Background: Group B streptococcus (GBS) is regarded as one of the most important causes of maternal and neonatal morbidity and mortality in many parts of the world. GBS recto-vaginal colonization is important in the health of a mother and her neonate, especially in developing countries. Maternal vaginal colonization with GBS at the time of delivery can cause vertical transmission to the neonate. Multilocus sequence typing (MLST) is a technique used to characterize microbial isolates by means of sequencing internal fragments of housekeeping genes and has the advantage of reproducibility and has been shown to correlate with the other typing techniques and thus has emerged as the standard for delineating the clonal population of GBS. The study aimed to investigate the epidemiology of GBS colonization among pregnant women and their neonates, and to characterize the isolates by multilocus sequence typing technique at Dr George Mukhari Academic Hospital, Pretoria. Methodology: A total of 413 pregnant women who visited the antenatal clinic were recruited and screened. Participants were interviewed using a questionnaire to gather demographic and other relevant information such as history of current pregnancy, previous miscarriages and still births. Samples from maternal rectum and vagina as well as neonate ear and umbilical cord were taken for culture using colistin and nalidixic acid (CNA) blood agar and incubated for 24-48 hours. If negative after 48 hours, Todd-Hewitt broth was subcultured after 18-48 hours onto sheep blood agar. Multilocus sequence typing (MLST) was used to characterize seven group B streptococcus isolates collected at Dr George Mukhari academic hospital. Fragments of seven housekeeping genes were amplified by polymerase chain reaction (PCR) for each strain and sequenced. CLC bio software (Inqaba biotech, South Africa; Pretoria) was used to analyse sequenced loci and UPGMA dendrogram was constructed. Results: The colonization rate for GBS in pregnant women and their neonates was 30.9% and 0%, respectively. A higher proportion of GBS were isolated from the rectum (37.9%) as compared to the vagina (20.6%). Most socio-economic, demographic and obstetric factors analysed were not significantly associated with.GBS colonization. On 128 positive samples, the results of Todd-Hewitt enrichment broth and direct plating method using CNA were compared. A total of 45.3% of colonised were positive on direct selective agar (CNA); an additional 54.7% samples were recovered from Todd-Hewitt broth. Three genes (adhP, glnA and tkt) were sequenced successfully for six samples (1, 2. 4,6,12 and 65). The UPGMA tree with 1000 bootstrap showing the relationship between six samples was drawn.Conclusion: This study revealed that pregnant women of all ages are at risk of group B streptococcus colonization. Group B streptococcus was common among pregnant women at Dr George Mukhari Academic Hospital. No socio-economic risk factor was associated with group B streptococcus colonization. Results confirm that the combination of Todd-Hewitt broth and CNA agar plate is a time saving and sensitive method. The allelic profile, characteristics such as G+C (guanine+cytosine) content and dN/dS ratio were not analysed because of the smaller sample size used in this study, which shows that the MLST method was unsuccessful in this study. The UPGMA tree based on differences in consensus of the isolates showed that all group B streptococcus isolates are clustered and descend from a single node. / Life Sciences / M.Sc. (Life Sciences)

Indiana University-Purdue University Indianapolis (IUPUI) / Gender differences in the basal function of autonomic cardiovascular control are well documented. Consistent baroreflex (BRx) studies suggest that women have higher tonic parasympathetic cardiac activation compared to men. Later in life and concomitant with menopause, a significant reduction in the capacity of the BRx in females increases their risk to develop hypertension, even exceeding that of age-matched males. Loss of sex hormones is but one factor. In female rats, we previously identified a distinct myelinated baroreceptor (BR) neuronal phenotype termed Ah-type, which exhibits functional dynamics and ionic currents that are a mix of those observed in barosensory afferents functionally identified as myelinated A-type or unmyelinated C-type. Interestingly, Ah-type afferents constitute nearly 50% of the total population of myelinated aortic BR in female but less than 2% in male rat. We hypothesized that an afferent basis for sexual dimorphism in BRx function exists. Specifically, we investigated the potential functional impact Ah-type afferents have upon the aortic BRx and what changes, if any, loss of sex hormones through ovariectomy brings upon such functions. We assessed electrophysiological and reflexogenic differences associated with the left aortic depressor nerve (ADN) from adult male, female, and ovariectomized female (OVX) Sprague-Dawley rats. Our results revealed sexually dimorphic conduction velocity (CV) profiles. A distinct, slower myelinated fiber volley was apparent in compound action potential (CAP) recordings from female aortic BR fibers, with an amplitude and CV not observed in males. Subsequent BRx studies demonstrated that females exhibited significantly greater BRx responses compared to males at myelinated-specific intensities. Ovariectomy induced an increased overall temporal dispersion in the CAP of OVX females that may have contributed to their attenuated BRx responses. Interestingly, the most significant changes in depressor dynamics occurred at electrical thresholds and frequencies most closely aligned with Ah-type BR fibers. Collectively, we provide evidence that, in females, two anatomically distinct myelinated afferent pathways contribute to the integrated BRx function, whereas in males only one exists. These functional differences may partly account for the enhanced control of blood pressure in females. Furthermore, Ah-type afferents may provide a neuromodulatory pathway uniquely associated with the hormonal regulation of BRx function.

