Dissertations / Theses on the topic 'Health behavior South Australia'
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1
Chalmers, Jane. "The oral health of older adults with dementia." Title page, contents and abstract only, 2001. http://web4.library.adelaide.edu.au/theses/09PH/09phc438.pdf.
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Bibliography: leaves 347-361. Presents results of 2 longitudinal studies investigating the oral health of older adults with dementia, using questionnaires and clinical inspections at baseline and one year. Groups studied were nursing home residents and those living in the community, with moderate to severe dementia or no dementia diagnosis. Caries experience was related to dementias severity and not to specific dementia diagnoses. Coronal and root caries experience was higher in dementia participants with moderate-severe dementia, the socio-economically disadvantaged, more functionally dependent, taking neuroleptic medications with high anticholinergic adverse effects, with eating and swallowing problems, were not attending the dentist, who needed assistance and were behaviourally difficult during oral hygiene care and whose carers were burdened.
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McNamara, Laurence James. "Just health care for aged Australians : a Roman Catholic perspective /." Title page, contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09PH/09phm1682.pdf.
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Alexander, Kathy. "Promoting health at the local level : a management and planning model for primary health care services /." Title page, contents and introduction only, 1994. http://web4.library.adelaide.edu.au/theses/09PH/09pha376.pdf.
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Aguilar, Manuel. "The psychological health of the central American community in Adelaide, South Australia /." Title page, contents and abstract only, 1994. http://web4.library.adelaide.edu.au/theses/09ARPS/09arpsa283.pdf.
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Gunnell, Pamela Ann. "Community health in South Australia : some practical lessons for the Green Movement /." Title page, table of contents and summary only, 1994. http://web4.library.adelaide.edu.au/theses/09ENV/09envg976.pdf.
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Cronin-O'Reilly, Sorcha. "Benthic community structure, health and function of a microtidal estuary in south-western Australia." Thesis, Cronin-O'Reilly, Sorcha (2021) Benthic community structure, health and function of a microtidal estuary in south-western Australia. PhD thesis, Murdoch University, 2021. https://researchrepository.murdoch.edu.au/id/eprint/61786/.
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Microtidal estuaries are prone to anthropogenic degradation, with natural features of those in south-western Australia making them more susceptible. However, the benthic ecological health of these systems is rarely assessed, despite the importance of the benthos and frequent application of benthic indices in estuaries elsewhere, particularly macrotidal systems in the northern hemisphere. The aim of this research was to assess the current status of the benthic macroinvertebrate community and its role in the function and management of the microtidal Peel-Harvey Estuary. After accounting for the effects of natural hydrological conditions (e.g. salinity, temperature), the benthic macroinvertebrate community was shown to respond to anthropogenic stress as represented by sediment condition (i.e. oxygenation, organic enrichment, mud content, sulphide presence), demonstrating its potential utility for assessing estuarine health. However, existing benthic indices commonly used in macrotidal estuaries (e.g. the multivariate AZTI Marine Biotic Index) yielded results inconsistent with sediment condition, demonstrating their limitations when applied to highly adaptive, stress-tolerant macroinvertebrate communities that are common in microtidal estuaries. A new multi-metric Estuarine Benthic Community Index was developed, following a multivariate approach to select community metrics that showed greater responses to sediment condition than natural stress. Overall, the benthic macroinvertebrate community in the Peel-Harvey Estuary was typically in good to fair health, with decreased health in the summer and deeper depositional areas. It is largely dominated by small-bodied, opportunistic species, and apparently retained in early succession due to chronic natural and anthropogenic stress. This was further reflected by the community’s limited impacts on solute fluxes of benthic metabolism, nutrient exchange and denitrification, with sediment condition being more influential. These findings demonstrate that these benthic faunal communities do not play a substantial role in estuarine function, with the application of resulting benthic indices restricted to assessing more structural aspects (e.g. diversity) of benthic ecological health.
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Johnson, Bruce. "An evaluation of the use and impact of a school based child abuse prevention program /." Title page, contents and abstract only, 1995. http://web4.library.adelaide.edu.au/theses/09PH/09phj658.pdf.
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Thesis (Ph. D.)--University of Adelaide, Dept. of Psychiatry, 1996.Addendum and errata are pasted in onto back end papers & back pages. Copy of author's previously published article inserted. Includes bibliographical references (leaves 451-466).
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Coulibaly, Souleymane. "Understanding African migrants' and refugees' experiences of digital health technologies in south east Queensland, Australia." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/236175/1/Souleymane%2BCoulibaly%2BThesis%282%29.pdf.
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This thesis focuses on the African migrant and refugee community in South East Queensland to investigate how community members use digital technologies for accessing health information. It demonstrates that African community members in Australia access and use digital technologies differently to non-African members of the community. The thesis highlights that an information sharing culture, especially via instant messaging apps such as WhatsApp, prevails in the African community. The thesis also shows that digital technologies, which convey health information and services around the world, are not equally experienced by people and this has implications for health providers and policy makers.
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Kasper, Marta L. "The population ecology of an invasive social insect, Vespula germanica (Hymenoptera : vespidae) in South Australia /." Title page, table of contents and abstract only, 2004. http://web4.library.adelaide.edu.au/theses/09PH/09phk1928.pdf.
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Chapman, Stellina M. Aubuchon. "Oral Health Beliefs as Predictors of Behavior: Formative Research for Oral Health Campaigns in South Africa." Ohio University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1385140049.
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Ashby, Lachlan. "Spatial patterns of Lepidoptera in the eucalypt woodlands of the Sydney Basin, New South Wales, Australia." Department of Biological Sciences - Faculty of Science, 2008. http://ro.uow.edu.au/theses/93.
