The Environmental Protection Agency estimates that numerous lung cancer deaths result every year due to radon exposure. Given this, radon education has become an important issue. The purpose of this research was to examine what action consumers had taken to respond to radon as a hazard following an education testing program and why they had taken that action. In the Fall of 1992, the Virginia citizens Consumer Council, in partnership with Virginia Cooperative Extension, conducted a radon education campaign to promote and sell radon test kits. This study is based on a follow-up telephone survey in which 100 Virginia consumers whose homes tested with high radon levels were asked what action they had taken to reduce their radon exposure. Using a proportional allocation, a sample was drawn from eight Virginia counties. statistical analysis included the use of cross tabulation tables and testing for association through the use of the gamma function. Statistically significant findings included: 1) objective risk does have an impact of hazard response; and 2) a correlation was found between how worried consumers were about their radon problem and their response to the hazard. / Master of Science

Background: Persistently elevated hospitalization rates in the home healthcare setting indicate the need to prioritize patients with undertreated conditions that can lead to negative outcomes. Urinary incontinence affects approximately 40% of older adults in home healthcare, yet often remains unaddressed. This leaves older adults with urinary incontinence at risk for potentially serious complications that can lead to emergency department visits, hospitalizations, and mortality. Multiple comorbidities, co-occurring symptoms, and disparities in care fuel the complexity of older adults in the home healthcare setting. The overall purpose of this dissertation was to leverage natural language processing to understand symptom clusters and factors associated with acute care utilization among older adults with urinary incontinence in home healthcare to improve comprehensive assessment, treatment, and outcomes. The aims of this dissertation were to: 1) identify relevant comorbidities among community-dwelling older adults with urinary incontinence; 2) develop and test a natural language processing algorithm to extract symptom information from home healthcare free-text clinical notes for older adults with urinary incontinence and analyze differences by race or ethnicity; 3) identify symptom clusters among older adults with urinary incontinence in home healthcare and examine differences by sociodemographic and clinical correlates; and 4) determine factors associated with the risk of emergency department visits or hospitalizations among older adults with urinary incontinence in home healthcare, including the impact of symptom clusters. Methods: This dissertation comprised four studies: 1) a scoping review of the literature to identify comorbidities to broadly characterize community-dwelling older adults with urinary incontinence, 2) a secondary analysis of cross-sectional electronic health record data using natural language processing to extract symptoms from free-text clinical notes and analyze differences by race or ethnicity using Chi-square tests and logistic regression models, 3) a secondary analysis of cross-sectional electronic health record data using hierarchical clustering to analyze the natural language processing-extracted symptom variables and examine differences in sociodemographic and clinical correlates using Chi-square tests, and 4) a retrospective secondary analysis of electronic health record data to identify factors, including symptom clusters, associated with emergency department visits or hospitalizations using Chi-square tests and backward stepwise logistic regression. Results: In the scoping review, we synthesized findings from 10 studies that identified comorbidities among community-dwelling older adults with urinary incontinence across neurologic, cardiovascular, respiratory, endocrine, genitourinary, musculoskeletal, and psychologic systems. In the natural language processing study, we identified eight symptoms of older adults with urinary incontinence (i.e., anxiety, constipation, dizziness, syncope, tachycardia, urinary frequency/urgency, urinary hesitancy/retention, and vision impairment/blurred vision) that were extracted from free-text clinical notes from approximately 29% of home healthcare episodes. Compared to White patients, home healthcare episodes for Asian/Pacific Islander, Hispanic, and Black patients were less likely to have any symptoms documented in clinical notes. In the clustering analysis, we identified five distinct symptom clusters: Cluster 1 (anxiety), Cluster 2 (broadly symptomatic), Cluster 3 (dizziness and anxiety), Cluster 4 (constipation, anxiety, and dizziness), and Cluster 5 (no symptoms) that correlate with sociodemographic and clinical characteristics. Finally, in the retrospective analysis, we found that Clusters 1-4 had higher odds of emergency department visits or hospitalizations, in addition to home healthcare episodes for Black and Hispanic patients, males, patients with an unhealed skin ulcer, and patients with a urinary tract infection 14 days prior to home healthcare admission. Conclusion: Older adults with urinary incontinence in home healthcare have complex physical and psychosocial needs, increasing the risk of negative outcomes. Improving comprehensive assessment and treatment for older adults with urinary incontinence is an urgent priority, given high hospitalization rates in home healthcare. Leveraging natural language processing, this dissertation identified key symptom clusters and factors associated with emergency department visits or hospitalizations, providing valuable insight for multidimensional interventions. Findings provide preliminary evidence to inform improvements in clinical practice, healthcare policies, and future research to enhance the care of older adults with urinary incontinence and reduce negative outcomes in the home healthcare setting.

