By 2020, cancer mortality rates are estimated to increase by 180% in Arab countries, where breast cancer is the most common type of cancer. This thesis explores and evaluates the ‘asabiyya-driven structuration (the cohesive force of the group that gives it strength in facing its struggles for progressive reproduction) of cancer agents, government agents, and the World Health Organization agents for breast cancer prevention and early detection in the Arab region. The layers of the philosophical standing from Ibn Khaldûn’s concept of ‘asabiyya and the theoretical foundation of social systems theory, structuration theory, social network analysis, and social capital theory are peeled in order to explore and evaluate the context, constraints, social networks, autopoiesis, and social capital. Utilizing a qualitative research design, this thesis employs content analysis and in-depth interviews, as well as NVivo as a tool for analysis. Data is collected from 122 publications and knowledgeable informants employed by cancer agencies, ministries of health, and World Health Organization offices in Egypt, Jordan, Morocco, and Oman. The findings are divided into the contextual scope of responsibility and resources, the progressive and hierarchal constraining structure, the optimal and weak social networks, the strong and vulnerable shields of autopoiesis, and the presence and absence of social capital momentum, followed by a discussion on the the struggle for structuration against breast cancer. The findings demonstrate that countries with a national cancer control program witness local strengthening ‘asabiyya and ‘asabiyya-driven structuration, while those without a national cancer control program witness weakening local ‘asabiyya. Ultimately, this thesis proposes strategic recommendations to accelerate the regional ‘asabiyya-driven structuration of breast cancer.

By 2020, cancer mortality rates are estimated to increase by 180% in Arab countries, where breast cancer is the most common type of cancer. This thesis explores and evaluates the ‘asabiyya-driven structuration (the cohesive force of the group that gives it strength in facing its struggles for progressive reproduction) of cancer agents, government agents, and the World Health Organization agents for breast cancer prevention and early detection in the Arab region. The layers of the philosophical standing from Ibn Khaldûn’s concept of ‘asabiyya and the theoretical foundation of social systems theory, structuration theory, social network analysis, and social capital theory are peeled in order to explore and evaluate the context, constraints, social networks, autopoiesis, and social capital. Utilizing a qualitative research design, this thesis employs content analysis and in-depth interviews, as well as NVivo as a tool for analysis. Data is collected from 122 publications and knowledgeable informants employed by cancer agencies, ministries of health, and World Health Organization offices in Egypt, Jordan, Morocco, and Oman. The findings are divided into the contextual scope of responsibility and resources, the progressive and hierarchal constraining structure, the optimal and weak social networks, the strong and vulnerable shields of autopoiesis, and the presence and absence of social capital momentum, followed by a discussion on the the struggle for structuration against breast cancer. The findings demonstrate that countries with a national cancer control program witness local strengthening ‘asabiyya and ‘asabiyya-driven structuration, while those without a national cancer control program witness weakening local ‘asabiyya. Ultimately, this thesis proposes strategic recommendations to accelerate the regional ‘asabiyya-driven structuration of breast cancer.

Following the Second World War, the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) teamed up to construct an international Codex Alimentarius (or “food code”) in 1962. Inspired by the work of its European predecessor, the Codex Europaeus, these two UN agencies assembled teams of health professionals, government civil servants, medical and scientific experts to draft food standards. Once ratified, the standards were distributed to governments for voluntary adoption and implementation. By the mid-1990s, the World Trade Organization (WTO) identified the Codex as a key reference point for scientific food standards. The role of science within this highly political and economic organization poses interesting questions about the process of knowledge production and the scientific expertise underpinning the food standards. Standards were constructed and contested according to the Codex twin goals of: (1) protecting public health, and (2) facilitating trade. One recent criticism of Codex is that these two aims are opposed, or that one is given primacy over the other, which results in protectionism. Bearing these themes in mind, in this dissertation I examine the relationship between the scientific and the ‘social’ elements embodied by the Codex food standards since its inception after the Second World War. I argue that these attempts to reach scientific standards represent an example of coproduction– one in which the natural and social orders are produced alongside each other. What follows from this central claim is an attempt to characterize the pre-WTO years of the Codex through a case study approach. The narrative begins with a description of the predecessor regional group the Codex europaeus, and then proceeds to key areas affecting human health: 1) food additives, 2) food hygiene, and 3) pesticides residues.