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The patterns of spatial distribution and abundance were investigated for moth assemblages in the eucalypt woodlands of the Sydney Basin. A total of 228 species of Lepidoptera, distributed among 25 families, were recorded from three national parks located on the perimeter of the Sydney metropolitan region.From within the eucalypt woodland habitat of the Sydney Basin, the study investigated the spatial variation of night-flying Lepidoptera present at several different scales of observation, from the trap level through to across the landscape. Assemblages varied with spatial scale, with uniformity occurring across the landscape as a whole, however becoming patchy at finer spatial scales. Multivariate and turnover analysis indicated that although heterogeneity of abundance and richness may vary significantly depending on spatial scale, sites and national parks contained their own unique suite of species in comparison to one another.The structure of the assemblages of moths in the eucalypt woodlands of the Sydney Basin can vary, and is dependant on the level of spatial scale of observation. Further study needs to be conducted at a range of temporal scales to ascertain the presence of patterns in the Lepidoptera communities in the Sydney region in order to contribute to the development of suitable conservation strategies in the Sydney Basin.
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Asia, Ida. "The adolescent and sexual health." Thesis, Stellenbosch : University of Stellenbosch, 2004. http://hdl.handle.net/10019.1/16251.
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Thesis (MCur)--University of Stellenbosch, 2004.ENGLISH ABSTRACT: Research and in certain instances the lack of research as well as extensive experience of the researcher in this field of study convinced the researcher that a scientific study / exploration is critical on the different aspects of adolescent sexual health. A study, based on a combination of qualitative and quantitative methods (triangulation), was conducted to identify and describe the factors playing a role in adolescents’ experiencing problems in maintaining their sexual health. Adolescents are at risk of contracting Sexually Transmitted Diseases including HIV/AIDS because of their sexual behaviour. Initiation of early sexual relations contributing to possible multiple sexual partners and failure to consistently use condoms contribute to this risk. Failure to continuously use a reliable contraceptive method also enhances the risk of unintended pregnancies and consequent exposure to the risks involved in termination of pregnancy or the psychological effects of giving the baby up for adoption, the hardship of raising the baby as a single parent or being forced to marry at a young age. Thus the physical-, emotional-, and social well being of the adolescent is at risk when they are not equipped to maintain their sexual health.The study concludes that adolescents that are sexually active and have multiple sexual partners have a higher probability of not maintaining their sexual health. Based on the outcome of this study the researcher feels strongly that the following needs to be addressed in order to promote the maintenance of adolescent sexual health: • Professional nurses need to be trained and sensitized to guide and manage adolescents seeking sexual or reproductive advice; • Sexuality programmes need to be integrated into school curricula; • Positive use of the mass media to promote healthy lifestyles; and • Training programmes for parents and adolescents.
AFRIKAANSE OPSOMMING: Navorsing en in sekere gevalle die gebrek daaraan sowel as ekstensiewe ondervinding van die navorser in die studieveld, het die navorser oortuig dat ‘n wetenskaplike studie / eksplorasie oor die veskillende aspekte van adolessente seksuele gesondheid krities was. ‘n Studie, gebaseer op ‘n kombinasie van kwalitatiewe en kwantitatiewe metodes (triangulasie), was uitgevoer om die faktore wat ‘n rol speel in adolessente se vermoëns om hul seksuele gesondheid te handhaaf, te identifiseer en te bepreek. Adolessente se risiko is hoog om Seksueel Oordraagbare siektes, insluitend MIV/VIGS, op te doen weens hul seksuele gedrag. Die aanvang van vroeë seksuele verhoudings dra by tot moontlike meervoudige seksmaats en die gebrek aan konsekwente gebruik van kondome verhoog die risiko. Gebrek aan die aaneenlopende gebruik van ‘n betroubare kontraseptiewe metode verhoog ook die risiko van ‘n ongewensde swangerskap en gevolglike blootstelling aan die risiko’s verbonde aan terminasie van swangerskap of die psigologiese effekte wat gepaard gaan met aanneming, enkel ouerskap en geforseerde trou op ‘n vroeë ouderdom. Derhalwe word die fisiese-, emosionele- en sosiale welsyn van die adolessent bedreig as hulle nie toegerus is om hul seksuele gesondheid te handhaaf nie.Die gevolgtrekking van die studie is dat adolessente wat seksueel aktief is en meervoudige seksmaats het, ‘n hoër waarskynlikheid het om nie hul seksuele gesondheid te handhaaf nie. Gebaseer op die uitkoms van die studie is die navorser van mening dat die volgende aangespreek moet word ten einde die handhawing van adolessente seksuele gesondheid te bevorder: • Geregistreerde vepleegkundiges moet opgelei en gesensitiseer word om adolessente te hanteer en van leiding te voorsien; • Seksualitiet programme moet in die skool kurrikulum integreer word; • Positiewe gebruik van die massa media om gesonde lewenstyle te bevorder; en • Opleidingsprogramme vir ouers en adolessente.
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Kariminia, Azar Public Health & Community Medicine Faculty of Medicine UNSW. "Death among a cohort of prisoners in New South Wales Australia ??? a data linkage study." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2007. http://handle.unsw.edu.au/1959.4/32476.
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This thesis examines mortality rates among adults who experienced full-time imprisonment in New South Wales between January 1988 and December 2002, by record linkage to the Australian National Death Index. The cohort included 76383 men and 8820 women. Over a mean follow-up of 7.7 years, 5137 deaths (4724 men, 423 women) were identified. Three hundred and three deaths (295 men, eight women) occurred in custody. The median age at death was 36.6 years for men and 32.7 years for women. The prominent causes of death were drug overdose, suicide, accidental and cardiovascular disease. The crude mortality rate was 797 per 100000 person-years for men and 685 per 100000 person-years for women. Risk of mortality was 3.7 times greater in male and 7.8 times greater in female prisoners than the standard population. The excess mortality was substantially raised following release from prison in both men (standardised mortality ratio 4.0 vs 1.7) and women (standardised mortality ratio 8.2 vs 2.1). The period of highest risk of death was the first two weeks after release. Drug overdose was the main cause of death, responsible for 68% of the deaths in the first two weeks for men and for 90% of the deaths in this period for women. In men, there was also a clustering of suicide directly after release. Prisoners admitted to prison psychiatric hospital, repeat offenders and those in the early stage of followup were at increased risk of mortality. Violent offenders were overrepresented in suicide figures and property offenders in death from overdose. Minority groups, in particular men, had a lower risk of death than white people. The above findings reinforce how disadvantaged prisoners are, measured by mortality as the most fundamental scale of human wellbeing. Prison represents a potential opportunity for treatment and public health intervention to address some of the health problems underlying the high mortality found in this study. The key challenge is, however, to provide a continuum of care between the prison and community.
