Health beliefs of 221 postmenopausal women were assessed to predict the Breast Cancer Screening Behaviors of breast self-examination (BSE) and utilization of mammography. Champion's (1991) revised Health Belief Model (HBM) instrument for BSE, which assesses the HBM constructs of Seriousness, Susceptibility, Benefits, Barriers, Confidence and Health Motivation, was utilized along with her Barriers and Benefits instrument for mammography usage. Ronis' and Harel's (1989) constructs of Severity-Late and Severity-Early were evaluated along with Cuing and demographic variables. These exogenous latent constructs were utilized in a LISREL path model to predict Breast Cancer Screening Behavior.

Submitted in partial compliance with the requirements for the Master's Degree in Technology : Chiropractic, Durban University of Technology, Durban, South Africa, 2015. / Introduction: Symptoms associated with large breasts result from bra strap chafing, poor body posture, headaches, neck, shoulder, thoracic and lower back pain. There is a paucity of literature quantifying objective data regarding the effect of breast size on posture. Therefore correct bra sizing may improve posture, however this is undetermined. This study aimed to investigate the effect of bra correction on selected postural parameters in order to determine its relevance in a clinical setting. Methodology: Sixty five females who met the inclusion criteria had the following parameters recorded: age, height, weight, body mass index, occupation, and underbust and overbust bra size. An anterior-posterior, right and left lateral digital photographs were taken before and after bra correction. These were then processed using the Posture Pro software. The data was analysed using the latest version of SPSS. The results were presented by means of standard deviations and ranges and differences between pre and post measures were performed with an ANOVA. Results: It was found that there was no correlation between changes in any of the four parameters from pre to post correction, which changed significantly with postural correction (4/43 post correction significant readings) and the demographic variables. Most participants changed to a larger cup sizes after correction which is in line with Greenbaum, (2003) who found that participants tend to buy a smaller bra size. In this study 3% of the study population changed to a bigger cup size and 97% wore bras that were too tight. Similar to the findings of Wood eta/., (2008) who found that 70% of the study population wore bras that are too small and 10% wore bras that were too big. Conclusion: In the study on effect of incorrect bra size on selected postural parameters it was found the there were four parameters that changed significantly with p<O, 05 [ANOVA]. Further investigation needs to be done on a larger sample size, age group range, BMI and different demographic. / PDF copy unavailable. please refer to hard copy for full text information / M

Background: A global cervical cancer health disparity persists despite the demonstrated success of primary and secondary preventive strategies, such as cervical visual inspection (VI). Cervical cancer is the leading cause of cancer incidence and death for women in many low resource areas. The greatest risk is for those who are unable or unwilling to access screening. Barriers include healthcare personnel shortages, cost, transportation, and mistrust of healthcare providers and systems. Using community health workers (CHWs) may overcome these barriers, increase facilitators, and improve participation in screening for women in remote areas with limited access to clinical resources. Aim: To determine whether the accuracy of VI performed by CHWs was comparable to VI by physicians or nurses and to consider the affect components of provider training had on VI accuracy. Methods: A systematic review and quantitative meta-analysis of published literature reporting on VI accuracy, provider type, and training was conducted. Strict inclusion/exclusion criteria, study quality, and publication bias assessments improved rigor and bivariate linear mixed modeling (BLMM) was used to determine the affect of predictors on accuracy. Unconditional and conditional BLMMs, controlling for VI technique, provider type, community, clinical setting, HIV status, and gynecological symptoms were considered. Results: Provider type was a significant predictor of sensitivity (p=.048) in the unconditional VI model. VI performed by CHWs was 15% more sensitive than physicians (p=.014). Provider type was not a significant predictor of accuracy in any other models. Didactic and mentored hours predicted sensitivity in both BLMMs. Quality assurance and use of a training manual predicted specificity in unconditional BLMMs, but was not significant in conditional models. Number of training days, with ≤5 being optimal, predicted sensitivity in both BLMMs and specificity in the unconditional model. Conclusion: Study results suggest that community based cervical cancer screening with VI conducted by CHWs can be as, if not more, accurate than VI performed by licensed providers. Locally based screening programs could increase access to screening for women in remote areas. Collaborative partnerships in “pragmatic solidarity” between healthcare systems, CHWs, and the community could promote participation in screening resulting in decreased cervical cancer incidence and mortality. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection

