吳木欣. / "2008年7月". / "2008 nian 7 yue". / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 169-174). / Abstracts in Chinese and English. / Wu Muxin. / 目錄 / 引言 --- p.9 / Chapter 第一章 --- 文獻回顧 / Chapter 1 --- 何謂 MSM? --- p.11 / Chapter 2 --- 回顧亞洲男男性接觸者感染愛滋病之情況 --- p.11 / Chapter 3 --- 愛滋病感染率急升之原因 --- p.14 / Chapter 3.1 --- 香港同性戀者情況 --- p.17 / Chapter 4 --- 各地政府和NGOs之回應 --- p.19 / Chapter ■ --- 歧視與愛滋病的關連 --- p.20 / Chapter 4.1 --- 美國經驗´ؤ´ؤ活動取向之多元 --- p.21 / Chapter 4.2 --- 亞洲經驗一政府的不支持，非政府組織的無力 --- p.23 / Chapter 5 --- 回顧政府和香港非政府組織(NGOs)的角色 --- p.24 / Chapter 5.1 --- 香港政府採取的措施 --- p.24 / Chapter 5.1.1 --- ACA的建議政策角色 --- p.26 / Chapter 5.1.2 --- ATF的撥款機制角色 --- p.28 / Chapter 5.1.3 --- 非政府組織的工作 --- p.35 / Chapter 6 --- 是次研究的分析框架和概念 --- p.38 / Chapter 7 --- 研究重要之處 --- p.45 / Chapter 第二章 --- 研究方法 --- p.47 / Chapter 第三章 --- 誰是決策者 --- p.52 / Chapter 第四章 --- 主流組織的失敗一一反思一筆過撥款的弊端 --- p.73 / Chapter 第五章 --- 愛滋病非政府組織的無力 --- p.94 / Chapter 第六章 --- 草根組織的掙扎求存 --- p.103 / Chapter 第七章 --- 政府的割裂 --- p.115 / Chapter 第八章 --- 非政府組織的工作---愛滋病只是愛滋病嗎？ --- p.130 / Chapter 第九章 --- 總結 --- p.158 / 參考文獻 --- p.169 / 附件一 --- p.175 / 附件二 --- p.176

Introdução: No contexto do envelhecimento populacional, uma questão fundamental é avaliar se as estratégias de prevenção de doenças crônicas poderiam contribuir para o aumento dos anos vividos em boas condições de saúde, pela população idosa. Objetivo: Avaliar se a eliminação de determinadas doenças crônicas é capaz de levar à compressão da morbidade em indivíduos idosos. Métodos: Estudo transversal analítico, de base populacional, utilizando dados oficiais secundários para o Município de São Paulo, em 2000, e dados obtidos a partir do estudo SABE. O método de Sullivan foi utilizado para o cálculo de expectativas de vida livre de incapacidade (E.V.L.I.). O impacto da eliminação de uma doença na prevalência de incapacidade foi estimado com um modelo de regressão logística múltipla. Tábuas de vida de eliminação de causas foram utilizadas para calcular as probabilidades de morte com a eliminação de doenças. O efeito da eliminação das doenças crônicas foi avaliado, considerando a teoria de riscos competitivos e a abordagem proposta por Nusselder e colaboradores. Resultados: Os maiores ganhos em E.V.L.I., com a eliminação de doenças crônicas, ocorreram no sexo feminino, levando a um processo de compressão absoluta da morbidade. Nos indivíduos de idade mais avançada, os ganhos em E.V.L.I., ocorreram em função de um processo de compressão relativa da morbidade. Nos homens com idade de 75 anos, todas as doenças estudadas, com exceção da doença cardíaca e da hipertensão arterial sistêmica, levaram a um processo de expansão absoluta da morbidade, mas simultaneamente a um processo de compressão relativa da morbidade, ao serem eliminadas. A doença cardíaca apresentou-se como aquela que mais promoveria a compressão da morbidade, caso fosse eliminada, em ambos os sexos. Conclusão: A eliminação de doenças crônicas na população idosa poderia levar a uma compressão da morbidade em homens e mulheres, tanto na idade de 60 anos, quanto na de 75 anos / Introduction: In the context of the aging process, a key issue is to assess whether strategies to prevent chronic diseases may contribute to the increase in years lived in good health among elderly individuals. Objective: To evaluate whether elimination of certain chronic diseases can lead to the compression of morbidity, in the elderly. Methods: Analytical cross-sectional survey, based on official data for the city of São Paulo, in 2000, and data obtained from the SABE study. Sullivans method was used for the calculation of disability-free life expectancy (DFLE). Cause-deleted disability prevalence was estimated using multiple logistic regression model. Cause-deleted probabilities of dying were derived with the cause-elimination life-table technique, considering the independence of the causes of based on the approach proposed by Nusselder and co-workers. Results: The greatest gains in DFLE, with the elimination of chronic diseases, occurred in women, leading to a process of absolute compression of morbidity. Among individuals of a more advanced age, gains in DFLE occurred due to a relative compression of morbidity process. Among men aged 75 years, all diseases eliminated, except heart disease and hypertension, led to a process of absolute expansion of morbidity, but simultaneously, to a relative compression of morbidity. If eliminated, heart disease was the condition that would most lead to the compression of morbidity in both genders. Conclusion: The elimination of chronic diseases in the elderly population could lead to the compression of morbidity in men and women at both 60 years of age and in 75 years of age or older