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Stocks, Nigel. "Trachoma and visual impairment in the Anangu Pitjantjatjara of South Australia /." Title page, contents and abstract only, 1992. http://web4.library.adelaide.edu.au/theses/09MD/09mds865.pdf.
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Jardine, Andrew. "The impact of dryland salinity on Ross River virus in south-western Australia : an ecosystem health perspective." University of Western Australia. School of Population Health, 2007. http://theses.library.uwa.edu.au/adt-WU2007.0182.
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[Truncated abstract] A functional ecosystem is increasingly being recognised as a requirement for health and well being of resident human populations. Clearing of native vegetation for agriculture has left 1.047 million hectares of south-west Western Australia affected by a severe form of environmental degradation, dryland salinity, characterised by secondary soil salinisation and waterlogging. This area may expand by a further 1.7-3.4 million hectares if current trends continue. Ecosystems in saline affected regions display many of the classic characteristics of Ecosystem Distress Syndrome (EDS). One outcome of EDS that has not yet been investigated in relation to dryland salinity is adverse human health implications. This thesis focuses on one such potential adverse health outcome: increased incidence of Ross River virus (RRV), the most common mosquito-borne disease in Australia. Spatial analysis of RRV notifications did not reveal a significant association with dryland salinity. To overcome inherent limitations with notification data, serological RRV antibody prevalence was also investigated, and again no significant association with dryland salinity was detected. However, the spatial scale imposed limited the sensitivity of both studies. ... This thesis represents the first attempt to prospectively investigate the influence of secondary soil salinity on mosquito-borne disease by combining entomological, environmental and epidemiological data. The evidence collected indicates that RRV disease incidence is not currently a significant population health priority in areas affected by dryland salinity despite the dominant presence of Ae. camptorhynchus. Potential limiting factors include; local climatic impact on the seasonal mosquito population dynamics; vertebrate host distribution and feeding behaviour of Ae. camptorhynchus; and the scarce and uneven human population distribution across the region. However, the potential for increased disease risk in dryland salinity affected areas to become apparent in the future cannot be discounted, particularly in light of the increasing extent predicted to develop over coming decades before any benefits of amelioration strategies are observed. Finally, it is important to note that both dryland salinity and salinity induced by irrigation are important forms of environmental degradation in arid and semi-arid worldwide, with a total population of over 400 million people. Potential health risks will of course vary widely across different regions depending on a range of factors specific to the local region and the complex interactions between them. It is therefore not possible to make broad generalisations. The need is highlighted for similar research in other regions and it is contended that an ecosystem health framework provides the necessary basis for such investigations.
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Owen, Julie. "Development of a culturally sensitive program delivering cardiovascular health education to indigenous Australians, in South-West towns of Western Australia with lay educators as community role models." University of Western Australia. School of Population Health, 2006. http://theses.library.uwa.edu.au/adt-WU2006.0061.
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[Truncated abstract] Indigenous Australians suffer cardiovascular disease (CVD) at a rate six times greater than the general population in Australia and while the incidence of CVD has been reduced dramatically amongst the majority of non-indigenous Australians and amongst Indigenous populations in other countries in the last 30 years, there has been little change in the figures for Aboriginal Australians, showing that heart health campaigns have little impact, for this group of people. Aims : The principal aims of this study were firstly, to determine and record the barriers to the development and delivery of CVD prevention programs amongst Indigenous Australians and secondly, to develop an alternative, effective and culturally sensitive method of delivering heart health messages. Methods and results : The study was qualitative research undertaken in three South-West towns of Western Australia where the incidence of CVD was high amongst the Aboriginal community members. The use of semi-formal interviews, informal individual consultation, observation, and focus groups were methods implemented to obtain information. The first phase of the research was to identify the barriers which affected the Aboriginal Health Workers’ ability to deliver specialist educational programs. Questionnaires and interviews with the Aboriginal Health Workers and other health professionals in the towns, and community focus groups were undertaken in this phase of the study. The second phase of the research was aimed at developing an alternative strategy for delivering heart health messages. The focus changed to adopt more traditional ways of passing on information in Indigenous communities. The idea of small gatherings of friends or family with a trusted community member presenting the health message was developed. The third phase of the research was to implement this new approach. Lay educators who had been identified within focus groups and by Aboriginal Health Workers were trained in each of the towns and a protocol involving discussions of health issues, viewing a video on CVD, produced by the National Heart Foundation, sharing in a ‘heart healthy’ lunch and partaking in a ‘heart health’ knowledge game which was developed specifically for the gatherings. Several of these gatherings were held in each of the towns and they became known as ‘HeartAware parties’.
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Shirangi, Adeleh. "A descriptive epidemiology and health promotion study of asthma in the southern area of Adelaide, South Australia /." Title page, table of contents and abstract only, 1996. http://web4.library.adelaide.edu.au/theses/09MPM/09mpms558.pdf.
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Gates, Jody. "An ecological study of Bush stone-curlews Burhinus grallarius on Kangaroo Island, South Australia." Title page, abstract and contents only, 2001. http://web4.library.adelaide.edu.au/theses/09SM/09smg259.pdf.