Thesis (M.CUR.) -- University of Limpopo, 2014 / Indigenous practices (IPs) are experiences generated by people who are living in a specific region context and a specific cultured group. IPs are shaped by cultural traits that are passed from one generation to the next. The practices are rooted and embedded in such a society and, therefore, the practices become part of the people’s lifestyle. It is difficult to try and change these practices, since people have adhered to them throughout their entire lives. The believe system plays a major role in health care seeking behaviour of individuals because they are informed by the IPs that are observed in their environment (Shaik & Hatcher, 2005). IPs are stored in people’s memories and are expressed in songs, dances, beliefs, rituals, cultural values, myths, and healing of diseases by using herbs. During pregnancy, IPs are still applied worldwide. Ayaz and Efe (2008) indicate that it occurs mostly in Turkey and Africa where women’s reassurance is depending on the local context and meaning of pregnancy. THE PURPOSE OF THE STUDY To determine indigenous practices of pregnant women at the Dilokong Hospital in the Greater Tubatse Municipality of the Limpopo Province.This was achieved by the exploring and describing the indigenous practices of pregnant women in the antenatal (ANC) clinic of the maternity ward at the Dilokong Hospital.. DESIGN AND METHOD A qualitative, descriptive, explorative and contextual research design was used for the participants to describe the indigenous practices by pregnant women. Data was collected by means of unstructured one-on-one interviews in maternity unit of the ANC clinic at the Dilokong Hospital of the Greater Tubatse Municipality. Ethical considerations as described by Denosa (2000) were adhered to in order to ensure the v quality of the study. The criteria for trustworthiness were observed as stipulated in Babbie and Mouton (2009).Fifteen pregnant women were interviewed. FINDINGS AND RECOMMENDATIONS Four themes with sub-themes emerged from the data analysis by using Tech’ṡ open coding approach (Creswell 2006, Botma, Greef, Mulaudzi & Wright, 2010). Four themes were emerged namely; indigenous practices based on ancestral knowledge; indigenous practices based on spiritual diviners versus church principles; restricted practices versus instructions followed during pregnancy and labour and indigenous practices during labour and delivery. It is recommended that a national IP strategy needs to be developed to provide a framework and platform to support and promote grass roots IPs into mainstream development in the health care system in relation to midwifery practice. CONCLUSION The study findings indicated that IPs were regarded as an honourable health intervention by THPs, families, and pregnant women. They showed trust in methods used to preserve pregnancy, labour, and delivery, although, the indigenous practices by pregnant women still continue. Indigenous practices such as cords around their waists, are still observed during physical examinations. However, there is a reduction of prescribed potions mixed with cool drinks for use to accelerate labour and to prevent negative consequences because the potential toxicity has been explained during the provision of health education. These findings call for health care professionals to emphasise training and workshops for the THPs church diviners that are the fundamental principle of effective implementation of IPs to enhance improvement in the prevention of complications during pregnancy, labour and delivery. KEYWORDS Pregnant women Indigenous practice Indigenous knowledge Antenatal care

