The following treatise first frames the role of CBOs in responding to the HIV/Aids crisis in relation to their position in the global health governance system through a literature survey that moves from an analysis of the global structures down to the local. The survey covers the role of international organisations, international NGOs (INGOs), national governments, local NGOs and CBOs and outlines the context in which Masizakhe is working within the global health governance structure. Secondly the research design and methodology are outlined focusing on the longitudinal, case study and participant--‐observation approaches. Hypotheses, conceptualisation, definitions, key variables are described and data collection methods and fieldwork practice extrapolated upon. Following that data capturing, editing and analysis are discussed in conjunction with shortcomings and sources of error. In the fourth chapter the research discusses the history, structure and outlines the research findings by comparing what has changed within the organisation over time, presenting and discussing the results. The outcomes of this research have shown that existing problems in this particular CBO are very difficult to overcome without committed, sustained support from donors, government, community and the organisation’s members. CBOs are often hamstrung by a series of intersecting factors which hamper their ability to problem--‐solve, even when the route to overcoming the problem is clear, particularly when the capacity and will to do so is not always present from both within the organisation and from outside support systems. These challenges then impact on the overall quality of and ability to deliver the services the organisation is structured to deliver. The major challenge for the organisation remains the inconsistent donor cycle and resultant instability thus created within an organisation already working in a highly volatile, unstable situation marked by poverty and disease. Thus the title, The Aids of Aid?, captures the essence of Masizakhe’s struggle with its own syndrome of problems. It summarises a comment made by the project secretary said that: “Sometimes it feels like we are not only fighting for the health of our people – We are fighting for the health of our organisation. We are a sick organisation trying to help sick people. All we need is donors and funding –we can’t live without them, and when they don't give, we get sick” (Stamper, Pers Comm, 2011). The other emergent challenges were a battle internally with ‘founder syndrome’, lack of management transparency and a dysfunctional board.

Thesis (MTech (Nursing))--Cape Peninsula University of Technology, 2018 / Health risks are continuing to be a challenge worldwide. Globally, young people aged 15-24 are amongst the most vulnerable groups. It was revealed that between 2007 and 2010, the rate of HIV infection increased in this age group. In sub-Saharan Africa, three out of four new HIV infections are amongst girls aged 15 to 19 years of age. Young women aged 15 to 24 are twice more likely to live with HIV than men in 2019. South Africa is the country with the largest human immunodeficiency virus (HIV) infected population in the world, with an estimated 7 million people living with HIV and 380 000 new HIV infections in 2015. University students are a very important group of young people because they are being prepared for the world of work and to assume leadership roles. However, they are the group most exposed to a range of health risks, particularly regarding sexuality and HIV/AIDS. The aim of this study was to explore potential health risk factors amongst students at a Higher Education Institution (HEI) in the Western Cape with regard to sexuality and HIV/AIDS. The objectives of the study were to explore the factors that may increase health risk behaviours amongst students at an HEI and to discover and describe the knowledge university students have regarding potential health risks related to sexuality and HIV/AIDS. A qualitative research design was employed. Focus group interviews were done to collect data and a thematic content analysis was employed to analyse the data. Results revealed that the university students engaged in high-risk sexual behaviours, such as transactional sex, casual sex, multiple partner sexual relationships and unprotected sex. Such behaviours lead to a high-risk of contracting STIs and HIV/AIDS. Among the factors that were found to be contributing to these risky behaviours, was the new-found freedom of being away from the supervision of parents. Peer pressure at HEIs, as well as abuse of alcohol and drugs, also contribute to risky behaviours. Recommendations were that there should be organised and measured approaches to expose both lecturers and the students to HIV/AIDS education through an integrated curriculum design. There should be teamwork amongst lecturers, support staff and students to create powerful discussions and an exchange of ideas to clarify issues regarding HIV/AIDS, sexuality and other related topics to reduce high-risk behaviours and promote solid constructive attitudes amongst the university community.

