PhD (Health Sciences) / Department of Advanced Nursing Science

PhD (Health Sciences) / Department of Advanced Nursing Science / Introduction: For newly graduated midwives to function effectively with regard to provision of quality midwifery services, successful transition from student status to professional status should be enhanced. It is therefore important that transition support programmes be put in place in order to provide a baseline for guidance and support of newly graduated midwives. Purpose: The purpose of this study was to develop a transition support programme to enhance effective support of newly graduated midwives during their transition period in Limpopo Province, South Africa. Setting: The study was conducted in maternity units of selected regional hospitals and a tertiary hospital in all the districts of Limpopo Province, South Africa. Methods: Phase 1: A qualitative, exploratory and descriptive design was used for the study. The population comprised of all newly graduated midwives who have undergone a comprehensive nursing programme (R425 of 19 February 1985, as amended) and qualified as nurses (General, Psychiatric and Community) and Midwifery from the universities and nursing colleges; as well as all professional nurses working at selected hospitals. A non-probability, purposive sampling method was used to select five newly graduated midwives who have been working for a period less or equals to one year following their successful completion of training, and were working in maternity units of the selected hospitals. Five professional nurses qualified as midwives and have been working in maternity units of the selected hospitals for at least five years, were also sampled through a non-probability, purposive sampling method. Data were collected through in-depth individual face-to-face interviews; a ABSTRACT vii voice recorder was used to capture information shared by participants, and field notes were also taken. An open-coding method was used to analyze data. Ethical principles and measures to ensure trustworthiness were considered. Major themes, themes and sub-themes were identified from the analyzed data. The following major themes emerged from data analysis: Experiences of being a newly graduated midwife in labour ward, Support provided by experienced midwives, Relationship between experienced and newly graduated midwives in labour ward, Expectations of experienced midwives from newly graduated midwives as well as Newly graduated midwives’ views related to placement in the labour ward. Empirical findings revealed that newly graduated midwives viewed labour ward as a traumatic environment as it is very busy with serious shortage of staff. Graduates also expressed a professional nurse’s role as stressful as it demands high level of responsibility and accountability which they did not have, resulting in frustration and anger. Newly graduated midwives felt that the support they received from the experienced midwives was ineffective, as they were neither mentored nor properly supervised and the environment was not conducive for learning. The relationship between graduates and experienced midwives was poor and some experienced midwives displayed negative attitudes towards the graduates. Results showed that graduates failed to meet experienced midwives’ expectations as they were unable to function independently, resulting in failure to reduce the workload. Newly graduated midwives recommended that their placement in maternity ward be extended from a period of six months to a year in order for them to build confidence in midwifery practice. Phase 2: Results of phase 1 of the study revealed transition support gaps which led the researcher to analyze ‘effective transition support’ as a core concept. Concept analysis was done in accordance with Walker and Avant’s method; in order to clarify its meaning. The findings of both phase 1 and concept analysis guided the ABSTRACT viii development of a transition support programme aimed to enhance effective support of newly graduated midwives during their transition period. Development of a transition support programme was based on Duchscher’s transition theory as well as ADDIE’s model for training and instructional design, the steps of which were: analysis, design, development, implementation and evaluation. A developed transition support programme was validated using a quantitative approach, whereby exploratory and descriptive designs were employed. The main aim was to validate for effectiveness and applicability of a developed transition support programme. Validation was conducted in a similar setting as in phase 1, with the same population. Puposive sampling method was used to select participants who met inclusion criteria. A sample consisted of twelve (12) newly graduated midwives, thirty eight (38) experienced midwives of which thirteen (13) were operational managers. A self developed questionnaire was used for data collection. The validation process was based on a framework for programme evaluation in public health by the Centers for Disease Control and Prevention. According to the validation results, the developed transition support programme met the standard as it can be easily implemented, it is practical, utilizable, appropriate and will benefit patients, family members, health care facilities and the community at large. Recommendations: The developed transition support programme addressed the major challenges identified in the findings of the main study. Only aspects of the results which were not addressed by the developed transition support programme were covered in the recommendations. Recommendations were directed to the nursing education, nursing practice as well as future research. / NRF

