The way gender relations influence access to care and treatment particularly access to antiretroviral medicines is a challenge to HIV/AIDS programmes and to the individuals and families with HIV. Gender norms that push women and men to adhere to dominant ideals of femininity and masculinity may restrict women's access to economic resources, health care and fuel the spread of HIV. The aim of this study was to determine the role of gender relations in influencing decision-making for access to antiretroviral medicines between partners and in the family.

This investigation aimed to determine factors that influence women's utilisation of maternal health services, with specific focus on the quality of care and services available to disadvantaged communities in South Africa. It used the women's perspectives to assess the quality of maternal healthcare services in peri-urban commercial farming and rural areas with the purpose of understanding why women utilise maternal services the way they do.

The purpose of this study was to evaluate whether the current CDC/ACSM physical activity recommendation, ("30 minutes or more of accumulated moderate-intensity activity, most if not all, days of the week") would improve women's health through a reduction ofcoronary heart disease (CHD) risk factors. Twenty-one sedentary females (ages 49 ± 7 yrs.) with one or more CHD risk factors underwent baseline laboratory including: resting heart rate and blood pressure, resting electrocardiogram, body mass index, bioelectrical impedance, skinfold measures, waist-to-hip, blood lipid profile, and V02max. The VO2 was determined by an exercise treadmill test using the Ball State University Ramp protocol. The subjects were instructed on the CDC/ACSM recommendation, the physical activity survey, and given examples of moderate-intensity activity. The survey data was collected bimonthly over the six month period. The subjects reported participating in >_ 30 min. of moderate-intensity activity an average of 4 f 1 days/week with an average duration of 54 ± 26 min. On the remaining days, the subjects reported doing an average of 14 ± 6 minutes per day. Also, 90% of the women reported doing the activity in continuous bouts. Following the six month study period, the women were retested in the laboratory. Sixteen subjects completed the post-testing. The results of the sixteen women showed a significant improvements in HDL-cholesterol (51 ± 15 vs.56 ± 15 mmHg; p=<.05) and TC/HDL ratio (4.5 ± 1 vs.4.25 ± 1.3; p=<.05). There were no significant changes in the other risk factor variables examined or their V02,„.. It was concluded that the majority of previously sedentary, middle aged women can not meet the CDC/ACSM recommendations for daily activity and total energy expenditure. Additionally, it appears that when given the choice, these women choose to do activity in continuous time blocks versus breaking the daily activities into shorter time periods. / School of Physical Education

Older adults are more vulnerable to the ill effects of life stress due to physiological changes associated with aging that result in decreased immunocompetence. Stressors interacting with an aging immune system may produce further declines in health. Variables shown to modulate the effect of stressors on neuroendocrine and immune function and health include social support, personality, coping style, and health locus of control. A comprehensive model is proposed that includes: life stressors, social resources, psychological resources, interaction between stressors and social resources, neuroendocrine and immune function, and symptomatology. This model was evaluated using structured equation modeling. Participants were 97 active, community dwelling, older women, ranging in age from 60 to 93 years.

Well-being is critical to fostering improved physical, mental, and emotional health among women. Regular physical activity also has significant implications for women’s health. Addressing the barriers that women experience to exercise may help improve exercise adherence and—ultimately—help to promote well-being in women. Mind-body therapies (e.g., yoga and meditation) have long been considered health promoting efforts with a well-being emphasis. Research confirms that these therapies are generally beneficial, safe, flexible, cost-effective and accessible. In addition, gratitude has strong links to mental health and life satisfaction, and has been shown to enhance well-being and facilitate goal attainment. There is an abundance of research on yoga, meditation and gratitude practices, though there is no program that effectively combines all three. This dissertation therefore developed, implemented, and evaluated the feasibility and effectiveness of a health promotion effort that integrates elements of yoga, meditation, and gratitude practice. One-hundred and eleven women participated in the study (nexperimental = 56 and ncontrol = 55). Data on adherence and feasibility were collected throughout the program. Data on study outcomes (including well-being) were collected at baseline and again following completion of the program from both groups. Qualitative data were also collected to help contextualize participant experiences in the program. The participants adhered to the yoga component of the program exceptionally well. The average participant completed 125% of the yoga classes, 86.58% of the meditations and 88.24% of the gratitude practices. Paired sample t-tests were conducted to examine pre- and post-intervention changes in well-being between and within groups. Despite the popularity and positive response to the program - 93.10% of participants in the yoga, meditation and gratitude group (YMG; n=54) reported a perceived improvement in well-being - many of the well-being findings were statistically insignificant. However, significant improvements on disposition and positive relationships were observed among the YMG group; suggesting the intervention had a significant impact on experiencing gratitude in everyday life, as well as on one’s positive assessment of personal relationships. This study lays important groundwork for future and larger scale research to create and subsequently implement successful mind-body health promotion programs for women.

