Breast cancer poses a serious public health concern. This case-control study describes the relationship of night-shift working on the development of breast cancer in 57 women diagnosed with breast cancer compared to 49 women with other types of cancer in the Vaal Triangle area (selected through non-probability purposive sampling from CANSA). The study revealed that women who work night-shift developed breast cancer 1.24 times more often than women who do not work nightshift (OR=1.24 [95% CI 0.52 to 2.89]). The odds ratio was further increased in women who worked rotating-shift (OR=1.44 [95% CI 0.58 to 3.59]). Night-shift work exposure was not statistically related to the development of breast cancer. It is recommended that the relationship between night-shift exposure and breast cancer risk be further explored through cross-sectional and cohort studies, and other breast cancer pathways. / Health Studies / M. A. (Public Health)

Lau, Chun Hong. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 224-256). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese. / Some appendixes in Chinese.

Lok, Yuet Wan. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 156-176). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract and appendix also in Chinese.

Introduction. HIV positive men who have sex with men (HIVMSM), facing severe stigma and many stressors, have high prevalence of mental health problems, such as depression. However, there is a lack of mental health promotion and treatment services targeting HIVMSM in China. The Three Good Things (TGT) exercise is one of the commonly used positive psychology interventions; its benefits in reducing depression have been scientifically proven in many disease groups. Yet, TGT has not been applied among HIVMSM. In addition, social support has shown to be protective of depression. The emergence of electronic social media allows for integration of social networking and TGT exercise among HIVMSM. / Objectives. This study aimed to evaluate the efficacy of a one-month online intervention combining TGT with social networking (TGT-SN) versus a control of dissemination of information in reducing depressive symptoms among HIVMSM in Chengdu, China. / Methods. A randomized controlled trial design was applied. A total of 205 HIVMSM were recruited and randomly assigned to the TGT-SN (N=100) or control group (N=105) by four well-trained peer fieldworkers. Self-administered surveys were given to all participants at baseline, at the end of the 1-month intervention (T1), and at the 3-month (T2) and 6-month (T3) post-intervention follow-ups. The intervention was delivered via “QQ”, the most widely used Chinese social networking service. Participants in TGT-SN group were divided into four “QQ” groups, each the size of 20-30 persons. Participants in TGT-SN were asked to post three things they experienced that they feel grateful about daily onto the QQ platform and share them with members of their group. They were also asked to read others’ messages and give positive and encouraging feedbacks to those messages. Members of the control group received information about mental health promotion from research assistants via QQ once a week during the one-month intervention period. The primary mental health outcome was probable case of mild to severe depression measured by Center for Epidemiologic Studies Depression Scale (CES-D). Secondary psychological outcomes include depressive symptoms, anxiety, positive and negative affect, life satisfaction, subjective happiness, gratitude level, and perceived social support. Generalized Estimating Equation models were fit. Structural