M.Tech. (Homoeopathy) / Stress urinary incontinence (SUI) is the involuntary loss of urine when sudden, external forces cause a brief increase in intra-abdominal pressure during stress events such as coughing, sneezing, laughing, bending, lifting, or exercise (ICS, 2013).SUI is a subcategory of urinary incontinence (UI) and affects middle aged women predominantly due to weakened support of the bladder by the pelvic floor and surrounding structures (Beji et al 2010). Damage to the pelvic floor and pelvic structures can cause the bladder and bladder neck to move or bend into problematic positions which adds unnecessary placement of external pressures on the bladder and in turn urine loss occurs (Badlani et al., 2009). The treatments available for treating SUI is behavioural changes, pelvic floor muscle rehabilitation or invasive surgeries. Pharmacological treatment options available for incontinence focus more on different subcategories of UI and has little effect on treating SUI directly and due to various side effects of these medications many patients avoid taking it (Shamilyan et al., 2012). There is currently no known effective treatment for SUI (ICS, 2013). SUI is the loss of small amounts or a few drops of urine at a time (Beers et al., 2006). Although the symptoms of this condition may not be life threatening it can interfere with the quality of life in those who suffer from loss of bladder control (Cheung et al., 2012). The negative effects can be seen in all areas physical activities, social activities, relationship strain and even emotional status of the patient (De Ridder et al, 2013). Many women report having SUI for several years and have learned to live with the incidents and use preventative methods when severity of SUI episodes worsen (Peterson, 2008). Additionally the symptom can be distressing on a physical level and consistent SUI episodes may cause recurrent urinary tract infections, irritation, pain and discomfort of the lower urinary tract (Beers et al., 2006). The aim of this study was to determine the efficacy of the homoeopathic remedy Causticum 30cH on SUI episodes experienced by women by means of using a voiding diary and validated quality of life questionnaires. This was a five week double blind, placebo-controlled study, using forty female participants between the ages of 30-65 years old, and was conducted at a homoeopathic practice in Alberton, Johannesburg (Appendix B) under the supervision of a qualified homoeopath. There were three consultations, at the first consultation the study was explained and a full history taking and focused physical examination was conducted which included vital signs and a midstream urine dipstick test (Appendix E) to rule out any UTI. Participants were required to complete the QOLQ IIQ-7 SF (Appendix F) and the UDI-6 SF (Appendix G) (Uebersax et al., 1995). iii The first week no remedy was given (baseline week) and was followed by a four week treatment period. Participants had to complete a 7-day voiding diary (Appendix H) to evaluate symptom frequency for the duration of the study at home and were collected at the follow-up consultation after week three and week five. Participants were requested to complete the QOLQ IIQ-7 SF (Appendix F) and UDI-6 SF (Appendix G) (Uebersax et al., 1995) during the follow up consultations. Nocturnal voiding was also recorded on the voiding diaries. After week one the voiding diaries were collected and the participants were asked to select a remedy thereby, randomly allocating herself to either the experimental group or the control group. Data was collected and was analysed by STATKON. Frequencies, descriptives and crosstabulations were done for the demographic information between groups. Non-parametric test were utilized for the analysis because the sample size was small. The inter-group data analysis was performed using the Mann-Whitney test to compare between the groups. Comparisons over time for each group were assessed using the Friedman test, and a Wilcoxon Signed Ranks test was done to ascertain where in time the differences had occurred. The Bonferrani adjustment/correction test is a post-hoc test and was done after the Wilcoxon Signed Ranks test which is an adjustment to the original p value and a re-evaluation of p value of the comparisons (Becker, 2013)...

A research report submitted to the faculty of the Humanities at the University of Witwatersrand in partial fulfilment of the degree of Master of Arts in Demography and Population Studies, June 2017 / Background An estimated 2,000 women in Zambia suffer from obstetric fistula. Suggestions are that more women could be suffering from the same condition but do not report it due to fear of stigmatization. Incidences of obstetric fistula in Zambia may indicate that most pregnant women do not access the much-needed maternal health services, especially at the time of delivery. Therefore, understanding the factors that lead to obstetric fistula is vital for developing primary preventive interventions. This study estimated the prevalence and investigated the factors associated with obstetric fistula among women in Zambia. Methodology The study used data from the 2013-14 Zambia Demographic and Healthy Survey (ZDHS). A sample of 16,411 women aged 15-49 years old took part in the fistula module of the ZDHS. Descriptive and Complementary log-log regression model were conducted to assess the relationship between the covariates and obstetric fistula. Results The prevalence of obstetric fistula was estimated at 5.91 obstetric fistulas per 1000 women of reproductive ages. Age at first sex (AOR=0.86, CI: 0.77-0.97) and being in households of rich wealth status (AOR=0.36, CI: 0.14-0.79) were negatively associated with obstetric fistula. Conclusion Evidence suggest that in order to eradicate obstetric fistula in Zambia, there is need to implement interventions that will focus on improving the socioeconomic, health status, reproductive status, access to health care and use of healthcare resources of women. / XL2018

Abstract Background In sub-Saharan Africa, malaria is the leading cause of morbidity and mortality. An estimated 15 million malaria cases and 40 000 malaria deaths were reported in Kenya. Malaria during pregnancy is associated with adverse health outcomes for both the mother as well as her foetus. The purpose of this study was to examine the relationship between socioeconomic correlates and the uptake of malaria prevention methods during pregnancy. Methodology: Data was drawn from the 2008-2009 Kenya Demographic and Health Survey. A total of 8098 women aged 15-49 were analysed. Stata version 12 was used for the management and analysis of data. Univariate, bivariate and multivariate analysis was carried out to meet the objectives of this study. Results: Forty-eight percent of women made use of Insecticide Treated Net (ITNs), 52 percent were administered with Intermittent Preventative Therapy (IPTp) and 36 percent made use of both measures during pregnancy. Multivariate results indicate that urban women were found to display slightly higher odds of ITN usage (1.13) and the combined usage of ITNs and IPTp (1.22) during pregnancy in comparison to rural women. Women with higher levels of education and women from middle income and rich households displayed higher odds of the uptake of these malaria prevention methods during pregnancy. Conclusion: This study has shown that socioeconomic indicators influence the usage of malaria prevention methods during pregnancy. It is therefore imperative that these factors be considered when designing and implementing policies aimed at improving the uptake of these measures during pregnancy.

