ABSTRACT THE EXAMINATION OF FACTORS THAT INFLUENCE TREATMENT SEEKING DELAY AMONG OLDER ADULTS DIAGNOSED WITH ACUTE MYOCARDIAL INFARCTION By Deonna S. Tanner Early diagnosis and treatment of acute myocardial infarction (AMI) can greatly reduce the morbidity and mortality associated with this condition. However, individuals, particularly older adults, delay seeking treatment for AMI symptoms. The purpose of this study was to examine the relationship of factors that influence pre-hospital delay in seeking treatment among older adults diagnosed with AMI. A descriptive, cross-sectional, comparative study design with a correlational component was used. Data were collected from 82 hospitalized older adults (60-80 years of age). For statistical analyses, older adults were divided into two groups. The shorter delay group delayed ≤ 120 minutes from the onset of symptoms (OS) and the longer delay group delayed > 120 minutes. Using the Common Sense Model as a guide, groups were compared on the following variables: internal influences (age, gender, race, history of AMI) and external influences (personal and professional support), cognitive representations of symptoms (symptom interpretation, perceived level of control, seriousness), and emotional representations of symptoms (anxiety and uncertainty). The majority of participants were retired/unemployed (64.6%) White men (82.9%) who were married (73.2%) with a mean age of 69.04 (± 5.82) years. The median delay time was 2.6 hours (range 0.5 - 432 hours). Participants experienced on average eight (± 3.86) symptoms (typical and atypical) with high levels of pain (M= 7.1 ± 3.4) and high state anxiety (M = 56.47 ± 10.37) at the time of the AMI. Findings show the only significant independent predictor of delay time was personal support. Being more certain that symptoms were heart related or having a previous AMI resulted in significantly shorter delay time (p <.05). Contacting a healthcare provider was not helpful for these older adults. Findings show factors influencing delay are challenging and complex, yet laypersons play an important role in the decision to seek treatment. Future research should include community-based educational programs focusing on atypical AMI symptoms and ways to increase the activation of emergency medical services soon after the OS.

<p>The main aim of the current study is to examine the relationship between community violence exposure and the development of psychopathology and examine the relationship between community violence exposure and other types of trauma, that is, childhood trauma and stressful life events. It was hypothesised that exposure to community violence will have a high correlation with development of psychological disorders such as mood and anxiety and psychotic disorders. The main study employed a quantitative research design in order to determine the relationship between PTSD in children and adolescents. The current study used secondary data to measure the correlation between exposure to community violence and the development of psychopathology. The data for this study was collected from 132 consecutive referrals between the ages of 13 to 19 (mean age = 15.4, SD = 1.6) from a youth stress clinic at a university in the Western Cape. Findings indicated that community violence prevalence was higher than previous South African studies but lower compared to American studies. There was generally a high prevalence of PTSD and major depressive disorder (MDD) in this sample compared to previous South African studies. An unexpected outcome was that even though there was a high prevalence of PTSD, there was no relationship between community violence exposure and PTSD in this sample, rather, community violence exposure was related to MDD. Furthermore, MDD and not PTSD was related to experiences of childhood trauma. Stressful life events were related to acute stress disorder (ASD).</p>

Introduction The prevalence of work-related musculoskeletal disorders is very common. The main objective of the study was to identify any association between the severity of musculoskeletal symptoms and treatment choice by workers in automobile manufacturing plants. Methods A cross-sectional study of 1017 production workers in six automobile manufacturing plants was performed. The study included the structured interviews to determine symptoms, preexisting personal risk factors, treatment choices (health care provider or no treatment sought), job strain, and job satisfaction. Nordic style questionnaire for symptoms, Karasek’s Demand Control Model and three job satisfaction questions were used to assign symptom severity, job strain, and job satisfaction, respectively. The case definition was that the person sought treatment from plant clinic or personal health care provider. The independent variables were symptom severity (2 levels), job strain (2 levels), job satisfaction (3 levels). The logistic analysis was used for data analysis. Results The Whole Body symptoms severity score was taken as the highest symptoms severity for any body region. Those with High symptoms were more likely to seek treatment than those with Low symptoms, OR=2.3 (1.23-4.27, 95%CI). There was no effect associated with job strain and job satisfaction. Those with osteoarthritis, neurological disorders and hypertension sought more treatment, OR= 3.32 (1.55-7.11, 95%CI), OR=30.5 (5.37-173, 95%CI) and OR=2.97 (1.19-7.44, 95%CI). Sex was significant, where women were more likely to seek treatment than men, OR=2.3 (1.33-3.07, 95%CI). There were no significant findings for BMI, diabetes, rheumatologic disorder, thyroid problems, and smoking. Conclusion The study found an association between the severity of the symptoms for a musculoskeletal disorder and the decision to seek treatment from a health care provider (either plant clinic or private provider). Participants with osteoarthritis, neurological disease and hypertension were also more likely to seek treatment more than those without the conditions. Women were more likely to seek treatment than men.

