>Magister Scientiae - MSc / Scientific studies have shown that chronic diseases of lifestyle (CDL) such as hypertension and diabetes mellitus are major causes of mortality and morbidity, accounting for about 60% of the disease burden globally. Available statistics for Swaziland indicate that hypertension and heart diseases are on the increase and are responsible for 33,540 and 3,146 cases per year respectively. Regular physical activity (PA) is widely recognised as a means for the primary and secondary prevention of CDL due to their multi-factorial beneficial effects on an individual‟s health. Therefore, the aim of this study was to determine PA participation among adults with hypertension in Mbabane, Swaziland and the extent to which they are encouraged to be physically active. A cross-sectional design, utilising quantitative methods was employed in the study and three validated standardised interview administered questionnaires were used to collect data from both hypertensive individuals and health professionals. A sample size of 422 hypertensive individuals and 72 health professionals was included in the study. Statistical Package for Social Sciences (SPSS) version 20 was used to analyse the data. Descriptive statistics were employed to summarise data and was expressed as means, standard deviation, frequencies and percentages. The Students‟t-test was used to compare mean age and PA. Chi-square tests were used to test for associations between categorical variables with significant levels set at 5% (p < 0.05). Blood pressure was classified into controlled (≤ 140/≤ 90 mmHg) and uncontrolled (≥ 140/≥ 90 mmHg). PA was dichotomised into active (> 600 MET-minute/week) and sedentary (< 599 METminute/ week). BMI was classified as underweight (<18.5), normal (18.5-24.9), overweight (25-29.9) and obese (>30). The findings of the current study revealed that a considerable number of individuals with hypertension (53%) were physically inactive with poorly controlled blood pressure (57%). A statistical significance was found between mean age and PA (sedentary and active) (P= 0.000 ˂ 0.05). iii The study also revealed that the perceived benefits of PA as reported by individuals with hypertension outweighed the perceived barriers. In addition, the majority of health professionals were found to be poor counsellors of PA (58%). Most health professionals informed their patients on becoming physically active but did not include important components of PA counselling such as the types of PA, intensity and duration. The common reasons for not including PA as part of the daily routine include: not my area of specialty and lack of time. These factors could significantly contribute to sedentary behaviour among hypertensive individuals in developing countries such as Swaziland. For this reason, an urgent need for PA promotion programmes which will motivate hypertensive individuals to participate in sufficient levels of PA as recommended by public health research has been established. The programmes should include educating health professionals on current trends in the promotion of PA. A combination of these approaches will help to reduce morbidity and mortality from cardio-vascular disease (CVD), in particular hypertension.

It is the responsibility of professions to provide evidence of the demonstrable value and quality of service delivery. Occupational therapists in mental health care settings find it difficult to produce convincing evidence of the demonstrable value and their contribution to health care. Currently no effective outcome measure for occupational therapists in mental health practices exists for the South African context . The development of an outcomes measuring system is much needed in these crucial times of cost-cutting, rendering quality of care with the minimum resources and the quest for evidence of the effect of intervention. The purpose of this study was to fill the outcome measurement gap by developing a system that is clinically tested and user-friendly for occupational therapists in mental health care settings. Such a system had to represent the outcomes in the occupational therapy programmes, meet the needs of the therapist in terms of purpose of the tool, be easily administered and be standardised. It was also important that the outcome measure was grounded in the theoretical framework that guides intervention programmes, namely Vona du Toit’s Model of Creative Ability. This theoretical framework is widely used in South African mental health care settings and was found suitable to be transformed into a rating scale for the outcome measure. A participatory approach combined with a mixed method exploratory design, specifically the instrument development model, was selected to guide the study. The development of the outcome measure happened in three phases. Domains for the outcome measure emerged after participation from occupational therapy clinicians and mental health care users in Phase 1. The operationalisation of the domains and the development of the rating scale happened during Phase 2. The third phase was the piloting of the outcome measure to identify issues to be optimised for the final implementation of the outcome measure. Eight domains with 52 representative items emerged from Phase 1. The domains were Process skills, Communication and Interaction skills, Lifeskills, Role performance, Balanced lifestyle, Motivation, Self-esteem and Affect. Clinicians were satisfied that these domains represented the service that they deliver and compared well with the mental health care users’ need for occupational therapy. The involvement of mental health care users in confirming relevant domains for the outcome measure ensured a client-centred approach in the research process. The outcome measure, named as the Activity Participation Outcome Measure (APOM), has a unique feature of generating reports and spider graphs for every mental health care user. The APOM was piloted in three mental health care settings. In spite of good intentions from clinicians to apply the measure, it was clear that measuring outcomes is neither a priority, nor a routine task in clinical settings. The preliminary investigation into the psychometric properties yielded positive results. However, the sample sizes for the validity and reliability samples were not optimal and further data collection needs to continue for confirmation. It is recommended that investigations into the psychometric properties of the instrument continue to eventually market it as a valid and reliable outcome measure for occupational therapists in mental health care settings. / Thesis (PhD)--University of Pretoria, 2010. / Occupational Therapy / unrestricted

No description available.

