Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The availability and provision of good antenatal care services ensure early detection and prompt management of any complication or disease that may adversely affect pregnancy outcome. To ensure high quality care, an ongoing health education and empowerment of pregnant women with pregnancy related information, need to be provided by midwives throughout pregnancy. The purpose of this study, therefore, was to explore the pregnant women`s experiences and perceptions regarding health education given during the antenatal period. The objectives set were to - explore the content of the health education given to pregnant women by midwives during the antenatal period - determine whether the health education offered by midwives is understood by pregnant women - determine whether information regarding Health Education during antenatal period is applicable and is used by pregnant women. A qualitative approach with an explorative descriptive design was applied for the purpose of this study. The population included pregnant women who attended an antenatal clinic for the second time in 2012. Ten pregnant women were selected purposively who consented to participate in the study. The trustworthiness of this study was assured by using Lincoln and Guba`s criteria of credibility, transferability, dependability and confirmability. A pretest was done with one participant not included in the actual study. Ethics approval was obtained from the Ethics Committee of the Faculty of Medicine and Health Sciences at Stellenbosch University, reference: S12/05/136. Informed written consent was obtained from each participant which included a recording of the interview. Data was collected through semi-structured interviews using an interview guide and a tape recorder. The researcher approached two women per day for five days. A total of ten (10) pregnant women were interviewed until data saturation reached. The use of Tesch's eight steps of data analysis was used to analyse the transcribed data as described in De Vos et al. (2004:331). Findings revealed that health education was given to pregnant women at the institution under study but with minimum explanations. The midwives were perceived as supportive and regarded as a source of information and self-care agents. Antenatal attendance was regarded as important by participants. Participants indicated that their unborn babies were monitored by the midwives in order to detect abnormalities early. However, midwives emphasised non-pregnancy related complications specifically HIV/AIDS and neglected to give basic antenatal care, such as antenatal exercises, personal hygiene and diet. Language was found to be a barrier and contributed to a lack of information. Recommendations include basic antenatal aspects to be covered in the health education, such as emphasis on personal hygiene, exercises, diet and avoidance of harmful sociocultural practices. With the implementation of appropriate teaching principles language, age and involvement of influential people during health education should be considered. In conclusion, to reduce maternal morbidity and mortality rates and promoting self-care reliance, antenatal care services should be accessible to facilitate ongoing health education by midwives throughout pregnancy. / AFRIKAANSE OPSOMMING: Die beskikbaarheid en voorsiening van goeie voorgeboortesorgdienste verseker die vroeë en vinnige bestuur van enige komplikasie of siekte wat swangerskap-uitkomste nadelig mag beïnvloed. Om hoë gehalte sorg te verseker, moet gesondheidsvoorligting en bemagtiging van swangervroue rakende swangerskap inligting deurlopend deur vroedvroue verskaf word. Die doel van hierdie studie was om vervolgens die swangervrou se ervaringe en persepsies ten opsigte van gesondheidsopvoeding gedurende die voorgeboortelike stadium te ondersoek. .Die doelwitte soos gestel was om: - die inhoud van die gesondheidsvoorligting wat deur vroedvroue gedurende die voorgeboorte periode aan swangervroue verskaf word, te ondersoek - te bepaal of die gesondheidsvoorligting wat verskaf word deur vroedvroue deur swangervroue verstaan word - vas te stel of die ligting aan swangervroue gepas is en te bepaal of dit toegepas word deur swangervroue. ’n Kwalitatiewe benadering met ’n beskrywende ontwerp is vir die doel van hierdie studie toegepas. Die populasie het swangervroue ingesluit wat ’n voorgeboortekliniek vir die tweede keer gedurende 2012 besoek het. Tien vrouens is doelgerig geselekteer wat daartoe ingestem het om aan die navorsing deel te neem. Die betroubaarheid van hierdie studie was verseker deur van Lincoln en Guba se kriteria van geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestigbaarheid