Masters in Public Administration - MPA / The historic social and economic inequalities had a negative impact on majority of young children in South Africa. This dates back to post-apartheid era where the development of young children. of some previously disadvantaged communities, has been weakened by inadequate access to health care, quality education, social service and quality nutrition. The present study evaluated the progress made on the implementation of the National Development Plan (NDP) 2030 using a case study of Early Childhood Development (ECO) centres in Site-B Township based in Khayelitsha. To support the notion of "leaving no one behind and universal access to education", the study used a Humanistic Approach Theory Framework and Human Capital Approach to determine the current status of the formalisation of the ECD centres, infrastructure and equipment, basic service delivery as well as safety at the ECD centres in Site-B. The study adopted a qualitative research design using a semi structured face-to-face interview schedules with respondents. Purposive sampling was applied to select the critical case perceived useful for the study. It comprised of 20 respondents, all principals or owners of the selected ECD centres. ECD centres were selected from the database obtained from the Department of Social Development (DSD) and the Department of Basic Education (DBE). From the samples, the study revealed that even though a lot has been done by different stakeholders to support Early Childhood Development, learning centres located in historically disadvantaged areas such as Site-B still face a number of challenges. Key among them are: challenges to comply with the registration process and lack of trained and skilled teachers; inadequate funding to meet compliance standards; insufficient infrastructure and educational equipment and lack of support for ECO safety and security measures and health related emergencies.

A key element in evidence-based medicine approaches is the ability for clinicians to evaluate the scientific rigor and relevance of research evidence. In the treatment of diabetes, clinicians make increasingly difficult decisions about which drug regimens are best for their patients with limited evidence-based information. While the consensus is that metformin should be the initial drug treatment when diet and exercise are not sufficient, clinicians disagree on whether sulfonylureas should remain a suitable therapy after metformin. While this would be improved with further research investigating the comparative safety of therapeutic options, there is also need for better ways to synthesize available information to guide evidence-based decision-making in health services research. Study 1 summarizes the pre-existing evidence on the long-term safety risks associated with sulfonylurea therapy relative to other drug classes. Results from a series of meta-analyses provide some evidence that sulfonylureas are associated with elevated all-cause mortality and cardiovascular risks relative to several other medications, either as a monotherapy or in combination with metformin. Study 2 analyzes the comparative safety of second-line treatment in diabetic patients in the Veterans Health Administration to address gaps in the literature. Results suggest that second-line use of sulfonylureas is associated with increased risks compared to thiazolidinediones. Results also suggest that changes to existing metformin therapy may lead to differential hazards. Clinicians may disagree about the quality of the evidence as well as the relevancy to their own treatment population. Improvements in methods for evidence-based medicine that take this into account are needed. Study 3 applies an underutilized research method that allows for a more thoughtful synthesis of all available evidence. This framework allows clinicians to incorporate the scientific rigor and relevancy of previous study results when integrating new data into their current knowledge base. Results suggest an elevated risk in all models for sulfonylureas compared to thiazolidinediones and highlight the need to design more focused research to support clinical decision-making around medication safety. This novel application to evidence synthesis shows promise as applied to a health services research problem and has potential as a useful framework in other health services research areas. / 2017-12-09T00:00:00Z

