Problem. Approximately 400 000 children are in the year 2018 living in foster care in South Africa. Many of these children have wounds from neglect and abuse from their original family. Even though foster care is intended to be a safe haven many of the children instead end up drifting from one foster home to another, waiting to be placed in a permanent family. Because of the deficiencies in foster care it is of importance to investigate the social workers’ views of a suitable family, since we believe this will affect the assessment, which in the end will affect the child. This thesis explores what conceptions social workers at a child protection organization in South Africa have of a suitable family for vulnerable children. Method. We interviewed seven social workers at mentioned organization, working with formal foster care and reunification with parents or relatives. We use theme analysis to process our findings which we thereafter analyze using Maslow’s hierarchy of needs. Result. Our findings reveal that the emotional needs of the child are considered most important by the social workers, followed by the physiological needs. Criminal behavior and poor values and morals are thought to make a family unsuitable. Conclusion.  We found that there are some differences in the social workers’ conception of a suitable family for vulnerable children, although they all underlined the same factors as most important. They also state that these children are thought to have the same needs as any other child; it all comes down to what they consider is the best interest of the child. Regardless which values the individual social worker has, what they look for in every family is that the child will feel safe and loved. / Problem. Cirka 400 000 barn lever i fostervård i Sydafrika år 2018. Många av dessa barn är påverkade av den försummelse och våld deras familj har utsatt dem för. Även att syftet med fostervård är att det ska vara en fristad är det många av barnen som flyttar från familj till familj och hela tiden väntar på att komma till en permanent familj. På grund av bristerna i fostervården är det viktigt att undersöka socialarbetarnas syn på en passande familj, eftersom vi anser att detta kommer påverka utredningen, vilket i slutändan kommer påverka barnet. Den här uppsatsen utforskar vad socialarbetare på en barnskyddsorganisation i Sydafrika uppfattar som en passande familj för utsatta barn. Metod: Vi intervjuade sju socialarbetare på nämnd organisation, som arbetar med formell fostervård och återförenande med föräldrar eller släktingar. Vi använder tematisk analys för att bearbeta vårt undersökningsresultat vilket vi sedan analyserar med Maslows behovstrappa. Resultat. Våra undersökningsresultat visar att socialarbetarna anser att de emotionella behoven hos barnet är de viktigaste, vilka sedan följs av de fysiologiska behoven. Kriminellt beteende och olämpliga värderingar och moral tros utgöra en opassande familj. Slutsats. Resultatet visar att det är vissa skillnader i socialarbetarnas uppfattning av en passande familj för utsatta barn, samtidigt som de alla betonar samma faktorer som mest viktiga. De menar också att dessa barn anses ha samma behov som vilket annat barn som helst; allt handlar om vad de anser är det bästa för barnet. Oavsett vilka värderingar den individuella socialarbetaren har, vad de letar efter i varje familj är att barnet ska kunna känna sig säkert och älskat.

La maladie coronaire représente un problème majeur de santé publique. Sa manifestation la plus sévère, le syndrome coronarien aigu, est en grande majorité lié à la rupture de plaques d'athérome vulnérables. Les travaux effectués dans le cadre de cette thèse portent sur l'étude pré-clinique de la plaque d'athérome dans un modèle murin : la souris déficiente en apolipoprotéine E (apoE-/-).La rupture des plaques d'athérome vulnérables survient à la suite d'une élévation des contrainte mécaniques au niveau de la capsule fibreuse. Une première partie de ce travail de thèse porte sur l'évaluation de la contrainte présente dans la paroi des vaisseaux de souris apoE-/- porteuses de lésions athéromateuses. Ces lésions présentent une faible rigidité et en conséquence de faibles contraintes. Ces observations donnent un élément d'explication de l'absence de rupture dans ce modèle animal.Les plaques d'athérome vulnérables présentent une inflammation importante ; l'imagerie de l'inflammation vasculaire est une approche pertinente pour l'identification des plaques d'athérome vulnérables. Une seconde partie de ce travail de thèse porte sur l'imagerie de l'athérosclérose en ciblant le processus inflammatoire chez la souris apoE-/- avec d'une part l'évaluation de radiotraceurs peptidiques développés au sein du laboratoire et décrits comme ligands de la molécule d'adhésion VCAM-1, surexprimée dans le contexte inflammatoire, et d'autre part l'évaluation du [18F]-fluorodésoxyglucose (FDG), décrit pour s'accumuler dans les cellules inflammatoires et le tissu adipeux brun. L'évaluation poussée des peptides originaux a mis en évidence un manque de robustesse dans leur comportement biologique. D'autre part, une captation similaire de FDG a été observée dans les lésions athéromateuses et du tissu le brun