<p>The negative effect of poor oral health on quality of life and financial implication of work days lost as a result of dental pain can be accepted as a rationale for inclusion of oral health in the primary health care (PHC) package for South Africa. The norms of the PHC package for oral health services are to expose at least 50% of primary schools to organized school preventive programmes and to ensure basic coverage of everybody in the catchment areas. Currently these norms are not adequately fulfilled in Randfontein. The purpose of this study was to gather information that can be used to improve oral health services in Randfontein. The aim of the study was to gain an understanding of the factors that influence the choice of oral health care seeking behaviour as perceived&nbsp / by residents in different contexts and to use these perceptions to inform appropriate health planning strategies and implementation of measures that can improve health promotion in Randfontein. This qualitative study explored oral health care seeking behaviour. The study population comprised all residents of Randfontein above seventeen years old who had visited the oral health section in the Randfontein Primary Health Care (PHC) Facility. There were two focus group discussions (FGDs) from each of three separate residential areas namely Mohlakeng with&nbsp / mainly black residents, Toekomsrus with mainly coloured race residents and from town which is a predominantly Caucasian race area. Data collected was analysed during the data collection stage and thereafter until they made sense to the researcher. To strengthen validity, the accuracy of the interpretation of what respondents said was confirmed with them. Analysed themes were&nbsp / coded and categorized to enable the key researcher to interpret them for final reporting. Appropriate ethical procedures were followed. The findings were that although all focus groups preferred&nbsp / allopathic oral health care seeking, various barriers existed. The study concluded that there should be adequate oral health education and promotion, effectivecommunication and an expansion of these services to Toekomsrus, where they do not exist. Perceptions on factors influencing oral health seeking by Randfontein residents&nbsp / </p>

The aim of this research is to know the training of health professionals in health promotion and disease prevention, and to examine its manifestation among the actions and interventions for prevention of tobacco, alcohol or cannabis consumption. The sample includes 225 professionals. The study used a self-made design of quantitative methodology (survey study). The most important results are: the formative limitations in health education and prevention of substance use and the fact that professionals who have received specific training in substance use tap more health education as a prevention tool in their daily activities. It is also noted that 80% of professionals believe they should improve quality training, and 67% quantity, always in relation to the tobacco, alcohol and cannabis use. Generally, the overload care and the lack of time are cited as factors preventing the health education activities. Finally, the study also shows that secondary prevention activities are the most used, while community interventions are underutilized by professionals. / L’objectiu d’aquesta recerca és conèixer la formació dels professionals sanitaris en matèria de promoció de la salut i prevenció de la malaltia, i com es concreten les seves intervencions en la prevenció del consum de tabac, alcohol i cànnabis. La base del treball és una mostra de 225 professionals de la salut. S’ha utilitzat un disseny propi de la metodologia quantitativa (estudi d’enquesta). Entre els resultats obtinguts destaquem: les limitacions formatives en educació per a la salut i en prevenció del consum de substàncies, i el fet que els professionals que han rebut formació específica en consum de substàncies utilitzen més l’educació per a la salut com a eina de prevenció en la seva activitat diària. També s’observa que el 80% dels professionals considera que hauria de millorar la seva formació en qualitat, i un 67% en quantitat, sempre sobre el consum de tabac, alcohol i cànnabis. En general, la sobrecàrrega assistencial i la manca de temps són esmentats com a factors que obstaculitzen les activitats d’educació per a la salut. Finalment, l’estudi posa de manifest que les activitats de prevenció secundària són les més realitzades, mentre que les intervencions comunitàries són poc utilitzades pels professionals.