Socio-cultural factors oppress and construct women as men’s objects of desire and pleasure, thus increasing women’s vulnerability to HIV infection and, subsequently, maintaining the HIV and AIDS epidemic and prevalence in South Africa’s rural areas. South Africa’s rural women and their sexuality has not received adequate attention to date. This qualitative study sought to explore rural women’s perceptions on their sexuality and HIV prevention within the socio-cultural context of Schoemansdal (South Africa). A sample of ten participants, who are women from the Swazi ethnic group between the ages of twenty and fifty, were purposefully drawn to participate in this study. Data were collected by means of tape–recorded, face-to-face interviews and focus group discussions. Results of the study reveal that women’s social and cultural contexts have an influence on their perceptions of sexuality and HIV prevention, and that this poses a hindrance to women’s HIV-prevention behaviours such as condom use. The study’s findings reveal that in examining HIV infection and prevention, women’s diverse contexts and experiences cannot continue to be overlooked. This is because they may provide relevant understanding of the epidemic that is plaguing South Africa’s rural women. / An explorative study of rural women's perceptions of sexuality and HIV prevention in their local socio-cultural context : a case study of rural Schoemansdal, Mpumalanga / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

Includes bibliographical references (leaves 103-113) / The advent of HIV and AIDS has had a negative impact on the Catholic, Anglican and Methodist churches (as well as others) in Manicaland, Zimbabwe. This was due to the difficulty of accepting the reality of this pandemic. This happened because the disease came with unbearable psycho-social suffering rooted in stigmatisation and discrimination, especially among women, who were the most vulnerable group. This study critically examines and exposes the effects of HIV and AIDS on Manyika women. The researcher argues that, on the one hand, some religious and cultural practices contributed to the spread of the HIV and AIDS infection. On the other hand, some of these practices discouraged the spread of HIV and AIDS pandemic and needed to be enhanced. Furthermore, even if churches are involved in the battle against HIV, their efforts are hindered by cultural practices such as the Manyikas’ unwillingness to discuss taboo issues such as sex and gender in public. This makes women vulnerable. In addition, the problem has been complicated by the fact that the issue of sexuality is not openly discussed in the churches. Using qualitative methods, the researcher conducted interviews with Catholics and found that there is a need to continually engage with these communities. Their lived experiences can be used to bring about their liberation and improve their capacity to deal with their situation. The argument of this study is that there is an urgent need to liberate and empower women in the era of HIV and AIDS. The journey that has already been started by the Circle of Concerned African Women Theologians (“the Circle”) could assist in the liberation of women to deal with the HIV and AIDS pandemic. In addition, this can build on Catholic Church HIV and AIDS interventions among the Manyika people of Zimbabwe as a premise of that process of liberation. / Philosophy, Practical and Systematic Theology / D. Phil. (Theology)

Socio-cultural factors oppress and construct women as men’s objects of desire and pleasure, thus increasing women’s vulnerability to HIV infection and, subsequently, maintaining the HIV and AIDS epidemic and prevalence in South Africa’s rural areas. South Africa’s rural women and their sexuality has not received adequate attention to date. This qualitative study sought to explore rural women’s perceptions on their sexuality and HIV prevention within the socio-cultural context of Schoemansdal (South Africa). A sample of ten participants, who are women from the Swazi ethnic group between the ages of twenty and fifty, were purposefully drawn to participate in this study. Data were collected by means of tape–recorded, face-to-face interviews and focus group discussions. Results of the study reveal that women’s social and cultural contexts have an influence on their perceptions of sexuality and HIV prevention, and that this poses a hindrance to women’s HIV-prevention behaviours such as condom use. The study’s findings reveal that in examining HIV infection and prevention, women’s diverse contexts and experiences cannot continue to be overlooked. This is because they may provide relevant understanding of the epidemic that is plaguing South Africa’s rural women. / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