péri-aortique se trouvant à proximité chez la souris apoE-/- . Cette limitation souligne la nécessité de l'optimisation des procédés expérimentaux destinés à l'évaluation de l'inflammation des lésions d'athérosclérose avec le FDG dans ce modèle animal. / Coronary artery disease is a major healthcare issue. Acute coronary syndrome is mainly caused by the rupture of vulnerable coronary plaques. This thesis focused on the preclinical study of atherosclerosis in a mouse model: the apolipoprotein E-deficient mouse (apoE-/-).Vulnerable plaque rupture is caused by an elevation of mechanical stress in the fibrous cap of atherosclerotic plaques. The first part of this thesis focused on the parietal stress evaluation in atheromatous lesions from apoE-/- mouse vessels. Atherosclerotic tissue showed low stiffness resulting in low levels of mechanical stress in atheromatous lesions. The low level of mechanical stress might account for the atherosclerotic plaque stability in this animal model.Rupture-prone vulnerable atheromatous plaques are highly inflammatory; vascular inflammation imaging appears therefore as a relevant strategy for vulnerable plaque imaging. The second part of this thesis dealt with atherosclerosis imaging in the apoE-/- mouse model, firstly with the evaluation of original peptidic radiotracers described as a VCAM-1 binders, an adhesion molecule over-expressed during inflammation, and secondly with the evaluation of [18F]-fluorodeoxyglucose (FDG), which was shown to accumulate in inflammatory cells and in the brown adipose tissue (BAT). Advanced evaluation of peptides revealed a lack of robustness in their biological behavior. A similar FDG uptake was observed in the atherosclerotic lesions and in the periaortic brown adipose tissue of apoE-/- mouse found in the vicinity. This potential confounding factor emphasizes the need to carefully design preclinical studies using FDG for the evaluation of lesion inflammation in this animal model.

Made available in DSpace on 2015-04-11T13:54:55Z (GMT). No. of bitstreams: 1 Dissertacao-Sonia Maria Lemos.pdf: 695519 bytes, checksum: bb2fa6ad04591a080c83bb6ae077b805 (MD5) Previous issue date: 2009-07-15 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The complexity of the individual-environment relation has brought about uneasiness and a search for strategies in order to minimize or avoid the negative impact of human actions upon the environment. The quest for some understanding on this complexity makes it possible to widen knowledge upon these two facts, stimulating the discussion about a proposition that one will be able to establish healthier and less aggressive ways of living as far as environmental issues are concerned based on environmental-related conceptions and their effects upon the environment .Therefore, it all starting out from a conception that environmental commitment demands engagement, be it in the production of such knowledge or in the rational use of the natural resources. That information is relatively available does not mean that people in general may feel compelled to making use of it or applying it. It is understood that the problem behind environmental issues is complex and interdependent on the social problematic issues arising from population growth, poor income division, allocation of people in big city centers being the spaces smaller and smaller and social inequity larger and larger each day. The various technical-scientific transformations have triggered ecological unbalances and a progressive deterioration on both single and collective ways of living. These changes and the population growth have led to changes in the way people feel or perceive reality. The objective of this study was to analyze people´s environmental forms of commitment at moments of vulnerability and, how these constitute the socio environmental ethos of this population. The issues on vulnerability to which the poorer classes are exposed have represented a challenge in the search for strategies after risk reduction and applicable ways that people can actively develop. The methodological strategy adopted was of a filed research of the descriptive exploratory qualitative type, carried out in an urbanized city zone in the vicinities of the Ouro Verde residential area, Coroado III, Zona Leste in Manaus. The environment is muddy, located in a flooding area and several water streams run across it and wind up in a creek that gets polluted with tossed waste and trash, causing major environmental problems and bringing about a great deal of difficulty to the dwellers. The techniques for the collection of information were the participative observation and semistructured interview, being Content the method of the analysis. A set of ethical phenomena was identified in the current study in order to justify the proposed commitment and three categories emerged from the socio-environmental reality were named after active passivity ; supportive passivity and controlled passivity , which, after all constitute the socioenvironmental ethos built by this population and browses through the environmental-related issues, their understanding and engagement. The questions arisen do not only contribute to the discussion of these people´s