Chez l’adulte, la production écrite est une activité motrice automatisée. L’écriture est fluide et rapide car la production de chaque lettre repose sur l’activation préalable d’une mémoire procédurale connue sous le terme « programme moteur » ou « carte sensori-motrice ». Nous nous sommes attachés à comprendre comment s’élaborent ces programmes moteurs au cours de l’apprentissage de l’écriture. Nous avons étudié comment l'écriture des enfants évoluait d’une programmation trait par trait à une programmation lettre à lettre. Dans toutes nos études nous avons enregistré les mouvements d’écriture des enfants à l’aide d’une tablette digitalisante. Dans la première expérience, 98 enfants de 6 à 9 ans devaient produire des lettres de complexité variable, dépendant de leur nombre de strokes. Les résultats ont indiqué qu’à 6 et 7 ans, la durée du mouvement, la dysfluence et la trajectoire augmentaient avec le nombre de strokes de la lettre. Chaque allographe était produit par l’activation du premier stroke, puis du deuxième stroke et ainsi de suite jusqu’à la réalisation de la lettre complète. Le nombre de strokes des lettres affectait beaucoup moins la production des enfants plus âgés. Les enfants regroupaient la programmation de ces strokes en chunks, qui augmentaient en taille progressivement pour aboutir, à la fin du processus d’automatisation, à une production lettre à lettre. L’analyse a révélé que les premiers automatismes se stabilisaient aux alentours de 8 ans. Toutefois, certaines lettres restaient représentées en chunks même chez les enfants les plus âgés. La nature du stroke à produire semblait affecter également la mise en place des automatismes. Ainsi, une autre expérience a été réalisée pour étudier l’impact de la production des strokes nécessitant des mouvements de rotation, indispensables à la production de traits courbés (e.g., pour la lettre o), et des mouvements de pointage nécessaires pour positionner l’outil scripteur après leur lever (e.g., pour mettre le point sur le i). Nous avons demandé à 108 enfants âgés de 6 à 10 ans d’écrire des séquences de lettres majuscules variant en termes de mouvements de pointage et de rotation. Les résultats ont indiqué que les pointages requerraient un compromis entre les durées des mouvements sur la feuille et en l’air. Les mouvements de rotation impliquaient une réduction de l’écart entre les vitesses maximales et minimales. Le respect d’un tempo de l’écriture semble gouverner ces stratégies compensatoires qui sont spécifiques au type de mouvement. Au niveau développemental, la présence de paliers dans les données cinématiques, laisse à penser que la majeure partie de l’évolution se situe dans la période 6-8 ans, et précède une phase de stabilisation entre 8 et 10 ans caractérisant le début de l’automatisation des mouvements d’écriture. Notre travail met ainsi en évidence que plus l’enfant grandit et pratique l’écriture, plus il/elle est capable de programmer des chunks d’informations plus importantes. Or, cette augmentation en taille de la mémoire procédurale n’est pas seulement quantitative, elle s’accompagne d’une gestion différentielle en fonction du type de stroke à réaliser. Le contenu du programme moteur ne se limiterait donc pas à des informations sur la forme, l’ordre et la direction des strokes mais détiendrait également des informations permettant la mise en place de stratégies cinématiques compensatoires pour des gestes spécifiques comme ceux de rotation et de pointage. Les programmes moteurs s’élaborent pendant le processus d’apprentissage, qui s’étale sur la période 6-7 ans. À partir de 8 ans, ces acquisitions commencent à s’automatiser avec la pratique et l’augmentation des capacités cognitives, attentionnelles et mnésiques. L’automatisation de l’écriture semble être acquise pour la plupart des lettres entre 9 et 10 ans, et devient alors un outil de communication langagière. Les implications de ces résultats sont directement applicables en milieu scolaire. / Written production is an automated motor activity for adults. Writing is smooth and fast because letter production relies on the prior activation of a procedural memory known as “motor program” or “sensori-motor map”. Our investigation focused on how motor programs develop during writing acquisition. We examined how writing evolved from stroke-to-stroke programming to letter-to-letter programming. In all our studies we recorded the children's writing movements with a digitizer. In the first experiment, 98 children aged 6 to 9 had to write letters of varying numbers of strokes. The results indicated that at ages 6-7, movement duration, dysfluency and trajectory increased with the letter’s number of strokes. The letters were produced by the activation of the first stroke, then the second stroke, and so on until the completion of the whole letter. The number of strokes affected much less the productions of the older children. They assembled the strokes into chunks, which gradually increased in size, until they could write, at the end of the automation process, with a letter-to-letter programming strategy. The analysis revealed that the first automatisms stabilized at age 8. However, some letters remained represented in chunks even among the older children. Specific types of strokes affected the stabilization of letter automation. We thus carried out another experiment to examine the impact of the rotation strokes that are necessary for the production of curved lines (e.g., to produce letter o) and the pointing movements that position the pen after a lift (e.g., to produce the dot on letter i). In the experiment, 108 children aged 6 to 10 wrote sequences of upper-case letters varying in pointing and rotation movements. The results indicated that the production of rotation movements required a speed trade-off to decrease differences between maximum and minimum velocities. Pointing movements required a duration trade-off between the movements executed on the sheet and in the air. There seems to be a sort of tempo for letter production that modulates letter production. This requires compensatory strategies that are cognitively demanding. At the developmental level, the kinematic data suggests that most of the learning process takes place between ages 6 to 8. Then there is stabilization phase that marks the beginning of writing automation. It evolves between ages 9 and 10. Our work thus revealed that as the child practices writing, the motor programs code increasingly bigger information chunks. This quantitative increase in procedural memory is also accompanied by qualitative information for certain types of strokes that require specific processing. Therefore, the content of motor programs is not limited to information about letter shape, stroke order and direction. Motor programs also code information on compensatory kinematic strategies for rotation and pointing movements. These motor programs are elaborated during the learning process between ages 6 to 7. At around age 8, with practice and the increase of cognitive, attentional and memory skills, they start to stabilize and become automated. At ages 9-10, writing is automated for most letters and becomes a linguistic communicational tool. The implications of these results are directly applicable in schools for the improvement of pedagogical tools in teaching writing.

