This mini-dissertation was submitted in partial compliance with the requirements for the Master's Degree in Technology: Homoeopathy, Durban Institute of Technology, 2006. / This study sought to determine the perceptions that currently exist amongst pregnant women towards homoeopathy, in light of the fact that drug use during pregnancy is limited. This study aimed at identifying myths and misconceptions that currently exist towards homoeopathy by looking at the attitudes and perceptions held by this target group. This information can be used to develop future homoeopathic education initiatives for this target group. This study was carried out using the survey method with a questionnaire as the measurement tool. The 'Perceptions in Pregnancy' questionnaire was adapted from Moys (1996), and administered to pregnant adults attending private antenatal facilities. The questionnaire was divided into three sections: A) Demographic data; B) Knowledge and attitudes towards homoeopathy; C) Previous health care experience. This sample was obtained from private antenatal facilities through convenience sampling. Antenatal class instructors within the greater Durban area were approached and briefed about the study. Willing instructors were asked to sign a 'Letter of Permission' (see Appendix A) agreeing to allow the study to be conducted within their classes. Instructors were asked to hand out copies of the 'Participant Information Letter' (see Appendix B) within the class informing potential candidates of the study. Subjects willing to participate were then given a copy of / M

Submitted in fulfilment for the degree of Doctor of Philosophy Department of Clinical Microbiology and Infectious Diseases School of Pathology Faculty of Health Sciences University of Witwatersrand 2017. / Background Vaccination of pregnant women with conserved group B Streptococcus (GBS) surface proteins has the potential to confer serotype independent protection against invasive GBS disease. Susceptibility to early onset (<7 days of age) GBS disease in infants is associated with maternal recto-vaginal colonisation, low circulating maternal antibodies and reduced trans-placental transfer of antibodies specific to GBS capsular polysaccharides (CPS). Additionally, invasive GBS disease beyond infancy has been reported in individuals with underlying conditions associated with immunosuppression including HIV infection. In this study we undertook retrospective analysis of serum IgG titres against select GBS surface proteins in relation to invasive GBS disease risk factors. Methods Multiplex Luminex immunoassay was used to measure serum IgG titres against GBS capsular polysaccharides of serotype Ia, Ib, III and V and surface proteins Fibrinogen binding surface Antigen (FbsA), GBS Immunogenic Bacterial Adhesin (BibA), Surface immunogenic protein (Sip), gbs0393, gbs1356, gbs1539, gbs0392; and lipoproteins gbs0233, gbs2106 and Foldase PsrA. Furthermore, in vitro expression of Sip, gbs2106, gbs0393 and gbs1356 proteins on the surface of clinical GBS isolates was assessed by flow cytometry using protein specific polyclonal antibodies generated in rabbits. Results Retrospective analyses of serum antibody titres against GBS surface proteins and CPS were measured in children between 4-7 years of age who were either HIVinfected (n=68) or HIV-uninfected (n=77). Lower geometric meant titres (GMT, U/mL) against Sip and gbs2106 were detected in HIV-infected children (77.03 and 53.10) compared to HIV-uninfected children (196.41 and 139.11, p<0.001) respectively. Similar results were observed for antibodies against CPS, with HIV-infected children having lower IgG GMC for serotype Ib (p=0.012) and V (p=0.005). Protein specific antibody titres were measured in pregnant women at 20-25 and ≥37 weeks of gestation age who were either non-colonised or colonised with