Stroke is one of the most common causes of disability and death worldwide. The most commonly experienced stroke in the clinical setting is focal ischaemia in which the middle cerebral artery (MCA) is occluded and leads to a complex series of various pathophysiological pathways that ultimately lead to neuronal cell death. Several studies have been conducted on various therapeutic agents in the search for a neuroprotective drug and various animal models have been used to carry out this research. While theanine, a component of green tea and minocycline, a tetracycline antibiotic, have been shown to possess some neuroprotective properties, the mechanisms by which these two agents carry out these effects still remains unclear. The objectives of this study were to investigate the mechanisms by which these drugs carry out these neuroprotective effects and their neuroprotective ability in a MCA occlusion model of focal ischaemia. Ischaemia leads to oxidative stress due to the imbalance of free radicals and the endogenous antioxidant defence system. An antioxidant assay using the stable 2, 2-diphenyl-1-picrylhydrazyl (DPPH●) radical was used to assess the antiradical properties of each drug. It was found that minocycline showed superior antioxidant activity in vitro when compared to theanine. Further studies on the drugs‟ ability to attenuate the Fenton reaction (in which iron catalyses the formation of reactive species) were elucidated using electrochemical analysis, UV/VIS studies, ferrozine and ferritin assays. It was found that minocycline, in contrast to theanine, was able to bind to iron ions and thus potentially prevent the participation of iron in metal catalysed radical reaction. The antioxidant activity of both drugs was further investigated by assessing their effect on cyanide-induced superoxide generation and quinolinic acid (QA)-induced lipid peroxidation (LP). Experimental evidence shows that both drugs had no significant effect on the generation of superoxide in vitro and that there was a significant decrease in LP for minocycline in vitro and theanine in vivo. The metal binding and antioxidant properties were postulated to be a possible mechanism through which these agents reduced lipid peroxidation. A study was conducted to determine the effects of the drugs on the biosynthesis of the neurotoxin, QA and it was found that minocycline increases the levels of holoenzyme activity of tryptophan-2, 3-dioxygenase (TDO) in vitro and that theanine reduces the levels of the same enzyme in vivo after treatment for 10 days. TDO is the enzyme that converts tryptophan to other products that enable enzymatic activity to change it to QA. Minocycline was thought to bring about this effect as it has been shown from preceding experimental studies that it is an effective reducing agent. Theanine on the other hand is hypothesised to bring about a reduction in holoenzyme activity by changing the binding of tryptophan to the enzyme or affecting the radicals that participate in the enzymatic degradation of tryptophan. A focal ischaemic model of stroke was induced by occluding the MCA. Histological examination of the hippocampus post -ischaemia shows a reduction in the size of the infarct after pre-treatment with minocycline only. A further study into the effects of the drugs on the generation of superoxide and on the levels of the endogenous glutathione after a stroke was carried out. Pre-treatment of the animals with either theanine or minocycline showed no significant effects on the generation of the radical species or of the endogenous antioxidant which ruled out these as a mechanism of neuroprotection of both drugs, post-ischaemia.The findings of this study provide novel information on the possible mechanisms by which both theanine and minocycline act to bring about neuroprotection. In particular in this study, pre-treatment with minocycline has shown promise in the focal ischaemic model of stroke.

