Thesis (Ph. D.)--University of Missouri-Columbia, 1998. / Appendix C in Korean. Typescript. Vita. Includes bibliographical references (leaves 142-151). Also available on the Internet.

Thesis (M.S.)--University of Michigan, 1989.

Thesis (M.S.)--University of Michigan, 1979.

The objectives of this study were to determine what the Tumbuka people of northern Malawi consider to be the most dangerous childhood diseases, to explore their perceptions about the aetiology, prevention and treatment of these diseases, and to determine how such perceptions have changed over the years. The study was done in Chisinde and surrounding villages in western Rumphi District, northern Malawi. Although a household questionnaire was used to collect some quantitative data, the major data collection methods comprised participant observation, in-depth interviews with mothers with children under five and old men and women, and key informant interviews with traditional healers, traditional birth attendants, village headmen, health surveillance assistants and clinical officers. Informants in this study mentioned chikhoso chamoto, diarrhoea, malaria, measles, and conjunctivitis as the most dangerous childhood diseases in the area. Old men and women added that in the past smallpox was also a dangerous disease that affected both children and adults. Apart from measles and smallpox, community-based health workers and those at the local health centre also mentioned the same list of diseases as the most dangerous diseases prevalent among under-five children. Though health workers and informants mentioned the same diseases, the informants' perspectives about the aetiology and prevention of these diseases and the way they sought treatment during childhood illness episodes, in some cases, differed significantly from those of biomedicine. For example, while health workers said that the signs and symptoms presented by a child suffering from "chikhoso chamoto" were those of either kwashiorkor or marasmus, both young and elderly informants said that a child could contract this illness through contact with a person who had been involved in sexual intercourse. Biomedically, diarrhoea is caused by the ingestion of pathogenic agents, which are transmitted through, among other factors, drinking contaminated water and eating contaminated foods. While young men and women subscribed to this biomedical view, at the same time, just like old men and women, they also believed that if a breastfeeding mother has sexual intercourse, sperms will contaminate her breast milk and, once a child feeds on this milk, he or she will develop diarrhoea. They, in addition, associated diarrhoea with the process of teething and other infections, such as malaria and measles. In malaria-endemic areas such as Malawi, the occurrence of convulsions, splenomegaly and anaemia in children under five may be biomedically attributed to malaria. However, most informants in this study perceived these conditions as separate disease entities caused by, among other factors, witchcraft and the infringement of Tumbuka taboos relating to food, sexual intercourse and funerals. Splenomegaly and convulsions were also perceived as hereditary diseases. Such Tumbuka perceptions about the aetiology of childhood diseases also influenced their ideas about prevention and the seeking of therapy during illness episodes. Apart from measles, other childhood vaccine-preventable diseases (i.e. tetanus, diphtheria, tuberculosis, pertussis and poliomyelitis) were not mentioned, presumably because they are no longer occurring on a significant scale, which is an indication of the success of vaccination programmes. This study reveals that there is no outright rejection of vaccination services in the study area. Some mothers, though, felt pressured to go for vaccination services as they believed that non-vaccinated children were refused biomedical treatment at the local health centres when they fell ill. While young women with children under five mentioned vaccination as a preventative measure against diseases such as measles, they also mentioned other indigenous forms of 'vaccination', which included the adherence to societal taboos, the wearing of amulets, the rubbing of protective medicines into incisions, isolation of children under five (e.g. a newly born child is kept in the house, amongst other things, to protect him or her against people who are ritually considered hot because of sexual intercourse) who are susceptible to disease or those posing a threat to cause disease in children under five. For example, since diarrhoea is perceived to be caused by, among other things, a child feeding on breast milk contaminated with sperms, informants said that there is a strong need for couples to observe postpartum sexual intercourse. A couple with newly delivered twins is isolated from the village because of the belief that children will swell if they came into contact with them. Local methods of disease prevention seem therefore to depend on what is perceived to be the cause of the illness and the decision to adopt specific preventive measures depends on, among other factors, the diagnosis of the cause and of who is vulnerable. The therapy-seeking process is a hierarchical movement within and between aetiologies; at the same time, it is not a random process, but an ordered process of choices in response to negative feedback, and subject to a number of factors, such as the aetiology of the disease, distance, social costs, cost of the therapeutic intervention, availability of medicines, etc. The movement between systems (i.e. from traditional medicine to biomedicine and vice-versa) during illness episodes depends on a number of factors, including previous experiences of significant others (i.e. those close to the patient), perceptions about the chances of getting healed, the decisions of the therapy management group, etc. For example, febrile illness in children under five may be treated using herbs or antipyretics bought from the local grocery shops. When the situation worsens (e.g. accompanied by convulsions), a herbalist will be consulted or the child may be taken to the local health centre. The local health centre refers such cases to the district hospital for treatment. Because of the rapidity with which the condition worsens, informants said that sometimes such children are believed to be bewitched, hence while biomedical treatment is sought, at the same time diviners are also consulted. The therapeutic strategies people resort to during illness episodes are appropriate rational decisions, based on prevailing circumstances, knowledge, resources and outcomes. Boundaries between the different therapeutic options are not rigid, as people move from one form of therapy to another and from one mode of classification to another. Lastly, perceptions about childhood diseases have changed over the years. Old men and women mostly attribute childhood illnesses to the infringement of taboos (e.g. on . sexual intercourse), witchcraft and other supernatural forces. While young men and women also subscribe to these perceptions, they have at the same time also appropriated the biomedical disease explanatory models. These biomedical models were learnt at school, acquired during health education sessions conducted by health workers in the communities as well as during under-five clinics, and health education programmes conducted on the national radio station. Younger people, more frequently than older people, thus move within and between aetiological models in the manner described above.

