A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Science in Medicine (Pharmaceutical Affairs) Johannesburg, 29 August 2014 / In South Africa’s current healthcare structure, about 8.3% of GDP is spent on healthcare. This is well above the WHO recommended 5% of GDP spend. Despite the heavy spending, health outcomes remain poor when compared to similar middle-income countries. Solutions need to be found to cut back on healthcare costs. Approximately half (4.1%) of the healthcare spend is consumed by the private sector which benefits a very small segment (16%) of the population. This segment is largely on medical schemes. Using generic medicines can aid in cutting back on drug costs but are generics being adequately assimilated by the consumers of healthcare in the private sector? The objective of the study was to evaluate the perceptions attitudes and knowledge of the consumers of healthcare in the Northern suburbs of Johannesburg towards generic medicines. A survey was conducted on a sample of 402 respondents across 9 randomly selected pharmacies in the Johannesburg north region between November 2012 and February 2013. A researcher administered questionnaire was the sole data collection tool. Questions asked covered the research objectives and also included demographic data and other explanatory variables. Data analysis was carried out in SAS. The 5% significance level was used throughout, unless specified otherwise. The chi-squared (Χ2 ) test was used to assess the relationships between categorical variables. Fisher’s exact test was used for 2 x 2 tables or where the requirements for the Χ2 test could not be met. The strength of the associations was measured by Cramer’s V and the phi coefficient respectively. Key results on respondent demographics included high representation of the higher income earning groups (78% >R10 000); furthermore 44% had completed tertiary education, 60% were comprehensively insured, 61% regularly visited a pharmacy, 38% were on prescription medication and 24% on chronic medicine. On knowledge, 5% of respondents were able to most accurately define generic medicines. On attitudes, 78% had used generics however the level of agreement was lower for the highest education category (p<0.0001; Cramer’s V=0.18). Trends favoured brands over generics with increasing severity of illness as generics were chosen by 10% in major illness and 5% in chronic illness. 80% perceived generics as safe while 95% perceived brands as safe. 75% of respondents felt that generic medicines were as effective as branded medicines. 15% indicated that branded medicines have fewer side effects. 64% showed positive perceptions of quality of generics compared to 93% for brands. Bowker’s test of symmetry was significant (p<0.0001) showing a shift towards slightly more negative perceptions towards generic medicines amongst those who thought highly of brand quality. Knowledge of generics was overall low. Perceptions regarding safety, quality, efficacy, and side effects of generic medicines were generally positive but responses proved more positive for brands. Attitudes towards generic medicines were mostly positive however willingness to use generics lessened with increasing severity of illness. Household income, health insurance (medical aid) status, level of education, experience with medicines and racial demographics played a key role in explaining consumer beliefs and behaviours. Pharmacists and Doctors had a positive influence on generic use patterns amongst other factors.

A thesis submitted in fulfilment of the requirements for the degree of Master of Public Health in the department of school of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg, 2003 / Smoking is a preventable cause of death. Young people start smoking at an early age due to certain external influences such as peer pressure, advertising etc. Once they start smoking, they often remain smokers forever because of the addictive effects of nicotine. The international studies show that the high morbidity and mortality rates caused by cigarette smoking can be reduced if health promotion strategies target school going children. The aim of the study was to investigate knowledge, attitudes and practices of students in matric as regards smoking in the Greater Tshwane Metropolitan area (Pretoria). This will inform the health promotion programmes, in particular health education, dealing with tobacco smoking prevention and control in schools / IT2018

Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (leaves 165-178).

This thesis explores teachers' current knowledge and practice about classroom assessment processes in the Mauritian primary schools and reports the results of a case study, the data of which were collected during the three terms of the school year in 1998 from four primary schools that included thirty-five teachers. The interest of the case study is not to appraise the teachers' work or the school in any way; rather it is to accurately describe classroom assessment practices within the context of Mauritian primary schools. The research addresses three main questions: why teachers conduct classroom assessment, how it is conducted and what is assessed. The findings of the study indicate that teachers assess their pupils for three main reasons: providing feedback to the pupils and to themselves, reviewing the teaching methods and for diagnostic purposes. Another minor purpose noted is for communicating information to Parents. Questioning and observation are the two methods most common in the conduct of classroom assessment. Questioning techniques are mostly closed ones, with a view to seeking a specific answer from the pupils. Teachers interpret the information collected with reference to three general standards: criterion -referenced, norm-referenced and self-referenced. In general, the findings indicate that teachers' practices are oriented more towards the traditional pedagogy in terms of emphasis on the lower level objectives, whole class teaching and focusing on the product. No provision is made for the able or the less able. All the pupils are treated the same and are given the same tasks. Almost a decade after the introduction and implementation of the Learning Competencies and the scheme for Continuous Comprehensive Evaluation, it is found that Mauritian primary teachers do not have the relevant training in assessment to fully apply the progressive reforms. Despite the education system being very centralised, it seems that teachers assess their pupils independently and without any support from the government. There is no monitoring, moderating or policing of policies. Assessment practices are derived from their habit and ideology rather than from the official directives.

Thesis (M.P.H.M.)--Mahidol University, 1999.