Mental illness among college students is a significant public health concern. Among mental health issues, one of the most prevalent and impairing is depression. Although many students experience depression, the majority do not seek help. Past research has shown that stigma beliefs are associated with help-seeking, but interventions targeting stigma have been unsuccessful at increasing help-seeking prompting the need to explore alternative models. Currently, there has been little research evaluating the role of threat-based beliefs related to help-seeking processes. As well, it remains unclear how different threat-based beliefs may interact and be related to help-seeking intentions. The purpose of these studies was to develop new measures that assess threat-based beliefs based on facilitating threats, as defined by perceived severity, mortality, loss of functioning, and loss of control threats and obstructing threats, as defined by general stigma, interpersonal rejection, and workplace rejection beliefs. As well, it was hypothesized that facilitating threats would be positively associated with help-seeking intentions and that this relationship would be moderated by obstructing threats such that higher levels of obstructing threats would attenuate the relationship between facilitating threats and help-seeking. Data were analyzed using structural equation modeling. The measurement development phase (N = 240) supported the proposed factor structure with the exclusion of the stigma and severity threat measures. When testing the moderation hypothesis (N = 212), results did not support the hypothesized relationships between facilitating threats, obstructing threats, and help-seeking intentions. The implications of these results for future research, theory, and prevention program directions are discussed.

Magister Psychologiae - MPsych / The main aim of the current study is to examine the relationship between community violence exposure and the development of psychopathology and examine the relationship between community violence exposure and other types of trauma, that is, childhood trauma and stressful life events. It was hypothesised that exposure to community violence will have a high correlation with development of psychological disorders such as mood and anxiety and psychotic disorders. The main study employed a quantitative research design in order to determine the relationship between PTSD in children and adolescents. The current study used secondary data to measure the correlation between exposure to community violence and the development of psychopathology. The data for this study was collected from 132 consecutive referrals between the ages of 13 to 19 (mean age = 15.4, SD = 1.6) from a youth stress clinic at a university in the Western Cape. Findings indicated that community violence prevalence was higher than previous South African studies but lower compared to American studies. There was generally a high prevalence of PTSD and major depressive disorder (MDD) in this sample compared to previous South African studies. An unexpected outcome was that even though there was a high prevalence of PTSD, there was no relationship between community violence exposure and PTSD in this sample, rather, community violence exposure was related to MDD. Furthermore, MDD and not PTSD was related to experiences of childhood trauma. Stressful life events were related to acute stress disorder (ASD). / South Africa

In the fields of development and public health, the decisions of the rural poor are often treated as simple, unanimous, and driven by cultural preconceptions and beliefs. This is particularly the case for sub-Saharan Africa, where a dehistoricizing tendency presupposes an ontological link between an African culture and its tendency to interpret the world through the lens of belief. Generally, household activities are not seen as the kinds of modes of objectifying social practice that are the outcome of complex historical struggles over representation, and pre-disposing cultural factors are presumed to be the key determinants of household behavior. The three papers that constitute this alternative-format, article-based dissertation interrogate these assumptions. Although they address diverse subjects (the rise of West African Pentecostalism; the logic of treatment-seeking behavior in Benin; credit and savings strategies in rural Mali), they share a methodological concern with close analysis of the complexity of household decision-making in the moment, study over time, and attention to local concerns in the context of larger social transformations. In both medical and economic contexts, this approach demonstrates not only that behavior is primarily determined by enabling factors, but that the cultural factors that do condition behavior can be understood as creative, rational, and instructive of larger concerns, rather than merely as an impediment to development goals.

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