This thesis explores the problem of sexual behaviour change in a country which has the largest number of people living with HIV in the world. Despite awareness of HIV, and knowledge of protective behaviours, many young South Africans still engage in risky sexual practices, exposing themselves to risk of HIV infection. This lack of behaviour change by people who know the risks involved is the focus of this thesis. I begin by developing a critique of the dominant behaviour change theories which underpin HIV and AIDS interventions, and the way in which they conceptualise the relationship between the individual and society. These theories assume a universal, rational individual who engages in decision-making before action, or is prevented by problematic factors of ‘context’ (e.g. poverty, culture, gender dynamics) from engaging in appropriate protective health decisions. This conceptualisation of behaviour is inadequate in understanding the problem of behaviour change. Cultural-historical activity theory (CHAT), with its roots in the theories of Marx, Engels, Vygotsky and Leontiev, enables a different gaze on the problem of behaviour change, shifting the primary focus from cognition to activity. This provides an alternative dialectical conceptualisation of the relationship between the individual and society. In this thesis I articulate and extend the methodology inherent in CHAT. In a study conducted in a rural area in South Africa I recruited qualitative research processes to explore the cultural-historical context of early sexual experiences leading to intercourse; and the participants’ experiences of sexual activity in relation to HIV and AIDS. The conceptual and methodological tools inherent in CHAT enabled the production of the context of sexual activity. The focus on sexual activity as the central object unit and the analysis of the activity system illuminated the activity of sex as a social practice, produced and enacted within particular interpersonal, social and historical dynamics. Through an historical and current contextualisation of sexual activity CHAT-based analysis of the data enabled an articulation of contradictions and turbulence within the activity system. The problem of a lack of behaviour change is understood through this production of context. Activity system analysis revealed how the introduction of the injectable contraceptive gendered the division of labour in sexual activity. An analysis of the relationship between the subject and the object of the activity system revealed a phalocentric identity investment as an outcome of sexual activity. This analysis also illustrated the relative invisibility of HIV compared to pregnancy as a negative outcome of sexual activity. These dynamics of the activity system structure power and resistance to change in the interaction. By accounting for the status of the activity system this analysis facilitated an understanding of a lack of behaviour change in response to HIV and AIDS. This research process forms the basis for a tentative proposal for intervention using the CHAT-based Change Laboratory approach. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2009.

This dissertation aims to explore problems of gender, masculinity and cultural memory shared by men in the theatre workshop process through looking at the workshop process of four HIV/AIDS plays. The narrative that evolved in the process of creating each play carries an important and current documentation of story and myth that illustrate a unique social understanding of varied but relevant HIV/AIDS issues. In this dissertation the scripts will act as primary text in an exploration of the importance of workshop theatre in documenting the creation of stories and myth in the HIV/AIDS context. The focus of the exploration is on the male participants, with the intention of gaining a greater understanding of contemporary masculine issues in the context of HIV/AIDS. / Thesis (M.A.) - University of KwaZulu-Natal, Pietermaritzburg, 2008.

In the postwar period Swedish communities have become more multicultural. Although there are about 120,000 Finnish immigrant children below the age of 18 in Sweden, knowledge about their dental health is rather sparse. Dental health and related factors were studied in Finnish immigrant children aged 5,8 and 14 years, living in the city of Luleå, northern Sweden. The effect of early dental health education to parents at the Child Health Centres was studied in one age group in Luleå and in one in the municipality of Botkyrka, Stockholm county. All groups of Finnish children were compared to Swedish children matched for age, sex and social class. At the age of 5 the prevalence of dental caries was higher than in Swedish control children. At the age of 8, this difference persisted, but was less pronounced in the permanent than in the primary dentition. The net mean caries increment between 5 and 8 years of age was 11.2 in the Finnish group compared to 7.4 in the Swedish. The proportion of children selected for individual prophylaxis and the time used between age 5 and 8 did not differ between the Finnish and the Swedish groups. In the Finnish teenagers, the prevalence of dental caries was higher than in the Swedish teenagers. Periodontal health was equally good in all age groups of Finnish and Swedish children. The difference in caries prevalence between the two groups was mainly explained by a more frequent between-meal eating and a higher intake of sucrose-containing products between meals in the Finnish children. Even though they had been included in organized dental care with individual prophylaxis, this was obviously not enough to guarantee them as good a dental health as in the Swedish children. Flourides were used to an equal extent in the Finnish and Swedish groups. Toothbrushing was less frequent in all Finnish age groups than in the Swedish controls. The Finnish parents were less convinced than the Swedish about their ability to influence the child’s dental health, and more Finnish than Swedish parents also found it necessary to visit a dentist only when they had toothache. The Finnish teenagers who had received almost twice as many hours of individual prophylaxis as the Swedish, knew less about the etiology of dental caries but equally much about the etiology of gingivitis. The best result of early dental health education to parents, evaluated by comparing prevalence of dental caries of the children at the age of 3, was obtained when information was given three times in Finnish. If information in the mother tongue cannot be offered, an extra session of information in Swedish can also benefit the dental health of the child. / <p>S. 1-42: sammanfattning, s. 43-115: 5 uppsatser</p> / digitalisering@umu