Thesis (Ph. D.)--University of Missouri-Columbia, 2006. / "December 2006" The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Vita. Includes bibliographical references.

A Research report submitted to the Faculty of Health Sciences at the University of the Witwatersrand in partial fulfillment of Master of Medicine in Emergency Medicine Johannesburg, 2016 / Objective Intimate partner violence (IPV) is a significant social and health concern in South Africa, with far reaching consequences. One in three South African women will experience IPV, and many of the survivors of IPV will have contact with Emergency Care Practitioners (ECPs), either for treatment related to the direct sequelae of the abuse or for other health issues. ECPs already play a role in identifying and managing IPV but current knowledge, attitudes and practices were not known. The aim of the study therefore was to describe current levels of knowledge, attitudes and practices regarding IPV amongst ECPs, including doctors, nurses and paramedics in South Africa and to describe differences according to the respondent's reported prior training and profession. Methods A prospective, cross sectional study was performed using an online survey administered anonymously to ECPs in South Africa. Information regarding demographic data, qualification, prior IPV training, knowledge, attitudes and practices towards IPV were obtained. Results One hundred and fifty three respondents completed the survey. Of those 56% were doctors, 33% paramedics and 9.8% nurses. In total 65% reporting having received no training on IPV. There was a significant association between respondents reporting having received any IPV training and improved self-reported knowledge (p=0.0001), and actual knowledge (p=0.011). Of the respondents in clinical practice 75% had diagnosed IPV in the last six months, although the frequency of diagnoses being made is lower than would be suggested by the South African prevalence rates. Those respondents who reported any prior training on IPV were more likely to have diagnosed IPV in the last 6 months (p= 0.0076) Most of the ECPs who diagnosed IPV counselled the patients on options and/or referred to police and/or social workers. Conclusion Although ECPs are diagnosing and managing IPV, training in this important health concern is inadequate. Any reported training on IPV for ECPs improves self-reported knowledge, actual knowledge and practices regarding IPV. / MT2017

FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / Objetivou-se avaliar o conhecimento, a atitude e a prÃtica dos enfermeiros atuantes na EstratÃgia SaÃde da FamÃlia (ESF) acerca do controle da sÃfilis na gestaÃÃo; associar as variÃveis explanatÃrias com o conhecimento, a atitude e a prÃtica dos enfermeiros acerca do controle da sÃfilis na gestaÃÃo e comparar o conhecimento e a atitude com a prÃtica em relaÃÃo à sÃfilis na gestaÃÃo. Trata-se de um estudo avaliativo do tipo Conhecimento, Atitude e PrÃtica (CAP) e abordagem quantitativa, realizado no perÃodo de junho a agosto de 2012, com 171 enfermeiros da ESF, utilizando-se como instrumento um questionÃrio inquÃrito CAP em relaÃÃo à sÃfilis na gestaÃÃo. Os dados foram organizados em tabelas e grÃficos, segundo a estatÃstica descritiva e inferencial utilizando-se os testes Mann-Whitney, Kruskal-Wallis, Qui-quadrado e Fisher. O estudo foi aprovado pelo COMEPE/UFC com o protocolo de n 81/12. Quanto ao perfil dos enfermeiros, verificou-se uma idade mÃdia de 37,5 anos, com 90,1% do sexo feminino, 64,3% com ensino superior em instituiÃÃes pÃblicas e 77,8% sÃo especialistas, formados hà cerca de 12 anos, atuando na ESF hà uma mÃdia de 9 anos e 53,8% tinha alguma capacitaÃÃo sobre a temÃtica. Em relaÃÃo ao conhecimento dos enfermeiros, a maioria (67,3%) foi classificada como adequado, mas ainda 32,7% de enfermeiros teve conhecimento inadequado e regular. Quanto à atitude e prÃtica, observou-se 97,1% dos participantes tinham crenÃas e opiniÃes adequadas e 94,2% as colocavam em prÃtica adequadamente. Houve uma associaÃÃo estatisticamente significativa entre a instituiÃÃo de graduaÃÃo e a atitude dos enfermeiros; a autoclassificaÃÃo positiva em relaÃÃo ao conhecimento acerca da sÃfilis na gestaÃÃo com a prÃtica adequada; o conhecimento e a prÃtica, bem como entre a atitude e a prÃtica. As principais dificuldades percebidas pelos enfermeiros no controle da sÃfilis congÃnita foram: a demora dos resultados dos exames de VDRL (45,6%); a dificuldade de convocar o(s) parceiro(s) e a sua adesÃo ao tratamento (28,1%), assim como o inÃcio tardio do prÃ-natal (19,9%). Frente ao exposto, destaca-se a importÃncia do reconhecimento da sÃfilis congÃnita como um importante problema de saÃde pÃblica pelo enfermeiro, visto que a partir de suas aÃÃes adequadas e baseadas no conhecimento tÃcnico-cientÃfico podem interferir diretamente no controle da sÃfilis congÃnita, ofertando-se uma assistÃncia prÃ-natal de qualidade, integral e humanizada.

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 144-158).

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 6 uppsatser.