There is an increasing interest in ethnomedical and ethnoveterinary practices, especially as it relates to the use of medicinal plants for treating various ailments. As a result, the current trend in government health authorities is to integrate herbal medicine with primary healthcare. This arises because nearly 80% of people in the developing world, particularly those from rural communities where modern drugs are unaffordable, inaccessible or, unavailable, depend on phytomedicine for primary healthcare. Despite this, however, most medical and veterinary professionals distrust herbal medicines due to concerns of scientific evidence of efficacy and safety. Hence, there is need for their validation, before herbal medicines gain wider acceptance and use. Traditional healers and rural farmers use extracts of Peltophorum africanum (a medicinal plant wide-spread in southern Africa and other tropical regions), to treat diarrhoea, helminths and abdominal parasites, dysentery, HIV-AIDS, acute and chronic pain, anxiety and depression, infertility, and to promote well-being and resistance to diseases. To evaluate these ethnobotanical leads, dried leaves, bark and root from mature P. africanum (Fabaceae) trees were extracted with acetone, ethanol, dichloromethane and hexane. Chromatograms were made on silica gel plates. Thin layer chromatograms (TLC) were sprayed with 0.2% 2, 2-diphenyl-1-picryl hydrazyl (DPPH) for qualitative screening for antioxidants. Quantification of antioxidant activity was done in comparison with L-ascorbic acid and Trolox (6-hydroxy-2, 5, 7, 8-tetranethylchromane-2-carboxylic acid). With regard to the extracts, minimum inhibitory concentrations (MIC) were determined for Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Enterococcus faecalis. The total antibacterial activity (TAA), signifying the volume to which active compounds present in 1 g of plant material can be diluted and still inhibit bacterial growth, was also determined. In vitro anthelmintic activity was evaluated by effects of acetone extracts on the egg hatching and larval development of parasitic nematodes Haemonchus contortus and Trichostrongylus colubriformis. The eggs and larvae of the two parasites were incubated in various concentrations of the leaf, bark and root extracts for two and five days respectively. Furthermore the efficacies of the acetone extracts were tested on lambs artificially induced with H. contortus and T. colubriformis infections. Toxicity was performed in brine shrimp and MTT assay on Vero monkey kidney cells. The extracts had substantial activity against both Gram-positive and Gram-negative bacteria, with MIC values of 0.08 mg ml-1 for Staphylococcus aureus and 0.16 mg ml-1 for Pseudomonas aeruginosa ; the corresponding TAA values were 1263 and 631 ml g-1. The acetone extracts the bark, and root of P. africanum had higher antioxidant activity than L-ascorbic acid (Vitamin-C) and Trolox (6-hydroxy-2, 5, 7, 8-tetramethylchromane-2-carboxylic acid), a synthetic vitamin-E analogue, and much higher than Ginkgo biloba extract (EGb 761). The standardized extract of Ginkgo biloba (EGb 761) is widely employed for its significant benefit in neurological disorders. The respective EC50 for the P. africanum root , bark and leaf extracts, L-ascorbic acid, and EGb761 were 3.82 µg ml-1, 4.37 µg ml-1, 6.54 µg ml-1, 5.04 µg ml-1, and 40.72 µg ml-1. The extracts inhibited egg hatchability and larval development (from L1 to infective stage L3) of both H. contortus and T. colubriformis (both parasitic nematodes of ruminants) at concentrations of 0.2-1.0 mg ml-1. The plant extracts, at concentrations of 5-25 mg ml-1 completely lysed larval forms (L1) and eggs of the nematodes. In all assays, the root extracts had higher antibacterial, antioxidant and anthelmintic activity than the bark and leaf. Although the extracts were safe and non-toxic, the reduction in faecal egg and adult worm counts in lambs infected with H. contortus and T. colubriformis was not statistically significant (P=0.073). From the acetone extracts of the root, a brownish crystalline compound, bergenin was isolated. Bergenin was also assayed for toxicity with brine shrimp and Vero monkey kidney cells like the extracts, where the compound was found to be not toxic. In a disc diffusion test, the inhibitory activition of bergenin was determined for the bacteria E. coli, P. aeruginosa, Mycobacterium vaccae, and the fungi Sporobolomyces salmonicolor and Penicillium notatum. Bergenin had reasonable antimicrobial activity against S. salmonicolor, moderate activity against M. vaccae, E. coli and P. aeruginosa, but non inhibitory against P. notatum. P. africanum extracts have therefore, potential for treatment of infection-related diseases by either directly inhibiting bacterial growth or by stimulating the immune system of the host. The traditional use of P. africanum concoctions against diarrhoea, dysentery and unthriftness, may be also due to anthelmintic activity as these signs are consistent with parasitic astroenteritis. Antioxidants are also important in