Conclusion. The missing data is a common problem in clinical trial. The methodology development is urgently needed to detect the difference of two treatments drug in patient quality of life. The modified pattern mixture model incorporating generalized estimating equation method or multiple imputation method provides a solution to tackle the non-ignorable missing data problem. Different clinical trials with various treatment schedules, missing data patterns will be formed. Further studies are needed to study the optimal choice of patterns under the methods. / Introduction. Health-related Quality of Life (HRQoL) has now been included as a major endpoint in many cancer clinical trials in addition to the traditional endpoints such as tumor response and survival. It refers to how illness or its treatment affects patients' ability to function and whether it induces symptoms. Toxicity, progression and death are common outcome affecting patient's QOL in cancer trial. Since this type of missing data are not occurred at random and are called non-ignorable missing data, conventional methods of analyses are not appropriate. It is important to develop general methods to deal with this problem so that treatment effectiveness for improving patient's QOL or those with serious side effect that is detrimental to patient's QOL can be identified. / Methods. The generalized estimating equation based on modified pattern mixture model is constructed to deal with non-ignorable missing data problem. We conducted a simulation study to examine performance of the model for different types of data. Two scenarios were examined. The first case assumes that two groups have quadratic trend but with different rates of change. The second case assumes that one group has linear trend with time while the other group has quadratic trend with time. Moreover, the second methodology is the multiple imputation based on modified pattern mixture model. The main idea is to resample the data within each pattern to create the full data set and use the standard method to analyze the data. Comparison between two methods was carried out in this study. / Recently, joint models for the QOL outcomes and the indicators of drop-outs are used in longitudinal studies to correct for non-ignorable missing. Two broad classes of joint models, selection model and pattern mixture model, were used. Most of the methodology has been developed in the selection model while the pattern mixture model has attracted less attention due to the identifiability problem. Although pattern mixture model has its own limitation, a modified version of this model incorporating Generalized Estimating Equation can be used in practice. / Result. The power of generalized estimating equation alone is higher than pattern mixture model when the missing data is missing at random. Moreover, the bias of generalized estimating equation is less than that of pattern mixture model when the missing data is missing at random. However, the pattern mixture model performs well when the missing data is missing not at random. On the other hand, the modified pattern mixture model has higher power than the standard pattern mixture model if one group has quadratic trend and other group has linear trend. However, the power of modified pattern mixture model is similar or worst than the standard when the data is both quadratic trends with different rates of change. On the other hand, the results of multiple imputation based on modified pattern mixture model were similar but the power was less than the generalized estimating equation model. / Mo Kwok Fai. / "August 2006." / Adviser: Benny Zee. / Source: Dissertation Abstracts International, Volume: 68-09, Section: B, page: 6051. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 91-93). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Environmental deterioration and social injustice highlight the discrepancy between ‘educated' and ‘wise' and, by corollary, call into question our approach to education. In order to investigate how we might advance Education for Sustainability (EfS) in a Scottish secondary school context this research engages with: relevant theory, the educational policy context, and practice in the form of two action research pilot projects. The concepts of utopianism and design are proposed as original and potentially useful to understand, guide and evaluate EfS and are linked to an analytical framework to clarify the concept of EfS endorsed in this thesis. The analytical framework developed comprises four thinking modes: systems thinking; future thinking; an emphasis on values and priorities; and action competency, each qualified through reference to practice. The pilot projects highlighted the challenges of monitoring and evaluating; illustrated opportunities and challenges to deliver EfS theory; offered new theoretical insights into EfS implementation; and enabled reflection on the status of EfS in the wider curriculum. The challenge of undertaking action research as a postgraduate student led to critical analysis of action research in academia. The thesis highlights the potentially promising policy context to facilitate EfS, particularly in Scotland, but also the practical challenges to implement EfS. Such challenges include: concerns over the clarity of policy documents; teachers' interest and ability to facilitate pupil-led learning; and resources to support the quality of EfS being delivered. Recommendations for future research include additional classroom-based projects; policy implementation analysis; and investigation of teachers' values, attitudes and capacity. It was concluded that utopianism, design, and the four thinking modes can potentially contribute to qualifying EfS in current policy and facilitate pupils to critique the status quo, and develop and share alternative visions of a sustainable future.

