L’ocytocine est un petit peptide synthétisé par des neurones de l’hypothalamus. Il est connu pour ses rôles dans la reproduction et les interactions sociales, en particulier dans les interactions mère-enfants, mais possède également un effet analgésique endogène. Au cours de cette thèse, j’ai cherché à comprendre plus en détail les circuits qui sous-tendent son effet analgésique. Dans un second temps j’ai cherché à déterminer si une séparation maternelle précoce, qui affecte les interactions mère-enfants, perturbe les réponses à la douleur et l’analgésie ocytocinergique chez la descendance. Ces travaux ont permis d’identifier un groupe de neurones ocytocinergiques dans l’hypothalamus, capables de diminuer la douleur par une double action. D’une part ils inhibent directement la transmission de l’information nociceptive dans la moelle épinière, et d’autre part contrôlent l’activité de neurones à ocytocine libérant la molécule dans la circulation sanguine. Notre étude sur la séparation maternelle démontre qu’elle induit une hypersensibilité à la douleur à l’âge adulte et un dysfonctionnement de l’analgésie endogène ocytocinergique. / Oxytocin is a small peptide synthesized in hypothalamic neurons. She is well known for its roles in reproduction and social interactions, especially in mother-infant interactions, but also displays analgesic effects. During this thesis, I tried to get a better understanding of the circuits underlying OT analgesia. Then, I tried to determine if neonatal maternal separation, affecting mother-infant interactions, alters adult pain responses and oxytocin analgesia. This work allowed to identify a subgroup of oxytocinergic neurons in the hypothalamus, able to decrease pain through a dual action. They directly inhibit nociceptive transmission in the spinal cord and control the activity of another population of oxytocinergic neurons releasing the peptide in the bloodstream. Our work on maternal separation shows that it induces nociceptive hypersensitivity at adulthood, and a dysfunction in oxytocin analgesia.

Historically there has been many changes to the construction of fatherhood. These changes have not been linear and most significant changes took place during the twentieth century. Four ways of being and acting as a father (i.e., Discourses) have been identified: the father as moral overseer; the father as distant breadwinner; the father as sex-role model, and the new nurturant father. Previous studies have indicated that men’s experiences of fatherhood are very diverse and multifaceted. Fathers may experience intense feelings of elation and happiness, as well as depression and anxiety. Results even indicated that some fathers experienced physical symptoms such as morning sickness or hormonal changes, similar to what the mother could experience. There is also a distinction between three phases: pre-natal, the birth, and post-natal. However, there is a significant gap in the available knowledge related to the subjective experience of fathers, particularly in the South African context. This study is an exploration from within a social constructionist framework, of the experiences of first-time fatherhood. Using a multiple-case study design, the aim was to explore and answer the question: “How do men experience first-time fatherhood?” A qualitative approach to research was applied and three first-time fathers were recruited applying purposive and snowball sampling strategies for interviews that were conducted during May to June 2003. The Zaltman Metaphor Elicitation Technique, which requires the participants to build a collage and participate in a semi-structured interview, was utilized for data collection. Data were analysed by way of thematic analysis, based on transcriptions and translations of the interview material. Three major themes emerged from the data: responsibility, feelings and thoughts and relationships. Collectively, ten sub-themes were extracted from the interviews.. With regard to responsibility, the three first-time fathers indicated that they associated aspects such as financial, emotional and educational provision as primary concerns of first-time fatherhood. Thoughts and feelings ranged from feelings of happiness and elation, stress and anxiety, to confusion and helplessness, as well as a sense of a loss of freedom. In terms of relationships, family, marriage, and the father-child relationship, emerged as significant in their overall experience of first-time fatherhood. These themes and the sub-themes were identified in both the collage and interview material collected for each father. The utilisation of the ZMET and a qualitative approach based in a social constructionist perspective proved useful in eliciting the more intimate experiences of first-time fatherhood. The project was, however, limited because only white male subjects were involved, and themes related to masculine stereotypes in the construction of the father’s reality of first-time fatherhood, and the gender of the baby, could not be explored. Further research on the topic is therefore proposed to explore the richness of the topic and to offer context-specific constructions of the multiple realities of first-time fatherhood. / Dissertation (MA (Research Psychology))--University of Pretoria, 2006. / Psychology / unrestricted

