No / Nigerian health professionals are impacted by several global forces bearing down on them, one of which is the positive economic prospects associated with emigrating to work abroad. This emigration is an aspect of increased global mobility which has had an adverse effect on the Nigerian health economy. This is important globally because countries with the smallest healthcare workforce capacities such as Nigeria have the poorest health outcomes. The emigration of health professionals from Nigeria will continue until domestic structures such as improved healthcare infrastructures, job security, and financial rewards change for the better. Thus, it is important that measures aimed at supporting the Nigerian health workforce be implemented with a focus on building and managing for sustainability within the context of international interdependency. Accordingly, this chapter is aimed at creating a theoretical framework for building capacities and managing the challenges of the Nigerian health workforce vis-à-vis the opportunities offered by globalization.

Low back disorders (LBDs) are one of the most commonly occurring injuries in industry. To attempt to reduce these work-related injuries, billions of dollars are being budgeted for formal training in the U.S. However, the outcomes of this training are below a satisfactory level. The majority of organizations utilize the Four-level Evaluation Model to evaluate their training program. However, previous studies have pointed out some limitations regarding this evaluation model. Moreover, most organizations collect only trainee reaction, the first level of the Four-level Evaluation Model, to determine the effectiveness of their training program. Many studies reveal that trainee reaction is an invalid indicator to determine the effectiveness of a training program, and further suggest multi-dimensional categorization within each level of the Four-level Evaluation. Therefore, in this study, the Revised Bloom's Taxonomy was employed to enable multidimensional categorization of learning outcomes in a lifting and lowering training program. The learning outcomes of interest in such a training program relate to procedural knowledge and the cognitive process involved are categorized as remembering, understanding, applying, and evaluating the contents of the training program. Two research questions were asked. What types of learning outcomes are most predictive of training performance? How do the learning outcomes predict training performance compared to affective and utility type reactions? The ability of different types of learning outcomes to predict training performance was tested by multiple regression analyses. The results revealed that apply-procedural learning outcomes and the interaction variable of understand-procedural and apply-procedural learning outcomes were the most predictive of training performance. Further, these learning outcomes were more predictive of training performance than the trainee reactions (affective and utility type reactions) to explain training performance. The results of this study yielded a set of recommendations that may be useful in designing and evaluating lifting and lowering training programs. Moreover, this study examined the Revised Bloom's Taxonomy as a novel method of considering the multidimensional nature of learning and provided a potential application of the Revised Bloom's Taxonomy in the training discipline. / Master of Science

In a small rural school division in Virginia, three small high schools were consolidated into one medium-sized high school in the fall of 1992. This study examined that consolidation. The research question was: What happened when three small high schools consolidated into one medium-sized high school? Data were collected from the following sources through: interviews with key actors of the consolidation process; surveys of students, teachers, and parents; and, public documents. Results of the study include: (1) Prior to consolidation some key actors favored and others opposed the consolidation. Their opinions did not change following the consolidation. (2) Some of the advantages articulated by the proponents and some of the disadvantages articulated by the opponents were realized. (3) Student outcomes did not change. (4) The number of teacher preparations decreased and the student/teacher ratio increased, but not to the point of exceeding state guidelines. (5) Transportation costs increased. (6) Expenses for Administration, Instruction, Operation and Maintenance, and Facilities decreased. (7) Time on the bus did not change. Any locality that is considering a consolidation must identify the issues and concerns that are important to that locality. Those issues and concerns will vary location to location and should constitute the components of any subsequent evaluation. / Ed. D.

The purpose of this thesis was to review findings regarding human touch and positive and negative effects on preterm infants. The review and synthesis of findings included data from research articles published from 2000-2006. Studies showed positive outcomes associated with infant massage, kangaroo care, gentle human touch, and facilitated tucking. One study noted negative effects ofbradycardia/hypoxia during kangaroo care. Positive effects included increases in weight gain, improved bone formation and mineralization, ability of infants to maintain temperature, and decreased pain responses. Limitations included the small number of studies within the US in comparison to other countries and small sample sizes. This work provides a single source for nurses in regard to the care of preterm infants using these interventions.