gebruik te maak. ’n Loodsondersoek was met een deelnemer wat nie in die werklike studie ingesluit was nie, gedoen. Etiese goedkeuring is verkry van die Etiese Komitee van die Fakulteit van Geneeskunde en Gesondheidswetenskappe aan die Universiteit van Stellenbosch, verwysing: S12/05/136. Ingeligte skriftelike toestemming is verkry van elke deelnemer wat ook ’n opname van die onderhoud ingesluit het. Data is ingesamel deur van semi-gestruktureerde onderhoude gebruik te maak met behulp van ’n onderhoudsgids en ’n bandopnemer. Die gebruik van Tesch se ag stappe van data-analise is gebruik om die getranskribeerde data te analiseer (De Vos et al., 2004:331). Bevindinge het getoon dat gesondheidsvoorligting wel aan swangervroue by die inrigting onder die soeklig met die minimum verduidelikings verskaf is. Die vroedvroue is as ondersteunend en as ’n bron van inligting, asook as selfsorgagente waargeneem. Voorgeboorte bywoning is as belangrik deur deelnemers gesien. Deelnemers het aangedui dat hulle ongebore babas gemonitor is deur vroedvroue om abnormaliteite vroeg op te spoor. Nietemin, vroedvroue het nie-verwante swangerskap komplikasies, spesifiek MIV/VIGS beklemtoon en het nagelaat om aandag te gee aan basiese voorgeboortesorg soos voorgeboorte oefeninge, persoonlike higiëne en dieet. Daar is bevind dat taal ’n hindernis is en dat dit bygedra het tot ’n gebrek aan inligting. Aanbevelings sluit in basiese voorgeboorte aspekte wat gedek moet word in gesondheidsvoorligting, soos die beklemtoning van persoonlike higiëne, oefeninge, dieet en die vermyding van nadelige sosio-kulturele praktyke. Met die implimentering van doeltreffende onderrigbeginsels moet taal, ouderdom en die betrokkenheid van invloedryke mense gedurende gesondheidsvoorligting in ag geneem word. Ten slotte, om moeder-morbiditeit en-mortaliteitsyfers te verminder en selfsorgvertroue te bevorder, behoort voorgeboortesorgdienste toeganklik te wees, sodat vroedvroue volgehoue gesondheidsvoorligting tydens swangerskap kan fasiliteer.

Thesis (MPhil)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: This thesis investigates the role that magic and medicine played in the lives of ancient Egyptian women and children. In a time when giving birth often ended in the death of the mother and child, and child mortality was extremely high, a variety of protective measures were undertaken by the ancient Egyptians. Medicine as the scientific treatment of ailments and women's health in general did exist in Egypt, however, life in Egypt was determined by religion and especially magic. The health of the ancient Egyptian woman and her child was studied by looking at the way in which magic influenced medicine, as well as by looking at how this connection between magic and medicine influenced the life and health of ancient Egyptian women and children. The research model followed was that of an interlinking society in which each aspect of Egyptian life had varying impacts on each other. The degree of impact of magic on aspects such as menstruation, conception and pregnancy was investigated, as well as, the magico-medical spells, amulets and other devices that were used to protect a woman and her baby. A catalogue of sources is given, including written and non-written sources. The first included the medical papyri and magical spells against evil forces and sickness. The second group were visual representations, divine statuettes, amulets and the specialized magical stelae (cippl) and "magical wands" ("Zaubermesser"). This thesis attempts to better understand how feminine issues such as menstruation, pregnancy, and giving birth were perceived and contended with, as well as to shed some light on the medical and magical treatment and protection of the women and children in ancient Egypt. / AFRIKAANSE OPSOMMING: Hierdie tesis ondersoek die rol wat magie en medisyne in die lewens van vrouens en kinders in antieke Egipte gespeel het. In 'n tyd toe die geboorte van 'n kind baie keer die dood van die ma en haar baba veroorsaak het, en kindersterftes uiters hoog was, het die antieke Egiptenare 'n verskeidenheid beskermingsmaatreëls gebruik. Medisyne as die wetenskaplike behandeling van siektes en vroulike gesondheidsorg het in Egipte bestaan, maar die lewe in Egipte was egter bepaal deur die godsdiens en veral die magie. Die gesondheid van die vroue en kinders van antieke Egipte is bestudeer deur te kyk hoe magie medisyne beïnvloed het, sowel as om te kyk hoe die verband tussen magie die medisyne die lewe en gesondheid van vroue en kinders in antieke Egipte bepaal het. Die navorsingsmodel wat gevolg is, is van 'n samelewing waarbinne elke aspek van die lewe in Egipte 'n impak op die ander het. Die graad van impak van magie op aspekte soos menstruasie, konsepsie en swangerskap is ondersoek, sowel as die "magies-mediese" spreuke, amulette en ander middels wat as beskerming vir die vrou en haar baba gebruik is. 