Introduction: Persistent health inequalities are the focus for much public health policy activity. Understanding the policy response to public health problems, the role of evidence, and the roles and strategies of different actors may help explain this persistence. Research suggests that policy actors often access knowledge through interpersonal relations, but current perspectives in the literature do not analyse relational aspects of finding evidence and influencing policy. Identifying powerful and influential actors (in terms of personal characteristics, strategies, and network properties) offers a method of exploring the policy process and evidence use. Methods: Network data were gathered from a public health policy community in a large urban area in the UK (n = 152, response rate 80%), collecting relational data on perceived power, influence, and sources of evidence about public health policy. Hubs and Authorities analyses were used to identify powerful and influential actors, to test whether powerful and influential actors were also sources of information; and betweenness and Gould-Fernandez brokerage were used to explore the importance of structural position in policy networks. These data were analysed in conjunction with qualitative data from semi-structured interviews (n = 24) carried out with a purposive subsample of network actors. Characteristics of powerful and influential actors, the use of evidence in the policy process, and roles and strategies used to influence policy were analysed using a framework approach, and combined with network data. Results: The most influential actors were mid-level managers in the NHS and local authorities, and to a lesser extent, public health professionals. These actors occupied advantageous positions within the networks, and used strategies (ranging from providing policy content, to finding evidence, to presenting policy options to decision-makers) to influence the policy process. Powerful actors were also sources of information for one another, but providing information did not predict power. Experts, academics and professionals in public health were represented in the networks, but were usually more peripheral and played fewer roles in the policy process. This study presents empirical evidence to support the suggestion that recognition of network structure assists individuals to be influential, and proposes a framework to categorise their activities. Conclusions: In order to influence policy, actors need good relationships with other influential actors, and the skills to exploit these relationships. The relational approach is useful for both identifying powerful and influential people (potential evidence-users) and for exploring how evidence and information reaches them. Identifying powerful and influential actors and describing their strategies for influencing policy provides a new focus for researchers in evidence-based policy, and for those wishing to influence policy. For academics and researchers, this study demonstrates the importance of directly creating ties with decision-makers

The impact of ethnic residential concentration on the process of integration of ethnic minorities into the mainstream society has been increasingly debated among both scholars and policy makers across Europe. This thesis seeks to contribute to this debate by addressing the effect of ethnic residential concentration on the political participation of Black Africans in Britain. The study pursues three main objectives: investigating the marginalising or mobilising impact of co-ethnic residential concentration on political participation; disentangling the processes underpinning this relationship by focusing on the effect of ethnic-based social networks, represented here by voluntary organisations, religious institutions and informal social networks; exploring the influence of the immigration-related heterogeneity that characterises the Black African community on the relationship between residential concentration, ethnic social networks and political participation. A mixed-method approach is adopted. The quantitative enquiry focuses on the Black African community as a whole and relies on secondary data drawn from the 2010 Ethnic Minority British Electoral Survey. The qualitative enquiry is based on primary data collected through face-to-face interviews and participant observation among Ghanaians and Somalis in London. The quantitative analysis shows that, among Black Africans, residential concentration has a mobilising effect on voter turnout but a marginalising effect on non-electoral participation. Ethnic social networks do not seem to mediate this relationship. Residential concentration is significantly, and positively, correlated to individual participation in ethnic places of worship and embeddedness in ethnic informal networks but not to involvement in ethnic organisations. In turn, the latter positively influences non-electoral engagement whereas ethnic places of worship and informal networks are not related to political engagement. The qualitative findings suggest that residential concentration is more relevant for the creation of and participation in ethnic organisations among Somalis than among Ghanaians. However, this relationship is likely to be influenced by other contextual factors such as institutional support, ethnic diversity and tribal homogeneity. Somali organisations also seem to play a more active political role than Ghanaian groups with regard to both electoral and non-electoral engagement. The two communities appear to be more similar when considering the relationship between ethnic religious institutions and informal connections with co-ethnics. These networks are not necessarily dependent on ethnic residential clustering and their effect on political engagement is primarily linked to informal political discussion. Overall, the results suggest that the relationship between residential concentration, ethnic social networks and political participation of Black Africans varies considerably between the two national groups researched, primarily due to their immigration-related characteristics, as well as across modes of political engagement (i.e. electoral, non-electoral) and local contexts.