First eleven leaves not numbered / The purpose of this study was to identify, explore and describe the potential contributing factors of the upsurge of HIV among children aged three to eighteen months in the Mangaung Metropolitan area of the Free State Province in South Africa. The study was conducted at five primary healthcare facilities and one hospital in the Mangaung metropolitan municipality of the Free State Province with sixty randomly selected mothers of children testing HIV-positive for the first time between the ages of three and eighteen months. The convergent mixed-methods research design was opted for, according to which both qualitative and quantitative data were collected at the same health facilities selected by means of cluster sampling. The review of medical records, unstructured interviews, and structured questionnaires were used for qualitative and quantitative data collection, while random cluster sampling was used for participant selection. Thematic data analysis was applied for the interpretation of recurrent patterns of qualitative and quantitative data. The study results revealed that mothers were well-informed about the prevention of mother-to-child-transmission. The main factors that contributed to more children testing HIV positive after the routine tests were conducted at ten weeks included non-adherence factors to PMTCT prescripts mainly by mothers, such as: babies were not brought to the clinics for testing and immunisations at ten weeks, and that mothers acquired HIV infection during the breastfeeding period. Some other potential contributing factors were late antenatal booking which lead to the delay in initiation of antiretroviral treatment, nonadherence to antiretroviral therapy during pregnancy, and mixed feeding. The themes that emerged from the qualitative data were psychological factors, emotional factors, socioeconomic factors, missed opportunities, risky behaviour, as well as women disempowerment; while some mothers were left with unanswered questions. The results of the qualitative part complemented the quantitative findings as they uncovered the factors that led to the deviation from the PMTCT prescripts by the mothers. The study’s recommendations include PMTCT psychological assessment and counselling; partner and community involvement; women empowerment; and that couple testing at antenatal and postnatal clinics should be a national policy subjected to protracted monitoring and evaluation processes. / Health Studies / D. Litt. et Phil. (Health Studies)

Post-natal care is a care given to the mother and the newborn during post-natal period. This period is crucial to save the lives of the mother and the newborn. Despite its importance, the utilisation of this service is very low in Ethiopia. This study was conducted to establish the views and experiences of women and health care workers on post-natal care services and determine the factors influencing its utilisation with the ultimate purpose of developing guidelines to improve uptake and quality of the services in South West Shoa Zone of Oromia Region, Ethiopia. The objectives of the study were to explore and describe the women’s views and experiences on utilisation of post-natal care service. Furthermore, the study sought to explore and describe health care workers views and experiences on provision of the services and to assess the factors facilitating or hindering to the utilisation of it. Ultimately, the study had intended to develop guidelines that would contribute towards improving the uptake and quality of the post-natal care services. The study used a qualitative descriptive and explorative research design to address the research questions. Qualitative data were collected from 19 women who gave birth in the past six months and from 24 health care workers providing post-natal care services (health care workers and health extension workers) and coordinating the overall maternal, neonatal and child health services in the study area (Zone and district health officials; primary health care units heads). The study used in-depth interview guides to collect data from the aforementioned study participants. Inductive thematic analysis was performed on the verbatim transcriptions using the Atlas ti version 8 qualitative data analysis software. / Health Studies / D. Litt. et Phil. (Health Studies)

This study, BLACK COMMUNITY ATTITUDES TOWARDS THE DISABLED - EDUCATIONAL IMPLICATIONS, set out to investigate the attitude of the black community towards the disabled. Literature was consulted to provide a backdrop against which the empirical surveys could be measured. The study used systematic observation interviews for data collection. Appointments were made to conduct the interviews. The study obtained responses from 70 interviewees from four African cultures namely the Vend~ Pedi, Tsonga and Ndebele, who were divided into seven groups, ten per group, i.e. parents of the disabled, the disabled themselves, siblings of the disabled, parents of non-disabled, youth, old people and professional workers. Findings indicated that disabilities such as cerebral palsy, orthopaedic disabilities, blindness and deafness are undesirable and constitute problems in the life of a disabled, their families in general perspective and the community at large. Disabilities constituted different attitudes and were identified as varying from total rejection to acceptance which are brought about by the components of the TRIPARTITE MODEL I A B C MODEL being cognitive, affective and behavioural. Education of the whole black community concerning the issue of disabled people seems to be the only answer to bring about a change of attitude towards the disabled. Therefore a number of recommendations were included to serve as guidance and counselling so that myth and witchcraft ideologies and negative attitudes can be uprooted. The researcher hopes that the effort that went into this· study will be beneficial in the process of educating the black community about the disabled with the ultimate goal of changing existing negative attitudes towards the disabled into positive attitudes of acceptance and support. / Psychology of Education / D Ed. (Psychology of Education)