engagement to sharing the possibilities of facing their own problematic, but also to giving greater visibility on this process so there can be more effective and efficient interventions. / A complexidade da relação pessoa-ambiente tem produzido inquietação e busca de estratégias para minimizar ou evitar o impacto negativo da ação humana sobre o meio. A busca de entendimento desta complexidade possibilita ampliar o conhecimento sobre estes dois aspectos, estimulando a discussão de uma proposta, onde a partir da compreensão das concepções sobre o meio e dos efeitos sobre ele é possível estabelecer modos de vida mais saudáveis e menos agressivos em termos ambientais. Portanto, partiu-se de uma concepção de que o compromisso ambiental exige envolvimento, seja na produção do conhecimento ou no uso racional dos recursos naturais. O fato das informações estarem relativamente disponíveis não significa que as pessoas em geral se sintam comprometidas em sua apropriação e aplicação. Entende-se que a problemática ambiental é complexa e interdependente da problemática social decorrente do crescimento populacional, má distribuição de renda, alocação das populações em grandes cidades - com espaços cada vez mais restritos, e do alargamento das desigualdades. As diversas transformações técnico-científicas ocasionaram desequilíbrios ecológicos e progressiva deterioração nos modos de existência individuais e coletivas. Essas mudanças e o crescimento demográfico levaram a transformações no modo de viver e perceber a realidade. O objetivo deste estudo foi analisar as formas de compromisso ambiental de pessoas em situação de vulnerabilidade e como estas constituem o ethos socioambiental dessa população. As questões de vulnerabilidade a que estão expostas especialmente as populações menos favorecidas têm representado um desafio na busca das estratégias para diminuição dos riscos e envolvimento para uma participação mais ativa das pessoas no estabelecimento de meios para a sua aplicabilidade. A estratégia metodológica adotada foi de pesquisa de campo do tipo qualitativa exploratória descritiva, que foi desenvolvida em uma ocupação urbana localizada nas adjacências do conjunto Ouro Verde, Bairro Coroado III, Zona Leste na cidade de Manaus. O ambiente é alagadiço, situado em área de charco e entrecortado por vários córregos que deságuam no igarapé onde são jogados os dejetos e o lixo, causando problemas ambientais importantes e trazendo inúmeras dificuldades aos moradores. As técnicas para a coleta de informações foram a observação participante e entrevista semi-estruturada, sendo que o método de análise foi o de conteúdo. Foram identificados neste estudo um conjunto de fenômenos éticos para explicar o compromisso e propusemos três categorias que emergiram da realidade socioambiental que foram denominadas passividade ativa ; passividade suportiva e passividade cerceada que por fim constituem o ethos socioambiental construído por esta população e perpassa o seu entendimento e envolvimento com as questões mbientais. O levantamento dessas questões contribui não apenas com a discussão acerca do envolvimento das pessoas compartilhando possibilidades de enfrentamento das problemáticas vividas por elas, mas também dar maior visibilidade desse processo para intervenções mais eficazes e eficientes.

In South Africa today only one in every three children lives with both of their biological parents. Most children not living with biological parents live with a grandparent. Vulnerable children are those whose basic needs for food, shelter, safety, protection, and education are not met or are insufficiently met. Many children who are orphaned are vulnerable, but vulnerability is not limited to orphans only. Children who live with their grandparents can be called vulnerable children as they suffer the loss of parental contact through death, illness, abandonment or migrant labour. Care-givers of vulnerable children face numerous challenges in their daily lives. Although the care of grandchildren by grandmothers is not unusual or new, the traditional network of financial and emotional support for this care-giving task has gradually fallen away over the years as parents are deceased, or too ill to work or have abandoned their children. This has left care-givers, many of whom are elderly and themselves vulnerable, with less resources and more financial and care-giving responsibility. Care-givers and the children for whom they care live in a wider context of poverty, unemployment, the HIV pandemic and crime in South Africa. Care-givers are at risk of burn-out due to the intensity of the challenges they face. Increasing resilience of care-givers serves to increase the positive outcomes for the vulnerable children in their care. The goal of this study was to explore whether participation in awareness-based Gestalt group work sessions would enhance the resilience of care-givers of vulnerable children. In the context of applied research, a mixed methods approach was used, specifically an embedded mixed methods approach. The study measured respondents‟ resilience before and after the implementation of a series of eight Gestalt group work sessions. A quasi-experimental research design, the comparison group