Submitted by Caroline Falcao (caroline.rfalcao@ufpe.br) on 2017-05-24T17:31:26Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) BRUNO FERREIRA-protegido - DISSERTAO.pdf: 4975980 bytes, checksum: e85d55190b5c3de6c457c5d296450623 (MD5) / Made available in DSpace on 2017-05-24T17:31:26Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) BRUNO FERREIRA-protegido - DISSERTAO.pdf: 4975980 bytes, checksum: e85d55190b5c3de6c457c5d296450623 (MD5) Previous issue date: 2011-02-24 / Os Parâmetros Curriculares Nacionais (PCN) de Matemática pressupõem para a educação fundamental, dentro do bloco de Espaço e Forma, a interpretação e representação de posição e de movimentação no espaço. Entretanto, por diversas razões, o ensino da Geometria Gráfica, disciplina que desenvolve habilidades de visualização espacial necessárias para os requisitos citados dos PCN, tem se enfraquecido na educação básica, tendo como consequência, entre outras, levar ao ensino superior alunos com baixo nível dessa habilidade. Investigações na Área da Expressão Gráfica e da Educação Matemática levantam três tipos de dificuldades: epistemológicas, didáticas e cognitivas. Referente ao uso de tecnologias computacionais, estudos apontam que essas dificuldades podem ser superadas. Porém, o simples uso do computador não garante que ocorram aprendizagens. Nessa direção, propomos investigar os efeitos do uso de um programa de modelagem computacional por alunos de graduação para resolver uma situação problema de Geometria Gráfica Tridimensional. Como hipótese inicial, pressupomos que ao utilizarem o programa as dificuldades com relação à visualização espacial diminuem, contribuindo para os alunos resolverem o problema corretamente. Para nossa investigação, iniciamos com o estudo da Geometria Gráfica Tridimensional, enfocando a questão da representação desde a fisiologia da visão até os métodos de ensino utilizados. Após o estudo histórico e metodológico do método de Monge, enfocamos as questões didático-pedagógicas, abordando as dificuldades de aprendizagem dos alunos. Utilizamos a teoria das Situações Didáticas de Brousseau como norteadora da organização do nosso experimento, preocupando-se com a noção de meio (milieu) e sua importância na construção de situação de aprendizagem. Em nossa metodologia realizamos uma análise a priori para a escolha do programa de modelagem, bem como do problema. Foram sujeitos da pesquisa oito alunos do curso de licenciatura em Expressão Gráfica da UFPE, matriculados na disciplina de Geometria Gráfica Tridimensional I. O Conteúdo escolhido foi “interseção entre planos”. Como instrumento de coleta de dados, utilizamos um teste de visualização espacial, no início do semestre. A situação problema foi aplicada em dois ambientes, em prancheta, com uso dos instrumentos tradicionais de desenho e em laboratório de informática, usando uma ferramenta computacional selecionada, além de entrevistas semiestruturadas após cada aplicação da situação problema. Como técnica de análise utilizamos a “análise de conteúdo” a partir do levantamento de técnicas utilizadas na resolução do problema e nas fases de resolução de problemas em GGT, fases inspiradas de Barros & Santos e Polya. Como resultado, percebemos que o uso do programa de modelagem minimizou as dificuldades quanto à visualização espacial, apesar deste fato não garantir o avanço da resolução do problema em comparação com o uso dos instrumentos tradicionais de desenho. Isso se deve à dificuldade com relação ao próprio conteúdo. Em contrapartida, os alunos realizaram a fase de retrospecto em todo processo operacional, o que antes não ocorria ou somente ocorria no final da resolução. Além disso, a etapa de Exploração proporcionou a elaboração de maior número de técnicas com uso da ferramenta computacional, dando-nos a oportunidade de identificar a gênese das dificuldades dos alunos para, futuramente, elaborar metodologias que minimizem essas dificuldades, conduzindo o aluno a uma aprendizagem efetiva dos conhecimentos em jogo. / Les programmes nationaux d'enseignement (PCN) des mathématiques présuppose pour l'enseignement fondamental, dans le bloc de contenus « Espace et Forme », l'interprétation et la représentation de positions et mouvement dans l'espace. Pour diverses raisons, l'enseignement de la géométrie graphique, discipline que développe les aptitudes de visualisation spatiale nécessaire aux exigences des PCNs cités, a perdu de l'espace dans l'enseignement fondamental, permettant à des élèves ayant ces aptitudes peu développées d'accéder à l'enseignement supérieur. Des recherches dans le domaine de l'expression graphique et de l'enseignement des mathématiques mettent en évidence trois types de difficulté : épistémologiques, didactiques et cognitives. Relativement à l'utilisation de technologies informatiques, des études