Ghana is identified among the developing countries with high maternal mortality ratio in Africa. This study unpacked the Demographic and Health Survey data by examining the maternal health indicators at the district level using GIS methods. Understanding the geographic patterns of antenatal care, place of delivery, and skilled birth attendants at the small scale will help to formulate and plan for location-specific health interventions that can improve maternal health care behavior among Ghanaian women. Districts with high rates and low rates were identified. Place of residence, Gini-Coefficient, wealth status, internet access, and religious affiliation were used to explore the underlying factors associated with the observed patterns. Economic inequality was positively associated with increased use of maternal health care services. The ongoing free maternal health policy serves as a cushion effect for the economic inequality among the districts in the Northern areas. Home delivery is common among the rural districts and is more prominent mostly in the western part of Northern Region and southwest of Upper West. Educating women about the free maternal health policy remains the most viable strategy for positive maternal health outcomes and in reducing MMR in Ghana.

Objectives: Research on life stressors and adverse life events has a long tradition. Few studies have addressed this topic in connection to very old people. Life stressors, especially major life stressors (MLSs) experienced by clients of home care services in the community have rarely been the subject of studies. Considering this gap, we investigated the prevalence of MLSs in home care clients. We examined the effects that MLSs have on their mood and health status as well as the impact of clients’ social resources on MLSs and their outcomes. Method: We used assessment data from 2,884 home care clients in six European countries. The methodological basis was the comprehensive and standardized interRAI Home Care Assessment (interRAI HC). Results: Fifteen point four percent of the sample—that consisted of women and men with an average age of 82.89 years–experienced an MLS in the last 6 months before the assessment. They were more depressed than persons without these experiences, and their health status indicated a higher level of instability and deterioration. At reassessment after 6 months, the situation changed. Despite the fact that both outcomes of the MLSs, depression and health status became worse in the reassessment-sample, home care clients without MLS were more affected by the worsening, especially that of depression. The expected buffering impact of social resources was low. Discussion: Although this study worked with limited information on MLSs, it could contribute to closing various knowledge gaps. The study shows that the MLSs represent a prevalent problem in a population of home care clients and that this problem has negative consequences for their mood and the stability of their health status. Furthermore, this research took up the situation of very old and vulnerable adults, who have previously rarely been considered in studies on major critical life events and stressors. Conclusion and Research Perspective: Future research on MLSs has to take up the issue of the time passage between the MLS and the impact on health and well-being of individuals dependent on care. It has to determine immediate as well as later consequences and identify those factors that are appropriate to reduce the MLS-effects on very old people dependent on care.

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<p>Background: Health status and quality of life (QOL) instruments developed for children were created with many different conceptual perspectives. These perspectives were based on contextual understandings of the terms health and QOL at different points in time. As a result, there is a wide variety in the perspectives, health and life domains that are measured with these instruments.</p> <p>Purpose: This thesis is dedicated to resolving conceptual inconsistencies that arise from various instruments using content analysis techniques.</p> <p>Method: A method for analyzing the content of self-report instruments has been created and validated for adult measures. This method uses the International Classification of Functioning, Disability and Health (ICF) as the conceptual framework and the standard terminology to code each item from each instrument. Content analysis using this method will be reviewed, revised and validated for child health status and QOL instruments.</p> <p>Results: The content analysis method was revised to resolve issues regarding the perspective of instruments (e.g. health status versus QOL). Once applied to child self-report instruments, many inconsistencies between measures and their application were discovered.</p> <p>Discussion: The field of child health and QOL measurement applies and interprets the use of health status and QOL instruments inconsistently and this impacts upon content validity. Additionally, the repercussions of conceptual inconsistencies have an important effect on consequential validity in child health.</p> / Doctor of Philosophy (PhD)

