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A research report submitted to the Faculty of Health Sciences of the University of the Witwatersrand in partial fulfillment of the requirements for the degree of Master of Medicine in the branch of Community Health (Public Health Medicine). May 2014 / Background Occupational stress represents a substantial public health challenge. Although there has been an extensive focus on this form of stress within the international setting, there appears to be a paucity of relevant evidence within South Africa. Specifically, within the local context, there are relatively few: (1) reliability testing studies of screening and assessment instruments, (2) prevalence analyses of occupational stress and (3) work-related stress management intervention designs. Methods A cross-sectional descriptive and analytical study was undertaken in a large tertiary hospital in Johannesburg. Primary data were collected between February 2013 and September 2013 using the Copenhagen Psychosocial Questionnaire (COPSOQ). A sample (n=166) of administrative staff was selected, stratified into front line staff (n=54), back office staff (n=90) and managers (n=22). Data analysis included reliability testing of the COPSOQ using the Cronbach‘s alpha statistic. Prevalence measurement was also undertaken to describe the distribution of stress and other variables across the study sample. Finally, logistic regression was used to estimate associations between the exposure variables and the stress outcome (at the p < 0.05 level of significance). Results The Cronbach‘s alpha range for the COPSOQ was 0.31 to 0.85. Two out of 24 scales of the instrument fell below the unacceptability threshold of 0.5. In terms of prevalence, the stress mean for the study sample (on a scale from 0 to 100) was 38.8 (SD 19.8). Furthermore, 68.1% (n=113) of the study sample had a stress value above the reference mean. There were also significant differences in the stress values by job category, with managers having the highest mean at 51.2 (SD 24.2). Adjusting for job category, risk factors significantly associated with occupational stress in the main logistic model were offensive behaviour (OR 3.38, 95% CI: 1.54 – 7.43), quantitative demands (OR 2.83, 95% CI: 1.35 – 5.92) and emotional demands (OR 2.32, 95% CI: 1.08 – 4.96), while quality of leadership (OR 0.32, 95% CI: 0.15 – 0.67) was a protective factor. Further analysis showed that the most harmful risk factor for females was work-family conflict (OR 4.03; 95% CI: 1.45 - 11.21), and for males was exposure to offensive behaviour (OR 4.63; 95% CI: 1.15 - 18.63). Finally, ordinal regression found offensive behaviour (OR 3.60; 95% CI: 1.92 - 6.75) and quantitative demands (OR: 2.38; 95% CI: 1.27 - 4.46) to be significant risks for moving from low stress to high stress, while a commitment to workplace (OR 0.46; 95% CI: 0.24 - 0.86) could help to prevent this. Conclusions The level of occupational stress in the study sample was high relative to reference values. An occupational stress intervention is recommended, which should include primary, secondary and tertiary prevention strategies (according to identified risks). Further development of the instrument is also recommended, so as to improve its reliability in the local context. Finally, future research into occupational stress should explore the impact of factors such as resource constraints and HIV/AIDS, and should include an expansion into other settings and occupational categories. Key words Occupational stress, questionnaire reliability, psychosocial risks, intervention design.

