There is strong evidence supporting the view that beliefs and attitudes influence health behaviour. Furthermore, cultural and social beliefs also have been shown to influence the way health care facilities are used. Although western medicine plays a dominant role in the mass control of disease, traditional or folk medicine continues to play an important role in the health care of black communities. They therefore, possess unique attitudes, values and beliefs about health and illness which integrally influence their health behaviour. This study aims therefore to: understand phenomenologically the urban African’s perception of illness, disease and health; identify attitudes that directly influence health behaviour: identify “trigger factors” that precipitate health action and isolate factors that contribute to “negative” health behaviour. The sample in this study consisted of 3 groups of urban Africans who were 20 years and older. Group 1 comprised first time attenders to a medical outpatients department Group 2 and Group 3 were sample groups drawn from the Umlazi Township and the Kwa Mashu Township respectively. The Health and Illness Battery in the language of the participants were administered by trained interviewers. This study has demonstrated the following: urban Africans have a personal conception of illness, health and disease that influences their manner of help‐seeking; there are certain attitudes and beliefs that directly influence both positive and negative health behaviour;. there are several health beliefs which interact in a complex way and may lead to medical help‐seeking. Health action was found to be influenced by significant individuals in the subject's environment; demographic variables, such as, age, sex, education and urbanisation strongly influence the health and illness beliefs; these results validated some of the fundamental aspects of the common western health and illness models; the use of services and facilities are determined by the location, accessibility and the quality of services; financial costs, time, transport, lack of community supports, negatively affected helpseeking; symptoms have been identified as a “trigger factor” of help‐seeking. Individuals use other forms of treatments independent of medical treatments. A model of help‐seeking for urban Africans is proposed. / Thesis (Ph.D.)-University of Natal, 1993.

Thesis (Ph. D.)--Dept. of Community Medicine, University of Adelaide, 1992. / Typescript (Photocopy). Includes bibliographical references (leaves 307-320).

Made available in DSpace on 2015-06-17T19:34:10Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-08-28. Added 1 bitstream(s) on 2015-06-18T12:49:22Z : No. of bitstreams: 1 000830266.pdf: 1085091 bytes, checksum: d7b5fa492df895687f6e915bd8e7f045 (MD5) / Objetivos: Estimar a prevalência de transtorno mental comum (TMC) entre os estudantes de medicina da Faculdade de Medicina de Botucatu (FMB) no primeiro (2006) e sexto (2011) anos do curso e analisar a associação com variáveis explanatórias. Método: Estudo longitudinal, realizado a partir de uma amostra de estudantes do curso de medicina da FMB em dois momentos, 2006 (1º. ano) e 2011(6º. ano). Foi utilizado questionário para autopreenchimento, investigando características sociodemográficas, apoio social e sofrimento psíquico. Foi estabelecido como desfecho o aumento do escore obtido no SRQ, quando comparado o ano de ingresso e o sexto ano, estudando-se sua associação com as variáveis de exposição. Para a análise multivariada, foi construído um modelo de Regressão Logística Stepwise tipo retrógrado e adotou-se o nível de significância estatística de 5% para rejeição da hipótese de nulidade. Resultados: Dos 90 estudantes que compõem a turma de alunos, 67,8% participou nos dois momentos (n=61). Dentre estes, 31,2% (IC 95%: 19,2-43,1) pontuou para TMC no início do curso e 37,7% (IC 95%: 25,2- 50,2) ao final do curso, não havendo diferença significativa entre os dois períodos. Na análise multivariada ajustada para idade, sexo e pensar em abandonar o curso; ter maiores pontuações na escala de apoio interação em 2006 se manteve associado à redução da chance de aumento nos escores no SRQ ao longo do curso (OR= 0,84, IC 95%: 0,72-0,99). Conclusões: Apoio interação em 2006 constitui-se um fator de proteção contra o aumento dos escores no SRQ ao longo do curso médico. Tendo em vista a alta prevalência de TMC entre os estudantes de medicina, faz-se necessário mais estudos longitudinais e qualitativos a fim de ampliar a compreensão dos fatores de risco e proteção associados ao adoecimento psíquico desta população. A Escola Médica deve estar atenta à saúde mental dos alunos por promover estratégias de ... / Aim: Estimate the prevalence of common mental disorders among Botucatu Medical School's students on the first (2006) and last year (2011) of the medical course, and analyze its association with the explanatory variables. Methods: Longitudinal study based on a sample of Botucatu Medical School's students using a self-administered questionnaire answered in two moments of the medical course (2006 and 2011). Social-demographic characteristics, social support and common mental disorder were investigated. The dependent variable was the increasing score on the Self- Reporting Questionnaire (SRQ) when compared 2006 and 2011 data, analyzing its association with the exposure variables. On the multivariate analyses, it was built a Stepwise Logistic Regression model and p<0,05 was adopted to reject the nullity hypothesis. Results: In a class of 90 students, about 67.8% of the medical students have participated in the two moments. Among these, 31,2% (CI 95%: 19,2-43,1) achieved score level to common mental disorders on the beginning of the course and 37,7% (IC 95%: 25,2- 50,2) on the last year; nevertheless there was no significant difference between the two moments. On the multivariate analyses, adjusted for age, sex and 'considering giving up the medical course', those having a higher score on interaction-support scale in 2006 remain linked to a lower chance of rising on the SRQ score along the course (OR=0,84; CI 95% 0,72-0,99). Conclusion: Interactionsupport in 2006 demonstrated to be a protection factor related to the increasing SRQ score along the medical course. Considering the high prevalence of common mental disorder among the medical students, it is necessary more longitudinal and qualitative studies to increase the comprehension of the risk and protection factors associated with the mental illness of this population. The Medical School must pay attention to the undergraduate's mental health and promote changes through psychological ...