BACKGROUND. Unhealthy lifestyle behaviours such as physical inactivity are global risk factors for chronic disease. Despite this, a substantial proportion of the UK population fail to achieve the recommended levels of physical activity. This may partly be because the health messages presently disseminated are not sufficiently potent to evoke behaviour change. There has been an exponential growth in the availability of digital health technologies within the consumer marketplace. This influx of technology has allowed people to self-monitor a plethora of health indices, such as their physical activity, in real-time. However, changing movement behaviours is difficult and often predicated on the assumption that individuals are willing to change their lifestyles today to reduce the risk of developing disease years or even decades later. One approach that may help overcome this challenge is to present physiological feedback in parallel with physical activity feedback. In combination, this approach may help people to observe the acute health benefits of being more physically active and subsequently translate that insight into a more physically active lifestyle. AIMS. Study One aimed to review existing studies employing fMRI to examine neurological responses to health messages pertaining to physical activity, sedentary behaviour, smoking, diet and alcohol consumption to assess the capacity for fMRI to assist in evaluating health behaviours. Study Two aimed to use fMRI to evaluate physical activity, sedentary behaviour and glucose feedback obtained through wearable digital health technologies and to explore associations between activated brain regions and subsequent changes in behaviour. Study Three aimed to explore engagement of people at risk of type 2 diabetes using digital health technologies to monitor physical activity and glucose levels. METHODS. Study One was a systematic review of published studies investigating health messages relating to physical activity, sedentary behaviour, diet, smoking or alcohol consumption using fMRI. Study Two asked adults aged 30-60 years to undergo fMRI whilst presented personalised feedback on their physical activity, sedentary behaviour and glucose levels, following a 14-day wear protocol of an accelerometer, inclinometer and flash glucose monitor. Study Three was a six-week, three-armed randomised feasibility trial for individuals at moderate-to-high risk of developing type 2 diabetes. The study used commercially available wearable physical activity (Fitbit Charge 2) and flash glucose (Freestyle Libre) technologies. Group 1 were offered glucose feedback for 4 weeks followed by glucose plus physical activity feedback for 2 weeks (G4GPA2). Group 2 were offered physical activity feedback for 4 weeks followed by glucose plus physical activity feedback for 2 weeks (PA4GPA2). Group 3 were offered glucose plus physical activity feedback for six weeks (GPA6). The primary outcome for the study was engagement, measured objectively by time spent on the Fitbit app, LibreLink app (companion app for the Freestyle Libre) as well as the frequency of scanning the Freestyle Libre and syncing the Fitbit. RESULTS. For Study One, 18 studies were included in the systematic review and of those, 15 examined neurological responses to smoking related health messages. The remaining three studies examined health messages about diet (k=2) and physical activity (k=1). Areas of the prefrontal cortex and amygdala were most commonly activated with increased activation of the ventromedial prefrontal cortex predicting subsequent behaviour (e.g. smoking cessation). Study Two identified that presenting people with personalised feedback relating to interstitial glucose levels resulted in significantly more brain activation when compared with feedback on personalised movement behaviours (P < .001). Activations within regions of the prefrontal cortex were significantly greater for glucose feedback compared with feedback on personalised movement behaviours. Activation in the subgyral area was correlated with moderate-to-vigorous physical activity at follow-up (r=.392, P=.043). In Study Three, time spent on the LibreLink app significantly reduced for G4GPA2 and GPA6 (week 1: 20.2±20 versus week 6: 9.4±14.6min/day, p=.007) and significantly fewer glucose scans were recorded (week 1: 9.2±5.1 versus week 6: 5.9±3.4 scans/day, p=.016). Similarly, Fitbit app usage significantly reduced (week 1: 7.1±3.8 versus week 6: 3.8±2.9min/day p=.003). The number of Fitbit syncs did not change significantly (week 1: 6.9±7.8 versus week 6: 6.5±10.2 syncs/day, p=.752). CONCLUSIONS. Study One highlighted the fact that thus far the field has focused on examining neurological responses to health messages using fMRI for smoking with important knowledge gaps in the neurological evaluation of health messages for other lifestyle behaviours. The prefrontal cortex and amygdala were most commonly activated in response to health messages. Using fMRI, Study Two was able to contribute to the knowledge gaps identified in Study One, with personalised glucose feedback resulting in a greater neurological response than personalised feedback on physical activity and sedentary behaviour. From this, Study Three found that individuals at risk of developing type 2 diabetes were able to engage with digital health technologies offering real-time feedback on behaviour and physiology, with engagement diminishing over time. Overall, this thesis demonstrates the potential for digital health technologies to play a key role in feedback paradigms relating to chronic disease prevention.