It is the norm for institutions to report on their retention and graduation rates only for first-year student cohorts. Colleges and universities that report their first-year retention rates in the 90% range often do not account for their newly admitted transfer students. Much of the nuance in reporting retention comes from unaccounted transfer student registrations and enrollments. Reporting transfer retention is also much harder, since many transfer students do not have predictable patterns of enrollment. This study examined factors that contribute to graduation, dropout and persistence and how they differ by race, socioeconomic class, and gender. Based on a new student questionnaire conducted in 2015, 2016, 2017 by a large research institution in the Mid Atlantic, an exploratory statistical technique CHAID (Chi-Squared Automatic Interaction Detection) designed for a categorical dependent variable, was employed to establish the characteristics of transfer students who had a high probability to drop out after transferring to their new institution. Examining the dendrogram, one can easily classify the various “at-risk” student groups by tracing each of the terminal groups to the root of the tree. The results of this study provide context and information for developing transfer-friendly programming and interventions at both community colleges and four-year institutions. The results will be valuable to senior-level staff, front line student support staff, faculty, and community organizations focused on helping students who seek re-enrollment after an extended academic leave period. Additionally, this study will demonstrate how modeling techniques can be used to develop predictive models for different populations, across different colleges. / Urban Education

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Food waste is an arguably increasing problem in society, with consumers being responsible for as much as half of all combined food waste. The problem needs to be tackled from all angles, but there is no all encompassing solution for all situations. One context consumers find themselves in is the kitchen at their place of work, where the shared nature of the refrigerator creates situations and problems not found in the home environment. It is for these shared kitchens that this study is focused on providing a physical solution based on The Behavioural Change Wheel (BCW), book providing methods and tools for designing with the goal of behavioural change. The intention of this study was to develop, test and later evaluate a prototype on its behavioural change capacity and potential, using the tools presented in the BCW. The developed prototype took form as an RFID activated labelling system, providing users with the current date and their name on a label to be adhered on the articles they place in the shared refrigerator. After the testing period, an online questionnaire was sent out and was answered by fourteen out of seventeen participants. The two week testing period and subsequent questionnaire provided no conclusive answers regarding detected behavioural change capacity, but the potential is considered high based on participants qualitative comments and attitudes, and their quantitative usage. No measurements of change in food waste is conducted, but the target behavioural changes would provide a positive development resulting in less food waste in the workplace kitchen, if not only a more orderly refrigerator. / Matavfall är ett påtagligt ökande problem i samhället, där konsumenter ansvarar för så mycket som hälften av allt kombinerat matavfall. Problemet bör hanteras från alla möjliga håll, men det finns ingen allmän lösning för alla situationer. Ett sammanhang som konsumenterna befinner sig i är köket på deras arbetsplats, där kylskåpets gemensamma natur skapar situationer och problem som inte återfinns i hemmiljön. Det är för dessa delade kök som denna studie riktar sig på att tillhandahålla en fysisk lösning baserad på The Behavioural Change Wheel (BCW). Den innehåller metoder och verktyg för att designa med beteendeförändring som mål. Syftet med denna studie var att utveckla, testa och senare utvärdera en prototyp angående dess beteendeförändringsförmåga och potential, med hjälp av de verktyg som presenteras i BCW. Den färdigställda prototypen tog form som ett RFID-aktiverat etikettsystem, som gav användarna det aktuella datumet och deras namn på en etikett som ska sättas på artiklarna som de placerar i det delade kylskåpet. Efter testperioden skickades ett frågeformulär ut och fjorton av sjutton deltagare svarade. En testperiod på två veckor och efterföljande frågeformulär gav inga avgörande svar angående påvisad beteendeförändringsförmåga, men potentialen anses vara hög baserad på deltagarnas kvalitativa kommentarer och attityder, och deras kvantitativa användning. Inga mätningar kring mängd matavfall utfördes, men målbeteendeförändringarna skulle ge en positiv utveckling som resulterar i mindre matavfall i arbetsplatsens kök, om inte bara ett mer ordnat kylskåp. / Smart storage solutions in the fridge of the future to reduce food waste

The purpose of this thesis was to examine associations between parenting and child callous-unemotional (CU) behavior in a high-risk sample of children aged 2-9 years. First, a narrative review examined the construct of CU behavior, focusing specifically on definitions and measurement of the affective and interpersonal dimensions of psychopathy, and their applicability to youth. Second, a systematic review examined evidence from 30 studies that had investigated associations between dimensions of parenting and CU traits. Studies were classified as testing one of five different research questions. Third, five different empirical studies tested various research questions pertaining to associations between parenting and CU behavior. Data from mother-child dyads N = 731; 49&percnt; female) were collected from a multi-ethnic and high-risk sample, and included multi-method observed measures of parenting. Study 1 found that observed harsh and positive parenting predicted child CU behavior from ages 2-4, controlling for earlier child behavior and various demographic covariates. Study 2 employed a moderator design, and found that harsh and warm parenting were more strongly related to the conduct problems of children with high versus low levels of CU behavior. Study 3 tested cross-lagged simultaneous and reciprocal effects models, and found that parental warmth (observed and expressed by parents in speech samples) uniquely predicted child CU behavior versus conduct problems. Study 4 tested the factor structure of Inventory of Callous-Unemotional Traits (ICU; Frick, 2004), finding support for a three-Bifactor structure. Finally, Study 5 found that parent-child affective interactions at ages 2-3 predicted CU traits at age 9, over and above general behavior problems. Taken together, the results of this thesis suggest that CU features are more malleable than previously thought. In particular, aspects of parental affect and warm parenting behavior appear to be important key targets of investigation for future empirical and intervention studies.

