Diabetes and related complications are one of the leading causes of death for Mexican American women. Although dietary behavior is a critical component of diabetes management, research is lacking in relation to the interplay of food habits, culture, and diabetes among this population. The specific aims of this ethnographic study were to: (1) explore the relationships between culture, food habits, and type 2 diabetes as experienced by low income Mexican American women; (2) examine the role of food in the cultural identity of low-income Mexican American women; (3) examine how trying to adhere to the ADA dietary guidelines for people with diabetes impacts the relationship between food and culture of low income Mexican American women with type 2 diabetes. This sample consisted of 16 Mexican American women between the ages of 39 to 60 years. Twelve of the sixteen had experienced diabetes for at least 10 years, and were considered experts in the management of their illness. The remaining four had experienced diabetes for a shorter period of time and were considered novices. Individual interviews were conducted with each informant. All interviews were audiotaped with the exception of one. The interviews, observations, and field notes were analyzed for data. The analysis of data rendered 6 themes: (1) “la dieta,” (2) the location and fluidity of food (3) confidence-defiance self-management connection, (4) negotiating sociocultural and biomedical expectations, (5) eating for diabetes is a family affair, and (6) strategies for self-care. In addition, preliminary comparisons were conducted between experienced and more novice individuals with diabetes. / text

Antiretroviral therapy is an important public health strategy to reduce the risk of HIV vertical transmission. Implementation of such therapy depends on the identification of HIV-infected pregnant women. This study investigated how the biographical characteristics of the pregnant women (16-45 years) influenced their health decision-making in Bulawayo clinics. The study was guided by the theories of health behaviour. The study assumed that the respondents’ demographic characteristics will influence their attitudes towards PMTCT programme. Using a structured questionnaire, forty pregnant women who visited the Bulawayo clinics to have prenatal checkups were interviewed. The majority of respondents came from a poor, high-density township. Most of the respondents were married, but about a third were not married at the time data collection and 5% were separated. The survey items were demographic characteristics, knowledge of PMTCT, HIV risk perceptions and service utilisation. The levels of literacy among the respondents were high; more than 80% had completed primary education. Overall the respondents’ demographic characteristics influenced their attitudes towards PMTCT. Majority of the women knew that a mother with HIV can pass the virus to her child, during pregnancy, delivery and breastfeeding. The pregnant women’s health-seeking behaviour and their attitudes toward reproductive health services are influenced by their demographic situation. / Health Studies / (M.A. (Social Behavior Studies in HIV/AIDS))

Diseases of Women, Book I, is part of the Hippocratic Corpus of approximately seventy treatises, although different authors contributed to the writings, as is evident by slight changes in text. It is the first of three works by Hippocrates on gynaecological problems. Fifth century BC doctors did not dissect either humans or animals, so their theories were based purely on observation and experience. Book I deals with women who have problems with menstruation, either the lack of it or an excess, infertility and, when conception does take place, the threat of miscarriage and dealing with the stillborn child. Various remedies are given, including herbal infusions, vapour baths and mixtures that the modern day patient would shudder at, e.g. animal dung and headless, wingless beetles. One remedy, hypericum, or St John's Wort, used for depression, has become popular today as an alternative medicine. / Old Testament and Ancient Near Eastern Studies / M.A. (with specialisation in Ancient Languages and Cultures)

The purpose of this study was to analyse and describe the factors that influence the choice of site of delivery by pregnant women in Mukono district. By employing quantitative, non experimental research methods, 431 women were interviewed by using structured questionnaires. These women had either delivered at; home, TBA, private or public clinic and 72% had been delivered by skilled attendants. Choice of delivery site was influenced by the attitudes of health workers which were rather poor in public sites, proximity of site, attendance of antenatal clinic at a site, availability of supplies and drugs, plus level of care including emergency obstetric care. / Health Studies / M. A. (Public Health)

Young women working in SMEs are increasingly being affected by HIV and AIDS, and SMEs are expected to respond to HIV and AIDS through workplace policies and programmes. This requires commitment from SMEs to help young women who face various gendered vulnerabilities to HIV and AIDs. The study, whose purpose was to investigate young women workers’ experiences of the HIV and AIDS response of small and medium enterprises in a semi urban area in KwaZulu-Natal, used a qualitative approach and collected data from three SMEs in Pietermaritzburg during the period of the study. Findings of the study indicate that the majority of respondents from all three SMEs agree on experiencing limited or no HIV and AIDS policies and programmes in SMEs. With reference to incomplete or limited responses, two SMEs provide financial assistance for funerals. However, some aspects such as education and awareness, monitoring, management commitment, provision of medical aid, facilitation of peer education, appointment of an HIV officer and more were not evident. Thus recommendations were made on how SMEs should respond, and future research ideas were outlined. / Health Studies / M. A. (Social Behaviour Studies in HIV/AIDS)