O presente estudo, com abordagem quantitativa, foi motivado pela reduzida adesão ao uso do preservativo pela mulher soropositiva ao HIV/com aids e pela gravidez indesejada. Teve como objetivo geral discriminar fatores de impacto que influenciam as ações de mulheres soropositivas ao HIV/com aids no uso de preservativos, e como objetivos específicos: construir um instrumento para avaliação de fatores de impacto no campo de interesse; identificar os fatores de impacto relacionados à adesão aos preservativos pela mulher soropositiva ao HIV/com aids; associar a situação sociodemográfica dessa mulher às variáveis de maior influência na adesão aos preservativos. Na construção do instrumento de coleta de dados, especialistas avaliaram o formulário original e emitiram sugestões que resultaram em sua reformulação. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Secretaria Municipal da Saúde da Prefeitura da Cidade de São Paulo. Os dados foram coletados no período de setembro de 2009 a setembro de 2010, por meio de entrevistas com 201 mulheres soropositivas ao HIV/com aids que frequentavam um serviço de assistência especializada em DST/aids no município de São Paulo. Os achados foram tratados estatisticamente, iniciando pela avaliação da consistência do instrumento utilizado. Identificaram-se dez fatores de impacto que influenciam na adesão aos preservativos da mulher HIV positivo/com aids. Em ordem decrescente de valor, os impactos obtidos foram: Relações de Gênero, Cultural, Comportamental, Cognitivo, Drogadição, Religioso-Sentimental, Intencional, Socioeconômico, Protetor e Fidelidade. Como se vê, as relações de gênero mostraram-se com maior impacto na adesão ao preservativo; no outro extremo, a fidelidade entre os parceiros mostrou menor impacto sobre esta situação. Os dados mostraram, também, que as mulheres apresentavam dificuldade na decisão em aderir ao uso do preservativo, mesmo recebendo orientações sobre sua necessidade, pelo serviço de assistência especializado. Concluiu-se que a assistência à mulher soropositiva ao HIV necessita ser implementada em relação às orientações sobre o uso do preservativo em todas as relações sexuais; orientações que devem ser realizadas com o casal, priorizando as suas dúvidas e dificuldades. O apoio deverá ser contínuo, para fortalecer e incentivar a aderência ao preservativo. Sugere-se, também, a replicação do instrumento construído para sua validação junto a outros grupos de mulheres infectadas pelo HIV/com aids, no país. / This study, with a quantitative approach, was motivated by the reduced use of protection by women who are HIV positive/with AIDS and also by the undesirable pregnancy. The general aim was to discriminate the factors of impact that influences these HIV womens actions, according to the use of protection. The specific aims were: to create an instrument to evaluate the factors of impact in the field of interest; to identify the factors of impact related to the use of protection by the HIV women with AIDS and also to relate the socio-demographic situation of these women to the variables that have higher influence in the use of protections. During the creation of the instrument for data collection some changes were done considering the suggestions given by the experts who have evaluated the original. The study was approved by the Ethic and Research Committee of the Health Department of São Paulo city. The data collection was done between September 2009 and September 2010, by interviews with 201 women who are with STD/AIDS and used to go to a STD/AIDS assistance service in São Paulo city. The findings were statistically analyzed, starting from the consistency of the instrument used. It was found ten factors that influenced the use of protection by the HIV women with AIDS. In a decreasing order of value, the factors of impact were: Relation of Gender, Culture, Behavior, Cognition, Use of Drugs, Religion-Feeling, Intention, Society-Economic, Protection and Fidelity. According to the results, the relation of gender had more impact in the use of protection; on the other hand, the fidelity between the partners had less impact on the situation. The findings also showed that the women had difficult in deciding the use of protection, even after the specialized assistance service has given them orientation to the necessity. It was concluded that the assistance to the HIV women needs to be improved in order to give better orientation towards the use of protection during all sexual intercourses. This orientation has to be given to the couple, prioritizing their doubts and difficulties. The support must be continuous, in order to motivate and intensify the use of protection. It was also suggested the use of the instrument created, in order to get its validation with other groups of HIV women with AIDS, in the country.

