Magister Artium - MA / In the majority of the schools in South Africa (SA), learners commence education in English. This English milieu poses a considerable challenge for English second-language speakers. In an attempt to bridge the gap between English as the main medium of instruction and the nine indigenous languages of the country and assist with the implementation of mother-tongue based bilingual education, this study focuses on the cross-validation of a monolingual English test used in the assessment of multilingual or bilingual learners in the South African context. This test, namely the Woodcock Muñoz Language Survey (WMLS), is extensively used in the United States in Additive Bilingual Education in the country. The present study is a substudy of a broader study, in which the original WMLS (American-English version) was adapted into SA English and Xhosa. For this specific sub-study, the researcher was interested in investigating the scalar equivalence of the adapted English version of the Verbal Analogies (VA) subscale of the WMLS across English first-language speakers and Xhosa first-language speakers. This was achieved by utilising differential item functioning (DIF) and construct bias statistical techniques. The Mantel-Haenszel DIF detection method was employed to detect DIF, while construct equivalence was examined by means of exploratory factor analysis (EFA) utilising an a priori two-factor structure. The Tucker's phi coefficient was used to assess the congruence of the construct across the two language groups / South Africa

Magister Artium (Psychology) - MA(Psych) / The fall of apartheid and the rise of democracy have brought assessment issues in multicultural societies to the forefront in South Africa. The rise of multicultural assessment demands the development of tests that are culturally relevant to enhance fair testing practices, and issues of bias and equivalence of tests become increasingly important. This study forms part of a larger project titled the Additive Bilingual Education Project (ABLE). The Woodcock Munoz Language Survey (WMLS) was specifically selected to evaluate the language aims in the project, and was adapted from English to isiXhosa. Previous research has indicated that one of the scales in the adapted isiXhosa version of the WMLS, namely the Picture Vocabulary Scale (PV), displays some item bias, or differential item functioning (DIF), across rural and urban isiXhosa learners. Research has also indicated that differences in dialects can have an impact on test takers’ scores. It is therefore essential to explore the structural equivalence of the adapted isiXhosa version of the WMLS on the PV scale across rural and urban isiXhosa learners, and to ascertain whether DIF is affecting the extent to which the same construct is measured across both groups. The results contribute to establishing the scalar equivalence of the adapted isiXhosa version of the WMLS across rural and urban isiXhosa-speaking learners. Secondary Data Analysis (SDA) was employed because this allowed the researcher to re-analyse the existing data in order to further evaluate construct equivalence. The sample of the larger study consisted of 260 learners, both male and female, selected from a population of Grade 6 and 7 learners attending schools in the Eastern Cape. The data was analysed by using the statistical programme Comprehensive Exploratory Factor Analysis (CEFA) and the Statistical Package for Social Sciences (SPSS). Exploratory factor analysis and the Tucker’s phi coefficient were used. The results indicated distinct factor loadings for both groups, but slight differences were observed which raised concerns about construct equivalence. Scatter plots were employed to investigate further, which also gave cause for concern. It was therefore concluded that construct equivalence was only partially attained. In addition, the Cronbach’s Alpha per factor was calculated, showing that internal consistency was displayed only for Factor 1 and not for Factor 2 for the rural group, or both factors for the urban group. Scalar equivalence across the two groups must therefore be explored further.

Family-centered care (FCC) focuses on considering the family in planning/implementing care and is associated with increased patient satisfaction. Little is known about factors that influence FCC. Using linear mixed modeling and Generalized Estimating Equations to analyze data from a cross-sectional survey of primary care practices in Ontario, this study sought to determine whether models of primary care service delivery differ in their provision of FCC and to identify characteristics of primary care practices associated with FCC. Patient-reported scores of FCC were high, but did not differ significantly among primary care models. After accounting for patient characteristics, practice characteristics were not significantly associated with patient-reported FCC. Provider-reported scores of FCC were significantly higher in Community Health Centres than in Family Health Networks. Higher numbers of nurse practitioners and clinical services on site were associated with higher FCC scores but scores decreased as the number of family physicians at a site increased.