Recent developments in educational research raise important questions about the design of learning environments—questions that suggest the value of rethinking what is taught, how it is taught, and how is it assessed. During the past few decades, STEM disciplines began formally recognizing and integrating discipline-based education research (DBER) into their research programs to improve STEM education. One of the less literature-affluent areas of DBER addresses curriculum order and design appertaining to concept types and the order in which we teach those concepts. As educational researchers, we pose the question: does content order matter? In this project we designed, implemented and analyzed a concrete-to-abstract curriculum as a way of teaching and learning that not only builds off what students already know but how their intellect develops throughout the learning process. This semester-long curriculum design is scientifically supported and provides a learning environment aimed to not only building a student’s declarative knowledge of the subject but procedural knowledge as well and a way of developing scientific reasoning skills. This design also aimed at enhancing a student’s ability to make connections between biological concepts despite being classified as different biological concept types (e.g. descriptive, hypothetical, and theoretical concepts) as described by Lawson et al (2000). The reasoning behind and development of this project was based from Jean Piaget’s proposed stages of intellectual development, which supports the concrete-to-abstract theory. We found that, when compared to a traditional biology course (abstract-to-concrete in terms of content order), a concrete-to-abstract order of content resulted in significantly higher biological declarative knowledge and ability to make concept connections. While we failed to detect a significant difference between the two courses in terms of how quickly scientific reasoning skills are developed or how students’ scores on scientific reasoning skill assessments, the concrete-to-abstract course did show significantly higher gains in reasoning between the start and end of the semester. In addition to this project, a significant amount of time was also allocated to the design and evaluation of a health promotion and education program in Samoa. We developed a program which centered on a principal-run caregiver meeting as a means to expand health promotion and prevention efforts concerning Rheumatic Heart Disease, which is a significant cause of child morbidity and mortality in Samoa. We found that training principals on how to inform their student’s caregivers was an effective way to increase RHD awareness and disseminate correct health information including what to do if their child presents with a sore throat.

Thesis( MPH.) -- University of Limpopo, 2021 / Title: The Perceptions of Postgraduate Students About Female Condoms at The University of Limpopo Background: The female condom is one of the safest and effective female-initiated methods of contraceptives that has been promoted as an integral part of inventions that provide protection against the widespread of Human Immunodeficiency Virus and other Sexual Transmitted Infections among the youth, including at institutions of higher learning. A number of university students in South Africa are at risk of contracting HIV because of their risky sexual behaviours. How one perceives the female condom can have greater potential to influence its use. There is a gap in literature about this condom. Therefore, this study seeks to understand and document perceptions of postgraduate students about the female condom at the University of Limpopo. Objectives: To explore demographic characteristics of postgraduate students at the University of Limpopo regarding female condoms. To describe perceptions of postgraduate students at the University of Limpopo about female condoms. Methods: The study used the qualitative research approach. Participants of the study were full-time male and female postgraduate students at the University of Limpopo. Data was collected through semi-structured interviews, participants were interviewed one by one using an interview guide. The sample size of the study was 10 participants which was determined by saturation of data. An audiotape was also used to record interviews with participants, and field notes were also taken during the interview. Data was analysed through Thematic Content Analysis. Results: Literature suggests that students are aware of the female condom and its potential to reduce the risk of contracting HIV and STI but are still reluctant to use it in preference of the MC which is well marketed and promoted. The observed discarding and misuse of female condoms among students is associated with lack of knowledge and their perceptions of it. Although this study does not generalise the overall students’ perceptions regarding the female condom, but as a qualitative research, the study provides a useful qualitative enquiry of postgraduate students at the University of Limpopo about the female condom. Conclusion: Many studies have concluded that a female condom is a female-initiated method that is developed to empower and educate women to take control of their sexual health issues as well as to develop other programmes that prioritise women against HIV/AIDS and other STI. There is a need for effective interventions and campaigns to improve student knowledge in order to minimise wasteful expenditure in the process of the procurement and distribution of female condoms. There is also a need to increase the availability and accessibility of these condoms at institutions of higher learning.

No description available.

