M.Cur. / An exploratory descriptive study was undertaken, focusing on sexually transmitted diseases among teenagers. The aim of the study was to explore and describe the possible reasons for the high rate of sexually transmitted diseases in teenagers. The knowledge, attitudes and opinions of teenagers and community nurses involved in the teenage clinic in a specific predominantly black area were assessed. Twenty teenagers and five community nurses in a specific predominantly black area, were participants in the study. Focus group interviews are used. The study is conducted in two phases: teenagers representing phase one (1) and community nurses as phase two (2). It can be concluded that the attitudes of community nurses may have an influence on the high rate of sexually transmitted diseases, and the knowledge of the teenagers about sexually transmitted diseases is based on myths and misconceptions. The recommendations made are that the training standards for all community nurses should be reviewed and adapted to meet the needs of teenagers attending the teenage services. The policy on in-service training must be reviewed and monitored. Community nurses' intensive training on teenage service delivery and sexually transmitted diseases services should be in correlation with the principles of Primary Health Care. Community nurses need to attend intensive courses on interpersonal skills specifically related to teenagers. Selection procedures for recruiting community nurses to attend specifically to teenagers should be researched. The attitude of community nurses and teenagers should be the core of the service delivery. Teenagers should be involved in planning programmes and the teenage clinic should be evaluated frequently to improve the standards. The availability of teenage services should result in a decrease in sexually transmitted diseases among teenagers.

The fight against epidemics/pandemics is one of man versus nature. Technological advances have not only improved existing methods for monitoring and controlling disease outbreaks, but have also provided new means for investigation, such as through modeling and simulation. This dissertation explores the relationship between social structure and disease dynamics. Social structures are modeled as graphs, and outbreaks are simulated based on a well-recognized standard, the susceptible-infectious-removed (SIR) paradigm. Two independent, but related, studies are presented. The first involves measuring the severity of outbreaks as social network parameters are altered. The second study investigates the efficacy of various vaccination policies based on social structure. Three disease-related centrality measures are introduced, contact, transmission, and spread centrality, which are related to previously established centrality measures degree, betweenness, and closeness, respectively. The results of experiments presented in this dissertation indicate that reducing the neighborhood size along with outside-of-neighborhood contacts diminishes the severity of disease outbreaks. Vaccination strategies can effectively reduce these parameters. Additionally, vaccination policies that target individuals with high centrality are generally shown to be slightly more effective than a random vaccination policy. These results combined with past and future studies will assist public health officials in their effort to minimize the effects of inevitable disease epidemics/pandemics.

Thesis (MPH.) -- University of Limpopo, 2019 / Background: HIV and AIDS is the leading cause of death among adults in subSaharan Africa, and the burden of non- communicable diseases such as diabetes mellitus is high and growing as well. This has resulted in the increase of dual diagnosis of HIV and Diabetes Mellitus in recent years increasing disease burden and self-care challenges being experienced by these patients. This study explored patient challenges arising from this dual diagnosis, and investigated how well the Limpopo healthcare system is servicing these lived experiences, and disease burden challenges these patients have to bear. Methods: A qualitative study approach was used and a phenomenology study design employed in this study. Patients‟ lived experiences and their capability to cope with the co-morbidity of HIV and Diabetes Mellitus was investigated. Sixty four (64) HIV patients with Diabetes Mellitus were identified representing 48% of HIV patients in the HIV/AIDS program at the sites of the study (Mankweng hospital POP clinic, Nobody and Dikgale Clinics) in the Polokwane municipality area of the Limpopo province in South Africa. Fifteen (15) of these patients made the sample and were interviewed. In addition, the five (5) of the seventeen (17) health care providers participated in the interviews. Criterion purposive sampling was used whereby the subjects had to have HIV and AIDS and diabetes in order to be part of the study. The semi-structured interview was conducted. An interview schedule was created to ensure that the key research questions related to workload and capacity are adequately covered during the interviews. Results: The evidence collected suggested that HIV and Diabetes comorbidity patients had increased workload and capacity challenges for self-care. Among the challenges was despondency. Patients found it difficult to adjust to symptoms and demands of the dual diagnosis. Counseling and education was noted as easing anxiety and lowered despondency. Poor services at the clinics worsened their experience and disease burden. Shortage of staff, poor housing of clinics, poor facilities and equipment, lack of training and occasional shortage of drugs were the reasons put forward by the health 2 care professional for the poor services. Separate clinics for HIV and Diabetes Mellitus increased the patients time away from a productive life, increased expenses, and somewhat complicated their lives. Good compliance to treatment was observed. Most patients coped well with medication and had no side effects, the few that had side effects continued to take their medication incorporating additional instructions from the health workers who managed the side effects. Family and buddy support improved the capability to cope with the disease burden and their general attitude to life. Conclusion and recommendations: Primary health care must be strengthened to meet the challenges disease convergence is bringing through continued education of staff and improvement of facilities and equipment, and streamlining service delivery processes. Note of significance is that despite the health care professionals being poorly prepared and under staffed, the clinic facility being poorly housed and poorly equipped, the healthcare professionals are managing to meet their service mandate through commitment and hard work.

No description available.