The HIV/AIDS pandemic has had a devastating effect in the world, as it is now rated as the world’s greatest killer since its appearance in the mid 1980s. A UNICEF Report (2005) states that sub Saharan Africa is the hardest hit with countries like Botswana, Zimbabwe, South Africa, Namibia and Mozambique having an average of one in every five adults being infected. Sub Saharan Africa has less than 3 percent of the world’s population but it has an estimated 65 percent of the world’s population living with HIV/AIDS as it has 26 million of the 40 million infected people worldwide. In May 2003 the Government of Zimbabwe declared HIV/AIDS a national emergency a move that seems to have yielded results as the HIV prevalence rate has come down from 26.1 percent to 18.6 percent in 2005 and further to 15.6 percent in 2007. The Ministry of Health and Child Welfare (2004) states that if the prevalence had continued at 26.1 percent, about two thirds of today’s 15- year-olds would die from this disease. The deterioration of the political, social and economic situation since 1999 and the withdrawal of donor development support due to policy differences require concerted efforts from all parties concerned, now, rather than later. More commitment must be shown by private and public sector organisations to active participation in the establishing of effective workplace programmes, to assist employees, for the pandemic has placed a heavy strain on the health delivery system, as AIDS patients occupy between 50 percent to 70 percent of all hospital beds. Furthermore, the pandemic is killing the youth at the prime of their working careers so the pandemic, while being a health problem also has a negative macro-economic impact which may lead to a developmental crisis. A study was conducted of six organisations, using two questionnaires, one for management and one for non-management level employees. The study investigates whether the organisations had HIV/AIDS programmes and whether such programmes were effective. The findings were that all six organisations had HIV/AIDS programmes in place. However, some of the programmes were not effective because the employees did not know of their existence. Furthermore, it was found that management initiated awareness programmes and made condoms available but the employees were not changing their risky behaviour.

As doenças cardiovasculares são uma realidade no país, apresentando um impacto significativo na morbi-mortalidade dos indivíduos e no gasto público relacionado aos tratamentos e aposentadorias precoces. Os altos índices de morte por doença cardiovascular podem ser explicados pela grande incidência de fatores de risco associados a baixos níveis de intervenção sobre esses fatores. O presente trabalho tem como objetivos: caracterizar os indivíduos segurados por planos de saúde privados com relação às variáveis sociodemográficas, antropométrica, comportamental e clínicas; identificar o risco cardiovascular obtido por meio do Escore de Risco de Framingham (ERF) e comparar o ERF entre os indivíduos com relação às referidas variáveis.Trata-se de um estudo transversal comparativo/correlacional, de abordagem quantitativa. A pesquisa foi realizada em uma empresa privada prestadora de serviços de gerenciamento de doentes crônicos para operadoras de planos privados de saúde, em diversos estados do Brasil. Os critérios de inclusão na amostra foram ter pessoas de ambos os sexos; com idade entre 30 e 74 anos e com prontuários eletrônicos completos para a realização do estudo. Foram estudados 2967 associados, sendo 1339 homens e 1628 mulheres. A amostra foi composta em sua maioria por mulheres (54,9%), por pessoas com 60 anos ou mais (57,4%), com sobrepeso ou obesas (79,5%), com colesterol total e HDL-c dentro da normalidade (61,5% e 59%, respectivamente), normotensos (PAS < 130 = 55,2%; PAD < 85 = 83,1%), não diabéticos (57,9%), não tabagistas (91,4%) e aposentados e donas do lar (60,1%). A escolaridade mostrou predomínio de indivíduos analfabetos ou com nível de escolaridade até o ensino fundamental (39,1%). As patologias mostraram predomínio de indivíduos portadores da HAS (35,8%) e de HAS acompanhada por DM (20,9%). Com relação à estratificação do risco cardiovascular, a maior parte da amostra estava classificada na faixa de médio e alto, ou seja, risco superior a 10% de desenvolver doença arterial coronariana em 10 anos - (55,6%). A análise de regressão logística mostrou que possuem maior risco de apresentar ERF médio/alto os indivíduos do sexo masculino, mais velhos, obesos, com