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The prevalence of Autism Spectrum Disorder (ASD) and its defining features has been increasingly investigated in genetic syndromes associated with intellectual disability, with syndrome specific profiles reported. The experience of catatonia and other movement disorders in people with ASD has been increasing highlighted within both research and diagnostic guidelines. However, these issues have not typically been investigated alongside other features of ASD within research into genetic syndromes. The first paper in this thesis provides a review of the literature on movement disorders in genetic syndromes associated with ASD, which focuses on the prevalence of reported movement disorders, the methods of assessment used, and the quality of research to date. An empirical study is reported in Paper 2. Within a cohort of individuals with Cornelia de Lange and Fragile X syndromes the prevalence of attenuated behaviour [autistic catatonia] is examined, based on parent/carer report, and the extent to which features of ASD predict later attenuated behaviour is investigated. Paper 3 provides a critical reflection on the first two papers as well as some wider considerations on undertaking research in this area. The results of both the literature review and the empirical study indicated that across a number of genetic syndromes (Angelman syndrome, Cornelia de Lange syndrome, Fragile X syndrome and Rett syndrome) attenuated behaviour [autistic catatonia] and/or movement disorders affect a substantial proportion of individuals. Furthermore, repetitive behaviours, one of the characteristic features of ASD, appear to predict later attenuated behaviour in Cornelia de Lange and Fragile X syndromesThe results presented in this thesis have important implications for the way services support individuals with specific genetic syndromes. Paper 1 confirms the high prevalence of movement problems in Angelman and Rett syndromes, and Paper 2 provides a new insight into movement problems in Cornelia de Lange and Fragile X syndromes. Movement disorders are reported to impact negatively on wellbeing and quality of life in people with ASD, and are likely to have a similar impact on the lives of people with genetic syndromes. Greater awareness and recognition of movement problems in CdLS and FXS is required, and although specialist services may already be aware of some of the above issues, there should be an increased emphasis on ensuring that community services are aware of the needs of individuals with genetic syndromes, including the implications of movement problems for support needs and quality of life.

Thesis M. Med.(Family Medicine))--University of Limpopo (Medunsa Campus), 2010. / Background The use of HAART in HIV/AIDS patients has been recognised worldwide to improve the quality of life and survival prospects. Neverthess, factors such as WHO clinical stage III-IV, CD4< 200, VL> 100,000, anaemia, blood transfusion, malnutrition, male gender, intravenous drug use, drug toxicity, HAART experienced by patients, hospitalization, older age and depression have been reported to be associated with negative outcomes whereas, in contrast, white ethnicity, adherence > 90%, antiretroviral naïve subjects, longer period of viral suppression, younger age, and female gender have been reported to be associated with positive clinical outcomes. Methods The researcher conducted a descriptive retrospective study of 78 systematically selected patients who initiated HAART during the period of 5 June 2007 to 5 December 2008. Data regarding demographics, nutritional status, patients’ opportunistic infections, patients’ use of ARV drugs and HAART regimens, side effects and adverse events, baseline and follow up measurements of CD4 cell count, VL, ALT and Hb were collected at initiation, 6 and 12 months of HAART and analysed, utilizing descriptive statistics. Results Of the 78 patients recruited for the study, 60 (77%) were females and 18 (23%) males, 77 (98.8%) black and 1 (1.2%) coloured. The majority of patients belonged to the two age-groups 26-35 years (35.9%), and 36-45 (37.2%). The majority of patients [73/78 (93.4%)] were unemployed and residents of Vryburg town. Nutritionally, 17/78 (21.8%) patients were underweight. Clinically, 79.4% were classified as WHO clinical stage III - IV. The mean weight improved in both sex at 6 and 12 months of HAART respectively, from 57.5kg (SD 8.0) to 63.0kg (SD 13.0) and 65.2kg (SD 4.5) for males. 12 Conclusion The administration of HAART to patients attending ARV clinic at Vryburg District Hospital was followed by better clinical outcomes in terms of weight gain, correction of anaemia, increase in CD4 and achievement of virological suppression. Female gender, VL > 100,000 copies/ml, Younger age (< 46 years) and good adherence were found to have positive influence on clinical outcomes.