Approximately 85% of Canadians are physically inactive. This project seeks to support physical activity (PA) as a health intervention within primary care using innovative approaches to help people access community-based PA opportunities. We hypothesize that participants will increase and maintain their moderate to vigorous PA in 10-minute bouts (MVPA10Mins) over 10-months. One-hundred-nineteen patients recruited from two primary care facilities did not change their primary outcome of MVPA10Mins from baseline to 10-months. However, secondary outcomes light and total sporadic PA increased by the 4th month and were maintained until 10-months. Furthermore, self-report data including self-efficacy, mood, and quality of life all improved by the end of the 4-month intervention. Sedentary time increased from baseline to 4-months and was sustained until 10-months. The ENCOURAGE intervention did not increase MVPA10Mins over time. However, improvements in other secondary outcomes indicate that a multilevel intervention delivered within primary care may contribute to health behavior changes.

This study forms part of a larger SANPAD project focusing on a comprehensive community-based HIV stigma reduction and wellness enhancement intervention, responding to the continuous burden of HIV stigma on both national and international levels and the paucity of research in sustainable HIV stigma reduction interventions. HIV stigma is considered all over the world as a complex, far-reaching and powerful phenomenon that continues to affect people living with HIV (PLWH) and also people living close to them (PLC). The impact of stigma has far reaching effects on aspects like the wellness of PLWH and PLC, but also on the health behaviour of PLWH. There is paucity in research on the lasting effect of HIV stigma reduction interventions, intervention within a community context, as well as in urban and rural settings. The research objectives of this study were to test the change-over-time in HIV stigma experiences of PLWH and stigmatization by PLC with regard to the psychosocial well-being of PLWH and PLC, and with regard to health behaviour of PLWH in both urban and rural settings, following a comprehensive community-based HIV stigma reduction intervention. A quantitative experimental single system research design with a pre-test and repetitive post-tests were conducted by means of purposive voluntary sampling for PLWH and snowball sampling for PLC. The intervention was based on three tenets, namely a) the sharing of information on HIV stigma and coping with it, b) the equalisation of relationships between PLWH and PLC through increased interaction and contact, and c) empowerment of both PLWH and PLC towards leadership in HIV stigma reduction through practical knowledge and experiences of planning and implementing HIV stigma reduction projects in their own communities. Several valid and reliable scales and instruments were used to measure effect. The initial analysis indicated no statistically significant difference between stigma experiences of PLWH and stigmatisation by PLC from urban and rural settings, or between psychosocial well-being of PLWH and PLC or health behaviour of PLWH from the two different settings. The urban-rural data was therefore pooled for the further analysis. The similarity of data could possibly be ascribed to the fact that most of the participants were Setswana-speaking and living in the North West Province. Stigma experiences as well as stigmatisation could be decreased and the decrease could be sustained over a year through the comprehensive community-based HIV stigma reduction intervention. The findings also showed that changes-over-time in psychosocial well-being following the intervention were better sustained by the PLC than the PLWH. Results furthermore indicated that HIV stigma reduction positively influenced the health behaviour of the PLWH. Recommendations for further HIV stigma reduction and wellness enhancement include the continued application of this comprehensive community-based HIV stigma reduction and wellness enhancement intervention, with its supporting tenets, content and methodology. This intervention should, however, be expanded into urban and rural communities, and to different cultures as well. It would be meaningful to build HIV stigma reduction community-based networks. More effort could be made to specifically include a workshop for PLWH on psychosocial well-being as well. HIV stigma interventions should be an indisputable part of health behaviour change workshops for PLWH. / PhD (Nursing), North-West University, Potchefstroom Campus, 2014