For women with anorexia nervosa, control and routine are important in managing distress and maintaining a sense of self in challenging situations. The transition to motherhood is characterised by change and uncertainty. Women may struggle to integrate the demands of anorexia alongside the challenges of motherhood. The aim of this thesis was to review the literature regarding the experiences of pregnancy and motherhood for women with eating disorders and develop a grounded theory of the transition to motherhood for women with anorexia nervosa. The literature regarding experiences of pregnancy and motherhood with an eating disorder was reviewed. The findings suggested a trend for remission of eating disorder symptoms in pregnancy followed by relapse during the postpartum period. Women with eating disorders were most likely to experience depression and anxiety during the later stages of pregnancy and postpartum. The review highlighted how eating disorders impacted on women's ability to embrace motherhood and bond with their children. There was a paucity of research exploring the lived experience of motherhood for women with specific eating difficulties, most notably anorexia. A grounded theory was informed by the experiences of eight mothers with anorexia. A core process of breaking the cycle highlighted how women were attempting to make lasting positive changes. They achieved this by protecting their children from anorexia, exploring new perspectives, setting a good example to their children and battling temptation to succumb to anorexia. This study provides a unique insight into the experiences of mothers with anorexia. In the final chapter the research process is reflected upon. It is hoped that these findings will influence clinical practice and help professionals to better understand women's experiences.

There is extensive evidence that the rehabilitation of individuals with coronary heart disease needs to include psychological components to complement the exercise and dietary recommendations that are normally provided. However, psychological aspects have not been integrated into medical care in South Africa to any significant degree. Psychological interventions overseas have included the modification of the Type A behaviour pattern, stress management, cognitive restructuring, relaxation techniques, improved communication skills, the identification and expression of emotions, and emotional support. The aim of the present study was to design a short-term group intervention which incorporated these aspects and which included an exploration of the mind-body experience post infarct. In addition, the intervention aimed to increase participants' awareness of the compensatory dynamics of the Type A behaviour pattern. The intervention was tailored to South African conditions and was evaluated by means of a multiple case study design. The intervention was delivered to a group of nine coronary heart disease patients which included six survivors of myocardial infarction, the remaining participants having undergone a by-pass operation. Data included weekly feedback sheets evaluating each session, repeated measures on the Profile of Mood States, the Jenkins Activity Survey, a Spouse Rating Scale and extensive qualitative data on each participant including tape recordings of each session and data collected from a series of interviews before, during and after the programme. The feedback sheets and recordings of the sessions were used as a basis for recommendations for revising the content and structure of the programme for future use. Case narratives were written for three of the participants and provided an in-depth look at how and why individual changes did or did not occur in response to the intervention. In addition, the case narratives revealed the role played by the compensatory dynamics of the Type A behaviour pattern in complicating rehabilitation for survivors of myocardial infarction. Two participants were offered a series of individual sessions at 18-month follow-up and the material from these sessions was also used to aid in the interpretation of the data. The content of the 18-month follow-up sessions provided evidence for the importance of conducting a developmental analysis of the origins of low self-esteem and insecurity that maintain and drive the Type A behaviour pattern. In these sessions, this analysis provided the basis for a brief focused psychodynamic psychotherapy that facilitated marked changes that had not been achieved in the 12-week structured group intervention. It is recommended that future research investigate the use of brief psychodynamic psychotherapy on an individual basis as a complement to a group intervention focusing on psycho-education, building social support and management of problematic emotions in everyday situations.