L'aumento delle intolleranze, e la crescente volontà dei consumatori di seguire diete più sane, stanno interrogando il dibattito scientifico circa il ruolo del glutine e del lattosio nelle abitudini alimentari, sia dal punto di vista nutrizionale che di qualità di vita. Nel contesto italiano, l'improvviso cambiamento nelle diete dei consumatori sta causando cambiamenti critici dal punto di vista economico e culturale. Le motivazioni alla base di questi cambiamenti alimentari sembrano poco chiare, suggerendo così la necessità di uno approccio psicologico. Questa tesi di dottorato propone una ricerca mixed-methods volta a esplorare le determinanti psicologiche delle diete “senza” glutine e lattosio tra i consumatori italiani, con particolare attenzione ai consumatori tolleranti. I risultati mostrano che questi consumatori sembrano coinvolti in un profondo cambiamento psicologico e che le diete "senza" rappresentano per loro un "passaggio" per iniziare a ricostruire il loro equilibrio attraverso nuovi piani alimentari (e di stile di vita). Riflettendo sul caso critico delle diete “senza” lattosio e glutine, questa ricerca sottolinea le potenzialità per la psicologia di studiare le scelte alimentari e promuovere la salute e il benessere dei consumatori. / The estimated increase in the adverse reactions from food, along with consumers’ desires to pursue healthier diets, are raising questions for people about the role of gluten and lactose in their food habits. Consequences of this food regimen on a healthy population are under discussion, both from nutritional perspective and broader quality of life. In the Italian context, the sudden change in consumer diets is bringing about critical changes economically and culturally. The motivations behind these dietary changes in tolerant consumers appear unclear, thus suggesting the need for a psychological approach. This dissertation propose a mixed-methods research aimed at exploring to explore the psychological determinants of gluten and lactose-free diets among Italian consumers, with a main focus on tolerant consumers. Results show that these consumers appear involved in a deep psychological change and “free from” diets represent for them a “gate” to start rebuilding a perceived balance through new food (and lifestyle) plans. This is a first attempt that, reflecting on the critical case of lactose- and gluten-free diets, would underline potentialities for psychology to intervene in this field and to promote consumer health and wellbeing through food consumptions.

abstract: A defining feature of many United States (U.S.) doctoral engineering programs is their large proportion of international students. Despite the large student body and the significant impacts that they bring to the U.S. education and economy, a scarcity of research on engineering doctoral students has taken into consideration the existence of international students and the consequential diversity in citizenship among all students. This study was designed to bridge the research gap to improve the understanding of sense of belonging from the perspective of international engineering doctoral students. A multi-phase mixed methods research approach was taken for this study. The qualitative strand focused on international engineering doctoral students’ sense of belonging and its constructs. Semi-structured interview data were collected from eight international students enrolled at engineering doctoral programs at four different institutions. Thematic analysis and further literature review produced a conceptual structure of sense of belonging among international engineering doctoral students: authentic-self, problem behavior, academic self-efficacy, academic belonging, sociocultural belonging, and perceived institutional support. The quantitative strand of this study broadened the study’s population to all engineering doctoral students, including domestic students, and conducted comparative analyses between international and domestic student groups. An instrument to measure the Engineering Doctoral Students’ Quality of Interaction (EDQI instrument) was developed while considering the multicultural nature of interactions and the discipline-specific characteristics of engineering doctoral programs. Survey data were collected from 653 engineering doctoral students (383 domestic and 270 international) at 36 R1 institutions across the U.S. Exploratory Factor Analysis results confirmed the construct validity and reliability of the data collected from the instrument and indicated the factor structures for the students’ perceived quality interactions among domestic and international student groups. A set of separate regression analyses results indicated the significance of having meaningful interactions to students’ sense of belonging and identified the groups of people who make significant impacts on students’ sense of belonging for each subgroup. The emergent findings provide an understanding of the similarities and differences in the contributors of sense of belonging between international and domestic students, which can be used to develop tailored support structures for specific student groups. / Dissertation/Thesis / Doctoral Dissertation Engineering Education Systems and Design 2020

Background: Healthcare personnel (HCP) often experience undesirable working conditions. Risk behaviours for organism transmission can lead to healthcare associated infections and risk behaviours has been described to be influenced by working conditions. Research is lacking regarding HCPs working conditions and its relation to risk behaviours for organism transmission which this thesis aims to investigate.  Methods: Study I had a mixed-methods convergent design. Observations and interviews were performed with 79 HCP, i.e., registered nurses (RNs) and assistant nurses (ANs). First-line managers were interviewed about the unit´s overall working conditions. The qualitative and quantitative data were analysed separately and then merged. Study II was a cross-sectional study with 417 RNs and ANs. The questionnaire included: self-efficacy to aseptic care, structural empowerment (SE), work engagement (WE) and work-related stress (WRS). Correlational analysis and group comparisons were performed.  Results: In Study I risk behaviours frequently occurred regardless of measurable and perceived working conditions. The HCP described e.g. staffing levels and interruptions to influence risk behaviours. In the statistical analyses, risk behaviours were more frequent in interrupted activities and when the HCP worked together. In Study II the HCP rated high levels of self-efficacy to aseptic care. Differences were found between self-efficacy and some of the grouped working condition variables and definite but small relationships were found between self-efficacy to aseptic care and SE/WE/WRS.  Conclusion: The HCP rated high levels of self-efficacy to aseptic care, but on the other hand, risk behaviours frequently occurred irrespective of working conditions. Healthcare managers are responsible for HCPs work environment and should continuously work to promote sufficient working conditions and to increase HCPs understanding of risk behaviours, which consequently also promote patient safety.