Indiana University-Purdue University Indianapolis (IUPUI) / While the majority of chronic pain patients report receiving inadequate care, there is evidence that female and Black patients receive less analgesic medications and treatment for their chronic pain compared to male and White patients, respectively. While treatment disparities have been evidenced in the literature, there is little understanding of provider-factors, such as their decision-making awareness and attitudes, which may contribute to the differences in treatment. This investigation employed quantitative and qualitative procedures to examine the relationship between patient demographics and chronic pain treatment variability, providers’ awareness of these non-medical influences on their decisions, and the extent to which providers’ gender and racial attitudes associate with their treatment decisions. Twenty healthcare trainees made pain treatment decisions (opioid, antidepressant, physical therapy, pain specialty referral) for 16 computer-simulated patients presenting with chronic low back pain; patient sex and race were manipulated across vignettes. Participants then selected among 9 factors, including patient demographics, to indicate which factors influenced their treatment decisions for the simulated patients and completed gender and racial attitude measures. After online study completion, follow-up semi-structured interviews were conducted to discuss the medical/non-medical factors that influence trainees’ clinical treatment decisions. Quantitative analysis indicated that 5%-25% of trainees were actually influenced (p<0.10) by patient sex and race in their treatments, and on the whole, trainees gave higher antidepressant ratings to White than Black patients (p<.05). Fifty-five percent demonstrated concordance, or awareness, between their actual and reported use of patient demographics. Follow-up McNemar’s test indicated trainees were generally aware of the influence of demographics on their decisions. Overall, gender and racial attitudes did not associate with trainees’ treatment decisions, except trainees’ complementary stereotypes about Black individuals were positively associated with their opioid decisions for White patients. During qualitative interviews, aware and unaware trainees discussed similar themes related to sex and racial/ethnic differences in pain presentation and tailoring treatments. We found that (1) a subset of trainees were influenced by patient sex and race when making chronic pain treatment decisions, (2) trainees were generally aware of the influence of patient demographics, and (3) trainees discussed differences in pain presentation based on patients’ sex and ethnic origin. These findings suggest trainees’ are influenced by patient demographics and hold stereotypes about patient populations, which may play a role in their decision-making.

The purpose of this study was to explore and describe contributing factors that influence the perceptions of women with fibroids from diverse cultures regarding hysterectomy. The area of research was delimited to issues of hysterectomy among women with fibroid uterus. The study employed a descriptive explorative method and data were collected by means of structured questionnaires. The study was conducted in one academic referral hospital, over a period of six months. The respondents were the patients with fibroid uterus and the doctors and nurses in the gynaecological units of the hospital. The majority of the patients indicated that they were afraid of undergoing a hysterectomy because of the social stigma associated with this life-saving procedure, such as alienation or marginalization by members of their respective communities. The nursing staff and gynaecologists in the unit emphasized the deep-seated fear of hysterectomy amongst women from diverse cultures. The study found that women need information about their bodies and how they function. Health education is also needed for women and their communities. Research is needed amongst members of different communities and diverse cultures to voice their perceptions of women undergoing hysterectomy because of ill health. / Health Studies / M.A. (Health studies)

The purpose of this study was to explore and describe contributing factors that influence the perceptions of women with fibroids from diverse cultures regarding hysterectomy. The area of research was delimited to issues of hysterectomy among women with fibroid uterus. The study employed a descriptive explorative method and data were collected by means of structured questionnaires. The study was conducted in one academic referral hospital, over a period of six months. The respondents were the patients with fibroid uterus and the doctors and nurses in the gynaecological units of the hospital. The majority of the patients indicated that they were afraid of undergoing a hysterectomy because of the social stigma associated with this life-saving procedure, such as alienation or marginalization by members of their respective communities. The nursing staff and gynaecologists in the unit emphasized the deep-seated fear of hysterectomy amongst women from diverse cultures. The study found that women need information about their bodies and how they function. Health education is also needed for women and their communities. Research is needed amongst members of different communities and diverse cultures to voice their perceptions of women undergoing hysterectomy because of ill health. / Health Studies / M.A. (Health studies)