equation modeling was applied for mediation analysis. / Results. Among all participants, the prevalence of probable mild, moderate, and severe depression were, respectively, 14.6%, 9.3%, and 35.6% at baseline. All baseline background characteristics and outcome measures were balanced (statistically non-significant) between the two groups. Based on data obtained at T1, T2 and T3 that were analyzed by GEE model, there was a significant main effect of TGT-SN on reducing depression (B=-2.35, 95% CI=-4.53, -0.16, p=0.035), indicating significantly lower depression score in the intervention group as compared with that of control group. Nonetheless, such significant effect became non-significant (B=-1.67, 95% CI=-3.79, 0.46, p=0.124) when controlled for baseline depression score. Significant differences were also found between the TGT-SN and the control group in anxiety symptoms (B=-1.14, 95% CI=-2.06, -0.22, p=0.016) and negative affect (B=-2.08, 95% CI=-3.62, -0.55, p=0.008). The effect of TGT-SN on reducing depression was most evident at T3. Structural equation modeling indicated that gratitude and negative affect fully mediated the effect of TGT-SN in reduction of depression and anxiety (mediation effect=-0.17, 95% CI=-0.30, -0.04, p<0.05) at T3. / Conclusions. TGT-SN is a feasible, acceptable, sustainable, and scalable intervention to improve mental health among HIVMSM. It is warranted to increase awareness and policy support for mental health services for people living with HIV (PLWH). Mental health services should be integrated into the HIV/AIDS care system as a key component. Future translational studies are needed to further investigate the efficacy and effectiveness of the intervention in other groups of PLWH and in other cultures and countries. / 研究背景：艾滋病在男男性接觸（men who have sex with men, MSM）人群中的感染率正在以前所未有的速度在我國蔓延。艾滋病陽性的男男性接觸（HIV positive men who have sex with men, HIVMSM）人群面臨極大的壓力，心理疾病（例如抑鬱症）的患病率很高。但是，目前我國對HIVMSM人群的心理健康服務比較缺乏。“三件好事情”是最被廣泛使用的能有效降低抑鬱症的積極心理學干預。這項練習要求參與者每天寫下三件令他們感到高興或者感激的事情。“三件好事情”這兩練習還沒有在HIVMSM 人群中應用。此外，社會支持對抑鬱症有保護作用。電子社交網絡是一種潛在的有效的平台，可以將調查對象（HIVMSM）的“好事情”相互傳遞，加強“三件好事情”的效果。 / 研究目的：本研究的目的是在中國成都市使用隨機對照研究評估積極心理學結合社會網絡干預對減少HIVMSM人群抑鬱症的效果。 / 研究方法：本研究採用隨機對照試驗。四名同伴調查員共招募205位HIVMSM，其中100人被隨機分配到“三件好事情結合電子社交網絡組（TGT-SN）”，105人被分配到對照組。所有參與本研究的調查對象將在隨機分組之前完成基線調查（T0），並在一個月的干預結束時（T1）、干預結束后三個月（T2）、十二個月（T3）時完成隨訪調查。 / TGT-SN干預通過騰訊QQ實施。騰訊QQ是在中國最被普遍使用的社交網絡。TGT-SN組的調查對象將被分配到4個QQ組，每組20-30人。TGT-SN干預要求調查對象在一個月的干預期，每天需要完成以下三個任務：i）每天回想當天發生的三件或以上令自己開心、感激的事情，并將這三件好事情發佈到各自的QQ群留言板；ii）每天閱讀本QQ群其他組員發佈的三件好事情；iii）每天對組員發佈的三件好事情進行正面的積極的評論。被隨機分配到對照組的調查對象在一個月的干預期內，每週收到一條有關心理健康促進的信息。 / 本研究的主要結果為抑鬱症狀，採用美國國立衛生研究院流行病學研究中心抑鬱量表。次級結果包括焦慮症狀、正性和負性情緒、生活滿意度、主觀幸福感、感恩心理、以及社會支持。分析採用廣義估計方程模型（GEE）。中介效應分析採用結構方程模型。 / 研究結果：所有調查對象中，59.5%有輕度到重度抑鬱症（CESD≥16）。TGT-SN和對照組基線所有的背景變量及結果變量均無顯著性差異。基於對T1、T2和T3數據的GEE模型分析，相比于對照組，TGT-SN對降低抑鬱症有顯著主效應（B=-2.35, 95% CI=-4.53, -0.16; p=0.035）。但是此顯著主效應在控制基線抑鬱症狀后變為不顯著（B=-1.67, 95% CI=-3.79, 0.46, p=0.124）。相比于對照組，TGT-SN對降低焦慮症狀（B=-1.29, 95% CI=-2.22, -0.36; p=0.007）和負性情緒（B=-2.24, 95% CI=-3.73, -0.74; p=0.003）也有顯著效果。TGT-SN對降低抑鬱症的效果在T3最為顯著。結構方程模型表明，負性情緒和感恩心理對TGT-SN干預降低T3時抑鬱症和焦慮症的效果中發揮完全中介效應（中介效應=-0.17, 95%置信區間=-0.30, -0.04; p<0.05）。 / 研究結論：TGT-SN能有效減少HIVMSM人群的心理健康問題（例如抑鬱症和焦慮症），並且是可行的和被HIVMSM所接受的干預措施。TGT-SN練習的實施成本較低並且不需要心理學專家的參與，因此可以在資源有限的國家和地區（例如中國）推廣實施。未來需要更多的研究來評估TGT-SN干預在其他艾滋病病毒感染者人群中以及其它國家的效力和效果。" / Li, Jinghua. / Thesis Ph.D. Chinese University of Hong Kong 2015. / Includes bibliographical references (leaves 136-149). / Abstracts also in Chinese; some appendixes in Chinese. / Title from PDF title page (viewed on 06, October, 2016). / Li, Jinghua. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