baixa escolaridade, fumantes, com CT >= 200 mg/dl, com baixos níveis de HDL-c, com PAS >= 130 mmHg, com PAD > 90 mmHg e diabéticos (p< 0,05). A análise de regressão multinomial mostrou que possuem maior risco de apresentar ERF médio e alto os indivíduos do sexo masculino, acima do peso, com baixa escolaridade, fumantes, CT >= 200 mg/dl, HDL < 60 mg/dl, PAS >= 130 mmHg, PAD >= 85 mmHg e diabéticos (p< 0,05). O uso da curva ROC mostrou que o ERF pode identificar indivíduos de baixo risco, médio/alto risco, médio risco e alto risco com acurácia considerada ótima (com valores da área sob a curva variando de 0,82 a 0,94). Esses resultados fornecem subsídios na determinação de prioridades de intervenção na pratica clinica com relação aos fatores de risco / The cardiovascular diseases are reality in Brazil, presenting a significant impact in morbi-mortality of the population and in the public expenses related to treatments and precocious retirements. The high averages of death for cardiovascular illness can be explained by the great incidence of risk factors associated to low levels of intervention on these factors. The present research has as objective: to characterize people insured for private health plans related to sociodemographics, anthropometrics, behavioral and clinical variables; to identify the cardiovascular risk by the Framingham Heart Score (FHS) and to compare the FHS among the participants and based on the related variables. This is a transversal, comparative/correlational, quantitative study. The research was realized in a private company that manages people who has chronic diseases for private health plans operators, in diverse states of Brazil. The criteria of inclusion in the sample was: to include people of both the gender; aged between 30 and 74 years and having complete electronic medical register for the accomplishment of the study. 2967 associates had been studied, 1339 men and 1628 women. The sample was composed in its majority by women (54,9%), 60 years old or more (57,4%), overweight or obeses (79,5%), normal results of serum cholesterol and HDL-c (61.5% and 59%, respectively), normal blood presure (systolic blood pressure - SBP < 130 = 55,2%; diastolic blood pressure - DBP < 85 = 83.1%), non diabetic (57,9%), non smoking (91,4%) and pensioners and housewives (60,1%). The scholarity level showed predominance of illiterate individuals or with low scholarity level (39,1%). The patologies showed predominance of associates who have hypertension (35,8%) and hypertension and diabetes (20,9%). About the stratification of the cardiovascular risk, most of the sample was classified in the band of medium/high risk, and/or risk higher than 10% to develop coronary arterial disease in 10 years (55,6%). The analysis of logistic regression showed that have greater risk to present FHS medium/high: male sex associates, older, obeses, with low scholarity levels, smokers, serum cholesterol >= 200 mg/dl, low levels of HDL-c, SBP >= 130 mmHg, DBP > 90 mmHg and diabetic (p < 0,05). The analysis of multinomial regression showed that have greater risk to present average and high FHS: male sex associates, overweight, low scholarity levels, smokers, serum cholesterol >= 200 mg/dl, HDL-c < 60 mg/dl, SBP >= 130 mmHg, DBP >= 85 mmHg and diabetic (p < 0,05). The ROC curve showed FHS can identify individuals of low risk, medium/high risk, medium risk and high risk with accuracy considered excellent (values of the area under the curve varying from 0,82 to 0,94). These results supply subsidies to determine priorities of intervention on risk factors in clinical practice

A mini-thesis submitted in partial fulfilment of the requirements for the degree of Master of Education in the Faculty of Education, Cape Peninsula University of Technology, 2010 / Education and knowledge are regarded as imperative tools to changing human attitudes, perceptions and behaviour. The researcher embarked on the study to explore possibilities in the teaching and learning process to substantiate the importance and implications of integrating HIV/AIDS education and awareness into the Grade 8 curriculum. The ultimate purpose of this study is to see how teaching and learning can take place in a collaborative setting, with the possibilities of exploring how effectively an integrated programme can be implemented into the curriculum. The secondary purpose of this study is to use this information to make a contribution to integrate HIV/AIDS education and awareness into the Grade 8 curriculum. The pivotal question with regard to