pre-test-post-test design, was used for the quantitative part of the study and a case study design for the qualitative part. Quantitative data were collected through a structured interview using a pre-determined interview schedule based on theoretical constructs of resilience. Qualitative data were collected through semi-structured interviews, observations and field notes. The respondents were 19 care-givers of vulnerable children from a semi-rural area in KwaZulu-Natal. They were selected through snowball sampling and were assigned into comparison and experimental groups through a simple random sampling method. The experimental group participated in the Gestalt group work sessions whilst the comparison group did not. Although the quantitative results showed no significant difference in the pre- and post-test results, the qualitative results confirmed that experimental group members experienced a positive effect upon their resilience through participating in the Gestalt group work. Conclusions drawn from the qualitative findings indicated that respondents had a high level of resilience present in their lives before the research began. The awareness-based Gestalt group work sessions had a positive impact upon aspects related to the resilience of care-givers of vulnerable children. / Dissertation (MSW)--University of Pretoria, 2013. / gm2014 / Social Work and Criminology / unrestricted

Introduction : La sécurité routière sur le réseau interurbain est un problème majeur de santé publique dans les Pays à Revenu Bas et Moyen (PRBM) mais peu d'attention y a été consacrée. Les objectifs de cette thèse étaient d’évaluer le fardeau des traumatismes en relation avec le trafic interurbain, la déclaration des usagers blessés dans des bases de données différentes, d’analyser l’association entre les facteurs situationnels (caractéristiques physiques et circonstances environnementales) et les sites des accidents et la perception de la dangerosité des tronçons accidentogènes dans les PRBM. Méthodes et résultats : Pour répondre à ces objectifs, cinq études spécifiques ont été réalisées dans deux PRBM, le Cameroun et le Pakistan. L’étude I a évalué le nombre de tués par véhicules-km parcourus et les facteurs qui leur étaient associés, en utilisant les rapports de police entre 2004 et 2007 sur l’axe Yaoundé-Douala, Cameroun. Le taux de mortalité était de 73 par 100 millions véhicules km parcourus, un taux 35 fois plus élevé que sur un même type de route en pays à revenu élevé. La mortalité était plus élevée pour les accidents impliquant des usagers vulnérables, les véhicules roulant en sens opposé et ceux dus à une défaillance mécanique, y compris un éclatement de pneu. L’étude II a évalué les différences de déclaration d’accidents faites par les services de police, d’ambulance et des urgences en 2008 sur l’axe Karachi-Hala, Pakistan. La mortalité était de 53 par 109 véhicules-km parcourus ; le taux de mortalité était 13 fois plus élevé sur cet axe par rapport à un même type de route en France. La police a déclaré un mort sur cinq et un blessé grave sur dix. Les usagers de la route vulnérables, y compris les piétons et deux-roues ont été deux fois moins déclarés par la police que par les services d'ambulance ou des urgences. L’étude III a étudié les facteurs situationnels associés aux sites des accidents sur l’axe Yaoundé-Douala par une approche de type cas-témoins. Les facteurs tels que le profil routier plat (rapport de cotes [RC] ajusté =1,52 ; intervalle de confiance à 95 % [IC95 %]=1,15-2,04), les surfaces irrégulières (RC=1,43 ; IC95 %=1,04-1,99), les obstacles à proximité (RC=1,99 ; IC95 %=1,09-3,63) et les intersections à trois (RC=3,11 ; IC95 %=1,15-8,39) ou à quatre directions (RC=3,23 ; IC95 %=1,51-6,92) étaient significativement associés à des sites d’accidents corporels. De plus, la probabilité des accidents augmentait dans des zones urbaines situées dans des régions de plaine (RC=2,23 ; IC95 %=1,97-2,77). L’étude IV a étudié le fardeau des traumatismes dus aux accidents ainsi que les facteurs associés dans des zones en travaux sur l’axe Karachi-Hala en utilisant les méthodes de cohorte historique. Un tiers de la mortalité routière était survenu dans des zones en travaux et le risque de mortalité était quatre fois plus élevé dans ces zones que dans les autres zones. Un accident sur deux a eu lieu entre des véhicules roulant en sens opposé dans ces zones. L’étude V a étudié la perception de la dangerosité des tronçons accidentogènes (au moins 3 accidents sur 3 ans) et non accidentogènes (aucun accident déclaré) sur les deux axes des précédentes études, en montrant leurs vidéos à des conducteurs volontaires pakistanais. Les conducteurs n’ont perçu comme dangereux que la moitié des tronçons accidentogènes. La perception de la dangerosité des tronçons plats et droits était plus faible par rapport aux tronçons en courbes et avec une pente. La perception de la dangerosité en zone urbaine d’un tronçon accidentogène était significativement moins élevée (RC=0,58 ; IC95 %=0,51-0,68) que celle d’un tronçon non accidentogène ayant la même caractéristique (RC=2,04 ; IC95 %=1,51-2,74). La perception de la dangerosité d’un tronçon accidentogène avec panneau de signalisation était