Using a theoretical synergy between the Psychological Continuum Model (PCM) and Behavioral Ecological Model (BEM), the current dissertation research provides empirical evidence to support that organized participant sporting events can play a significant role in building a healthier community. First, using a proprietary U.S. community-based panel data from 2008 to 2014, study 1 examines the incremental effects of participant sporting events (PSE) in promoting active living at the population level. Panel regression with an instrumental variable approach and Multigroup Latent Growth Curve Analysis were administered. The key findings included (1) these population-based interventions have the capacity to impact population health at the state level; (2) such an influence significantly varies across the United States contingent upon a state’s economic development and the geographical region to which a state belongs. In study 2, the Multilevel Mediation Analysis was conducted with a spatially clustered cross-sectional data in 2014. The findings revealed that the access to exercise opportunities at the state level represents the underlying mechanism through which various forms of participant sporting events have the ability to elicit positive effects on health with respects to mental health, physical health, and physical activity participation at the county level. The findings suggested that PSEs represent effective public health platform to create healthier communities through integrating physically active leisure into population’s everyday routines. Overall, empirical results also help us better understand the importance of effectively leveraging community sporting events to deliver required health benefits to the general public and create practical guidelines to inform policy formation on resource allocation. / Tourism and Sport

This study tries to understand the internal dynamics of the civil society organizations in Turkey on the experiences of three CSOs: the Ankara Branches of KADER, MAZLUMDER and IMO by focusing on the intra&ndash / organizational practices (the decision making processes, elections, general meetings, division of labor, basic conflicts and divergences, the disagreements, the way of deliberation and consensus). It tries to shed light on the transformative potential of the CSO&rsquo / s in public sphere as civil organizations themselves in time both in the sense of their political stances and organizational structure. The research was designed in the form of a case study including both the depth interwiews and participant observations. In this framework, ten depth-interviews were made with members having different qualities for each of these CSOs and participant observations were realized in the general meetings, elections and activities of these organizations. Since the aim of this study is to understand the contribution of the CSOs to the public sphere, the research findings were interpreted and considered basically in the light of the two main theoretical positions: the deliberative (Habermas) and agonistic (Laclau and Mouffe) democracy. The study espoused a post-structuralist conception of democracy combined with a weakened model of deliberation and dialogue pointing out the requirement of the existential publicity of man (Arendt) in the world. In this context, this study tries to discuss the following questions within the framework of the public sphere experience of the three CSOs throughout the thesis. Is the concept of civil society a proper concept for understanding the peculiar experience of Turkey (with reference to the historical context of civil associational life in Turkey and the recent civil resurrection)? Do civil organizations have the capacity to serve for deepening and consolidation of democracy in public sphere? Are these civil organizations democratic and participatory with regard to their intra-organizational structures and decision-making processes? And, more importantly, do they have any capacity to influence the process of democratic transformation in Turkey?

Substantial decreases in physical activity have been observed between early to late adolescence in males and females, with decreases in levels of activity into adulthood. Physical inactivity among young adults leads to medical conditions such as Type 2 diabetes, stroke, ischemic heart disease, falls resulting in hip fractures, and depression later in life. Advanced Nurse Practitioners have a significant impact on the problem of physical inactivity among young adults through education to improve knowledge regarding physical activity participation. The focus of this project was to develop a toolkit on lifestyle modification as a resource for physical education teachers and nurses to increase physical activity participation and to decrease sedentary behaviors among young adults. The project practice question asked whether an evidence-based toolkit would address the identified needs of improving lifestyle diet and physical activity in young adults. Pender’s health promotion model guided the planning and development of the project. The Computer Attitude Questionnaire together with the 3-Day Physical Activity Recall was used during a needs assessment. Feedback from the survey was included in the development of the toolkit. A 5-item survey was given to 5 content experts who evaluated the toolkit. Data were analyzed using descriptive statistics to obtain a content validity index score of 1.00. Findings show universal agreement about the content of the toolkit as a resource for physical education teachers and school nurses to encourage physical activity participation in young adults. The implications of project findings for positive social change include the potential to increase the involvement of young adults in activities that improve the lives of the individual.