Postmenopausat women on hormone replacement therapy (HRT) have been reported to be stronger when compared to women who are not using HRT. The first goal of this study was to investigate whether muscle morphology was altered in women who use HRT when compared to women who do not use HAT. In addition, this study examined the combined effects of a 6-month moderate-intensity strength training (ST) routine and HRT on the neuromuscular system of early postmenopausal women. Because not all the women completed the ST, this study was separated into two separate analyses, baseline (n=17; 7 HRT, 10 non-HRT) and training (n=14; 6 HRT, 8 non-HRT). ST consisted of two exercises (squat and dead lift), two days a week, for 6-months. Vastus lateralis muscle biopsies were taken at baseline and 6-months after exercise training. Biopsy samples were sectioned and analyzed histochemically for muscle fiber type and fiber cross-sectional area (CSA). In addition, voluntary knee extension strength was assessed at 30��/sec using an isokinetic dynamometer at these two time points. At baseline there were no significant differences in knee extensor strength between groups (HRT: 443 �� 121 N, non-HRT: 490 �� 106 N). Regardless of hormone status, Type I fibers were significantly larger (p=.005) in GSA (Type I=3705 �� 877��m��; Type II=2790 �� 756��m��). However, there were significantly more Type II fibers (p<.0001) (61.5 �� 7.9% of total) and consequently, Type II fibers occupied significantly more total fiber area p=.00l2) (Type I=45.3 �� 7.4%; Type II=54.7 �� 7.4%). No significant differences were found in the fiber type distributions of the HAT (37.9 �� 2.5% Type I, 62.1 �� 2.5% Type II) and non-HRT (38.9 �� 2.9% Type I, 61.1 �� 2.9% Type II) groups. There were no significant differences in fiber CSA of Type I fibers (HRT: 3615 �� 886 ��m��, non-HRT: 3769 �� 912 ��m��) or Type II fibers (HRT: 2770 �� 722 ��m��, non-HRT: 2849 �� 804 ��m��) obtained from the two groups. Six months of ST had no effect on the strength, fiber CSA, and fiber type distribution for HRT and non-HRT subjects. These results suggest that HRT does not alter muscle strength, fiber type distribution, and fiber CSA in early postmenopausal women. / Graduation date: 2003

Osteoporosis is a skeletal disease affecting 44 million Americans. A primary strategy to prevent osteoporosis is to develop a high peak bone mass in youth. Oral Contraceptives (OCs) alter hormones in women and could affect bone mass development. The interaction between OCs and skeletal mineralization is poorly understood. PURPOSE: Our aims were to 1) compare bone mineral density (BMD) of young women who had a history of OC use with regularly menstruating controls, 2) compare changes in BMD in controls, women who initiate OC use, and those who have a history of use, and 3) to evaluate predictive capabilities of physical activity and years of oral contraceptives use on changes in BMD. METHODS: We recruited women, 18 to 25 years of age, with a history of OC use and controls. BMD at the hip, whole-body, and spine (AP, g/cm�� and width-adjusted lateral, g/cm��) was measured by dual-energy x-ray absorptiometry. Physical activity (METs) was measured via questionnaire and grip strength was evaluated using an isometric dynamometer. RESULTS: Groups were similar in body mass index (BMI), fat mass, grip strength, calcium intake and physical activity but controls were slightly older than OC users. In analysis of covariance (ANCOVA), controlling for age and BMI, controls had significantly greater BMD than OC users at baseline at the AP and lateral spine, hip, and whole-body (p<0.05). By ANCOVA (covariates = age at baseline, change in weight), oral contraceptive users had greater bone loss at L��� in the lateral view than controls whereas, controls had greater increases in L��� volumetric BMD, BMD of the total hip, and whole body than OC users (p<0.05). Stepwise regression results did not reveal years of oral contraceptive use, grip strength, or METs to be a significant predictor of changes in BMD at any site. CONCLUSIONS: We conclude that, in the cross-sectional analysis, oral contraceptive use by young women may compromise bone health during a time when mineral is still accruing. In the prospective analysis, regularly menstruating controls had greater BMD accrual or less bone loss over a 12-month time period than women with a history of oral contraceptive use. / Graduation date: 2005

In order to develop effective interventions designed to encourage more middle-aged individuals to engage in regular exercise, there is a need to further understand the mechanisms involved in the decision to exercise. One appropriate conceptual framework involves future-oriented self-conceptions, or possible selves (Markus & Nurius, 1986). Possible selves, both hoped-for and feared, have been shown to vary over the lifespan in content and number (Cross & Markus, 1991), and to be predictive of future health behaviors (Hooker & Kaus, 1992,1994). The role of possible selves in the exercise context can be explored using the Stage of Change Model (Prochaska & DiClemente, 1983), which identifies participation as a process consisting of five identifiable stages. The purpose of this study was to examine the number and content of possible selves generated by individuals across stages of exercise behavior, in order to determine whether possible selves can differentiate those stages and be predictive of exercise-related behavior. Participants were 204 middle-aged women employed at a university in the U.S. Pacific Northwest. Results indicated that differences in the number and content of open-ended possible selves across stage of exercise were relatively few, although differences that did exist held potential for future interventions. Of particular interest was the significant finding of possible selves related to body image, which differed by stage for both hoped-for and feared selves. Responses to focused possible selves directly related to exercise behavior showed a number of differences between stage of exercise, providing support for previous literature as well as for the methodology employed in the present study. Individuals whose self-efficacy and outcome expectancy associated with a particular possible self related to exercise was high, were most likely to engage in exercise behavior. Finally, when the strongest predictor of exercise behavior was combined with exercise self-efficacy, the variance accounted for by the possible self was negligible. Findings support the conclusion that possible selves are worthy of future research in the exercise domain, including the role of possible selves as an antecedent to exercise self-efficacy. Results are discussed in terms of past research, practical applications, and future research directions. / Graduation date: 1998