This study set out to examine the levels of galactic cosmic radiation exposure to Australian aircrew during routine flight operations, with particular attention to the high southern latitude flights between Australia and South Africa. Latitudes as high as 65?? South were flown to gain the data and are typical of the normal flight routes flown between Sydney and Johannesburg on a daily basis. In achieving this objective it became evident that suitable commercially available radiation monitoring equipment was not readily available and scientific radiation monitors were sourced from overseas research facilities to compliment my own FH4lB and Liulin monitors provided by UNSW. At the same time it became apparent that several predictive codes had been developed to attempt to model the radiation doses received by aircrew based on flight route, latitudes and altitudes. Further, it became apparent that these codes had not been subjected to verification at high southern latitudes and that they had not been validated for the effects of solar particle events. Initially measurements were required at the high latitudes followed by mid-latitude data to further balance the PCAIRE code to ensure reasonableness of results for both equatorial and high latitudes. Whilst undertaking this study new scientific monitors became available which provided an opportunity to observe comparative data and results. The Liulin, QDOS and a number of smaller personal dosimeters were subsequently obtained and evaluated. This appears to be the first time that such an extensive cross comparison of these monitors has been conducted over such a wide range of latitudes and altitudes. During the course of this study a fortuitous encounter with GLE 66 enabled several aspects of code validation to be examined, namely the inability of predictive codes to estimate the increased dose associated with a GLE or the effects of a Forbush decrease on the code results. Finally I review the known biological effects as discussed by numerous authors based on current epidemiological studies, with a view to high-lighting were the advent of future technology in aviation may project aircrew dose levels.

The practise of male traditional circumcision is severely challenged with enormous problems ranging from hospitalisation of the initiates as well as deaths of the initiates. The background of the problem is focused in the Eastern Cape Province where the researcher has noted several initiates being treated in hospitals for physical and as well for psychological problems. The objective of this study was to explore and describe newly initiated Xhosa men's experiences of traditional circumcision rites at East London in the Eastern Cape Province and to describe the guidelines for support of these newly initiated Xhosa men by public health professionals. A qualitative explorative, descriptive contextual and phenomenological design was followed. Purposive sampling technique was used to select the participants. Fourteen participants volunteered to participate in the study after they met the eligible criteria. Focused group interviews were used as a method for data collection. Data analysis of the study showed that there are several factors affecting newly initiated men whilst undergoing circumcision rites. These factors can present at any of the three circumcision stages i.e. pre-circumcision, peri-circumcision and post-circumcision. The recommendations of the study strongly suggest a cultural competence in rendering effective health care services to culturally and ethnically diverse clients. All the five constructs of cultural competence are entailed in the support guidelines that have been developed by the researcher. They are cultural awareness, cultural knowledge, cultural skill, cultural encounter and cultural desire. Finally limitation of the study and the need for a further research has been clearly stated. / Health Studies / M.A.

With the advent of the new National Health Act, health care in South Africa is at a critical point as this will be the first time in history that a National Health Insurance is being implemented in this country. Globally National Health Insurance has been around for more than a hundred years, however some countries with long established national health schemes are currently grappling with funding issues surrounding their health systems. South Africa should take note of these issues as it embarks on this journey. The objective of this study was to perform a literature review on how South Africa’s National Health Insurance can be funded taking cognisance of the history of the country and experiences of other countries. It is imperative for each country to achieve optimal health care funding to ensure the success and long-term sustainability of National Health Insurance. The analysis of the problems experienced by other countries revealed that balancing the three main funding options namely, allocated from the national revenue fund, user charges and or donations or grants from international organisations, is critical as the funds needed in a system to achieve coverage at an affordable cost is dependent on the current state of health care in a country. Considering South Africa’s history and current inequality in society and health care it is clear that the majority of funding for the National Health Insurance should be supplied by the national revenue fund. The required funds can either be raised by increasing existing taxes or introducing a new tax specifically aimed at financing the National Health Insurance. The use of user charges is important however, although not purely for a revenue collection point, but from a cost control point of view as well. Some studies have revealed that the lack of user charges results in a misuse of the system. / Financial Accounting / M. Phil. (Accounting Science)

