Cervical cancer is the second most commonly diagnosed cancer and the third leading cause of cancer death among women in less developed countries. Screening for cervical cancer is the most accepted and successful strategy for cervical cancer control. The purpose of the study was to investigate factors that determine cervical cancer screening practice among women in Addis Ababa, Ethiopia and develop guidelines to improve the utilisation of cervical cancer screening services. The researcher used the health belief model (HMB) as the theoretical foundation of the study and a convergent parallel mixed methods design. Quantitative data was obtained from screened and not screened women attending maternal health services at selected public health centres. Statistical Package for Social Sciences (SPSS) Version 23 was used for entry and analysis of data Qualitative data was obtained in key informant interviews from health service professionals on their perceptions of women‟s cervical cancer screening uptake at the health centres. The study found that higher age >35 years category (X2 =33.618 and p-value <0.001), contraceptive use (X2 value=20.7 and p-value <0.001), having two or more children, and knowledge of cervical cancer and screening (chi-value X2 =51.649, p-value=0.001) were strongly associated with screening practice. In addition, women‟s perception of susceptibility (t-test=3.42 and 3.432, p-value=0.001) was a predictor of screening. Lack of awareness was a serious barrier to cervical cancer screening and health service providers‟ information was a strong promoter of screening. The study recommends promoting and facilitating health education on cervical cancer at all health facilities; organising awareness campaigns, education programmes, and community mobilisation to raise awareness of cervical cancer screening; integrating cervical cancer screening with other reproductive health services, and capacitating the health professionals in order to increase utilisation of cervical cancer screening services. Consequently, the researcher used the findings of the study to develop guidelines to improve the uptake and quality of cervical cancer screening services. / Health Studies / D. Litt. et Phil. (Public Health)

First Nations women face nearly three times the risk of cervical cancer and mortality rates of up to six times higher than their non-Aboriginal counterparts. While cervical cancer is almost completely preventable, Southern Alberta First Nations women seldom access cervical screening services. The purpose of this qualitative focused ethnography was to gain an understanding of the cervical screening needs of un- and under-served First Nations women living off-reserve. Thirteen purposefully selected First Nations women participated in three focus groups utilizing semi-structured interviews. Personal self-worth and cervical screening awareness and relevance are essential to the pursuit of cervical screening. Barriers and incentives for screening and opportunities for acceptability and sustainability are explored. A holistic approach, intersectoral collaboration and cultural safety are described by focus group participants as foundational for optimal service delivery. / xii, 223 leaves ; 29 cm.

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South Africa has one of the highest prevalence of HIV infections in the world. Sexual transmission is the primary mode of transmission across the country’s population. Misinformation about AIDS, negative attitudes to HIV testing and AIDS’ stigmatizing beliefs represent potential barriers to seeking HIV testing. Youth between 15-24 years have the greatest risk of HIV infection but only 37% of students at the University of KwaZulu-Natal (UKZN) had undertaken HIV counselling and testing (HCT) according to the HEAIDS (2008) report. Prevention of HIV and behaviour change includes knowledge about, and adequacy of, HIV counselling and testing (HCT) resources on campuses. The aim of this study was to investigate students’ perceptions about HCT at UKZN and make recommendations regarding improvements. An observational, analytical, cross-sectional study of UKZN undergraduate students on the five campuses was conducted. Participants completed anonymous self-administered questionnaires. Of 965 surveyed students, 663 (71%) had tested for HIV among whom 545 (58%) were females and 501(52%) were 20-25 years. Fear of positive results, perceived low risk of acquiring the infection and having confidence in his/her partner influenced student HIV testing behaviour (p<0.001). A significant difference was also found in positive attitudes towards HCT on campus between people who had tested (median score 20) and people who had not tested (median score 18) (p < 0.05). Since one third of students at UKZN had not tested for HIV, HCT at UKZN needs to be advertised more effectively so as to increase HIV testing by students on campuses. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2013.

