Despite our theoretical commitment to community development (CD) approaches in occupational therapy, current practice models focus on individual interventions, rather than identifying how occupational therapists (OTs) can contribute at a community level. Consequently, OTs attempting to work with communities may not have clear guidance on methods of community engagement or strategies for addressing community level issues. This research examined three cases of OTs working in CD in different regions of Canada in order to 1) generate in-depth interpretive case descriptions of CD practice; and 2) conceptualize CD from the perspective and practices of occupational therapy. Data collection in each case occurred over three weeks and included approximately 30 hours of observations, document reviews and 14 interviews with health professionals and program participants. Constructivist grounded theory informed data analysis. The conceptual framework generated from the cross-case analysis describes the context of CD in which the OTs bridged the health and community sectors. The OTs were in community-focused positions located within regional health authorities. The OTs strategically used both professional and personal self to enable more equitable power sharing between health services, community agencies and consumers, creating opportunities for meaningful engagement with and in communities. Four main CD strategies contributed to this power shift: 1) building consumer and community capacity, 2) nurturing community partnerships, 3) influencing the health care system, and 4) linking sectors and resources. These OTs focused on a set of core values while drawing on their professional experiences. Individual, organizational and community-level changes resulted from these CD initiatives. The conceptualizations developed in this study can inform the practice of OTs by identifying potential CD strategies for enabling occupations with communities and sensitizing OTs to historical contextual tensions and power inequities. From this, the applicability of current occupational therapy models to communities can be extended, enhancing reflexive CD practice. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2010-03-04 13:35:42.337

I Sverige ökar frekevensen av psykisk ohälsa. Mindfulness är en form av uppmärksamhetsträning att vara i nuet, som kan kan öka förmågan till lugn istället för att fastna i invanda beteenden såsom oro för framtiden. I aktuell studie delger fyra respondenter individuellt sina upplevelser kopplat till hälsa, efter deltagande i ett mindfulnessprogram. Denna kvalitativa studie med en tematisk analys på narrativ bas visar att berörda anammat mindfulness i varierande grad för att hantera egen hälsa och tillvaro i arbete samt privatliv inklusive relationer. Ytterligare studie rekommenderas kring effekter av mindfulness i ett mer långsiktigt perspektiv samt att utröna eventuellt andra påverkansfaktorer. / In Sweden, the frequency of mental disorder increases. Mindfulness is a form of awareness training to be in the present, who can increase the ability to calm instead of getting stuck in habitual behavior, such as anxiety about the future. In the current study four respondents provide individually their experiences related to health, after participating in a mindfulness program. This qualitative study, with a thematic analysis of narrative base, shows that the mindfulness is embraced in varying degrees to manage their own health and life at work and private life including relationships. Further study is recommended on the effects of mindfulness in a longer term perspective, and to determine any other influencing factors.

The prevalence of low back pain has assumed an upsurge trend in the last five decades despite the many interventional strategies. One interventional strategy that has been unsuccessful has been patient education. Lack of positive results from many of the existing patient education programmes is probably due to the type of health information that has been presented and the method that has been used. Many of the health education programmes have been planned according to what the medical professionals assumed the individuals needed to know, assumptions that could have ignored some crucial aspects. This study explored the perceived health education needs of individuals with low back pain at the Nairobi Hospital Rehabilitation Unit in Kenya, the method used to educate the individuals, the appropriateness of the method according to the individuals in addition to identifying the source of the health education that the individuals had.

<p>Low back pain (LBP) is a growing health and socio-economic problem worldwide, affecting humans from adolescent to adult age. In developed countries, more than 80% of adults are at risk of suffering a disabling episode of LBP at one point during their life time. In developing countries, particularly in Africa, the life time prevalence of LBP varies in population groups, but the disability due to LBP is increasing. The aetiology of LBP is multifactorial, and there is still no consensus on the exact cause and contributing factors to LBP. In addition, little is known about patients&rsquo / knowledge and beliefs on the contributing factors to their LBP. The current study therefore, aimed to identify patients&rsquo / knowledge, attitudes and beliefs on the contributing factors to LBP, among patients attending physiotherapy outpatient departments in Malawi.</p>