the integration of life-skills into the school curriculum is: How do educators and learners perceive a teaching-learning scenario that can efficiently promote genuine learning of HIV/AIDS within the Life-skills curriculum? In this study, semi-structured interviews and a tool for teaching styles was used to assess 16 educators’ perceptions towards integration and how it can lend itself to integrate HIV/AIDS education and awareness. Furthermore, a questionnaire and a learning styles inventory were used to assess 70 learners’ perceptions of integration. The study found that learners could be assisted with information and be guided to make their own responsible choices. The ideal could therefore be to provide learners with the skills, knowledge, attitudes and values that might enable them to make informed choices among conflicting and competing moral codes. The study found that learners should be given more ownership and responsibility in the teaching and learning process. In doing so, educators should relinquish more control. Educators should also work in collaboration with their colleagues in order for integration to be successful. It will be essential to develop curricula that prepare learners for a new reality which might threaten their future with the HIV/AIDS pandemic. Outcomes-based education allows learners to learn at their own pace and the content selected can be age appropriate that suits learners and their community best to prepare them to be responsible citizens in a democratic country.

Orientador: Cáris Maroni Nunes / Banca: Mary Marcondes / Banca: Sonia Regina Pinheiro / Resumo: A leishmaniose visceral (LV) é um importante problema de saúde pública e as medidas de prevenção preconizadas nem sempre são conhecidas pela população. Esta pesquisa avaliou, por meio da aplicação de um questionário, o conhecimento que a população de Três Lagoas, MS tem sobre esta zoonose. Dos 384 entrevistados, 100% afirmaram que já tinham conhecimento prévio da LV, 64,5% sabiam que é transmitida através do inseto vetor e 65,4% sabiam que a prevenção se dá evitando o criadouro deste. Observaram-se 93,5% de respostas para manutenção do quintal limpo como medida preventiva conhecida. Pelo menos um método de prevenção era utilizado no animal por 50,5% dos entrevistados e observou-se associação estatisticamente significante entre o grupo de proprietários cujos cães nunca apresentaram leishmaniose visceral canina e o grupo que fazia uso de alguma prevenção no animal (p=0,0006). / Abstract: Visceral Leishmaniasis (VL) is an important public health problem and the measures to prevent it are not always known by the population. This research evaluated the knowledge that the population of Três Lagoas, MS, Brazil has about this zoonosis. One hundred percent of the interviewed (384) had previous knowledge of the disease, 64.5% knew that a vector transmits it and 65.4% knew that the prevention is achieved by preventing vector's breeding sites. Maintenance of the backyard clean was informed by 93,5% as a known preventive measure. At least one preventive method was used in the animal by 51% of the interviewed ones and statically significant association between the group of owners whose dogs had never presented canine visceral leishmaniasis and owners that used some preventive method in the animal (p=0.0006) was observed. / Mestre

Essa tese de doutorado em cotutela analisa a formação em enfermagem a partir do lugar da promoção da saúde e da prevenção de doenças no Brasil e na França. Para tanto, desenvolvemos um dispositivo de pesquisa a partir de abordagem socioclínica institucional (MONCEAU, 2012) do referencial da análise institucional (LOURAU, 1995) que pudesse fazer dialogar as similaridades, as diferenças, as contradições, as tensões da formação em um Curso de Graduação em Enfermagem de um estabelecimento de ensino superior do Estado de São Paulo (Brasil) e em um Curso de Graduação em Enfermagem de um Institut de Formation en Soins Infirmier (IFSI) da região parisiense. Após a aprovação do Comitê de Ética em Pesquisa (CEP) da EERP-USP protocolo nº 31343814.8.3001.5504 iniciamos o trabalho de campo. No Brasil, a pesquisa socioclínica foi promovida entre julho a dezembro de 2014 e na França entre janeiro a julho de 2015. As técnicas utilizadas na produção de dados foram: análise documental, entrevistas, observações participantes e restituições. Constatamos que apesar de origens sócio históricas diferentes existe uma forte influência do modelo nightingaleano na Enfermagem e na formação em enfermagem. No Brasil, ainda