The purpose of this study was to determine the impact of unemployment on the mental well-being of the South African working age population. The implication of exploring this relationship is to indicate the importance of good mental health among persons who are not employed. The present study also aimed atinvestigating the role that government can play in mitigating the impact of unemployment on mental health. This part of the research assessed the effectiveness of government’s social security system. The current study employs a mixed research design whereby both quantitative and qualitative methods of data analysis are used. The relationship between unemployment, mental well-being and government intervention is investigated using a cohort group in which the mental health of persons not employed, aged between 15 and 64 years, are followed over the period, 2004 to 2008. The results are presented using two types of data. First, secondary data from Statistics South Africa’s General Household Survey (GHS) were used to measure the impact of unemployment on mental health and to ascertain the impact of government social assistance on affected individuals’ mental well-being. Secondly, in order to explore individual perceptions around government intervention, the research employed a qualitative phenomenological design. This involved conducting semi-structured personal interviews with four unemployed women residing in Gauteng. The results showed that incidences of self-reported mental health illnesses were most likely to be found among individuals who were not employed as compared to those that were employed. This finding proved to be consistent using both descriptive and multivariate statistics which included predictive models. In terms of government intervention, positive mental well-being was shown to be positively related to access of social welfare services (in the form of social grants). This finding was true for all the years of reporting (i.e., 2004 to 2008). In conclusion, although unemployment was found to have a negative impact of mental well-being, government intervention was shown to positively mitigate this impact, thereby giving hope to an otherwise hopeless situation. Unemployment and its impact on mental well-beingalso proved to be a complex subject, requiring multidisciplinary intervening strategies to solving it. / Psychology / D. Litt. et Phil. (Psychology)

Les impacts des changements climatiques sur la population sont nombreux et ont été relativement bien documentés, ce qui n’est pas le cas de ces impacts sur la santé et la sécurité des travailleurs. L’objectif de cette thèse est de documenter les effets négatifs des changements climatiques sur la santé et la sécurité des travailleurs dans une région d’un pays industrialisé à climat tempéré, comme le Québec. Pour y arriver, deux approches ont été utilisées : a) les dangers et les effets sanitaires ont été identifiés par une revue de la littérature validée par des experts nationaux et internationaux, et des priorités de recherche ont été établies à l’aide d’une méthode de consultation itérative, b) des modèles statistiques, utiles à l’estimation des impacts sanitaires des changements climatiques, ont été développés pour apprécier les associations entre la survenue de lésions professionnelles et l’exposition des travailleurs aux chaleurs estivales et à l’ozone troposphérique, deux problématiques préoccupantes pour le Québec. Le bilan des connaissances a mis en évidence cinq catégories de dangers pouvant affecter directement ou indirectement la santé et la sécurité des travailleurs au Québec (vagues de chaleur, polluants de l’air, rayonnements ultraviolets, événements météorologiques extrêmes, maladies vectorielles transmissibles et zoonoses) et cinq conditions pouvant entraîner des modifications dans l’environnement de travail et pouvant ultimement affecter négativement la santé et la sécurité des travailleurs (changements dans les méthodes agricoles et d’élevage, altérations dans l’industrie de la pêche, perturbations de l’écosystème forestier, dégradation de l’environnement bâti et émergence de nouvelles industries vertes). Quant aux modélisations, elles suggèrent que les indemnisations quotidiennes pour des maladies liées à la chaleur et pour des accidents de travail augmentent avec les températures estivales, et que ces associations varient selon l’âge des travailleurs, le secteur industriel et la catégorie professionnelle (manuelle vs autre). Des associations positives statistiquement non significatives entre les indemnisations pour des atteintes respiratoires aiguës et les concentrations d’ozone troposphérique ont aussi été observées. Dans l’ensemble, cette thèse a permis de dégager douze pistes de recherche prioritaires pour le Québec se rapportant à l’acquisition de connaissances, à la surveillance épidémiologique et au développement de méthodes d’adaptation. Selon les résultats de cette recherche, les intervenants en santé au travail et les décideurs devraient déployer des efforts pour protéger la santé et la sécurité des travailleurs et mettre en place des actions préventives en vue des changements climatiques. / The impacts of climate change on human health are multiple and have been extensively studied in the general population, whereas these impacts on the working population have received little attention. In this perspective, the objective of this research is to document the negative effects of climate change on Occupational health and safety (OHS) in northern industrialized countries with a temperate climate, such as in Quebec. To achieve this goal, two approaches were used: a) exposure/hazards and potential effects of climate change on OHS were identified using a narrative review of the scientific literature validated by a working group of international and national experts and Quebec’s stakeholders, and research priorities applicable to the Quebec context were established by a consensus approach, b) statistical models, useful for quantifying the health impacts of climate change, were developed to estimate the associations between occupational illnesses, injuries and exposure to summer outdoor temperatures or tropospheric ozone, as these climate conditions are among the most preoccupying issues related to climate change in Quebec. The literature highlighted five categories of hazards that are likely to impact OHS in Quebec (heat waves/increased temperatures, air pollutants, UV radiation, extreme weather events, vector-borne/zoonotic diseases) and five conditions that could potentially affect the working environment and negatively impact the OHS (changes in agriculture/breeding methods, alterations in the fishing industry, disruptions of the forest ecosystem, deterioration of the built environment and emerging green industries). The modeled associations suggest that daily compensations for heat-related illnesses and work-related injury increase with ambient temperature, and that these relations vary according to workers age, industries and physical demand of the occupation (i.e. manual vs other type). Positive non-statistically significant associations were observed between acute respiratory problems compensations and levels of ozone. Overall, this work produced a list of twelve research topics for the Quebec context, all related to the knowledge acquisition, the surveillance of diseases or the development of adaptation strategies. According to this thesis, stakeholders and decision-makers should make effort to increase the protection of workers health and safety in the context of climate change.

