Development of neonatal nursing care clinical competency-based assessment tool for Nurse-midwife technicians in CHAM nursing colleges, Malawi

Philosophiae Doctor - PhDLiterature has shown that Malawi is experiencing a shortage of qualified healthcare providers, with the greatest burden on maternal and neonatal health. The majority of health service providers are Nurse-Midwife Technicians (NMT), contributing to 87% of the nursing and midwifery workforce. However, research has shown that the NMTs lack the ability to transfer skills into different clinical settings. It was not known what competencies were taught in Christian Health Association of Malawi colleges to equip the NMTs with clinical competence in neonatal nursing practice and how the clinical teachers assisted these NMTs to acquire the competencies. Furthermore, there was no documentation on the availability of a clinical competency-based assessment tool to validate the NMTs’ achievement of clinical competence in neonatal nursing. The purpose of this study was to develop a neonatal nursing care clinical competency-based assessment tool to validate NMTs’ achievement of clinical competence in CHAM nursing colleges. The competency, outcomes and performance assessment (COPA) model and the skills acquisition model were the conceptual frameworks used as the foundation of the study. The study adopted a sequential mixed method approach in which both qualitative and quantitative methods were utilized. Data collection was conducted using focus group discussions, document review and cross-sectional survey. The design and development model developed by Reeves (2006) and steps to development of assessment tools identified by the Department of Training and Workforce Development (2012) guided the study and development of the competency-based assessment tool. The study was conducted in eight CHAM nursing colleges. The researcher employed purposive, convenient and proportional stratified sampling to select the participants. Ethics clearance was obtained from the University of Western Cape and the National Health Sciences Ethical Research Committee in Malawi, prior to data collection. The data collection involved 31 midwifery clinical teachers and 140 third year students for the FGD and 48 midwifery clinical teachers and 195 third year students for the cross section survey. Document analysis was conducted at all the eight nursing colleges. The qualitative data was analysed using content analysis with Atlas.ti 7 and the quantitative data was analysed using descriptive analysis with SPSS 22. The research findings showed that the NMTs were taught basic nursing skills to enable them provide basic care to the health newborn baby. However, there were inadequate clinical assessments done to validate the NMT’s achievement of clinical competence in this setting. In addition, the clinical teachers used skills checklists to evaluate the NMTs clinical performance on specific procedures. The outcome of this study was the establishment of neonatal nursing clinical competencies, and development of a neonatal nursing care clinical competency-based assessment tool for the validation of NMT’s achievement of clinical competence. The tool provides a framework for neonatal nursing clinical teaching and assessments as well as tracking of the NMT’s clinical performance in this setting. It is recommended that training institutions should reinforce mechanisms to track the students’ clinical experience and performance assessments using this tool to ensure quality student outcomes. Furthermore, the clinical teachers should be oriented on the use of the developed assessment tool for familiarisation; thereby enhancing consistency and objectivity in the students’ performance assessments.ICAP-NEPI Project Malaw

Genome-wide Linkage Scan to Identify Loci for Age at First Cigarette in Dutch Sibling Pairs

Most smokers begin smoking during adolescence and early age of smoking initiation is related to more frequent current smoking, daily smoking and more dependent smoking (Everret et al., 1999; Lando et al.

Alcohol portrayals in movies, music videos and soap operas and alcohol use of young people: Current status and future challenges

Contains fulltext : 102765.pdf (publisher's version ) (Open Access)Aims: To provide an overview of studies of the effects of alcohol portrayals in movies, music videos and soap operas on alcohol consumption among young people. Moreover, we highlight important issues that need to be addressed in future research. Methods: This paper reviews the current literature on alcohol portrayals on-screen and the associated gaps and challenges in alcohol media research. Results: Thirteen longitudinal studies, 8 cross-sectional studies and 6 experimental studies examined the effects of alcohol portrayals on-screen on alcohol consumption among young people. They showed a relation between on-screen alcohol exposure and onset and progression of alcohol consumption. A distinction can be made between long-term effects and immediate effects on alcohol consumption. Only lately, more attention has been paid to processes underlying the effects of on-screen alcohol exposure. Conclusion: Replication of findings and development of new research designs is essential. On-screen alcohol exposure does not affect everyone. It is important to test individual differences in susceptibility to on-screen alcohol portrayals. Further, not all media alcohol portrayal might provoke similar effects. It is therefore essential to test the effect of different types of alcohol portrayals.12 p

Effects of alcohol portrayals in movies on actual alcohol consumption: an observational experimental study

Aims - This study uses an experimental design to assess the effects of movie alcohol portrayal on alcohol consumption of young adults while watching a movie. Gender, weekly alcohol use and identification with the movie actor/character were assessed as moderators. Design - A two (sex) x two (movie: alcohol or no portrayal of alcohol) between-subject design was used. Setting - Participants watched a contemporary movie in a semi-naturalistic living room setting. Participants - A total of 122 same-sex, young adult dyads (ages 18-29 years) participated in the experiment. Measurements - Their actual alcohol consumption while watching was examined. A multivariate regression analysis was used to examine the effects of the movie condition on alcohol consumption. Findings - Assignment to movie alcohol increased alcohol consumption during the movie for men but not women. Identification and weekly alcohol consumption did not moderate the relation between movie condition and alcohol consumption. Conclusions - Viewing a movie with alcohol portrayal can lead to higher alcohol consumption in young men while watching the movie