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Includes bibliographical references (leaves 150-161). Documents the historical distribution and subsequent decline of bush stone-curlews in South Australia, determines their current distribution and status on Kangaroo Island, their home range sizes and movements, the characteristics of foraging habitat, day roost areas and nest sites and the availability of habitat, the diet and food resources, and potential threats to the population. As a result of the findings of this survey, bush stone-curlews have been downgraded from endangered to vulnerable in South Australia.
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Boshoff, Jacobie. "Towards facilitating change in occupational therapy managers' perceptions of early intervention service delivery in South Australia." Pretoria : [s.n.], 2002. http://upetd.up.ac.za/thesis/available/etd-07082008-161801.
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Smith, Derek Richard. "Dermatological and musculoskeletal disorders of nursing home workers in Australia, Japan, South Korea and Taiwan." University of Southern Queensland, Faculty of Sciences, 2003. http://eprints.usq.edu.au/archive/00001510/.
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Although skin disease and musculoskeletal disorders are believed to be common among nursing home workers, to date there have been no coordinated international studies of these occupational issues. Therefore, it was considered appropriate to conduct one of the first cross-cultural investigations of occupational dermatology and ergonomic complaints among nursing home workers in Australia, Japan, South Korea and Taiwan using a standardised methodology. This thesis documents a 4-year investigation of skin disease and musculoskeletal disorders conducted among 465 nursing home staff in Australia, Japan, South Korea and Taiwan. Skin diseases were diagnosed by specialist physicians during medical examinations, while information on musculoskeletal disorders was collected by means of a self-reported questionnaire. There were major differences in both the location and type of skin disease between the 4 groups. Overall, the Australian group suffered a generally higher prevalence of skin disease than in the other three countries investigated, most likely due to their significantly higher rate of sun-induced skin damage. The high prevalence of cutaneous fungal disease seen within the Taiwanese subjects most probably arose from the comparatively higher temperature and relative humidity of Taiwan. Other potentially important skin disease risk factors included previous skin disease and a history of allergy, both of which are consistent with current knowledge. Although musculoskeletal disorders were found to be most prevalent among the Japanese nursing home staff at almost all body sites, the reasons for this are not clear. It may have related to a generally higher musculoskeletal rate, or a higher degree of self-reporting on their questionnaires. Individual MSD risk factors included moving patients, washing patients, working as an assistant nurse and daily alcohol consumption. Interestingly, MSD was found to be a co-factor for current skin disease. Overall, this study indicated that certain occupational health issues consistently affect nursing home staff in the 4 countries, but the prevalence and rank order varies from nation to nation. It was also shown that nursing home work incurs a reasonable degree of risk and that skin disease and musculoskeletal disorders are important occupational issues within these facilities.
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Kirigia, Doris Gatwiri Public Health & Community Medicine Faculty of Medicine UNSW. "Beyond needs-based health funding: resource allocation and equity at the state and area health service levels in New South Wales - Australia." Awarded By:University of New South Wales. Public Health & Community Medicine, 2009. http://handle.unsw.edu.au/1959.4/44733.
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Addressing inequities in health both within and between countries has attracted considerable global attention in recent years. In theory, equity remains one of the key policy objectives of health systems and underpins the allocation of health sector resources in many countries. In practice, however, current evidence demonstrates that only limited progress has been made in terms of bridging the health inequity gap and improving the health of the least advantaged. The persistence of inequities in health and health outcomes raises concerns about how governments and health authorities distribute limited health resources to improve the health of the poor and most vulnerable and thereby promote equity. This thesis is about equity and allocation of financial resources in the health system of New South Wales, one of the eight states of Australia. It investigated the extent to which there has been a movement towards equity in resource allocation to Area Health Services under the NSW Health Resource Distribution Formula and whether this has been reflected in equitable resource allocation within Area Health Services. It considered only resources allocated through the NSW Department of Health. The study employed a combination of qualitative and quantitative methods to gather and analyse data. The qualitative component analysed data gathered through semistructured interviews with policy makers, health executives, managers, and other stakeholders to establish the resource allocation processes and the factors upon which the allocation decisions were based. The quantitative component analysed health expenditure and health needs data to assess the extent to which allocation of resources from the State to Area Health Service levels has been equitable in terms of reflecting the level of health needs. Two indices were constructed and used as proxies for health needs. Principal component analysis was used in the construction of one of the indices, using demographic, socioeconomic and health-related data. The other index was developed using a combination of premature mortality and morbidity data. The quantitative study spans the two decades 1989/90 to 2006/07, with a more detailed analysis of material for the years 2003/04 to 2006/07. The findings of the study show a considerable degree of inequity in resource allocation with several Area Health Services (AHSs) receiving less than a fair share of funding for the years analysed, although some movements towards equity were evident. This contradicts the general impression that the introduction of the resource distribution formula in NSW has significantly improved equity in resource allocation. In general, funding allocation at the State level correlated significantly with population size but not with health needs of the eight AHSs in NSW. Similarly, within the AHSs, allocation of funds was based on programs and services and not on health needs. Key issues that emerged from the qualitative data as affecting the equity with which health funds are allocated in the NSW health system include limited use of the resource distribution formula at the state level, lack of an effective resource allocation tool to guide the distribution of funds within AHSs, and insufficient emphasis on equity at the AHS level. It is crucial that these and several other issues identifies in the study are addressed if current inequities in funding and in health outcomes generally are to be effectively reduced.
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Allnutt, S. Jane. "An Exploration of Three New South Wales Nurse Practitioner Services in 2008." Thesis, Australian Catholic University, 2018. https://acuresearchbank.acu.edu.au/download/10006e59ffd517c6e3c66eabe3a26a5a441eba18650548dca86fcf9b073f1ffb/4830225/ALLNUTT_2018_THESIS.pdf.