Thesis (MPH.) --University of Limpopo, 2015 / Background Cervical cancer is the 2nd most common cancer in women globally representing 13% of female cancers and accounting for 11% of the total cancer deaths (Ahmedin et al.2011). Several studies demonstrated the association between HIV and HPV. In Zimbabwe the prevalence of HIV/AIDS is high and cervical cancer is the leading cause of cancer deaths among women of all age groups. The aim of the study was to determine the knowledge, attitude and practices of HIV infected women on cervical cancer and cervical cancer screening at Musiso Hospital, Masvingo Province, Zimbabwe. Methods 208 self administered questionnaires were used with a 100 per cent response rate. Quantitative data were analysed using STATA statistical package version 12 for descriptive and inferential statistics. Chi-squared tests were done for hypothesis testing at 5 per cent level of significance and 95 per cent confidence level. Multiple variable logistic regressions models were also used to assess association between outcomes of interest and socio-demographic characteristics. All open ended questions were analysed using qualitative methods. Results Out of the 208 participants, 45 (21.6 per cent) respondents claimed to know what cervical cancer is. About 55.3 per cent said cervical cancer is preventable. The majority (92.8 per cent) did not know any screening tests. Just above three quarters (77.3 per cent) of the respondents believed they were at risk of having cervical cancer. About 9 per cent (18) of all participants had screened for cervical cancer before and 95.8 per cent respondents reported would like to screen for cervical cancer in the future. Conclusion HIV infected women at Musiso mission hospital were found to be having inadequate knowledge, positive attitude and inadequate practices on cervical cancer and cervical cancer screening. There is need to equip these women with knowledge on cervical cancer and cervical cancer screening to increase cervical cancer screening uptake. Key Concepts: knowledge, attitude, practice, screening, cervical cancer

Identity is an important determinant of behavior. This paper proposed an identity model as one way of understanding those factors related to the perceived probability or willingness of a worker to participate in health promotion programming at the worksite. Part of a larger study on employee wellness, this study took place in the municipal complex of a small city in the southeastern United States. A stratified cross sectional sample of 150 employees was selected utilizing a systematic random sampling methodology. Structured interviews were conducted with 129 participants resulting in a response rate of 92% after adjusting for those people no longer employed by the city. In order to test the identity model developed by this author, descriptive analysis, simple multiple regression analysis and path analysis were utilized. The dependent variable, perceived willingness to participate in health promotion programming, was examined in relationship to commitment to one's health identity, commitment to one's organizational identity, tendency to comply with health initiatives, and the forms of supervisory power utilized to enact employee compliance. The descriptive analysis revealed that subjective health status is moderately and positively associated with commitment to one's health identity, that individuals can be strongly committed to a negative/destructive health identity, and that both the family and physician play important roles as health advice givers. The path analysis revealed that commitment to one's organizational identity, commitment to one's health identity, and tendency to comply with health initiatives are significantly and positively associated with willingness to participate in health promotion programming, accounting for 25% of the variance in the dependent variable. In contrast, the forms of supervisory power were not shown to be related to the dependent variable. In conclusion, the identity model appears to be a useful tool for the understanding of health attitudes and behaviors within a work setting.