In response to concerns about using only standardized multiple-choice assessments, some school districts have moved to using alternative ratings of student achievement with authentic assessments. However, such assessments are often limited in terms of the psychometric validity data supporting their use. The present study mixed quantitative and qualitative methods to examine the validity, development, and refinement of an authentic rating approach currently in use in middle school mathematics classes from a large suburban school district in the Southwest United States. A sample of teachers (n = 14), rated students (n = 110) using a pilot rubric of 187 items. Analyses resulted in a 32-item rubric with 20 themes and 9 factors. Results from a G-study revealed the facet that best explained variance in student scores was the interaction between raters and assessment units, as well as students and assessment units. As part of the development of the assessment, a content validity exercise revealed 18% of the rubric items as below average quality. Findings highlight the need to enhance contextualization of rubrics, use a strategy of assessment that includes contextualized and decontextualized assessment, and to investigate the role of utilization deficiency in explaining low student scores.

abstract: The science, technology, engineering, and math (STEM) education community is interested in using virtual reality (VR) to help students learn STEM knowledge. Prior research also provided evidence that VR learning can increase students’ motivation and learning achievement. However, it was not clear whether the effect of VR on learning was partly from sensory novelty and whether the effectiveness was sustainable. This study was to satisfy the concern on the sustainability of VR STEM learning in instruction and address the research gaps in exploring the effect of VR on a STEM learning experience with a consideration of novelty. The study used a mixed-methods experimental design and involved a three-session VR STEM learning intervention. The quantitative data was collected through the intervention by survey questionnaire, session quiz, and pre- and post-tests, while the interviews were taken after the intervention. The structural equation modeling method was used to explore the relationships among factors in the VR learning experience. Longitudinal quantitative comparisons were conducted with the multiple imputation method. Its purpose was to evaluate the changing magnitude of factors across sessions. After quantitative analysis, interview transcripts were analyzed. They were used to triangulate or provide context for understanding of quantitative results. The results showed that motivation and engagement play a critical mediation role in an effective VR learning experience. While individuals’ psychological responses and motivation may significantly increase in a VR learning experience for novelty, the novelty effect may not steeply decrease when individuals are becoming familiar with the novelty. This phenomenon is more observable in a VR condition having a high degree of immersion and embodiment. In addition, novelty does not necessarily increase learning achievement. The increase of learning achievement is more dependent on a match between the learning content and the learning method. The embodied learning method is appropriate for instructing difficult knowledge and spatial knowledge. Reserving enough time for reflection is important to deep learning in a VR environment. / Dissertation/Thesis / Doctoral Dissertation Engineering Education Systems and Design 2020

Various assessments and international studies have shown that learners in South African schools experience challenges and perform poorly with respect to literacy and numeracy. To become competitive in the global arena, there is an urgent need to raise the standards of education. Language is required for all learning, including numeracy and mathematics. Many young learners in South Africa struggle to develop adequate language skills because of an inherent pathology and/or barriers in their learning environment. Learners who do not develop adequate listening and language skills during their early years are most likely to experience difficulty in acquiring literacy and numeracy skills, resulting in poor academic progress. By supporting learners to overcome their developmental delays as early as in the foundation phase, future learning problems may be prevented. To raise education standards, teachers need to heighten their attempts to facilitate literacy and numeracy in the foundation phase. Teachers currently have to adapt to a new national curriculum statement (NCS) that is based on an outcomes-based education (OBE) approach (Department of Education, 1997:16). Many teachers, especially those in black townships and other previously disadvantaged areas, find this difficult as they have not been sufficiently trained or are not adequately qualified. Educational changes have necessitated the need for high quality staff development and support. Speech-language therapists (SLTs) working within a collaborative approach in the education context can support the learners who need to acquire listening and language skills, as well as the teachers who have to facilitate these skills. This study developed a support programme for foundation phase teachers to facilitate listening and language for numeracy. The multifaceted programme consisted of training, mentoring, and practical components, which aimed at developing the participants’ competence (foundational, practical, and reflective competence). The programme integrated the principles of adult learning within an OBE approach while taking culture and diversity into consideration. The programme was evaluated within a Logic Model framework. The research made use of a concurrent, equal status triangulation design where triangulation was obtained by transforming QUAL data into QUAN data to be compared. In the QUAN strand, data were collected from 96 teacher participants (who were selected by using a convenience sampling method) by means of questionnaires, portfolio assignments, attendance registers, and financial statements. Qualitative data were collected from eight focus group discussions (using a nested design with 12 participants at a time) as well as a research diary, testimonials, and various correspondences. The findings indicated that all the participants have gained knowledge, skills, and confidence, but to varying degrees. Factors that affected the outcomes included aspects related to time, the choice of venue, age, prior support and qualifications, as well as motivation related to the context. Group learning was identified as a suitable strategy for teacher support in these contexts. Provided that specific factors are considered to increase effectiveness, the outcomes indicated that the programme could be used to support foundation phase teachers in these specific contexts. / Thesis (DPhil)--University of Pretoria, 2010. / Speech-Language Pathology and Audiology / unrestricted