<p>Kangaroo mother care (KMC) was first initiated in Colombia due to shortages of incubators and the incidence of severe hospital infections of new-born infants during hospital stay (Feldman, 2004). Currently it is identified by UNICEF as a universally available and biologically sound method of care for all new-borns, particularly for low birth weight infants (Department of Reproductive Health and Research, 2003) in both developed and developing countries. The Western Cape Provincial Government implemented a policy on KMC as part of their strategy to decrease the morbidity and mortality of premature infants in 2003 (Kangaroo Mother Care Provincial task team, 2003). Essential components of KMC are: skin-to-skin contact for 24 hours per day (or as great a part of the day as possible), exclusive breastfeeding and support to the motherinfant dyad. Successful implementation of KMC requires relevant education of nurses, education of mothers on KMC by nursing staff, monitoring of the implementation of KMC by nurses, planning for a staff mix with varying levels of skill and experience with KMC, the identification of institution specific barriers to the implementation of KMC, and the implementation of institution specific strategies to overcome these barriers (Wallin,et al., 2005 / Bergman &amp / Jurisco, 1994 / Cattaneo, et al., 1998). This study aims to determine the knowledge of and attitude towards kangaroo mother care, of nursing staff and kangaroo mothers in the Eastern sub-district of Cape Town.</p>

<p>This study attests to the fact that disability is an issue in conflict-affected populations, in particular refugees. Refugees with disabilities living in Mayukwayukwa refugee camp also have poor HRQOL similar to other studies. Education was the only variable significantly correlated to the psychological and social domains of the HRQOL. The study highlighted that environmental and personal variables played a role in the determination of health related quality of life among refugees with disabilities.</p>

Introduction: The epidemic of overweight and obesity both worldwide and in Canada is indicative of the need for proper growth monitoring beginning at birth. This study evaluated Family Physician’s (FP) Level of Use (LoU) of the recommended 2006 and 2007 World Health Organization (WHO) Growth Charts for monitoring their paediatric patients’ growth. It explored factors influencing LoU, utilizing the Diffusion of Innovations (DOI) theory and Ecological Framework for Effective Implementation (EFEI) as guiding models. FPs’ awareness of resources to support paediatric weight management was also assessed. Methods: A survey was distributed to FP in British Columbia (BC), Canada (N = 2853). The survey addressed provider and innovation characteristics, prevention delivery and support system factors, and barriers and facilitators to chart use. Correlations and multiple linear regression were used to determine correlates and predictors of LoU. Results: Sixty-two surveys were returned (2.2%). WHO Growth Chart LoU was 80.4%. Six variables significantly predicted LoU, including age (β = -.28, t = -3.15, p < .05), practicing in Fraser Health Authority region (β = -.24, t = -2.67, p < .05), assessing head circumference of birth to two year olds (β = .23, t = 2.45, p < .05), perceived growth chart accessibility (β = .39, t = 4.22, p < .05) and compatibility (β = .47, t = 5.27, p < .05), and innovativeness (β = -.37, t = -4.11, p < .05). These variables accounted for 69% of the variance in LoU. The most commonly identified barrier and facilitator to chart use was related to the Electronic Medical Record (EMR) system. FPs’ awareness of resources to support overweight paediatric patients was low. Conclusion: The majority of FP in BC in this sample had adopted the WHO Growth Charts. The results showed partial support for DOI theory and EFEI derived factors. Despite a small sample size, the findings highlighted the importance of installing the charts in the EMR systems, and can provide a foundation for future public health dissemination efforts and research on medical guideline implementation. / Graduate / 0573 / 0769 / erand@uvic.ca

