Thesis (M.S.P.H.)--University of Michigan, 1935.

D.Ed. / The underlying dynamics of Cases A and B have been integrated into a comprehensive description in this chapter. The cross case analysis allowed the researcher to determine the similarities and differences in these two cases. These research findings were then verified against a detailed literature control. The research, as verified by current literature, shows that women who were sexually abused as children all suffer from an Identity Problem. Most literature on the treatment of sexual abuse victims stresses the need to address the women's low selfesteem. Yet, the treatment is geared at her present low self-esteem believed to be a result of the abuse. The research findings agree that sexually abused women have low self-esteem, although their Identity Problem is not a result of the abuse, but an intensification of an already present low self-esteem and Identity Problem. The research findings indicate that their Identity Problems started before the abuse, as early as in the womb. The present Identity Problem renders the young girl more vulnerable to the abuse. The treatment of women who were sexually abused as children should be aimed at reconstructing their Identity's and specifically at treating the root cause of the problem, which is not the abuse itself. Women who were sexually abused as children are prone to feelings of worthlessness and responsibility. Powered by their Identity Problem, a Spiritual Walking Zombie Syndrome develops. Sexually abused women have an overwhelming sense of being responsible for others. And if they cannot keep others happy, which is impossible, they feel like failures and think they are worthless. The feeling of being responsible starts before the sexual violation and the abuse only intensifies these feelings. The research finds that sexual abuse can be a physical, subconscious threat to a person. Subconscious reactions to life threatening incidents differ from individual to individual. If one has accepted death one tends to act dead-like. On the other hand, if one expects death one lives in fear of dying and life is full of disasters. The research also finds that as a result of pre-natal and early childhood experiences, sexually abused women tend to act immaturely when compared to their chronological age. Their immaturity is evident in their dress, their constant self-rejection and by their dysfunctional relationships. From the research findings it is clear that each individual plays out her own life script. This life script determines how she reacts to herself and her environment. Women who were sexually abused as children have a similar life script, which in turn makes them more prone to abuse. Sexually abused women deny themselves the right to be themselves. Their perceived shameful existence, of relegating themselves, starts prior to the abuse. Treatment should therefore address these destructive life scripts and not treat the presenting symptoms. Chapter 7 proposes recommendations for the treatment and prevention of sexual abuse.

published_or_final_version / Community Medicine / Master / Master of Public Health

This study uses non-random and snowball sampling methodologies in order to get a truer insight into the life, activities and health care problems of 100 drug using prostitutes, and 50 non using prostitutes in Manchester, contacted directly in the streets or saunas / massage parlours. A subsidiary study of 120 male clients of female prostitutes was also conducted by means of self-completed questionnaires and telephone interviews. Among the sample in the main study of female prostitutes, drug users, 71% of whom were injecting users, were shown to have had a much more disrupted childhood than non users. They were also more likely to take risks in relation to condom use, to the type of sexual and drug taking activities they were engaged in, and to their general health care. A majority had been for an HIV test, with 2 reporting a positive result. Most of them (78%) had had at least one pregnancy, 10% of these making their first contact with health services whilst in labour. Access to methadone scripts tended to reduce criminal activity and rates of injecting, but only 13% had regular contact with community drug services which were not regarded as very useful. 4 The client study revealed that 62% of the sample were either married or living with a regular partner, and 86% in full time employment. One fifth had had a venereal disease check, and one fifth an HIV test (none reported positive). A majority used condoms (mostly supplied by the prostitute), although 23% reported not using one in their last contact. Clear implications arise from the study for the health, social services and criminal justice systems to ensure greater efforts are made to respond to the needs of female drug users.

