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Search Results: 1 - 10 of 5940 matches for " Louis Frederick Small "
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Students’ perceptions regarding the objective, structured, clinical evaluation as an assessment approach
Louis Frederick Small,Louise Pretorius,Althea Walters,Maria Ackerman
Health SA Gesondheid , 2013, DOI: http://dx.doi.org/10.4102/ hsag.v18i1.629
Abstract: The nursing profession is characterised by the fact that a significant amount of time is spent on competency-related activities. The assessment of clinical competence is therefore an important issue in nursing education and the utilisation of objective structured clinical evaluation for that purpose was considered to be very important in this study. The objective of this research was to explore and describe the perceptions of first- and third-year student nurses with regard to the objective structured clinical evaluation assessment approach. A quantitative, cross-sectional, analytical research design was used. The instrument was a questionnaire (ordinal). This questionnaire focused on the perceptions of student nurses with regard to the objective structured clinical evaluation approach in particular, and with regard to aspects such as reality, execution, time allocation and student and assessor variables. The findings indicated that, as an assessment tool, the objective structured clinical evaluation approach was perceived as not being totally realistic, especially by the more senior nursing students (third-year) as compared with the first-year nursing students. Varying degrees of stress were experienced by the nursing students in their first and third years but, in general, the overall perception appeared to be that the approach was well organised and that the respective students would be able to perform equally well in the clinical field. It may be concluded that the majority of students appreciate the format of the objective structured clinical evaluation approach. However, the study further highlighted the fact that more extensive training of students on time management and the relief of emotional stress is necessary during the implementation of this approach.
A Support Programme for Caregivers of Children with Heart Disease in Rural Namibia  [PDF]
Kristofina Amakali, Louis F. Small
Open Journal of Social Sciences (JSS) , 2014, DOI: 10.4236/jss.2014.211014

The majority of children suffering from heart disease in Namibia receive treatment as outpatients, with their caregivers taking responsibility for their continuing care. To provide the care required by these children, the caregiver has to remain vigilant. Many of these children live in rural areas and their caregivers may have only a limited educational background, as well as limited financial resources, as they depend on subsistence agriculture for a living. The development of the support programme discussed in this article originated from the results of a qualitative, exploratory, phenomenological study that addressed the issue of how these caregivers managed this responsibility. The findings of this study revealed that the caregivers generally had poor coping experiences. Subsequently, these findings formed the basis for the proposal about a support programme for the rural caregivers of children with heart disease in Namibia. As part of the study, interventions for home-based health care were developed, implemented and evaluated in order to facilitate the caregiver’s coping with the demands of home care. The findings of an outcomes evaluation indicated that the caregivers’ knowledge of the child’s condition, as well as the skills for providing care at home and the information about community-based resources that could provide them with support to cope, increased. If the programme were to be extended to other families in similar contexts, the programme interventions could make a difference in terms of their coping with the demands of care. This paper describes the implementation process involved in a home-based health care programme intervention of the study, and the subsequent outcomes of the programme evaluation.