Thesis (M Sport Sc)--Stellenbosch University, 2007. / ENGLISH ABSTRACT: Global aging is occurring at an unprecedented rate. South Africa has the highest proportion of older adults in Southern Africa, with nearly 7% of the population over the age of 60 years in 1997. However, although people are living longer, statistics show that they are not necessarily living healthier. The majority of women who outlive men have to deal with more chronic diseases as well as a poorer functional status than the latter. The purpose of the present study was to implement a movement competence programme suited to the needs of South African older adult women; requiring inexpensive apparatus and that can be performed in any environment. A time-series design was used which included follow up testing 9 months after the cessation of the movement competence programme. The intervention group consisted out of 21 (76.14±5.44 years) older adult women, who were randomly selected from a retirement village. The movement competence programme was broad based in nature and was performed in two one hourly sessions a week for 12 weeks. After pre-tests of functional capacity, selfperception and resilience, the older adult women were tested using the Physical Self-Perception Profile (Fox & Corbin, 1989) and the Resilience Scale (Connor & Davidson, 2003) respectively. Significant improvements (p<0.05) were observed in the Berg Balance Scale, 8-Foot Up-and-Go and the Physical Self-Perception’s results of the older adult women. No significant (p>0.05) difference was noted in the Barthel Index and Resilience Scale after the 12-week movement competence programme. Follow up testing indicated a significant improvement in the resilience of the older adult women who continued to exercise, compared to those that chose a sedentary lifestyle after the movement competence programme. / AFRIKAANSE OPSOMMING: Globale veroudering vind teen ’n ongekende tempo plaas. Suid-Afrika beskik oor die hoogste verhouding ouer volwassenes in Suidelike Afrika met amper 7% van die populasie in 1997 ouer as 60 jaar. Hoewel mense egter langer lewe toon statistiek dat hulle nie noodwendig gesonder lewe nie. Die meerderheid dames wat langer lewe as mans het te kampe met meer chroniese siektes asook ’n swakker funksionele status as dié van laasgenoemde. Die doel van die huidige studie was om ’n bewegingsbevoegdheidsprogram te implementeer wat aan die behoeftes van ouer Suid-Afrikaanse volwasse dames voldoen, waar goedkoop toerusting benodig word en in enige omgewing uitgevoer kan word. ’n “time-series” ontwerp was gebruik wat opvolgtoetse ingesluit het nege maande ná die beëindiging van die bewegingsbevoegdheidsprogram. Die intervensiegroep het bestaan uit 21 (76.14±5.44 jaar) ouer volwasse dames wat lukraak geselekteer is by ’n aftree-oord. Die bewegingsbevoegdheidsprogram was breed in fokus en was uitgevoer in twee eenuurlikse sessies per week vir 12 weke. Ná voortoetse oor funksionele kapasiteit, selfpersepsie en veerkrag, is die ouer volwasse dames getoets deur respektiewelik gebruik te maak van die Fisieke Selfpersepsie Profiel (Fox & Corbin, 1989) en die Veerkragskaal (Connor & Davidson, 2003). Beduidende verbeterings (p<0.05) van die ouer volwasse dames is waargeneem in die Berg Balansskaal, “8-Foot Up-and-Go” en die resultate op die Fisieke Selfpersepsie. Geen beduidende (p>0.05) verskil is waargeneem in die Barthel Indeks en Veerkragskaal ná die 12 weke aanbieding van die bewegingsbevoegdheidsprogram nie. Opvolgtoetse het ’n beduidende verbetering aangedui in die veerkrag van die ouer volwasse dames wat aangehou het met oefening in teenstelling met dié wat gekies het om ’n sedentêre leefstyl te volg nadat die bewegingsbevoegdheidsprogram voltooi is.