montrent que ces difficultés peuvent être dépassées, pourtant la simple utilisation de l'ordinateur ne garantit qu'il y ait des apprentissages. Dans ce sens, nous avons proposé d'étudier les effets de l'utilisation par des élèves d'université d'un logiciel de modelage pour résoudre une situation problème de Géométrie Graphique Tri-dimensionnelle. Comme hypothèse initiale, nous avons supposé que par l'utilisation du programme, les difficultés relatives à la visualisation spatiale diminuerai et contribuerai à ce que les élèves résolvent le problème correctement. Pour notre recherche, nous commençons par l'étude de la Géométrie Graphique, nous focalisant sur la question de la représentation graphique de la physiologie de la vision aux méthodes d'enseignement en oeuvre. Après l'étude historique et méthodologique des principes géométriques de Monge, nous avons abordé les questions didactiques-pédagogiques, nous intéressant particulièrement aux difficultés d'apprentissage des élèves. La théorie des situations didactiques de Guy Brousseau nous a servi de guide pour l'organisation de notre expérimentation, nous préoccupant particulièrement de la notion de milieu et son importance dans la construction de situation d'apprentissage. Pour notre méthodologie, nous avons réalisé une analyse a priori pour le choix du logiciel de modelage et de la situation problème. Huit élèves du cours de licenciatura en Expression Graphique de l'UFPE faisant la disciplina de Géométrie Graphique Tri-Dimensionnelle I. Le contenu choisi a été l'intersection entre plans. Comme instrument de collecte des données, nous avons utilisé un test de visualisation spatiale au début du semestre ; une situation-problème appliquée dans deux environnements : planchette avec l'utilisation des instruments classiques de dessin et en laboratoire d'informatique avec le logiciel de modelage sélectionné ; et des interviews semi-structurées après chaque mise en oeuvre de la situation problème. Comme technique d'analyse, nous avons mis en oeuvre l'analyse de contenu à partir de la mise en évidence de techniques utilisées de la résolution de problème et des phases de résolutions de problème en GGT, phases inspirées de Barros & Santos et Polya. Comme résultat, nous avons observé que l'utilisation d'un logiciel de modelage a réduit les difficultés de visualisation spatiale, mais ce fait n'a pas garanti l'avancée dans la résolution de problème en comparaison avec l'utilisation des instruments classiques de dessin. Ceci vient de la difficulté avec le contenu lui-même. En contrepartie, les élèves ont effectué la phase de rétrospective dans tout le processus opérationnel, ce qui n'est pas le cas ou seulement à la fin de la résolution dans l'environnement classique. De plus, l'étape d'exploration a provoqué l'élaboration d'un plus grand nombre de techniques dans l'environnement informatique donnant la possibilité d'identifier la genèse des difficultés des élèves et, dans le futur, élaborer des méthodes que minimisent ces difficultés, amenant les élèves à un apprentissage effectif des connaissances en jeu.

INTRODUÇÃO: Programa Nacional de Alimentação Escolar (PNAE) consiste na transferência de recursos financeiros do Governo Federal, em caráter suplementar, aos estados, Distrito Federal e municípios, para a aquisição de gêneros alimentícios destinados à merenda escolar. Em 16 de junho de 2009 foi criada a Lei 11.947 que determina a utilização de, no mínimo, 30 por cento desses na compra de produtos da agricultura familiar. A Lei é relativamente recente e, portanto, o processo de operacionalização da compra da agricultura familiar pelo PNAE encontra-se em fase de implementação, sendo que alguns municípios lograram realizar as compras diretamente dos agricultores familiares, enquanto outros ainda não. OBJETIVO: Conhecer e descrever o processo de implementação da Lei 11.947/09 e alguns fatores que se relacionaram com a compra direta da agricultura familiar para o PNAE no âmbito escolar e da gestão municipal, em uma amostra probabilística dos municípios do estado de São Paulo. METODOLOGIA: Trata-se de um estudo descritivo que envolveu metodologias quantitativas para a descrição e caracterização dos municípios avaliados. Foram excluídos municípios em que a nutricionista e/ou o funcionário do departamento de compras não aceitaram participar, bem como quando o secretário municipal de educação não autorizou a pesquisa junto às escolas. A amostra final se constituiu por 25 municípios que compraram alimentos dos agricultores familiares em 2012 (Grupo A) e 13 que não o fizeram (Grupo B), totalizando 38. Foram visitadas 162 escolas. Foram entrevistados nutricionista responsável técnica pelo PNAE, funcionário do departamento de compras, autoridade escolar e merendeiras de cada escola sorteada. Para esta pesquisa foram desenvolvidos