'n Katalogus van bronne is ingesluit en sluit beide skriftelike en nie-skriftelike bronne in. Onder die eerste groep val mediese papiri en magiese tekste teen bose magte en siekte. Die tweede groep gee aandag aan visuele voorstellings, godebeeldjies, amulette en die gespesialiseerde magiese stelae (cippl) en "toorstaffies" ("Zaubermesser"). Hierdie tesis poog om beter te verstaan hoe vroulike sake soos menstruasie, swangerskap en geboorte gesien en hanteer is, sowel as om meer lig te werp op die mediese en magiese behandeling en beskerming van vrouens en hulle kinders in antieke Egipte.

Thesis (MPhil (Public Management and Planning))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: The research was conducted to explore the experiences of people living with Acquired Immunodeficiency Syndrome (AIDS) (PLWAs), especially women, as well as the factors influencing their non-participation in development projects aimed at improving their socio-economic status. The study was conducted amongst PLWAs who are members of the Tembisa Main Clinic and Winnie Mandela Clinic support groups in Tembisa, South Africa. The researcher was motivated to conduct the research because in her work as a social worker she is confronted daily with PWLAs who are from disadvantaged backgrounds and are struggling to make ends meet. Initiatives have been undertaken to try and encourage self–reliance and improve the health status of these women by developing food gardens to provide them with fresh vegetables and possible income sources from these gardens. The reluctance of members of two support groups of PLWAs to stay involved in these projects encouraged the researcher to explore these issues. The researcher consulted various sources to obtain literature on the factors influencing non-participation in development projects. In addition she undertook a qualitative study, wherein twenty participants participated. The data from this study was then interpreted and compared to the literature. The findings of this study highlighted several factors such as discrimination, local beliefs, stigma and lack of support, which influence the non- participation of PWLAs in sustainable development projects. The findings of this research also indicate that developments projects often fail to thrive because of topdown decisions about the projects, the fact that there is no start-up funding available for the projects and participants who become demotivated to participate. The research therefore concludes with recommendations in order to address these problems. / AFRIKAANSE OPSOMMING: Die navorsing is onderneem om die ondervinding van mense, veral vroue, wat met Verworwe Immuniteitsgebrek Sindroom (VIGS) lewe, te ondersoek, asook die faktore wat hulle daarvan weerhou om deel te neem aan ontwikkelingsprojekte wat daarop gemik is om hul sosio-ekonomiese status te verbeter. Die studie is onderneem onder pasiënte wat lede was van ondersteuningsgroepe by Tembisa Hoofkliniek en Winnie Mandela Kliniek in Tembisa, Suid-Afrika. Die navorser is gemotiveerd om die studie te onderneem omdat sy daagliks in haar werk as sosiale werker gekonfronteer is deur mense wat met VIGS lewe, wat uit minder bevoorregte agtergronde kom en wat sukkel om te oorleef. Inisiatiewe is onderneem om hierdie vroue se selfstandigheid te bevorder en om hul gesondheidstatus te verbeter deur groente tuine te ontwikkel om hulle van vars groente te verskaf, asook moontlike inkomstebronne uit hierdie tuine. Die onwilligheid van die lede van twee ondersteuningsgroepe om in hierdie projekte betrokke te bly, het die navorser aangemoedig om hierdie aangeleentheid verder te ondersoek. Die navorser het verskeie bronne geraadpleeg om literatuur te verkry oor die faktore wat die nie-deelname in ontwikkelingsprojekte beïnvloed. Sy het ook kwalitatiewe studie onderneem waaraan twintig respondente deelgeneem het. Die data van hierdie navorsing is daarna geïnterpreteer en met die literatuur vergelyk. Die bevindinge van hierdie navorsing het verskeie faktore uitgelig wat die niedeelname beïnvloed van mense wat met VIGS lewe, soos diskriminasie, plaaslike gelowe, stigma en gebrek aan ondersteuning. Die navorsing het ook bevind dat ontwikkelingsprojekte dikwels nie floreer nie as gevolg van die ‘topdown’ besluitneming oor die projekte en omdat daar nie genoegsame vooraf befondsing beskikbaar is vir die projekte nie en die deelnemers dus demotiveer om verder deel te neem. Die navorsing sluit dus af met voorstelle om hierdie probleme aan te spreek.