Effect of health exercises and swimming for women after breast cancer Abstract Defining the problem: The theoretical part of the thesis will be devoted to course of illness and subsequent convalescence of women with breast cancer. We will give a list of suitable health exercises that are applicable in the gym and at home. The next part will be devoted to the benefits of the movement program in the water. We will focus on swimming stroke breaststroke and backstroke. The practical part will contain the data from the input diagnosis before the application motion program, the program and the output diagnosis after four months of movement intervention. Objective: The aim of this work is to create movement program for improvement of locomotive system women after breast ablation, which is composed of the health exercises applicable in the gym and in the water. Method of solution: Probands undergo the entry diagnostic, which is comprised from anthropometry, goniometry and interview about their day's physical activities. Output diagnosis is ensues after four months of movement intervention and it is same as the input diagnosis. The resulting values will be compared. Results: We found that motion intervention we have chosen is after breast ablation akcepted by women and is friendly for them. The application of the...

Title: Effects of water-based aerobic programme on health-related physical fitness and health-related quality of life level in elderly females Objectives: The aim of this study was to asses the effect of shallow water aerobic programme on changes of health-related physical fitness and health- related quality of life level in elderly females. Methods: 33 women (mean age 67 ± 5,2 years) were eligible for participation for the study. Participants were divided into experimental and control group. The experimental group (n = 17) participated in a 6month shallow water aerobic programme once a week 60 minutes. The control group did not participate in the physical program. Body composition, low-back and hamstring flexibility, hand grip strength, upper body and lower body strength, aerobic capacity, dynamic postural stability and health-related quality of life were determined before and after completion. Results: This study has shown that the training programme caused a significant increase in aerobic capacity (p = 0,01; r = 0,62) and in general health perception (p = 0,04; r = 0,36). Keywords: physical fitness, water exercise programme, ageing, quality of life

Philosophiae Doctor - PhD / Cardiovascular disease is amongst the top three leading causes of mortality in South Africa and the world. The effects of cardiovascular disease can be seen in limitations of function within all spheres of life, including work function. Cardiac rehabilitation programmes have been documented to improve functional abilities, but little is known about the return to work rate after cardiac rehabilitation. Access to cardiac rehabilitation programmes in the Western Cape is limited. This study aimed to determine the return to work rates and influencing factors after cardiac rehabilitation as well as to design an intervention programme that is accessible and could facilitate return to work for individuals with cardiovascular disease.