Healthcare data can contain sensitive, personal, and confidential information that should remain secure. Despite the efforts to protect patient data, security breaches occur and may result in fraud, identity theft, and other damages. Grounded in the theoretical backdrop of integrated system theory, the purpose of this study was to determine the association between data privacy breaches, data storage locations, business associates, covered entities, and number of individuals affected. Study data consisted of secondary breach information retrieved from the Department of Health and Human Services Office of Civil Rights. Loglinear analytical procedures were used to examine U.S. healthcare breach incidents and to derive a 4-way loglinear model. Loglinear analysis procedures included in the model yielded a significance value of 0.000, p > .05 for the both the likelihood ratio and Pearson chi-square statistics indicating that an association among the variables existed. Results showed that over 70% of breaches involve healthcare providers and revealed that security incidents often consist of electronic or other digital information. Findings revealed that threats are evolving and showed that likely factors other than data loss and theft contribute to security events, unwanted exposure, and breach incidents. Research results may impact social change by providing security professionals with a broader understanding of data breaches required to design and implement more secure and effective information security prevention programs. Healthcare leaders might affect social change by utilizing findings to further the security dialogue needed to minimize security risk factors, protect sensitive healthcare data, and reduce breach mitigation and incident response costs.

Health inequality conflates a huge number of economic, social, and political issues. These issues, together described as social determinants, determine a population's health through influencing health status and life expectancy. The research purpose of this study was to examine how social determinants affected the life expectancy of the women of Edo State, based on secondary data from Nigeria's 2008 demographic and health survey (NDHS). The theories that guided the study were self-efficacy beliefs of the social cognitive theory and physical self-concept of the health belief model. This quantitative cross-sectional study examined the associations between socioeconomic status, nutritional status, literacy/educational attainment, access to household sanitation facilities, and life expectancy. The dependent variables were health status and life expectancy (assessed using parity and age at first delivery). The independent variables were employment, ability to read and write, listening to the radio, type of place of residence, and persons responsible for reproductive health decisions. The analysis was based on data from 950 completed face-to-face interviews in the 2008 NDHS covering 846 households in Edo State selected using a stratified 2-stage cluster sampling design. Regression analyses showed that listening to the radio, persons responsible for decisions on reproductive health issues, employment, and type of place of residence had significant positive effects on parity and age at first delivery. Employment was the best predictor of both dependent variables. Ability to read and write had a negative relationship with the age at first delivery. The social change implications include the attainment of longer lives in Edo State, Nigeria, through effective policies on employment and education.

Due to anxiety, low confidence, and inadequate content knowledge, many college students struggle to complete their developmental math coursework. As colleges redesign their programs to address these issues, careful research is imperative to determine the factors that best meet the needs of these struggling students. The purpose of this study was to analyze the impact of one college's redesigned program (integrating online, mastery, and project-based learning) compared with the traditional program. Using Weiner's attribution theory of achievement motivation and emotion as a guide, this mixed methods case study used a quasi-experimental nonequivalent control group design in conjunction with a qualitative examination of student interviews. The study used archived quantitative data and interview data from community college students in the Western United States. The quantitative data was analyzed using multiple regression, and a thematic analysis was used for the interview data. The results indicated that students in traditional courses achieved higher final exam scores than those in the revised courses. However, the revised and traditional math students did not exhibit significantly different attitudes toward math. Some of the key factors that directly impacted student success included the availability of student support services, student collaboration, and self-concept and motivation. Based on these results, the participating college and similar colleges will be able to make more informed decisions to improve the efficacy of their developmental math programs. These revisions will then help to improve student attitude and success in mathematics, will motivate students to persist in their education, and will better equip students to positively contribute to their future communities and workplaces.