Thesis (M. Med.(Family Medicine))--University of Limpopo (Medunsa Campus), 2010. / A study on Factors associated with non-disclosure of HIV positive status to sexual partners by adult patients attending the VCT clinic at Nhlangano health centre, Swaziland. Aim: To describe the factors associated with non-disclosure of known HIV sero-positive status to sexual partners by adult patients attending the VCT clinic at Nhlangano health center, Swaziland. Design:- Cross-sectional study using questionnaire administered by a trained research assistant. Setting:- Nhlangano health center VCT clinic, Nhlangano town in the Shiselweni region, Southern Swaziland. Study population:- All adult patients above the age of 18 years who had undergone HIV testing, who knew their positive HIV status and had follow up visits at the VCT clinic of Nhlangano health centre, from November 2005 (when the centre started rendering VCT service) till the beginning of the data collection, in September, 2008. Results:-The vast majority (89.1%) disclosed their positive HIV status to their sexual partners and 94.6% believed that letting their sexual partner/s know about their HIV status was very important. In terms of knowing the HIV status of their partners, 55.4% knew the HIV status of all of their sexual partners and 44.6% knew only the status of the regular partner/s. With regard to condom use, 96.7% believed that using condoms helps them to prevent transmission of HIV and 91.3% expected that letting their partners know about their HIV status would help them use condom IV more frequently. Only 53.3% said they would insist on condom use even if their partner is not willing to use. Conclusion:-  The rate of positive HIV status disclosure to sexual partner found in this study compared to many studies done in other settings is considerably high. This is encouraging especially considering the existing very high prevalence of HIV infection in the country. Despite this though, knowing partner's HIV status was relatively lower. Therefore, people are more likely to share their HIV status with a partner than insist that the partner does the same.  Even though the study was done only amongst patients attending VCT, it is important to note that the majority of the patients had positive attitudes about HIV status disclosure to a partner, and believed in the importance of letting their sexual partner/s know about their HIV status. Patients understood the unethical nature of engaging into sexual intercourse without disclosing their positive HIV status to their partner. It is possible to conclude that factors which contributed to these positive results should be implemented at a larger scale, namely creating awareness, health education, good counseling and follow up of treatment.  Awareness of the importance of condom use in preventing HIV transmission (including the fact that disclosure of HIV status to a partner enhances its better use) was impressively high amongst almost all participants. But it is worrisome that only half of the participants said they would insist on condom use irrespective of their partners’ willingness to use it or not. V  The variables that were found to be independently associated with disclosure to a partner comparing those who disclosed with those who did not were gender, age, marital status, education, number of sexual partners, and stage of the HIV condition.

Thesis (MPH) -- University of Limpopo, 2011. / Introduction HIV/AIDS is major cause of child mortality and an increase in the number of sick children presenting to health services worldwide (UNICEF 2008). A significant number of children live with HIV/AIDS in South Africa. Research indicates that in poor resourced countries, there is an increase in the prevalence of hospital admissions and re-admissions among HIV infected children as compared to developed countries. Research data on hospital admissions, treatment and care of HIV positive children South Africa is limited. Objectives This study was therefore initiated to determine the demographic and clinical causes of HIV positive children admitted and readmitted at the paediatric ward of Dr George Mukhari Hospital (DGMH), South Africa in the year 2003. Methods This was mainly a descriptive quantitative study using medical records of HIV infected children admitted and readmitted in the paediatric ward of DGMH from 1st January to 31st December 2003. A full census of all the records of children admitted in the two paediatric wards was carried out. Descriptive and inferential statistics were used to analyze data. Results The study comprised 74 children, 28 (37.8%) female and 48 (62.2%) males. The average mean of initial admission length of hospital stay was 12.3 days and (SD = 12.1) days. The different diagnoses were classified in accordance with World Health Organization (WHO) Clinical Staging of HIV disease for infants and children with established HIV infection. Out of a total of 581 initial admissions, 74 (12.7%) children were readmitted. The mean interval days between the discharge date and readmission date was 9.8 days (SD = 7.0 days) and 94.6% of the readmissions occurred within the first two weeks of discharge date. Second readmission decreased by 75.3% as only 18 patients were readmitted. A further 95.9% decrease in the third readmission was noted with only 3 patients getting readmitted. iv The commonest causes of admission with HIV were broncho-pneumonia, gastro-enteritis, vomitting, oral thrush, immunosuppression with symptoms like fever,cough, respiratory distress. Causes of readmissions were broncho-pneumonia, oral thrush, diarrhoea, vomitting, immunosuppression, pulmonary tuberculosis, wasting and failure to thrive, dehydration associated with symptoms like fever, cough, respiratory distress and upper respiratory distress. Conclusion The rate of readmission was (12.7%) and majority of the readmitted children were in the 0- 2-year age group. The study results show a high prevalence of diseases of the respiratory system with a high frequency of broncho-pneumonia and a high prevalence of diseases of the digestive system with a high frequency of gastro-enteritis. The average mean of the initial hospital admission stay was 12.3 days, which was significantly higher than other studies previously conducted. The probable reason for a long hospital stay could be the high prevalence of co-infections among the children admitted.