This study focuses on the association between patient characteristics, which include both demographic and contextual factors, and patients' experiences with health care. The pre-existing literature provides rich information about patients' various demographics related to patient experience. Despite the abundance of empirical evidence showing that patients' demographics do affect how they perceive their health care. However, there is little to no empirical knowledge explaining the significance of such factors. As the existing literature points out the need for taking into contextual factors such as patient's beliefs, attitudes, skills that are pertinent to dealing with health care, my study proposes patient activation as such a contextual factor that explains the association between patient demographics and patient experience. Findings suggest that patient activation is a strong predictor of two patient experience measures: patients' rating of doctor-patient communication and their self-reported difficulties in getting needed care. However, it is also observed that the mediating effects of patient activation vary by the two dimensions of patient experiences. Though this study demonstrates that promoting patient activation may be able to normalize how patients report the quality of doctor-patient interaction, further research is needed to address access to care issues.

No description available.

Thesis (MBA)--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: The prevalence of overweight and obesity escalated over the past 30 years worldwide in adults, children, and adolescents. Estimates are that 26% of the global adult population is either overweight or obese. However, the most alarming fact is the increase in obesity in children and adolescents. In South Africa, the estimated overweight and obesity prevalence in adults is 45% and 20% in children below 6 years of age. The World Heath Organisation acknowledges obesity as an unforgiving, formidable chronic disease, an eminent global epidemic, and the most significant independent risk factor to chronic disease. There are about 30 different diseases associated with obesity of which cardiovascular disease, metabolic syndrome, lifestyle cancers, depression, and diabetes are the most prominent. The current rising obesity trends increase the prevalence of these obesity-associated diseases, as well as a wide range of psychosocial problems. Global expectations are that weight-related chronic disease will develop into the most significant healthcare problem in the 21st century. The overarching trend of globalisation has transformed the global landscape into a more obesogenic environment with resultant changes in behavioural lifestyles of increased caloric consumption and less physical activity at home and at work. However, genetic, social, and cultural determinants enhance weight gain, which contributes largely to current obesity trends. Obesity is a major public healthcare problem in South Africa, with African women and Caucasian men most at risk. However, the competing priorities of unemployment, poverty, and HIV/AIDS place high demands on the South African economy, with resultant neglect of obesity. Obesity has the potential to incur a large impact on the South African economy through the reduction in labour productivity, corporate profitability, and national output, especially in combination with HIV/AIDS. / AFRIKAANSE OPSOMMING: Die insidensie van oorgewig en obesiteit het toegeneem oor die afgelope 30 jaar wereldwyd in volwassenes, tieners, en kinders. Omtrent 26% van die globale populasie is of oorgewig of vetsugtig. Die erns van die huidige situasie is egter die toenemende voorkoms van obesiteit in kinders en tieners. Die voorkoms van oorgewig en obesiteit in Suid-Afrika word geskat op 45% in volwassenes en 20% in kinders jonger as 6 jaar. Die Wereld Gesondheid Organisasie het in 1997 obesiteit geklassifiseer as 'n chroniese siekte en hul kommer uitgespreek oor die feit dat obesiteit epidemiese proporsies bereik het. Obesiteit word ook nou erken as die belangrikste, onafhanklike risiko faktor vir chroniese siekte. Obesiteit word geassosieer met omtrent 30 verskillende siektetoestande waarvan kardiovaskulere siekte, metaboliese sindroom, lewensstyl kankers, depressie, en diabetes die belangrikste is. Stygende obesiteit syfers verhoog ook die voorkoms van hierdie siektes asook verskeie psigososiale probleme. Verwagtings is dat gewig verwante siektes die belangrikste gesondheid probleme sal wees gedurende die 21 ste eeu. Die proses van globalisasie het die wereld landskap verander in 'n omgewing wat meer obesogenies is, wat gelei het tot veranderings in leefstyle in die rigting van 'n hoër inname van kaloriee en minder aktiewe leefstyle. Genetiese, sosiale, en kulturele faktore verhoog ook die vatbaarheid van die individu tot gewig toename en speel 'n groot rol in die huidige obesiteit status. Obesiteit is tans 'n geweldige gesondheidprobleem in Suid-Afrika met Swart vrouens en Blanke mans die populasiegroepe wat die hoogste risiko dra. Die probleem is egter dat die kompeterende prioriteite van werkloosheid, armoede, en MIV/VIGS alreeds hoe eise stel aan die Suid-Afrikaans ekonomie met gevolglike verwaarlosing van obesiteit. Obesiteit het die potensiaal om 'n groot effek uit te oefen op die Suid-Afrikaanse ekonomie deur middel van 'n verlies in produktiwiteit, verminderde korporatiewe wins, en ekonomiese groei, veral in kombinasie met MIV/VIGS.

published_or_final_version / Social Work / Master / Master of Social Work