This qualitative phenomenological study explored the key themes of an adolescent journey during a wilderness adventure therapy program through expressive letter writing to their parents. Ten complete sets of letters (five boys and five girls) totaling over 400 pages were analyzed by four independent coders until saturation of themes were reached. There were five overarching themes that emerged from the data: impact of wilderness experiences, desires for improved relationships, apology and accountability, negative emotions, and positive growth and coping. These themes were presented in the chronological pattern that they appeared in the letters. The findings represent the adolescents’ experiences written in their own words. This research is the first of its kind and has implications for parents and adolescents who are considering this growing treatment modality of wilderness adventure therapy, and for professionals, especially family therapists, who can use the pattern in assessment and as an intervention tool in working with families.

Submitted in fulfilment of the requirements of the Degree of Master of Technology: Environmental Health, Durban University of Technology, 2011. / Worldwide Tuberculosis (TB) is a major public health concern. The Directly Observed Treatment Strategy (DOTS) has been used widely internationally and in South Africa (SA) to control the disease yet defaulting on treatment has still not achieved its World Health Organization (WHO) guideline of 5.0%. The eThekwini Municipality reported a defaulter rate of 18.9% in 2007 even with the adoption of DOTS in 1996. This study aimed to investigate the predictors of default amongst informal dwellers of eThekwini and to evaluate the implementation and the efficiency of the DOTS programme within the eThekwini Municipality, KwaZulu-Natal (KZN), and SA. The study population comprised of 102 defaulters from informal settlement, 16 nurses and 5 health personnel that are involved in TB management and control. The study was a mixed method cross sectional descriptive study that generated both quantitative and qualitative data. The Cyril Zulu Communicable Disease Centre (CDC) Electronic TB Register was used to trace the defaulters from the informal settlements that were interviewed. Non-defaulters were matched from the CDC Electronic TB Register but could not be traced due to accessibility and financial issues. Due to the low response from nurses 16(53%), semi structured qualitative interviews were conducted with health personnel. The three sets of data generated were analysed using descriptive statistics and content analysis. Multivariate logistic regression models found smoking, drinking and having a family member with TB as statistical significant predictors of default. Based on the multivariate model with a 95% confidence interval (CI), smoking (OR: 11.23, CI: 5.79, 21.78; p<0.005), alcohol consumption (OR: 15.22; CI: 7.66, 30.25; p<0.005) and had family member with TB (OR: 4.60, CI: 2.34, 9.04; p<0.005) were all significantly associated with defaulting. It was apparent that DOTS implementation was partly implemented due to lack of human resources. Tracing of defaulters, DOTS supporters, DOTS sites and incentives to patients and volunteers were major challenges hindering the iv effective implementation of the DOTS programme in eThekwini. Defaulting occurs as a result of an association between patient and health care characteristics. This study provides useful information specific to predictors of default amongst informal dwellers and the implementation and efficiency of the DOTS programme specific to informal settlements. The results from this study could be used to improve TB control and management specifically in informal settlements addressing factors that predict default and tracing and supporting patients to ensure adherence to TB treatment. / DUT Finance

Magister Public Health - MPH / Background: Human Immune Deficiency Virus (HIV) is a public health challenge worldwide. Antiretroviral therapies (ART) are medications that treat HIV virus infection by suppressing the virus and stopping progression of HIV disease, and that improve quality of life. People initiated on ART need to adhere to their treatment for the rest of their lives. In 2016, there were 7,1 million people (age 15-49) in South Africa living with HIV, representing 19 % of the global HIV burden, with 56% of the adults on ART. Life expectancy of South Africans for both males and females improved between 2009 and 2011 because of ART treatment. People lost to follow up while on ART compromise their own health and the long term positive benefits of the ART regimen, and hence there is a growing emphasis to improve the retention of people who are already on treatment. Aim: This study was conducted examining HIV positive South African Clothing and Textile Workers Union (SACTWU) members who are currently on ART treatment and had previously been lost to follow up (LTFU) from ART care. The study aimed to explore factors associated with LTFU of clients on ART treatment and care among the South African Clothing and Textile Union members living with HIV and attending the SACTWU Worker Health Program Clinic.

Thesis (M.P.H.)--Georgia State University, 2008. / Title from file title page. Frances McCarty, committee chair; Derek G. Shendell, co-chair; Ike S Okosun, committee member. Electronic text (140 p. : col. ill., col. maps) : digital, PDF file. Description based on contents viewed July 15, 2008. Includes bibliographical references (p. 103-108).