significativement plus élevée (RC=2,75 ; IC95 %=2,38-3,16) par rapport à des tronçons non accidentogènes ayant la même caractéristique (RC=0,50 ; IC95 %=0,34-0,72). Conclusion : Cette thèse montre combien des méthodes épidémiologiques simples, mais novatrices, peuvent être utiles pour évaluer le fardeau des traumatismes par accidents et leurs facteurs de risques dans les PRBM. Ces pays sont confrontés à un énorme fardeau de morbidité routière qui est souvent sous-déclarée dans les données de la police. Un système de surveillance fiable et valide est nécessaire dans les PRBM. De plus, la politique de prévention pourrait être améliorée par une meilleure communication d’information entre les autorités routières et policières concernant les facteurs situationnels. De la même façon, les mesures de sécurité dans les zones en travaux devraient être contrôlées par un système dédié. Enfin, la sécurité routière sur les routes interurbaines dans les PRBM pourrait être améliorée en rendant les routes plus « informant », en particulier avec l’application de mesures peu couteuses telles que les panneaux de signalisations sur les tronçons accidentogènes. / Background: Interurban traffic safety is a major public health problem, but has received little attention in Low- and Middle-Income Countries (LMICs). The objectives of this thesis were to assess the burden of injury related to interurban traffic, and reporting of these injuries in different datasets, to analyze situational factors (physical characteristics and environmental circumstances) associated with crash sites, and road hazard perception of high-risk crash sites in LMICs. Methods and results: These objectives were assessed in five specific studies conducted in two LMICs, Cameroon and Pakistan. In study I, traffic fatality per vehicle-km and associated crash factors were assessed using police reports for years 2004 to 2007, on the two-lane Yaoundé-Douala road section in Cameroon. Traffic fatality was 73 per 100 million vehicle-km, a rate 35 times higher than a similar road in a high-income country. Fatality was higher for crashes involving vulnerable road users, crashes between oppositely-moving vehicles, and those due to mechanical failure including tyre burst. In study II, traffic injury reporting to police, ambulance, and Emergency Department (ED) in 2008 was assessed, on the four-lane Karachi-Hala road section in Pakistan. Crash fatality was over 53 per 109 vehicle-km, a rate 13 times higher than a similar road in France. Police reported only one out of five fatalities and one out of ten severe injuries. Vulnerable road users were two times less reported in police data than ambulance or ED data. In study III, situational factors associated with injury crash sites were assessed on the Yaoundé-Douala road section, using case-control methods. Factors such as flat road profiles (adjusted Odds Ratios [OR]=1.52; 95% Confidence Interval [95%CI]=1.15-2.01), irregular surface conditions (OR=1.43; 95%CI=1.04-1.99), nearby road obstacles (OR=1.99; 95%CI=1.09-3.63), and three- (OR=3.11; 95%CI=1.15-8.39) or four-legged (OR=3.23; 95%CI= 1.51-6.92) intersections were significantly associated with injury crash sites. Furthermore, the likelihood of crash increased with built-up areas situated in plain regions (OR=2.33; 95%CI=1.97-2.77). In study IV, traffic injury burden and factors associated with Highway Work Zones (HWZs) crashes were assessed on the Karachi-Hala road section, using historical cohort methods. HWZs accounted for one third of traffic fatalities, and fatality per vehicle-km was four times higher in HWZs than other zones. One out of two HWZ crashes occurred between oppositely moving vehicles. In study V, hazard perception of high-risk (with ≥ 3 crashes in 3 years) and low-risk sites (no crash reported) from the two above road sections was assessed by showing videos to voluntary Pakistani drivers. Drivers were able to identify only half of the high-risk sites as hazardous. Sites with a flat and straight road profile had a lower hazard perception compared to those with curved and slope road profile. High-risk sites situated in built-up areas were perceived less hazardous (OR = 0.58; 95%CI=0.51-0.68) compared to low-risk sites (OR = 2.04; 95%CI=1.51-2.74) with same road situation. Further, high-risk sites with vertical road signs were more likely to be perceived hazardous (OR = 2.75; 95%CI=2.38-3.16) than low-risk sites (OR = 0.50; 95%CI=0.34-0.72) with such signs. Conclusion: This thesis illustrates how innovative yet simple epidemiological methods can be useful in assessing the injury burden and specific risk factors in LMICs. These countries face a high burden of interurban road injuries, mostly under-reported in police data. A reliable and accurate injury surveillance system is needed in these countries. Moreover, prevention policy can be improved by better information transfer between road and police authorities regarding situational factors. Similarly, a monitoring system is required to examine the HWZ safety interventions in these countries. Lastly, interurban road safety can be improved by making roads self-explaining, especially by implementing low-cost interventions such as vertical signs at high-risk sites.