The commercial mining of asbestos occurred in four Provinces of South Africa (Northern Cape, North West, Limpopo and Mpumalanga). It was initiated in the late 1800's and lasted for over a hundred years into the beginning of this century. As a producer of amphibole asbestos, South Africa far outpaced every other country being responsible for 97% of global production. The last crocidolite mine closed in 1996 and chrysotile in 2002. Anecdotal information concerning environmental contamination as a result of the former mining activities and the improper disposal of mine waste tailings has been reported by a variety of authors. Few comprehensive or systematic surveys have been conducted to date to document this issue and very little quantifiable research has been completed on the communities located in close proximity to the former mine sites to determine the extent of contamination. In 2004-2006 communities were surveyed within the Northern Cape and North West Provinces to determine the extent and severity of environmental contamination. This research developed and applied a methodology to select those communities suspected of environmental contamination, a targeted survey methodology, and a protocol for rapid sample laboratory analysis. A total of 41 communities were initially predicted by the model to be suspected for environmental asbestos contamination. Based on the inclusion of local knowledge, a final 36 communities were selected for a screening-level field assessment, 34 of which were found to contain environmental asbestos contamination at rates ranging from 20 to 100% of the surveyed locations. A total of 1 843 samples of soil and building material were collected in the screening level assessment. One community (Ga-Mopedi) was selected as being representative of the total cohort and a more detailed house to house survey was completed. A total of 1 486 samples were collected during the detailed survey. Results of the detailed survey revealed 26.2% of the homes were contaminated with asbestos containing soil and/or building material. A theoretical quantitative cumulative exposure assessment was developed to estimate the disease burden within the study area population of 126,130 individuals within the surveyed communities resulting in a predicted range of 25-52.4 excess deaths per year from lung cancer and mesothelioma due solely to environmental exposures to asbestos pollution.

Although herbivory and other types of plant damage typically are viewed as detrimental to plant survival and performance, vigorous regrowth, greater seed set, and fitness benefits may be possible when damage to the apical meristem, or actively growing stem terminal, is involved. Such damage releases apical dominance, or the hormonal suppression of lateral buds, activates dormant lateral buds, and enables lateral shoots to grow. Since in plants with terminal flowers, each stem may bear a flower, removal of the apical meristem may result in stem bifurcation and ultimately increase the number of flowers and seeds, thereby increasing potential fitness. In the current study, possible overcompensation in response to apical meristem damage caused by simulated herbivory (clipping) and the gall midge Asphondylia borrichiae Rossi and Strong (Diptera: Cecidomyiidae) (galling) was investigated in the native coastal halophyte, sea oxeye daisy Borrichia frutescens (L.) DC. (Asteraceae), in relation to nutrient supplementation. Results suggest a strong correlation between stem count and gall count at the study site; moreover, apical dominance was relatively weak early in the growing season and stronger in short plants that were shaded by taller neighbors later in the season. Results also indicate that overcompensation or even full compensation is an unlikely response to apical meristem damage in B. frutescens. Stem count was similar across all stem treatments, but increased significantly with nutrient supplementation, which all supports weak apical dominance in sea oxeye daisy. Nearly all measures of fitness also were either slightly or significantly lower when clipped and galled compared to plants with stems intact, while seed count responded positively to nutrient supplementation.

The purpose of a study of spirituality and its relationship to the compliance of hemodialysis patients is to consider changing the approach of the treatment team in the dialysis setting. The interdisciplinary treatment team at the dialysis center consists of physicians, nurses, dietitians, and social workers. One of the many roles of the dialysis social worker is to facilitate the adjustment to and acceptance of the patient's need for dialysis.