More than 16 years post-apartheid, South Africa is still regarded as the most unequal society in the world. The government is facing various obstacles and challenges in improving the standard of living and quality of life for all its citizens, for example in facilitating the access to clean drinking water and sanitation, building houses and providing basic education. In addition, the country is facing the world’s largest HIV/AIDS epidemic with a national prevalence rate of 18.1 %, equalling approximately 5.7 million people who are currently infected. (Pressly, 2009; UNAIDS, 2008c) Against this background, the aim of this thesis was to study the Madwaleni community, situated in a deeply rural area of the former apartheid homeland Transkei. Applying the Community Oriented Primary Care approach, a strategy of ‘community assessment and diagnosis’ was used to obtain a holistic community profile and to determine the perceptions of its community members regarding their health and social problems and needs, intending to make recommendations to health care providers working at Madwaleni Hospital regarding future health education and disease prevention programmes. (Brown and Fee, 2002) This research used a cross-sectional design. In a preliminary survey, qualitative data was collected in short interviews with health care providers working at Madwaleni Hospital (N=46). The information served as a basis to develop and design parts of the Madwaleni community survey questionnaire. The questionnaire consisted of 36 questions, complying with the aim and objectives of this thesis. It was used for the structured interviews with the main study population, all of whom were members of the Madwaleni community (N=200), whereas half of the main study population were men and half were women, then again, half were unaware of their HIV status and half were HIV+ and had joined the Madwaleni HIV/AIDS programme. Key findings 1) Madwaleni community profile and characteristics Thoughtful sexual behaviour: Particularly interesting in light of the HIV/AIDS epidemic, more than 90 % of the sexually active community members were monogamous at the time of the survey. While only 36.4 % of the men and women unaware of their HIV status used condoms, 76.5 % of the HIV+ community members claimed to do so, indicating that the Madwaleni HIV wellness programme and especially its counselling and health education components are adequate and valuable in serving their purpose. High rates of illiteracy and insufficient education: Only 56.5 % of the interviewed community members were ‘functionally literate’ at the time of the survey. Of those, only 8 % had received a matriculation and not one of the community members had received any higher degree. In addition, 19.5 % of the sampled men and women were not able to read at all. High rates of unemployment, poverty and dependency on welfare grants: Only 20 % of the Madwaleni community members were employed at the time of the survey. Taking the daily income per capita as a reference, one third of the community members suffered from ‘moderate poverty’, defined as an income of 1 to 2 US $ per day, while the other two thirds suffered from ‘extreme poverty’, defined as an income of less than 1 US $ per day, although more than 90 % of the corresponding households received at least one type of welfare grant already. Large household sizes and predominance of traditional dwellings: In the Madwaleni community, an average of eight people lived together per household at the time of the survey, whereas 95 % of the community members lived in traditional dwellings, constructed from freely occurring natural resources. In need of safe drinking water, sanitary systems and access to electricity: More than 80 % of the Madwaleni community members obtained their drinking water from rivers or stagnant dams, while only 6.5 % used rain water and 9.5 % had access to piped water. In addition, almost 70 % of the community members had no access to any sanitary systems, using nearby bushes instead. Furthermore, more than 90 % had no access to electricity. The majority used paraffin for cooking, candles for lighting and wood for heating their homes. Small-scale cultivation to provide an extra source of food: In the Madwaleni area, 90 % of the families owned a small garden patch attached to their houses, used for small-scale cultivation. In addition, almost 90 % owned livestock, mainly poultry, cattle and goats. Crops and animals were used to provide an extra source of food; however, not one of the households could solely live on subsistence farming. Difficulties in accessing health care