Master of Public Health - MPH / Introduction: People with mental illness (PMI) are likely to die of chronic diseases, primarily cardiovascular, cerebrovascular and respiratory diseases at a younger age compared with the general population. The side-effects of psychotropic medications particularly weight gain and impaired glucose intolerance increase the risk of premature mortality in PMI. Behavioural risk factors for non-communicable diseases such as physical inactivity and unhealthy diet (diets high in fat and low in fruit and vegetables) are also thought to be consequences of negative symptoms of mental illness and emotional dysregulation.

Master of Public Health - MPH / Obesity is one of the critical problems that threatens not only health, but the economy at a global level. Among the factors associated with obesity is less than optimum level of nutrition literacy. Nutrition literacy is more than just the food knowledge, it is a combination of other essential factors that help individuals to maintain healthy a body size. These factors include the selection and consumption of nutritious food; acquiring knowledge and skills in the areas of meal planning and preparation; as well as using and knowing how to read food labels correctly.

This paper examines whether compliance with COVID-19 mitigation measures is motivated by wanting to save lives or save the economy (or both), and which implications this carries to fight the pandemic. National representative samples were collected from 24 countries (N = 25,435). The main predictors were (1) perceived risk to contract coronavirus, (2) perceived risk to suffer economic losses due to coronavirus, and (3) their interaction effect. Individual and country-level variables were added as covariates in multilevel regression models. We examined compliance with various preventive health behaviors and support for strict containment policies. Results show that perceived economic risk consistently predicted mitigation behavior and policy support—and its effects were positive. Perceived health risk had mixed effects. Only two significant interactions between health and economic risk were identified—both positive. / New York University Abu Dhabi

Background: The health systems in many low-middle income countries are faced with an increasing number of patients with non-communicable diseases within a high prevalence of infectious diseases. Integrated chronic disease management programs have been recommended as one of the approaches to improve efficiency, quality of care and clinical outcomes at primary healthcare level. The South African Department of Health has implemented the Integrated Chronic Disease Management (ICDM) Model in Primary Health care (PHC) clinics since 2011. Some of the expected outcomes on implementing the ICDM model have not been achieved, and there is a dearth of studies assessing implementation outcomes of chronic care models, especially in low-middle income countries. This thesis aims to assess the degree of fidelity, moderating factors of fidelity and costs associated with the implementation of the ICDM model in South African PHC clinics. Methods: The study was a cross-sectional study design using mixed methods and following the process evaluation conceptual framework. A total of sixteen PHC clinics in the Dr. Kenneth Kaunda (DKK) health district of the North West Province as well as the West Rand (WR) health district of the Gauteng Province, that were ICDM pilot sites were included in the study. The degree of fidelity in the implementation of the ICDM model was evaluated using a fidelity criterion from the four major components of the ICDM model as follows: facility reorganization, clinical supportive management, assisted self-support and strengthening of the support systems. In addition, the implementation fidelity framework was utilized to guide the assessment of ICDM model fidelity moderating factors. The data on fidelity moderating factors were obtained by interviewing 30 purposively selected healthcare workers. The abbreviated Denison Organizational Culture (DOC) survey was administered to 90 healthcare workers to assess the impact of three cultural traits (involvement, consistency and adaptability) on fidelity. Cost data from the provider's perspective were collected in 2019. The costs of implementing the ICDM model current activities for three (facility reorganization, clinical supportive management and assisted self-management) components and additional costs of implementing with enhanced fidelity were estimated. Costs data was collected from budget reviews, interviews with management teams, and other published data. Descriptive statistics were used to describe participants and clinics. Fidelity scores were summarized using medians and proportions and compared by facilities and health districts. Qualitative data were analysed thematically. Pearson correlation coefficient was utilized to assess the association between fidelity and culture. The annual ICDM model implementation costs per PHC clinic and patient per visit were presented in 2019 US dollars. Results: The 16 PHC clinics had comparable patient caseload, and a median of 2430 (IQR: 1685-2942) patients older than 20 years received healthcare services in these clinics over six months. The overall implementation fidelity of the ICDM model median score was 79% (125/158, IQR: 117-132); WR was 80% (126/158, IQR: 123-132) while DKK was 74% (117/158, IQR: 106-130), p=0.1409. The highest clinic fidelity score was 86% (136/158), while the lowest was 66% (104/158). The fidelity scores for the four components of the ICDM model were very similar. A patient flow analysis indicated long (2-5 hours) waiting times and that acute and chronic care services were combined onto one stream. Interviews with healthcare workers revealed that the moderating factors of implementation fidelity of the ICDM model were the existence of facilitation strategies (training and clinical mentorship); intervention complexity (healthcare worker, time and space integration); and participant responsiveness (observing operational efficiencies, compliance of patients and staff attitudes). Participants also indicated that poor adherence to any one component of the ICDM model affected the implementation of the other components. Contextual factors that affected fidelity included supply chain management, infrastructure and adequate staff, and balanced patient caseloads. The overall mean score for the DOC was 3.63 (SD = 0.58), the involvement cultural trait had the highest (3.71; SD = 0.72) mean score, followed by adaptability (3.62; SD = 0.56), and consistency (3.56; SD = 0.63). Although there were no statistically significant differences in cultural scores between PHC clinics, culture scores for all three traits were significantly higher in WR (involvement 3.39 vs 3.84, p= 0.011; adaptability 3.40 vs 3.73, p= 0.007; consistency 3.34 vs 3.68, p= 0.034). The mean annual cost of implementing the ICDM model was $148 446.00 (SD: $65 125.00) per clinic, and 84% ($124 345.00) was for current costs while additional costs for higher fidelity accounted for were 16% ($24 102.00). The mean cost per patient per visit was $6.00 (SD:$0.77). Conclusion: There was some variability of fidelity scores on the components of the ICDM model by PHC clinics, and there are multiple (context, participant responsiveness, intervention complexity and facilitation strategies) interrelated moderating factors influencing implementation fidelity of the ICDM model. Organizational culture needs to be purposefully influenced to enhance adaptability and consistency cultural traits of clinics to enhance the ICDM model's principles of coordinated, integrated, patient-centred care. Small additional costs are required to implement the ICDM model with higher fidelity. Recommendations: Interventions to enhance the fidelity of chronic care models should be tailored to specific activities that have low degree of adherence to the guidelines. Addressing some of the moderating factors like training and mentoring of staff members, role clarification and supply chain management could contribute to enhanced fidelity. Organizational culture enhancements to ensure that the prevailing culture is aligned with the planned quality advancements is recommended prior to the implementation of new innovative interventions. Further research on the cost-effectiveness of the ICDM model in middle-income countries is recommended.