The enormous amount of household food waste in developed countries is a global environmental and climate threat. To reduce household food waste, various behavior change campaigns and interventions are conducted. Most conventional behavior change interventions designed to reduce household food waste are based on the Theory of Planned Behavior (TPB) and are information heavy. These have shown, however, to not be effective enough to result in a fast and sizable enough decrease of household food waste in developed countries, thus reducing climate and environmental impact in a timely and sizeable enough way. The more systemic, holistic and practically oriented Social Practice Theory (SPT) theoretical framework is proposed by different authors as an alternative to the conventionally used TPB theoretical framework to design (behavior) change interventions. SPT is thought to lead to greater and faster reduction of food waste at the household level and to a general change in the food supply system. Nevertheless, interventions are oftennot created according to their proposed theoretical framework and no “direct” comparison between both theoreticalframeworks at the intervention level has been conducted. This thesis compares two case studies describing food waste reduction interventions, one with a TPB theoretical framework and the other with a SPT theoretical framework. The results show that when considering food waste reduction interventions at the household levels in developed countries the SPT might be a more effective theoretical framework for an intervention design compared to a TPB theoretical framework. Specifically, the SPT theoretical framework includes more relevant system stakeholders in the intervention creation leading to a more context specific design. Additionally, the emphasis of actual “doing” in an intervention based on an SPT theoretical framework createsa potential for more long-term change, compared to a TPB theoretical framework. However, this thesis also suggests that merging of the two theories should be further research and discussed, because of the potential greater effectiveness in actual food waste reduction.

Global warming is one of the gravest concerns that the world is now dealing with. This phenomenon is caused by a variety of factors. Carbon dioxide emitted from transportation networks is a significant contributor to global warming. Transportation systems comprise both the urban mobility sector (including public transportation and private vehicles) and the road transportation system. In line with this issue, governments across the globe have been implementing new technologies and strategies to mitigate carbon dioxide emissions. Meanwhile, changing passengers’ mobility behaviors through the application of nudging techniques has recently been identified as a feasible option by them. This research seeks to improve the efficiency of nudging approaches used in the mobility sector by assisting local authorities in designing appropriate behavioral interventions. To do so, ten city representatives including sustainability experts, and city managers were chosen, and semi-structured interviews were carried out to thoroughly understand their needs and expectations in terms of selecting the most effective nudges for encouraging citizens to use more sustainable modes of transport. The collected data were analyzed applyingtheThematicmethod. Finally, using the Value Proposition Design model, the design characteristics for the development of an ‘Intervention Design Tool’are determined. Our findings reveal that features such as simulating scenarios and interventions based on the behavior context and then providing users with situation-aware nudges are crucial for the creation of an 'intervention Design Tool’. Furthermore, this device must provide city representatives, as the main user of the tool, with a comprehensive view of the targeted city while alerting them to crucial situations and trends. As a consequence, the benefits that city representatives obtain from using this tool include reducing effort and saving time while increasing the reliability of their decisions.