Thesis (MMed)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: The Objective: To review the difference in short term neonatal and maternal outcomes among singleton infants with breech presentation delivered by vaginal or elective caesarean section route at term, at Tygerberg Academic Hospital (TBH) in Cape Town. The study design was a retrospective case control study. Method: Part I A total of 120 patients were selected. 60 vaginal breech deliveries and 60 elective caesarean sections for breech presentation (comprising the control group). 60 cases of vaginal deliveries were collected and 60 control cases of planned elective caesarean sections, where the indication for CS was breech presentation, were collected in the same manner. Part II Nineteen registrars completed a questionnaire regarding their subjective experiences of vaginal breech deliveries at Tygerberg Academic Hospital. Results: Part I An analysis of the results found statistically significant differences in maternal ages between the two groups, with younger women delivering by CS; gravidity and parity was lower in the CS group; blood loss was observed to be higher in the CS group with more women requiring a blood transfusion when compared to vaginal delivery; there were more neonatal admissions in the vaginal delivery group as well as more birth trauma, neonatal seizures and death in this group; Apgar scores were higher in the CS group and finally, neonates born by CS were more commonly discharged at the same time as their mothers in the CS group. Part II When analyzing the registrar questionnaire it can be noted that although clinicians are performing an adequate number of breech vaginal deliveries, with an average of 10 deliveries per year, the skills training for clinicians is invaluable. Not all registrars learned skills from a senior clinician and skills training in skills labs are essential for initial and even continual training of these clinicians. It is suggested that these skills training programs be made compulsory for all registrars and that a biyearly attendance and completing of such a course be mandatory for those wishing to work in the labour ward. Conclusions: Although not statistically significant, there was more morbidity and mortality associated with vaginal breech delivery. / AFRIKAANSE OPSOMMING: Doel: Om die korttermyn neonatale en moederlike uitkomste van enkeling swangerskappe met stuitligging wat vaginaal of met elektiewe keisersnee verlos is by die Tygerberg Akademiese Hospitaal in Kaapstad, te bepaal. Die werkstuk is ‘n retrospektiewe gekontroleerde-gevallestudie. Metode: Deel 1 ‘n Totaal van 120 pasiënte is gekies. 60 gevalle van vaginale stuitverlossings en 60 kontrolegevalle van beplande elektiewe keisersnitte waar die indikasie stuitligging was. Deel 2 Negentien kliniese assistente het die vraelys oor hul persoonlike ervaring van vaginale stuitverlossing by die Tygerberg Akademiese Hospitaal ingevul. Resultate: Deel 1 ‘n Ontleding van die resultate wys statisties betekenisvolle verskille in die moederouderdom van die twee groepe, met meer jong vroue wat met keisernit geboorte gee. Graviditiet en pariteit was laer in die keisersnit-groep. Bloedverlies was hoër in die keisersnit-groep en in vergelyking met die vaginale verlossings met meer vroue wat bloedoortapping benodig. In die vaginale verlossingsgroep was meer neonatale toelatings nodig asook meer geboortetrauma, neonatale konvulsies en sterftes. Apgar-tellings was hoër in die keisersnitgroep en neonate wat met ‘n keisersnitte gebore is, is meer dikwels saam met hul moeders ontslaan. Deel II Ontleding van die vraelys vir kliniese assistente wys dat hoewel klinici ‘n genoegsame getal van gemiddeld 10 vaginale stuitverlossings per jaar uitvoer, vaardigheidsopleiding vir klinici van onskatbare waarde sal wees. Nie alle kliniese assistente leer vaardighede by senior klinici nie en opleiding in ‘n vaardigheidslaboratorium is noodsaaklik vir die aanvanklike en selfs voortdurende opleiding van dié kliniese assistente. Dit word voorgestel dat hierdie vaardigheidkursusse verpligtend gemaak word vir alle kliniese asssistente en bywoning en voltooiing van die kursus twee maal per jaar verpligtend moet wees vir diegene wat in ‘n kraamsaal wil werk. Gevolgtrekking: Vaginale stuitverlossings, hoewel nie stastisties betekenisvol nie, het met meer morbiditeit en sterftes gepaardgegaan.

Exposure to increased diversity has been found to produce beneficial results in both learning and democracy outcomes across races; however, this relationship is more consistent for White students than students of color (Gurin, Dey, Hurtado, & Gurin, 2002). Using the data from a campus-wide diversity survey, the relationship between two types of diversity (informal-interactional and classroom) with learning and democracy outcomes was examined in a mid-sized university. Additional analyses were conducted to identify trends in diversity attitude and perception of campus climate toward diversity. Increased classroom diversity and informal-interactional diversity were both found to be related to increased learning and democracy outcomes for White students. For students of color, only classroom diversity was related to increased learning and democracy outcomes. Students of color and females were found to possess more positive attitudes toward diversity. Students of color perceived the more negative campus diversity climate than did White students.