Orientador: Regina Moura / Resumo: A Síndrome de Cockett (SC) se deve a uma compressão extrínseca da veia ilíaca comum esquerda (VICE) pela artéria ilíaca comum direita (AICD). Em consequência há o desenvolvimento de lesões intraluminais. Este cruzamento entre a artéria e a veia é considerada uma condição anatômica usual, porém em cerca de 29% da população ela pode torna-se sintomática. Os sintomas causados pela SC são: edema, dor, claudicação venosa, hiperemia, varizes e úlceras, podendo evoluir também com complicações como trombose venosa, embolia pulmonar, e mais raramente com Flegmasia Cerúlea Dolens. Até hoje não existe consenso sobre a melhor forma de tratar pacientes com SC na presença ou ausência de trombose da VICE, dividindo as opiniões se deve ser feito o tratamento clínico e/ou endovascular. Preferencialmente alguns autores optam pelas técnicas endovasculares em todos os casos e sugerem que a mesma seja realizada, na tentativa de melhorar a fluxo venoso evitando as complicações tardias. Á curto prazo, os resultados do tratamento endovascular com stents, tem mostrado excelente perviedade, embora estejam alguns deles associados ao uso de antiagregantes, anticoagulantes e ao tratamento clinico convencional com a meia elástica. Objetivo: O presente estudo teve a finalidade de comparar os resultados de perviedade e a taxa de complicações ocorridas em pacientes portadores da SC, tratados com angioplastia e stent, na presença e ausência de trombose da VICE, utilizando a Revisão Sistemática e Meta-análise ... (Resumo completo, clicar acesso eletrônico abaixo) / Mestre

Background Cervical cancer is one of the common cancers worldwide. Despite the available screening services, the uptake of cancer of the cervix is very low. The incidence and mortality in western countries has reduced greatly due to the introduction of cervical cancer screening programmes. However, this is not the same in Africa where cervical cancer is more prevalent in lower resource countries to lack of access to effective screening and services that enhances early detection and treatment. Purpose/Aim of the study The purpose of this research is to determine knowledge of cervical cancer and the level of awareness of screening regimes/routines among HIV positive women in Swaziland. The study was conducted at one hospital specifically at the HIV Care Unit and Public Health Unit between January and June 2015. Methods The questionnaire was administered to collect data and consisted both open and close-ended questions. The questionnaire comprises of three sections: Section A: Socio-demographic data and Section B: Awareness on Cervical Cancer. Section C: Awareness/knowledge on cervical cancer screening. The sample consisted of 123 HIV positive who are on antiretroviral therapy (ART) or ART naive. The mean age for the respondents was 35 years. Results From this study, N=28 (23%) out of 123 (77%) reported to have received annual Pap smear for cervical cancer screening. A low proportion of the respondents (45%) had knowledge on cervical cancer screening. In addition, 63% of those who got information about cervical cancer screening through the radio perceived themselves to be at risk of getting cervical cancer. Only 4% heard about cervical cancer at the ART clinic, despite having been followed up for their care at the HIV clinic. Those who screened for cervical cancer were younger in age 25-34 years (80%). This study also revealed that education increased the changes of a woman to be screened for cervical cancer. If a woman had a university or high school education, she perceived herself to be at risk of getting cervical cancer. Conclusion Knowledge is power, cervical cancer campaigns should be conducted at national level in order to promote prevention through screening. Cervical cancer screening should be fully integrated into HIV services / Health Studies / M.A. (Public Health)

