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Thesis (Ph. D.)--University of Hawaii at Manoa, 2004. / Includes bibliographical references (leaves 174-184). / Also available by subscription via World Wide Web / xv,184 leaves, bound ill. 29 cm

<p>The present healthcare system in South Africa suffers from a number of serious deficiencies. Whilst orthodox bio-medicine is well established in most first world countries, its total introduction and implementation into all communities within South Africa faces many obstacles. The cost of diagnostic techniques, investigative procedures and pharmaceutical products, the availability of competent medical staff in the non-urban areas, and the lack of acceptance of the philosophy and practice of orthodox bio-medicine in rural regions are but some of the factors which conspire against the general application of this orthodox medical paradigm.<br /> <br /> Another problem confronting healthcare and medical practice in South Africa, particularly at this stage of our historical development, is the absolute focus on orthodox bio-medicine, often to the detriment of other medical paradigms that also have advantages to offer. Can the integration of another medical paradigm, such as Unani-Tibb, enhance the practice of orthodox bio-medicine in this country?<br /> <br /> The aim of the thesis was to investigate the possibility of integrating Unani-Tibb with orthodox biomedicine (also termed conventional, Western or allopathic medicine) and assess its potential for improving delivery of an effective, affordable and appropriate healthcare system in South Africa.<br /> <br /> The research questions which the thesis seeks to answer is whether this integration is possible and whether the delivery of healthcare to the South African population can be enhanced. Changes in the provision of medical education are necessary, and occupy a pivotal role in allowing for this integration. Unani-Tibb is a traditional medical system practiced extensively on the Indian sub-continent and in other parts of the world. At present, however, it is minimally practiced in South Africa. Its primary principle is the energetic promotion of health maintenance behaviour and the prevention of disease, through effective application of dietotherapy, pharmacotherapy and other interventions, as well as the empowerment of the patient towards adopting behavioural changes and lifestyle adaptations. One positive aspect of Unani-Tibb is that it has many features in common with both orthodox biomedicine and African Traditional medicine. These commonalities should allow for greater acceptance by orthodox healthcare professionals, as well as the general population. The first part of the study involved the research and conceptualisation required for the production of a series of customized training modules which introduced the theory and practice of Unani-Tibb. A twelve month part-time training programme based on these modules was subsequently conducted with a number of healthcare professionals presently in active practice and with a background of orthodox medical or nursing healthcare. This outcomes-based training programme included a number of specifically designed training activities, such as case studies, practical exercises and assignments. Appropriate evaluations and assessments were pursued in order to measure performance outcomes and attitudes. Questionnaires for assessing the motivation and satisfaction of the participants were also completed. The second part of the study was in the form of a pilot participant research project, in which the participants applied the information from the integrative programme to a number of chronically ill patients who had previously been treated with standard orthodox bio-medical procedures. The parameters derived for clinical efficacy, cost-benefit and improvement in Quality of Life from Unani-Tibb treatment were then compared to equivalent results obtained by orthodox bio-medicine. In all parameters inspected, the integrative training programme compared favourably to orthodox bio-medical practice. Not only was there an improved clinical efficacy, but the cost-benefit was shown to be superior in most indices measured. The Quality of Life comparison, which assessed the patient&rsquo / s total health status, subjective behaviour and attitude, generally favoured the integrative training programme. The thesis serves to suggest that the integration of Unani-Tibb into orthodox bio-medical training in South Africa is a distinct possibility, and could ultimately allow for treatment which is clinically acceptable, cost-effective and which provides an improved Quality of Life for the population as a whole. I suggest that this pilot study be repeated more extensively, thereby allowing for a more confident and objective assessment.</p>

El Ni??o-Southern Oscillation (ENSO) is the most important coupled ocean-atmospheric phenomenon to cause global climate variability on interannual time scales. Efforts to understand recent, apparently anomalous ENSO behaviour are hampered by the lack of long, high-quality climate records. While instrumental data generally covers the past 150 years, record length is insufficient for the assessment of past changes in the frequency, magnitude, and duration of ENSO. Here, multiproxy networks of high-resolution tree-ring, coral, ice and documentary records derived from eastern and western Pacific ENSO ???centres of action??? are analysed (A.D. 1525-2002). Considerable improvements in ENSO reconstruction are achieved from expanding the use of records from the western Pacific. In particular, ~500 years of a continuous 3,722 year ENSO sensitive tree-ring record from New Zealand is introduced. Although extreme ENSO events are seen throughout a 478-year discrete event analysis, 43% of extreme, 20% of very strong and 28% of all protracted ENSO events occur within the 20th century. Principal component analysis was used to extend instrumental records of the Southern Oscillation Index (SOI) Ni??o 3.4 Sea Surface Temperature (Ni??o 3.4 SST) and a newly developed coupled ocean-atmospheric ENSO index (CEI) by 347 years. Significantly, of the three indices reconstructed here, CEI reconstructions were largely found to be the best predictors of ENSO. The results suggest that ENSO may be more effectively characterised using a coupled ocean-atmosphere index, particularly for December-May periods. Compared to the pre-instrumental period, the late 19th and early 20th centuries indicate a clear trend toward increased ENSO variability over the past 150 years. Significantly, spectral analysis of reconstructed indices reveals a marked change in the frequency and intensity of ENSO beginning ~A.D. 1850, coinciding with the end of the Little Ice Age and the boom in global industrialisation. This suggests that ENSO may operate differently under natural (pre-industrial) and anthropogenically influenced background states. This study asserts that recent ENSO variability appears anomalous in the context of the past five centuries. Given the considerable socio-economic impacts of ENSO events, future investigation into the implications an increasingly anthropogenically-warmed world may have on ENSO is vital.

Thesis (D. Min.)--Southwestern Baptist Theological Seminary, 1989. / Includes bibliographical references (leaves 138-148).

Thesis (Ed.D.)--Georgia Southern University, 2007. / "A dissertation submitted to the Graduate Faculty of Georgia Southern University in partial fulfillment of the requirements for the degree Doctor of Education." Under the direction of Walter S. Polka. ETD. Electronic version approved: May 2007. Includes bibliographical references (p. 90-97) and appendices.

Thesis (Ed.D.)--Georgia Southern University, 2007. / "A dissertation submitted to the Graduate Faculty of Georgia Southern University in partial fulfillment of the requirements for the degree Doctor of Education." Under the direction of William M. Reynolds. ETD. Electronic version approved: May 2007. Includes bibliographical references (p. 116-127) and appendices.

Thesis (Ed.D.)--Georgia Southern University, 2007. / "A dissertation submitted to the Graduate Faculty of Georgia Southern University in partial fulfillment of the requirements for the degree Doctor of Education." Under the direction of Walter S. Polka. ETD. Electronic version approved: May 2007. Includes bibliographical references (p. 107-116) and appendices.