Orientador: Maria Cristina Pereira Lima / Banca: Ana Tereza de Abreu Ramos Cerqueira / Banca: Luiz Fernando Tofoli / Resumo: Objetivos: Estimar a prevalência de transtorno mental comum (TMC) entre os estudantes de medicina da Faculdade de Medicina de Botucatu (FMB) no primeiro (2006) e sexto (2011) anos do curso e analisar a associação com variáveis explanatórias. Método: Estudo longitudinal, realizado a partir de uma amostra de estudantes do curso de medicina da FMB em dois momentos, 2006 (1º. ano) e 2011(6º. ano). Foi utilizado questionário para autopreenchimento, investigando características sociodemográficas, apoio social e sofrimento psíquico. Foi estabelecido como desfecho o aumento do escore obtido no SRQ, quando comparado o ano de ingresso e o sexto ano, estudando-se sua associação com as variáveis de exposição. Para a análise multivariada, foi construído um modelo de Regressão Logística Stepwise tipo retrógrado e adotou-se o nível de significância estatística de 5% para rejeição da hipótese de nulidade. Resultados: Dos 90 estudantes que compõem a turma de alunos, 67,8% participou nos dois momentos (n=61). Dentre estes, 31,2% (IC 95%: 19,2-43,1) pontuou para TMC no início do curso e 37,7% (IC 95%: 25,2- 50,2) ao final do curso, não havendo diferença significativa entre os dois períodos. Na análise multivariada ajustada para idade, sexo e pensar em abandonar o curso; ter maiores pontuações na escala de apoio interação em 2006 se manteve associado à redução da chance de aumento nos escores no SRQ ao longo do curso (OR= 0,84, IC 95%: 0,72-0,99). Conclusões: Apoio interação em 2006 constitui-se um fator de proteção contra o aumento dos escores no SRQ ao longo do curso médico. Tendo em vista a alta prevalência de TMC entre os estudantes de medicina, faz-se necessário mais estudos longitudinais e qualitativos a fim de ampliar a compreensão dos fatores de risco e proteção associados ao adoecimento psíquico desta população. A Escola Médica deve estar atenta à saúde mental dos alunos por promover estratégias de ... / Abstract: Aim: Estimate the prevalence of common mental disorders among Botucatu Medical School's students on the first (2006) and last year (2011) of the medical course, and analyze its association with the explanatory variables. Methods: Longitudinal study based on a sample of Botucatu Medical School's students using a self-administered questionnaire answered in two moments of the medical course (2006 and 2011). Social-demographic characteristics, social support and common mental disorder were investigated. The dependent variable was the increasing score on the Self- Reporting Questionnaire (SRQ) when compared 2006 and 2011 data, analyzing its association with the exposure variables. On the multivariate analyses, it was built a Stepwise Logistic Regression model and p<0,05 was adopted to reject the nullity hypothesis. Results: In a class of 90 students, about 67.8% of the medical students have participated in the two moments. Among these, 31,2% (CI 95%: 19,2-43,1) achieved score level to common mental disorders on the beginning of the course and 37,7% (IC 95%: 25,2- 50,2) on the last year; nevertheless there was no significant difference between the two moments. On the multivariate analyses, adjusted for age, sex and 'considering giving up the medical course', those having a higher score on interaction-support scale in 2006 remain linked to a lower chance of rising on the SRQ score along the course (OR=0,84; CI 95% 0,72-0,99). Conclusion: Interactionsupport in 2006 demonstrated to be a protection factor related to the increasing SRQ score along the medical course. Considering the high prevalence of common mental disorder among the medical students, it is necessary more longitudinal and qualitative studies to increase the comprehension of the risk and protection factors associated with the mental illness of this population. The Medical School must pay attention to the undergraduate's mental health and promote changes through psychological ... / Mestre

The aims of the current investigation are to (1) examine the directive mechanism of selective attention on energy as measured by body temperature and to (2) assess the clinical impact of a meditation practice that uses this directive mechanism of selective attention. Despite the recent surge of interest in Eastern contemplative and medicinal practices, there exists a large gap between teachings of such Eastern traditions and empirical research findings of psychology in the West. Specifically, Eastern thought has for millennia emphasized the role of attention or intent in directing energy within the body, and importantly, the role that this phenomenon has on mental and physical health. Conversely, Western psychology has largely conceptualized attention as an unidirectional information-processing mechanism, not as an agent through which energy is directed. The present study contains two experiments that respectively incorporate a basic science approach to identify an alternative function of selective attention and an applied science approach to explore the clinical efficacy of a focused attention dantian (area in the lower abdomen) meditation practice compared to that of a standard Mindfulness-based Stress Reduction (MBSR) practice. Experiment 1 (N = 12) tested through an experimental design whether selective attention can function as a directive mechanism for energy by measuring bilateral hand temperatures. Experiment 2 (N = 16) measured various health and psychological indices before and after a six-week meditation practice in either a dantian-focused method or an MBSR practice. Findings suggest that selective attention does in fact function as a directive mechanism for energy within the body and that the use of this method within the context of a dantian meditation practice improves aspects of mental health more efficaciously than an MBSR practice. This study ultimately seeks to interpret a traditional Eastern understanding of attention and its implications for health through the lens of empirical Western psychology.

