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Dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology, Durban University of Technology, 2010. / It is well documented that the chiropractic profession has been searching for a unified professional identity. Acknowledging this need for a professional identity relevant to the public, the World Federation of Chiropractic (WFC) attempted to address these concerns by conducting an international questionnaire based Identity Consultation. However, of the 3689 chiropractors who responded, only 34 were from South Africa. Therefore this study aimed to determine the perception of South African chiropractors regarding their public identity and to compare the results with those from international studies. Objectives: To determine the demographic profile of South African chiropractors, and how they perceived their professional identity relative to their own opinions, those of the public and those of medical doctors. This study investigated how South African chiropractors saw their profession relative to physiotherapy and South African chiropractor’s knowledge of the WFC Identity Consultation. Method: The study was a population based demographic study making use of a descriptive, observational, cross sectional design. It was a quantitative selfadministered questionnaire distributed to those South African chiropractors meeting the inclusion criteria (n=398). The WFC Identity Consultation questionnaire was modified and developed by the researcher to suit a South African audience after permission was obtained from the chairperson of the WFC. Results: A response rate of 30.15% was obtained. Ninety percent of South African chiropractors felt that it was important for their profession to have a clear identity. However, only 1.7% agreed that it did have a clear identity. When asked how the public viewed chiropractic, 45% felt that the public had no clear perception of the profession, with 92.5% viewing it as Complementary and The Perceptions of South African Chiropractors, Regarding Their Professional Identity iv Alternative Medicine (CAM). However, 89.2% of South African chiropractors would like the public to perceive chiropractic as mainstream medicine. When asked how chiropractic was viewed by South African chiropractors relative to physiotherapy, it was agreed that they were two separate professions each with their own identity (74.2%). The chiropractic adjustment was seen as a strong brand advantage over physiotherapy. When asked how they thought medical doctors viewed chiropractic, 73.3% felt that they did not have a clear perception of the profession, with 96.7% considering medical doctors to view chiropractic as CAM. Medical doctors’ perceptions were considered to be very important with respect to inter-professional relations. Just over half (54.2%) of South African chiropractors knew about the WFC identity, less than half of whom (47.5%) agreed with it. Conclusions: The study revealed that there was a significant difference between how South African chiropractors thought the public and medical doctors currently perceived chiropractic and how they would like to be perceived. It revealed that like their international counterparts chiropractors in South Africa are striving for a unified identity that is different to the way they are currently perceived by the health care stakeholders.

Submitted in fulfilment of the requirements of the Degree of Master of Technology: Marketing, Durban University of Technology, 2013. / Indications from the initial phase of this study suggest that key marketing fundamentals apparent in this business sector differ significantly from those generally recognisable in commodity, consumer product and industrial marketing. It is postulated that whilst these differences are probably symptomatic of particular professional service practice norms and business ethics the formulation, implementation and evaluation of effective marketing can be facilitated utilising appropriate contemporary marketing paradigms. This study explores the current marketing milieu in a multinational professional services organisation and attempts to identify factors relevant to marketing within the organisation. The objective of this study was to identify the critical factors that influence the successful marketing of professional services and to develop a framework to support these findings. In order to accomplish this objective, the study was undertaken from a phenomenological, rather than a positivist paradigm. An exploratory quantitative Likert-scale survey combined with the allowance for qualitative open-ended comments/ feedback was adopted. The quantitative study incorporated employees in managerial, middle and junior roles from the Specific Professional Services Organisation ‘SPSO’s’ national offices based in Durban, Johannesburg, Pretoria, and Cape Town. Marketing representatives from the ‘SPSO’s’ international offices were also included in the survey. It can be summarised that the main factors influencing the marketing of professional services can be grouped according to Strategy, Product/ Service, Price, Place, Promotion, Physical Evidence, People, Process, and Other. A framework was devised, comprising the nine identified groups of factors including correlating recommendations, as well as a tabular outlay of additional constructive qualitative comments recorded from respondents with recommendations.