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Rationale: Critical questions have been raised about the overcrowding of primary care services, such as community health centres (CHCs) and clinics in predominantly Xhosa-occupied areas in the Western and Eastern Cape, with clients who present with minor health ailments. Suggestions have been made about the integration and the use of the indigenous health knowledge (IHK) carried by older Xhosa women in the services as a strategy for managing minor health ailments, and as a way of encouraging appropriate health-seeking behaviour. Preliminary studies have reinforced the need for the revival of the IHK that currently is lying dormant within communities. The studies affirm that such knowledge could be an asset if integrated into, and valued by, the Western biomedical model, and could play a major role in contributing towards alleviating the problem of overcrowding in primary care (PC) services. Aim: This study primarily explored and described the IHK carried by older Xhosa women and used in the management of health problems in their home situation. Secondary recommendations were made to key stakeholders regarding the use, retainment and integration of the IHK into PC services. Method: This ethnographic, feminist and emancipatory study used qualitative methods of data collection. Thirty-six (36) older Xhosa women were purposefully selected to participate in four FGDs, to explore the IHK that they used for managing health problems in their home situation. Sixteen (16) in-depth interviews were conducted with the elite older Xhosa women and their family members to validate the findings from the four FGDs. The process of analysis and interpretation was informed by an inductive process of a combination of narrative analysis and the analysis of narratives strategies. Findings: The findings showed that the older Xhosa women possess IHK regarding the management of minor health problems within the home situation. Assessment, treatment strategies and medications were identified. Functionality and observation are mainly used to diagnose and manage illness. This approach also includes monitoring the progress, severity and recovery from illness in the patient. The findings further demonstrated that older Xhosa women were also managing illnesses that could be classified as major. They could clearly distinguish between what was health and what was illness in their village. Distance from health care services had an impact on the health-seeking behaviour of the older Xhosa women, with those closer to health care services wanting all illnesses, even those that could be classified as minor health ailments, to be managed by the health service, and those who were farther away from the hospital appearing to manage complex illnesses, and only referring clients with those illnesses to external health care services quite late. The findings further showed communication and attitudinal problems that existed between the clients and health care providers. Conclusion: Many studies have already challenged the manner in which PHC was implemented in developing countries, as it appeared to focus on the curative approach to disease and left out disease prevention and health promotion. It is within this area that the older Xhosa women appear to express the greatest concern for the health of their homes and villages. The older Xhosa women in the Eastern Cape appear to be struggling with problems of broken family units, and are left behind to struggle to keep the home together, as they lack the necessary resources to do the hard work involved with producing food and building the home and village. In the light of the promise of National Health Insurance and the revitalisation of PHC, the study proposes that the two major national health policies should take cognisance of the IHK utilised by the older Xhosa women, and that there should be a clear plan as to how the knowledge can be supported within a health care systems approach. A rural health model is proposed by the study to do this. / AFRIKAANSE OPSOMMING: Rasionaal: Daar word kritiese vrae gestel oor die toeloop van mense met geringe