No description available.

This study explored social workers’ perceptions of their role in providing palliative care to patients with life-limiting illnesses in six hospitals across Namibia. A qualitative grounded theory approach was use in which in-depth interviews were conduct with twenty (20) social workers. Several key findings are presented: First, the emerging constructivist grounded theory of social workers’ multi-dimensional roles in providing palliative include identities of advocate, assessor, broker, counsellor, educator, facilitator, patient liaison, mediator, discharge planner and manager of in-country referrals. Second, several participants’ uncertainties of what palliative care entails offered insight that they are in need of palliative care education and training. Third, healthcare professionals do not understand the role of the social workers and therefore social workers receive inadequate support from them. Fourth, there is a lack of in-service training and continuous education in palliative care. Fifth, there are inadequate practice opportunities in palliative care for undergraduate social work students. Finally, the well-being of social workers is another concern with limited debriefing opportunities available. Further research needs to be conducted and policy guidelines established to identify ways to improve the field of palliative care social work. In achieving this, formal education and palliative care practice opportunities for social workers need to be established, providing continuing education and establishing a Centre of Excellence on palliative care provision. This study argues that the social work profession is well positioned to draw upon its values, culture and experiences (particularly from their clients) to get involved in creating a constructivist grounded theory of social workers’ roles in providing palliative care. / Sociology / D. Phil. (Sociology)

Health related absenteeism was identified as a problem in the schools in the Molopo region, needing a multi-disciplinary approach which included the parents. A conceptual framework on absenteeism was used as a guideline for the descriptive research design. Using a convenience sampling technique 426 absentees, 22 teachers and 2 school nurses filled in three separate questionnaires in ten schools selected to determine the extent of absenteeism due to health related and other problems, the control measures taken and the awareness of school personnel. Health problems were identified as the main reasons for absenteeism. Inadequate communication between the schools and parents as well as lack of guidelines on the control of absenteeism, were other problems identified. Recommendations made related to the provision of school health services that promote the health status of the pupils based on Primary Health Care principles, parental involvement in school health matters and the formulation of policies aimed at controlling absenteeism in schools. / Health Sciences / M.A. (Nursing Science)