GBS in the rectal and/or vaginal tract. Acquisition of GBS colonisation in the vagina was associated with higher antibody titres compared to colonisation in the rectum for proteins Sip (p=0.049), Foldase (p=0.0094), gbs0233 (p=0.0039), gbs0393 (p=0.027), gbs1539 (p=0.0004) and gbs1356 (p=0.039). The likelihood of acquiring GBS colonisation during pregnancy was lower in women having median IgG titres against gbs0233 ≥200 U/mL (adjusted OR=0.47 [95% CI: 0.25-0.89], p=0.021) and gbs1539 ≥85 U/mL (adjusted OR=0.44 [95% CI: 0.24-0.82], p=0.01). The influence of maternal HIV infection on trans-placental transfer of antibodies against GBS surface proteins was evaluated by comparing IgG titres between 83 HIV-infected and 81 HIV-uninfected mother-newborn dyads. Maternal HIV infection was associated with reduced trans-placental transfer of antibodies, demonstrated by the difference in cord-maternal antibody ratios between HIV-infected and HIV-uninfected mothernewborn pairs for Sip (25.8%, p<0.001), Foldase (30.4%, p<0.001), gba0392 (36.5%, p=0.006), gbs0393 (32.9%, p<0.001), gbs1539 (39.2%, p<0.008), gbs2106 (35.7%, p<0.001) and BibA (19.4%, p=0.004). A case control study was used to evaluate the association of protein specific IgG titres and invasive disease in neonates and young infants born to GBS colonised mothers, including 116 with healthy infants and 66 with invasive GBS disease at <90 days of age. Lower IgG GMT were detected in neonates who developed early-onset disease compared to control infants for Sip (65.48 vs 145.43, p<0.001), Foldase (50.45 vs 109.87, p=0.005), gbs0393 (106.42 vs 221.81, p=0.006) and gbs1356 (45.34 vs 94.52, p=0.01). Similarly, young infants with late-onset disease had significantly lower IgG GMT (U/mL) compared to healthy controls for Sip (43.72 vs 79.69, p=0.04) and gbs2106 (30.46 vs 65.35, p=0.003). Infants born to women with Sip specific antibody titres ≥150 U/mL antibodies titres against Sip were 66% less likely to develop invasive disease. Of the 82 GBS isolates collected from mothers who deliverd term babies (39 with invasive GBS disease and 43 healthy controls) that were assessed for in vitro expression of specific proteins, Sip, gbs2106 and gbs0393 were expressed in 70.7% 93.9% and 87.8% GBS isolates respectively. The expression of gbs2106 on the surface of GBS was more frequent in strains of women with infants who developed invasive disease compared to those with healthy infants (100% vs 88.4%, p=0.028). The distribution of Sip and gbs0393 expression between GBS isolates from women of infants with invasive GBS disease and healthy controls was similar, 71.8% vs 69.8% (p=0.84) and 89.7% vs 86.0% (p=0.61) respectively. Among women carrying GBS strains expressing gbs2106, having antibody titres ≥100 U/mL was associated with 90% lower likelihood for delivering infants that develop invasive GBS disease (OR=0.11 [95% CI: 0.02-0.54], p=0.002). Conclusion Vulnerability to invasive GBS disease in HIV-infected immunocompromised individuals is possibly due to reduced antibody levels against CPS, Sip and gbs2106. Also, susceptibility to invasive GBS disease in infants may be exacerbated by maternal HIV-infection, which was associated with reduced transplacental transfer of antibody against GBS surface proteins. Higher maternal antibodies titres against Sip and gbs2106 proteins were associated with reduced odds of their infants developing invasive GBS disease. These data support consideration of Sip and gbs2106 proteins as possible vaccine candidates in pregnant women to protect their infants against invasive GBS disease. Furthermore, reduced GBS colonisation during pregnancy can be achieved by maternal immunisation of gbs0233 and gbs1539, which may subsequently result in lower rates of GBS transmission to newborns and thereby decreasing their risk for invasive GBS disease. / MT2017