Background: Decades of research indicate that physical activity is an important behavior for health promotion and disease prevention. Despite dissemination of these research findings, many American adults are sedentary. The rates for sedentary behavior vary by race/ethnicity and gender. Women and adults from minority groups are most likely to be sedentary. Research on adults who are physically active has identified several factors that predispose, enable, and reinforce this behavior. The presence of social support is one such factor. Purpose: The purpose of this study was to identify the nature and extent of social influence on physical activity in a nationally-representative sample of minority women. Methods: A telephone survey of 2912 women ages 40 and older from various racial/ethnic groups was conducted from July 1996 to June 1997. Information on physical activity as well as other preventive health behaviors was collected. Analysis: Descriptive analyses were done on physical activity levels (including an accumulation of household and occupational physical activity), physical activity-related social support (PASS), support network, and measures of social contact. Logistic regression was used to determine differences in PASS levels and physical activity. Linear Regression was used to determine the relationship between social influence and physical activity level. Results: Women with high levels of physical activity- related social support were more likely to meet recommended levels of physical activity. There was no difference by racial/ethnic group. An index of social influence was not a significant predictor or physical activity level among all women in the sample. Conclusion: While women with higher levels of specific support for physical activity were more likely to be physically active, a more general measure of social support did not predict level of physical activity. More research is needed in assessment of both physical activity and social support in this population. / Graduation date: 1999

Given the high risk of relapse during the first year of exercise involvement, it is important to determine the processes of self-motivation which enable novice exercisers to become long-term maintainers. This study was designed to extend previous Stages of Change (Prochaska & DiClemente, 1983) research by comparing the Possible Selves (Markus & Nurius, 1986) of individuals at different points within the Maintenance stage of exercise. Participants consisted of female university employees, spouses, and dependents age 35-59 years who volunteered for the study. Participants completed the Stage of Exercise Scale (SOES; Cardinal, 1995) and a self-administered form of the Possible Selves Inventory (Cross & Markus, 1991) which was adapted to address the exercise domain. Women classified by the SOES as being in the Maintenance stage of exercise V=92) were assigned to one of three groups based on the duration of their exercise maintenance (6 months-5 years, 6-10 years, and 11-20 years). The three maintenance groups were compared with regard to the number and category of open-ended and exercise-related possible selves and the self-efficacy and outcome expectancy associated with three focused selves (most important, exercise-related, and exercise-specific). The results indicated that the three maintenance groups did not differ significantly in their possible selves. These findings provide support for the current conceptualization of the Stages of Change Model (Prochaska & Di Clemente, 1983) and suggest that differences between novice and expert maintainers may be behavioral, rather than cognitive, in nature. Several implications for intervention design and suggestions for future research are discussed. / Graduation date: 1998

The purpose of this investigation was to determine the validity and reliability of the Nicholas Manual Muscle Tester (NMMT), a portable dynamometer, as a measure of the isometric strength in women with arthritis. Female subjects (N=13; 66 �� 13.89 yrs.) with arthritis were tested for isometric muscle strength on the shoulder and hip (abduction, adduction, flexion, extension). Subjects were tested on three separate days using NMMT and Kincom 500-H dynamometers. Each subject performed three maximal isometric contractions for each joint action. A visual analog pain scale was used to determine level of pain prior to testing. Reliability values based on intraclass correlations coefficients (R) ranged from .85 to .93., with the exception of shoulder abduction being .49. Validity was determined correlating the mean value of the NMMT score with corresponding Kincom isometric measure. Pearson product moment correlations ranged from (r) .02 to .86, with 4 of 8 values meeting .05 level of significance. Correlation coefficients for pain and isometric force values were inconclusive and ranged from -.305 to .218. Major conclusions were: a) NMMT had high test-retest reliability in this sample; b) NMMT provides little criterion evidence of validity with the Kincom for most movements of hip and shoulder; c) level of pain was not a significant factor in subject reliability. / Graduation date: 1995

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Thirty-seven overweight/obese (BMI: 25-35 kg/m2), premenopausal women that were randomly assigned to either an ad libitum low-carbohydrate (LC) (20% CHO, 30-40% protein, 30-40% fat), or an ad libitum low-fat (LF) (55-60% CHO, 15-20% protein, 20-25% fat) diet.All subjects were given weekly menus matching their assigned macronutrient requirements to aid in meal planning and dietary compliance. Baseline and post-diet measures included height, weight, body composition (DXA), blood lipids [total cholesterol (TC), HDL, LDL, and triglycerides (TG)], and plasma insulin levels. There were no significant group differences in any of the above-listed variables prior to the study. Nineteen women completed the 6-wk study (LC=11, LF=8). Compliance to the diets was adequate as indicated by weekly 24-hr recalls and daily urinary ketone levels. Both groups lost a significant amount of weight and body flat, (P<0.05); and weight and body fat losses were not significantly different between the groups. All groups experienced similar decreases in TG, TC, LDL, HDL, and insulin levels. These results indicate a LC diet is no more effective than a LF diet in promoting favorable changes in body weight, body composition, blood lipids and insulin levels. / Department of Family and Consumer Sciences