Although eating disorders have been the focus of much research, the inclusion of minority populations has been minimal. A recent review of the literature by Dolan (1991) has found that eating disorders were most likely to be present in non-White women who were exposed to Western societies and cultures. Thus, the purpose of this study was to examine personality, physical, and cultural correlates of bulimic symptomatology in a sample of African American college women. The Bulimia Test Revised (BULIT-R) was used to assess bulimia symptoms. The African American Acculturation Scale (AAAS), the Beliefs about Attractiveness Scale Revised (BAAR factors 1 and 2), the Rosenberg Self-Esteem Scale (SES), the Centers for Epidemiological Depression Scale (CES-D), Body Parts Satisfaction Scale (BPSS), and body mass were the independent variables hypothesized to predict bulimic symptoms. Hierarchical regression analysis revealed that body mass, depression, and low self-esteem were the best predictors of bulimic symptomatology, together accounting for 38% of the variance. Beliefs about attractiveness and body satisfaction were related to bulimic symptoms but not when considered simultaneously with the other variables. Acculturation was not predictive of bulimic symptoms. 0-ordered correlations revealed that beliefs about attractiveness and body satisfaction were correlated with bulimic symptoms. Acculturation was not related to any variables except depression. Implications for counseling interventions as well as directions for future research are discussed.

Introduction: Evidences indicate that human immuno-deficiency virus (HIV) and diabetes (DM) impact pregnancy outcomes but no experience on the integrated service delivery of HIV, DM and pregnancy care. This study explored the domains and levels of integration among DM, HIV and pregnancy care to prepare a service delivery model in Ethiopia. Methods: A sequential exploratory mixed method and the integration theoretical framework guided the study. An exploratory qualitative phase used focused group discussion, in-depth interview and observation to explore the level of integration and to refine a questionnaire for the quantitative phase. The data were transcribed and coded for theme-based analysis. The descriptive quantitative phase described HIV, DM and pregnancy care services, and determined the burden of DM among HIV patients and the prevalence of pregnancy and pregnancy outcomes. Data was analysed using Epi-info. The findings were triangulated, discussed and interpreted. Results: Seven themes were generated: joint plan, shared budget, monitoring system, structural location, the need of policy guide, the practice of integrated service delivery and suggested integration approaches. A coordinated HIV and pregnancy care services were noted. There was a linkage between diabetes and HIV, and diabetes and pregnancy care. The 1.5% of diabetes among HIV, the low number of pregnancies per a mother in diabetes (1.8) and HIV (1.3); the high adverse pregnancy outcomes among HIV (13.4% abortion, 12.4% low birth weight (LBW), 3.5% pre-term birth, 2.1% congenital malformation) and diabetes (3.2% big baby, 3.2% LBW, 3.1% Cesarean-section); the respective absent and low (16.2%) diabetes screening service at anti-natal and HIV clinics, the absent pregnancy care service for diabetic females justified the development of the tripartite integrated service delivery model of diabetes, HIV and pregnancy care. Conclusions: The model suggests active diabetes screening, evaluation and treatment at HIV and antenatal clinics. It considers the coordination between non-communicable diseases (NCD), HIV and maternal health units. Pregnancy care could be coordinated at HIV and NCD units. Full integration can be practiced between HIV and pregnancy care units. Preparing policy guide, building the capacity of health providers, advocating and piloting the model may be prioritized before the implementation of the model. / Health Studies / D. Litt. et Phil. (Health Studies)