Malaria is still one of the most proli c communicable diseases in the world with more than 200 million infections annually, its greatest e ect is felt in the poor nations with-in sub-saharan Africa and south-east Asia. It is especially fatal for women and children where out of the 660 000 fatalities in 2010, 86% were below the age of 5. In the past decade the global fatality rate due to malaria has been signi cantly reduced, primarily due to proliferation of vector control using treated nets and indoor residual spraying of DDT. There have, however, been few innovations in anti-malarial therapeutics and with the threat of the spread of drug resistant strains a need still exists to develop novel drugs to combat malaria infections. One of the major hinderances to drug development is the huge cost of the drug development process, where candidate failures late in development are extremely costly. This is where post-genomic information has the potential of adding great value. By using all available data pertaining to a disease, one gains higher discerning power to select good drug candidates and identify risks early in development before serious investments are made. This need provided the motivation for the development of Discovery; a tool to aid in the identi cation of protein targets and viable lead compounds for the treatment of malaria. Discovery was developed at the University of Pretoria to be a platform for a large spectrum of biological data focused on the malaria causing Plasmodium parasite. It conglomerates various data types into a web-based interface that allows searching using logical lters or by using protein or chemical start points. In 2010 it was decided to rebuild Discovery to improve it's functionality and optimize query times. Also, since its inception various new datasources became available speci cally related to bio-active molecules, these include the ChEMBL database and TCAMS dataset of bio-active molecules and the focus of this project was the integration of said datasets into Discovery. Large quantities of high quality bioactivity data have never been available in the public domain and this has opened up the opportunity to gain even greater insight into the activity of chemical compounds in malaria. Due to conserved structural/functional similarities of proteins between di erent species it is possible to derive predictions about a malaria protein or a chemicals activity in malaria due to experiments carried out on other organisms. These comparisons can be leveraged to highlight potential new compounds that were previously not considered or prevent wasting resources persuing potential compounds that pose threats of toxicity to humans. This project has resulted in a web based system that allows one to search through the chemical space of the malaria parasite. Allowing them to view sets of predicted protein-ligand interactions for a given protein based on that proteins similarity to those existing in the bio-active molecule databases. / Dissertation (MSc)--University of Pretoria, 2014. / gm2014 / Biochemistry / unrestricted

>Magister Scientiae - MSc / According to the WHO (2017), non-communicable diseases (NCDs) which include stroke, cancer, heart disease, chronic respiratory disease and diabetes is the leading cause of death and is responsible for seventy one percent of deaths worldwide. Beaglehole et al., (2009) reported that management of chronic diseases depends primarily on early detection of early disease, identification of high-risk status, interventions including pharmacological and psychosocial intercessions and long term follow up with monitoring and promotion of adherence to treatment.