Foreign nursing students: Their profile and perceptions of nursing care in Namibia
Louis Small,Louise Pretorius
Health SA Gesondheid , 2010, DOI: 10.4102/hsag.v15i1.431
Abstract: A survey was conducted using open and close-ended questions to determine how visiting nursing students in Namibia could be assisted during their visits (cultural encounters). Many students decide to complete their clinical exposure in a foreign country, either for personal reasons or in order to meet the course requirements for transcultural nursing. Since 1998, Namibia has received a number of these students. In discussion and from passing remarks from the students themselves, the question has arisen as to how an optimum placement for each student might be achieved. Aspects of the Campina–Bacote model and The Process of Cultural Competence in the Delivery of Health Care Services were used to answer this question. It was decided to gather both biographical (profile) information and information on perceptions of nursing care in Namibia from such foreign nursing students. The biographical (profile) information collected indicates a prevalence of certain shared biographical characteristics among international students. Such students tend to be adventurous, caring and sensitive to human rights issues. This finding correlates with the constructs of cultural desire and cultural awareness as described in the model of Campina–Bacote. Based on this finding, specific recommendations were made for clinical allocations. From the data gathered from the open-ended questions, three themes emerged: firstly, nursing in Namibia has identifiable characteristics; secondly, there is a paternalistic and one-sided communication style among nursing caregivers in Namibia; and finally, nursing care delivery in this country is often characterised by a detached attitude. It was concluded that these themes correlated with a cultural awareness and cultural knowledge among the nursing students. The discovery of these themes was useful for making recommendations for clinical guidelines to help these students adapt, as well as for providing a foundation and substantiation for clinical placement. Opsomming ’n Opname bestaande uit oop en geslote vrae is uitgevoer om te bepaal hoe besoekende verpleegstudente aan Namibi ondersteun kan word (kulturele ervarings). Baie studente besluit om hulle kliniese praktika in die buiteland te voltooi, óf om persoonlike redes óf om aan kursusvereistes in transkulturele verpleging te voldoen. Sedert 1998 het Namibi ’n aantal van hierdie studente ontvang. Uit gesprekke met sowel as spontane kommentaar deur hierdie studente het die vraag ontstaan hoe hulle optimum plasing verseker kan word. Aspekte van die model van Campina–Bacote, naamlik The process of
Empowerment of the Rural Parents/Caregivers of Children with Heart Diseases in Namibia to Facilitate Coping with the Demands of Caring at Home
Kristofina Amakali,Louis F. Small
Global Journal of Health Science , 2012, DOI: 10.5539/gjhs.v5n2p74
Abstract: Aim: The purpose of this study was to describe how the parents/caregivers of children with heart diseases cope with the demands of caring for these children at home, with the purpose to develop a home-based health care programme to facilitate the parents/caregivers’ coping with the demands of care. Methods: A qualitative, exploratory, descriptive, and contextual study was conducted. Phenomenological data on the lived experiences of coping with the demands to care by the parents/caregivers and of living with the burden of the disease by the children were gathered and interpreted from a purposefully selected sample of 5 multiple cases of parents/caregivers and children with heart disease from the rural areas. Results: The findings have revealed poor coping with the demands of caring among the parents/caregivers, as characterized by the experiences of emotional challenges, disruptive social functioning and social relations, lack of support from the family and societal organizations, financial difficulties and of course the experiences of decreased vitality by the children. As a result, the need to empower the parents/caregivers for them to cope with providing a continuum care to their children who have heart disease was identified. The dynamics to mitigate the negative experiences were conceptualized. Therefore, the interventions of a home-based health care programme as an interface to facilitate the parents/caregivers to cope with the challenges caused by the demands to care were developed. Conclusions: The need for empowerment of these parents/caregivers can be met through the implementation of multi-component interventions, which draw together all the possible determinants factors and the coping methods to facilitate coping.
The Plight of Parents/Caregivers of Children with Heart Disease in the Rural Areas of Namibia: A Problem of Coping
Kristofina Amakali,Louis F. Small
Global Journal of Health Science , 2012, DOI: 10.5539/gjhs.v5n2p62
Abstract: Providing care for a child with heart disease is a daunting task for any parent/caregiver, particularly for those living in poor conditions in rural Namibia. A qualitative, exploratory, phenomenological and contextual study was conducted to describe such parents’/caregivers’ experiences of providing care for a child with a heart disease. The study also examined the children’s experiences of living with the burden of disease at home. The findings revealed experiences of emotional turmoil, disruptive social functioning and social relations, lack of support from the family, lack of organised forms of support from societal organisations, as well as experiences of low vitality among the children. These experiences together signify the overall poor coping by the parents/caregivers and the children. This paper presents the findings of a situational analysis of the experiences of caring for a child with heart disease and of living with heart disease.