Diploma thesis is dealing with the political party programme as the basic building block of political rhetoric and related phenomena in the Czech and Slovak political discourse of reasoning, rhetoric and related statements and case studies that describe and approach these phenomena with examples from the current domestic political rhetoric. Author bases on contemporary critical analysis of argumentation and theory of pragma-dialectic which opposes fallacies or false arguments and then sees both methods in construction of arguments in cases of political rhetoric, mass media discourse and conotative values that they are gaining. Powered by TCPDF (www.tcpdf.org)

Masters in Public Administration - MPA / This study examined the issues and concerns for improving productivity in the public sector in South Africa, aligned in particular with the processes of its fundamental transformation, and the aims and objectives of the Reconstruction and Development Programme (RDP). More than that, it provided the view, the approach, the strategies and techniques to bring about productivity improvement. Productivity is not presented as a panacea to solve all problems. It is presented mainly as an attitude about the importance of productivity that must be acquired followed by suggestions for how to bring about its development. To provide both a comprehensive and at the same time a focused approach to improving productivity in the public sector. A second objective was to describe new skills and proven strategies that could be used for productivity improvement. The study discusses various approaches to improving productivity in the public sector that can be implemented in a number of practical ways. A third and primary objective was to recommend a model that would effectively improve productivity in the public sector. This model deals with the quantification of productivity gains through the restructuring of budgets and thereby achieving significant savings that could be transferred to priority RDP programmes. This study used both qualitative and quantitative methods. The study reviewed both domestic and international published work and current research within universities, policy bodies, government departments and elsewhere, including a reconsideration of previous work. The following conclusions were reached and recommendations made: Substantial efficiency and productivity gains are envisaged through the introduction of various models for improving productivity which include a structured productivity improvement programme, the use of performance enhancing methods, performance measurements and performance related pay. Furthermore, savings, resources and capacity can be released by the RDP programmes through: Restructuring and reprioritizing the budget programmes by making small cuts in what were apartheid-serving programmes and reallocating the human, material and financial resources thus released for high priority RDP programmes/projects. International experiences show that a direct link between falls in public investment, physical infrastructure and decline in productivity exists. The effectiveness of the public sector to a large extent conditions economic development. The move towards a leaner and more cost effective public service in South Africa should be based, not on privatisation, but on the creation of effective partnerships between government, labour, business and civil society, and the building of high levels of community involvement in the local delivery of services.

The focus of this project is on the quality and relevance of Vocational Counselling programme in Nigerian schools. It analyses the discipline’s training syllabuses in Universities and the extent and manner of its application in secondary schools by graduates in the field and proffers suggestions on how to improve upon both the training and the practice. As a professional field of study, Guidance and Counselling was first introduced at the University of Ibadan, in the 1980s. Within a few years, the Universities of Benin and Lagos also commenced a programme in the discipline. However, and as I have discovered, the products of the programme have really not achieved much impacts in Nigerian secondary schools almost thirty years after it was first introduced. As at today, most secondary schools still do not have professional career counselors. Where they exist, they are not always very competent, and are not often consulted by pupils while selecting their subject combinations. In the Universities, Guidance and Counselling syllabus are found to be outdated. Two major approaches were adopted in carrying out this research. The first method is empirical and was executed through field research. I visited the Universities of Ibadan, Ife and Lagos – all in Nigeria - to conduct interviews with students and lecturers of Guidance and Counselling in the Universities. I also collected documents like manuals, handbooks and course outlines issued by personnels in the Departments. I also visited, conducted interviews with, and served questionnaires on, professional counselors in a selection of public and private secondary schools in Nigeria. At the end of the field work, the documents, questionnaires and interviews were analysed and what I identified as the strengths and weaknesses of Guidance and Counselling programmes in Nigerian Universities were laid out. The second approach adopted in this study has to do with analysis of scientific publications in the field. Books, journals, manuals and even electronic publications by Guidance and Counselling experts in Germany, Europe and other places were assembled and carefully studied. In the end, what constitutes minimum competence requirements were underlined. Applied to the data earlier collected in the field, my conclusion is that the various Guidance and Counselling programmes in Nigeria need to be improved upon II and/updated and that its importance in secondary education needs to be further stressed. To improve the programme, I suggested, among others, the need for Nigerian Universities to actively work toward the development of collaborative and exchange programmes with institutions in Europe and other parts of the world.