The toxic combination of social, psychological, environmental, cultural, and physiological trauma Mayas living in Southeast Florida face daily places them at higher risk for mental and physical disorders (Marmot & Wilkinson, 2006; WHO, 2010, September). The burden of disease is not limited to mental disorder comorbidities; psychological stress can also induce or exacerbate chronic medical diseases such as obesity, diabetes, and hypertension (Brunner & Marmot, 2006; Sridhar, 2007). ... The continuation of this disregard will add to the health disparity of this nation by delaying assessment, treatment, and development of interventions. The purpose of this study was to explore cumulative trauma as it related to social determinants of health and pathophysiological, psychological, and health behaviors of 102 adult Mayas living in Southeast Florida. The trauma profile for the Mayan population sample obtained through this study reflected high exposure to different types of trauma; collective identity trauma was most frequently reported, followed by survival trauma, achievement trauma, secondary trauma, and personal identity trauma, with high rates of repetition of the same traumas ... Key words: Maya; alcohol; ASSIST; cumulative trauma; Beck Depression Inventory-II; genocide; Guatemala; Hispanic; social determinants of health. / by Eugenia I. Millender. / Thesis (Ph.D.)--Florida Atlantic University, 2013. / Includes bibliography. / Mode of access: World Wide Web. / System requirements: Adobe Reader.

Whilst there has been a recent increase in interest in using positive reinforcement training for laboratory-housed primates, there remains a reluctance to put into practice training programmes. Much of this reticence seems to stem from lack of expertise in the running of training programmes, and a perception that training requires a large time investment, with concurrent staff costs. The aim of this thesis was to provide practical recommendations for the use of training programmes in laboratories, providing primate users and carestaff with background information needed to successfully implement training programmes whilst improving the welfare of the animals in their care. Training was carried out with two species, cynomolgus macaques (Macaca fascicularis) and common marmosets (Callithrix jacchus) in three different research laboratories to ensure practicability was as wide ranging as possible. Training success and the time investment required were closely related to the primate's temperament, most notably an individual's willingness to interact with humans, in both common marmosets and cynomolgus macaques. Age and sex however had no effect on an individual's trainability. The training of common marmosets was more successful than that with cynomolgus macaques, possibly due to differences in early experience and socialisation. Positive reinforcement training helped both species to cope with the stress of cage change or cleaning, with the monkeys showing less anxiety-related behaviour following the training programme than before. Involving two trainers in the training process did not affect the speed at which common marmosets learned to cooperate with transport box training, but behavioural observations showed that initial training sessions with a new trainer led to animals experiencing some anxiety. This however was relatively transient. Whilst the training of common marmosets to cooperate with hand capture was possible, there seemed little benefit in doing so as the monkeys did not show a reduced behavioural or physiological stress response to trained capture as compared to hand capture prior to training. However strong evidence was found that following both training and positive human interactions the marmosets coped better with capture and stress was reduced. It is recommended that an increased use of early socialisation would benefit laboratory-housed primates, and would also help improve the success of training. Further, the time investment required shows that training is practicable in the laboratory for both species, and that positive reinforcement training is an important way of improving their welfare likely through reducing boredom and fear.

Thesis abstract This thesis will focus on the ways in which the transformations in nineteenth-century Gothic stories mirror the gradual changes in the Victorian society's notions about perception and about the metaphysical. The nineteenth century marks a time when advances in science made it clear that not seeing something does not mean that it does not exist, and when psychologists made it clear that seeing something does not necessarily mean it does exist. Moreover, the nineteenth century was a time when religious notions that were previously accepted without question started to be doubted. When people lost their faith in the unseen and at the same time became aware that their eyes are not sufficient to see everything and that their mind may play tricks on them, the notion of reality was increasingly problematized, which is made especially clear in the genre of the Gothic. It could be argued that while the basic tropes of the Gothic remain more or less the same; however, the way they are used, the reactions of the protagonists as well as the general outlook of the story are problematized by newly introduced ideas about vision and human mind. It could be said that in many cases there is no longer a clear boundary between the protagonist and the 'other' of the story, which can often be interpreted as an...