Master of Public Health - MPH / Background: The repercussions of being HIV positive coupled by the complications of antiretroviral therapy are likely to cause distress, emotional and psychological problems particularly among children infected by the virus. The limited support services for children experiencing distress intensify the urgency to address this challenge. Despite the availability of social workers and nurses' interventions currently in place, the number of children in need of psychological care continues to increase. This is particularly true at Deborah Retief Memorial (DRM) hospital, one of the main antiretroviral therapy facilities in Kgatleng district, Botswana. Method: The purpose of this study was to explore and describe the perceptions of social workers, nurses and caregivers on key factors contributing to psychological distress of HIV positive children. A descriptive, exploratory qualitative study design that employed the use of in-depth interviews was used to conduct this study. Participants included four caregivers of HIV positive children who seek antiretroviral therapy at DRM hospital Infectious Diseases Control Clinic, together with five nurses and two social workers who worked in the same clinic. Conventional content analysis was used to analyse the in-depth interview transcripts. Results: Perceived psychological stressors for HIV positive children included disclosure of HIV status, orphanhood, social problems, lifelong treatment, stigma, poor caregiver-child relationship and lack of caregiver‟s love, care and support. However the caregivers did not fully understand the psychological distress the HIV positive children were experiencing, hence were unable to recognize it in these children. The study highlighted that major challenges faced by the health-workers included lack of qualified personnel, lack of adequate knowledge and skills, and a non-conducive working environment required to effectively assist children with psychological distress. The findings also indicated the need for education and support of caregivers and HIV positive children by the educators, family and health-worker systems. Conclusion: The profile of key stressors of psychological distress, the challenges and support needs suggested by the participants in this study can provide a framework for improving the existing services for HIV positive children with psychosocial problems. This information is important for use in training nurses and social workers involved with children with psychological behaviours.

This research was based on the development of a Personal Growth Programme to address the emotional needs of ECD practitioners dealing with vulnerable children in previously disadvantaged communities, mostly in Gauteng. Early childhood development practitioners placed emphasis on their emotional needs and the kind of interventions necessary to assist them in dealing effectively with the emotional needs of children in their care. A Personal Growth Programme was designed with the aim of stimulating and sustaining reflexive practices and emotional growth through self-exploration, role-play and sharing of experiences. Relying on semi-structured interviews, the practitioners’ evaluations of the Personal Growth Programme were presented. All agreed that the programme had benefited them as individuals and as practitioners. They reported that the most important skills they had learnt were self-knowledge and empathy with the children in their care, both of which improved their practice. Some cited how these skills had benefited not only their practice but their personal relationships with family. Some of the skills were thus cited as life-changing. Regarding the sustaining of support groups, only three groups managed to meet at least once after the personal growth programme, with the aim of discussing their work or other issues related to it. The programme therefore made a difference for individuals but its sustainability revealed less success, suggesting that sustainability needed more attention. Copyright / Dissertation (MA)--University of Pretoria, 2012. / Psychology / unrestricted

While tobacco use remains a leading preventable risk factor for mortality and morbidity in Canada (Patra, Rehm, Baliunas & Popova, 2007), the overall smoking prevalence rate of Canadians has decreased substantially from close to 50% of the population in 1965 to 16.1% of the population in 2012 (Canadian Tobacco Use Monitoring Survey (CTUMS) 2012; Reid, Hammond, Rynard & Burkhalter, 2014). However, up to 85% of individuals with a mental illness continue to use tobacco products (Harris, Parle & Gagne, 2007), contributing to an inequitable distribution of negative health outcomes for this population. Individuals with severe mental illness die an estimated twenty-five years earlier than the general population, with sixty per cent of these deaths due to cardiovascular, pulmonary and infectious disease (Parks, Svendsen, Singer, & Foti, 2006). A recent study that examined specific tobacco-attributable deaths in these populations found that tobacco accounted for 53% of deaths in individuals with schizophrenia, 50% of all deaths for those diagnosed with a depressive disorder, and 48% of all deaths for those with a diagnosis of bipolar disorder (Callaghan et al., 2014). This research project is intended to increase our understanding of what constitutes an effective intervention for smoking cessation and smoking reduction in a population of individuals with severe mental illness who are homeless or vulnerably housed, living in a large urban setting. Two areas of inquiry were proposed. The first inquiry examined data collected as part of a needs assessment to determine the overall prevalence rate of smoking and related behaviours for a population of individuals with severe mental illness receiving