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Background
To control increasing health costs, the Australian government initiated a range of health care reforms in the late 1990s. In 2000, the development of the Nurse Practitioner (NP) Service in New South Wales (NSW) was one strategy implemented to improve health care delivery. Supported by legislation, NPs extended their role beyond other nursing roles. The number of NPs in NSW doubled between 2004 and 2007, and NP Services flourished. With little published evidence, research was vital to justify the contribution of this new and rapidly evolving service model to existing health services and the acceptability of the new service model to patients seeking health care. Through interviewing relevant stakeholders and a medical record audit, this study generated knowledge about both the integration of the NP Service with existing health services and patient perceptions of the NP Service.
Aim and Research Objectives
Aim:
Using an intrinsic case study design, the aim of this study was to gain an understanding of the early implementation of the NSW NP Service in 2008.
Specifically, this study sought to answer five research objectives:
1) To understand the physical environment and organisational characteristics of the NP Service.
2) To investigate the patient care provided by the NP Service.
3) To examine NPs’ views about their role and its integration into the existing health care team.
4) To investigate health professionals’ views about the NP Service and its integration into the existing health care team.
5) To examine the patients’ experiences of the NP Service.
Methods
Using Stake’s (1995) classification, this intrinsic case study design was conducted from November 2008 to April 2009. The case was the NP Service and three services were studied as embedded units. Three NPs from three different health services (a mental health NP working in an emergency department, an emergency NP working in the subacute area of an emergency department and a neonatal NP working in neonatal intensive care), who met the inclusion criteria of being authorised and endorsed nurse practitioners, were sampled by geographical and service diversity. Data sources included participant observation, interviews and medical record audit. Participant observation examined the physical and organisational characteristics of the NP Service. The NPs were interviewed about their role and integration with health care teams using face-to-face semi-structured interviews. Semi-structured interviews were also conducted with 5 health professionals and 5 patients per site, selected using maximum variation sampling, about their views and experiences of the NP Service. A medical record audit of 10 consecutive patients (included those interviewed plus an additional 5 patients per site) was undertaken following consultation with the NP, to identify the elements of care provided by the NP. Qualitative data (interviews and participant observation) were analysed using thematic analysis, triangulation and concept modelling. Medical record audit data were analysed descriptively. Enablers and constrainers to the implementation of the NP Service were identified. Results were compared and contrasted within and between the three sites.
Findings:
Medical record audit data showed that all three NPs engaged in therapeutic communication (96.7%), prescribed medications (80%) and referred patients for further assessment (73.3%). From thematic analysis, four themes emerged that reflected the concept of evolution: speciation, adaptation, co-operation and succession. Enabling factors that supported the implementation of the NP Service included the legislated protection of the NP title and scope of practice, and the development of standards of practice. The perceived overlapping boundaries between the NP and other colleagues on the health team were identified as constrainers during implementation. Findings were consistent across all three sites.
Conclusion:
This thesis provides new knowledge on the implementation and evolution of the NP Service in NSW. New knowledge includes support given (or withheld) to the NP Services, the physical environment and organisational characteristics of each service, the diversity of patient care provided, the perceptions of NPs and health professionals regarding integration of the NP Service with existing services, and patients’ understanding of their experience with the NP Service. NPs have worked through the stages of speciation and adaptation to define the scope and work differentiating them from their colleagues. Through co-operation with their colleagues NPs continue to define their specific contribution to the health care team, but they experience ongoing impediments to establishing succession, primarily due to organisational and fiscal constraints within the workplace. Two key recommendations from this study were the need for better communication with patients and health professionals about the role of the NP Service and the need to generate short and long-term workforce strategies to sustain NP Services. If the NP Service is to be viable in the future, health services need to develop comprehensive communication strategies to promote the role of the NP Service and establish strong and formal succession planning programs.
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van, Eyk Helen, and helen vaneyk@health sa gov au. "Power, Trust and Collaboration: A case study of unsuccessful organisational change in the South Australian health system." Flinders University. Medicine, 2005. http://catalogue.flinders.edu.au./local/adt/public/adt-SFU20060130.095828.
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Internationally, health systems have been undergoing an extended period of endemic change, where one effort at health system reform inevitably seems to lead to further attempts to make adjustments, re-direct the focus of the reform effort, or bring about further, sometimes very different changes. This phenomenon is described as churning in this thesis. Churning is a result of continual efforts to adjust and �improve� health systems to address intractable �wicked� problems, often through applying solutions based on neo-liberal reform agendas that have influenced public sector reform in developed countries since the early 1980s. Consistent with this, the South Australian health system has been caught up in a cycle of change and restructuring for almost thirty years.
This qualitative study explores a case study of unsuccessful organisational change initiated by a group of health care agencies in the southern metropolitan area of Adelaide, South Australia, which took place between 1996 and 2001. The agencies sought to develop and establish a regional health service through a process they called �Designing Better Health Care in the South� which aimed to improve the way that services were provided in the area, and to enable the agencies to manage the increasing budgetary and workload pressures that they were all experiencing. A significant policy shift at the state government level meant that this initiative was no longer supported by the central bureaucracy and could not proceed. The agencies reverted from a focus on regional planning and service delivery to an institutional focus.
The changes that are described within the scope of the case study are universally recognisable, including centralisation, decentralisation, managerialism and integration. The experience of Designing Better Health Care in the South as an unsuccessful attempt to implement change that was overtaken by other changes is also a universal phenomenon within health systems. This study locates the case study within its historical and policy contexts. It then analyses the key themes that emerge from consideration of the case study in order to understand the reasons for constant change, and the structural and systemic impediments to successful reform within the South Australian health system as an example of health systems in developed countries.
As a case study of organisational change, Designing Better Health Care in the South was a story of frustration and disappointment, rather than of successful change. The case study of Designing Better Health Care in the South demonstrates the tensions between the differing priorities of central bureaucracy and health care agencies, and the pendulum swing between the aims of centralisation and regionalisation. The study uses the theory of negotiated order to understand the roles of the key themes of trust, partnership and collaboration, and power and control within the health system, and to consider how these themes affect the potential for the successful implementation of health care reform. Through analysis of the case study, this thesis contributes to an understanding of the difficulties of achieving effective reform within health systems in advanced economies, such as the South Australian health system, because of the complex power and trust relations that contribute to the functioning of the health system as a negotiated order.