<p>The purpose of this thesis was to explore how health units servicing large rural populations in Ontario are integrating the built environment into public health interventions related to physical activity for the purpose of fostering healthy and sustainable communities. Additionally, this research sought to identify barriers and/or enabling structures that rural health units face in addressing the built environment within physical activity programming.</p> <p>This exploratory research study employed a descriptive qualitative approach. Semi-structured interviews were conducted with a purposeful sample of public health practitioners and managers identified by participating health units (n=12) as those most knowledgeable about program planning, implementation, and policy development in relation to physical activity and the built environment. Key themes were identified using qualitative content analysis and an inductive approach.</p> <p>The types of interventions were: engagement with policy work at a county or municipal level; building and working with community partners; gathering and providing evidence; hosting knowledge sharing opportunities; program development and implementation; social marketing, information sharing and awareness raising; and resource development and dissemination. Barriers and enabling processes and structures were identified at an organizational, community, and systemic level. Specific rural contextual enablers and barriers were also identified.</p> <p>This was the first study to the researchers’ knowledge that has examined current practices of Ontario’s rural health units related to built environment initiatives. In-depth perspectives elicited from public health practitioners and managers address gaps in the literature and contributes to new knowledge regarding built environment interventions to enhance physical activity in rural settings.</p> / Master of Science (MSc)

Despite the relevance of pressure ulcers (PU) in inpatient care, the predictive power and role of care-related risk factors (e.g. anesthesia) remain unclear. We investigated the predictability of PU incidence and its association with multiple care variables. We included all somatic cases between 2014 and 2018 with length of stay ≥ 2d in a German university hospital. For regression analyses and prediction we used Bayesian Additive Regression Trees (BART) as nonparametric modeling approach. To assess predictive accuracy, we compared BART, random forest, logistic regression (LR) and least absolute shrinkage and selection operator (LASSO) using area under the curve (AUC), confusion matrices and multiple indicators of predictive performance (e.g. sensitivity, specificity, F1, positive/ negative predictive value) in the full dataset and subgroups. Analysing 149,006 cases revealed high predictive variable importance and associations between incident PU and ventilation, age, anesthesia (≥ 1 h) and number of care-involved wards. Despite high AUCs (range 0.89–0.90), many false negative predictions led to low sensitivity (range 0.04–0.10). Ventilation, age, anesthesia and number of care-involved wards were associated with incident PU. Using anesthesia as a proxy for immobility, an hourly repositioning is indicated. The low sensitivity indicates major challenges for correctly predicting PU based on routine data.

This study examined the role of the Anglican Church in the prevention of the spread of HIV and AIDS in the Limpopo Province, South Africa, using a random sample of 51 members of the Zoutpansberg parish. The study found that the Church currently contributes to the prevention of the spread of HIV among its congregation through HIV-related activities to reduce stigma, prejudice and discrimination against people living with HIV and AIDS (PLWHA). At the same time, however, much still needs to be done in the areas of cultural perception, sexual practices, and myths surrounding HIV and AIDS. Most of the respondents indicated that they would like to see the Church play an active role in voluntary counselling and testing (VCT), marital counselling, and encouraging openness with regard to HIV and AIDS. It is recommended that the Church should extend its activities to include members of the community outside the congregation in the prevention of the spread of HIV and AIDS. / Health Studies / M.A. (Health Studies)