The purpose of this study was to verify the efficiency of McDowell's leisure counseling model for potential use with cardiac rehabilitation and intervention programs in effecting leisure attitudes, work attitudes, work self-concept, leisure self-concept and leisure satisfaction. To test the effectiveness of McDowell's model, an experimental research design, utilizing a pretest-posttest control group design, was used. The independent variable was counseling and the dependent variables, stated as alternative research hypotheses, were a positive effect on leisure self-concept, work self-concept, leisure attitudes, work attitudes and leisure satisfaction. Over a three month period, 24 adult subjects from an Adult Fitness Intervention Program volunteered for leisure counseling and were randomly assigned to one of two groups after which treatment was also randomly assigned. A test for homogeneity of regression revealed the subjects to be representative of the population on all variables except Work Self-Concept. In the study, a client typically was married, middle-aged, white-collar male worker. To measure the dependent variables, five instruments designed to be used with McDowell's model were used. The data obtained from the leisure counseling sample was first subject to a test for homogeneity of regression after which hypotheses one, two, three and five, were subjected to an analysis of covariance. The findings of the analysis of data allowed for the rejection of the null hypotheses and the acceptance of the research hypotheses for hypotheses two and five. For hypotheses one and three, the researcher failed to reject the null hypothesis, and rejected the research hypothesis. An interpretation of these findings suggested that leisure counseling using McDowell's model can affect one's leisure self-concept and leisure satisfaction. From the study it was concluded that for the sample studied McDowell's leisure counseling model can be said to have positively increased the clients' leisure self-concept and leisure satisfaction on a short term basis. It was also concluded that leisure counseling as a component of cardiac rehabilitation/intervention programs using McDowell's model was said to be neither effective or ineffective for the sample studies. These results must account for the fact that the research methodology was not able to identify the possible reactive effect of the pretest. / Ed. D.

published_or_final_version / Community Medicine / Master / Master of Public Health

No description available.

Cardiovascular disease (e.g., myocardial infarction, stroke, coronary artery disease) is the leading cause of death and disability worldwide. There is a growing body of literature that indicates sexual minority (e.g., gay, lesbian, bisexual, queer) adults are at a higher risk of cardiovascular disease than their heterosexual counterparts. The aim of this dissertation was to identify factors that contribute to the cardiovascular health (CVH) disparities that have been observed among sexual minority individuals. Guided by an adaptation of the minority stress model of CVH among sexual minority individuals, this dissertation includes three studies. In the first study (i.e., Chapter 2), we conducted a scoping review of the literature that investigated social determinants of cardiovascular health among sexual minority adults. Although findings were mixed, several social determinants of health were found to influence the CVH of sexual minority adults. For instance, sexual minority adults who lived in environments that were more supportive of sexual and gender minority people had lower odds of being overweight or obese. In the second study (i.e., Chapter 3), we used data from a racially and ethnically diverse sample of sexual minority women to examine the associations of family-related factors (i.e., sexual identity disclosure and family social support) with self-reported incident hypertension. Additionally, we examined whether these associations were moderated by race/ethnicity and sexual identity, or mediated by depressive symptoms. We found that higher levels of family social support were associated with lower levels of depressive symptoms among sexual minority women. However, family-related factors were not associated with self-reported incident hypertension. Further, race/ethnicity and sexual identity did not moderate the associations between family-related factors and reported incident hypertension. In the third study (i.e., Chapter 4), we used data from a nationally representative sample of adults to investigate sexual identity differences in ideal CVH (as defined by the American Heart Association’s Life Simple 7) and whether these associations were mediated by depressive symptoms. Compared to exclusively heterosexual women, mostly heterosexual and lesbian women were less likely to meet ideal criteria for tobacco use. In contrast, lesbian women were more likely to meet ideal criteria for glycosylated hemoglobin than exclusively heterosexual women. Among men, relative to exclusively heterosexual men, mostly heterosexual men were less likely to meet ideal criteria for tobacco use. Gay and bisexual men were less likely to meet ideal criteria for physical activity, whereas gay men were more likely to meet ideal criteria for body mass index compared to exclusively heterosexual men. Bisexual men were less likely to meet ideal criteria for blood pressure relative to exclusively heterosexual men. Depressive symptoms were found to partially mediate the association between sexual identity and physical activity only among mostly heterosexual women. Overall, these dissertation findings highlight CVH disparities among sexual minority adults. Clinicians should be educated about the CVH disparities that have been documented among sexual minority adults to provide personalized and culturally competent care. Results also indicate there is a need to develop behavioral interventions tailored specifically to the needs of sexual minority adults to improve their CVH outcomes and reduce CVH-related disparities.

"May 2004" / Includes bibliographical references (leaves 243-270) / xviii, 270 leaves : ill. (some col.), maps ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, School of Social Sciences, Discipline of Geographical and Environmental Studies, 2004

Having a chronic illness may feel alienating, yet examination of the literature shows limited research on social connectedness and health. In order to contribute to the understanding of this impact of illness, I examined perceived levels of social connectedness in persons with chronic diseases (CD), functional somatic syndromes (FSS) and medically unexplained symptoms (MUS). A major focus of this study was to investigate the association of social connectedness with depression, anxiety, and general health in patients with ongoing symptoms of illness. Data collection was obtained through the use of four online surveys collectively known as VOICE (Verification of Coping, Illness and Experience). For the purposes of this study, five measures were used: the Social Connectedness Scale, Short Form Health Survey (SF-36), Patient Health Questionnaire depression scale (PHQ-8), Hopkins Symptoms Checklist (HSCL) and the Social Impact Scale. Participants were recruited through announcements via online message boards and support groups, as well as through the distribution of brochures in local medical practices. A total of 148 participants (80% female) completed all four surveys. Results indicated that the chronic illness groups did not significantly differ in social connectedness, although there was some indication that the FSS group felt more social isolation. Regression analyses indicated that, while accounting for socio-cultural and health factors, social connectedness was the strongest predictor of depression (β = - .43, p < .001), anxiety (β = -.48, p < .001) and general health (β = .34, p < .001) in chronically ill persons. The independent and robust relationship of social connectedness with psychological and physical health in individuals with chronic illness suggests that this is an important factor deserving of future research with important clinical applications.