This study forms part of a larger SANPAD project focusing on a comprehensive community-based HIV stigma reduction and wellness enhancement intervention, responding to the continuous burden of HIV stigma on both national and international levels and the paucity of research in sustainable HIV stigma reduction interventions. HIV stigma is considered all over the world as a complex, far-reaching and powerful phenomenon that continues to affect people living with HIV (PLWH) and also people living close to them (PLC). The impact of stigma has far reaching effects on aspects like the wellness of PLWH and PLC, but also on the health behaviour of PLWH. There is paucity in research on the lasting effect of HIV stigma reduction interventions, intervention within a community context, as well as in urban and rural settings. The research objectives of this study were to test the change-over-time in HIV stigma experiences of PLWH and stigmatization by PLC with regard to the psychosocial well-being of PLWH and PLC, and with regard to health behaviour of PLWH in both urban and rural settings, following a comprehensive community-based HIV stigma reduction intervention. A quantitative experimental single system research design with a pre-test and repetitive post-tests were conducted by means of purposive voluntary sampling for PLWH and snowball sampling for PLC. The intervention was based on three tenets, namely a) the sharing of information on HIV stigma and coping with it, b) the equalisation of relationships between PLWH and PLC through increased interaction and contact, and c) empowerment of both PLWH and PLC towards leadership in HIV stigma reduction through practical knowledge and experiences of planning and implementing HIV stigma reduction projects in their own communities. Several valid and reliable scales and instruments were used to measure effect. The initial analysis indicated no statistically significant difference between stigma experiences of PLWH and stigmatisation by PLC from urban and rural settings, or between psychosocial well-being of PLWH and PLC or health behaviour of PLWH from the two different settings. The urban-rural data was therefore pooled for the further analysis. The similarity of data could possibly be ascribed to the fact that most of the participants were Setswana-speaking and living in the North West Province. Stigma experiences as well as stigmatisation could be decreased and the decrease could be sustained over a year through the comprehensive community-based HIV stigma reduction intervention. The findings also showed that changes-over-time in psychosocial well-being following the intervention were better sustained by the PLC than the PLWH. Results furthermore indicated that HIV stigma reduction positively influenced the health behaviour of the PLWH. Recommendations for further HIV stigma reduction and wellness enhancement include the continued application of this comprehensive community-based HIV stigma reduction and wellness enhancement intervention, with its supporting tenets, content and methodology. This intervention should, however, be expanded into urban and rural communities, and to different cultures as well. It would be meaningful to build HIV stigma reduction community-based networks. More effort could be made to specifically include a workshop for PLWH on psychosocial well-being as well. HIV stigma interventions should be an indisputable part of health behaviour change workshops for PLWH. / PhD (Nursing), North-West University, Potchefstroom Campus, 2014

Persistent infection with certain subtypes of Human papillomavirus (HPV) is a necessary cause of cervical cancer, the second most common cancer among women worldwide. Uptake of HPV vaccines in the targeted Canadian female population has been lower than anticipated. This study’s primary objective was to determine undergraduate women’s perceptions about HPV vaccination. A total of 401 female University of Ottawa undergraduate students completed a newly developed cross-sectional web survey. The prevalence of HPV vaccination was 49%. While the overall attitude towards receiving the vaccine was positive, vaccinated respondents had more favorable attitudes toward the vaccine. Lack of vaccine knowledge and cost were the primary barriers that have prevented HPV vaccination among non-vaccinated respondents. Offering HPV vaccination for women aged 18 to 25 presents a strategy for addressing suboptimal vaccination coverage in the targeted female population and may reduce health inequities demonstrated by variations in cervical cancer incidence within jurisdictions.