Submitted by LENIZE DA SILVA RODRIGUES (nize_silva@hotmail.com) on 2017-09-27T19:16:54Z No. of bitstreams: 1 DISSERTACAO DE MESTRADO PESQUISA CLINICA - LENIZE DA SILVA RODRIGUES.pdf: 2672614 bytes, checksum: 59d7f6f68213dfaccdca11f5c0b0f7bf (MD5) / Approved for entry into archive by Monique Sasaki (sayumi_sasaki@hotmail.com) on 2017-09-28T14:36:32Z (GMT) No. of bitstreams: 1 rodrigues_ls_me_bot.pdf: 2672614 bytes, checksum: 59d7f6f68213dfaccdca11f5c0b0f7bf (MD5) / Made available in DSpace on 2017-09-28T14:36:32Z (GMT). No. of bitstreams: 1 rodrigues_ls_me_bot.pdf: 2672614 bytes, checksum: 59d7f6f68213dfaccdca11f5c0b0f7bf (MD5) Previous issue date: 2017-09-01 / A Síndrome de Cockett (SC) se deve a uma compressão extrínseca da veia ilíaca comum esquerda (VICE) pela artéria ilíaca comum direita (AICD). Em consequência há o desenvolvimento de lesões intraluminais. Este cruzamento entre a artéria e a veia é considerada uma condição anatômica usual, porém em cerca de 29% da população ela pode torna-se sintomática. Os sintomas causados pela SC são: edema, dor, claudicação venosa, hiperemia, varizes e úlceras, podendo evoluir também com complicações como trombose venosa, embolia pulmonar, e mais raramente com Flegmasia Cerúlea Dolens. Até hoje não existe consenso sobre a melhor forma de tratar pacientes com SC na presença ou ausência de trombose da VICE, dividindo as opiniões se deve ser feito o tratamento clínico e/ou endovascular. Preferencialmente alguns autores optam pelas técnicas endovasculares em todos os casos e sugerem que a mesma seja realizada, na tentativa de melhorar a fluxo venoso evitando as complicações tardias. Á curto prazo, os resultados do tratamento endovascular com stents, tem mostrado excelente perviedade, embora estejam alguns deles associados ao uso de antiagregantes, anticoagulantes e ao tratamento clinico convencional com a meia elástica. Objetivo: O presente estudo teve a finalidade de comparar os resultados de perviedade e a taxa de complicações ocorridas em pacientes portadores da SC, tratados com angioplastia e stent, na presença e ausência de trombose da VICE, utilizando a Revisão Sistemática e Meta-análise de estudos observacionais. Método: Foram utilizadas as recomendações do manual Cochrane Handbook for Intervention Reviews produzido pela Cochrane que orienta a produção de revisões sistemáticas utilizando como referência para a escolha do método. A produção desta dissertação e manuscrito foi baseada no MOOSE statement para garantir que todas as etapas do estudo sejam reportadas claramente. As bases de dados utilizadas foram: Medline, EMBASE, LILACS, Scopus, Scielo, Pubmed e, Web of Science. A data da última busca foi 06 de abril de 2017. Esta pesquisa incluiu estudo de 2 grupos principais, tratados com angioplastia e stent: no G1: foram incluídos pacientes com a SC ausência trombose VICE e no G2 foram incluídos pacientes com SC presença de trombose da VICE. Resultados: De 250 artigos foram selecionados 3 estudos comparativos observacionais, sendo o número total de pacientes avaliados igual a 243. Nestes trabalhos selecionados foram associados ao tratamento endovascular o uso de antiagregantes plaquetários, anticoagulantes durante o período 3 a 12 meses e o uso da meia elástica. A patência primária, respectivamente, no G1 e G2 foi de e 93,4% e 89,2% (OR 0.55, 95% IC [0.15, 2.06], P= 0.37; I2=29%, P=0.24). E a patência secundária, respectivamente, de G1 e G2 foi de 93.5% e 82.06% (OR 0.50, 95% IC [0.05, 4.72], P= 0.54; I2=69%, P=0.04). Embora não estatisticamente significante, observa-se uma tendência em ocorrer maior patência nos pacientes do G1. Em relação ás complicações no total, houve tendência maior no G2 em relação ao G1. Conclusão: Os resultados obtidos neste estudo de revisão sistemática, mostraram que o tratamento endovascular é eficaz em ambos os grupos à curto prazo e longo prazo, mas, sugere que no grupo 1 a perviedade é discretamente melhor que no grupo 2, com menores complicações. / The Cockett Syndrome (CS) is due to an extrinsic compression of the common left iliac vein (CLIV) by the common right iliac artery (CRIA). Consequently, there is a development of intraluminal lesions. This crossing between the artery and the vein is considered a usual anatomic condition; however, in about 29% of the population it may become symptomatic. The symptoms caused by the CS are: edema, pain, venous claudication, hyperemia, varicose veins e ulcers, being possible also to evolve with complications such as venous thrombosis, pulmonary emboli and more rarely with Flegmasia Cerúlea Dolens. Until today there´s no consensus about the best way to treat patients with CS in either the presence or the absence of CLIV thrombosis, it has been dividing opinions whether the clinical or the endovascular treatment should be done. Preferably, some authors choose the endovascular techniques in all cases and suggest that it be performed, in the attempt of improving the venous flow thus avoiding later complications. In short term the results of the endovascular treatment with stents, have shown excellent patency, although some of them are associated to the use of antiplatelet, anticoagulants and to the conventional clinical treatment with compression stocking. Objective: the present study had as goal to compare the results of the patency and the complication rate occurred in patients bearing the CS, treated with angioplasty and stent, in the presence and absence of the CLIV thrombosis, using the Systematic Review and Meta-Analysis in the observational studies. Method: It has been used the recommendations of the manual Cochrane Handbook for Intervention Reviews which orients the production of systematic reviews using as reference for the choice of the method. The production if this dissertation and manuscript has been based on the MOOSE statement to assure that all phases of the study be reported with clarity. The data bases used were: Medline, EMBASE, LILACS, Scopus, Scielo, Pubmed and, Web of Science. The date of the last search was April 6th 2017. This research includes the study of two main groups, both treated with angioplasty and stent: in the G1: it has been included patients with CS without CLIV thrombosis and in the G2: it has been included patients showing CS without CLIV thrombosis. Results: From 250 articles, it has been selected three comparative observational studies, being the total number of analyzed patients equal to 243. In these selected works it has been associated the use of antiplatelet, anticoagulants during the period from 3 to 12 months and the use of the compression stocking. The primary patency, respectively, in G1 and G2 has been of 93.4% and 89.2% (OR 0.55 (95% IC [0.15, 2.06], P= 0.374; I2=29%, P=0.24). And the secondary patency, respectively, in G1 and G2 has been of 93.5% and 82.06% (OR 0.50, 95% IC [0.05, 4.72], P= 0.54; I2=69%, P=0.04). Even though statistically not relevant in both patencies, it can be observed a tendency in the occurrence of a greater patency in patients from G1. In relation to the complications in the total, there has been difference being greater G2 in relation to the G1. Conclusion: The results obtained in the study of systematic review, have shown that the endovascular treatment is effective in short and long terms, but it suggests that in group 1 the patency is discreetly greater than in group 2, with less complications.