facilities: On average, each of the community members needed three-quarters of an hour to access their closest clinic and almost one and a half hours to reach Madwaleni Hospital, with 40 % and 60 % respectively depending on public taxi transport to get there. No substantial improvement of the living circumstances since apartheid: Comparing the Madwaleni community characteristics with corresponding data from apartheid-times, no substantial improvement of the living circumstances and conditions could be noticed, proving that governmental and non-governmental actions, programmes and services have not yet reached all remote communities. Similar community characteristics in the neighbouring communities: Comparing these characteristics with corresponding features of communities in the immediate or surrounding areas, namely Cwebe, Ntubeni, Mboya, Shixini and Zithulele, various similarities could be detected, indicating that the living circumstances and conditions might be generalisable to a certain degree, at least to deeply rural communities in the former Transkei area. More disadvantaged than the general South African population: The Madwaleni community differed significantly from the general South African population in 75 % of the compared characteristics. For example, amongst the community members the illiteracy rate (21.7 % vs. 13.6 %, p = 0.002) and unemployment rate (80.5 % vs. 25.5 %, p < 0.001) were significantly higher. In addition, the ‘poverty headcount ratio of 2 US $ per day’ showed that significantly more people were suffering from poverty in the Madwaleni area (92.2 % vs. 34 %, p < 0.001). The Madwaleni community members were less likely to have access to clean drinking water, along with significantly higher proportions of them using river water as their main source of drinking water (75.5 % vs. 5.1 %, p < 0.001). Also, they were less likely to have access to any sanitation or toilet facilities (31.3 % vs. 91.8 %, p < 0.001) or to electricity (8.5 % vs. 80.2 %, p < 0.001). 2) Weightiest health and social problems as experienced by the Madwaleni community In the Madwaleni area, the three health problems with the highest impact on the community were TB, HIV/AIDS and hypertension. On the basis of the applied 3-to-0-point rating matrix, they were rated by more than 95 % of the community members as being relevant problems, with mean values of 2.33, 2.30 and 2.14 respectively. Interestingly, women rated HIV/AIDS higher than men. Musculoskeletal problems and headache were additional health problems with relevant impact on the Madwaleni community, rated by more than 90 %, with mean values above 1.80. While pain and discomfort experienced by PLWHA have been recognised and researched before, there are no corresponding studies on rural communities and further research is necessary to identify the contributing factors. Additional relevant health problems: Interestingly, six health problems were rated higher by HIV untested than by HIV+ community members, namely bilharzia/ schistosomiasis, epilepsy, Herpes Zoster, HIV/AIDS, lung infections and stroke. Since the HIV+ men and women were educated about and screened for all of those diseases within the Madwaleni HIV/AIDS programme, this might explain the deviating rating patterns between the different sub-samples. Moreover, these results demonstrate that health education and disease prevention programmes are able to reduce the perceived burden of health problems and might therefore serve as a substantial argument in their favour. Interestingly, for the Madwaleni community, social matters had a higher impact on their lives than health problems, whereas the three social problems with the highest impact on the community were alcohol abuse, dependency on social grants and smoking. They were rated by more than 98 % of the community members as being relevant problems, with mean values of 2.75, 2.73 and 2.72 respectively. In accordance with these findings, employment & lack of work opportunities, education & illiteracy, food supply and poverty were additional social problems with relevant impact in the Madwaleni area, rated by more than 90 %, with mean values above 2.00. 