hoje temos uma clara divisão de classes demarcada pelas categorias do enfermeiro, técnico de enfermagem e auxiliar de enfermagem. Na França, essa divisão encontra-se na prática e na formação do Infirmière e do Aide-Soignante. Também temos em comum uma identidade fortemente vinculada ao hospital e materializada em atos: \"ato privado do enfermeiro\" no Brasil e \"rôle propre et rôle prescrit de l\'infirmier\" na França. A Enfermagem e a formação do enfermeiro nos dois países são marcadas por profundas diferenças associadas ao Sistema de Saúde e ao processo de universitarização com o advento da pesquisa e da pós- graduação. Consideramos que esse contexto sócio histórico define as práticas profissionais em enfermagem e a formação ao mesmo tempo que é definido por elas. A universitarização foi desenvolvida em tempos e espaços diferentes nos dois países, demarcando uma certa distância entre as duas realidades. Em particular, os enfermeiros franceses e brasileiros não carregam a mesma identidade, papel e status. Evidenciamos que existe na França como no Brasil um lugar anunciado na formação do enfermeiro para a promoção e a prevenção, mas constatamos uma distância entre a formação prescrita e a formação realizada, que é distinta nas duas realidades. A partir de tensões entre o prescrito e o real são produzidos novos saberes e fazeres de educação e de promoção da saúde. Os professores brasileiros têm desenvolvido práticas com uma abordagem transdisciplinar na pesquisa e, sobretudo, na extensão. Os dispositivos extensionistas provocam movimentos de desterritorialização e desestratificação, criando linhas de fuga (DELEUZE; GUATTARI, 1995) na rigidez da estrutura curricular. Para alguns formadores dos IFSI da França, as práticas de promoção e de prevenção são desenvolvidas prioritariamente no espaço extra hospitalar (creches, escolas, dispensários), no entanto, priorizam os estágios no hospital. Colocar em análise essas contradições permite-nos concluir que embora sejam chamadas com o mesmo nome - enfermagem e enfermeiros - existem práticas profissionais e formações distintas nos dois países / This cotutorial doctorate thesis analyzes the nursing education from the place occupied by the health promotion and disease prevention in Brazil and France. For this purpose we develop a strategy of research from the institutional socio clinical approach (MONCEAU, 2012) of institutional analysis referential that could make dialogue the similarities, differences, contradictions and tensions in a undergraduate course in Nursing of an institution of higher education in the state of São Paulo (Brazil) and a Graduate Program in Nursing of an Institut de Formation en Soins Infirmier (IFSI) of the Paris region. After the approval of the Ethics Research Committee of EERP-USP protocol nº 31343814.8.3001.5504 we start the field work. In Brazil, the social clinical research was promoted from July to December of 2014 and in France from January to July of 2015. The techniques used in data production were: documental analysis, interviews, participating observations and restitutions. We found that despite of different origins socio-historical there is a strong influence of Nightingale model in the profession of Nursing and the Nursing training. Today in Brazil we still have a clear class division demarcated by categories of nurse, nursing technician and nursing assistant. In France this division is found in the practical and formation of nurse and the nurse assistant. We also have in common an identity strongly linked to the hospital and materialized by acts: private act of nurse in Brazil and self role and prescript role of nursing in France. The Nursing and the Nursing training in both countries are marked by profound differences associated with the Health Sistem and by the universitarization process with the coming of research and postgraduate. We consider that social historical context define the professional practices in nursing and training in the same time that is defined by them. The universitarization are developed in different times and spaces in these two countries marking a distance between these two realities. Particularly the French and Brazilian nurses do not carry the same identity, role or status. We noted that there in France as in Brazil, a place advertised in nursing education for health promotion and prevention but we found a distance between the prescribed formation and the realized formation, which is distinct in those two realities. In this clash between the prescribed and the real new knowledge