Thesis (MPH) -- University of Limpopo, 2011. / Introduction With the increased availability of the life-saving ARVs in most Sub-Saharan Africa more HIV -infected children are surviving into their adolescent years and beyond hence giving rise to the question of whether the caregiver should disclose or not disclose the child's HIV diagnosis to child. Little is known of the reasons and experiences that motive or hinder caregivers from disclosing the HIV diagnosis to the child. Study Aim and objectives This was aimed at identifying caregivers' reasons for HIV diagnosis disclosure and non-disclosure to HIV-infected children under their care. The study also explores their experience with process of HIV diagnosis disclosure and non-disclosure to the child. Study methodology Using qualitative descriptive research approach, twenty (20) caregivers of HIV¬infected children aged between 6 - 16 years receiving ART at Thamaga Primary Hospital IDee with unknown HIV diagnosis disclo~ure status were ~.ubjected to audio-taped in-depth interviews for data capturing. Thematic content analysis was used for data analysis using, Nvivo8 software and 16 themes with their sub categories were identified. Findings Both caregivers of disclosed and non-disclosed HIV-infected children perceived disclosure as a good thing to do with majority of the caregivers (60%) having disclosed. Reasons for telling the children their HIV diagnosis were that the child had the right to know his/her status; caregiver tired of keeping child HIV diagnosis a secret; the caregiver's believe that disclosure will improve the child's ART adherence and finally some caregivers felt the child had reached the right age or maturity for disclosure. Non-disclosing caregivers felt that health care workers should assist them in doing disclosure and identified the reasons for non-disclosure as the child being too young and not asking questions about their illness; fear that disclosure might hurt the child psychologically; fear that the child might not keep their HIV diagnosis a secret leading to discrimination in the community while some caregivers lack of knowledge on how to disclose. Non-disclosing caregivers managed disclosure by not telling the child the truth about their diagnosis and using threats to coerce them to take their ARV drugs. Conclusions and recommendations The decision to disclosure or not to disclose the HIV diagnosis to a child by a caregiver is influenced by a number of reasons and their experiences. Caregivers of HIV-infected children need to be assisted by a health care provider when disclosing to the child and further assessment should be made in making disclosure part of the holistic management of an HIV -infected child. v

No description available.

Thesis (M. Phil.)--University of Hong Kong, 2006. / Title proper from title frame. Also available in printed format.

Thesis (M.Sc.)--York University, 2004. Graduate Programme in Kinesiology and Health Science. / Typescript. Includes bibliographical references (leaves 68-74). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL:http://gateway.proquest.com/openurl?url%5Fver=Z39.88-2004&res%5Fdat=xri:pqdiss&rft%5Fval%5Ffmt=info:ofi/fmt:kev:mtx:dissertation&rft%5Fdat=xri:pqdiss:MQ99282

Thesis (Ph. D.)--University of Hawaii at Manoa, 2001. / Includes bibliographical references (leaves 127-162).