Human health is frequently omitted from household-level studies on agricultural productivity, land-use choices, and forest degradation and deforestation. Intuition, however, suggests that it could be an extremely important factor. This dissertation is built on three essays that use household survey data from the Brazilian Amazon to examine the conditions under which human health and other critical market conditions are important factors in determining household agriculture production choices and efficiency. Essay I (Chapter 2) examines how health affects the labor allocation and production choices of migrant smallholders in the Brazilian Amazon. We show that the impacts of illness on household decisions depend critically on labor market function in the rural areas of the tropics. Furthermore, results from a formal statistical test of the labor markets shows that they do not work well, in other words are incomplete or thin, in the study area. These results are important both in specification of future smallholder household economic models and in targeting policies to better alleviate poverty and encourage more sustainable use of forest and land resources in similar tropical regions. Essay II (Chapter 3) investigates the role of health as a productive input and non-input factor of production. By using a non-neutral stochastic production approach, the impact of health is decomposed into direct effect on the production function and indirect effects on technical efficiency. The finding of the essay suggests that poor health has significant negative impacts on rural household production. The most important policy implication is that careful designing of agriculture development and rural settlements programs is important, and the provision of health care should be tied to these development projects. Essay III (Chapter 4) examines the demand for labor applied to land clearing, staple food production, livestock, working off-farm, and time taking care of sick people in the household. Specifically the empirical application examines the impact of disease on labor allocation, accounting for time lost by households taking care of sick members as a non-productive activity. Disease plays an important role in household decisions because farm activities are performed inefficiently by sick households and changes in household labor efficiency brings about a change in the relative price of competing uses for a household's time. Chapter 5 provides a summary and general conclusion of the work, and then provides comments on policy design and recommendations for further studies. In summary, the combined results of these studies show that both health condition and the quality of labor markets have significant interacting impacts on the labor allocation decisions by smallholders with accompanying welfare and deforestation implications. / Doctor of Philosophy / Most of the rural population of the Brazilian Amazon is made up of small-scale farmers – the so-called 'smallholders' – who are characterized by a lack of access to formal credit, a disconnection from social services, poor access to markets, and a dependency on their own labor as the main input in agricultural production, and thus survival. Since labor is the main input used in smallholder activities, albeit to different extents, anything that changes total household labor or labor efficiency adjusts the relative returns of competing uses, and thus labor allocation decisions. This PhD dissertation is an effort to understand whether markets, family health, and seasonality affect labor allocation decisions, and furthermore, whether those allocation decisions vary depending on productive activity. Based on cross-sectional farm data from the Brazilian Amazon, I find that the impacts of illness on household decisions depend critically on how well labor market function in rural areas. The results from a statistical test of the labor markets shows that they do not work well in the study area. These results are important both in specification of future smallholder household economic models and in targeting policies to better alleviate poverty and encourage more sustainable use of forests and land resources in similar settings. Also, I find that poor health has a significant negative impact on technical efficiency of rural household farm production. The most important policy implication is that careful designing of agriculture development and rural settlements programs is important, and the provision of health care care should be tied to these development projects. Finally, in the context of the region of study, where labor markets are thin, disease plays an important role on in household decisions because farm activities are performed inefficiently by sick households and change in labor efficiency brings about a change in relative prices of competing uses of household's time. My empirical work supports the hypothesis that health influence labor allocation decisions. In conclusion, the combined results of these studies show that both health conditions and the quality of labor markets have significant interacting impacts on the labor allocation decisions by smallholders with accompanying welfare and deforestation implications.

Health related absenteeism was identified as a problem in the schools in the Molopo region, needing a multi-disciplinary approach which included the parents. A conceptual framework on absenteeism was used as a guideline for the descriptive research design. Using a convenience sampling technique 426 absentees, 22 teachers and 2 school nurses filled in three separate questionnaires in ten schools selected to determine the extent of absenteeism due to health related and other problems, the control measures taken and the awareness of school personnel. Health problems were identified as the main reasons for absenteeism. Inadequate communication between the schools and parents as well as lack of guidelines on the control of absenteeism, were other problems identified. Recommendations made related to the provision of school health services that promote the health status of the pupils based on Primary Health Care principles, parental involvement in school health matters and the formulation of policies aimed at controlling absenteeism in schools. / Health Sciences / M.A. (Nursing Science)