<p>Poor food safety in informal, open-air markets remains a pressing issue in Cambodia, contributing to both foodborne illness and malnutrition. In order to design food safety programs that successfully promote positive food safety practices among the various actors involved in these markets, is important to understand their perceptions of food safety and of their own capability, opportunity, and motivation for adopting positive food safety behaviors. To that end, this research sought to explore and describe the perceptions of vegetable vendors, vegetable distributors, and vegetable growers in the Cambodian provinces of Battambang, Siem Reap, and Phnom Penh regarding food safety and their own personal capability, opportunity, and motivation for implementing specific food safety practices.  To note, this research was made possible by the generous support of the American people through the United States Agency for International Development (USAID) though Cooperative Agreement No. 7200AA19LE00003 to Purdue University as management entity of the Feed the Future Innovation Lab for Food Safety. The contents are the responsibility of the authors and do not necessarily reflect the views of USAID or the United States Government. </p> <p>The first portion of the research, which examined levels of perceived capability, opportunity, and motivation for positive food safety practices among actors involved in informal vegetable markets in Cambodia, employed a quantitative questionnaire based on the Capability, Opportunity, Motivation-Behavior model of behavior and the Theoretical Domains Framework. A pilot study using this questionnaire was performed with vegetable vendors in the Province of Phnom Penh (<em>N</em> = 55), after which the questionnaire was revised and implemented in person with vegetable distributors in Battambang Province (<em>n</em> = 37) and vegetable vendors and growers in Battambang (<em>n</em> = 26 and <em>n</em> = 27, respectively) and Siem Reap Provinces (<em>n</em> = 61 and <em>n</em> = 30, respectively). To validate the questionnaire, response data from participants in Battambang and Siem Reap were evaluated using confirmatory factor analysis. The resultant nine-factor model had a comparative fit index of .91, a Tucker-Lewis index of .89, and a root mean square error of approximation of .05. Data analysis proceeded using a fitted general linear mixed model. Results of this analysis suggested that levels of perceived motivation and capability for the target food safety practice were typically significantly higher (<em>p</em> < .05) than levels of perceived opportunity among vegetable vendors and distributors, regardless of location. Levels of perceived opportunity and perceived capability were significantly lower (<em>p</em> < .05) than levels of perceived motivation among vegetable growers in both Battambang and Siem Reap. Significantly higher (<em>p</em> < .05) levels of perceived opportunity and motivation for the target food safety practice were observed among vendors in Battambang in comparison to vendors in Siem Reap; perceptions of all three behavioral determinants were higher among vendors in Battambang than among farmers in either location. </p> <p>Subsequently, a quantitative questionnaire regarding participants’ perceptions of vegetable safety was implemented in person with vegetable growers in Battambang (<em>n </em>= 41) and Siem Reap (<em>n</em> = 28) and vegetable vendors in Phnom Penh (<em>n </em>= 31). Response data were analyzed using a fitted logistic regression model. Nearly all respondents indicated that they were concerned about vegetable safety (overall mean estimate 97.4%, 95% CI = [89.7, 99.4]%), with ≤ 62.7% of respondents in all groups reporting at least moderate concern (lower bounds of 95% confidence intervals 46.2% at the lowest). Across all groups, chemical contamination was perceived as more concerning than microbial contamination (84.9%, 95% CI = [76.0, 90.9]%). The majority of respondents reported that they were familiar with the potential health effects of consuming vegetables contaminated with either chemicals (71.4% [61.5, 79.6]%) or microbes (57.3% [47.2, 66.9]%). Nonetheless, when those who reported familiarity were asked to give examples of such health effects, fewer than 50% (ranging from 7.3% to 48.4%) provided an example of a commonly understood health effect of consuming contaminated vegetables. </p> <p>Both chemical and microbial contamination were most frequently perceived as occurring mainly “at the farm”, regardless of participants’ occupation and location (≥ 76.7%, lower bounds of 95% confidence intervals at least 61.5%, and ≥ 39.3%, lower bounds of 95% confidence intervals at least 21.2%, respectively). Correspondingly, “vegetable farmers’ were most often perceived as having the greatest responsibility for chemical contamination prevention (≥ 51.6% across all