3) Recommendations for future health education and disease prevention programmes At the time of the survey, the three most relevant health education and disease prevention topics for the Madwaleni community were HIV/AIDS, TB and healthy nutrition. They were rated by more than 95 % of the community members as being relevant health education problems, with mean values of 2.65, 2.51 and 2.36 respectively. In addition, STIs, alcohol & drug-related problems, water & sanitation and body & muscle pain were rated as the subsequent issues of relevance, with mean values above 2.00, supporting the identified community characteristics as well as the listing of the weightiest health and social problems. In addition, valuable new insight could be gained. For instance, HIV untested men rated the topic HIV/AIDS lower than all other community members, which is particularly interesting since men only constitute a minority of 20 % of the people testing for HIV in the Madwaleni area. Besides, topics not previously considered, such as injury prevention and basic first aid, were in-fact relevant for more than 85 % of the community members and require further attention. Furthermore, deviating rating patterns between men and women and the corresponding need for gender-specific educational workshops became evident, for example, for men about prostate & testicular cancer check-up or erectile dysfunction and for women about breast & cervical cancer check-up & papsmears or nutrition & growth. In addition, HIV+ community members rated depression & stress and psychiatric diseases higher than HIV untested men and women, with further studies required to identify the underlying reasons for these deviating rating patterns. Taking all findings from this Madwaleni community survey into consideration, health care providers working at the hospital and its peripheral clinics should first and foremost concentrate their efforts on maintaining the existing programmes, particularly, the Madwaleni HIV/ARV programme and the workshops on hypertension and diabetes mellitus. In addition, if qualified and motivated personnel can be recruited and the necessary funding can be raised, future health education and disease prevention programmes should focus on TB, alcohol & substance abuse-related problems as well as water & sanitation.

No description available.

<p>The negative effect of poor oral health on quality of life and financial implication of work days lost as a result of dental pain can be accepted as a rationale for inclusion of oral health in the primary health care (PHC) package for South Africa. The norms of the PHC package for oral health services are to expose at least 50% of primary schools to organized school preventive programmes and to ensure basic coverage of everybody in the catchment areas. Currently these norms are not adequately fulfilled in Randfontein. The purpose of this study was to gather information that can be used to improve oral health services in Randfontein. The aim of the study was to gain an understanding of the factors that influence the choice of oral health care seeking behaviour as perceived&nbsp / by residents in different contexts and to use these perceptions to inform appropriate health planning strategies and implementation of measures that can improve health promotion in Randfontein. This qualitative study explored oral health care seeking behaviour. The study population comprised all residents of Randfontein above seventeen years old who had visited the oral health section in the Randfontein Primary Health Care (PHC) Facility. There were two focus group discussions (FGDs) from each of three separate residential areas namely Mohlakeng with&nbsp / mainly black residents, Toekomsrus with mainly coloured race residents and from town which is a predominantly Caucasian race area. Data collected was analysed during the data collection stage and thereafter until they made sense to the researcher. To strengthen validity, the accuracy of the interpretation of what respondents said was confirmed with them. Analysed themes were&nbsp / coded and categorized to enable the key researcher to interpret them for final reporting. Appropriate ethical procedures were followed. The findings were that although all focus groups preferred&nbsp / allopathic oral health care seeking, various barriers existed. The study concluded that there should be adequate oral health education and promotion, effectivecommunication and an expansion of these services to Toekomsrus, where they do not exist. Perceptions on factors influencing oral health seeking by Randfontein residents&nbsp / </p>