This thesis examines the impact of the housing experiences of resettled refugees. It reiterates that becoming a refugee was not a matter of choice, but for those in refugee situations it was imperative to seek refugee status for their survival. This study focuses on the housing experiences of the Auckland Somali resettled refugees and seeks to identify the effect of housing policy and provision in Auckland. It also demonstrates the links of housing to employment, education and health. Refugees face considerable resettlement challenges based on differential factors such as ethnocentrism, immigration status, household composition and socio-economic conditions. These barriers are exacerbated by a lack of English language proficiency, a variety of educational backgrounds and unfamiliarity with institutional practices, especially during their early years of adaptation as relative newcomers to New Zealand.The vulnerable position of this group in housing markets requires up to date information to increase the provider's awareness of housing experiences and their impact on the resettlement process. In turn, an increased knowledge allows evidence-based decisions for appropriate intervention, policy, and strategy developments to facilitate optimum resettlement outcomes. Policy formulation and effective implementation must focus on the identification of suitable services to address the specific barriers experienced by this group. The empirical evidence supports previous findings that there were close correlations between the participants housing experiences that are the types of housing they occupied and their income.The study developed and implemented a Participatory Research Design involving a case study approach with multiple data collection methods. The primary field data was collected from focus group participants through a workshop of qualitative discussion and a survey.

The impact of Internet technology on critical thinking is of growing interest among researchers. However, there still remains much to explore in terms of how critical thinking can be fostered through online environments for higher education. Ten years ago, Garrison, Anderson, and Archer (2000) published an article describing the Community of Inquiry (CoI) framework which provided an outline of three core elements that were able to describe and measure a collaborative and positive educational experience in an online learning environment, namely teaching presence (design, facilitation, and direct instruction), social presence (the ability of learners to project themselves socially and emotionally), and cognitive presence (the extent to which learners are able to construct and confirm meaning through sustained reflection and discourse). This dissertation extends the body of research surrounding the CoI framework and also the literature on developing critical thinking in online environments by examining and exploring the extent to which teaching and social presence contribute to cognitive presence. The researcher was able to do this by offering 189 learners enrolled in 10 research methods courses and educational research courses an opportunity to use an innovative online resource (Research Design Learning Resource – RDLR) to assist them in learning about educational research and developing research proposals. By exploring how participants used this resource the researcher was able to gain insight into what factors contributed to a successful online learning experience and fostered cognitive presence. Quantitative and qualitative research approaches (mixed methods) were used in this study. The quantitative results indicated that both social and teaching presence had a strong positive relationship with cognitive presence and that learners generally perceived to have a positive learning experience using the RDLR. The qualitative findings helped elaborate the significant quantitative results and were organised into the following themes: making connections, multiple perspectives, resource design, being a self-directed learner, learning strategies, learning preferences, and barriers to cognitive presence. Future directions for critical thinking in online environments are discussed.

Significant research has investigated Jack Gibb’s model of defensive and supportive communication, but little has explored the influence of the type of talk -- defensive or supportive -- on perceptions of communication climate and the role that verbal aggressiveness may play in influencing both the types of talk and these perceptions. This thesis explored the relationship between defensive and supportive talk, verbal aggressiveness and communication climate using a mixed-method approach. Specifically, the Verbal Aggressiveness Scale was used to group participants for a dyadic problem solving exercise which generated conversational data that was analyzed qualitatively. Then, the Communication Climate Inventory was used to measure participants’ perceptions of the communication climate that emerged in their problem-solving dyad. The findings highlight factors that may influence the perception of communication climate. Examples of supportive talk that builds positive communication climates and limits the effects of verbal aggressiveness and examples of defensive talk that leads to negative communication climates are provided. This research demonstrates that language has an influence on communication climate through the words that shape the complex ways people perceive and understand each other and, interestingly, that the negative impact of defensive communication overrides the positive impact of supportive communication on the emergent communication climate.