Abstract Background: Insufficient physical activity has become a health problem worldwide and is closely connected to the development of various diseases such as Non-communicable diseases (NCDs). This has become a national problem in Thailand as well, and during the last decade, the government have launched various campaigns in attempt to increase the physical activity level of the population. Studies around the world have shown a positive correlation between physical activity (PA) and the prevention and treatment of diseases. Purpose: The purpose of this study was to gain knowledge about young Thai adults’ points of view and experiences of PA during their lifespan. Method: The study was a qualitative interview study based on five semi-structured interviews. The participants were young Thai adults studying or working at a computer-oriented college. When recruiting participants, both purpose and convenience sampling methods were used. Qualitative content analysis was used to analyze the collected data. Results: Five categories and twelve subcategories were identified during the analysis process. The five categories represented the broad focus areas and aspects of the participants’ views and experiences of PA. Conclusion: The participants had significant variations in both views and experiences regarding PA. The participants had a positive attitude towards PA due to different health outcomes. However, a lack of fundamental theoretical knowledge from their schoolyear’s regarding PA was identified. Further research is therefore needed to deeper investigate the knowledge gap and possible underlying causes.   Keywords: physical activity, non-communicable diseases, Thailand, experiences, views, physiotherapy / Sammanfattning Bakgrund: Otillräcklig fysisk aktivitet (FA) har blivit ett hälsoproblem världen över och är nära kopplat till utvecklingen av olika sjukdomar, t.ex. folksjukdomar. Detta har blivit ett nationellt problem även i Thailand och under det senaste decenniet har regeringen lanserat olika kampanjer i försök att öka den fysiska aktivitetsnivån hos befolkningen. Studier runt om i världen har visat att det finns ett positivt samband mellan FA och förebyggande och behandling av sjukdomar. Syfte: Syftet med studien var att få kunskap om unga thailändska vuxnas syn på och erfarenheter av FA under deras livstid. Metod: Studien var en kvalitativ intervjustudie baserad på fem semistrukturerade intervjuer. Deltagarna var unga thailändska vuxna som studerade eller arbetade på en dataorienterad högskola. Vid rekryteringen av deltagare användes både metoder för ändamåls- och bekvämlighetsurval. Kvalitativ innehållsanalys användes för att analysera den insamlade datan. Resultat: Fem kategorier och tolv underkategorier identifierades under analysprocessen. De fem kategorierna representerade de övergripande fokusområdena och aspekterna av deltagarnas åsikter och erfarenheter av FA. Slutsats: Deltagarna hade betydande variationer i både åsikter och erfarenheter av FA. Deltagarna hade en positiv attityd till FA på grund av olika hälsorelaterade effekter, dock konstaterades det att det fanns en brist på grundläggande teoretiska kunskaper kring FA från deras skolår. Ytterligare forskning behövs därför för att djupare undersöka kunskapsluckan och eventuella bakomliggande orsaker.   Nyckelord: physical activity, non-communicable diseases, Thailand, experiences, views, physiotherapy

Magister Public Health - MPH / Non-communicable diseases (NCD) continue to rise globally, causing significant morbidity and mortality. Low and medium-income countries (LMIC) such as South Africa are the worst affected because of an existing burden of infectious diseases and general poverty in the population. In South Africa, NCDs were responsible for 57.8% of total deaths in 2017, surpassing group 1 diseases (30.7%) that include tuberculosis and HIV/AIDS. Studies have shown that early detection of NCDs and interventions to reduce NCDs' risk significantly prevent suffering and further loss of lives. Workplace health promotion and healthy university concepts are widely being implemented globally to promote health at workplaces and institutions of higher learning. The study aimed to determine the prevalence of selected non-communicable disease risk factors and to assess the risk of cardiovascular disease among administrative staff at the University of the Western Cape (UWC), South Africa, using secondary data collected in 2011.

Magister Public Health - MPH / Chronic non-communicable diseases (NCDs) have not received adequate attention in Eswatini (formerly Swaziland) due to the high burden of HIV/AIDS, tuberculosis and other communicable diseases. However, in 2019, NCDs were estimated to account for 45.86% of all deaths in the country with cardiovascular diseases, diabetes mellitus and chronic respiratory conditions amongst the top ten causes of death. Persistent shortages of medicines in public health facilities in Eswatini have been observed resulting in patients purchasing their medicines from private retail pharmacies.

Purpose: The purposes of this research are to evaluate the effectiveness of a vaccine education module (VEM) in 1) contributing to new vaccine knowledge of university freshmen; and 2) identifying common vaccine concerns of university freshmen before and after completing the VEM. Methods: A VEM, including information about vaccine-preventable diseases, benefits of vaccines, principles of community or herd immunity, and where to go to get vaccinated, was created for freshman students. Student vaccine concerns were identified using a pretest/posttest quasi-experimental design using an online questionnaire before and after completing the VEM. After the VEM, participants were also asked to identify newly acquired knowledge. Results: Prior to viewing the VEM, the most common participant vaccine theme was the overall decrease of vaccination rates in the general population. After completing the VEM, the most common vaccine concern was the erosion of community immunity. The second most common theme were concerns about vaccine safety. Participants were also concerned about their own vaccination status. When asked what new knowledge they gleaned from the VEM, participants most frequently reported learning information about communicable diseases. Data were collected in the fall of 2019. Conclusions: Following the completion of the VEM, freshman university students reported fewer concerns about vaccine safety and more concerns regarding their current vaccination status. This demonstrates how a VEM contributes to vaccination knowledge and addresses vaccination concerns in university students.