Thesis (MPhil)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The study was carried out for the purpose of establishing how young working adults perceive the effect of billboards on HIV and AIDS awareness in Zimbabwe. The study sample was taken from the Directorate of Pharmacy Services, a department within the Ministry of Health and Child Welfare of Zimbabwe, located in the capital city of Harare. A representative number of women (40%) out of the 15 participants were interviewed as certain responses were required based on a participants gender. In-depth interviews were carried, the sections covered positioning and appearance of billboards, billboard content and general aspects. 47% of the participants regarded the billboards as well located, 40% felt that there are adequate numbers of billboards, 47% perceived them as attractive and not needing any improvements while 67% described them as well laid out. The language used on them was said to be fine by 73%, and gender-sensitive by only 33% (of which the majority were men). All the women felt that the billboard contents are sensitising the public to HIV and AIDS as well as most of the men (67% participants in total). However all the participants see billboards as not the best method to bring about HIV and AIDS awareness, but would want a multi-media approach so that they compliment other methods. Billboard usage for HIV and AIDS awareness is making a significant impact but there is room for improvement, and many recommendations were derived from this study. / AFRIKAANSE OPSOMMING: Die studie is onderneem met die doel om te bepaal hoe jong werkende volwassenes die effek van advertensieborde rakende MIV en VIGS-bewustheid in Zimbabwe ondervind. Die studie is onderneem in die Direktoraat vir Apterkersdienste, 'n afdeling binne die Ministerie van Gesondheid en Kinderwelsyn van Zimbabwe, wat in die hoofstad, Harare, geleë is. Daar is onderhoude gevoer met ‘n verteenwoordigende aantal vroue (40%) vanuit die 15 deelnemers, aangesien sekere response benodig was op grond van geslag. In-diepte onderhoude is gevoer en die afdelings het die volgende gedek: posisionering en die voorkoms van advertensieborde, inhoud van advertensieborde sowel as algemene aspekte daar rondom. 47% van die deelnemers het gevoel dat die advertensieborde goed geleë is, 40% het gevoel dat daar voldoende getalle advertensieborde is, 47% het gevoel dat die borde aantreklik is en nie verbeteringe benodig nie, terwyl 67% voel dat hul goed uitgelê is. 73% van die deelnemers het gevoel dat die taal wat op die borde gebruik word goed is. Slegs 33% het gevoel dat die borde geslagsensitief is (waarvan die meerderheid mans was). Al die vroue het gevoel dat die inhoud van die reklameborde die publiek sensitiseer tot MIV en VIGS, so ook meeste van die mans (67%). Al die deelnemers voel dat advertensieborde nie die beste metode is om MIV en VIGS-bewustheid te bring nie, maar stel ‘n multi-media benadering voor om ander metodes te komplimenteer. Die gebruik van advertensieborde het ‘n beduidende impak op MIV en VIGS-bewustheid, maar daar is ruimte vir verbetering en baie aanbevelings is afgelei uit hierdie studie.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The AIDS epidemic has brought out both the best and the worst in people. The disease brings out the best when individuals group together in solidarity to combat the consequences of HIV/AIDS and to support and care for PLWHA. HIV/AIDS also brings out the worst when individuals are stigmatized and ostracized by their loved ones, their family and their communities and discriminated against individually as well as institutionally. This research has reviewed available scientific literature on HIV/AIDS stigma and discrimination. The research has also established HIV/AIDS stigma and discrimination comes in different forms and occurs in different contexts. Stigma and discrimination play a significant role in HIV/AIDS prevention and treatment efforts. Analysis of this research indicates stigma and discrimination has a negative impact on HIV/AIDS prevention and treatment efforts. / AFRIKAANSE OPSOMMING: Die VIGS-epidemie het beide die beste en die slegste in mense. Die siekte bring die beste wanneer individue groep saam in solidariteit die gevolge van MIV / VIGS te bestry en te ondersteun en sorg vir PLWHA. MIV / VIGS bring ook die ergste wanneer individue gestigmatiseer en verstoot deur hul geliefdes, hul familie en hul gemeenskappe en teen gediskrimineer individueel sowel as institusioneel. Hierdie navorsing het hersien dat die beskikbare wetenskaplike literatuur oor MIV / VIGS stigma en diskriminasie. Die navorsing het ook vasgestel dat MIV / VIGS stigma en diskriminasie kom in verskillende vorms voor en kom in verskillende kontekste. Stigma en diskriminasie speel 'n belangrike rol in MIV / VIGS voorkoming en behandeling pogings. Ontleding van hierdie navorsing dui daarop dat stigma en diskriminasie het 'n negatiewe impak op MIV / VIGS voorkoming en behandeling pogings.

No abstract available. / Thesis (M.Dev.Studies)-University of Natal, Durban, 2002.