In research, it is typical to analyse and discuss the utility of education in economic terms—specifically the market value of a particular degree or the financial returns associated with additional years in higher education. However, education may also generate outcomes that belong to the non-market sphere, such as open-mindedness, societal cohesion, community involvement, better health, and gender equality; yet these outcomes have received little scholarly attention. The main objective of this thesis, therefore, is to investigate the relationship between education and four non-market outcomes: agency, voice, health behaviour and psychological distress. By utilizing two longitudinal data sets, the Swedish Survey of Living Conditions and the Northern Swedish Cohort, it is possible to assess the long-term effects of education on each of these four non-market outcomes. Results clearly demonstrate that education has a critical impact on each of the outcomes of interest. Having a higher education—and in particular a university degree–enhances individuals’ agency and voice, reduces psychological distress, and improves individuals’ health behaviour. Further, results show that different academic subjects generate field-specific resources. In contrast to a market perspective, where the value of the specific field of study is assessed only in economic terms, results indicate that fields that are commonly viewed as having low market value may actually yield non-economic rewards that benefit individuals in critically important ways. Analyses also show that individual and social factors shape the extent to which education leads to positive outcomes. In terms of agency and voice, results indicate that education can compensate for social differences. Among those with a working class background, earning a university degree contributes to increasing levels of agency and voice, while no significant effects of education exist for those with a white-collar background. Results also demonstrate that the impact of education on psychological well-being differs for men and women. For men, labour market resources (i.e., being employed) was important for reducing psychological distress, while for women social resources (i.e., having a partner) was more important. Due to its use of high quality, longitudinal data, this thesis makes a significant contribution to the scholarly literature and to what we know about the impact of education attainment. A limitation of cross-sectional analyses is that it is difficult to separate causal effects from selection effects. By adopting a longitudinal approach, it is possible to control for earlier (baseline) circumstances and therefore assess the causal impact of education on individual outcomes. This strategy yields robust results that make clear the long-term effects of educational attainment on individuals.

Darbo tikslas. Įvertinti gyvensenos ir genetinių veiksnių sąsajas su dvynių antropometriniais rodikliais. Uždaviniai. 1. Nustatyti monozigotinių ir dizigotinių dvynių antropometrinius rodiklius; 2. Įvertinti antropometrinių rodiklių ir gyvensenos sąsajas su genetiniais veiksniais; 3. Nustatyti normalaus svorio ir antsvorio turinčių dvynių gyvensenos skirtumus; 4. Nustatyti gyvensenos veiksnių ryšį su antropometriniais rodikliais, atsižvelgiant į genetinius veiksnius. Tyrimo metodika. Tirti Lietuvoje gyvenantys 18–54 metų dvyniai, kurie yra įtraukti į Dvynių centro registrą ir kurių buvo žinomas elektroninio pašto adresas. Vykdyta apklausa paštu. Anketą sudarė 51 klausimas apie dvynių socialinius rodiklius, sveikatos būklę, jų ūgį ir svorį bei gyvensenos įpročius. Anketos buvo išsiųstos 146 dvynių poroms. Jas grąžino 159 asmenys (atsako dažnis 54,5 proc.). Analizuoti 70 (40 monozigotinių ir 30 dizigotinių) dvynių porų duomenys. Antsvorio paplitimas skaičiuotas pagal kūno masės indeksą (KMI>25 kg/m2). Rezultatai. Antsvorio paplitimas tarp vyrų buvo 31,3 proc., tarp moterų – 19,4 proc. Jis dažniau nustatytas 35 metų ir vyresniems bei turintiems kolegijos išsilavinimą dvyniams. Nustatyti stiprūs ryšiai tarp visų MZ dvynių porų antropometrinių rodiklių. Labiausiai susijęs buvo monozigotinių dvynių ūgis (koreliacijos koeficientas – 0,941). Monozigotiniai dvyniai dažniau turėjo vienodus fizinio aktyvumo, mitybos ir žalingus įpročius nei dizigotiniai. Antsvorio paplitimas buvo... [toliau žr. visą tekstą] / Aim of the study. To evaluate the associations of behavioural and genetic factors with anthropometrical measurements of twins. Objectives. 1. To assess the antropometric indicators of monozigotic and dizigotic twins; 2. To evaluate the relationship between genetical factors and anthropometric indicators; 3. To identify the differences in health behaviour of twins with normal weight and overweight; 4. To evaluate the aoosiations the behavioural factors with antropometric indicators, taking into account genetic factors. Methods. Study population was 18–54 years old twins living in Lithuania, which were registered in the Twin Center and have e-mail addresses. For this study, the original questionnaire was developed which included 51 questions on sociodemographic characteristics, health status, weight and height, and behavioural habits of twins. The questionnaires were sent by email to 146 twin pairs; 159 individuals returned the filled in questionnaires (response rate 54.5%). The data of 70 twin pairs (40 monozigotic ir 30 dizigotic) were analyzed. Overweight was defined when body mass index (BMI) was >25 kg/m2. The statistical analysis was performed using SPSS 13.0 software package for Windows Results. 31,3 percent of men and 19,4 percent of women had overweight. It is more common for twins over 35 years old, with college degree. A strong correlation among all monozigotic twin couples was found. The height of monozigotic twins was found to be the most related (correlation... [to full text]

