Thesis (M.A.)--Oregon State University, 2007. / Printout. Includes bibliographical references (p. 83-86). Also available on the World Wide Web.

Theses (Ph. D.)--Marshall University, 2007. / Title from document title page. Includes abstract. Document formatted into pages: contains vi, 108 pages Bibliography: p. 100-108.

Theses (Ed.S.)--Marshall University, 2007. / Title from document title page. Includes abstract. Document formatted into pages: contains iii, 23 pages. Bibliography: p. 22-23.

Mental health has become an increasingly importantly focus in the UK policy landscape because of its social and economic impact. However, most research to date has focused on living with mental health issues, or providing mental health services, in urban settings. There is limited understanding of the experiences of rural dwellers with mental health issues or the role of the voluntary sector in terms of its contribution to mental health service provision in rural areas. Thus, this PhD explores the experiences of rural mental health service users and providers in Scotland and Canada, and also considers the contribution of mental health voluntary organisations in helping to overcome the challenges of social exclusion for service users, as identified in previous research. Two theoretical lenses were used to frame the research questions. First, the concept of social inclusion provided a lens to analyse the processes by which service users achieve, or not, a sense of belonging and connection in society (Philo 2000). Second, Putnam's (2000) theory of social capital provided a further analytical lens by which to explore the contribution of rural voluntary organisations. Social capital focuses on the features of populations such as social networks, trust and norms of reciprocity that shape the quality and quantity of social interactions (McKenzie & Harpham 2006). The aims of the research were to: To explore the impact of rural life for mental health service users' daily life and access of services To understand the contribution of rural mental health services to tackling social exclusion for service users The five research questions used in this thesis were: What does it mean to experience mental health problems in remote and rural areas? What are the challenges that service providers face in remote and rural areas? What benefits are there for service users attending voluntary groups in remote and rural areas?

There has been little discussion in the literature regarding the financial value of the services provided to the participants in health fairs. This article examines the financial value of preventive services provided through a community health fair in an economically depressed area of southwest Virginia. Current Procedural Terminology codes were assigned to the services provided in order to estimate costs participants might incur for such services. An average 50-year-old man would have paid up to $320 to obtain commonly recommended preventive services available free at the fair. An average 50-year-old woman would have paid up to $495. Overall, over $58,000 in services were provided through the health fair. This community health fair provided preventive services that many participants otherwise might have found to be cost-prohibitive.

It has been the purpose of this study to determine the medical care needs among rural Pulaski County folks in relation to tenure, land class, and occupations which are indicative of income, age and sex, schooling of the homemaking, size of family or household, distance from medical personnel and facilities, and loss of income through absenteeism from wrong because of illness. The expenditures for six types of medical care and health insurance were also studied in relation to the factors above. / M.S.

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Discourse for the partial fulfillment of the requirements for the degree of Master of Science (Development Planning) at the University of the Witwatersrand, Johannesburg, / A definition of development includes improving living conditions and the quality of life. There is an interrelationship between health and social and economic development. "Health Leads to and at the same time is dependant on a progressive improvement in conditions and quality of life". (World Health Organisation). Therefore a dIscussion on health has to take into account the socio-economic and political context. In assessing the health profile of the homeland populations one finds them to be the least healthy. The problem is that the level of health of the rural population is low and the health care situation follows that of a developing society, where poverty-related diseases and infant mortality rates are high and life expectancies are unacceptably low. The rationale of this discourse is to express the need of action by governments, and health Bnd development workers, to protect and promote health. The aim is to examine the primary health care approach in Q sample area and see how it can be used to achieve an acceptable level of health. Background on the state of health will be addressed. The health services under apartheid is discussed in the first section, with attention given to statistical information and health indicators. / AC2017

The overall purpose of this dissertation was to examine evidence of spillover effects of HIV care and treatment service scale up in sub-Saharan Africa in the past decade. Particularly the focus was to quantify any effect HIV treatment initiation by a person living with HIV (PLHIV) may confer health benefits to the HIV negative population by increasing utilization of non-HIV services or reduce mortality risk. This dissertation had three primary aims. The first aim was to conduct a systematic review of the effect of increasing ART uptake in high HIV prevalence communities on use of non-HIV health services, including maternal, child, in/out-patient, non-HIV laboratory, and TB diagnosis and treatment services. Overall positive effects were found on the majority of health service indicators examined for non-HIV laboratory service utilization and Tuberculosis diagnosis and treatment services. We found negative associations on the majority of indicators examined for child health services. The existing evidence did not point to clear tendencies for maternal health services and outpatient and inpatient services. Restricting the sample to studies with stronger study designs for causal inference, the positive effect on non-HIV laboratory services and the negative impact on child health services held but evidence was mixed for TB diagnosis and treatment services, maternal health services and outpatient and inpatient services. The second aim of this dissertation was to conduct regression discontinuity quasi-experiments to determine whether exposure to health benefits from ART utilization by a person living with HIV (PLHIV) in a household affects uptake of TB, hypertension (HTN) and diabetes mellitus (DM) treatment by other household members with these conditions. The study was conducted in the comprehensive population cohort followed by the Africa Health Research Institute (AHRI) in Kwazulu-Natal (KZN), South Africa. We linked PLHIV engaged in HIV care to their cohabitating household members aged ≥15 years using a unique identifier for homesteads. Household ART utilization significantly increased treatment for diabetes (RR 1.90: 95% CI 1.07-3.40) but not for TB (RR 1.12: 95% CI 0.71-2.03) or hypertension (RR 1.31: 95% CI 0.97-1.77). The third aim of this dissertation was to use the same regression discontinuity design and KZN cohort data as in aim 2 to determine whether exposure to health benefits from ART utilization by PLHIV in a household reduces all-cause mortality of other household members. Overall, household ART utilization did not decrease all-cause mortality (Hazard Ratio (HR) 0.95: 95% CI 0.65-1.4), however, restricting the analysis to a narrow CD4+ cell count range around the regression discontinuity threshold showed reduced all-cause mortality by 67% (HR 0.43: 95% CI 0.22-0.85) among household members of PLHIV on ART; the reduced risk was driven largely by the significant reduction noted among female household members (HR 0.21: 95% 0.08, 0.56).

A key factor to the Scottish Governments' public policy and public service reconfiguration is collaborative working between service providers and service users in a framework of co-production. A second key factor in this reform is a place-based approach. Despite this rhetoric of co-production of health services having been used for some time in health policy, and considering the numerous interpretations of the meaning of both co–production and 'place' in the academic and professional literature, how rural dwellers experience rurality in terms of places and space, and how this may in turn affect health and interactions with co-production, remains underrepresented in health policy planning. In light of changes in health service provision, rural health care poses itself as a potentially emotive and sometimes volatile topic. A co-productive approach may encourage understanding, acceptance and better usage of health services and neighbourhood resources, by the residents registered as patients with local medical practices. This doctoral research study considered the use of participatory mapping techniques to generate, gather and capture the local voice of residents from two rural Scottish communities, regarding the self-perception of their health in relation to the place they call home. Through a participatory action research approach, using iterative co-design, residents were asked how their environment impacted on their health, and in particular their cardiovascular health. Qualitative data were collected through participatory mapping techniques and co- analysed using a thematic analysis process. The application of the concept of therapeutic landscapes revealed the importance of the 'sense of place' and its impact on health, along with the physical, social and cultural environmental aspects traditionally considered in public health disciplines. Results were digitised using geographic information systems (GIS) to illustrate the interactions between place, people and health, through a relational lens. This research demonstrates a working example of how, drawing from the discipline of health geography, a place based approach can make an important contribution to rural health service co- planning within a co-production framework.