The impact of Internet technology on critical thinking is of growing interest among researchers. However, there still remains much to explore in terms of how critical thinking can be fostered through online environments for higher education. Ten years ago, Garrison, Anderson, and Archer (2000) published an article describing the Community of Inquiry (CoI) framework which provided an outline of three core elements that were able to describe and measure a collaborative and positive educational experience in an online learning environment, namely teaching presence (design, facilitation, and direct instruction), social presence (the ability of learners to project themselves socially and emotionally), and cognitive presence (the extent to which learners are able to construct and confirm meaning through sustained reflection and discourse). This dissertation extends the body of research surrounding the CoI framework and also the literature on developing critical thinking in online environments by examining and exploring the extent to which teaching and social presence contribute to cognitive presence. The researcher was able to do this by offering 189 learners enrolled in 10 research methods courses and educational research courses an opportunity to use an innovative online resource (Research Design Learning Resource – RDLR) to assist them in learning about educational research and developing research proposals. By exploring how participants used this resource the researcher was able to gain insight into what factors contributed to a successful online learning experience and fostered cognitive presence. Quantitative and qualitative research approaches (mixed methods) were used in this study. The quantitative results indicated that both social and teaching presence had a strong positive relationship with cognitive presence and that learners generally perceived to have a positive learning experience using the RDLR. The qualitative findings helped elaborate the significant quantitative results and were organised into the following themes: making connections, multiple perspectives, resource design, being a self-directed learner, learning strategies, learning preferences, and barriers to cognitive presence. Future directions for critical thinking in online environments are discussed.

Significant research has investigated Jack Gibb’s model of defensive and supportive communication, but little has explored the influence of the type of talk -- defensive or supportive -- on perceptions of communication climate and the role that verbal aggressiveness may play in influencing both the types of talk and these perceptions. This thesis explored the relationship between defensive and supportive talk, verbal aggressiveness and communication climate using a mixed-method approach. Specifically, the Verbal Aggressiveness Scale was used to group participants for a dyadic problem solving exercise which generated conversational data that was analyzed qualitatively. Then, the Communication Climate Inventory was used to measure participants’ perceptions of the communication climate that emerged in their problem-solving dyad. The findings highlight factors that may influence the perception of communication climate. Examples of supportive talk that builds positive communication climates and limits the effects of verbal aggressiveness and examples of defensive talk that leads to negative communication climates are provided. This research demonstrates that language has an influence on communication climate through the words that shape the complex ways people perceive and understand each other and, interestingly, that the negative impact of defensive communication overrides the positive impact of supportive communication on the emergent communication climate.

Aim: This thesis reports the outcomes of a study designed to explore whether and how ethical and responsive interviewing of children in care with varying levels of sensitivity to topics that may threaten their felt security can be achieved. Background: Children come into care with a complex array of developmental challenges. They have often experienced maltreatment, loss and disrupted attachment relationships. Little is known about the effects of interviewing children in care with varying sensitivity to questioning strategies designed to measure felt security and their perceptions of being in care. Methods: The present study was iteratively designed using an exploratory mixed qualitative design. Children’s reports (N= 12) were collected using a series of iteratively designed interview methodologies supplemented by information provided by their kinship carers. Results: The following factors influence the comfort experiences of children in care: interviewer skill, interviewer and child role, child competence (perceived and real), child characteristics, external factors, ethical factors and the interview methods. The potential influence of mental health status and age were less clear. Factors related to felt insecurity were: relational, self-perceived competence and confidentiality related factors. The maintenance of the comfort experience of children in care when interviewing, cuts across many dimensions of the research context including relational, performance and methodological aspects. Children engaged in strategies to mediate their comfort, this was somewhat reliant on the methodologies and interviewer competency. Overall acceptable levels of comfort were reported to be maintained over the span of the research process. Conclusions: Children in care have vulnerabilities that need to be addressed when including them in research. Careful consideration to the design of studies and interview methodologies will ensure children in care can participate in protective research environments. The benefits to this are reflected in the gathering of quality data which can contribute to the timely provision of the appropriate services for children in care. The present study findings provide guidance for future research involving children in various types of alternate care.