Purpose: Neurodevelopmental difficulties are correlated with lower mental well-being and more mental health problems. Issues in social relations such as bullying are a prominent risk factor in a social setting of high school, have also been associated with the status of disability. This thesis investigated the relation between mental health problems, mental well-being, and bullying in adolescents with self-reported neurodevelopmental difficulties and compared these with adolescents with Other disabilities. Materials and methods: Data from a Swedish longitudinal survey study (LoRDIA) was used. Mental health problems were measured through emotional and conduct problems scales of SDQ, mental well-being was measured with MHC-SF, and a bullying questionnaire was used. Results: Adolescents with NDD experience more bullying victimization and perpetration than adolescents with Other disabilities such as physical disability and autoimmune diseases. Significant association to bullying perpetration was found in NDD adolescents. Adolescents with Other disabilities indicated high mental well-being compared to NDD. While gender predicts high mental well-being, disability and emotional problems have a negative relation with it. Conclusion: Adolescents with NDD report more bullying victimization and perpetration experiences in comparison to adolescents with Other disabilities. Emotional problems have an inverse relation for predicting high mental well-being for adolescents with NDD and Other disabilities.

The diploma thesis is devoted to the area of mental health problems / mental illnesses as a possible topic of general primary prevention in the school environment. It points out, that the mental health and illness is not being systematically solved. In the area of primary prevention is not given the kind of attention it deserves. In the theoretical part, basic notions are defined first, such as mental health and illness, risk behavior, stigma and prevention. The focus is on the period of adolescence and the perspective of possible links between risky behaviors and mental health problems/illnesses. The theoretical part of the work is also centered on the coping strategies of adolescents and the area of general primary prevention of risk behavior in the current concept of the Ministry of Education. That includes ensuring and controlling the quality and effectiveness of primary prevention programs. In brief, follow-up care - supported education and early intervention is discussed. The aim of the work is to map the relation of the needs of young people with mental illnesses and primary prevention. In addition, the findings will be a base for recommendations how to incorporate the topic of mental health and illness into the existing system of primary prevention. The methodology is based on a qualitative research...

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.

Comorbid diabetes with depression is a challenging and often under-recognized clinical problem. During the current COVID-19 pandemic, a communicable disease is thriving on the increasing incidences of these non-communicable diseases. These three different health problems are bidirectionally connected forming a vicious cycle. Firstly, depressed individuals show a higher risk of developing diabetes and patients with diabetes have a higher risk of developing symptoms of depression. Secondly, patients with diabetes have a higher risk of developing severe COVID-19 as well as of experiencing breakthrough infections. Thirdly, in both patients with type 2 diabetes and in COVID-19 survivors the prevalence of depression seems to be increased. Fourthly, lockdown and quarantine measurements during the COVID-19 pandemic has led to an increase in depression. Therefore, it is of importance to increase the awareness of this interface between depression, diabetes and COVID-19. Finally, as symptoms of post-COVID, diabetes and depression may be overlapping, there is a need for educating skilled personnel in the management of these comorbidities.

Hintergrund: Psychische Auffälligkeiten beginnen häufig im Kindesalter und können in psychische Störungen münden. Vorhandene Präventionsangebote werden trotz Wirksamkeit nur spärlich in Anspruch genommen. Ziel war zu prüfen, inwiefern durch die Etablierung einer Versorgungskette Risikokinder frühzeitig identifiziert und Präventionsmaßnahmen zugewiesen werden können, sowie inwieweit indikative Präventionsprogramme schlussendlich in Anspruch genommen werden. - Methoden: In einer prospektiven Implementationsstudie wurde während der regulären U9- bis U11-Gesundheitsuntersuchungen (Altersbereich: 5–10 Jahre) der „Strengths and Difficulties Questionnaire“ als Screeninginstrument an Familien ausgegeben. Diese erhielten von ihren Kinderärzt*innen unmittelbar eine Ergebnisrückmeldung und im Falle von grenzwertig auffälligen emotionalen oder Verhaltensproblemen eine Empfehlung für ein indikatives Präventionsprogramm. Vor Programmteilnahme fand im Vorgespräch eine Indikationsprüfung statt. - Ergebnisse: Im Raum Dresden beteiligten sich n = 46 (38,7 %) Kinderärzt*innen am Projekt. In n = 28 Kinderarztpraxen nahmen n = 3231 (86,4 %) Familien am Screening teil, n = 864 (26,7 %) Kinder, deren Familien eine Ergebnisrückmeldung erhielten, bekamen eine Präventionsempfehlung. Zur Präventionsprogrammteilnahme meldeten sich n = 118/864 (13,7 %) Familien selbstständig. n = 215/624 (35,5 %) zeigten Interesse nach projektinitiierter Kontaktaufnahme. Über andere Zugangswege kamen n = 139 Teilnahmeanfragen. n = 337 (n = 461; über alle Zugangswege) Vorgespräche wurden geführt. Schließlich nahmen n = 237 (n = 337) Kinder ein indikatives Präventionsprogramm in Anspruch. - Schlussfolgerung: Eine Ausweitung der Vorsorgeuntersuchung auf psychische Auffälligkeiten ist umsetzbar, nützlich und erfährt breite Akzeptanz. Um eine Versorgungskette einzurichten, sollte eine Angebotsstruktur etabliert werden, um damit die Zuweisung zu und Inanspruchnahme von Präventionsmaßnahmen zu ermöglichen. / Background: Mental health problems usually have their onset in childhood. Undiagnosed, they may progress into mental disorders. Despite their effectiveness, existing preventive programs have been rarely used. We aimed to examine to what extent the establishment of a care chain can identify children at high risk at an early stage and assign them to preventive interventions. In addition, prevention program participation was assessed. - Methods: In a prospective implementation study, the Strengths and Difficulties Questionnaire was administered as a screening instrument to families during regular pediatric health examinations (U9–U11, child age 5–10 years). Families received feedback directly from the pediatrician, and in the case of borderline abnormal emotional or behavioral problems, a recommendation for an indicative prevention program. Program indication was additionally determined in an entry examination prior to program participation. - Results: In the area of Dresden (Germany), n = 46 (38.7%) pediatricians participated in the project. In n = 28 pediatric practices, n = 3231 (86.4%) families participated in the screening and n = 864 (26.7%) children received a prevention recommendation. Of the families, n = 118/864 (13.7%) self-registered for the prevention programs, n = 215/624 (35.5%) showed interest after being contacted by the study teamn. Through other pathways, n = 139 families requested participation. Clinical evaluation interviews to assess prevention indication were conducted in n = 337 children (n = 461; via all entry pathways). Finally, n = 237 (n = 337) children participated in an indicated prevention program. - Conclusion: Expanding screening to mental health problems during regular health checkups is feasible, useful, and widely accepted. In order to implement a care chain, a supply structure should be established to enable referral to and uptake of preventive interventions.