Thesis (M Med.(Obstetrics & Gynecology))--University of Limpopo,2009. / OBJECTIVE: The objectives of the study were: 1) To determine the pattern of toxicity/side-effects among women using Highly Active Antiretroviral Therapy (HAART) in the perinatal period in comparison with women who were treated with intra- partum prophylaxis of nevirapine at the time of delivery. 2) To evaluate the effects of either approach of therapy on maternal and fetal outcomes. METHODOLOGY: STUDY DESIGN The department of Obstetrics and Gynaecology has begun to administer HAART to pregnant women identified for ARV programme. These women were counseled and recruited prospectively for the study. The study involved comparison of pregnancy outcomes between women identified for HAART and those who were HIV infected but who only required intra-partum prophylaxis in labour to prevent mother-to-child transmission of HIV with nevirapine.

In The Bahamas between the years 2,000 to 2007, the percentage of single mothers under the age of 20 years accounted for 11.3 – 12.7% of all births in the country. Mothers between the ages of 10 -14 years accounted for 0.1 – 0.4 % of all births and mothers age 15 -19 years accounted for 11.2 – 12.6% of all births during the same time period. Purpose: The purpose of this study was to investigate the level of empowerment among pregnant adolescents living in The Bahamas aged 18-19 years by testing the levels of autonomy, environmental mastery, personal growth, relationship with others, purpose in life and religiosity. The findings of the study may well be used to highlight areas for future research in pregnancy prevention programs for adolescents in The Bahamas. Sample: The sample for this study was 105 pregnant adolescent females 18 and 19 years of age attending ante-natal clinics in The Bahamas. Measures: The self- administered questionnaires included demographic information, obstetric history, Ryff’s Scales of Psychological Well-Being and Santa Clara Strength of Religious Faith. Analyses: Data collected from the questionnaires were entered into SPSS for analysis. Descriptive statistics was obtained. Correlation analysis was performed to determine the significance among demographic data and levels autonomy, environmental mastery, personal growth, relationship with others, purpose in life and religiosity. Multiple regression analysis was performed to determine the variance explained between the number of pregnancies and level of health empowerment. Results: The Pearson’s correlation was calculated to answer the research questions of the relationship of level of autonomy, environmental mastery, personal growth, relationship with others, purpose in life, self acceptance, religiosity and overall health empowerment with number of pregnancies of 18 and 19 year old pregnant females. Number of pregnancies was negatively correlated with all dimensions of psychological well-being, religiosity and overall empowerment. Due to the small number in the sample with repeated pregnancy (19 of 105) the correlations were not statistically significant, except personal growth. Number of pregnancies was negatively correlated but not statistically significant with personal growth. Number of pregnancies was negatively correlated and statistically significant with current enrollment in school. Pregnancy outcome and delivery type were positively correlated and statistically significant with number of pregnancies. Overall health empowerment levels was negatively correlated with history of depression and positively correlated with religiosity. Level of education and religiosity were positively correlated and statistically significant to the level of health empowerment for the adolescents in this study. Conclusions: Based on the results of this study, level of education and religiosity are predictors of levels of health empowerment and type of delivery and the outcome of the pregnancy are predictors to the number of pregnancies in pregnant adolescents 18 and 19 years old in The Bahamas.

Objective: To describe the worldwide experience of Bacillus anthracis infection reported in pregnant and postpartum women. Data Sources: Studies were identified through MEDLINE, WEB OF SCIENCE, EMBASE, and GLOBAL HEALTH databases from inception until April 2012. The keywords [(“anthrax” or “anthracis”) and (“pregna*” or “matern*” or “post partum” or “postpartum” or “puerperal” or “lact*” or “breastfed*” or “fetal” or “fetus” or “neonate” or “newborn” or “abort*” or “uterus”)] were used. In addition, all references from selected articles were reviewed, hand searches were conducted and relevant authors were contacted. Methods of Study Selection: The inclusion criteria were: 1) published articles referring to women diagnosed with an anthrax infection during pregnancy or within six months postpartum, 2) any article type reporting patient-specific data, 3) articles in any language, and 4) non-duplicate cases. Non-English articles were professionally translated. Duplicate reports, unpublished reports and review articles depicting previously identified cases were excluded. Tabulation, Integration and Results: Two authors independently reviewed articles for inclusion. The primary search of the 4 databases yielded 800 articles and the secondary cross-reference search revealed 146 articles. Seven articles from these searches met inclusion criteria. By contacting the lead author of the largest systematic review of inhalation anthrax to date, 6 additional articles, published before the databases’ inception, were identified that met inclusion criteria. In total, 19 cases of anthrax infection were found, 16 in pregnant women and 3 in postpartum women. Conclusions: Based on these case reports, anthrax infection in pregnant and postpartum women is associated with high rates of maternal and fetal death. Evidence of possible maternal-fetal transmission of B. anthracis was identified in early case reports. Transmission of B. anthracis through breast milk has not been reported. This review provides important insight to guide anthrax treatment and prophylaxis recommendations for pregnant and postpartum women.

Thesis (Ph.D.)--Kent State University, 2009. / Title from PDF t.p. (viewed Jan. 22, 2010). Advisor: Cynthia Symons. Keywords: Medical students'; pregnant; alcohol use; alcohol screening; alcohol counseling Includes bibliographical references (p. 183-206).

Thesis (Ed. S.)--Marshall University, 2002. / Title from document title page. Document formatted into pages; contains 34 p. Includes bibliographical references (p. 20-22).

Thesis (Ph. D.)--University of Texas at Austin, 2002. / Vita. Includes bibliographical references. Available also from UMI Company.

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Thesis (Ph. D.)--University of Toronto, 2004. / Adviser: Ardra Cole.