The purpose of this study was to determine whether or not adults who were child incest participants exhibited greater personality adjustment problems than adults who were not child incest participants. The sample consisted of undergraduate students of The University of Arizona who had volunteered to participate in the study. Each student completed the Personal Orientation Inventory as a measure of personality adjustments, and a questionnaire adapted from the David Finkelhor Questionnaire, which placed each respondent into one of four groups. Group 1 respondents reported having had a childhood sexual experience with another child (a friend or a sibling). Group 2 respondents reported having had a childhood sexual experience with an adult who was not a family member. Group 3 respondents, the child incest participants, reported having had a childhood sexual experience with an adult who was a family member. Group 4 respondents reported having had no childhood sexual experiences. The data was analyzed in two 4 x 2 factorial analyses of variance. The P.O.I. scale scores and subscale scores were the dependent measures of personality adjustment. The independent measures of the first analysis were group membership and gender; of the second analysis, group membership and age. No statistically significant differences among the groups were found on any of the eight P.O.I. scale scores. There were statistically significant effects due to gender on three of the eight P.O.I. scales, females tending to score higher than males. The one exception to that trend was on the Time Competent scale, on which the males of Group 3 scored higher than the females of Group 3. Although that reversal trend occurred, there were no statistically significant interaction effects between group membership and gender. There were statistically significant effects due to age on two of the eight P.O.I. scales, older persons tending to score higher than younger persons. The one exception to this trend was on the Spontaneity subscale, on which the younger persons of Group 4 scored higher than the older persons. This reversal did result in a statistically significant interaction effect between group membership and age. The results of this study, although limited in scope, indicate that not all adults who were child incest participants exhibit greater personality adjustment problems than adults who were not child incest participants.

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No description available.

No description available.

Reproductive tract infections (R TIs), including but not limited to the sexually transmitted infections (STIs), are currently high on the public health agendas of most low-income countries. The reasons for this are manifold, but important contributing factors include the need to control the spread ofIDV, and the high costs to health care systems and infected individuals as a consequence of un- or mis-diagnosed infections. Strategies for the control and management of these infections in resource-poor settings have been advanced at a global policy level: syndromic management of symptomatic men and women is recommended in the absence of comprehensive laboratory facilities. This thesis describes a large cross sectional survey assessing the populationbased prevalence ofRTIs in one rural area of Bangladesh. The prevalence of these infections was determined from random selections of women and men. Patterns of health-care seeking behaviour were analysed, and the correlation between reported 5,ymptoms and the presence of infection was investigated. The prevalence of syphilis in pregnant women, and the incidence of ophthalmia neonatorum were also determined, and the cost-benefit of control strategies for these two problems in this population were investigated. Given that management of symptomatic persons forms a cornerstone of most national RTIISTI control programmes, the study described in this thesis also evaluated the efficacy of the most common syndromic algorithm in use (that for treating women with vaginal discharge). Training requirements for integrating the algorithm at primary health care level are also discussed as part of the findings, and finally the cost-effectiveness of the recommended algorithm was evaluated. Using the results of the five arms of the study, recommendations are advanced for RTIISTI control programmes in areas with similar epidemiological characteristics to those found in the population described in this study. Finally, areas where further research is needed are highlighted in the discussion.

M.A. / Sexual abuse of children has been a consistently high profile public issue throughout the late 1980’s and continues to be one. Nest and Woodhouse (1990:3) indicate that child sexual abuse and how to deal with it has become topics of enormous concern a preoccupation for health professionals no less than the media. Recent evidence points to an alarming prevalence of experiences of abuse, especially by young girls who become captive victims in their own homes. The researcher was therefore motivated to conduct this study because the incidents of child sexual abuse have increased dramatically in Soweto. Within the Western culture disclosure of sexual abuse and related interventions is well studied. In our black culture though, sexual abuse is regarded as a taboo, hence it is difficult for victims to report these cases. Even parents of abused children are not open about this problem and this makes it difficult for parents to deal with sexual abuse. The dilemma of non-disclosure causes a need for information about how parents in sexual abuse cases should handle the problem. The study focuses on formulating guidelines to help social workers in dealing with this issue of taboo. In this study the researcher conducted a groupwork with mothers of sexually abuse children in order to set a basis to develop a group intervention programme. Gomes-Schwartz (1990:20) indicates that mothers' responses to the disclosure often influence the relationship with their children. Developing a group intervention programme to address these damaged relationships is relevant to social work practice in South Africa. The aim of this study is to develop a group programme for mothers of victims of sexual abuse and to develop a treatment plan based on the literature survey. This is done by means of a literature survey (general) in the related field of child sexual abuse. The data gained from the literature study were used to develop a group programme and to make conclusions and recommendations in this regard. / Dr. E. Oliphant