Um dos tópicos mais importantes na análise de demanda por transportes é a relação entre as necessidades individuais de realização de atividades geograficamente distribuídas, a estrutura urbana, as características individuais e domiciliares, o sistema de transporte e as diferenças no comportamento relacionado a viagens. Isto motivou o desenvolvimento desta pesquisa, que tem como objetivo principal analisar o comportamento individual subjacente ao encadeamento de viagens sob a perspectiva de três grupos de variáveis: (1) participação em atividades; (2) características socioeconômicas; e (3) uso do solo. Há dois objetivos secundários, fundamentais para se atingir a finalidade do trabalho: (a) propor um conjunto de variáveis de uso do solo; e (b) testar a significância do grupo de variáveis ora proposto. Este trabalho baseou-se nos dados da pesquisa origem-destino de 1997 da região metropolitana de São Paulo, sendo extraídas e analisadas seis amostras finais que foram caracterizadas por setor econômico (no caso de trabalhadores) e grau de instrução (no caso de estudantes). Com utilização conjunta de técnicas de análise multivariadas, confirmatórias e exploratórias, foi possível representar a variável dependente (Análise de Cluster), bem como encontrar relações entre variáveis envolvidas (Árvore de Decisão) e, finalmente, mensurar a significância estatística das variáveis independentes (Regressão Linear Múltipla). Através dos resultados obtidos, foi possível analisar a influência dos três grupos de variáveis na seqüência de viagens: (1) variáveis socioeconômicas (renda familiar, usa vale transporte, nº provável de carteiras de habilitação no domicílio, idade, nº de automóveis no domicílio) afetam principalmente a seqüência de modos de transporte utilizados durante as viagens; (2) participação em atividades (estuda, trabalha) interfere na seqüência de motivos de viagem; e, enfim, (3) variáveis de uso do solo (parcela acumulada de empregos ou escolas por faixas de distância a partir do centróide da zona de residência) influenciam a seqüência de destinos escolhidos. Espera-se que o presente trabalho constitua uma contribuição ao meio acadêmico, tanto em termos de representação da intensidade e distribuição geográfica das atividades no meio urbano (variáveis de uso do solo), quanto em relação à influência de tais variáveis nos deslocamentos dos indivíduos. / One of the most important topics in transportation demand is the relationship between individual needs to carry out geographically distributed activities, urban configuration, individual and household characteristics, transportation system and travel behavior. For that reason, the main aim of this work is to analyze the individual trip-chaining behavior in terms of three variables groups: (1) activity participation; (2) socioeconomic characteristics; and (3) land use. There are also two secondary objectives derived from the main objective: (a) to propose one set of land use variables; and (b) to verify the statistical significance of the created land use group variables. This work was based on the origin-destination survey carried out in the São Paulo metropolitan area in 1997, from which six final samples were extracted, analyzed and characterized by economic sector (for workers) and level of education (for students). Applying multivariate analysis techniques, confirmatory and exploratory, it was possible to represent the dependent variable (Cluster Analysis), as well as to find relationships between the concerned variables (Decision Tree) and, finally, to measure the statistical significance of the independent variables (Multiple Regression). From the results, it was possible to analyze the influence of the three variables groups on trip-chaining: (1) socioeconomic variables (household income, transit voucher use, probable number of driver licenses per household, age, car-ownership) affect the travel mode sequence used for the trips; (2) activity participation (study, work) has an effect on the trip purpose sequence; and (3) land use variables (accumulated proportion of jobs or schools by distance buffers starting from the residence zone centroid) influence the sequence of chosen destinations. It is expected that the present work could be a contribution to the scientific community for the representation of the activities level and their geographic distribution in the urban configuration (land use variables), and the influence of such variables on individuals displacements.

No description available.