Background / Hand, foot, and mouth disease (HFMD), in particular those associated with enterovirus 71 (EV71), has caused large outbreaks in the Western Pacific and Southeast Asian countries in the past three decades. There is currently no effective chemoprophylaxis or vaccination for HFMD or EV71 infection. Public health strategies rest on good understanding of the epidemiological features of HFMD. The present series of studies examined the epidemiological characteristics of HFMD in Hong Kong, with a view to better understand the disease epidemiology so as to guide public health actions. / Methods and results of individual studies / Study (1)--characterizing the changing epidemiological features identified from various surveillance systems for HFMD / The trend of HFMD activities from 2001-2009 was analyzed using the sentinel surveillance statistics and HFMD outbreaks. The type of institutions reporting HFMD over time, incidences of outbreaks in 18 districts, and age and sex distribution of affected persons of HFMD outbreaks were analyzed. The clinical presentation, hospitalization rate, complication rate and case fatality of outbreaks were examined. The circulating enterovirues each year were determined by laboratory surveillance findings from 2001-2009 and test for morbidity caused by EV71. Seasonal peak was detected from warmer months of May through July but a smaller winter peak was found from October to December since 2006. An increasing trend of more older children aged above 5 years were infected, from 25.4% in 2001 to 33.0% in 2009 (p=0.01, Mantel-Haenszel Chi-square test). Laboratory surveillance detected a cyclical high activity of EV71 in every 3 to 4 years, which was associated with a higher average hospitalization rate among patients of the HFMD outbreaks reported in corresponding year, although it was only marginally significant (p=0.09, linear regression test). / Study (2)--analyzing the characteristics of EV71 epidemic in 2008 / All EV71 cases diagnosed by PHLC from 1998-2008 were analyzed. The complication and case fatality rates, percentage requiring hospitalization, median duration of hospital care, and the likelihood of being associated with an HMFD outbreak in institution in 2008 were compared with the corresponding rates calculated from cases reported from 1998-2007. Phylogenetic tree was constructed by using the neighbour-joining method and the molecular epidemiology of EV71 detected in 2008 was compared with the past years’ trends. Ninety-eight EV71 cases were reported in 2008, highest in the past decade. The annual incidence was 1.4/100 000 in general population, with highest incidence reported in children aged 0-4 years old (27.9/100 000). 11.2% had complications including meningitis or encephalitis (6.1%), pneumonia (3.1%), acute flaccid paralysis (1.0%), and shock (1.0%). There was only one fatal case (CFR: 1.0%) attributed to interstitial pneumonitis. 45.9% had concurrent HFMD outbreaks in their schools or institutions, and six schools required temporarily class suspension for 14 days. Both the complication rate and CFR werenot significantly different from the corresponding rates of the past 10 years (p=0.12 and 1.00 respectively). Phylogenetic analysis found that most cases reported in 2008 were C4 strains, which were the predominant circulating strains in the past ten years. / Study (3)--examining the association between meteorological parameters and HFMD activity / The sentinel consultation rate of HFMD was tested for any association with the meteorological parameters obtained from the Hong Kong Observatory from 2000-2004. Different regression models were examined to find the best model for predicting HFMD consultation rates from 2005-2009. In multivariate regression analysis, model M2 (in which mean temperature, diurnal difference in temperature, relative humidity and wind speed were positively associated with HFMD) was found to have a higher R2 (0.119) than M0 and M1 models with an R2 of 0.079 and 0.062 respectively, indicating that HFMD consultation rates were better explained using meteorological parameters measured 2 weeks earlier. The predicted trend of HFMD consultation rates for 2005 to 2009 matched well with the observed one (Spearman’s rank correlation coefficient=0.276, P=0.000). Sensitivity analysis showed that the estimated HFMD consultation rates were mostly affected by varying the relative humidity and least affected by wind speed. / Study (4)--determining the basic reproduction number of coxsackievirus A16 and enterovirus 71 using mathematical model / The basic reproduction numbers (R0) of EV71 and CoxA16 from laboratory confirmed HFMD outbreaks reported to DH from 2004-2009 were determined using mathematical model. Thirty four outbreaks were analyzed, 27 due to CoxA16 and seven due to EV71. The median R0 of EV71 was 5.48 with an inter-quartile range of 4.206.51 while median R0 of CoxA16 was 2.50 with an inter-quartile range of 1.963.67. In the sensitivity analysis, R0 of EV71 was significantly higher than that of CoxA16 in whole range of