and practices of education and health promotion are produced. Brazilian professors have developed practices with transdisciplinary approach in research and especially on extension. Extension strategies cause deterritorialization and destratification movements creating escape lines (DELEUZE; GUATTARI, 1995) in rigidity of curricular structure. For some trainers from the IFSI of France the promotion and prevention practices are developed primarily in outside spaces of the hospital (kindergartens, schools, dispensaries), however they prioritize the stages in the hospital. Analyze these contradictions, allow us to conclude that although they are called by the same name - nursing and nurses - there are different professionals and formation practices in these two countries

M.Ed. / The phenomenon of HIV/AIDS is not restricted to the medical and behavioural sciences. The social implications of what is labelled as a pandemic, has influenced both sufferers and those in their realm of social intercourse. Education has become one of the most important strategies in an attempt to arrest the spread of the virus. The National Curriculum Statement compels educators to integrate HIV/AIDS across the whole school curriculum. The needs of educators, learners and the community must be considered in a cross-curricular HIV/AIDS education program. A quantitative survey placed focus on educator questionnaires from which a situation analysis was drawn. The research indicated that 72 (n=72) participants contributed to the study. In the study for n=72, 76.4% were female and 23.6% male. The majority of the participants indicated their ethnicity as white (95.8%) with the remaining 4.2% indicating their ethnicity to be, Black, Indian or Coloured. It was found that an integration of HIV/AIDS through an inter-disciplinary approach in the curriculum of secondary schools is not convincingly implemented. In general it was found that educators consider the integration of HIV/AIDS into the curriculum as an imperative part of education. The emphasis of integrating HIV/AIDS into the curriculum does not replace the role of parental intervention strategies in educating adolescents on the dangers of high risk health behaviour. Thus, much emphasis is placed on values education as a priority in HIV/AIDS prevention strategies to be implemented in the curriculum. Secondly, it was found that the majority of respondents show a positive attitude and willingness to the integration of HIV/AIDS across the curriculum. In support of this inference, it was found that the majority of the participants believe that HIV/AIDS should not only be addressed in the Life Orientation class and most educators supported the concept of addressing HIV/AIDS throughout the curriculum. Thirdly, it was clear that learner receptiveness towards HIV/AIDS education can be perceived as positive. However, the inference can be made that attitudes towards the HIV/AIDS stigma and prejudice is not successfully addressed in the current intervention initiatives. Fourthly, the majority of educators indicated that the formal resources for teaching (viz. the textbook) did not include much relevant material on HIV/AIDS and that most educators employed the printed media as main source of information for their lessons. Furthermore, support of educators, especially through the integration of peer group leaders that should discuss the dangers of high risk behaviour with learners, is clear. Finally, the premise that an inter-disciplinary approach to HIV/AIDS (as well as other themes of education) is the underpinning element of authentic education, is strongly supported. / Dr. M.C. van Loggerenberg

Ph.D. / It has become an accepted fact that Coronary Heart Disease is an epidemic of modern civilisation. Coronary Heart Disease is responsible for approximately a third of all deaths in the Western world (Fullard, 1990) and South Africa is no exception. Several risk factors contributing to the development of heart disease have been identified but the extent and exact nature of their contribution is not fully understood. Traditionally accepted risk factors that play a role in the development of Coronary Heart Disease include diet, hypertension, hypercholestrolaemia, smoking, physical inactivity, age, sex and genetic disposition. However the strongest combination of these factors has been unable to predict the majority of heart disease cases. In this regard psychological factors are steadily gaining acceptance as risk factors, one of the most important of these being the Type A behaviour