Background/Aim: Historical evidences indicate that maternal health care by a skilled birth attendant is one of the key strategies for maternal survival. However, the rate of maternity care utilisation and reduction of maternal death is very low in Nigeria. This study was designed to investigate factors influencing access to emergency obstetric care with a view to guiding programmatic efforts targeted at overcoming these barriers and also contribute to health reforms in Nigeria. Hence, the need to understand factors influencing access to emergency obstetric care in Nigeria using the Socio-ecological Model (SEM) and Gender and Development (GAD) to identify associated factors operating at different levels. Methods: A mixed method was employed for this study. Data collection used questionnaires and in-depth interviews. Questionnaires were distributed to 330 respondents of which 318 of them were retrieved and qualitative in-depth interviews were conducted for 6 participants. Data collection were done using a sequential approach. The study was conducted in one of the tertiary health facilities in Nigeria from January-April, 2015, amongst mothers aged 15-45 years meeting the study inclusion criteria. Statistical Package for Social Sciences (SPSS) was used in analysing the quantitative data. Bivariate and logistic regressions were conducted for the quantitative data whilst a qualitative content analysis was done for the qualitative data. Results: The study established that education, income level, costs associated with seeking care, distance and time taken to travel were significantly associated with maternity healthcare services utilisation. Quality of service, staff attitude and women's autonomy showed consistent significant association with maternal health care utilisation. Conclusions: The study concludes that; costs of treatment, distance and time, income level, staff attitude and women's autonomy were critical in determining women utilisation of maternity care services. Recommendation: As an outcome of this research, best practice framework has been developed. The framework presents a coherent and systematic approach for achieving sustainable MH by providing a roadmap for instituting measures at the policy, health facility, community and at the individual levels, taking into account factors that are likely to promote or impede the achievement of sustainable MH.

This study evaluated the effects of participation in aerobic exercise on pregnancy outcomes. Pregnancy outcomes included type of delivery, length of labor, gestational age, neonatal birth weight, and maternal weight gain. The 137 nulliparas were categorized as active (N=44) or sedentary (N=93) based on self-reported aerobic exercise. Findings from this study suggest that pregnant women who were active during pregnancy were more likely to have vaginal deliveries than sedentary women. No significant differences between active and sedentary women were found in neonatal birth weight, maternal weight gain, length of labor, or gestational age.

This study analyzed the effects of estrogen replacement therapy (ERT), ethnicity, marital status, education level, maternal status and financial security on the perceived life satisfaction of women over fifty. Information was collected from 125 subjects at an independent school district. The instrument was adapted from a life satisfaction scale originally developed by B. Neugarten. Eight demographic items included ERT use, age, menopause status, marital status, educational level, ethnicity and perception of financial security. Statistical analysis consisting of one way analysis of variance, Student Newman-Keuls ad hoc procedure and multiple regression indicated an independent correlation between financial security and education level to life satisfaction scores. Neither ERT nor menopause status was correlated with perceived life satisfaction score of respondents.

Photocopy of typescript. / Digitized by Kansas Correctional Industries