sete questionários. RESULTADOS E DISCUSSÃO: Setenta e dois por cento das nutricionistas dos municípios que compraram diretamente dos AF assistiram alguma palestra de divulgação da mesma, sendo que 94,4 por cento os consideraram pertinentes, em contra posição às do Grupo B com 54 por cento e 92,3 por cento , respectivamente. Ainda no âmbito escolar, apenas 6,6 por cento das merendeiras (Grupo A) já haviam ouvido falar que os alimentos que elas produzem deveriam ser comprados de agricultores familiares, o que não foi semelhante ao Grupo B, em que 42,1 por cento das colaboradoras estava ciente da origem correta dos produtos. Todas as escolas visitadas estavam adequadas ao preconizado segundo a resolução 38 no que se tratava a servir pelo menos de três porções de frutas e hortaliças por semana. Segundo 64 por cento das nutricionistas do Grupo A, houve mudanças benéficas no cardápio, após a implementação da Lei nos municípios, dentre elas: aumento de frutas verduras e legumes; melhora de qualidade e variabilidade dos alimentos, o que os tornou mais saudáveis. Embora o Grupo B não compra alimentos da agricultura familiar, 77 por cento assinalam melhorias em relação ao cardápio após a divulgação da Lei. CONCLUSÃO: Concluímos que o diálogo entre os diversos atores envolvidos no processo é a via mais importante para que o processo de implementação das compras pelo PNAE seja bem sucedido. Os agricultores familiares necessitam de mais apoio e garantias para vender para as prefeituras e essa segurança pode vir através de editais de chamada pública mais simples e claros para que entendam melhor. / INTRODUCTION: National School Feeding Program (PNAE) is the transfer of funds from the Federal Government, in supplementary form to the states, Federal District and municipalities, for the purchase of food for school meals. On June 16, 2009 the Law 11.947 was created, which determines the use of a minimal of 30 per cent of this for purchase of products originating from family farms. The Law is relatively new and, therefore, the process of operationalization of purchases by the PNAE from family farms finds itselfs in the implementation stage, where some municipalities have succeeded making purchases directly from these farmers, while others have not yet done so. OBJECTIVE: The aim of this paper is to describe the factors that made possible the direct purchase from family farms by the PNAE for schools and municipal management (nutritionist and the purchasing department of municipalities) in a sample of municipalities in the state of São Paulo. METHODOLOGY: This is a descriptive study that involves quantitative methodologies to describe and characterize the municipalities evaluated regarding the process of implementation of the Law 11.947/2009. We excluded counties where the dietitian and / or the employee\'s purchasing department refused to participate, as well as the municipal secretary of education not authorized research in the schools. The final sample was constituted by 25 municipalities that bought food from family farmers in 2012 (Group A) and 13 who did not (Group B), totaling 38. 162 schools were visited. Were interviewed by the dietitian responsible Technical Program, employee of the purchasing department, school authority and cooks drawn from each school. For this research were developed seven questionnaires. RESULTS AND DISCUSSION: Seventy -two percent of nutritionists municipalities who bought directly from AF attended any lecture disclosure of the same, and 94.4 per cent considered them relevant, contrary to the position of Group B with 54 per cent and 92.3 per cent , respectively. Even at school , only 6.6 per cent of the cooks ( Group A) had heard that the food they produce should be bought from farmers , which was not similar to Group B , in which 42.1 per cent of the collaborators was aware of the correct source of the products. All schools visited were appropriate according to the recommended resolution 38 when it came to serve at least three servings of fruits and vegetables per week. According to 64 per cent of nutritionists in Group A, there were beneficial changes on the menu, after the implementation of the Law on municipalities, among them: increased fruit and vegetables; improves quality and variability of food, which made them healthier. Although Group B does not buy food from family farms, 77 per cent indicate improvements over the menu after the disclosure of the Law. CONCLUSION: We conclude that the dialogue between the various agents involved in the process is the most important method for the implementation of the purchasing process by the PNAE to be successful. Family farmers require more support and guarantees for selling to local governments and these may come through simpler and clearer public notices edicts that facilitate understanding.