Background Rising surgery rates have raised questions about the indications for spinal surgery. The study investigated patient-level and regional factors associated with spinal surgery for patients with spinal diseases. Methods We undertook a cohort study based on routine healthcare data from Germany of 18.4 million patients within 60.9 million episodes of two patient-years before a possible spinal surgery in the time period 2008 to 2016. Using a Poisson model, the effects of a broad range of patient-related (sociodemographic, morbidity, social status), disease- and healthcare-related (physicians’ specialty, conservative treatments) and regional variables were analyzed. Results There was substantial regional heterogeneity in the occurrence of spinal surgery which decreased by only one quarter when controlling for the various determinants assessed. Previous musculoskeletal and mental health disorders as well as physical therapy were associated with a lower probability of surgery in the fully-adjusted model. Prescriptions for pain medication and consultations of specialists were associated with a higher probability of surgery. However, the specific severity of the vertebral diseases could not be taken into account in the analysis. Furthermore, a substantial proportion of patients with surgery did not receive a consultation with an outpatient specialist (29.5%), preoperative diagnostics (37.0%) or physical therapy (48.3%) before hospital admission. Conclusion This large study on spinal diseases in Germany highlights important patterns in medical care of spinal diseases and their association with the probability of spinal surgery. However, only a relatively small proportion of the regional heterogeneity in spinal surgery could be explained by the extensive consideration of confounders, which suggests the relevance of other unmeasured factors like physicians’ preferences.

[EN] Investments in data infrastructures, data management, data repositories, and Open Data sharing policies and recommendations are viewed as increasingly important for scientific knowledge production. One of the underlying assumptions justifying these investments is that the more available Open Data becomes, then the greater the possibilities for creating new knowledge that can advance both science and human wellbeing. Yet efforts and investments in Open Data and other ways of data sharing only have value if data are actually reused. Recent scholarly efforts have brought forth some of the challenges and facilitators related to the reuse of data, in order to inform current and future policies and investments. However, despite these efforts, we still do not know why and how some researchers are successful in reusing data, despite the challenges they face, and why some researchers abandon the process of reusing data when facing such challenges. This dissertation aims to fill this gap by focusing on a causal explanation of the data reuse process, which it understands as being nested in broader patterns of researchers' motivations, scientific goals and decision-making strategies. The dissertation is comprised of three main elements. First, it proposes a heuristic model of the scientific actor, the bounded individual horizon (BIH) model, which understands that, on the one hand, researchers' work and careers are structured by their motivation to produce scientific contributions and rewards systems that prioritizes certain types of contributions. On the other hand, researchers' struggles to achieve their objective of creating new findings that accrue recognition and rewards occur within a frame of limited information and resources, conditioned by multiple institutional, social, and other factors. Second, the study proposes a mechanistic causal theoretical explanation that enables us to understand the data reuse process and its effects (outcomes). The data-reuse mechanism as it is called, enables us to understand how the satisficing behavior that characterizes scientific decision-making applies to the specific conditions and processes of data reuse. Third, a set of ten empirical case studies of data reuse in health research were conducted and are reported in the dissertation. These cases are analyzed and interpreted using the complementary theoretical lenses of the bounded individual horizon and the data-reuse mechanism approaches. The main findings explain that there is an apparent association between the extent and types of efforts required to reuse data, researchers' contextualized motivations, and broader goal-setting and decision-making frames. Access to data is a necessary condition for the reuse of data, yet is not sufficient for the reuse to happen. Characteristics of available data, including the context of their production, the extent of the preparation and stewarding of these data and their potential value in relation to researchers' motivations to make new scientific claims or generate background knowledge are found to be essential elements for understanding why some data reuse processes persist and succeed, while others do not. The thesis concludes