Retirement Transition Migration : Implications for Rural Development

Peer reviewedPublisher PD

Programs for the promotion of family wellness and the prevention of child maltreatment: A meta-analytic review

This thesis is a meta-analytic review of interventions that focus on the promotion of family wellness and the prevention of child maltreatment. Fifty-six evaluations which met the inclusion criteria were coded and effect sizes were calculated for each of the studies. I identified five key elements or “moderator variables,” through a review of the literature, which I believed might have an impact on the effectiveness of interventions. These moderator variables were: an ecological framework, an empowerment/strengths-based focus, the duration/intensity of the intervention, and the availability of social support and concrete support. A three step model testing process was used to evaluate the impact of the moderator variables on the effectiveness of the interventions. In Step 1, the impact of the moderator variables was tested across the entire sample of 56 studies. In Step 2, the studies were subdivided according to program type before testing for the impact of the moderator variables. There were eight distinct types of programs; four were proactive and four were reactive. In Step 3, testing for the impact of the moderator variables occurred after the studies were subdivided by both program type and outcome measure. Lastly post-assessment and follow-up effect sizes were examined separately to identify any possible trends. Findings indicated that although the proactive and reactive interventions had similar mean effect sizes (.37 and .43, respectively), the effect sizes for the proactive interventions tended to be larger at follow-up than post-assessment, while the effect sizes for the reactive interventions tended to have higher effect sizes at post-assessment than follow-up. This indicates that gains made through proactive interventions are sustained, and even enhanced, over longer periods of time, compared with those of reactive interventions. Other findings revealed that for home visiting interventions, higher effect sizes were found for interventions which were longer in duration and higher in intensity, and that interventions with components of social and concrete support had lower effect sizes than interventions without those components. Intensive family preservation interventions with high levels of participant involvement in program planning and implementation, an empowerment/strengths-based focus, and a component of social support had higher effect sizes than interventions without those elements. Lastly, both home visiting and intensive family preservation interventions achieved higher effect sizes with participants having mixed socio-economic status than those working solely with participants having low socio-economic status

Resilient practical assessment- Looking forward following a sociomaterial case study of a disrupted high stakes clinical assessment held during the COVID-19 pandemic.

Peer reviewe

Disembodied, dehumanised but safe and feasible : the social-spatial flow of a pandemic OSCE

Acknowledgements The authors wish to thank all those who took part in the OSCE under study and who contributed their time to be interviewed.Peer reviewedPublisher PD

Population need for primary eye care in Rwanda: A national survey.

BACKGROUND: Universal access to Primary Eye Care (PEC) is a key global initiative to reduce and prevent avoidable causes of visual impairment (VI). PEC can address minor eye conditions, simple forms of uncorrected refractive error (URE) and create a referral pathway for specialist eye care, thus offering a potential solution to a lack of eye health specialists in low-income countries. However, there is little information on the population need for PEC, including prevalence of URE in all ages in Sub-Saharan Africa. METHODS: A national survey was conducted of people aged 7 and over in Rwanda in September-December 2016. Participants were selected through two-stage probability proportional to size sampling and compact segment sampling. VI (visual acuity<6/12) was assessed using Portable Eye Examination Kit (PEEK); URE was detected using a pinhole and presbyopia using local near vision test. We also used validated questionnaires to collect socio-demographic and minor eye symptoms information. Prevalence estimates for VI, URE and need for PEC (URE, presbyopia with good distance vision, need for referrals and minor eye conditions) were age and sex standardized to the Rwandan population. Associations between age, sex, socio-economic status and the key outcomes were examined using logistic regression. RESULTS: 4618 participants were examined and interviewed out of 5361 enumerated (86% response rate). The adjusted population prevalence of VI was 3.7% (95%CI = 3.0-4.5%), URE was 2.2% (95%CI = 1.7-2.8%) and overall need for PEC was 34.0% (95%CI = 31.8-36.4%). Women and older people were more likely to need PEC and require a referral. CONCLUSIONS: Nearly a third of the population in Rwanda has the potential to benefit from PEC, with greater need identified in older people and women. Universal access to PEC can address unmet eye health needs and public health planning needs to ensure equitable access to older people and women

Hungry for Respect: Discrimination Among Adults Using Emergency Food Services

Objectives: We examined how adults using emergency food services report discrimination and how these reports may be associated with well-being. Methods: Data come from a survey (n=318) and from five focus groups of adults using emergency food services, conducted between 2003-2004. The survey included measures derived from the Everyday Discrimination Scale and the Centers for Epidemiologic Studies Depression Scale (CES-D). Focus groups were analyzed with content analysis. Results: The survey data suggest that everyday discrimination was associated with the CES-D, conditional on covariates. Focus group data are consistent with the survey results and suggest several avenues for future research, including how some individuals may forgo access to food and medications in order to protect their dignity in the face of discrimination. Conclusions: Qualitative and quantitative data converge into a similar theme - discrimination may be an important factor associated with well-being