The study is multidisciplinary and qualitative, incorporating a number of social science disciplines including sociology, political science, historical analysis and organisational theory. Data collection methods for the study included interviews, focus groups, document analysis and a survey.
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Walker, Taylor, Ifeoma Ozodiegwu, and Megan Quinn. "Association between Childhood Sexual Abuse and Risky Sexual Behavior among Adults in Munsieville Township, South Africa." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/asrf/2019/schedule/97.
Full textAbstract:
Exposure to violence and dysfunction in childhood is a major public health concern. The Adverse Childhood Experiences (ACEs) study demonstrated that childhood maltreatment and family dysfunction impact adult health, contributing to risk behaviors, infectious and chronic disease, and premature death. South Africa (SA) has one of the highest rates of violence and family dysfunction globally, and those living in townships are suspected to be disproportionately affected. Munsieville, the oldest undeveloped township in SA, has reported high rates of violence in the community. This study aimed evaluate the association between a history of childhood sexual abuse and various forms of risky sexual behavior. Data were collected by a team of researchers from the College of Public Health as part of a pilot study of ACEs in Munsieville. Self-report of sexual abuse before age 18 was used to compute the independent variable, which ranged from 0-1, with 0 implying the absence of any type of childhood sexual abuse and 1 implying one or more forms of childhood sexual abuse. Age and gender were deemed potential confounders. Two binary l outcomes representing forms of risky sexual behavior were considered, self-report of transactional sex and substance use before sexual activity. Descriptive analysis examined the frequency of childhood sexual abuse by each category of the study outcomes. Two multiple logistic regression models were individually constructed to examine the association between childhood sexual abuse and transactional sex, and substance use before sexual activity. Odds ratios and corresponding 95% confidence intervals were reported. Findings of the descriptive analysis indicated that 8.83% (43) of the sample reported participating in transactional sex, 22.4% (101) reported using either drugs or alcohol before sex. Moreover, 21.6% (103) reported experiencing one or more forms of childhood sexual abuse. A positive statistically significant association between self-reported childhood sexual abuse and transactional sex was identified (OR: 3.45; 95% CI: 1.71 – 6.98), illustrating that those who experienced any type of child sexual abuse had a 3.5 times as likely to report transactional sex compared to those who did not experience sexual abuse during childhood. Childhood sexual abuse was also significantly associated with substance use before sexual activity (OR: 1.93; 95% CI: 1.11 – 3.34). The study findings suggests a need for further research to understand the long term effects of child sexual abuse. Further, future public health interventions aimed at reducing sexual abuse and violence inflicted on South African children should be employed as means to improve their wellbeing in adulthood.
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Blue, Ian A. "The professional working relationship of rural nurses and doctors : four South Australian case studies." Title page, table of contents and abstract only, 2002. http://web4.library.adelaide.edu.au/theses/09PH/09phb6582.pdf.
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Browne, Felicia. "HIV Risk Behavior Among Adolescents and Young Adults in Cape Town, South Africa: the Role of Economic Support and Employment." Thesis, Harvard University, 2015. http://nrs.harvard.edu/urn-3:HUL.InstRepos:23205178.
Full textAbstract:
This three-paper dissertation examined the association between social and economic factors and HIV risk behavior among adolescents and young adults in Cape Town, South Africa. Studies in South Africa have demonstrated an important association between receiving financial or material resources and sexual risk behaviors. Most research has focused on economic exchanges that occur as part of transactional sex, and not economic support in main partnerships—which may not be transactional. Furthermore, little research has focused on men.
For the first paper, cross-sectional data from Black African and Coloured substance-using women (N = 671) were analyzed to examine the association between the frequency of economic support and unprotected sex in main partnerships. Negative binomial and multinomial logistic regression analyses were conducted to model the number of unprotected sex acts and the consistency of condom use, respectively. Results indicated that receiving daily or almost daily support was positively associated with the number of unprotected sex acts; an association was not observed with consistency of condom use.
For the second paper, binomial logistic regression was used to examine whether receiving economic support from a main partner was associated with unprotected last sex, and to test whether gender modified this association among young Black African and Coloured women and men (N = 1,456). Economic support from a main partner was not associated with sexual risk; however, receiving economic support from someone in the household other than a main partner was protective for women. Employment was protective for men and women.
The third paper used discrete-time hazard analyses to examine whether employment and schooling were associated with sexual initiation among Black African, Coloured, and White adolescents (N = 1,326). Results indicated that although employment was not associated with sexual initiation, working while in school was associated with greater odds of sexual initiation.
These papers provide a better understanding of the social and economic factors that may impact sexual risk behavior. The association between employment and risk behavior is complex, and how sexual risk is defined and measured matters. Findings also suggest the importance of assessing multiple sources of economic support, including frequency of support.
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Mudge, Jane. "Lead exposure and the prevalence of emotional and behavioural problems experienced by children in the Port Pirie cohort study /." Title page, contents and summary only, 1996. http://web4.library.adelaide.edu.au/theses/09PH/09phm944.pdf.
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Melis, Miriam J. "A formative study to develop and test a health promotion strategy for adolescents who experience grief." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2006. https://ro.ecu.edu.au/theses/354.
Full textAbstract:
The purpose of this research was to develop and test a health promotion intervention designed to minimise unhealthy adolescent grief reactions. A sample of Western Australian adolescents were consulted to identify their perceptions regarding the causes of grief for adolescents, the means by which they manage grief, their perceptions of what constitutes healthy and unhealthy grieving, and the risks associated with unhealthy grieving and the type of grief-management intervention they preferred.