Um dos tópicos mais importantes na análise de demanda por transportes é a relação entre as necessidades individuais de realização de atividades geograficamente distribuídas, a estrutura urbana, as características individuais e domiciliares, o sistema de transporte e as diferenças no comportamento relacionado a viagens. Isto motivou o desenvolvimento desta pesquisa, que tem como objetivo principal analisar o comportamento individual subjacente ao encadeamento de viagens sob a perspectiva de três grupos de variáveis: (1) participação em atividades; (2) características socioeconômicas; e (3) uso do solo. Há dois objetivos secundários, fundamentais para se atingir a finalidade do trabalho: (a) propor um conjunto de variáveis de uso do solo; e (b) testar a significância do grupo de variáveis ora proposto. Este trabalho baseou-se nos dados da pesquisa origem-destino de 1997 da região metropolitana de São Paulo, sendo extraídas e analisadas seis amostras finais que foram caracterizadas por setor econômico (no caso de trabalhadores) e grau de instrução (no caso de estudantes). Com utilização conjunta de técnicas de análise multivariadas, confirmatórias e exploratórias, foi possível representar a variável dependente (Análise de Cluster), bem como encontrar relações entre variáveis envolvidas (Árvore de Decisão) e, finalmente, mensurar a significância estatística das variáveis independentes (Regressão Linear Múltipla). Através dos resultados obtidos, foi possível analisar a influência dos três grupos de variáveis na seqüência de viagens: (1) variáveis socioeconômicas (renda familiar, usa vale transporte, nº provável de carteiras de habilitação no domicílio, idade, nº de automóveis no domicílio) afetam principalmente a seqüência de modos de transporte utilizados durante as viagens; (2) participação em atividades (estuda, trabalha) interfere na seqüência de motivos de viagem; e, enfim, (3) variáveis de uso do solo (parcela acumulada de empregos ou escolas por faixas de distância a partir do centróide da zona de residência) influenciam a seqüência de destinos escolhidos. Espera-se que o presente trabalho constitua uma contribuição ao meio acadêmico, tanto em termos de representação da intensidade e distribuição geográfica das atividades no meio urbano (variáveis de uso do solo), quanto em relação à influência de tais variáveis nos deslocamentos dos indivíduos. / One of the most important topics in transportation demand is the relationship between individual needs to carry out geographically distributed activities, urban configuration, individual and household characteristics, transportation system and travel behavior. For that reason, the main aim of this work is to analyze the individual trip-chaining behavior in terms of three variables groups: (1) activity participation; (2) socioeconomic characteristics; and (3) land use. There are also two secondary objectives derived from the main objective: (a) to propose one set of land use variables; and (b) to verify the statistical significance of the created land use group variables. This work was based on the origin-destination survey carried out in the São Paulo metropolitan area in 1997, from which six final samples were extracted, analyzed and characterized by economic sector (for workers) and level of education (for students). Applying multivariate analysis techniques, confirmatory and exploratory, it was possible to represent the dependent variable (Cluster Analysis), as well as to find relationships between the concerned variables (Decision Tree) and, finally, to measure the statistical significance of the independent variables (Multiple Regression). From the results, it was possible to analyze the influence of the three variables groups on trip-chaining: (1) socioeconomic variables (household income, transit voucher use, probable number of driver licenses per household, age, car-ownership) affect the travel mode sequence used for the trips; (2) activity participation (study, work) has an effect on the trip purpose sequence; and (3) land use variables (accumulated proportion of jobs or schools by distance buffers starting from the residence zone centroid) influence the sequence of chosen destinations. It is expected that the present work could be a contribution to the scientific community for the representation of the activities level and their geographic distribution in the urban configuration (land use variables), and the influence of such variables on individuals displacements.

Die Förderung körperlich-sportlicher Aktivität im Kindesalter stellt eines der momentan bedeutendsten Public-Health-Ziele dar. Um Präventionsprogramme sinnvoll erarbeiten sowie gezielt und effektiv einsetzen zu können, braucht es Wissen um die Bedingungen und Barrieren eines adäquaten Sport- und Aktivitätsverhaltens von Kindern. Die Dissertationsschrift folgt dieser Fragestellung. Auf Basis vorliegender theoretischer Ansätze sowie empirischer Evidenz wird ein Modell entwickelt, welches die Herausbildung unterschiedlicher Aktivitätsniveaus und Sportengagements von Kindern im Vorschulalter anhand von Bedingungsfaktoren und Vermittlungsmechanismen zu erklären versucht. Dieses Modell geht davon aus, dass die soziale Lebenslage und die biogenetischen Voraussetzungen eines Kindes sein Aktivitätsniveau und Sportengagement prädisponieren. Eine sehr individualspezifische Prägung dürfte es dabei vor allem durch die aktivitätsbezogenen Erfahrungen erhalten, die das Kind in den Handlungsfeldern Familie, Kindergarten, Sportverein usw. sammelt. Denn diese Erfahrungen konstituieren seine Orientierungen, Kapazitäten und Kompetenzen in besonderer Weise. In der empirischen Studie werden einzelne Ausschnitte des Modells fokussiert und anhand von Daten einer Stichprobe sächsischer Vorschüler analysiert.