Since the implementation of Outcomes Based Education (OBE) in South Africa, educators were confronted with new challenges regarding teaching, learning and assessment. A substantial number of educators seemed to experience these challenges as stressful, because they were not sufficiently prepared for the didactic paradigm shift and they were also unfamiliar with the OBE-terminology and methodology This situation resulted in a widespread degree of negativity and resistance amongst teachers towards the implementation of OBE in general, and specifically concerning issues related to outcomes based assessment (OBA). The primary aim of the research was to determine how educators perceive OBA and what problems they experience with the implementation thereof. In order to achieve the above-mentioned aim, 220 educators from the Bojanala West Region of the North-West Province participated in a survey. This survey was conducted by means of a questionnaire which contained structured and unstructured items. Based on the results emanating from this survey, the following conclusions were drawn: • The participants endorsed the theoretical foundations on which OBA is based and they were of opinion that OBA can provide the necessary focus for an improvement in teaching and learning, but they displayed negative perceptions concerning the practical implementation thereof. • The participants' negative perceptions regarding the implementation of OBA were caused by: • a lack of knowledge and skills due to inadequate training; • a lack of departmental support and guidance; • the administrative over-load brought on by OBA; • over-crowded classrooms and infrastructural deficiencies; and • a lack of parental support and involvement. In the light of the findings of the research, recommendations were made to enhance the practical implementation of OBA in schools. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2007

This thesis aims to undertake health technology assessments in high risk pregnancies through the following objectives: 1. In women with pre-eclampsia, a) To evaluate the association of maternal genotype and severe pre-eclampsia b) To assess the accuracy of tests in predicting adverse pregnancy outcomes c) To develop composite outcomes for reporting in trials on late onset pre-eclampsia 2. In women with multiple pregnancy, a) To study the association between chorionicity and stillbirth b) To identify the optimal timing of delivery in monochorionic and dichorionic twin pregnancies 3. In the field of prediction research in obstetrics a) To provide an overview of the existing prognostic models and their qualities b) To evaluate the methodological challenges and potential solutions in developing a prognostic model for complications in pre-eclampsia Methods The following research methodologies were used: Delphi survey, systematic reviews and meta-analyses. Results 1. a) Maternal genotype and severe pre-eclampsia: 57 studies evaluated 50 genotypes; increased risk of severe pre-eclampsia with thromobophilic genes. b) Accuracy of tests in predicting pre-eclampsia complications: 37 studies evaluated 13 tests. No single test showed high sensitivity and specificity. c) Delphi survey of 18/20 obstetricians and 18/24 neonatologists identified clinically important maternal and neonatal outcomes and maternal and neonatal composite outcomes were developed. 2. Prospective risk of stillbirth and neonatal deaths in uncomplicated monochorionic and dichorionic twin pregnancies: 32 studies were included. In dichorionic twin pregnancies, the risk of stillbirths was balanced against neonatal death at 37 weeks' gestation. In monochorionic pregnancies, there was a trend towards increase in stillbirths after 36 weeks but this was not significant. 3. a) From 177 studies included, 263 obstetric prediction models were developed for 40 different outcomes, most commonly pre-eclampsia, preterm delivery, mode of delivery and small for gestational age neonates. b) The obstetric prognostic model challenge of dealing with treatment paradox was explored and seven potential solutions proposed by expert consensus. Conclusion I have identified the strength of association for genes associated with complications in pre-eclampsia, components for composite outcomes for reporting in studies on pre-eclampsia, and the optimal timing of delivery for twin pregnancies. My work has highlighted the gaps in prediction research in obstetrics and the limitations of individual tests in pre-eclampsia.

Transition-age youth with mental health conditions experience adverse employment and educational outcomes and little is known about strategies for improving their outcomes. The purpose of this study was to review education and employment intervention programs that targeted transition-age youth with mental health conditions, to highlight the components, efficacy of the interventions, and predictors of better outcomes. Eighteen studies published between 1990 and 2017 met the inclusion criteria. Results indicate that interventions led to improvement in employment or education outcomes. Common intervention components included: mental health services, career counseling, career development, cognitive adaptation training, interagency collaboration, peer mentoring, functional skills assessment, individualized or person-centered counseling, social skill, and independent living skills training. Being married, active participation in vocational intervention, social support, prior work experience, high score on Social and Occupational Functioning Assessment Scale were found to be associated with better education and employment outcomes. Implications for research, and practice are discussed.

The student-teacher relationship (STR) is an important component of a student's success in school. STRs have the potential to serve as an asset for students' well-being and achievement throughout their school career. Current literature suggests that there are two major components of STRs associated with student's academic and behavioral outcomes: closeness and conflict. Research has indicated that STRs characterized by closeness are linked to positive academic and behavior outcomes for students while STRs characterized by conflict are associated with negative academic and behavior outcomes for students. Although research has demonstrated that closeness and conflict have an impact on student outcomes, research on the impact in kindergarten is limited. This study examined the associations between STRs characterized by closeness and conflict with reading, mathematics, and behavior outcomes in kindergarten students (n = 97), as well as the moderating effects of gender on these relationships. Results of the full hierarchical regression models indicated that prior reading and mathematics achievement were the strongest predictors of reading and mathematics outcomes. Closeness did not account for any of the variance in reading, mathematics, or externalizing behavior outcomes. Conflict on the other hand, was a small significant predictor for reading and mathematics outcomes, and a large significant predictor for externalizing behavior outcomes. Implications of these findings and suggestions for future research are discussed.