ongesteldhede by primêre-sorg(PS)-dienste, soos gemeenskapgesondheidsentrums (GGS) en klinieke, hoofsaaklik in Xhosa-woongebiede in die Wes- en Oos-Kaap. Voorstelle is geopper dat ouer Xhosa-vroue se inheemse gesondheidskennis (IGK) by die dienste geïntegreer en benut moet word as ’n strategie om minder ernstige gesondheidsprobleme te bestuur en om mense aan te moedig om toepaslike keuses oor gesondheidshulp te maak. Voorlopige navorsing het die nodigheid bevestig dat die kundigheid wat tans onbenut in gemeenskappe lê, herontgin behoort te word. Die navorsing bevestig dat sulke kennis ’n bate kan wees indien dit as ’n gewaardeerde element by die Westerse biomediese model ingeskakel word en dat dit ’n groot rol kan speel om die druk op PS-sentrums te verlig. Doelstelling:Hierdie navorsing ondersoek en beskryf hoofsaaklik die IGK waaroor ouer Xhosa-vroue beskik en wat in die hantering van gesondheidsprobleme in hul tuisomgewing aangewend word. Aanvullende aanbevelings rakende die gebruik, behoud en integrasie van IGK by PS-dienste is aan bepalende belanghebbers voorgelê. Metode: Kwalitatiewe data-insamelingsmetodes is in hierdie etnografiese, feministiese en bevrydingsgerigte navorsing gebruik. Ses-en-dertig ouer Xhosa-vroue is spesifiek uitgesoek vir deelname aan vier fokusgroepbesprekings (FGB’s) om hul hantering van gesondheidsprobleme in hul tuisomgewing aan die hand van hul IGK te ondersoek. Sestien indringende onderhoude is met die elite- ouer Xhosa-vroue en hul gesinslede gevoer om die bevindings van die vier besprekings te bevestig. Die proses van ontleding en vertolking is gerig deur ’n induktiewe proses wat ’n kombinasie van narratiewe ontleding en die ontleding van narratiewe strategieë behels het. Bevindings: Die bevindings wys dat ouer Xhosa-vroue IGK het rakende die hantering van minder ernstige gesondheidsprobleme in die tuisomgewing. Evalueringsmetodes, behandelingstrategieë en medikasie is uitgewys. Kwale word hoofsaaklik volgens funksionaliteit en waarneming gediagnoseer en hanteer. Die werkwyse sluit in dat pasiënte se vordering, die erns van hul siekte en hul herstel gemoniteer word. Die bevindings wys verder dat ouer Xhosa-vroue ook siektetoestande hanteer wat as ernstig geklassifiseer kan word. Hulle kan duidelik tussen gesondheid en siekte in hul gemeenskap onderskei. Die afstand vanaf gesondheidsorgdienste speel ’n rol in die gedrag van ouer Xhosa-vroue wat keuses oor gesondheidshulp betref; diegene wat na aan ʼn gesondheidsorgsentrum woon, verkies dat die gesondheidsdienste alle siektes - selfs dié wat as minder ernstige gesondheidskwale geklassifiseer kan word - moet hanteer, terwyl diegene wat verder van ’n hospitaal woon, klaarblyklik self komplekse siektetoestande behandel en eers op ’n gevorderde stadium sulke kliënte na eksterne gesondheidsorgdienste verwys. Die bevindings het ook probleme rakende kommunikasie en houdingsingesteldheid tussen kliënte en gesondheidsdiensverskaffers uitgewys. Gevolgtrekking: Verskeie ondersoeke het al die manier waarop PG-sorg in ontwikkelende lande toegepas word, bevraagteken, aangesien die benadering oënskynlik op genesing fokus terwyl dit siektevoorkoming en gesondheidsvoorligting verontagsaam. Dis oor hierdie aspek dat die ouer Xhosa-vroue skynbaar die grootste kommer oor die welstand van hul huishoudings en gemeenskappe het. Die ouer Xhosa-vroue in die Oos-Kaap het klaarblyklik met dieselfde probleme van gebroke gesinne as dié in die Wes-Kaap te kampe, en word dikwels alleen agtergelaat om die huishouding te laat oorleef. Hulle kry swaar om sonder die nodige hulpbronne die harde werk te doen om voedsel te produseer en om huishoudings en die gemeenskap op te bou. In die lig van die vooruitsigte wat nasionale gesondheidsversekering en vernuwing van die PGS inhou, stel hierdie navorsingsprojek voor dat bogenoemde twee hoofelemente van die nasionale gesondheidsorgbeleid aandag skenk aan die IGK wat ouer Xhosa-vroue toepas, asook dat ’n duidelike plan uitgewerk word oor hoe hierdie kennis binne die benadering tot gesondheidsorg ondersteun kan word. Die navorsings stel ’n model vir plattelandse gesondheidsorg voor om dié doelstellings te verwesenlik.