that efforts and investments designed to reap the benefits of data reuse should also be expanded to include training researchers in data reuse, including to efficiently recognize opportunities, navigate the challenges of the reuse process, and be aware of and acknowledge the limitations of the use of secondary data. Without such investments, the promises and expectations linked to emerging data infrastructures, data repositories, data management guidelines and open science practices are argued to be far less likely to reach their full potential. / [ES] Las inversiones en infraestructuras de datos, gestión de datos, repositorios de datos y políticas y recomendaciones de intercambio de Datos Abiertos (Open Data) se consideran cada vez más importantes para la producción del conocimiento científico. Una de las razones que justifica estas inversiones es que cuanto más Datos Abiertos haya, mayores serán las posibilidades de crear nuevo conocimiento que pueda hacer avanzar tanto la ciencia como el bienestar humano. Sin embargo, los esfuerzos y la inversión en Datos Abiertos y otras formas de compartirlos sólo tienen valor si se reutilizan realmente. Recientes trabajos académicos han puesto de manifiesto algunos de los retos y factores facilitadores relacionados con la reutilización de los datos, a fin de asesorar las políticas e inversiones actuales y futuras. Sin embargo, a pesar de esos esfuerzos, todavía desconocemos por qué y cómo algunos/as investigadores/as logran reutilizar los datos, a pesar de los retos a los que enfrentan, y por qué otros/as investigadores/as abandonan el proceso de reutilización de los datos. La presente tesis tiene por objeto llenar este vacío centrándose en una explicación causal del proceso de reutilización de los datos, que se entiende está inmersa en pautas de conducta más amplias que se relacionan con las motivaciones, los objetivos científicos y las estrategias de toma de decisiones de los/as investigadores/as. Este estudio consta de tres elementos principales. En primer lugar, propone un modelo heurístico del actor científico, el modelo del horizonte individual delimitado (BIH por su nombre en inglés, bounded individual horizon). En él se entiende que, por una parte, el trabajo y la carrera de los/as investigadores/as se estructuran en función de su motivación para producir contribuciones científicas y de los sistemas de recompensa que dan prioridad a determinados tipos de contribuciones. Por otra parte, los esfuerzos de los/as investigadores/as para lograr su objetivo de crear nuevos hallazgos que acumulen reconocimiento y recompensas se producen en un marco de información y recursos limitados, condicionados por múltiples factores institucionales, sociales y de otra índole. En segundo lugar, esta tesis propone una explicación teórica causal mecanicista que permite comprender el proceso de reutilización de los datos y sus efectos (resultados). El mecanismo de reutilización de datos (datareuse mechanism), como se denomina, nos permite comprender cómo la toma de decisiones científicas está caracterizada por una conducta que tiende a satisfacer esos objetivos en unas condiciones y procesos específicos de reutilización de datos. En tercer lugar, este estudio incluye los resultados del estudio empírico de diez estudios de casos de reutilización de datos en ciencias de la salud. Estos casos se han analizado e interpretado utilizando el modelo teórico del horizonte individual delimitado y los enfoques del mecanismo de reutilización de datos. Los resultados principales explican que existe una aparente asociación entre el alcance el alcance y tipo de esfuerzo requerido para reutilizar datos, las motivaciones contextualizadas de los/as investigadores/as y marcos más amplios de fijación de objetivos y toma de decisiones. El acceso a los datos es una condición necesaria para su reutilización, pero no es suficiente para que ésta se produzca. Para comprender por qué algunos procesos de reutilización de datos persisten y tienen éxito, mientras que otros no,son elementos esenciales: las características de los datos disponibles, incluido el contexto de su producción; el grado de preparación y administración de esos datos; y su potencial valor en relación con las motivaciones de los investigadores para hacer nuevas afirmaciones científicas o generar conocimientos de base. Este estudio concluye que los esfuerzos e inversiones destinados a aprovechar los beneficios de la reutilización de los datos también deberían ampliarse para incluir la capacitación de los/as investigadores/as en materia de reutilización de datos. En particular, debe insistirse en la capacidad para reconocer eficientemente las oportunidades, sortear los problemas del proceso de reutilización y ser conscientes y reconocer las limitaciones de la utilización de datos secundarios. Sin estas inversiones, las promesas y expectativas vinculadas a las emergentes infraestructuras de datos, los repositorios de datos, las directrices de gestión de datos y las prácticas científicas abiertas tienen muchas menos probabilidades de alcanzar su pleno