Introduction: The epidemic of overweight and obesity both worldwide and in Canada is indicative of the need for proper growth monitoring beginning at birth. This study evaluated Family Physician’s (FP) Level of Use (LoU) of the recommended 2006 and 2007 World Health Organization (WHO) Growth Charts for monitoring their paediatric patients’ growth. It explored factors influencing LoU, utilizing the Diffusion of Innovations (DOI) theory and Ecological Framework for Effective Implementation (EFEI) as guiding models. FPs’ awareness of resources to support paediatric weight management was also assessed. Methods: A survey was distributed to FP in British Columbia (BC), Canada (N = 2853). The survey addressed provider and innovation characteristics, prevention delivery and support system factors, and barriers and facilitators to chart use. Correlations and multiple linear regression were used to determine correlates and predictors of LoU. Results: Sixty-two surveys were returned (2.2%). WHO Growth Chart LoU was 80.4%. Six variables significantly predicted LoU, including age (β = -.28, t = -3.15, p < .05), practicing in Fraser Health Authority region (β = -.24, t = -2.67, p < .05), assessing head circumference of birth to two year olds (β = .23, t = 2.45, p < .05), perceived growth chart accessibility (β = .39, t = 4.22, p < .05) and compatibility (β = .47, t = 5.27, p < .05), and innovativeness (β = -.37, t = -4.11, p < .05). These variables accounted for 69% of the variance in LoU. The most commonly identified barrier and facilitator to chart use was related to the Electronic Medical Record (EMR) system. FPs’ awareness of resources to support overweight paediatric patients was low. Conclusion: The majority of FP in BC in this sample had adopted the WHO Growth Charts. The results showed partial support for DOI theory and EFEI derived factors. Despite a small sample size, the findings highlighted the importance of installing the charts in the EMR systems, and can provide a foundation for future public health dissemination efforts and research on medical guideline implementation. / Graduate / 0573 / 0769 / erand@uvic.ca

By 2020, cancer mortality rates are estimated to increase by 180% in Arab countries, where breast cancer is the most common type of cancer. This thesis explores and evaluates the ‘asabiyya-driven structuration (the cohesive force of the group that gives it strength in facing its struggles for progressive reproduction) of cancer agents, government agents, and the World Health Organization agents for breast cancer prevention and early detection in the Arab region. The layers of the philosophical standing from Ibn Khaldûn’s concept of ‘asabiyya and the theoretical foundation of social systems theory, structuration theory, social network analysis, and social capital theory are peeled in order to explore and evaluate the context, constraints, social networks, autopoiesis, and social capital. Utilizing a qualitative research design, this thesis employs content analysis and in-depth interviews, as well as NVivo as a tool for analysis. Data is collected from 122 publications and knowledgeable informants employed by cancer agencies, ministries of health, and World Health Organization offices in Egypt, Jordan, Morocco, and Oman. The findings are divided into the contextual scope of responsibility and resources, the progressive and hierarchal constraining structure, the optimal and weak social networks, the strong and vulnerable shields of autopoiesis, and the presence and absence of social capital momentum, followed by a discussion on the the struggle for structuration against breast cancer. The findings demonstrate that countries with a national cancer control program witness local strengthening ‘asabiyya and ‘asabiyya-driven structuration, while those without a national cancer control program witness weakening local ‘asabiyya. Ultimately, this thesis proposes strategic recommendations to accelerate the regional ‘asabiyya-driven structuration of breast cancer.