A nutrition education program for employed women on maintaining a healthy weight was developed and evaluated. Delivery of eight messages (two per week for four weeks) by electronic mail was tested for effectiveness. The subjects were 243 members of the Oregon State University Office and Personnel Association who were randomly assigned to three experimental groups. Group #1 received hard copies of the messages, group #2 received hard copies along with a weekly electronic tip on weight management, and group #3 received the messages by electronic mail (e-mail). An evaluation survey was developed to assess: 1) Participants' stage of change regarding fat in the diet, 2) Participants' social support network for weight maintenance, 3) Reactions to the program, 4) Impact of the program on positive behavior regarding weight control, and 5) Demographics. The survey was sent by campus mail about three weeks after the program. The evaluation was completed by 80.2% of participants. The nine male respondents and the two gender-unidentified respondents were not included in the data analysis to assure a total female population. A total of 181 surveys were analyzed (74.5%). The mean age of female respondents was 47.8 ± 13.3. Although it was hypothesized that electronic delivery of the program and/or supplementing the hard copy/print program with brief electronic tips would be associated with higher order stages of change (Transtheoretical Model), the results from this study did not support the hypotheses. There was no significant difference in stage of change among participants in the three modes of delivery. The messages appeared to have the greatest impact on women in the action and preparation stages. They tended to make more positive changes (i.e. reading food labels) than women in the maintenance, contemplation, and precontemplation stages. Mode of delivery did not appear to make a difference in whether the women looked forward to the messages, reactions to message length, how many were read, or the resulting knowledge or behavior change. Therefore, it may not be critical to program effectiveness. Women in the electronic group, however, were more certain that they received all eight messages and were more apt to ask questions of the researcher. The potential cost savings, convenience, and ease of quick communication make it a more attractive option. Access to the technology and participant preference are equally important factors. / Graduation date: 1997

O transplante cardíaco representa a última alternativa de tratamento e única possibilidade de sobrevivência do paciente com insuficiência cardíaca (IC) terminal. É indicado quando todos os procedimentos foram considerados ou excluídos no tratamento da cardiopatia grave. Atualmente, os resultados obtidos com a cirurgia de enxerto indicam possibilidade de aumento de sobrevida do transplantado que, de outro modo, iria a óbito. Em aproximadamente 80% dos transplantes de coração hoje realizados, os pacientes estão vivos dois anos após a cirurgia. Devido à escassez de trabalhos encontrados na literatura, a presente pesquisa foi realizada com mulheres cardiopatas indicadas à cirurgia de enxerto. Questiona-se a interferência de relações objetais estabelecidas pelas pacientes na decisão de submissão à cirurgia e adesão aos cuidados do pós-operatório. O objetivo principal foi verificar a dinâmica emocional de mulheres candidatas ao transplante cardíaco. Foram utilizados como instrumentos o Teste de Relações Objetais de Phillipson (TRO), interpretado através de investigações sobre o Sistema Tensional Inconsciente Dominante (STID), e a entrevista clínica classificada a partir da Escala Diagnóstica Adaptativa Operacionalizada (EDAO), aplicados em sete pacientes encaminhadas à avaliação psicológica pelo Setor de Transplante Cardíaco do Instituto Dante Pazzanese de Cardiologia (IDPC), em São Paulo. A análise dos achados se deu à luz da teoria psicanalítica das Relações Objetais de Melanie Klein. Constatou-se que as mulheres indicadas ao transplante de coração, participantes da presente pesquisa, estabelecem relações objetais persecutórias correspondentes às fases mais arcaicas do desenvolvimento esquizoparanóide e viscocárica. Agindo como fator tensional, a doença cardíaca terminal pode ser vivida como perigo interno, induzindo a excessiva pressão das forças de morte e agravando tendências à negação e abandono do tratamento. / The cardiac transplantation represents the last alternative of treatment and an unique possibility of surviving for the patient with terminal cardiac insufficiency (CI). It is indicated when all other procedures were considerate or excluded for the treatment of serious cardiomyopathy. Currently, the results archieved with the graft surgery indicate the possibility of growth in overlife of patients that submitted for a transplant which, otherwise, would die. In approximately 80% of the cases of heart transplantations today, the patients are still alive two years after the procedure. Due to the lack of studies found in literature, the current research was made with cardiomyopathy women that submitted for a graft surgery. It is questioned the interference of object relations established by the patients in the decision to submit for the surgery and in the adhesion to the pos-operatory cares. The main objective was to verify the emotional dynamic of women applying for a cardiac transplantation. Where used as instruments the Object Relations Test (ORT), by Herbert Phillipson, interpreted by investigations over Unconscious Tensional System, and clinical interviews using the Adaptive and Operationalized Diagnostic Scale (AODS), applied in seven patients sent to psychological analysis at the cardiac transplantation sector of Dante Pazzanese Institute (IDPC), in São Paulo. The analyses of the results were made using Melanie Klein´s psychoanalytical theory. The women investigated who applied to the transplantation established persecutory object relations corresponding to the more archaic phases of the development. Acting as a tensional factor, the terminal cardiac disease can be lived as an intern danger, inducting to excessive pressure of forces of death and aggravating tendencies to treatment denial and abandonment.

Health disparities and substance misuse are increasingly prevalent, costly, and deadly in Indian Country. Although women historically held positions of influence in pre-colonial Tribal societies and shared in optimum health, their current health is relegated to some of the worst outcomes across all racial groups in the United States. Women of the Choctaw Nation of Oklahoma (CNO) have some of the highest prevalence estimates in physical inactivity and excessive drinking in the United States. Building on the Indigenous Stress Coping model of indigenous health, "Our Vision of Health for Future Generations" explores the intersection of a historical event, the Trail of Tears, and its lasting impact on the contemporary health outcomes in tribal members. This inquiry is positioned within the Yappallí Choctaw Road to Health project that explores these broader issues. This culturally-centered study explores proximal and settings-based/intermediary motivations of twenty-three women who completed the Yappallí­ project, walked the Trail of Tears, and developed a holitobit ibbak fohki "sacred giving" community health event. Analysis was conducted using the Listening Guide method, that highlighted the contrapuntal voices of embodiment, motivation, challenges, and transformation. Participants shared stories in relation to both their individual health concerns (proximal), and deep love and commitment for the health of their family, community and for future generations (intermediary). This study provides another framework for the development of indigenized research, by using in-depth interviews, haklo "listen deeply" as a form of indigenous storywork that is centering of the experiences of marginalized people, and reflexivity as anukfilli "Deep Reflection."

No description available.

Includes bibliographical references (leaves 254-288). Examines language used by general practitioners and in mass media to ask 'what are the implications of constructions of menopause for health care practice and public health for women at menopause?'. Presents the findings of qualitative analysis of semi-structured interviews with nine general practitioners working in rural South Australia and qualitative and quantitative analyses of 345 south Australian newspaper articles from 1986 to 1998.

Includes bibliographical references (leaves 254-288). / x, 288 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Examines language used by general practitioners and in mass media to ask 'what are the implications of constructions of menopause for health care practice and public health for women at menopause?'. Presents the findings of qualitative analysis of semi-structured interviews with nine general practitioners working in rural South Australia and qualitative and quantitative analyses of 345 south Australian newspaper articles from 1986 to 1998. / Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 2001?