incubation periods, p≦0.025. R0was not associated with outbreak setting, size of the institution or number of persons affected. / Study (5)--assessing the impact of SARS and pandemic influenza H1N1 on transmission of HFMD in Hong Kong / I compared the observed HFMD consultation rates and the projected rates, which were constructed using mathematical model, in defined periods of 2003 and 2009 during which territory-wide public health interventions (including school closure) against Severe Acute Respiratory Syndrome (SARS) and pandemic influenza H1N1 were implemented. There was a reduction of 57.2% (95% C.I.:53.0-60.7%) in observed HFMD consultation rates during SARS period in 2003 and a reduction of 26.7% (95% C.I.:19.5-32.7%) during pandemic influenza H1N1 period in 2009. In 2003, the projected rates were still lower than the observed rates beyond week 31 until almost the end of the year. On the contrary, in 2009, the observed HFMD consultation rates became comparable to that of the projected rates in August, before the end of the defined intervention period. / Conclusions / This thesis bridges the knowledge gaps regarding epidemiological characteristics of HFMD. The changing epidemiology of HFMD, including the cyclical high activity of EV71 warrants vigilant surveillance of its activity in order to guide preventive measures. I have demonstrated that climate parameters may help predict HFMD activity, which could assist in explaining the winter peak detected in recent years and issuing early warning in the future. The R0 of EV71 and CoxA16 were first determined in the literature and I found that R0 of EV71 was higher than R0 of CoxA16. The reduction of transmission of HFMD during the SARS and H1N1 periods suggested that public health measures are effective in reducing the transmission of enteroviruses. / Ma, Siu Keung. / Thesis (M.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 121-149). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Table of content --- p.ii / Acknowledgements --- p.iv / Abbreviations --- p.v / Caption for Tables --- p.vi / Caption for Figures --- p.viii / Précis --- p.1 / Chapter PART I: --- LITERATURE REVIEW ON HFMD --- p.5 / Chapter Chapter 1. --- Current Understanding of Epidemiology of HFMD --- p.6 / Chapter 1.1 --- Causative agents and virology --- p.6 / Chapter 1.2 --- Clinical presentation and management --- p.8 / Chapter 1.3 --- Geographical distribution and past epidemics --- p.14 / Chapter 1.4 --- Host susceptibility and molecular determinants of neruovirulence --- p.26 / Chapter 1.5 --- Routes of transmission and transmission dynamics --- p.27 / Chapter 1.6 --- Knowledge gap identified from literature review --- p.29 / Chapter PART II: --- STUDIES ON EPIDEMIOLOGY OF HFMD IN HONG KONG --- p.33 / Chapter Chapter 2. --- Study Objectives and Main data source for analysis --- p.34 / Chapter 2.1 --- Aim and objectives of this thesis --- p.34 / Chapter 2.2 --- Sentinel surveillance system for monitoring HFMD activity --- p.35 / Chapter 2.3 --- Institutional outbreaks of HFMD reported to DH . --- p.37 / Chapter 2.4 --- EV 71 infection reported to Department of Health --- p.37 / Chapter 2.5 --- Laboratory surveillance for monitoring enteroviruses --- p.37 / Chapter Chapter 3. --- Study (1)--Characterizing the changing epidemiological features identified from various surveillance systems for HFMD --- p.38 / Chapter Chapter 4. --- Study (2)--Analyzing the epidemic of enterovirus 71 in 2008 and its public health implication to Hong Kong --- p.52 / Chapter Chapter 5. --- Study (3)--Examining the association between meteorological parameters and HFMD activity --- p.67 / Chapter Chapter 6. --- Study (4)--Determining the basic reproduction number of coxsackievirus A16 and enterovirus 71 using mathematical model --- p.85 / Chapter Chapter 7. --- Study (5)--Impact of SARS and Pandemic Influenza H1N1 on transmission of HFMD in Hong Kong --- p.100 / Chapter Chapter 8. --- Conclusion --- p.111 / List of publications related to this thesis --- p.119 / References --- p.121

This study examined the role of the Anglican Church in the prevention of the spread of HIV and AIDS in the Limpopo Province, South Africa, using a random sample of 51 members of the Zoutpansberg parish. The study found that the Church currently contributes to the prevention of the spread of HIV among its congregation through HIV-related activities to reduce stigma, prejudice and discrimination against people living with HIV and AIDS (PLWHA). At the same time, however, much still needs to be done in the areas of cultural perception, sexual practices, and myths surrounding HIV and AIDS. Most of the respondents indicated that they would like to see the Church play an active role in voluntary counselling and testing (VCT), marital counselling, and encouraging openness with regard to HIV and AIDS. It is recommended that the Church should extend its activities to include members of the community outside the congregation in the prevention of the spread of HIV and AIDS. / Health Studies / M.A. (Health Studies)