Magister Curationis - MCur / Introduction: The enrolled nurse is an important category of nurse in the health team. Regulation 2175 is the course leading to enrolment as a nurse, according to the South African Nursing Council, in terms of the Nursing Act 33 of 2005 as amended. This category has completed the training programme R2176 which is a course leading to enrolment as an auxiliary nurse. This level of training occurs in accredited hospitals schools, however it appears, from observation and personal experience, that pupil nurses experience many problems and programme does not have high pass rates. There has been no formal investigation of this situation. The aim of this study was to investigate factors that promote or inhibit nursing students’ success in qualifying for entrance to the SANC R2175 final examination at one of the nursing schools in the Western Cape. The objectives were (i) identify factors that promote or inhibit learning amongst the pupil nurses; and to (ii) determine the perceptions of educators with regard to factors related to the pupil nurses success or failure. Methods: The study used a multi-method approach. A quantitative, explorative and descriptive design was applied. Target population (N=90), consisted of student nurses following the course leading to registration as an enrolled nurse (R2175) according to Nursing Act No 33 of 2005. Convenience sampling was used to select participants to respond to a questionnaire which was used to collect data. In qualitative approach the target population consisted of nurse educators (N=6). Non-probability, purposive sampling was used to select participants for the focus group interview. Ethics: Ethical approval to conduct the study was obtained from the University of Western Cape and the University of Cape Town. Informed consent was obtained from the students and from the educators prior the commencement of the study. The questionnaire was pretested to ensure to ensure reliability and validity. Quantitative data was analysed with the help of the University statistician and was expressed in frequency tables and factor analysis. Qualitative data was analysed using coding to develop categories and themes with the help of the supervisor. Results: The results showed that academic performance by place of residence had a significant difference between the urban and rural students (x2 (1) = 0.014). The marital status of the student showed significant association with academic performance (x2 (3) = 0.021). The association between support from family and academic performance was significant (x2 (1) = 0.008). The focus group discussion with the nurse educators confirmed and supported some of the finding of the student survey. Recommendations: Some of the researcher’s recommendations included: a review of the recruitment and selection process; review of the curriculum; review of the value of bursary; reinstatement of the bridging programme and the implementation of preceptors in the clinical facilities.

Magister Curationis - MCur / Medication errors can result in harm and death, for which nurses are legally liable. The administration of medication by nurses can be improved through education and training to avoid medication errors in future. The study aimed to investigate fourth year Bachelor of Nursing students’ perceptions regarding the clinical learning opportunities and their competence in the administration of oral medication in a general hospital. A quantitative cross-sectional descriptive design was employed. The all-inclusive sample constituted 176 fourth year Bachelor of Nursing students. A total of 125 respondents completed the self- report questionnaires. Descriptive statistics were produced through data processing and univariate and bivariate analysis using of SPSS version 22. The study’s findings show that most of the 125 respondents were placed in a medical (92%, 115) and surgical ward (86.4%, 108). However, a total of 59.2% (74) of the 125 respondents did not practice administration of oral medication on a daily basis. The majority of the respondents perceived themselves as competent in the administration of oral medication. However, only a total of 19.2% (24) of the 125 respondents perceived themselves as competent in all 42 skills required for the correct procedure of administration of oral medication. A negative correlation was found between total self-assessment of competence scores and total clinical placement scores. An observation study, using the check list, of the competence of nursing students in the administration of medication is recommended to exclude bias associated with self-assessment. The use of simulation is recommended to enhance the opportunities and competence of the students in the administration of oral medication to many patients.

The thesis focuses on the Primary School Nutrition Programme (PSNP), particularly in the Eastern Cape, as a government nutrition and education project, and its failure to achieve its stated goals. The programme experienced problems almost as soon as it was introduced. The press reported incidents of fraud and maladministration and the programme was halted and restarted numerous times. The thesis seeks to offer some insight as to why the government was unable to reach its stated objectives in the implementation phase of the programme. State theory informs the thesis in an attempt to further explain why governments often seem unable to attain their intended goals. The thesis provides an alternative to government development programmes, arguing that NGOs are better equipped to deal with the particular problems that people on the ground experience when dealing with issues like nutritional vulnerability. Operation Hunger provides an excellent case study for how development of this nature ought to occur. The essential argument of the thesis is that there is an inherent tension between what a government's stated intentions is and what, it, in reality, intends to gain from such programmes. It is the contention of this thesis that the Government of National Unity embarked on the PSNP, not to ensure nutritional development for its own sake, but rather to curry favour with its constituents. Operation Hunger, and other organisations like it, provide relief to vulnerable communities with no hidden agenda in mind. Their mandate is solely that they provide assistance. The thesis argues, then, that NGOs have a role in domestic and international politics, that they can make up for or do better, or at least well, things that governments struggle to do.