A surveillance of needle-stick injuries amongst student nurses at the University of Namibia
Louis Small,Louise Pretorius,Althea Walters,Maria J. Ackerman
Health SA Gesondheid , 2011, DOI: 10.4102/hsag.v16i1.507
Abstract: Needle-stick injuries have the potential to change a student nurse’s life; yet they are dealt with covertly and many go unreported. This could create difficulties when evaluating a curriculum, because potential risk issues in nursing education might go undetected. In addition, needlestick injuries are inherently preventable occupational health hazards. The fact that there has been, until now, no information available on the incidence of, and context in which needlestick injuries occur amongst student nurses in Namibia, is of particular concern for nurse educators in that country. The purpose of this study was therefore to determine the incidence of needle-stick injuries and to describe the context of their occurrences. A framework known as Haddon’s matrix made it possible to approach this survey from both an occupational and a nursing education perspective. The questionnaire was completed by 198 students and it was found that, during 2008 alone, 17% of student nurses sustained needle-stick injuries, but only 55% of these reported it. In addition, in 55% of the occasions on which the student nurses were injured, they were not accompanied by a registered nurse. The recommendations made are based on the three phases of Haddon’s matrix, namely pre-injury, injury and post-injury phases. These recommendations focussed on student accompaniment by registered nurses, the completion of reflective exercises, sensitisation sessions before placement in clinical areas, as well as the utilisation of independent student counsellors. Opsomming Enige naaldprik-insident kan ‘n groot omwenteling in ‘n student-verpleegkundige se lewe te weeg bring. Ten spyte hiervan word sodanige insidente nie openlik hanteer nie, en dikwels word dit nie eers gerapporteer nie. Dit mag egter kurrikulering-evaluerings kompliseer want potensi le risiko-aspekte in verpleegonderwys mag dalk nie geidentifisser word nie. Naaldprik-ongelukke is in wese beroepsgesondheidsaspekte, wat inherent voorkombaar is. Dit was dan ook ‘n bron van kommmer onder verpleegopvoeders in Namibi , aangesien geen inligting beskikbaar was oor die voorkoms en konteks van naaldprik-ongelukke onder student-verpleegkundiges in Namibi nie. Die doel van hierdie studie was dus on die voorkoms en konteks waarbinne naaldprik-ongelukke plaasvind te beskryf. Daar was reeds a raamwerk beskikbaar, naamlik die Haddon-matriks. Diè raamwerk het dit moontlik gemaak om die opname te benader vanuit sowel ‘n beroepsgesondheids-perspektief as ‘n verpleegopvoedkundige perspektief. Die vraelys is voltooi deur 198 studente en van die bevinding
Pathways Activated during Human Asthma Exacerbation as Revealed by Gene Expression Patterns in Blood
Unnur S. Bjornsdottir, Stephen T. Holgate, Padmalatha S. Reddy, Andrew A. Hill, Charlotte M. McKee, Cristina I. Csimma, Amy A. Weaver, Holly M. Legault, Clayton G. Small, Renee C. Ramsey, Debra K. Ellis, Conor M. Burke, Philip J. Thompson, Peter H. Howarth, Andrew J. Wardlaw, Phillip G. Bardin, David I. Bernstein, Louis B. Irving, Geoffrey L. Chupp, George W. Bensch, Gregory W. Bensch, Jon E. Stahlman, Monroe Karetzky, James W. Baker, Rachel L. Miller, Brad H. Goodman, Donald G. Raible, Samuel J. Goldman, Douglas K. Miller, John L. Ryan, Andrew J. Dorner, Frederick W. Immermann, Margot O'Toole
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0021902
Abstract: Background Asthma exacerbations remain a major unmet clinical need. The difficulty in obtaining airway tissue and bronchoalveolar lavage samples during exacerbations has greatly hampered study of naturally occurring exacerbations. This study was conducted to determine if mRNA profiling of peripheral blood mononuclear cells (PBMCs) could provide information on the systemic molecular pathways involved during asthma exacerbations. Methodology/Principal Findings Over the course of one year, gene expression levels during stable asthma, exacerbation, and two weeks after an exacerbation were compared using oligonucleotide arrays. For each of 118 subjects who experienced at least one asthma exacerbation, the gene expression patterns in a sample of peripheral blood mononuclear cells collected during an exacerbation episode were compared to patterns observed in multiple samples from the same subject collected during quiescent asthma. Analysis of covariance identified genes whose levels of expression changed during exacerbations and returned to quiescent levels by two weeks. Heterogeneity among visits in expression profiles was examined using K-means clustering. Three distinct exacerbation-associated gene expression signatures were identified. One signature indicated that, even among patients without symptoms of respiratory infection, genes of innate immunity were activated. Antigen-independent T cell activation mediated by IL15 was also indicated by this signature. A second signature revealed strong evidence of lymphocyte activation through antigen receptors and subsequent downstream events of adaptive immunity. The number of genes identified in the third signature was too few to draw conclusions on the mechanisms driving those exacerbations. Conclusions/Significance This study has shown that analysis of PBMCs reveals systemic changes accompanying asthma exacerbation and has laid the foundation for future comparative studies using PBMCs.