Dissertation / The aim of this study was to determine the knowledge of persons with hypertension in a selected geographical area regarding cardiovascular risk factors in order to make recommendations for patient education. A quantitative, non-experimental, descriptive study was done in the form of a survey using a questionnaire as measuring instrument. The population was hypertensive patients from selected private medical practices in the western part of KwaZulu-Natal and the bordering eastern part of the Free State. Convenience sampling was used and 46 respondents participated in the study. Only 16 (35%) of the respondents achieved a percentage on or above the competency indicator of 50%. Respondents performed worst in questions where definitions, for example hypertension, were assessed. Recommendations for a patient education document, nursing practice and further research were made. / Health Studies / M.A. (Health Studies)

A quantitative study was conducted to determine the socio-economic outcomes for the beneficiaries of the Expanded Child Survival Initiative in Uganda. The population comprised of all orphans and vulnerable children who were trained under the Expanded Child Survival Initiative of which a sample of 102 respondents were included in the structured data collection process. The outcomes that were explored were employment, income, assets and family support to siblings and other dependants by the primary beneficiaries. The findings show that the outcomes of the Expanded Child Survival Initiative were positive and benefited socio economic lives of the respondents and their family members. The majority of the respondents were using the skills obtained from the training and were employed. The employment provided a source of income and the income earned facilitates the respondents in providing the basic needs of the family members. They were able to provide adequately for most of their basic needs. The findings also show that the respondents had accumulated some assets. A number of factors influenced the utilisation of the newly acquired skills including having tool kits, start-up capital and business management skills. It is recommended that training providers should provide start-up support to the apprentices in order to facilitate them to utilise the skills obtained from apprenticeship trainings. / Public Health / Thesis (M.A. (Public Health))

This study was concerned with establishing the extent to which various components of the environment were exposed to the three toxic minerals, arsenic, mercury and lead. The concentration of these three elements were determined in groundwater and surface water, soil, plants, animals such as goats, and humans in potentially contaminated areas in the Limpopo Province of South Africa. The focus of the study was to assess the possible exposure to infants through ingestion to arsenic, mercury and lead. Comparison of the mineral content of water at the study sites with international and national drinking water standards, indicated water from Rooiberg, Leeupoort and Gravelotte are not fit for human consumption due to high arsenic and lead concentrations. Water at Gravelotte also has unacceptably high levels of mercury. The soil, plants, goat’s milk and mother’s milk at Rooiberg have higher levels of arsenic and lead than have been recorded for many other countries. Mother’s milk and goat’s milk are the main sources of arsenic, lead and mercury contamination at Rooiberg. It is therefore newborns and toddlers who are most at risk from exposure to arsenic and lead. This is a cause for environmental and health concerns, but as this research is only a base-line study, it is imperative that more comprehensive surveys of potentially toxic mineral contamination be conducted in the province. / Environmental Sciences / (M.Sc. (Environmental Science))