This study is a contribution to the ongoing debate concerning the future of South Africa’s macro-economic policy known as the Growth, Employment and Redistribution (GEAR) strategy. The study attempts to draw parallels between the GEAR macro-economic policy framework and structural adjustment programmes in the South. By making use of this comparison, the study argues that the outcome of the GEAR will be no different from structural adjustment programmes in that it will fail to reduce poverty and cause government to meet the basic needs of the people. These conclusions are drawn from the fact that the GEAR policy is premised on the faith that the market is capable of redistributing income and wealth, and providing people with their basic needs.

Foodborne diseases are a major challenge to school feeding programmes because inadequate food safety knowledge and skills of staff can result in unsafe food handling practices and cross-contamination, thus causing foodborne disease outbreaks. The aim of this study was to investigate the food safety and quality assurance measures of the National School Nutrition Programme (NSNP) in Mpumalanga Province, South Africa. The research design was cross-sectional quantitative in nature. A total of 300 NSNP food service managers/coordinators and 440 food handlers were selected to participate in the study. Data collection was by means of a self-administered structured questionnaire and 192 food contact surface swap samples from 32 primary and secondary public schools. The majority of schools offering NSNP meals were located in informal settlements and most were found to lack basic resources such as electricity and potable tap water in their kitchens. 93% of food handlers did not know about Hazard Analysis Critical Control Point (HACCP). The NSNP food service managers in some schools, especially in schools located in rural settlements, were found to have little knowledge or awareness of HACCP. No school was found to have implemented the HACCP, and only a few staff had received food safety training. Inadequate food safety knowledge was worst in schools located in informal settlements due to a lack of training. Up to 60% of food handlers did not know the correct procedure for washing a cutting board after it had been used. In addition, just over 95% of the food handlers did not know how to sanitise utensils and cutting surfaces after cutting up raw meat. The lack of hygiene was confirmed by the presence of Listeria monocytogenes, Staphylococcus aureus, E.coli 015:H7, Salmonella and Shigella species on food contact surfaces. A total of 22 different bacteria genera were identified. It is essential to monitor NSNP kitchen hygiene practice to ensure the minimal contamination of food products and newly recruited food handlers should be trained on food handling practice and principles to ensure the safety of prepared food for school children. / Business Management / D. Phil. (Consumer Science)

Motivated by scarce academic consideration of project management control frameworks, this article explores usage, value and structure of frameworks with a focus on the popular Control Objectives for IT and related Technology (CobiT) construct. We attempt to add to an empirically validated structure of internal control over IT project management by including CobiT's views on the intended domain of content. Results from the empirical survey indicate that the metrics suggested by CobiT are regarded as feasible and important by project management professionals, and are regularly used in controlling practice. Experience, regularity of significant projects and the size of the hosting organisations, however, seem to be stronger moderators of success rates than the use of a management control system with or without support of CobiT. CobiT's suggestions are of generic nature and in particular useful for programme performance management. The latent dimensions of project quality on process and activity levels were not validated and gaps to other project assessment models were identified.