potencial. / [CA] Les inversions en infraestructures de dades, gestió de dades, repositoris de dades i polítiques i recomanacions d'intercanvi de Dades Obertes (Open Data) es consideren cada vegada més importants per a la producció del coneixement científic. Un dels supòsits subjacents que justifiquen aquestes inversions és que com més disponibles siguen les Dades Obertes, majors seran les possibilitats de crear nou coneixement que pugui fer avançar tant la ciència com el benestar humà. No obstant això, els esforços i les inversions en les Dades Obertes i altres maneres de compartir dades només tenen valor si les dades es reutilitzen realment. Recents investigacions acadèmics han posat de manifest alguns dels reptes i dels factors facilitadors relacionats amb la reutilització de les dades, a fi d'informar les polítiques i inversions actuals i futures. No obstant això, encara desconeixem per què i com alguns/es investigador(e)s aconsegueixen reutilitzar les dades, malgrat els reptes als quals s’enfronten, i per què altres investigador(e)s abandonen el procés de reutilització de les dades quan s'enfronten a aquests reptes. La present tesi té com a objectiu omplir aquest buit centrant-se en una explicació causal del procés de reutilització de dades, que s'entén que està associada amb pautes més àmplies derivades de les motivacions, els objectius científics i les estratègies de presa de decisions d’els/les investigador(e)s. La tesi consta de tres elements principals. En primer lloc, proposa un model heurístic de l'actor científic, el model de l'horitzó individual delimitat (BIH pel nom anglès, bounded individual horizon), que entén que, d'una banda, el treball i la carrera d’els/les investigador(e)s s'estructuren en funció de la seua motivació per a produir contribucions científiques i dels sistemes de recompensa que prioritzen determinats tipus de contribucions. D'altra banda, els esforços d’els/les investigador(e)s per aconseguir el seu objectiu d’obtenir nous resultats que acumulin reconeixement i recompenses es produeixen en un marc d'informació i recursos limitats, condicionats per múltiples factors institucionals, socials i d'altra índole. En segon lloc, aquesta tesi proposa una explicació teòrica causal mecanicista que permet comprendre el procés de reutilització de les dades i els seus efectes (resultats). El mecanisme de reutilització de dades (data-reuse mechanism), com es denomina, ens permet comprendre com el comportament satisfactori que caracteritza la presa de decisions científiques s'aplica a les condicions i processos específics de reutilització de dades. En tercer lloc, aquesta tesi inclou l'estudi empíric d'un conjunt de deu estudis de casos de reutilització de dades en ciències de la salut, així com també els resultats d’aquest estudi.. Aquests casos s'han analitzat i interpretat utilitzant les lents teòriques complementàries de l'horitzó individual delimitat i els enfocaments del mecanisme de reutilització de dades. Les principals conclusions expliquen que existeix una aparent associació entre l'abast i els tipus d'esforços necessaris per a reutilitzar dades, les motivacions contextualitzades d’els/les investigador(e)s i els marcs més amplis de fixació d'objectius i presa de decisions. L'accés a les dades és una condició necessària per a la seua reutilització, però no és suficient perquè aquesta es produeixi. Es considera que les característiques de les dades disponibles, inclòs el context de la seua producció, el grau de preparació i administració d'aquestes dades i el seu potencial valor en relació amb les motivacions d’els/les investigador(e)s per a fer noves afirmacions científiques o generar coneixements de base, són elements essencials per a comprendre per què alguns processos de reutilització de dades persisteixen i tenen èxit, mentre que uns altres no. Aquest estudi conclou que els esforços i inversions destinats a aprofitar els beneficis de la reutilització de dades també haurien d'ampliar-se per a incloure la capacitació d’els/les investigador(e)s en matèria de reutilització de dades, en particular per a reconèixer eficientment les oportunitats, superar els problemes del procés de reutilització i ser conscients i reconèixer les limitacions de la reutilització de dades secundàries. Sense aquests esforços i inversions, les promeses i expectatives vinculades a les infraestructures, repositoris i directrius de gestió de dades i les pràctiques científiques obertes tenen moltes menys probabilitats d'aconseguir el seu ple potencial. / Aleixos Borrás, MI. (2020). A causal model to explain data reuse in science: a study in health disciplines [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/153164