Darbo tikslas: Įvertinti Lietuvos gyventojų daržovių ir vaisių vartojimo įpročius ir jų ryšius su socialiniais ir gyvensenos veiksniais. Uždaviniai: Įvertinti Lietuvos gyventojų daržovių ir vaisių vartojimo įpročius ir jų pokyčius nuo 1996 m. Nustatyti daržovių ir vaisių vartojimo ryšius su socialiniais veiksniais. Nustatyti daržovių ir vaisių vartojimo sąsajas su gyvensenos veiksniais Tyrimo metodika. Analizuoti suaugusių Lietuvos žmonių gyvensenos tyrimų duomenys. Tyrimas vykdomas nuo 1994 m. kas antri metai. Tiriama atsitiktinė 3000 Lietuvos 20-64 m. gyventojų imtis, sudaryta iš gyventojų registro sąrašų. Vykdoma apklausa paštu. Per šešiolikos metų laikotarpį klausimyną užpildė 17161 žmogus (7361vyras ir 9800 moterų). Atsako dažnis - 53,8-74,4 proc. Klausimyną sudarė klausimai apie daržovių ir vaisių vartojimo dažnį, gyvensenos ir socialinius veiksnius. Rezultatai. Per keturiolika metų suaugusių Lietuvos gyventojų šviežių daržovių vartojimas padidėjo. Beveik kasdien valgančių šviežias daržoves vyrų dalis išaugo nuo 3,5 proc. 1996 m. iki 17 proc. 2010 m., o moterų – atitinkamai nuo 5,1 proc. iki 23,8 proc. Šviežių vaisių vartojimo dažnis padidėjo tik tarp moterų. Gyventojai, turintys aukštąjį išsilavinimą ir gyvenantys mieste, labiausiai padidino daržovių vartojimą. Didėjant amžiui didėjo daržovių ir vaisių vartojimo dažnis tarp moterų bei šviežių vaisių vartojimas tarp vyrų. Aukštojo išsilavinimo vyrai dažniau vartojo šviežias daržoves nei nebaigto vidurinio ar vidurinio... [toliau žr. visą tekstą] / Objectives: to evaluate vegetables and fruits consumption in Lithuanian adult population and trends since 1996; to assess the relationships between vegetables and fruits consumption and social factors; to evaluate associations of vegetables and fruits consumption with behavioural factors. Methods: The data from Health Behaviour Survey among Lithuanian adult population are presented. Since 1994 nine surveys have been carried out every second year. For every survey random sample of 3000 Lithuanians aged 20-64 was taken from the National Population Register. The study material was collected by mailed questionnaires. Altogether 17161 persons (7361men and 9800 women) participated in the surveys. Response rate varied from 53,8% to 74,4%. The survey instrument included the questions about fruits and vegetables consumption, social and behavioural factors. Results: Over 14-year period, the consumption of fresh vegetables and fruits has increased among Lithuanian adult population. In 1996, daily consumption of fresh vegetables was reported by 3.5% of men and 5.1% of women, while in the year 2010 this proportion was 17% in men and 23.8% in women. The positive changes in fresh fruits consumption were observed only in women. The largest increase in frequency of daily consumption of fresh vegetables was found among persons with university education and those living in cities. The proportion of women consuming fresh vegetables and fruits daily and the proportion of men consuming fresh... [to full text]