services from a community mental health agency. We found that the tobacco use prevalence was 72%, and 62% of smokers had high or very high levels of nicotine dependence; however almost half of respondents (47%) were interested in quitting or reducing tobacco within the next 6 months. Smokers were found to be over 9 times more likely to have a co-occurring substance use disorder (OR=9.44, 95%CI[6.33,14.08]). The second inquiry was a pilot study conducting a randomized controlled trial design to evaluate smoking cessation and smoking reduction outcomes for two groups of individuals (n=61) with severe mental illness receiving different smoking cessation interventions. Clients randomly assigned to the routine Smoking Cessation group (SC-R) received up to 24 weeks of no-cost Nicotine Replacement Therapy (NRT) and clients assigned to the Smoking Cessation Plus group (SC+) received up to 24 weeks of no-cost Nicotine Replacement Therapy (NRT) plus two initial individual sessions of motivational interviewing followed by weekly psychosocial group interventions for up to 24 weeks. Primary outcomes were levels of tobacco use at the 3-month and 6-month follow-up. The 7-day point prevalence abstinence rate measured at 3 months was 21.9% (n=7) for the SC+ group and 13.8% (n=4) for the SC-R group (OR=1.75,95%CI[.46,6.74]). At 6 months, the 7-day point prevalence abstinence rate was 12.5% (n=4) for the SC+ group and 6.9% (n=2) for the SC-R group (OR=1.93, 95%CI[.33,11.41]). Secondary outcomes included change in reported quality of life, physical health and mental health status functioning over the course of the study. We found that there were no statistically significant differences in the smoking quit or smoking reduction rates between the two treatment groups. At the 3-month time point the overall quit rate for both groups combined was 18% (n=11) and at the 6-month time point the quit rate was 10% (n=6). Reduction in the number of daily cigarettes smoked was statistically significant over time (F [1.68, 98.90] = 55.13, p < .001, η p 2 = 0.48) for both groups, as was the overall reduction of the FTND score (F [2, 94] = 17.98, p < .001, η p 2 = 0.28). This research demonstrates that collecting vital tobacco prevalence and dependency information is a straightforward and important task for community mental health agencies. Individuals with mental illness have both the interest and ability to quit or reduce their use of tobacco. Practitioners need to be aware of alternative smoking practices that may contribute to understanding tobacco use patterns and dependence in this population. Other factors such as co-morbid substance use disorder and level of community functioning may influence smoking status and, consequently, how treatment is provided. The findings of the pilot trial demonstrate the feasibility of conducting smoking cessation research with the population. Findings also suggest that a larger definitive trial is warranted to examine the effectiveness of the SC+ intervention. This research adds to the limited but growing knowledge base of how to address tobacco use and provide treatment to this vulnerable group, and will contribute to advances in population health by informing effective interventions with the attendant implications for program and policy development.

New immigrants to Canada are identified as a vulnerable population in mental health and, as a result, organizations are signaling the need to enhance their mental health supports. The research uses focus groups and questions based on the messaging of a Canadian school mental health program to understand how new immigrant mothers interpret and develop key aspects of their mental health literacy and how they attain parent empowerment. A thematic assessment of the knowledge, interpretation, action and decision-making of the study participants (n=7), all recent immigrants to Canada and mothers of high school students, shows that new immigrant mothers are prepared to follow a path towards mental health literacy. At the same time, however, there are barriers that can block progression towards mental health literacy for this audience. These findings are supported by three umbrella themes: the first main theme “home as haven” espouses maternal roles in mental health maintenance such as protector and communicator, the second main theme “knowledge versus suspicions of mental health and mental illness” represents informed views and support of mental illness and myths and illusions of mental illness, and the third main theme, “additional barriers to mental health literacy” includes the hardships of immigration and fear of knowledge. The study concludes that new immigrant mothers appreciate the importance of fostering mental health understanding and discussion with their children at the same time that they encounter obstacles to the advancement of their mental health literacy. This study is relevant to the field of communication in that it demonstrates the experience of new immigrant mothers as a secondary audience in mental health programming. As the caregivers of their children, they are in position to enforce the messages and health maintenance behaviours of a school-based mental health program aimed at adolescents.