pattern. The far reaching consequences of Coronary Heart Disease have necessitated investigations into methods of decreasing contact with risk factors, particularly psychological ones. The substantial success of the Recurrent Coronary Prevention Project (Friedman et al), coupled with the promising results from other intervention studies, suggests that behaviour change is a viable goal in the prevention of heart disease. Following on from the Recurrent Coronary Prevention Project, Venter (1993) and Viljoen (1993) adapted it for the South African population. Although relatively successful, it did have its flaws. Thus the motivation for redesigning this intervention addressing its shortcomings The revised intervention was administered to a group of 25 Coronary Heart Disease patients. A second group of 22 patients were subjected to the intervention utilised in the original South African Recurrent Coronary Prevention Project. A third group of 18 patients served as a waiting list control group. The results indicated that although the revised intervention produced larger changes in Type A behaviour than the original South African Recurrent Prevention Project intervention, these differences were not significant. Possible reasons for this were the measures utilised, the sample sizes and the nature of the groups themselves. However, the revised version of the SARCPP was found to be more effective in the reduction of the hostility and anger components of the behaviour pattern than the original version. In conclusion it was found that before any further research in this area be conducted, the measures utilised should be modified and the mechanisms of treatment effect be examined.

M.A. / The human immuno-deficiency virus (HIV), a virus which causes an illness known as acquired immune deficiency syndrome (AIDS) is spreading at an alarming rate in South Africa. The exact number of people already infected by this virus is unknown, since the epidemic can only be measured by the number of reported incidents of AIDS cases. Van Bilj on (1994:7) believes that the most accurate prediction is perhaps the result of estimations based on preventative studies, projections and mathematical models. hi short, HIV/AIDS is today widely regarded as a serious problem, which affects people economically, politically, ethically and socially. Lachman (undated) considered the ethical and social implications of HIV/AIDS as follows: the first is to protect the public's health; the second is to protect the inherent rights of AIDS patients and HIV-positive people who, although they seem to be healthy, are in actual fact sufferers; the third involves consideration of the allocation of scarce resources to people with HIV/AIDS and other groups in need of health care. The seventh national annual survey of women attending antenatal clinics, conducted by the Department of Health during October/November 1996 indicated that more than 2.4 million South Africans were HIV positive at that stage. More specifically, the level of HIV infection amongst the total population in the provinces was estimated as follows: Western Cape - 3,09%, Northern Cape - 6,47%, Northern Province - 7,96%, Eastern Cape - 8,10%, Gauteng - 15,49%, Free State - 17,49%, Mpumalanga - 15,77%, KwaZulu Natal - 19,90% and North West - 25,13%. According to this survey, North West has the highest level of HIV infection, and Western Cape the lowest. Initially this epidemic mainly involved white homosexual men. Today it is mostly found among heterosexuals and is increasing among mothers and children. The development and intensive utilization of HIV testing of blood transfusion resulted in better control of blood donation in South Africa and it is still being improved. Van Biljon (1994:8) believes that over the last few years the disease became more prevalent in black communities. Most of the reported AIDS cases fall in the age group 20 to 39 which represents the largest portion of the economically active population. From the results of some research projects conducted in the work situation it can be stated that many of the potential work-place problems associated with AIDS may stem from a lack of understanding of how the virus is passed on. Employers can help to promote understanding by providing information and encouraging thorough informed discussion of the issues. Trade union leaders should also play an important part in assisting employers to develop policies which will make the life of HIV infected people better. This is an essential feature of any company's AIDS policy.