The study was conducted to describe how socio-economic characteristics (SEC) of women affect their utilization of maternal healthcare services in Abuja Municipal Areas Council (AMAC) in Abuja Nigeria. A non-experimental, facility-based cross-sectional survey was done. Data was collected using structured interviewer administered questionnaire in 5 district hospitals in AMAC. Sample size of 384 was calculated a priori based on the assumption that 50% of the target population utilized maternal healthcare services during their last pregnancy. Equal allocation of samples per facility was done. The ANC register was used as the sampling frame and proportionate allocation of samples per clinic days was undertaken in each facility. Data analysis included descriptive statistics, cross tabulations and measures of inequality. Logistic regression analysis was used to test the hypothesized relationship between socioeconomic characteristics (predictors) and maternal healthcare service utilization. Other than birth order that showed consistent effect, the results of this study indicated that the predictive effect (predisposing and enabling factors) of the SEC of women included in this study (age, education, birth order, location of residence, income group and coverage by health insurance) on maternal healthcare service utilization were not consistent when considered independently (bivariate analysis) as opposed to when considered together through logistic regression. In addition, the study revealed that there was inequality in the utilization of maternal healthcare services (ante-natal care - ANC, delivery care and post natal care - PNC, and contraceptive services) among women with different SEC, and the payment system for maternal healthcare services was regressive. Addressing these predictors in the natural co-existing state (as indicated by the logistic regression) is essential for equitable access and utilization of healthcare during pregnancy, delivery and the postnatal period, and for contraceptive services in AMAC, Abuja Nigeria. Targeted policy measures and programme actions guided by these findings are recommended to optimise returns on investment towards achieving national and global goals on maternal health in Nigeria / Health Studies / D. Litt. et Phil. (Health Studies)

The study was conducted to describe how socio-economic characteristics (SEC) of women affect their utilization of maternal healthcare services in Abuja Municipal Areas Council (AMAC) in Abuja Nigeria. A non-experimental, facility-based cross-sectional survey was done. Data was collected using structured interviewer administered questionnaire in 5 district hospitals in AMAC. Sample size of 384 was calculated a priori based on the assumption that 50% of the target population utilized maternal healthcare services during their last pregnancy. Equal allocation of samples per facility was done. The ANC register was used as the sampling frame and proportionate allocation of samples per clinic days was undertaken in each facility. Data analysis included descriptive statistics, cross tabulations and measures of inequality. Logistic regression analysis was used to test the hypothesized relationship between socioeconomic characteristics (predictors) and maternal healthcare service utilization. Other than birth order that showed consistent effect, the results of this study indicated that the predictive effect (predisposing and enabling factors) of the SEC of women included in this study (age, education, birth order, location of residence, income group and coverage by health insurance) on maternal healthcare service utilization were not consistent when considered independently (bivariate analysis) as opposed to when considered together through logistic regression. In addition, the study revealed that there was inequality in the utilization of maternal healthcare services (ante-natal care - ANC, delivery care and post natal care - PNC, and contraceptive services) among women with different SEC, and the payment system for maternal healthcare services was regressive. Addressing these predictors in the natural co-existing state (as indicated by the logistic regression) is essential for equitable access and utilization of healthcare during pregnancy, delivery and the postnatal period, and for contraceptive services in AMAC, Abuja Nigeria. Targeted policy measures and programme actions guided by these findings are recommended to optimise returns on investment towards achieving national and global goals on maternal health in Nigeria / Health Studies / D. Litt. et Phil. (Health Studies)

This study, BLACK COMMUNITY ATTITUDES TOWARDS THE DISABLED - EDUCATIONAL IMPLICATIONS, set out to investigate the attitude of the black community towards the disabled. Literature was consulted to provide a backdrop against which the empirical surveys could be measured. The study used systematic observation interviews for data collection. Appointments were made to conduct the interviews. The study obtained responses from 70 interviewees from four African cultures namely the Vend~ Pedi, Tsonga and Ndebele, who were divided into seven groups, ten per group, i.e. parents of the disabled, the disabled themselves, siblings of the disabled, parents of non-disabled, youth, old people and professional workers. Findings indicated that disabilities such as cerebral palsy, orthopaedic disabilities, blindness and deafness are undesirable and constitute problems in the life of a disabled, their families in general perspective and the community at large. Disabilities constituted different attitudes and were identified as varying from total rejection to acceptance which are brought about by the components of the TRIPARTITE MODEL I A B C MODEL being cognitive, affective and behavioural. Education of the whole black community concerning the issue of disabled people seems to be the only answer to bring about a change of attitude towards the disabled. Therefore a number of recommendations were included to serve as guidance and counselling so that myth and witchcraft ideologies and negative attitudes can be uprooted. The researcher hopes that the effort that went into this· study will be beneficial in the process of educating the black community about the disabled with the ultimate goal of changing existing negative attitudes towards the disabled into positive attitudes of acceptance and support. / Psychology of Education / D Ed. (Psychology of Education)