boosting the immunity, critical in the management of helminthosis. There is ample scientific and empirical evidence supporting the use of plantderived antioxidants in the control of human immunodeficiency virus (HIV) and neurological diseases. Synergistic activity of plant antioxidants has been proposed as a mechanism by which viral replication and immune cell killing in HIV infection can be inhibited. Antioxidants may have neuro-protective (preventing apoptosis), as well as neuro-regenerative roles. Due to the high antioxidant activity of its extracts, P. africanum has prospects in the chemotherapy of HIV and management or control of neurodegenerative diseases. Thus there is great potential of P. africanum extracts in medicine. Further isolation and bioassay characterization of bioactive compounds from P. africanum is recommended as well as refinement of in vivo tests in target livestock, or clinical trials. Better methods of plant extraction easily adaptable to rural communities for sustainable exploitation of the tree, may have to be devised especially those using the leaves instead of bark or root. / Thesis (PhD(Paraclinical Sciences))--University of Pretoria, 2007. / Paraclinical Sciences / unrestricted

Understanding the philosophy of a different culture and integrating this understanding into the provision of pharmaceutical care is challenging and complex. This thesis argues the importance for community pharmacists to acknowledge that culture, religion, family and community dynamics can impact on patients' health, health seeking behaviour and medicines adherence. The perceptions of members of the South Asian population, general practitioners, and community pharmacists about how these factors are viewed in relation to community pharmacy services were explored in this study. It was conducted in Leicester City, which has a South Asian minority ethnic population of more than 25%. Participants' views of the role of extended community pharmacy services in the wider government agenda were explored. South Asians attitudes to healthcare, self care and the management of minor ailments were discussed. A qualitative methodology approach was adopted, which used constructivist and interpretive principles. Data collection for the study was conducted in two phases. In Phase 1, one to one semi-structured interviews were conducted separately with six local GPs and five community pharmacists from both 'white' (European) and South Asian backgrounds. In Phase 2, six gender specific focus groups were convened comprising of fifty five participants in total from the Sikh, Moslem and Hindu communities. Bi-lingual community workers were used in this study which allowed a more 'sensitive' exploration of the sociological aspects of health seeking behaviour and the impact of 'cultural' influences on medicines adherence. The need for 'cultural competence' of community pharmacists is discussed as one of the major contributions to the evidence base for pharmacy practice. Such initiatives would require pharmacists to acquire more effective consultation skills in the first instance. South Asians expressed views that community pharmacists need to be more knowledgeable, responsive and flexible in their professional practice by assessing their pharmaceutical needs and being aware of particular cultural sensitivities when planning their services in line with the new pharmaceutical contract. More specifically, South Asian participants illustrated the need for community pharmacists and their staff to be more 'culturally knowledgeable' about the communities in which they practice. It is argued that the provision of a more culturally sensitive and pro-active service is needed to develop a better patient-practitioner professional relationship that promotes trust. South Asians illustrated how certain behavioural, religious and cultural beliefs impact on medicines adherence, such as compliance issues whilst on holiday to their homeland, the impact of religious pilgrimage and fasts. Many South Asian participants had limited understanding about 'generic' medicines and considered these to be 'inferior' or 'less effective' than 'branded' medication. Participants' views of 'sharing' of medicines and medicines waste were also illustrated. Factors such as 'stress', 'fate' and 'karma' and their impact on health of the participants were discussed. Many of these factors could not be solely attributable to a South Asian 'culture'. However, the findings illustrate a need for a Medicines Use Review (MUR) service to include more 'targeted' exploration of medicines adherence and medicines optimisation for this population. The findings also highlighted why South Asians rarely consult the community pharmacist about sensitive or stigmatised issues such as depression, and how some conditions and symptoms were perceived to have negative impact on the 'social acceptance' of South Asian individuals within their own communities. South Asians suggested that community pharmacists needed to be more pro-active and 'responsive' to their pharmaceutical needs and respect