Sickness and healing expenence is universal, but the context in which both are perceived and dealt with is particular. Culture and the individual constitute the universal context. The social structures, values, beliefs, the symbol system of a culture and the tendency of the individual to act upon his existence within cultural parameters, inform the particular context. The relationship that exists between culture and the individual is best described as dialectic. The concept of dialect is the theoretical tool to analytically show how this relationship works out in real life. At the base of this relationship operates conflict. Sickness, or permanent ill health since early childhood as shown in an in-depth case study, triggers conflict on at least two levels: the personal-psychological and the socio­ cultural level. To effectively deal with sickness and the inner conflicts caused by it, is to channel the motivation to resolve them by way of employing a symbolic idiom, a cultural symbol that attains personal meaning. G. Chewe P. of Bemba ethnicity, the main actor of this thesis, demonstrates how his life experience of sickness made various symbols become operational, how he filled them with personal meaning, and that there was no hiatus between the public and private domain. Healing requires more than medical aid. Cultural symbols that become personal symbols are often tied into religious experience of some kind. Individuals who successfully employ personal symbols eventually achieve healing because the symbolic idiom helps them to resolve intrapsychic conflict. Missiology cannot escape from two realities: culture and the individual. If anything, missiology must be interested in culture and the individual. Missiology, in the role of aide-de-camps of the Christian Mission, shows the history of how individuals connect to God, and how God transforms them in their cultural environment. To be able to achieve both goals, the issues of context and conflict must be addressed. This thesis seeks to account for the dialectic between culture and the individual, how context and conflict shaped the person and the Christian G. Chewe P. of Bemba ethnicity, and how he acted upon this context to resolve his travail. / Christian Spirituality, Church History and Missiology / D. Th (Missiology)

The purpose of this study was to determine the impact of unemployment on the mental well-being of the South African working age population. The implication of exploring this relationship is to indicate the importance of good mental health among persons who are not employed. The present study also aimed atinvestigating the role that government can play in mitigating the impact of unemployment on mental health. This part of the research assessed the effectiveness of government’s social security system. The current study employs a mixed research design whereby both quantitative and qualitative methods of data analysis are used. The relationship between unemployment, mental well-being and government intervention is investigated using a cohort group in which the mental health of persons not employed, aged between 15 and 64 years, are followed over the period, 2004 to 2008. The results are presented using two types of data. First, secondary data from Statistics South Africa’s General Household Survey (GHS) were used to measure the impact of unemployment on mental health and to ascertain the impact of government social assistance on affected individuals’ mental well-being. Secondly, in order to explore individual perceptions around government intervention, the research employed a qualitative phenomenological design. This involved conducting semi-structured personal interviews with four unemployed women residing in Gauteng. The results showed that incidences of self-reported mental health illnesses were most likely to be found among individuals who were not employed as compared to those that were employed. This finding proved to be consistent using both descriptive and multivariate statistics which included predictive models. In terms of government intervention, positive mental well-being was shown to be positively related to access of social welfare services (in the form of social grants). This finding was true for all the years of reporting (i.e., 2004 to 2008). In conclusion, although unemployment was found to have a negative impact of mental well-being, government intervention was shown to positively mitigate this impact, thereby giving hope to an otherwise hopeless situation. Unemployment and its impact on mental well-beingalso proved to be a complex subject, requiring multidisciplinary intervening strategies to solving it. / Psychology / D. Litt. et Phil. (Psychology)

