Includes bibliographical references (p. 196-245). / A multicenter hospital-based case-control study with incidence density sampling was conducted between November 2001 and February 2003 to assess the impact of social and dietary habits, and the consumption of dietary and medicinal wild plants on the risk of developing oesophageal cancer (OC) among residents of the Eastern Cape Province of South Africa. The study was conducted on 670 incident cases (98/% response rate) and 1188 controls (96/% response rate) attending either of the three major referral hospitals in the Province, i.e Umtata General, Frere and Cecilia Makiwane Hospitals.

Bibliography : leaves 69-73. / This study analyses the user fee policy for health care in Kenya that was introduced to try and recoup some of the costs incurred in providing care as well as rationalise the use of resources. The study aims to generate policy-related findings that are crucial to MOH policy makers in their attempt to provide quality and affordable care. In particular, factors associated with proper function or malfunction of the user fee policy are discussed. The study focussed on four hospitals located in Central province of Kenya. This province was purposefully chosen for its convenience and its high potential for cost recovery. Equity in health care consumption, efficiency, sustainability and perceived quality of care are reviewed. Both primary and secondary data were used. Quantitative and qualitative data were solicited by way of administering questionnaires. Respondents were divided into two categories: providers (staff) and consumers (patients) of health care. The latter were subdivided into inpatients and outpatients. Each of these categories had a specific questionnaire. Further, an attempt is made to estimate net revenue generated in the year 1997/98 by the facilities under study. Costs associated with fee collection were estimated on monthly basis and then projected for the whole year. There are important findings from the study; though patients are charged higher fees at hospitals than at primary levels in order to bolster the referral system, many patients are bypassing the nearby primary care facilities. This study recommends that bypassing patients should be charged higher fees than referred ones.

Bibliography: leaves 51-59. / The objective of this study was to evaluate maté consumption as a risk factor for oesophageal cancer and to further evaluate the role of quantity and temperature in order to assess whether the effect is related to the carcinogenicity of the plant or the high temperature at which maté is consumed. In addition the effect of diet, alcohol drinking and tobacco smoking on oesophageal cancer risk was assessed.

Bibliography: p. 113-118. / The private sector in South Africa has a keen interest in ensuring that all employees are fully educated on issues related to HIV/AIDS (especially transmission mechanisms) to avoid losing a large proportion of the workforce and incurring a subsequent drop in productivity. In 1977, Woolworths, a South African retail company, implemented an HIV peer education programme for its employees. The broad aim of the programme is to reduce the HIV infection rate among staff by providing educational material on safe sexual practices, discussing various issues connected to HIV such as sexuality and modes of transmission and by providing free condoms to staff. The objective of this study is to provide a thorough and realistic evaluation of the Woolworths HIV/AIDS peer education programme. A formal evaluation is required to understand the current position of the programme and to determine its future direction.

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Scholars have called for contextual based explorations of factors impacting implementation of integrated health care (IHC), yet IHC researchers agree that a paucity of research remains. (Kirschbaum, Rask, Brennan, Phelan, & Fortner, 2012; Miller, Kessler, Peek, & Kallenberg, 2011). Even less is known about the process of behavioral and physical health care integration in student health centers on university campuses (Alschuler et al., 2008). The purpose of this study was to address specific gaps in the literature of contextualized processes of integration (Kwan & Nease, 2013; Xyrichis & Lowton, 2008) by examining clinician, support staff, and administrator experiences with the process of integration at a student health center and to identify how values, principles, and attitudes impact this process. The results of a qualitative analysis of nine focus groups show the complexity associated with the process of integration as well as the factors impacting implementation at a university health center. Grounded theory methodology was used to analyze the data in three steps: (a) open-coding, (b) axial coding, and (c) selective coding (Corbin & Strauss, 2015). The analysis revealed three axial level categories comprised of 16 open-coding level categories and subcategories. A grounded theory model was developed and depicts how the various phenomena revealed at the axial level were interrelated in the early stages of the Student Health Center’s integration efforts.The conclusions of this study revealed that this organization’s integration was characterized by a collection of interacting Individual-Level, Organization-Level, and Communication variables, including barriers and facilitators of integration, which impact the process of integration. At the center of the theoretical structure was a co-constructed base of knowledge and attitudes from which staff approached and understood integrationa Shared Construct Representing Integration. However, since staff were at the beginning of the process of integration, the form of this construct had not yet come into focus. Therefore, the model is depicted as a “snapshot” in time. These conclusions have many implications for Administrators of student health centers who are considering integration. Prior to embarking on the integration process, interested parties are encouraged to seriously consider the many variables, processes, and strategies identified in this study.

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This study uses a descriptive survey design to describe and examine the relationship among school nurses' level of education, years of experience, knowledge of asthma and identification of the school nurse's level of proficiency based on Benner's (1984) model of Novice to Expert. A convenience sample of school nurses employed in public schools within the state of Massachusetts with an RN degree (registered nurse) were sampled. The demographic data revealed that of the 325 participants who participated in the study, the majority of school nurses were female ranging in age from 40 to 50 (M = 47.0). The majority of nurses had a bachelor's degree in nursing and were employed in the nursing profession on an average of twenty-two years and in school nursing for ten years. Since the majority of the school nurses did not have a master's degree, they were not certified by a national certifying body. The majority of participants indicated that they had received certification through the Board of Education in Massachusetts. Most school nurses worked full time in a public school and were responsible for between six hundred and a thousand students. The majority of nurses indicated that they did not have a school-based clinic on site, nor did they have a school-based health center or clinic to refer students. There was little variability among sample characteristics with school nurses employed in Massachusetts being a fairly homogenous group. Those surveyed were sent a packet containing four questionnaires including one on demographics, as well as an asthma questionnaire, a questionnaire assessing chronic health problems in the schools, and a self-reporting questionnaire based on Benner's (1984) model. Further results of this study revealed that the majority of the school nurses had an average to above average knowledge of asthma. The three most common interventions performed by school nurses as well as non medical personnel for those students with chronic illness are nebulizations, inhalers, and peak flow meters. Based on the self-report model of Benner's (1984), these same nurses viewed themselves as expert in their level of practice. Mezirow's Adult Learning Theory as well as Benner's (1984) model of Novice to Expert were used to support the nurses level of practice based on experience, intuition and a constellation of meaning schemes developed from previous exemplars. Results of the study indicated that although the nurses surveyed were expert in their knowledge of basic nursing concepts, none had advanced practice level courses in advanced health assessment or clinical decision making in order to effectively manage the complexities of chronic illness such as ADHD, diabetes, and epilepsy, as well as asthma, the most common chronic illness in schools today.

No description available.