published_or_final_version / Medicine / Doctoral / Doctor of Philosophy

published_or_final_version / Buddhist Studies / Doctoral / Doctor of Philosophy

Background: Advanced breast cancer (ABC) is affecting substantial number of Chinese women in Hong Kong. Understanding their unmet supportive care needs (SCNs) is important for health care system to precisely allocate resources to areas demanded for help the most and for patients to achieve better quality of life. Objectives: (1) To validate Chinese version of Supportive Care Needs Survey Questionnaire (SCNS-SF34), (2) to address the prevalence of unmet SCNs at baseline (newly diagnosis of ABC) and explore relevant factors associating with baseline unmet SCNs, (3) to identify the trajectories of unmet SCNs from baseline, 6-week, 12-week, 18-week to one-year post-diagnosis of ABC among Hong Kong Chinese women and identify the predictors related to individual resources. Methods: The study consisted of two phases. In Phase I, breast cancer (BC) patients were recruited from six public hospitals and the SCNS-SF34 (which covers five domains of needs) was administered concurrently with measures of psychological distress CHQ-12 (Chinese Health Questionnaire-12), HADS (Hospital Anxiety and Depression Scale), symptom distress (MSAS-SF), and patient satisfaction (ChPSQ-9) to explore factor structure by using Exploratory Factor Analysis (EFA) and to examine internal consistency, and convergent, divergent and discriminant validities of the identified factor structure. In phase II, women newly diagnosed with ABC were recruited and followed up to assess their unmet SCN trajectories one year after diagnosis. Prevalence of initial baseline SCNs and associated demographic, medical and psychological factors were identified. Linear Mixed Modeling (LMM) was performed to assess trajectories for each SCNs domain. Hypothesized variables reflecting personal and social resources (optimism, trait hope, social support, psychological distress and patient satisfaction) were examined for association with the changes of unmet SCNs after adjusting for demographic and medical characteristics. Results: Instead of five-factor structure identified in the original SCNS-SF34, a four-factor structure with 33 items was identified, comprising: 1) Health system, information and patient support needs (HSIPS), 2) Psychological needs (PSYC), 3) Physical and daily living needs (PDL) and 4) Sexuality needs (SEX). The SCNS-SF33-C demonstrated moderate-to-good internal consistency (Cronbach’s alphas=0.75-0.92) across all domains. Acceptable convergent and divergent validity were demonstrated. Discriminant validity was demonstrated in the SCNS-SF33-C’s ability to differentiate between clinically distinct patient groups (ABC vs. localized BC and active treatment vs. no active treatment). Of the top 15 unmet SCNs, all belonged to the HSIPS domain. There were significant linear declines in unmet HSIPS and PSYC needs over the year after diagnosis, but not in PDL and SEX. After adjusting for demographic and medical factors, LMM identified symptom distress, patient satisfaction and patient satisfaction x time are predictors of HSIP. Total symptom distress, optimism, anxiety and anxiety x time predicted PSYC. Total symptom distress was predictor of PDL. Anxiety was predictor of SEX. Conclusions: The SCNS-SF33-C has a suitable factor structure and psychometric properties for the use in assessing unmet psychosocial SCN among Chinese women with BC. Generally, unmet HSIP and PSYC tended to decline, while levels of unmet PDL and SEX tended to persist over time. Specific individual resources predicted the future change of unmet SCNs. / published_or_final_version / Community Medicine / Master / Master of Philosophy