La violence est responsable de 2,5 % des décès à travers le monde, en plus d’avoir un impact important sur la santé physique et mentale des victimes. Par conséquent, il s’agit d’un problème de santé publique prioritaire. Des études récentes réalisées auprès d’individus atteints de troubles mentaux graves (TMG) ont démontré qu’il existe une association entre l’usage du cannabis et les comportements violents. Considérant que ces individus sont plus à risque de consommer des drogues et de commettre des crimes que la population générale, cette découverte est particulièrement importante dans le contexte actuel de la légalisation. L’objectif de mon projet de recherche était donc de valider et de préciser la relation entre le cannabis et la violence chez les individus TMG. Pour se faire, trois études ont été réalisées. La première visait à faire état de la littérature au moyen d’une méta-analyse. En regroupant les études ayant calculé une telle association chez les TMG, nous avons mis en lumière l’existence d’une association modérée entre l’usage du cannabis et la violence. Pour ce qui est de la deuxième étude, nous avons identifié les principaux facteurs de risque dynamiques et statiques de la violence et de la criminalité chez les TMG ; dans les deux cas, l’usage du cannabis était un facteur d’une importance majeure. La dernière étude a permis de confirmer la relation unidirectionnelle entre l’usage persistant du cannabis et la violence dans une population atteinte de schizophrénie. Finalement, ces résultats seront particulièrement importants afin de formuler des recommandations cliniques pertinentes. De futures études devront toutefois être réalisées afin d’élucider les mécanismes sous-jacents de cette association. / Worldwide, violence is responsible for 2.5% of deaths, besides having an important impact on victims’ physical and mental health. Therefore, it is a priority public health problem. Recent studies of individuals with severe mental illnesses (SMI) have shown that an association exists between cannabis use and violent behaviours. Considering that these individuals are at higher risk of drug consumption and crime than the general population, this discovery is particularly important in the current context of the legalization. My research project therefore aimed to validate and to specify the relationship between cannabis use and violence in SMI individuals. To do so, three studies were conducted. The first one was to report current literature through a meta-analysis. By grouping the studies that calculated such an association among SMI, a moderate association was found between cannabis use and violence. As for the second study, we identified the main dynamic and static risk factors for violence and criminality in SMI; in both cases, cannabis use was one of these factors. The last study confirmed the unidirectional relationship between persistent cannabis use and violence in a population with schizophrenia. Finally, these results will be particularly important in order to formulate relevant clinical recommendations. However, future studies will need to be conducted to elucidate the underlying mechanisms of this association.

The prevalence of Hepatitis C Virus (HCV) in the US is estimated at 3.5 million with 18,153 deaths in 2016. It is the most common bloodborne infection, with a higher age-adjusted mortality rate than Hepatitis B Virus or Human Immunodeficiency Virus. Without treatment, nearly 1.1 million people will die from HCV by 2060. About 41,200 new cases of HCV were reported in 41 states in the US in 2016. The reported cases of acute HCV in 2016 is 2.3 per 100,000 in Tennessee, which is more than twice the national goal set by Healthy People 2020. This is a descriptive study to ascertain the HCV prevalence and usefulness of screening in medical outreach settings (MO) compared to indigent healthcare clinics (IHC) in northeast Tennessee. This study period was from April 2017 – February 2019. Participants (n=250), were adults, who engaged in routine, opt-out HCV testing at 4 IHC and 3 MO sites in the Tri-Cities, TN region. During the screening, demographic information- age, gender, race- were collected and the de-identified data were analyzed using Statistical Analysis System (SAS 9.3) to perform a descriptive analysis. Also, several discrete Chi-Square tests of independence between the demographic variables, screening locations, and HCV antibody prevalence was conducted. A total of 250 clients were screened for HCV. The majority of clients screened were non-Hispanic whites 228 (91.20%); females 136 (54.40%); young adults 131 (52.40%) and at IHC clinics 187 (74.80%). Screening showed HCV antibody prevalence of 14.8%. The majority of positive cases were non-Hispanic whites 36 (97.30%; P=0.1561); females 19 (51.35%; P=0.6867) and young adults 23 (62.16%; P=0.286). The prevalence at the IHC clinics and MO settings were 36 (97.30%; P=0.0006) and 1(2.70%) respectively. This analysis shows the higher yield of targeted HCV screening at IHC clinics. Focused HCV screening is critical in the era of opioid epidemic, particularly when direct-acting antiviral agents (DAAs) which offer a Sustained Virologic Response (SVR) rate of more than 90% are available. The use of case control or cohort study designs to establish causality is recommended for improving focused HCV screening.

This explorative, descriptive quantitative survey attempted to determine whether the reduced number of consultations and admissions of sick children less than five years in Emfuleni sub- district clinics is due to the utilisation of the IMCI strategy or other health services. The research population comprised of all the mothers/caretakers of children less than five years who utilised the clinics and those who consulted the private medical doctor. The convenient sample consisted of 169 candidates. Data was collected by means of a questionnaire and analysed using the SAS/Basic computer statistical software package. Findings of the study revealed a need to address the major concern about the waiting time and operational times in all the three clinics. Recommendations were made that staff allocation procedures and policies be reviewed in order to abate long waiting periods at the clinics where children with childhood illnesses are treated. / Health Studies / M.A. (Health Studies)