Submitted in full compliance with the requirements for a Master’s Degree in Technology: Nursing, Department of Community Health Studies at the Durban University of Technology, 2009. / Purpose: Breastfeeding is a key child survival strategy important for the long-term health of both the mother and child. The number of women in paid employment has increased exponentially, yet very few of these women continue breastfeeding as recommended by the World Health Organisation. The purpose of this qualitative study was to identify the factors affecting breastfeeding practices in the workplace. Objectives of the study are to: 1: Describe managers’ attitudes to and knowledge about providing breastfeeding support. 2: Identify mothers’ attitudes towards breastfeeding and the workplace environment. 3: Describe the practices of the breastfeeding mothers in the workplace. 4: Identify factors that influence breastfeeding practices within the workplace environment Method The theoretical frameworks adopted were the Situation- Specific Theory of Breastfeeding and the BASNEF model. The frameworks together with the literature review provided the background which informed this study. The research was a case study of two multi -national companies in Durban, KwaZulu Natal; participants were mothers and managers in the companies. Purposive sampling was used for selecting eight women who participated in the focus groups, two follow up interviews were conducted and five managers were interviewed. Data collection techniques also included a reflexive journal and field observation. After a thorough review of the data, the main themes which emerged were used to guide the discussion and answer the objectives of the study. Results The two companies reflected a scenario of pressures in the workplace environment affecting women’s choices regarding combining work and breastfeeding; societal pressures were dictating acceptable behaviour. Breastfeeding was not a priority for employers, no breastfeeding policy existed. Breastfeeding mothers were isolated and employers and employees were not engaging on the issue. Conclusions and Recommendations Simple enabling factors within the workplace would allow mothers, their infants and employers to enjoy the benefits of supporting breastfeeding in the workplace; this would be a win-win situation. Government, non-governmental organisations and society have a responsibility to overtly protect, support and promote breastfeeding in society and in the workplace.

In presenting a Geography of Health of the Durban Metropolitan Area, the researcher has chosen a conceptual framework within which to sharply challenge the definition of health in a perfunctory/ functionalist way. Thus, the Geography of Health is, at the outset, locationally positioned in a socio-economic and environmental context of society. This argument is developed through a multi-conceptual approach that leads the thesis into building a framework with the central arching principles of biomedicine, social and humanistic philosophy in three randomly selected informal settlement contexts. The specific focus of this approach is on the growing poverty and homelessness, the inadequate health delivery system and the relationship between disease, physical, social and residential environments and structural inequalities. Thus, this study is embedded in numerous related contexts, the most important of which is the spatial! geographical and the social context in which health and health care is seen in relation to the nature of society and everyday life. To some extent this research endeavour is concerned with health and health care issues amongst specific categories of people within marginalized communities rather than some homogenous, non-existent category called "poor people". The key questions raised in the study relate thus to several variables that impact informal dwellers with the specific objective of determining socio-economic profiles, housing and environmental circumstances; the location and nature of health services; health status of people; the ways in which people conceptualise and prioritise health and the need for and possibility of community involvement in health and health care. In dealing with the above issues, a multi-faceted methodological approach allowed for the generation of 155 tabulations from the quantitative empirical data to be triangulated with the qualitative data produced through focus group interviews and also with the secondary data obtained. The most significant finding emerging from the study was the fact that the relationship between health and abject poverty is bi-directional. Respondents identified numerous factors that affected their health, the most important of which was poverty in respect of poor dwellings, lack of basic services, access to certain health services and the prevalence of disease. It is hardly surprising that a biomedical perspective largely prefaced the respondent's understanding of health. This can be attributed to locational factors but more specifically to the overriding socialising influence of biomedicine in South African society. In the focus group interviews with informal dwellers, the ranking exercises demonstrated that high health risks emerge from multiple and complex factors related to personal, economic, social, environmental and political factors. It is the contention of this thesis that health status improvement and the reduction of health risks of disadvantaged individuals and communities needs a multi-pronged approach with multiple solutions drawing on resources from international, national and local agencies and organisations. Finally, the study concludes by presenting an extensive pool of more concrete systematic and holistic interventions that would not only improve the quality of public health care, but also redefine the Geography of Health in South Africa. These, it is argued are seldom attainable in the short term as it is a continuous process underpinned by priorities, possibilities and planning. / Thesis (Ph.D.)-University of Durban-Westville, 2002.