confidentiality through use of private consultation areas for routine counselling, health promotion and medicines information. All participants endorsed a need for more 'professional' recognition of the pharmacist not only as an autonomous health care professional, but as one integral to providing NHS services relating to medicines and public health. The findings illustrated a lack of professional collaboration between community pharmacists and GPs, confounded by community pharmacists being 'subordinate' to GPs and portraying more of a 'shopkeeper' image. South Asians were well informed about the lack of shared medical records and relied heavily on a doctor's definitive 'diagnosis' for somatic symptoms related common ailments. South Asians pro-actively engaged with 'community action' based approaches in health education and health promotion, and an opportunity for community pharmacists to become more involved with social initiatives was inferred from the findings. Candid and animated discussions explored their understanding of exercise as part of weight management and their interpretation of effects of the use of herbal products, alternative practitioners and the importance of collaboration with religious and community leaders in promoting medicines adherence. Participants desired alternative communication methods other than leaflets (translated or otherwise), including the use of audio-visual means and use of media. Communication difficulties were still prevalent, and trained interpreters were rarely used. By embracing some of these challenges, community pharmacists could enhance the value of their services and provide a more meaningful, 'culturally' competent and responsive services based on the needs of their local populations and nurture a better trusting and professional relationship with their service users and healthcare colleagues.

Human trafficking is a criminal act that occurs globally. It affects both women and men, but most studies have focused on female victims; few have explored trafficked men or their related health issues. Though there are many forms of trafficking, it is believed that most male victims are trafficked as forced labor. Using gender schema theory as a framework, this quantitative study examined archival data to identify the types of trafficking men are subjected to, their health ailments, and how these differ from the health ailments of trafficked women. Archival data from 124 individuals subjected to human trafficking in Florida were analyzed using the Kruskal-Wallis, one-way ANOVA, Mann Whitney U, and Fisher's exact tests. Findings indicated that males were more likely to have been labor trafficked compared to other forms of trafficking, and that labor trafficked persons were not more susceptible to health ailments than were sex trafficked persons. Also, there was a significant difference in health conditions between male and female victims, with females reporting more issues such as malnourishment, skin rash, and anxiety. These findings help to alter the misperception that men are traffickers only by recognizing them to be victims as well. Implications for social change include increased awareness of male trafficking in health care policies and human trafficking prevention efforts.

O presente estudo teve como objetivo compreender as repercussões da doença renal crônica e do tratamento de hemodiálise na vida dos cuidadores principais, com o intuito de elaborar e implementar uma intervenção psicoeducativa. Foi realizada uma pesquisa de campo de caráter qualitativo, em que se utilizou como técnica a Análise de Conteúdo Temática. Este trabalho compreende três artigos: um teórico e dois empíricos. Para o segundo e o terceiro artigo, participaram dez cuidadores familiares dos doentes renais crônicos. O primeiro artigo fez uma revisão de literatura sobre o cenário da doença renal crônica, enfatizando conceitos, características, causas, tratamentos e a trajetória histórica da hemodiálise. A literatura consultada ressalta que apesar de o tratamento de hemodiálise ter evoluído tecnologicamente ao longo da história, trazendo uma melhor qualidade de vida aos pacientes renais crônicos, também trouxe implicações físicas, emocionais, sociais, econômicas e culturais para o paciente e para a sua família. O segundo artigo fez uma explanação acerca do cuidado e de suas ressonâncias na família, mais especificamente, no cuidador principal. A avaliação do material obtido através das entrevistas mostram que a doença renal crônica e o tratamento de hemodiálise requerem adaptações da família a uma nova rotina e que os que cuidam também necessitam ser cuidados. No terceiro artigo, descreve-se a elaboração e implementação de uma proposta de intervenção em grupo com estes familiares. Para avaliar o nível de estresse dos cuidadores, antes e após a intervenção, aplicou-se o Inventário de Sintomas de Stress para Adultos de Lipp. Foi observado o quanto se faz necessário que a família do paciente em hemodiálise também tenha um espaço que a possibilite criar, recriar e/ou fortalecer mecanismos de enfrentamento.