Philosophiae Doctor - PhD / Background: Satisfaction with the care mothers receive during child-birth is known to have a very strong influence on their future use of facility-based care during child-birth. Women and children continue to die from complications associated with pregnancy and child-birth and the majority of the causes that lead to mortality are related to labour and delivery. For this reason it is imperative for mothers to access facility-based child-birth care to receive skilled birth care. Mothers report dissatisfaction with facility-based child-birth care as one of the reasons for home births without skilled attendants. The presence of the skilled birth attendants is known to reduce maternal and neonatal mortality rates because of their ability to diagnose any early complications, and to intervene appropriately. Aim: The aim of the current study was to develop an in-service training programme for midwives to provide patient-centred child-birth care that would increase client satisfaction with child-birth care. Method and findings: The intervention research model by Rothman and Thomas (1994) – Design and development (D & D) – was used as the research framework. Only the first four of the six phases of the D & D model were applied in this study. In the first phase, a situational analysis was done using a qualitative study. The expectations, experiences, and satisfaction with child-birth care of antenatal and postnatal mothers, were explored. The research was conducted in four health institutions within the Kumasi Metropolis. Between 12 and 15 participants were purposively sampled in each hospital. Data were collected by means of individual in-depth interviews using an interview guide and data were analysed using content analysis. The study found that mothers expected to receive respectful care and safe care. Mothers had encouraging experiences and discouraging experiences during their child-birth care. The discouraging experiences did not align with their expectations of care, leading to dissatisfaction with child-birth care. In the second phase of the study an integrative literature review was conducted to identify evidence-based best practices to deal with client dissatisfaction with health care. The integrative literature review indicated that in-service training was commonly used as best-practice to improve health professionals' knowledge, skills and attitudes towards work and consequently to improve health outcomes for patients, including client satisfaction. In the third phase of the study, the in-service training programme to enhance patient-centred care was developed using Chinn and Kramer (2005) guidelines for programme development and steps to programme development by Management Sciences for Health (2012). The fourth phase entailed an assessment of feasibility and usability of the in-service training programme using 6 midwives in a district Hospital. The procedure was guided by the I-Tech Technical Implementation guide (2010). The outcomes of the assessment was used to refine and revise the developed in-service training programme. Conclusion: This study sought to develop an intervention to increase client satisfaction with child-birth care service by engaging the following processes in phases: • Assessing the expectations and experiences of mothers about child-birth care services. • An integrative literature review for evidence-based best practice to tackle client dissatisfaction with health care. • Designing a patient-centred care in-service training programme together with experts in the field of maternal and child health. • As assessment of feasibility and usability of the in-service training programme by means of a pilot test to refine the programme. Recommendations: It was recommended among others that, the study is carried out on a national scale to cover all administrative regions of Ghana. It is further recommended that the study findings and the programme developed form part of the continuous professional assessment course requirement for nurses and midwives.

Introduction: The participation profile of patients with chronic obstructive pulmonary disease (COPD) in pulmonary rehabilitation (PR) and the effectiveness of a video-based home exercise programme (VBHEP) were investigated using various research methods. Methods: The content analysis of the Move-On-Up exercise video against NICE guidelines and published research was performed. The video was evaluated for its suitability for use in VBHEP through focus groups involving UK population of patients with COPD and respiratory clinicians. Using the data from the content analysis and the focus groups, questionnaire items were synthesised for a national survey of both patients and clinicians. A study examined the relationship between participation in outpatient PR and patient measures of depression (Brief Assessment Depression Card), social support (Duke Social Support Index), multidimensional health locus of control (MHLC) and COPD severity (Medical Research Council dyspnea score). A randomised control trial (RCT) evaluated the effect of combining VBHEP and conventional outpatient PR on walking ability and PR benefit maintenance. The intervention arm received VBHEP concurrently with outpatient PR, while the control arm received only outpatient PR. Outcome measures included: the endurance shuttle walk test (ESWT), quality of life (QoL) (St George's Respiratory Questionnaire- SGRQ), MHLC and a modified Follick's activity diary. Measures were taken before PR, at the fourth and eighth weeks of PR and at six months post-PR. Focus groups were conducted between six and 20 months post-PR to evaluate patients' experience of and adherence to the use of VBHEP. Results: Critical review of 46 RCTs aided evaluation of the video demonstrating that the video content was consistent with both NICE recommendations and published research. The six focus groups that were part of the initial evaluation of the video involved 14 patients and 14 clinicians. The national survey generated responses from 60 patients and 62 clinicians; between 79 and 100% of respondents in each domain of the questionnaire indicated that the video is suitable for use. Fifty-one patients completed the study investigating the profile of patients participating in PR. The results indicated that depression has a moderate and negative statistically significant association with the uptake of PR (p < 0.05). Fifty-seven patients participated in the RCT [mean age 66.51 years (SD 9.96), mean FEV1% predicted 54.51% (SD 10.47)]. The results indicated that the use of VBHEP with outpatient PR has no significant additive effect in improving or maintaining the benefits of walking ability following PR (p<0.05). Seven patients participated in the follow-up focus groups where findings suggested that patients were still participating in VBHEP up to 20 months after it was first prescribed, though the frequency of its use appeared to diminish after PR ended. Conclusion: The Move-On-Up exercise video is suitable for VBHEP in patients with COPD. Patients with COPD and depression are less likely to take up a referral to PR compared to those without depression. The use of VBHEP concurrently with PR has no additive effect in improving or maintaining benefits of walking ability following PR. Adverse social circumstances and disease severity reduce the duration of participation in VBHEP.