Jordan has a higher fertility rate (3.8) than the averages of countries similar in income to Jordan (2.2) and compared to the Middle East and North Africa region as a whole (2.8) (WHO, WB, UNICEF, & DHS, 2011). The findings of the 2009 Jordanian Population and Family Health Survey demonstrated that the total fertility rate (TFR) has stopped declining in the country since 2002 (DOS, 2010b; USAID, 2010). The prevalence of contraceptive use has also shown little change in Jordan over the last decade (DOS, 2010b; USAID, 2010). Given that contraception is one of the proximate determinants of fertility (Rahayu et al., 2009), the main purpose of this study was to investigate which factors are contributing to women's current contraceptive behavior and intention for future contraceptive use. Research questions were developed in a comprehensive framework that considers women's intention and actual behavior as outcomes of various interactive factors within a socio-cultural context. In particular, the study's framework was directed by a theoretical basis adapted from Ajzen and Fishbein's Theory of Reasoned Action (TRA) and an extensive review of the available literature in the research area. Obviously, the social set-up and cultural norms in the study setting, together with attitudes toward children and family, represent a traditional scenario that could help explain the consistency of fertility and contraceptive use in the country. Further, the influences of background characteristics on women's contraceptive behaviors and intentions provide another scenario that could help assess the current situation of family planning (FP) in Jordan. In this study, demographic factors, spousal communication variables and healthcare system-related factors are all defined as background characteristics. Attitudes and social norms reflect the women's behavioral determinants and represent the main constructs of the TRA. In fact, involving a set of factors related to women's beliefs and social norms in the study's framework provided an opportunity to explore how these factors might promote or inhibit a woman's intentions and behaviors in respect to contraceptive use. In a three-manuscript format, this research was designed to achieve a number of objectives. The first manuscript aimed at identifying the major factors associated with the current use of contraception among women of childbearing age in northern Jordan. The second manuscript focused on investigating the main factors that are associated with women's contraceptive method preference (e.g. the choice of modern contraceptives as effective methods in preventing pregnancy versus the choice of traditional contraceptives as methods with high failure rates). The third manuscript attempted to explore the key factors associated with women's intention for future contraceptive use since the existence of such an intention would consequently translate into an actual behavior later. In 2010, original cross-section data were collected by means of a face-to-face interview using a structured pre-tested survey. The study sample included women who were currently married and were between 18 and 49 years old. Applying a systematic random sampling procedure, all respondents were recruited from the waiting rooms of five randomly selected Maternal and Child Health (MCH) centers in the Governorate of Irbid, northern Jordan. Using a list provided by the Ministry of Health, all centers in the Governorate were stratified according to the region (urban vs. rural) and randomly selected in proportion to their number in each region. The final sample size for this research consisted of 536 women surveyed, giving a response rate of 92.4 percent. Utilizing logistic regression analyses, the results of the dissertation manuscripts indicate that women's behaviors and intentions toward the use of contraception are affected by a number of factors at the individual, familial and institutional levels. The findings that emerged from the three manuscripts provide health professionals and policy makers with important information to assist in the design of FP programs and campaigns aimed at increasing current contraceptive use, enhancing the adoption of modern contraception and motivating the intention for future contraceptive use. This research strongly suggests that health professionals develop health policies that both expand the availability of MCH centers and strengthen the role of healthcare providers to dispel the numerous rumors and misconceptions surrounding the use of contraceptives, particularly modern ones. Health workers at the MCH centers need to ensure that women have sufficient information about the benefits and side effects of different types of contraception by offering proper FP counseling. The messages that religious leaders can use in advocating for FP would also help make contraceptive use socially acceptable since their opinions are often followed by the majority. This would be a key step toward removing the barriers to contraceptive use. Moreover, to design effective FP interventions, planners should take into account women's attitudes toward the use of contraceptive methods and the components of those attitudes (e.g. women's approval of contraceptive use for birth spacing and perceptions regarding the value of large family sizes and the importance of having male children in Jordanian families). / Graduation date: 2012 / Access restricted to the OSU Community at author's request from May 9, 2012 - May 9, 2013

Text in English / In order to address the paucity of knowledge in regard to the psychological and physiological processes associated with lifelong weight loss (>20 years), this study adopts a qualitative approach informed by phenomenology to explore the experience of lifelong weight loss and maintenance of women who participated in the ITAND Programme. The research questions guiding the exploration of the current research are: (i) Which strategies from the ITAND Programme do women perceive as assisting with initial weight loss? (ii) What are the processes mediating lifelong weight loss? (iii) What strategies and skills mediate the maintenance of lifelong weight loss? (iv) What feelings or beliefs motivate women to continue attempts to lose weight after experiencing multiple failures on diets? and (v) Which psychological, cognitive and behavioural processes are identified as mediating lifelong weight loss? Eight overweight and obese women were invited to write their narratives and engage in interviews in regard to exploring their relationships with food, their bodies and their weight, after a period of more than 20 years following their participation in an integrative, transactional analysis, anti-diet programme (the ITAND Programme). Narratives were used to explore their beliefs about constructs, processes and strategies mediating long-term weight loss maintenance. The participants’ narratives and interviews were analysed through applying narrative analysis and interpretive phenomenological analysis. In addition to a non-diet paradigm, four processes definingweight loss maintenance were identified, including the adult learning process of transformative learning, the psychological process of transactional analysis, the physiological process of intuitive eating and the cognitive-behavioural processes relating to weight loss maintenance. This study contributes an integrative, transactional analysis, non-diet treatment model (ITAND model) which is enabled by the processes of transformative learning, intuitive eating and cognitive-behaviour modification to the successful long- term treatment of overweight and obesity. This model may be applied in whole or in part in a primary health care or community context. The findings of this study may be used to inform future research into the development and implementation of non-diet weight loss maintenance interventions in the treatment of overweight andobesity. / Psychology / D.Litt. et Phil. (Psychology)