ABSTRACT Background: Electronic cigarettes are used to deliver nicotine to consumers. E-cigarettes are claimed to be an alternative method for smoking cessation. The use of electronic cigarettes is increasing among young people, especially current and former smokers. It is unknown what the harm or benefit that result from e-cigarettes’ use of the individuals on the well-being. Purpose: This study was conducted to explore the prevalence of e-cigarettes use and exposure among college-based health care students. Also to assess the awareness level and beliefs in regard to electronic cigarettes use among the college-based health care students. Methods: 217 college-based health care undergraduate students from nursing, nutrition and respiratory therapy programs were surveyed in this study. The survey was composed of 17 questions in regards to the awareness, prevalence of e-cigarettes use and beliefs about e-cigarettes use. The data analysis included descriptive statistics, independent sample t-test and one-way ANOVA. A significance level was set at 0.05. Results: The response rate was 98.1%, 87% of the respondents were female and 70% were between the ages of 19-25 years. Most of the respondents were nursing students (47.5%); followed by nutrition students (29.5%); and respiratory therapy students (23%). Most of the respondents were non-smokers (83.4%); former smokers were 13.8%; and smokers were 2.8%. Almost all the respondents had heard of e-cigarettes (99.5%), and 21.2% had tried e-cigarettes at least once in their lifetime. The mean awareness score was 5.1 (SD 0.11); smokers showed the highest mean awareness score of 6.0±2.28. The majority of the participants disagreed that e-cigarettes are less dangerous than traditional cigarettes or can help smokers to quit; and more than half of the participants disagreed that e-cigarettes are used only by smokers. There was a significant difference among male (5.71±1.51) and female (5.03±1.71) in regards to the e-cigarettes awareness level (p=0.047). The awareness level was significantly different among respondents who had previously used e-cigarettes (5.63±1.49) than participants who have not tried e-cigarettes at least once during their lifetime (4.98±1.72) (p=0.021) Conclusion: This study found that most of the students in the college of nursing and health professions were not e-cigarettes’ users. People who have tried e-cigarettes, have friends who have tried e-cigarettes as well. Furthermore, curiosity is the major reason that led them to try e-cigarettes. E-cigarettes’ awareness is high among smokers and e-cigarettes’ users; older students seem to have higher awareness than younger students. There were general disagreements on the use of e-cigarettes as a less dangerous alternative to tobacco cigarettes to help smokers to quit. Finally, male and female participants showed significant differences in their awareness of e-cigarettes.

Background: attachment theory provides an account of human behaviour across the lifespan, has a strong theoretical foundation and is clinical applicable. It is particularly relevant to older adults, who are often exposed to a greater number of losses. Despite a growing awareness of increasing life expectancy worldwide, services for older adults in the NHS remains under-resourced. However, increased exposure to death and loss in the work might result in clinical psychologists being more reluctant to choose this specialism and may raise issues about their own early attachment experiences. Therefore, it is important to understand how clinical psychologists approach the complexities of their work in light of their own early attachment experiences. Qualitative research of the lived experiences of clinical psychologists is sparse and to date there are no studies addressing this specific issue. Aims: this is an exploratory study which addresses a gap in the literature. The aims are to capture the early attachment experiences of clinical psychologists specialising in working with older adults. It is hoped that the outcome of the study will shed some light on the characteristics of this under-researched group and how they manage the challenges of the work. Methodology: a semi-structured interview schedule was developed to explore how clinical psychologists make sense of their work with older adults in light of their early attachment experiences. Interviews were carried out with five clinical psychologists working in specialist older adult services. The transcripts of the interviews were then analysed using Interpretative Phenomenological Analysis (IPA). Results: the analysis of the five interviews yielded five main themes – “Making sense of early attachment relationships”, “Developing identity in childhood and adolescence”, “Understanding of decision to work with older adults”, “Work with older adults as both challenging and rewarding” and “The person within the professional”. Each of the main themes and their subthemes were supported by excerpts from narratives of participants experiences. Implications: this study highlighted several research and clinical implications. First, the role of non-parental childhood attachments in the development of internal working models is currently an under-researched area which may provide important insights into resilience factors in the face of childhood adversity. Second, clinical implications suggest that access to older adult work early on in the career of clinical psychologists may increase desirability of working in specialist services. Third, the study supports attachment theory as a useful approach to understanding the work with older adults and as a valuable area for the professional development of clinical psychologists. Finally, systemic working with older adults remains an important part of the work which would benefit from further research in this area.