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Malan, Johanna Elizabeth. "The development, implementation and evaluation of a training intervention for primary health care providers on brief behaviour change counselling, and assessment of the provider’s competency in delivering this counselling intervention." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97977.
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Thesis (PhD)--Stellenbosch University, 2015.ENGLISH ABSTRACT: Unhealthy behaviour is a key modifiable factor that underlies much of the South African (SA) burden of disease and primary care morbidity. Chronic diseases such as heart disease, type 2 diabetes, lung diseases and some cancers are linked to underlying behavioural issues such as tobacco smoking, alcohol abuse, physical inactivity and unhealthy eating. Evidence shows that brief behaviour change counselling by primary care providers can be effective in helping patients to change risky lifestyle behaviours. However, the capacity of South African primary care providers to educate and counsel patients on lifestyle modification is generally poor. The need for primary care provider training in lifestyle counselling, is stated as a critical objective in ‘re-orientating’ the primary health care system to effectively address NCDs in the National Strategic Plan for the Prevention and Control of NCDs and their risk factors in SA. The overall aim of this research was to develop, implement and evaluate the effectiveness of a training intervention for primary care providers in the South African setting, which is based on teaching best practice, behaviour change counselling (BBCC) methods that can be used for patients with risky lifestyle behaviours associated with non-communicable diseases (NCDs). “Effectiveness” relates to the effect of the training on PCPs adoption of a patient centred approach, and skills acquisition after the training, and not the effectiveness in changing, or improving patient outcomes. The sequence of the abstracts of the four articles that were published from this research, gives an overview of the process.
AFRIKAANSE OPSOMMING: Ongesonde lewenstyl kan gekoppel word aan die meeste chroniese siektes wereldwyd, en dra grootliks by tot die las van primere sorg morbiditeit, asook in Suid Afrika. Rook, ongesonde dieet, fisiese onaktiwiteit, en alkohol misbruik word beskou as die onderliggende risiko faktore wat verantwoordelik is vir die ontwikkeling van kardiovaskulere siektes, tipe 2 diabetes, respiratoriese siektes, sowel as sommige kankers. Navorsing het bewys dat primere gesondheidsorg werkers effektief kan wees om pasiente te help om hierdie gewoontes te bekamp. Nieteenstaande hierdie bewyse, is die huidige kapasiteit van primere sorg dokters en verpleegsters in Suid-Afrika nie voldoende om sodanige diens te verskaf nie. In die Nationale Strategiese Plan vir die beheer van chroniese siektes, word opleiding vir primere gesondheidsorg werkers geprioritiseer as n kritiese uitkomste vir die beheer van chroniese siektes, en die onderliggende risiko faktore. Dit is dus duidelik dat daar n behoefte is om sodanige opleidingprogramme te ontwikkel. Die doel van hierdie navorsing was om n bewysgebaseerde opleidingsprogram te ontwikkel, te implementeer, en die effektiwiteit daarvan te evalueer in ons unieke primere gesondheidsorg sisteem in Suid-Afrika. Die opleidingsprogram moes ontwikkel word, vir beide primere sorg dokters en verpleegsters, sodat dit hulle in staat kan stel om pasiente te beraad oor enige van die vier risiko faktore.
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Dubasi, Hima Bindu, and Kiana Rachele Dr Johnson. "Sociodemographic Factors and Health-Risk Behaviors Associated with Recent Utilization of Dental Services Among South-Central Appalachian Adolescents." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/asrf/2019/schedule/20.
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Background: Oral health is crucial for overall health. Oral health care need is the most prevalent unmet health care need among children and adolescents in the United States. Youth characteristics and socio-demographic factors are known to influence dental health service utilization. While there have been studies listing the factors contributing to the oral health disparities in the Appalachian region, very few studies have inspected the risk behaviours of the youth and their association with dental health care utilization.
Methods: A structured questionnaire was administered to high school students in five counties of South-Central Appalachia. The survey included a question on a recent dental visit. The students provided information on socio-demographic characteristics and risk behaviours. Descriptive analysis was performed and the association between recent dental visit as the outcome variable and sociodemographic factors and health risk behaviours as independent variables were analyzed using logistic regression analysis. The analysis was performed using SAS 9.4.
Results:80.1% (N= 129) of the adolescents who had admitted to using tobacco products or electronic vapour products reported having visited the dentist in the past 12 months. 87.5% (N= 168) of the females and 80.3% (N=127) of the males reported having visited the dentist in the past 12 months and 81.43% (N=114) of the adolescents who received free or reduced lunch reported having visited the dentist in the past 12 months. Use of tobacco products was the only health risk behaviour significantly associated with dental visit in the past 12 months (p=0.04) after adjusting for covariates with OR=0.5 (95% C I:0.312 -1.01).
Conclusion: The findings suggest that health risk behaviours such as using tobacco products may be associated with dental health care utilization and future research should focus on adolescents with health-risk behaviours with the goal of identifying interventions for at-risk populations.
Keywords: Oral health, health disparities, youth, health risk behaviours
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Elliot, Michael. "Happiness in the private physiotherapy sector of South Africa." Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/15171.
Full textAbstract:
There is limited research pertaining to assessing the happiness levels of various disciplines within the healthcare industry. Furthermore, happiness and physiotherapy studies are two research areas that are not necessarily associated with one another on a global perspective. Hence, the happiness levels have not been adequately established for private physiotherapists. This treatise is the first attempt to evaluate the happiness levels of private physiotherapists in South Africa. A thorough literature review was conducted to determine the current climate of happiness studies pertaining to the business industry, with focus on private physiotherapy businesses in the healthcare sector. The literature review enabled the development of a hypothesised model, which was tested with quantitative techniques consisting of a questionnaire, data collection and statistical analysis. The research confirmed that influence, social relations, life balance, optimism, work and leisure are all positively associated with the happiness levels of private physiotherapists in South Africa. These variables are recommended as key focus areas for physiotherapy business owners to address, in order to positively affect happiness levels in the workplace and thereby create favourable bottom line results. In accordance with the reviewed literature and the findings of this treatise, by adequately addressing these variables the business owners of physiotherapy practices will generate a workforce that are more productive, demonstrate greater collaboration with colleagues and customers, produce happier customers, are more positively energised and are less absent and more loyal to the business. It is recommended that the proposed model is tested to provide further benefit to the industry by constructing evidence-based retention and recruitment strategies for high performing private physiotherapy staff.