Diagnosis with HIV disease is associated with a negative life event which impacts on health, longevity, reproduction and sexuality. Given the impact of disease stigma on prevailing constructions of masculinity and femininity, gender expectations are found to play an increasingly important role in prevention. In contexts in which increasingly more young people are living with HIV there is a need for appropriate sex-education, support for dealing with sexuality and self-identity with HIV. This calls for a prevention approach that gives a voice to those who have previously been marginalised and necessitates a move away from prevention approaches that are didactic and use top-down shifts in policy and regulation as a means of encouraging risk reduction. This study explores DramAidE’s Health Promotion project which locates young people who live openly with HIV in the centre of an HIV/AIDS mitigation project so that they can provide leadership and engage campus communities in HIV/AIDS related activities and events. Unlike most higher education stigma reduction efforts which draw on a model of "liberal enlightenment" in which communications experts design projects with the intention of correcting inappropriate thoughts and actions, this project avoids, what Paulo Freire (1972a) calls a ‘banking’ approach to health (Maluwa, Aggleton, and Parker, 2002). Participatory action research is associated with democratic struggles and is used in this dissertation to encourage resistance to stigmatising attitudes which are encoded within current prevention approaches. The findings suggest that peers exposed to the Health Promotion project engage with gender and prevention issues in a highly critical way. Peers living and affected by HIV have developed a context specific set of norms which encourage testing. An innovative approach to prevention has been adopted in which peer leaders living with HIV provide an alternative model of care and support which is community supported. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Darbo tikslas – įvertinti nuovargio ir pusės metų trukmės sveikatą stiprinančių pratybų įtaką širdies ir kraujagyslių sistemos reakcijai į dozuoto aerobinio krūvio mėginį. Darbo uždaviniai: 1 – Nustatyti ištvermės lavinimo pratybų įtaką elektrokardiogramos rodiklių kaitai. 2 – Palyginti EKG rodiklių kaitą prieš pratybas ir po jų, atliekant tris dozuoto intensyvumo fizinius krūvius. 3 – Nustatyti pusės metų trukmės sveikatą stiprinančių pratybų įtaką širdies ir kraujagyslių sistemos funkcinės būklės rodikliams. ŠKS funkcinių rodiklių registravimui atliekant krūvį ir atsigavimo metu naudojome kompiuterinę EKG analizės sistemą „Kaunas – Krūvis“, kuri apskaičiuodavo ir pateikdavo visų 12–koje EKG atvadų RR ir JT intervalo reikšmių vidurkius. Arterinį kraujo spaudimą (AKS) matavome Korotkovo metodu kairės rankos žasto srityje: sistolinį (S) ir diastolinį (D). Buvo registruojama prieš mėginį, iš karto po jo, baigiantis pirmajai ir antrajai atsigavimo minutėms. Miokardo depoliarizacijos ir repoliarizacijos procesų sąsajos kaitą vertinime pagal EKG QRS ir JTC intervalų kaitą, pasinaudodami matricinės analizės metodika. Pirmajame tyrime dalyvavo 12 vidutinių nuotolių bėgikų. Buvo vertinama tolygaus kroso įtaka širdies ir kraujagyslių sistemos (ŠKS) funkcinei būklei. Antrajame tyrime dalyvavo 16 tiriamųjų. Visi tiriamieji yra sveiki asmenys, nesiskundžiantys širdies ir kraujagyslių sistemos funkcija. Tiriamieji dalyvavo reguliariose sveikatos stiprinimo pratybose tris kartus... [toliau žr. visą tekstą] / The aim of this study was to evaluate the influence of tiredness and health-strengthening exercises on the reaction of cardiovascular system to the repeated measured aerobic loads. The next task was formulated: 1 – to assess the influence of endurance training session to indices of ECG. 2 – to compare the Dynamics OFM ECG indices before ant after exercise training session while performing 3 dosed exercise tests. 3 – To assess the influence of half-year health promotion training on functional indices of cardiovascular system. The computerized system „Kaunas- load“ was used for registration and analysis of 12-leads ECG: RR, JT intervals and their ratio, ST-segment depression. Arterial blood pressure (systolic and diastolic) was measured by Korotkov method. The concatenation between the depolarization and repolarization processes in myocardium by using the ECG indices QRS and JTC was assessed by method matrix analysis. Twelve middle distance runners participated in the first research. The effect of the even cross-country run on the functional state of cardiovascular system (CVS) was assessed. 16 surveyed persons in the second survey. All surveyed are conditionally healthy persons, not having any complains regarding function of cardiovascular system. The participant of this study take part in the regular health promotion groups by exercising three times per week, with the duration of an hour and a half at the gym, including frequent application of northern walking with sticks in... [to full text]

