospital stay, whereas second generation antipsychotics were under-prescribed. The profile changed after fourteen days and on discharge there were more patients on second generation drugs than on the older drugs. More patients were discharged on depot antipsychotic treatment than were admitted which is considered a favourable finding, however, many patients receiving the depot form continued to be prescribed the oral drug on a routine basis and for an indefinite period, resulting in antipsychotic polypharmacy. Anticholinergic drugs were prescribed as prophylaxis for the extra-pyramidal side-effects of the first generation antipsychotic drugs and more than a quarter of the sample received these drugs on discharge, after which they were to be taken routinely and indefinitely. A similar finding was made with the use of benzodiazepine sedatives, where nearly a quarter of patients received these drugs on discharge - again to be taken routinely and for an unspecified period. Sodium valproate was given increasingly to many patients in the sample and was prescribed to over a quarter of those upon discharge, without an indication of duration. Limitations: The study was retrospective in design, without the benefit of the patients’ clinical histories and treatment progress, and the findings were compared with guidelines whose age spanned more than a decade and some of which had become redundant. Conclusions: The study demonstrated some prescribing habits that were not in accord with the guidelines used for comparison in the study. The extent of the disagreement reveals the need for a prospective pilot study that will include the patients’ clinical progress in the study design which will provide greater insight into why specific medication parameters were chosen by the physician for the individual patient. If the findings justify it, then a programme promoting better adherence to the most current guidelines should be commenced.

Over the last 30 years Bahrain has witnessed remarkable economic growth and social development. This has resulted in tremendous changes in the dietary habits and lifestyle of the population and consequently increased levels of obesity. A cross-sectional study involving a representative sample of 506 Bahraini adolescents (249 males and 257 females), aged 12 to 17 years, was carried out to estimate the prevalence of obesity, its contributing factors and relationship to the risk of developing high blood pressure. The sample was selected, using a multi-stage random sampling technique, from intermediate and secondary schools in Bahrain. Data was collected using anthropometric measurements, blood pressure measurement and a self-administered questionnaire. A separate case control study, which included a sample of obese and non-obese adolescents, was carried out to investigate the relationship between adolescents' obesity and the family environment. Twenty one percent of the male and 35% of the female participants were obese using the WHO criteria for obesity in adolescents. A distinct sexual dimorphism in the accumulation of body fat during adolescence was observed. Thirty two percent of the boys and 60% of the girls had a percentage body fat at or exceeding the high-risk threshold for fatness, according to the currently accepted criteria. Systolic blood pressure, waist circumference and waist-hip ratio were all positively associated with body fatness. Multivariate analysis showed that higher levels of mother's education, frequent snacking and distress eating were all independent factors associated with an increased risk of obesity. Factors associated with a reduced risk of obesity included playing sport outside school, walking or cycling to school and eating meals with the family. Among the family environment variables, parental obesity and history of diabetes; mother's lifestyle variables, namely physical exercise and hours of television viewing, were all found to be independently related to risk of obesity in the Bahraini teenagers. Mother's degree of control over child's eating was strongly and indirectly related to risk of obesity in the adolescents. Breastfeeding, birthweight and availability and accessibility of high calorie foods in the house did not appear to be associated with adolescents' obesity. Eighteen percent of boys and 10% of girls had high blood pressure. BMI, percent body fat and waist circumference were all significantly and positively associated with a risk of having elevated blood pressure. Approximately 30% of the adolescents underestimated their current weight and about 40% thought that their parents/peers would consider them to be leaner than they actually were. More than half of the girls and about one third of the boys expressed discontent with their current body weight. Lifestyle changes and nutrition transition associated with economic development in Bahrain has increased risk of obesity among adolescents, a characteristic now evident in most countries in the Arab Gulf Region. This study provides an insight into the various determinants of this epidemic and will help to initiate public health strategies to deal with this increasing burden on health in the region.

Digitized by Kansas Correctional Industries

Digitized by Kansas Correctional Industries

Grade 9 students' academic failure has been documented to lead to future academic failure at the secondary level. Research has shown that lack of persistence and problem solving behaviors when dealing with adversity have multiple consequences, including low self-esteem and dropout. The purpose of this qualitative exploratory case study was to examine Grade 9 teachers' perceptions related to the use of Habits of Mind, a program designed to address the dispositions of thinkers when faced with problems such as resilience or persistence. Guided by Bandura's social cognitive learning theory, which holds that environment relates directly to behaviors and feelings of self-efficacy, the study was designed to examine teachers' perceptions regarding Habits of Mind and academic success. The research questions addressed teachers' perceptions about utilizing specific habits of mind to support students' academic success as well as how teachers' instructional designs incorporate Habits of Mind. Interviews with 10 9th grade teachers and surveys were used to gather data. Data analysis was conducted in a process of pre-coding, ongoing coding, and development of themes from the data. Results showed that teachers perceived habits of mind as necessary for success, handling adversity, and adapting to life beyond high school. They also indicated that the desire for purposeful collegial interactions most effectively embeds habits of mind instruction within and beyond classrooms. Implications for social change include maximizing students' problem solving strategies and knowledge related to dealing with adversity, including failure, in order to help prepare students for successful post-secondary academic experiences, employment, and productive, responsible citizenship.

Doctor of Philosophy / This work was digitised and made available on open access by the University of Sydney, Faculty of Dentistry and Sydney eScholarship . It may only be used for the purposes of research and study. Where possible, the Faculty will try to notify the author of this work. If you have any inquiries or issues regarding this work being made available please contact the Sydney eScholarship Repository Coordinator - ses@library.usyd.edu.au

Thesis (Ph. D.)--Virginia Polytechnic Institute and State University, 1982. / Vita. Abstract. Includes bibliographical references (leaves 275-286). Also available via the Internet.

Thesis (M.S.)--Eastern Illinois University. / Includes bibliographical references (leaves 85-87).

Thesis (Ph. D.)--Florida State University, 2003. / Advisor: Dr. Marsha Rehm, Florida State University, College of Human Sciences, Dept. of Family and Consumer Sciences Education. Title and description from dissertation home page (Nov. 24, 2003). Includes bibliographical references.

Background: Obesity is increasingly severe all over the world. With the development of the society, people tend to less eating time, perhaps because of longer working hours. Some studies showed that there was the association between eating rate and obesity. Yet, these studies are under‐researched. Objective: To explore if there is a positive association between eating rate and overweight or obesity using a systematic review. Method: I systematically reviewed relevant studies examining the association between eating rate and overweight or obesity published between 1st Jan., 2000 and 20th May, 2014 in PubMed, 万方 and 中国知网 databases using relevant key word search. There were no restriction in the study designs and population characteristics and animal studies were excluded. Results: Thirteen (13) studies were included in the systematic review. Among these 13 studies, 11 were English and 2 were Chinese. Eleven (11) studies were cross-sectional studies and the remaining 2 studies were longitudinal studies. The sample size ranges from 61 to 14,176, and from different parts of the world. The studies included used various exposures and outcomes to assess the association between fast eating and obesity. For example, exposures varied from self‐reported eating rate to calculated bite rate, and outcomes varied from body mass index (BMI) to six skinfold thickness. All 13 studies showed a positive association between the speed of eating and overweight or obesity. Discussion: This systematic review suggested a positive association between eating rate and obesity. However, given a lot of studies only used a cross‐sectional study design, more research is needed to explore the causal relationship between these two factors, possibly longitudinal and experimental studies. Such evidence would be important for relevant public health policies such public awareness to slow down eating rate. / published_or_final_version / Public Health / Master / Master of Public Health