Chemical (gaseous) emissions from wastewater treatment plants (WWTP) are perceived as odour and can generate undesirable health reactions. These could affect the quality of life to those regularly albeit intermittently exposed, although regular exposure may result in tolerance and loss of recognition of the odour. Consequently, research is necessary to establish the role of Environmental Impact Assessment (EIA) in ensuring that facilities such as WWTP do not pose a threat to local communities, particularly in relation to housing developments for poor communities. The aim of this study was to investigate if the EIA regulations were effectively implemented before building of the Residential Development Proiect (RDP) houses at KwaMathukuza, in Newcastle South Africa. Furthermore, the study intended to determine the impact the (WWTP) has on the health of people who reside close to the site and to establish if the families staying close to the WWTP have any common ailments such as handicapped babies, early deaths within families. Findings would also indicate if RDP houses should be built in close proximity to such sites. Data was collected through a survey of 85 residents living within five kilometers and ten residing beyond five kilometers from the WWTP. The participants were selected randomly. Municipality employees who worked with the WWTP were also sampled together with healthcare givers. Data included information about health of the community, their perception of the gases released from the WWTP as well as EIA meetings and processes related to the construction of the RDP houses. The outcome of this study revealed that EIA regulations were not adequately implemented and that this residential site was unsuitable for the construction of RDP houses. It emerged that the residence regularly experience unpleasant odours released from the WWTP. These could be associated with ill-health of the residents as well as v degradation the environment in general. The study also found that the effect of the WWTP affects even those communities who reside beyond five kilometers from the WWTP. The researcher argues for more stringent mechanisms to ensure that EIA regulations are properly implemented to prevent adverse effects on the communities. / Environmental Sciences / M. Sc. (Environmental Management)

The key objective of this study was to determine the relationship between burnout (measured by the Maslach Burnout Inventory – Human Services Survey (MBI-HSS)), work engagement (measured by the Utrecht Work Engagement Scale), and sense of coherence (measured by the Orientation of Life Questionnaire developed by Antonovsky (1987)). A quantitative study using a cross-sectional survey research design was conducted on a randomly selected sample (N = 178) of nurses at a central hospital in Kwa-Zulu Natal. A theoretical relationship was established between the variables. The empirical relationship revealed statistically significant negative relationship between burnout and work engagement. A statistically significant negative relationship was also established between burnout and SOC. The findings add valuable knowledge to industrial and organisational psychology and can be applied to promote employee and organisational wellness. / Industrial and Organisational Psychology / M. Com. (Industrial and Organisational Psychology)