Background More than 2/3 of children and adolescents in Germany regularly suffer from headaches. Headache-related limitations in everyday life, school drop-out and educational impairment are common. Structured therapy programs for young headache patients are widely missing. Methods One hundred eleven patients with frequent migraine and/or tension type headache were treated in a 15 hour group program in afternoons, parallel with school, parents received 7 hours of therapy. At the beginning of the program (T0), 6 (T1) and 12 months (T2) after completion, data on headache related disability (PedMidas), headache frequency, intensity, and pediatric pain disability score (PPDI) were prospectively collected to investigate the effects of the therapy. Results Seventy-five patients (9-19 years, median = 14; 66.7% female) and their parents provided patient reported outcome measures showing at T1 (65 patients) and T2 (47 patients) reduced headache frequency (last 3 months headache days median T0: 30 days; T1: 18 days, reduction of median 12 days since T0; T2: 13 days, reduction of median 17 days since T0). Linear mixed models revealed significant reduction (T0/T1 p = 0,002; T0/T2 p = 0,001). Reduced headache disability has been reported at T1 and T2 (PedMidas median T0 = 30, T1 = 15, T2 = 7; p < 0,001, p < 0,001 respectively). Follow up data of a subgroup of patients 24 months after the treatment point to sustainable effects. Conclusions The interdisciplinary multimodal headache therapy program DreKiP reduces headache frequency and headache related disability significantly 6-12 months following its completion.

no abstract available / Health Studies / M.A. (Health Studies)

Dissertation (Ph.D.)--University of South Florida, 2008. / Title from PDF of title page. Document formatted into pages; contains 160 pages. Includes vita. Includes bibliographical references.

no abstract available / Health Studies / M.A. (Health Studies)

Bakgrund: Patienter med långvarig ländryggssmärta upplever ofta funktionsnedsättning, utan att där finns en tydlig koppling till vävnadsskada. Funktionsnedsättning kan delvis vara skapad av vården, av att patienter har fått kontraproduktiva råd av vårdgivare. Syfte: Att undersöka attityder och attitydskillnader mellan studenter i termin 1 och 6 på fysioterapeutprogrammet vid Uppsala Universitet gällande kopplingen mellan långvarig ländryggssmärta och funktionsnedsättning, samt om den egna upplevelsen av smärta påverkar resultatet. Metod: Studenter i termin 1 respektive 6 på fysioterapeutprogrammet vid Uppsala Universitet svarade på Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS). HC-PAIRS mäter i hur stor utsträckning vårdpersonal associerar funktionsnedsättning med långvarig icke-specifik ländryggssmärta. Resultat: Termin 6 svarade signifikant lägre än termin 1, vilket betyder att studenterna i termin 1 har mer negativa förväntningar på funktionsförmågan hos patienter med ländryggssmärta (55 mot 46). Signifikanta skillnader fanns inom områdena “förväntningar på funktion”, “förväntningar på social förmåga” och “behov av bot”, men inte inom “projicerad kognition”. Egen upplevelse av smärta påverkade inte resultatet. Slutsats: Studenter i termin 6 har ett mer positivt synsätt på funktionsförmågan hos patienter med långvarig ländryggssmärta än studenter i termin 1. Spridningen är dock stor i båda terminerna. / Background: Patients with persistent spinal pain often experience a loss of function, without a clear association with tissue damage. Loss of function may partly be healthcare caused, after patients being provided counterproductive advice by their caregiver. Purpose: To investigate the differences in attitudes among first term and last term physical therapy students at Uppsala University, in regards to persistent spinal pain and loss of function and to investigate if student’s own experience of persistent pain influences these attitudes. Method: The students answered the Health Care Providers Pain and Impairment Relations Scale (HC-PAIRS) Questionnaire. HC-PAIRS measures to what extent health care providers link loss of function to persistent spinal pain. Results: There was a significant difference between the semesters. The students in semester one having a higher overall score compared to the students in semester six (55,5 compared to 46). There were significant differences regarding “functional expectations”, “social expectations” and “need for cure”, but not in “projected cognition”. The students’ own experiences of persistent pain did not affect their scoring. Conclusion: Students in semester six had a more positive outlook on the functional ability among patients with persistent spinal pain than students in semester one. However, there was a vast spread of results within both semesters.

No description available.