Implementation of an Educational Programme to Facilitate Critical Thinking of Student Nurses  [PDF]
Louise Pretorius, Hans Justus Amukugo, Agnes Van Dyk, Louis F. Small
Open Access Library Journal (OALib Journal) , 2016, DOI: 10.4236/oalib.1103063
The overall purpose of phase 3 was to implement the educational programme that was developed to facilitate the development of critical thinking in the student nurse. A quasi-experimental design within the quantitative approach for phase 3 was used. The purpose of a quasi-experimental design was to identify and demonstrate casual relationships, examine relationships and clarify why certain events happened. The educational programme was implemented over a period of three days, covering theoretical and practical content. The objectives for this phase were to select the two groups of final-year student nurses to fit the quasi experimental design as the experimental and control group; conduct a pre-test on both the experimental and the control group in Windhoek and Oshakati to determine their application of critical thinking skills to the management of a given case in an imaginary case scenario; implement and facilitate the educational programme over a predetermined period of three days during the second semester of training for the experimental group in Windhoek and ensure active participation by participants for the duration of the educational programme. The population for this study consisted of nursing students in their final year (fourth year) of study at the training hospitals of Windhoek and Oshakati. Both campuses are incorporated in the Faculty of Health Sciences. The full population of the fourth-year class at the Windhoek campus was selected to be part of the experimental group (47 students) and the students from Oshakati (53 students) formed the control group. The total number of students amounted to 100 students.
Evaluation of an Educational Programme to Facilitate Critical Thinking of Student Nurses  [PDF]
Louise Pretorius, Hans Justus Amukugo, Agnes Van Dyk, Louis F. Small
Open Access Library Journal (OALib Journal) , 2016, DOI: 10.4236/oalib.1103064
This article deals with phase 4 of the study, namely the evaluation of the educational programme developed in phase 2. The development of the educational programme was aimed at the facilitation of the development of critical thinking in the student nurse. The purpose of phase four (4) was to evaluate whether the researcher had achieved the objective of the educational programme, namely to facilitate the development of critical thinking skills of the final year student nurse. Specific objectives were therefore set for phase 4. Further, hypotheses were formulated and tested during this phase of the study. The aim of formulating a hypothesis was to determine whether any development had taken place in the experimental group who participated in the educational programme. All fourth-year nursing students (47) who complied with the inclusion criteria participated in the educational programme. Each participant consented in writing to be part of the programme—including the pretest and posttest. A total of 53 students participated as the control group in the pretest and posttest. All the participants in the experimental and control groups of the study were registered for the Comprehensive Diploma in Nursing at the University of Namibia. Reasons were advanced in chapter 3 for the fact that the participants in the study were final-year students at the Windhoek and Oshakati campuses of the Faculty of Medical and Health Sciences. It was concluded that the implementation and evaluation of a three-day educational programme on the facilitation of the development of critical thinking within a quasi-experimental design had desired results. Students from both the main campus (Windhoek) and the Northern Campus (Oshakati) of the Department of Nursing at the Faculty of Medical and Health Sciences of the University of Namibia were included in the quasi-experiment. Internal validity of the design was ensured by eliminating the threats to an experimental design.
Disequilibrium Pricing Theory—Bubbles and Recessions  [PDF]
Frederick Betz
Theoretical Economics Letters (TEL) , 2014, DOI: 10.4236/tel.2014.41009

How can one track a financial bubble as a likely precursor to bank panics and subsequent recessions? We model the Minsky-Keynes depiction of a financial marketby extending the “equilibrium-price” model to a “disequilibrium-price” model, through adding a third dimension of time. In this way, we use a topological graphic approach to see how the models from the two schools of economics, exogenous and endogenous, relate to each other as complementary models of production and financial sub-systems. These economic models are partial models in an economynot a model of the whole economy. However, such partial models can be used to anticipate financial bubbleshence bank runs and recessions due to bank runswhich typically follow.

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