groups, lower bounds of 95% confidence intervals at least 34.0%). There were significant between-group differences in participants’ perceptions of microbial contamination prevention responsibility, however (<em>p</em> = .02). With regards to practices intended to prevent vegetable contamination, 22.6% of surveyed vendors in Phnom Penh, 39.0% of surveyed growers in Battambang, and 53.6% of surveyed growers in Siem Reap described at least one commonly accepted contamination prevention practice. </p> <p>Considered as a whole, these findings indicate that food safety practice adoption may be more effectively encouraged among vegetable growers, distributors, and vendors in Phnom Penh, Battambang, and Siem Reap by emphasizing the importance of microbial contamination and integrating educational components regarding the health effects of consuming vegetables contaminated with microbes or chemicals into food safety programs. Such programs should also address the relatively lower levels of perceived opportunity present among all groups; environmental restructuring-based interventions may be one means by which to do so. Programs for vegetable vendors specifically should communicate that microbial contamination of vegetables is common and highlight the significance of the role of vegetable vendors in maintaining a safe vegetable supply. Food safety programs tailored to vegetable growers could draw on growers’ perception of their own responsibility for both vegetable contamination and contamination prevention as well as their perception of contamination as a common occurrence. Programs for vegetable growers also need to incorporate efforts to address the relatively lower levels of perceived capability present within this group. These efforts could include educational programming or hands-on demonstrations that increase participants’ perceptions of their own ability to implement positive food safety practices. </p>

Although the White Paper on Families (2013) stipulates that family resilience should be strengthened in family preservation services, no guidelines exist for social workers in the South African context to do so. A need for practice guidelines for social workers in rendering services to families to strengthen family resilience was identified. The following central research question was formulated: How and by doing what, can social workers foster and sustain family resilience? The Intervention Design and Development (IDD) model of Rothman and Thomas (1994) was adapted for the study which included qualitative research to explore and describe the understanding, experiences and suggestions of social workers on family resilience for informing the family resilience intervention guidelines. Data was collected through focus- group and face-to-face semi-structured interviews with social workers employed by the Department of Social Development, and the NGOs from Gauteng, North West and Limpopo province. Tesch’s steps (cited in Creswell 2009:186) were used to analyse the data systematically and data was verified by Guba’s model (cited in Krefting 1991:214–222). Implementing steps 1–5 of phase 1, steps 1–3 of phase 2, step 2 of phase 3 and steps 1–3 of phase 4 of the IDD model, “Practice Guidelines for Social Workers to foster and sustain Family Resilience” (“The Guidelines”) were developed by translating the family resilience theory into practice to guide social workers to be able to develop and implement a family resilience intervention. The content of “The Guidelines” include an introduction containing the social work service delivery principles, the theoretical approaches of service delivery to families and the legislative and policy framework for services to families that would underpin a family resilience intervention. Section 1 of “The Guidelines” was developed and structured around the understanding of the family resilience construct and the family resilience process model on how family resilience operates. Section 2 of “The Guidelines” is presented in a question and answer format. This section provides practical guidelines on how to identify the target group for family resilience interventions, the reciprocal relationship between individual resilience and family resilience, family resilience interventions following the social work intervention process (i.e. intake, developmental assessment, a family developmental plan, and intervention strategies in accordance with the basket of services for families and monitoring and evaluation), how to integrate the domains of family resilience into the family resilience intervention, the need for education of both the social worker and client family on family resilience, the multi-dimensional aspects of the family requiring a multi-disciplinary approach and the role that the safety of family members play when rendering a family resilience intervention. / Social Work / D. Phil. (Social Work)