The purpose of this study was to determine student nurses’ perceptions of (1) the role of the nurse in health promotion, and (2) how the concept of health promotion is presented in nursing curricula. Research questions for this study included the following: 1) Can nursing students explain the difference between health education and health promotion? 2) What have nursing students been exposed to within their curriculum regarding health promotion? 3) What health promoting behaviors are nursing faculty role modeling as perceived by nursing students? 4) What is the role of the nurse in implementing health promotion as perceived by nursing students? 5) How do nursing students define health? Attendees of the 57 Annual National Student Nurse Association (NSNA) Convention were asked to complete an anonymous survey. A total of n= 227 surveys were returned resulting in a participation rate of 47%. The findings from this study indicated that student nurses’ perceptions regarding the role of the nurse in health promotion revolve primarily around the concept of changing individual health behavior. While there are some indications that nursing students were exposed to the idea of health promotion as a socio-ecological approach that incorporates economic, policy, organizational and environmental changes, the majority of student nurses did not see faculty or nurses role-modeling a socio-ecological approach, nor did the students see themselves as participating in a more socio-ecological approach. For nurses to be recognized as health promoters, collaborate with health promotion leaders, and effectively teach nursing education, changes need to be made in the nursing curriculum to reflect appropriate and accurate health promotion concepts.

The complexity and lack of coordination of the U.S. health care system is especially challenging for older adults, many of whom have multiple chronic conditions. The faith community is a potential partner to assist them, due to strong religiosity of older adults and specific characteristics of faith communities. This study explores the knowledge and practices of faith community nurses (FCNs) in meeting care coordination needs of older adults and identifies a model of gap-filling by FCN practice. An approach combining both quantitative and qualitative approaches was used. A survey was distributed to all known FCNs in Kentucky. From the 60 respondents, 15 FCNs were selected for personal interviews, and six care recipients were also interviewed. Survey data revealed a relatively older workforce, M=57 years, with 73% in nursing for more than 20 years. All served as FCNs in their own congregations, mostly as volunteers. FCNs relied on informal rather than formal assessments, with little consistency in type of health-related information obtained from congregants. The combined interview data revealed themes including, strong grounding in faith, sense of congregational family, reliance on general nursing assessment skills, intentional empowerment, bridging expanses, trust, and continuity. Findings suggest that FCNs in Kentucky identify and fill significant gaps in health care for older adults. Spirituality and religious rituals were important for FCNs and those they served. Congregants sought out FCNs to answer questions, interpret medical information, and assist with health care interactions. The stability of the FCNs in the lives of congregations was regarded as important; congregants counted on FCNs presence through transitions in health. A model to explain FCN intervention was developed based on integration of a social ecological perspective with the WHO International Classification of Functioning, Disability, and Health. This model reflects contextual factors that occur throughout nested environments that surround each individual, including immediate family, congregational family, health and social care systems, and societal policies. FCNs serve as a bridge between and among these nested environments, connecting them and facilitating change within each level.