Cervical cancer is reported to be the first among the five leading cancers affecting women in South Africa and the leading cancer among Black females. There is a high incidence and mortality rate among underserved and under-screened women presenting with cervical cancer as they are often unable to access screening facilities. Very little has been done to establish the factors in private health care provision that influence the implementation of cervical screening programmes. The study investigates factors influencing cervical cancer screening programme implementation among private medical practitioners in Soshanguve to establish whether private practitioners assume their roles in cervical screening. The intention is to provide guidelines for a screening programme that could be implemented in private health facilities. The study is qualitative, explorative, descriptive and contextual, using interviews and observation as the main data-collection methods. Lack of awareness and interest, failure to inform patients about cervical screening, age and gender of medical practitioners were among the factors identified. The study concluded that awareness programmes about cervical screening and materials containing information on cervical cancer and predisposing factors should be designed. The utilization of cheaper laboratory service providers could increase participation by making the test affordable and accessible to cash patients. The establishment of a private Pap clinic within medical practices or even as an independent entity is also recommended. / Health Studies / M.A. (Public Health)

Cervical cancer is reported to be the first among the five leading cancers affecting women in South Africa and the leading cancer among Black females. There is a high incidence and mortality rate among underserved and under-screened women presenting with cervical cancer as they are often unable to access screening facilities. Very little has been done to establish the factors in private health care provision that influence the implementation of cervical screening programmes. The study investigates factors influencing cervical cancer screening programme implementation among private medical practitioners in Soshanguve to establish whether private practitioners assume their roles in cervical screening. The intention is to provide guidelines for a screening programme that could be implemented in private health facilities. The study is qualitative, explorative, descriptive and contextual, using interviews and observation as the main data-collection methods. Lack of awareness and interest, failure to inform patients about cervical screening, age and gender of medical practitioners were among the factors identified. The study concluded that awareness programmes about cervical screening and materials containing information on cervical cancer and predisposing factors should be designed. The utilization of cheaper laboratory service providers could increase participation by making the test affordable and accessible to cash patients. The establishment of a private Pap clinic within medical practices or even as an independent entity is also recommended. / Health Studies / M.A. (Public Health)

Text in English / Cervical cancer remains the leading cause of cancer mortality among women worldwide, a burden in the developing countries and commonly detected through symptoms at later invasive stages. The study aimed at establishing knowledge and awareness of the importance of cervical cancer screening in the Makhuduthamaga Sub-district by exploring the perceptions of women and professional nurses and through the review of the National Cervical Cancer Screening Policy (2013). Recommendations to address the gap in knowledge and to inform the National Cervical Cancer Screening Policy were developed based on the study findings. A mixed-method approach was used in this study through a sequential explanatory design, which is quantitatively driven was used. Quantitative data were obtained by using a researcher developed checklist. The checklist was developed from variables stated in the National Cervical Cancer Screening Policy and was used to review its implementation. Qualitative data was obtained through in-depth interviews with individual women and focus group discussions with professional nurses. The study was conducted in ten randomly selected clinics of Makhuduthamaga Sub-district. Purposive sampling was done to obtain qualitative data. An average score of 9.7 was obtained for all ten clinics that participated in the study with regard to the evaluation of the implementation of the National Cervical Cancer Screening Policy. Only 6 (60%) clinics implemented the policy whereas 4 (40%) clinics did not implement the policy. Women and professional nurses perceived cervical cancer screening as important. Lack of knowledge among women regarding cervical cancer screening contributed to the majority of women not screening for cervical cancer. Lack of resources, the 10 year interval of normal cervical cancer screening, the use of disposable vaginal speculums and brushes, lack of standardized cervical cancer screening training, centralization of cytology laboratories came out as factors that negatively influence the uptake of cervical cancer screening. Cervical cancer screening awareness campaigns, availability of resources and standardized in-service trainings on cervical cancer screening were recommended to enhance the cervical cancer screening uptake. Key concepts: / Health Studies / D. Litt. et Phil. (Health Studies)