Development of an item pool for a patient reported outcome measure of resilience for people living with dementia

Abstract Background and objectives Policies to support people living with dementia increasingly focus on strengths-based approaches, highlighting the importance of building resilience. This research responds to the lack of a suitable resilience measure for people with dementia. It develops a pool of items to inform a new measure of resilience for this population. Methods A conceptual model and associated data informed the item generation of the draft resilience measure. Regular meetings with professionals (n = 7) discussed response-scale formatting, content and face validity, leading to refinement and item reduction. Cognitive interviews with people living with dementia (n = 11) then examined the face and content validity of items and the suitability of response-scale formatting. These two phases informed subsequent revision and further item reduction of the resilience measure. Results The first item generation exercise led to 140 items. These were independently assessed by the professionals and this refinement reduced the measure to 63 items across 7 domains of the conceptual model (psychological strengths; practical approaches for adapting to life with dementia; continuing with hobbies, interests and activities; strong relationships with family and friends; peer support and education; participating in community activities; the role of professional support services). Cognitive interviews explored the 63 items with people living with dementia. Detailed feedback led to items removed due to difficulty with (a) understanding (N = 7); (b) answering (n = 11); (c) low preference for that item (n = 6); and (d) presence of a preferred item within a cluster of similar questions (n = 4). Items were amended to enhance clarity/conciseness (n = 19) leading to a final 37-item pool. Conclusion Established methods for measurement development included the expertise of people with dementia and led to the generation of a set of items for a new resilience measure that were understandable and acceptable to this target population. This 37-item pool reflects the conceptual understanding of resilience in dementia as being derived across individual, community and societal level resources

Development of an item pool for a patient reported outcome measure of resilience for people living with dementia

BACKGROUND AND OBJECTIVES: Policies to support people living with dementia increasingly focus on strengths-based approaches, highlighting the importance of building resilience. This research responds to the lack of a suitable resilience measure for people with dementia. It develops a pool of items to inform a new measure of resilience for this population. METHODS: A conceptual model and associated data informed the item generation of the draft resilience measure. Regular meetings with professionals (n = 7) discussed response-scale formatting, content and face validity, leading to refinement and item reduction. Cognitive interviews with people living with dementia (n = 11) then examined the face and content validity of items and the suitability of response-scale formatting. These two phases informed subsequent revision and further item reduction of the resilience measure. RESULTS: The first item generation exercise led to 140 items. These were independently assessed by the professionals and this refinement reduced the measure to 63 items across 7 domains of the conceptual model (psychological strengths; practical approaches for adapting to life with dementia; continuing with hobbies, interests and activities; strong relationships with family and friends; peer support and education; participating in community activities; the role of professional support services). Cognitive interviews explored the 63 items with people living with dementia. Detailed feedback led to items removed due to difficulty with (a) understanding (N = 7); (b) answering (n = 11); (c) low preference for that item (n = 6); and (d) presence of a preferred item within a cluster of similar questions (n = 4). Items were amended to enhance clarity/conciseness (n = 19) leading to a final 37-item pool. CONCLUSION: Established methods for measurement development included the expertise of people with dementia and led to the generation of a set of items for a new resilience measure that were understandable and acceptable to this target population. This 37-item pool reflects the conceptual understanding of resilience in dementia as being derived across individual, community and societal level resources

Synthesis and characterization of WS2/graphene/SiC van der Waals heterostructures via WO3−x thin film sulfurization

Van der Waals heterostructures of monolayer transition metal dichalcogenides (TMDs) and graphene have attracted keen scientific interest due to the complementary properties of the materials, which have wide reaching technological applications. Direct growth of uniform, large area TMDs on graphene substrates by chemical vapor deposition (CVD) is limited by slow lateral growth rates, which result in a tendency for non-uniform multilayer growth. In this work, monolayer and few-layer WS2 was grown on epitaxial graphene on SiC by sulfurization of WO3−x thin films deposited directly onto the substrate. Using this method, WS2 growth was achieved at temperatures as low as 700 °C – significantly less than the temperature required for conventional CVD. Achieving long-range uniformity remains a challenge, but this process could provide a route to synthesize a broad range of TMD/graphene van der Waals heterostructures with novel properties and functionality not accessible by conventional CVD growth