Als Bundesland mit dem höchsten Altersdurchschnitt in Deutschland und besonderen Strukturmerkmalen ländlich geprägter Gebiete sind die Folgen des demographischen Wandels bereits heute in Sachsen spürbar. Um die medizinische Versorgung von Parkinson-Patienten zu verbessern, bedarf es einer Status-quo-Analyse der aktuellen Versorgungspraxis. Ziel der Arbeit (Fragestellung) Inwieweit unterscheidet sich die Inanspruchnahme der medizinischen Leistungserbringung von Parkinson-Patienten im Vergleich von städtisch und ländlich geprägten Gebieten sowie im Vergleich von Parkinson-Patienten mit und ohne Neurologenkontakt im Beobachtungszeitraum von 2011 bis 2019? Material und Methoden Die Kohortenstudie basiert auf umfangreichen Routinedaten der Krankenkasse AOK PLUS der Jahre 2010 bis 2019 für Sachsen. Untersucht wurde eine Kohorte von insgesamt 15.744 Parkinson-Patienten (n = 67.448 Patientenjahre) und eine gematchte Vergleichskohorte (n = 674.480 Patientenjahre; Kriterien: Geburtsjahr, Geschlecht, Versicherungsjahr, Wohnsitz Stadt/Land) ohne ICD-10-Kodierung einer Bewegungsstörung. Ergebnisse Insgesamt war eine kontinuierliche Zunahme der Anzahl der Erkrankten in der dynamischen Kohorte von 2011 (n = 6829) bis 2019 (n = 8254) zu beobachten. Stadt-Land-Unterschiede zeigten sich insbesondere in der geringeren (Mit‑)Behandlung durch niedergelassene Neurologen in ländlich geprägten Gebieten. Parkinson-Patienten hatten ein 3,5- bzw. 4‑fach erhöhtes Risiko zu versterben im Vergleich zu Versicherten der Vergleichskohorte. Veränderungen der medikamentösen Parkinson-Therapie (Zunahme COMT- und MAO-Inhibitoren) sowie der Heilmittelerbringung (Zunahme Ergotherapie und Logopädie) über die Beobachtungszeit zeigten sich primär bei Parkinson-Patienten mit Neurologenkontakt. Diskussion In der Studie konnten eine erhöhte Morbidität und Mortalität bei Parkinson-Patienten identifiziert werden, die sich als Ziel für innovative Versorgungskonzepte eignen. Die zunehmende Zahl an Patienten und die beschriebenen Unterschiede dokumentieren hierfür den Bedarf. Gleichzeitig zeigen die Veränderungen in der Verordnungspraxis, dass innovative Therapien von niedergelassenen Neurologen eingesetzt werden. / Background The consequences of demographic change are already noticeable in Saxony, the federal state with the highest average age in Germany and predominantly rural areas. In order to improve medical care for patients with Parkinson’s disease (PwP), a status quo analysis of current care practice is required. Objective To what extent does the utilization of medical services by PwP differ a) between urban and rural areas in Saxony and b) between PwP with and without neurologist contact in the observation period from 2011 to 2019? Material and methods The cohort study was based on extensive routine data for Saxony from the health insurance company AOK PLUS from 2010 to 2019. A cohort of 15,744 PwP (n = 67,448 patient-years) was compared to a matched cohort (n = 674,480 patient-years; criteria: year of birth, gender, year of insurance, place of residence: urban/rural) without an ICD-10 coding of a movement disorder. Results Overall, there was a steady increase in the number of PwP in the dynamic cohort from 2011 (n = 6829) to 2019 (n = 8254). Urban-rural differences included a smaller proportion of patients being seen by a neurologist in rural areas. The PwP had a 3.5 to 4‑fold higher risk of dying compared to those in the comparison cohort. Changes in drug therapy for Parkinson’s disease (i.e., increases in COMT and MAO inhibitors) and in remedy delivery (i.e., increases in occupational therapy and speech therapy) over the observation period were primarily seen in PwP who were seen by a neurologist. Discussion The study identified increased morbidity and mortality in PwP who are suitable targets for innovative care concepts. The increasing number of patients and the described differences document the need for this. At the same time, changes in prescription practice show that innovative forms of treatment are being used by neurologists in outpatient care.

Given the importance of the ability to read, learners must have access to books in schools. The lack of functional school libraries in South Africa, especially in primary schools, is to the detriment of learners’ reading achievement. In the 2011 Progress in International Reading Literacy Study (PIRLS) study, Grades 4 and 5 children achieved the lowest scores in the reading comprehension tests of the 40 participating countries. The researcher proposes that one intervention that would help solve the low levels of reading literacy among learners would be for schools to have an official school library policy, and to have functional well-stocked school libraries. This study seeks to identify the self-reported reading attitudes of learners who took part in the PIRLS 2011 study using a secondary data analysis, and to investigate by means of a systematic literature review, materials published between 1994 and 2017 on the non-implementation of school library policies. This study recommends speeding up progress in meeting minimum norms for school infrastructure in order to create a space for functional school libraries in all schools. Secondly, it suggests that access to books for primary school learners should be improved, and lastly, that the national guidelines for school libraries on planning and reforming school libraries should be finalised and implemented. Key / Information Science / M. Inf. (Information Science)