Made available in DSpace on 2017-06-01T18:08:40Z (GMT). No. of bitstreams: 1 tarciana_elias_cavalcante.pdf: 38526651 bytes, checksum: 37ad713d9c0721d8254c5f4679ad3438 (MD5) Previous issue date: 2012-05-02 / The present study had the aim to understand repercussions of chronic renal patient s illness and hemodialysis treatment in the lives of main caregivers, with the goal to elaborate and implement a psychological-educational intervention. A qualitative research was conducted using Thematic Content Analysis technique. This study is composed by three papers: one theoretical approach and two empirical ones. In order to carry out the second and third studies, ten relatives of people with chronic renal disease in hemodialysis treatment were recruited. The first paper refers to a literature review on Chronic Renal Failure, with focus on its concept, main causes, characteristics, treatment and the history of hemodialysis. Consulted literature highlights that despite the technological evolution of hemodialysis treatment, which brought up better quality of life to chronic renal patients, it also brought up physical, emotional, social, economic and cultural implications to them and their families. The second paper is on caring and its repercussions in the family, especially regarding the main caregiver. Data analysis of the interviews showed that chronic renal disease and hemodialysis treatment require the family to adapt to a new routine and that caregivers also need caring. In the third paper, the elaboration and implementation of an intervention proposal for this group of relatives is described. Lipp's Inventory of Stress Symptoms in Adults was used to assess the level of stress in caregivers before and after the intervention. The need for relatives of patients in hemodialysis treatment to be assisted in a space that can facilitate the creation, reinvention and/or strengthening of coping mechanisms was observed. / O presente estudo teve como objetivo compreender as repercussões da doença renal crônica e do tratamento de hemodiálise na vida dos cuidadores principais, com o intuito de elaborar e implementar uma intervenção psicoeducativa. Foi realizada uma pesquisa de campo de caráter qualitativo, em que se utilizou como técnica a Análise de Conteúdo Temática. Este trabalho compreende três artigos: um teórico e dois empíricos. Para o segundo e o terceiro artigo, participaram dez cuidadores familiares dos doentes renais crônicos. O primeiro artigo fez uma revisão de literatura sobre o cenário da doença renal crônica, enfatizando conceitos, características, causas, tratamentos e a trajetória histórica da hemodiálise. A literatura consultada ressalta que apesar de o tratamento de hemodiálise ter evoluído tecnologicamente ao longo da história, trazendo uma melhor qualidade de vida aos pacientes renais crônicos, também trouxe implicações físicas, emocionais, sociais, econômicas e culturais para o paciente e para a sua família. O segundo artigo fez uma explanação acerca do cuidado e de suas ressonâncias na família, mais especificamente, no cuidador principal. A avaliação do material obtido através das entrevistas mostram que a doença renal crônica e o tratamento de hemodiálise requerem adaptações da família a uma nova rotina e que os que cuidam também necessitam ser cuidados. No terceiro artigo, descreve-se a elaboração e implementação de uma proposta de intervenção em grupo com estes familiares. Para avaliar o nível de estresse dos cuidadores, antes e após a intervenção, aplicou-se o Inventário de Sintomas de Stress para Adultos de Lipp. Foi observado o quanto se faz necessário que a família do paciente em hemodiálise também tenha um espaço que a possibilite criar, recriar e/ou fortalecer mecanismos de enfrentamento.