The Resilient Educators (REds) Support Programme was compiled by the North West University in 2006. The aim of the REds Programme is to promote the quality of life of HIV and AIDS-affected educators. It is therefore geared towards assisting educators to cope more effectively with the challenges of the pandemic by supporting them to respond adaptively to a teaching context that demands responses more typical of counsellors or social workers, or medical personnel trained to prevent HIV (Theron, Geyer, Strydom&Delport, 2008:84). The content of the REds Programme is grouped into nine modules. Each module provides thematic structure, background information and interactive activities. Since its conception in 2006 and subsequent implementation, REds has continued to evolve, being continually informed by empirical research, with the future aim of disseminating REds to the National Department of Basic Education in South Africa (Theron et al., 2008:84-85). Continual refinement and development of REds have thus been occurring to the extent that the fourth version has been implemented in 2009. REds has to date been implemented in four South African provinces, namely Gauteng, Mpumalanga, Free State and North West Provinces, but not in the Northern Cape. However, its extended implementation in the Northern Cape may deem invaluable to the standardisation of the programme for the South African educational context The goal of the research project was to determine the effectiveness of the REds Support Programme (fourth version) in enhancing the quality of life of HIV and AIDS-affected educators in the Northern Cape. The researcher embarked upon programme evaluation as a type of applied research. The study utilised the triangulation mixed methods research design, as this study combines qualitative and quantitative research methods. The research design for the quantitative research approach was the quasi-experimental comparison group pre-test post-test design, whilst the collective case study design was used for the qualitative research approach. Quantitative data were collected through a group standardised questionnaire, the Professional Quality of Life Scale (ProQOL) and for qualitative data different methods were used including narratives and drawings. The same standardised questionnaire was administered at both the pre- and post-test level with both the experimental and comparison groups. Narratives and drawings were also utilised for both groups before and after exposure to REds. The experimental group consisted of 11 respondents from a specific primary school in Kimberley, Northern Cape, while 10 respondents, from another primary school in Kimberley, participated as part of the comparison group. The quantitative research results suggested that even though a significant difference was indicated between the comparison group and the experimental group as it relates to the measure of burnout at the post-test level, it cannot be certain that this difference is as a result of the experimental group having been exposed to the REds programme, given that a significant difference between these groups already existed at the pre-test level. Qualitative research results, on the other hand, evidently indicated that participants have profited from the REds programme and that there was a positive mind shift in the post-exposure of respondents to the programme. This could be substantiated when comparing post-exposure findings of the comparison group and the experimental group. Based on the data obtained through ProQOL, the REds programme did not adequately address the support needs (Quality of Life) of participants. The qualitative results gathered through narratives and drawings seem to have given a better representation of the impact of the REds programme on participants when compared to the quantitative results. It is recommended that the qualitative component of the research project be elevated as the data gathered through this research method was much richer than the quantitative data. The impact of the programme is evident using this data collection method. It is recommended that other possible standardised questionnaires be explored or a self-structured questionnaire be compiled in order to identify a more applicable measuring instrument. It is also recommended that the possibility of excluding a quantitative measuring instrument be explored. / Dissertation (MSW)--University of Pretoria, 2012. / Social Work and Criminology / unrestricted