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-28T18:29:56Z No. of bitstreams: 1 elainecoelhocristovao.pdf: 14405925 bytes, checksum: 7ec0ed8454b605c34a83549ae90669f9 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-29T11:03:02Z (GMT) No. of bitstreams: 1 elainecoelhocristovao.pdf: 14405925 bytes, checksum: 7ec0ed8454b605c34a83549ae90669f9 (MD5) / Made available in DSpace on 2016-01-29T11:03:02Z (GMT). No. of bitstreams: 1 elainecoelhocristovao.pdf: 14405925 bytes, checksum: 7ec0ed8454b605c34a83549ae90669f9 (MD5) Previous issue date: 2014-08-26 / O trabalho trata de impactos ambientais da implantação de empreendimentos hidrelétricos, tendo como estudo de caso a Usina Hidrelétrica Barra do Braúna, instalada nos municípios de Leopoldina, Cataguases, Laranjal e Recreio, situados na Zona da Mata mineira. Embora a área de influência do empreendimento abranja os 04 (quatro) municípios citados, a ênfase do estudo será dada aos municípios de Laranjal e Palma, mais propriamente à comunidade de pescadores – enquadrada como do tipo vulnerável – a qual tende a sofrer a maior carga dos impactos ambientais, o que traz à baila a discussão sobre Conflito e Justiça Ambiental. Esta temática está inserida nas discussões acerca da implantação de grandes projetos, apoiando-se nos conceitos de Rede e Território, os quais nos auxiliam a compreender a dinâmica de implantação de certos empreendimentos, tal como àqueles hidrelétricos, os quais carregam a ideário da modernidade e do progresso, mas que no local podem ser portadores de contradições e desordem. Mais propriamente, a utilização do conceito de Rede técnica alude a uma conjuntura que pressupõe fluxos de todo o tipo – das mercadorias às informações – atrelados aos fixos, lugares de conexões, que constituem os nós, conforme Dias (2010). O conceito de Território utilizado é aquele concebido como uma apropriação simbólica e como um produto das relações de poder que incluem vários atores, tais como Estado, empresas e indivíduos, os quais através da construção de uma Rede dão forma a um território. Através de cartogramas temáticos, produzidos no ambiente Sistema de Informação Geográfica-SIG, a Zona da Mata é apresentada como um território produtivo, constituído de hidrelétricas dispostas em uma Rede técnica, mas que portam uma lógica estranha àquela existente nos locais de implantação e desencadeiam conflitos ambientais – territoriais – pelo uso e controle do recurso natural. Como uma evidência deste tipo de conflito, é apresentado o caso da população de pescadores atingida pelo empreendimento em tela, a qual ainda sofre pelo impacto da instalação e operação do empreendimento que alterou sua vida cotidiana e seu nicho de trabalho de forma a piorar sua condição de vida e, por essa razão, é alvo da maior carga de impactos ambientais, os quais ainda não foram minimizados, face às medidas de remediação já adotadas. Para o trato dessa questão utilizou-se da pesquisa qualitativa, ao lançar mão de uma revisão bibliográfica, consulta a documentos e realização de entrevistas semiestruturadas com os pescadores, cuja fala e perspectiva a respeito do conflito ambiental pode ser ampliada e explicitada, norteando as conclusões desta pesquisa. Tais conclusões apontam para a influência da lógica do modo de produção capitalista no contexto apresentado, o qual através de uma rede técnica cria um território produtivo, permeado por relações desiguais de poder, que tende a causar degradação, alteração de modos de vida e, portanto, conflito e injustiça Ambiental. / The work deals with environmental impacts of the implementation of hydropower projects, with case study the hydroelectric power plant of Barra do Braúna, located in the cities of Leopoldina, Cataguases, Laranjal and Recreio, in the Zona da Mata of Minas Gerais. Although the area of influence of the project covering the 04 (four) cities mentioned, the emphasis of the study will be given to the cities of Laranjal and Palma, more exactly the fishing community – framed as such vulnerable -which tends to suffer the brunt of the environmental impacts, which brings up the discussion about Conflict and Environmental Justice. This theme is included in discussions about the implementation of major projects, relying on the concepts of Network and Territory, which help us understand the dynamics of implementation of certain projects, such as those in hydroelectric, which carry the ideals of modernity and progress, but that the site can be carriers of contradictions and disorder. More specifically, the use of the concept of technical Network alludes to an environment that assumes cash flows of all kinds-of goods to informationcoupled to fixed, places of connections that constitute the us as Dias (2010). The concept of Territory used is that intended as a symbolic appropriation and as a product of power relations, which include several actors, such as State, enterprises and individuals, which by building a network form a territory. Through thematic cartogram, produced in Geographic Information System Environment-SIG, the Zona da Mata is presented as a productive territory, consisting of hydroelectric plants arranged in a network technique, but that bear a strange logic to that existing in the deployment sites and that may trigger environmental disputes-use and control the territorial natural resource. As evidence of this type of conflict is presented the case of the population of fishermen affected by development in the screen, which still suffers from the impact of the installation and operation of the enterprise, which changed his everyday life and your work niche in order to worsen his condition of life and, for this reason, it is the biggest load of target environmental impacts, which have not yet been minimized due to the remediation measures already adopted. To deal with this issue we used qualitative research, to make use of a bibliographical revision, consultation documents and semi structured interviews with fishermen, whose speech and perspective regarding the environmental conflict can be expanded and clarified, guiding the conclusions of this research. Such findings point to the influence of the logic of the capitalist mode of production in the context presented, which through a technical network creates a productive territory, permeated by unequal power relations, which tends to cause degradation, changing lifestyles and therefore, conflict and environmental injustice.