International organisations such as the World Health Organisation highlight the road crash problem in less motorised (or developing, or low income) countries like those in Southeast Asia and recommend the adoption of Western road safety measures. However, there are many differences between highly motorised and less motorised countries which raise questions about how successfully Western road safety knowledge and expertise can be transferred.----- A review of the statistical information on road crashes shows a great deal of uncertainty about both the scale and likely trajectory of road fatalities globally, in less motorised countries and in Asia. It is generally agreed, however, that Asia accounts for around half of all road fatalities, and analysis of the limited available data shows both that Southeast Asia is not an atypical region of Asia in road safety terms, and that Thailand and Vietnam are not atypical of Southeast Asian countries.----- A literature review of recommended practice approaches to road safety transfer in Asia shows that there are many economic, institutional, social and cultural factors which potentially influence the success of transfer. The review also shows that there is no coherent, comprehensive approach which either conceptualises these factors and their relationship to transfer outcomes, or uses an analysis of these factors to plan or modify transfer. To address this gap, this thesis develops a 'road safety space' model as a tool for conceptualisation and analysis, based on a biological metaphor which views the transfer of road safety measures from one context to another as analogous to the transfer of a species into a new ecological space. The road safety space model explicitly considers economic, institutional, social and cultural factors (from specific to broad) which influence the particular road safety issue which a particular road safety transfer effort seeks to address. A central contention of this thesis is that the road safety space model is both a feasible and useful tool to improve the process of road safety transfer to less motorised countries. Road safety space analysis is seen to have a role in a broader process of selection of road safety measures for transfer, along with knowledge of how the measures are considered to operate.----- The research reported in this thesis is comprised of three studies. Study 1 reviewed evaluations of road safety transfer to Thailand and Vietnam. Studies 2 and 3 were case studies of road safety transfer to Thailand and Vietnam respectively.----- Study 1 was an analysis of existing evaluations of road safety transfer to Thailand and Vietnam. The aims were to analyse the evaluations for their consideration of contextual factors, as described in the road safety space model, and to discuss whether the road safety space model assisted in understanding the reasons for success or failure of transfer. However, very few such evaluations exist, and those that were found generally lacked information on whether contextual factors were considered. This indicated the need for a more detailed, in-depth qualitative investigation of particular cases of road safety transfer, in order to investigate the feasibility and utility of the road safety space model.----- Two case studies (Study 2 and Study 3) were conducted to test whether the road safety space approach was both feasible and useful as a means of improving road safety transfer efforts. Study 2 was a case study of the development and implementation in Thailand of a road safety education program for school children, which involved the transfer of Western research and techniques. The transfer agents (i.e. those who effected the road safety transfer) were Australian consultants working for the Australian Road Research Board (ARRB). The transfer was funded by the World Bank and managed by the Thai Ministry of Education (MOE). Study 3 was a case study of the development and implementation of a motorcycle helmet wearing program in Vietnam, which involved the transfer of Western knowledge, techniques and technology. The transfer agents were staff of Asia Injury (AI), a non-government organisation (NGO), and the program was funded initially by a charitable fund, with the intention of becoming self-funding through operation of a helmet factory.----- The case studies employed background research into existing information on economic, institutional, social and cultural factors relevant to the road safety issues (road use behaviour of school children in Thailand and motorcycle helmet purchase and wearing in Vietnam), and collected data through interviews with key informants, analysis of secondary sources and observations. This information was used to derive the road safety space for each road safety issue, to identify the road safety space recognised and addressed by the transfer agents (ARRB and AI), and to determine which factors they missed, or were aware of but took no action on. The focus of this analysis was on the processes used in transfer, not on the road safety outcomes of transfer, although these provided information on the processes as well. Available evaluation information was used to draw links between the omissions and the success of the transfer processes. It was noted that information on how the transferred measures operate should come from a road safety space analysis in the originating country, although this raised questions about selection of country and time (when the measure was first introduced, or in its maturity).----- The feasibility and utility of the road safety space model were discussed. It was clear that the model provided information on the cases which was missed by the transfer agents. The questions examined next were whether this information could have been obtained from an exercise conducted before the transfer had commenced, whether the required effort and cost justified the potential benefits, and whether the information on the road safety space could have been useful for the transfer agents. Comparisons between the road safety spaces for the two cases showed some areas of commonality, e.g. perceptions of police corruption, but also many differences. It was considered likely that some broad factors could be generic, and the possibility was mooted that less motorised countries share issues with police enforcement. This requires further research, however, and at this stage it is better to treat each road safety space as a unique combination of contextual factors influencing the road safety issue of interest.----- It is concluded that the road safety space model is feasible if used in such a way as to minimise the research involved, and useful, although the degree of utility needs to be further explored in a prospective study. The limitation introduced by restricting informants to those who could speak English are discussed. An approach using road safety space analysis is recommended, emphasising analysis of the country to which the road safety measure is being transferred, supplemented by analysis of the originating country road safety space. Gaps in knowledge are identified for further research and development, in particular the theoretical and practical understanding of road use behaviours and their modification in less motorised countries in Southeast Asia. Elaboration of the model is also recommended, to take into account the influence of the type of measure transferred, the role of the transfer agent, the area of road safety (education, engineering or enforcement), and the time dimension (the time which might be needed for a transfer to show its effects).----- The findings of this research are likely to be applicable to road safety transfer in other less motorised regions of the world, however prospective testing is needed. They may also be relevant to issues of transfer for areas other than road safety, in particular public health and traffic engineering, where similar economic, institutional, social and cultural issues come together.

Thesis (Ph.D.)--University of Melbourne, Dept. of Opthalmology, 2007. / Typescript. SAFE Strategy refers to Surgery for trichiasis, Antibiotics for active infection, Facial cleanliness and Environmental improvements. Includes bibliographical references (leaves 233-253). Also available electronically: http://eprints.unimelb.edu.au/archive/00003844.