INTRODUÇÃO: As intervenções de promoção da saúde mental avançam e atividades não medicamentosas ganham espaço. Neste sentido, estudos apontam a atenção plena (mindfulness) como estratégia integrativa para o enfrentamento do estresse e de transtornos mentais comuns, bem como para obtenção do autocuidado. Mindfulness é referido no contexto laico contemporâneo como um estado mental presente em todos os indivíduos em maior ou menor intensidade que pode ser cultivado diariamente através de práticas meditativas. OBJETIVO: Descrever o nível da autopercepção de comportamentos relacionados à Mindfulness em profissionais da saúde de um Hospital Terciário e analisar a associação dos níveis de mindfulness autopercebidos com determinados indicadores das condições de vida e saúde. MÉTODO: Foi realizado um estudo transversal com 97 profissionais da saúde que compõem o complexo do Hospital das Clínicas - FMUSP por via de caracterização Sociodemográfica, da Escala Filadélfia de Mindfulness (EFM) e de um Questionário de Saúde Geral (General Health Questionnaire -12). Todos os questionários foram aplicados no período de fevereiro/novembro de 2014. RESULTADO: Na EFM, o escore médio apresentado foi maior para o componente \"Consciência\" (média 29,9; desviopadrão 0,62) do que para \"Aceitação\" (média 15,7; desvio-padrão 0,86), sendo a média 45,6 e desvio-padrão 1,1 para o Escore Total (componente \"consciência\" somada a \"aceitação\"); Verificou-se número significativo de indivíduos (41%) com suspeita de transtornos mentais comuns (TMC), aqueles que apresentaram um escore de três ou mais no GHQ-12. Em análise mais detalhada (Teste t e ANOVA) observou-se associações fortemente significantes (p < 0,01) entre maiores níveis de mindfulness autopercebido com o gênero masculino, estado civil casado/amigado, maior satisfação no trabalho, negar uso de medicamentos, sono satisfatório, lazer frequente e ausência de TMC. Na análise da associação GHQ-12 com Mindfulness estratificada por profissão verificou-se escores menores no grupo das categorias \"psicólogo, assistente social, profissional de educação física, biólogo, fisioterapeuta, farmacêutico e profissional administrativo\" com TMC; na análise da associação GHQ-12 com Mindfulness estratificada por tipo de doença concluiu-se que existem diferenças significantes (p < 0,01) no grupo das categorias \"mais de uma doença, neurológica ou psiquiátrica\", das quais o escore \"Total\" e \"Aceitação\" foram menores para quem apresenta TMC. A presença de TMC (referido pelo GHQ-12) está associada a menores escores de Mindfulness, indicando uma possível correlação negativa que se deve ao domínio de \"Aceitação\" CONCLUSÃO: Os níveis de comportamentos autopercebidos à atenção plena apontaram associações significantes com uma variedade de indicadores das condições de vida e saúde nos profissionais de saúde. Sugerindo assim, uma mesma direção de evidências científicas recentes de que mindfulness pode fazer parte de fatores de proteção à saúde favorecendo também o autocuidado e a qualidade de vida / INTRODUCTION: The Mental Health Promotion interventions advance and non-drug activities gain ground. In this case, studies show meditation as an opportunity to cope with stress and the common mental disorders, as well as to obtain self-care. Mindfulness is referred in contemporary laic context as a present mental state in all individuals in greater or lesser degree which can be daily cultivated through meditative practices. OBJECTIVE: This study aimed to describe the self-perceived level of Mindfulness-related behaviors in health care professionals of a tertiary care hospital as well as to analyze the association of self-perceived mindfulness levels with certain indicators of living conditions and health. METHOD: A cross-sectional study is proposed with 97 health professionals who make up the University Hospital complex - FMUSP via Socio Demographic characterization, a study of the Philadelphia Mindfulness Scale (PMS) and a Questionnaire of General Health (General Health Questionnaire -12). All interviews were conducted between February and November/ 2014. RESULT: In PMS, the average score was higher for the component \"awareness\" (mean 29.9, SD 0.62) than for \"acceptance\" (mean 15.7, SD 0.86), with an average 45.6 and SD 1.1 for the Total Score (component \"awareness\" added to \"acceptance\"); There was a significant number of individuals (41%) with suspected common mental disorders (CMD), those with a score of three or higher in the GHQ-12. In a more detailed analysis (T-Test and ANOVA) it was observed strongly significant associations (p < 0.01) with higher levels of self-perceived mindfulness in the masculine gender, married / living together unmarried, greater job satisfaction, not in use of medicinal drugs, satisfactory sleep, frequent leisure and no presence of CMD. In the analysis of the GHQ-12 association with Mindfulness stratified by profession it was observed that the scores were lower for the group of the categories \"psychologist, social worker, physical education professional, biologist, physiotherapist, pharmacist and administrative professional\" with CMD; in the analysis of the GHQ-12 association with Mindfulness stratified by disease type the results showed that there are significant differences (p < 0.01) for the group of the categories \"more than one disease, either neurological or psychiatric\", of which the score \"Total\" and \"Acceptance\" were lower for those who had CMD. The presence of CMD (referred by the GHQ-12) is associated with lower scores of Mindfulness, indicating a possible negative correlation due to the domain of \"Acceptance\". CONCLUSION: The levels of self-perceived behaviors to mindfulness showed significant associations with a variety of indicators of living conditions and health among health care professionals. Suggesting, thus, the same direction of recent scientific evidences that mindfulness may be part of health protective factors also favoring self-care and quality of life

Thesis (M.Nurs.)(Hons)--University of Western Sydney, Nepean, 1996. / Title from electronic document (viewed 25/5/10) Includes bibliography.

Health related absenteeism was identified as a problem in the schools in the Molopo region, needing a multi-disciplinary approach which included the parents. A conceptual framework on absenteeism was used as a guideline for the descriptive research design. Using a convenience sampling technique 426 absentees, 22 teachers and 2 school nurses filled in three separate questionnaires in ten schools selected to determine the extent of absenteeism due to health related and other problems, the control measures taken and the awareness of school personnel. Health problems were identified as the main reasons for absenteeism. Inadequate communication between the schools and parents as well as lack of guidelines on the control of absenteeism, were other problems identified. Recommendations made related to the provision of school health services that promote the health status of the pupils based on Primary Health Care principles, parental involvement in school health matters and the formulation of policies aimed at controlling absenteeism in schools. / Health Sciences / M.A. (Nursing Science)