Introduction: Education of physiotherapists still fails to meet the health and social needs of society. One instrument to steer change in health sciences education is a re-designed curriculum. The overall intent of this study was to develop standards of competencies, teaching and learning strategies, and assessment, for an undergraduate community physiotherapy curriculum in South Africa. The grounding for this research was pragmatism. The Six-step model for curriculum development and the Clinical Prevention and Population Health Curriculum framework guided the research process and main analysis. Methods : A sequential mixed method design was used. First, a two-phase parallel situation analysis was conducted which included a qualitative document analysis of community physiotherapy curricula of the eight physiotherapy university departments in South Africa and a review of health policy documents. The experience of 12 purposively selected physiotherapists who had completed a compulsory community service year was qualitatively explored through interviews within an appreciative inquiry stance. In phase 2, input was gained from physiotherapists, from all ecological levels, on the community physiotherapy curriculum through a Delphi study. Three rounds were used. Round 1 explored the roles of physiotherapy in community health, round 2 quantified consensus in overarching competency domains, and round 3 gathered learning and teaching, and assessment, strategies to gain these competencies. Results : All eight universities had gaps in their community physiotherapy curriculum and were variedly aligned with South African health policies and health profile. Graduates need to be able to provide physiotherapy over the lifespan, to conditions mirroring the quadruple burden of disease, in settings varying from hospitals to homes of clients, with emphasis on health education and promotion within an interprofessional team. They must be prepared for suboptimal practice environments and to utilise the compulsory community service year as a gateway in professional development. Graduates need resilience to cope during the year and awareness about the importance of identifying a mentor in the frequent absence of a profession-specific supervisor. Community physiotherapy needs three core knowledge and skill sets; i.e. clinical physiotherapy, population health and community development. Consensus of 70%+ was gained on competency criteria in the domains of the following professional roles: clinician, professional, communicator and collaborator, scholar, health promoter, public health practitioner, community developer (change agent), and manager/leader. Service-learning was identified as a strategy to develop these roles supported by learning and assessment portfolios. Reflection in different formats – essays, presentations, case analysis, projects such as community wellness programmes, diaries - is a core activity to facilitate learning. A range of complementary strategies were suggested that included direct observation, role-play, and journal clubs. Core to assessment for professional competencies is for the students to be able to give evidence of their own learning (e.g. in a portfolio or oral examination) and to get frequent formative feedback. Conclusion : The physiotherapy profession is important for improving the health status of the South African population. Physiotherapy students should be educated to take on relevant professional roles through the application of appropriate educational standards. The study recommends that the curriculum standards be implemented and evaluated and that the application of complex theory in the further development and implementation of the curriculum be investigated. Lastly, future research in the generic professional domains, such as public health and community development, should be interprofessional in nature. / Thesis (PhD)--University of Pretoria, 2013. / gm2013 / Physiology / Unrestricted

This research is logged in the field of language acquisition, focusing on Spanish as a foreign language learnt at university level. It investigates how learning strategies are used by students to develop proficiency in Spanish over a three-year period (from the first year to the third year). Adopting a cognitive lens that places special attention to how linguistic knowledge is constructed, deconstructed and reconstructed, this study focuses on the language learning process, specifically on what the students do to learn a language. Taking into account that the learning of foreign language poses particular and distinctive challenges – as opposed to the learning of a second language – and using a multiphase design that combines sequential strands encompassing quantitative and qualitative techniques, this study finds that those who successfully complete all the Spanish courses are the ones who report significantly more use of metacognitive strategies in the first year. The study concludes by proposing a framework that helps to classify the role that the use of strategies play in learning a foreign language from a student’s perspective. This framework adds a new dimension and provides valuable information to similar types of studies. Considering the above-mentioned findings, the study recommends introducing first-year students to the potential value of using metacognitive strategies in foreign language learning, and suggests that lecturers should recommend more activities for students to engage in the language outside the classroom. / Thesis (PhD)--University of Pretoria, 2017. / Modern European Languages / PhD / Unrestricted