Previous research has noted that members of research ethics committees are unclear about the extent of their roles. In this study, research amongst members of independent ethics committees (IECs) about how the ‘expert’ and ‘lay’ roles are understood and operationalized offers an explanation for this lack of clarity. IECs were selected for study because they have only addressed one type of research (Phase 1 ‘healthy volunteer’ studies) and this limited remit suggested that it would be in such committees that the member roles would have become most pronounced. Drawing on findings from the sociology of professions and employing a phenomenological approach to understanding, 20 semi-structured interviews with both expert and lay members of these committees revealed that a number of members were not only unclear about the roles, but unclear too whether they, or certain of their colleagues, were in which membership category. Notwithstanding this fact, and paradoxically, the ‘expert’ designation was seen as granting its members a privileged position on the committees. The expert member was seen to be either a medically qualified member or one tightly associated with the medical model. Such a repository of expertise being with the medical model privileges this model in ethics review such that other matters formally to be scrutinized by ethics committees become marginalised. Participant safety was the prime concern of the ethics review for IEC members. This relegated other matters including the adequacy of the insurance arrangements, the readability of the consent forms, the fairness of the inclusion criteria, and so forth, into areas of lesser concern. That this occurs though when the science, the safety and the methodology of the trials are already – separately - subject to an independent analysis by a body of experts, whose statutory role is to concern itself with these issues such that no trial may occur without their sanction, is of significance. IEC members were cognizant of this duplication of role but unable to resolve it. The situation could be accounted for as due to capture by the medical model and a cognitive dissonant process. Members’ training and education were found to have been neglected because under the medical professions’ gaze no other type of knowledge was considered necessary in ethics review. The study revealed that the medical profession’s dominance of such committees accounts for the members’ role uncertainty and as such allies itself to Freidson’s theory of professional dominance. If such a concept has been thought to be an obsolete one, this study suggests such a notion of the status of the theory is premature. The medical model’s status is implicitly accepted such that nothing else need be considered. The research calls for further studies to corroborate such findings in other research ethics settings and for a debate about what society wants its ethics committees to focus upon in their review.

CHDS State/Local / The Medical Reserve Corps (MRC) was formed to provide a cadre of trained medical volunteers to support and strengthen the public health infrastructure and improve its' emergency preparedness level. Training policies and standards are left to the discretion of the local MRC coordinator so the program maintains its flexibility to meet community needs. Training varies from unit to unit, and there are no protocols in place to measure or evaluate the effectiveness of that training. According to recent studies and surveys, disaster operations are an unfamiliar role for most MRC volunteers and the public health workforce in general. Evidence also suggests that few medical and public health workers receive this important preparedness training. In 2005, MRC working group members developed a list of core competency recommendations to provide training guidance, but specific educational content to satisfy those competencies were not defined. This thesis offers specific training content guidelines and strategies for achieving competency. The MRC must be able to integrate into the disaster environment while working safely, effectively and efficiently. Standards will set the mark for success, enabling the MRC to respond in a coordinated manner and at a consistently higher level to any public health emergency. / Captain, Texas State Guard-Medical Rangers

This study investigated three issues problematic to the state of knowledge on mentoring. These issues were: (a) lack of scientifically derived operational definitions in use in research on mentoring; (b) lack of agreement about how common mentoring is; and (c) lack of agreement about whether or not alternate forms of career support are more efficient than mentoring. The information collected to address each of these issues was acquired in two phases: a literature survey followed by a sample survey. The literature survey addressed the first issue. It resulted in the formulation of an operational definition of mentoring which was based on an empirical profile of an "ideal" mentoring relationship. Formulation of the profile was a major focus of this study.

The Academy of Nutrition and Dietetics is the leading professional organization for registered dietitians (RDs)--globally--with over 75,000 members. Professional organizations are often overlooked in communication scholarship. However, the Academy offers a rich setting for researching occupational identities, health activism, and neoliberalism. I used semi-structured interviews to explore how taken-for-granted discourses, power relationships, and unquestioned norms are challenged, reinforced, and (re)constructed within the Academy. Specifically, this study analyzed two challenges to the Academy and the dietetics profession: claims to professional expertise and a debate surrounding the Academy's corporate sponsorship. My findings suggest that the profession, which happens to be predominantly female, is struggling with issues of marginalization. RDs described their expertise through a rhetorical turf war--in which they defined themselves against nutritionists--to help elevate their profession. Further, I found that the Academy has a sub-group of health activists that are unified through their holistic approach to nutrition. These health activists attempted to address complaints about the Academy's corporate sponsorship program but lacked a unified vision for their efforts. By researching the Academy, I hope to contribute new understandings about how professional organizations, discourses of expertise, and corporate sponsorship contribute and influence the public's understandings of health and nutrition. While my results have practical and theoretical implications for RDs and the Academy, they also have broader implications for understanding power relationships and hidden discourses within our complex, dynamic food system.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.