This research project arose from my journeys with Protestant Christian women who were living in sexually unhappy marriages. In South African Protestant faith communities there is the expectation that Christian marriages will experience sexual fulfilment. For many Christian women however, sexual unhappiness becomes their reality. Sexuality is cocooned in silence not only within the church, but also in many Christian marriages. This leaves many Christian women (and men) with little or no recourse to address sexually unhappy marriages. My research journey briefly explored the social construction of sexuality within the history of Christianity to see which discourses underpin current constructions of White Christian female sexuality. This participatory feminist action research journey centralised the voices of present-day contexts: Protestant Christian women, as well as clergy, were invited to share their understandings and interpretations of matrimony and sexual practices in relation to their faith. With the help of narrative therapeutic practices, some of the dominant social and religious discourses that constitute White Christian female sexuality were explored, deconstructed and challenged. This research journey aimed to penetrate this silence and to invite Christian women, who are living in sexually unhappy marriages, to share their experiences. This exploration included the faith predicaments and relational complexities, challenges and dilemmas Protestant Christian women experience when living in sexually unhappy marriages. This feminist-grounded action research explored the effects and consequences which living in sexually unhappy marriages held for the cosearchers. / Practical Theology / D.Th. (Specialisation in Pastoral Therapy)

Text in Afrikaans / Die doel van hierdie ondersoek is om die ekstrinsieke en intrinsieke oorsake van leermislukking met spesifieke verwysing na skole in die Windhoek stadsgebied te bepaal en om aanbevelings te doen hoe om leermislukking teen te werk. Leermislukking en druiping is onrusbarend hoog in skole in die Windhoek stadsgebied. Nadat die Ministerie van Onderwys die semi-outomatiese promoveringstelsel ingestel het, het druiping afgeneem maar leermislukking het toegeneem omdat leerders gepromoveer word sander dat hulle sukses in die vorige graad behaal het. Volgens die literatuurstudie lê die oorsake van leermislukking by die ouerhuis, die skool, die omgewing en in die leerder self. Die empiriese ondersoek toon ooreenkomste met die literatuurstudie wat betref die oorsake van leermislukking. Om die oorsake teen te werk • moet onderwysers beter opgelei word • moet die ouers meer bewus gemaak word van hulle rot in die leersukses van hulle kinders. • is meer skoolgeboue en onderwysers nodig om kleiner klasse te bewerkstellig. / The purpose of this research is to establish the extrinsic and intrinsic causes of learning failure with specific reference to schools in the Windhoek municipal area and to make recommendations to counteract learning failure. Learning failure and grade failing are disconcertingly high in schools in the Windhoek municipal area. After the Ministry of Education implemented the semi-automatic promotion system, grade failing decreased, but learning failure increased because learners are promoted without achieving success in a prior grade. According to the literature study, the causes of learning failure are to be found in the home, the school, the environment, and the learner. Similarities regarding the causes of learning failure were found in the empirical investigation and the literature study. To counteract these causes • teachers should be better trained • parents should become more aware of their role in the learning success of their children • more school buildings and teachers are needed to limit class sizes. / Educational Studies / M. Ed. (Spesiale Behoeftes Onderwys)

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)

Many families have been deprived access to basic human needs like food, clothing, shelter, protection, education and health services because of poverty. In South Africa poverty remains a challenge, resulting from economic and social inequalities, where 40% of its population still live in poverty (Landman, Bhorat, Van der Berg & Van Aardt 2003). The study aimed at ascertaining and describing the needs identified by adult members living in poverty, in the Lukhanji Municipality. The researcher used a probability, systematic, random sampling method to obtain respondents for the study. A non-experimental, descriptive, quantitative research approach was adopted. A questionnaire was used to collect data from 150 respondents, after which a numerical data analysis was done with the assistance of a statistician. Unemployment could be ascribed to lack of education and skills, which exposed families to poor living conditions, ill-health, insecurity and other social ills. Recommendations were made to solve these problems. / Health Studies / M.A. (Health Studies)