Thesis (PhD (Sport Science))--University of Stellenbosch, 2006. / The continued integration of our global society has caused a shift in human social interaction and redefined the contexts of adolescents’ lives. Adolescents are inundated with a variety of choices at a stage of their lives where they are trying to create their own identity. This critical period of development is highlighted by an increased desire to experiment with adult life. Thus is experimentation not uncommon. The study examines the prevalence of a range of health risk behaviours amongst adolescent girls. It focuses on the identification of behaviours such as violence, smoking, alcohol and drug use and abuse, sexual behaviours, dietary behaviours and physical inactivity that place adolescents at increased risk for premature morbidity and mortality. An intervention programme was launched at the schools concerned in an effort to address these behaviour patterns and to inform learners regarding the dangers of these health risk factors. The sample population was selected from three previously disadvantaged high schools in the Worcester region. Due to restrictive circumstances at the schools, the sample could not be randomly selected and therefore the study is based on a quasi-experimental research approach. A sample of 1805 adolescent girls in Grades 8 to 10 completed a questionnaire, which assessed a range of health risk behaviours. This questionnaire was based on the Youth Risk Behaviour Survey (YRBS) and completed by all the respondents during the pre-test. A control and experimental group was selected from the Grades concerned, at the different schools. The experimental group was subjected to a six-months long intervention programme. At the end of the intervention programme a post-test was conducted on both the control and experimental groups. Four months after the post-test the respondents were subjected to the same test, which is now known as the follow-up test. The girls who dropped out of the study as it progressed are referred to as the drop-out group. Information regarding the socio-economic background of the girls, as well as permission to take part in the study, was obtained from the parents by means of a questionnaire. A self-designed questionnaire was used to obtain information regarding the state and status of Physical Education (PE) and movement programmes within Life Orientation at the schools. Teachers who were responsible for Grades 8, 9 and 10, completed the questionnaire. To keep track of body size and growth, mass and length were determined and body mass index (BMI) was calculated. Blood pressure was measured to determine to what extend these girls suffer from hypertension. Skinfold measures were taken to determine the fat percentage. The 20m shuttle run (Bleep test) was used to indirectly determine the physical activity levels of the respondents. The main results are discussed next. The results indicate that more respondents in the post-test (64%) reported that learners carry weapons on school grounds than in the pre-test. According to the results 64% of the respondents indicated in the post-test that learners carry weapons on school grounds compared to 29% of the respondents in the follow-up test (p<0.01). The pre-tests results indicate that 11% of the respondents smoke cigarettes in comparison to 14% in the post-test (p<0.01). Approximately 9% of the respondents in the pre-test indicated that they drank at least one alcoholic drink in the week before the study was undertaken in comparison to the 22% of the post-test (p<0.01). Regarding the smoking of dagga 2% of the respondents indicated in the pre-test that they smoked dagga whereas 9% in the post-test indicated that they did. More sexual active respondents during the follow-up test (57%) indicated that they used condoms during their last sexual experience than in the post-test (46%). The results of the pre-test indicate that approximately 49% of the respondents did something to loose weight or to prevent weight-gain in comparison to the 25% of the post-test and the 31% of the follow-up test. According the results, 35% of the respondents purported to have PE at their school in comparison to 30% during the post-test and 54% during the follow-up test. Although there were some exceptions, in most cases a tendency existed that indicated an increase in the variables measured between the pre-test and post-test. In most cases the results remained constant between the post-test and the follow-up test. This study can therefore be a starting point for further research into the process to combat health risk behaviours amongst adolescent girls. This can be done with educational programmes in cooperation with several role-players in the community.

Thesis (MEdPsych (Educational Psychology))--University of Stellenbosch, 2006. / Stress has become endemic amongst teachers globally. Although there are common factors that account for the increased levels of stress among teachers, the particular factors involved differ from country to country. South Africa has gone through more than a decade of political and social change. Coping with the extended transitions within the educational system has affected teachers’ wellness. Emotional intelligence or emotionalsocial competencies, the term used in the study, offers a way of viewing the means of primary prevention as a whole, rather as loosely related elements. This offers a practical way of describing the key range of competencies that make it possible to modulate emotions, to solve social problems creatively, to be effective leaders or collaborators, to be assertive and responsible, or to be able to ask evocative and/or social questions that lead to new learning. This study focuses on the need for teachers to develop specific social and coping skills, as well the need for them to have the necessary environmental support, to prevent stress and promote wellness in teachers. This interpretive study used questionnaires, semi-structured interviews, and "a day in the life of" interviews to explore the perceptions of Life Orientation teachers about the emotionalsocial competencies that improve and support their wellness. The South African teachers surveyed consider that certain emotionalsocial competencies enhance their wellness. In their view, all teachers would benefit from having a toolkit emotionalsocial competencies. They also expressed the need for pre-service teacher education to offer training in these competencies.

Dissertation / The aim of this study was to determine the knowledge of persons with hypertension in a selected geographical area regarding cardiovascular risk factors in order to make recommendations for patient education. A quantitative, non-experimental, descriptive study was done in the form of a survey using a questionnaire as measuring instrument. The population was hypertensive patients from selected private medical practices in the western part of KwaZulu-Natal and the bordering eastern part of the Free State. Convenience sampling was used and 46 respondents participated in the study. Only 16 (35%) of the respondents achieved a percentage on or above the competency indicator of 50%. Respondents performed worst in questions where definitions, for example hypertension, were assessed. Recommendations for a patient education document, nursing practice and further research were made. / Health Studies / M.A. (Health Studies)