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Oliver, JoAnn Simon. "Prostate screening patterns among African American men in the rural South." unrestricted, 2007. http://etd.gsu.edu/theses/available/etd-12192007-093453/.
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Thesis (Ph. D.)--Georgia State University, 2007.Title from file title page. Cecilia G. Grindel, committee chair; Armenia Williams, John C. Higgenbotham, committee members. Electronic text (100 p. : ill. (some col.)) : digital, PDF file. Description based on contents viewed Oct. 21, 2008. Includes bibliographical references (p. 72-81).
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Kader, Rehana. "The relationship between substance abuse, health status and health behaviours of patients attending HIV clinics." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/79891.
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Thesis (PhD)--Stellenbosch University, 2013.ENGLISH ABSTRACT: HIV infection, substance abuse, and psychiatric disorders are major public health issues in South Africa. Psychiatric disorders and substance-use disorders together have a negative impact on the health outcomes of people living with HIV and AIDS (PLWHA), such as poor adherence to anti-retrovirals (ARVs), HIV disease progression, lower CD4 counts, vulnerability to opportunistic infections, high viral loads, possible drug resistance, and an earlier onset of death. The overall aim of this study was to investigate the relationship between substance abuse practices and the health status and health behaviour of patients attending HIV clinics in the Cape Metropole. The study used a cross-sectional study design for collecting data on hazardous or harmful use of alcohol and problematic drug use, demographic information and health status among patients attending eight HIV clinics in the Cape Metropole. A sub-sample of patients were assessed on the following domains: depression, psychological distress, psychopathology, post-traumatic stress disorder (PTSD), risky sexual behaviour, adherence to ARVs, levels of resilience, levels of social support and patient’s work, family and social functioning. Of the 608, 10% of consecutively selected patients completed an additional psychiatric diagnostic interview (Mini International Neuropsychiatric Interview). The main findings to emerge from this study are: 1. Patients reporting hazardous or harmful use of alcohol and/or drug use are significantly more likely to be non-adherent to ARVs and have lower CD4 counts than their non-substance abusing counterparts 2. Hazardous or harmful use of alcohol has a direct influence on CD4 count resulting in lower CD4 counts and participants being less likely to be on ARVs. 3. Hazardous or harmful use of alcohol has a direct relationship in predicting tuberculosis (TB). 4. Hazardous or harmful users of alcohol and/or problematic drug users are more likely to report psychological distress (anxiety and depression), depression and low levels of family support than their non-using counterparts. 5. Participants who met the criteria for major depression are significantly more likely to be non-adherent to ARVs. 6. Gender, depression, psychological distress, and PTSD were found to be significant determinants of hazardous or harmful use of alcohol. 7. Psychological distress (anxiety and depression) is significant in directly predicting ARV non-adherence. 8. Male participants and those who stopped taking their ARVs were more likely to have lower CD4 counts than female participants and those who did not stop. 9. PTSD was found to predict psychological distress indicating that participants who experienced trauma were more likely to suffer from psychological distress (anxiety and depression) compared to those who did not experience any PTSD. Participants with lower levels of family support were more likely to suffer from psychological distress than those with high levels of family support.
AFRIKAANSE OPSOMMING: MIV infeksie, dwelmmisbruik en geestesversteurings is groot gesondheidskwessies in Suid-Afrika. Geestesversteurings en dwelmmisbruik het gesamentlik 'n negatiewe uitwerking op die gesondheid van mense wat met MIV en VIGS saamleef (PLWHA), soos byvoorbeeld nie-nakoming in die gebruik van antiretrovirale (ARV’s), MIVsiekteverloop, laer CD4-tellings, vatbaarheid vir opportunistiese infeksies, hoë virale ladings, moontlike weerstand teen medikasie en 'n verkorte leeftyd. Die oorkoepelende doel van hierdie studie was om die verhouding tussen dwelmmisbruik en die gesondheidstatus en -gedrag van pasiënte wat MIV klinieke in die Kaapse Metropool besoek, te bestudeer. Die studie het 'n deursnee-ontwerp gebruik om data in te samel oor die nadelige en gevaarlike gebruik van alkohol en problematiese dwelmgebruik, demografiese inligting, en die gesondheidstatus onder pasiënte wat agt MIV klinieke in die Kaapse Metropool besoek het. 'n Subgroep pasiënte geassesseer op die volgende gebiede: depressie, psigologiese angsversteuring, psigopatologie, posttraumatiese stresversteuring (PTSV), riskante seksuele gedrag, nakoming in die gebruik van ARV’s, weerstandigheidsvlakke , vlakke van sosiale ondersteuning, asook pasiënte se werk, familie en sosiale funksionering. Van die 608 deelnemers is 10% van die pasiënte opeenvolgend geselekteer om 'n addisionele diagnostiese psigiatriese onderhoud te ondergaan (Mini International Neuropsychiatric Interview). Die vernaamste bevindinge wat uit die studie gekom het, is: 1. Pasiënte wat nadelige en gevaarlike gebruik van alkohol en/of dwelms rapporteer is beduidend meer geneig om nie die gebruik van ARV’s na te kom nie, en het laer CD4-tellings as hulle eweknieë wat nie dwelms misbruik nie. 2. Die nadelige en gevaarlike gebruik van alkohol het 'n direkte invloed op CD4- tellings wat lei tot laer CD4-tellings en dat pasiënte minder geneig is om op ARV’s te wees. 3. Die nadelige en gevaarlike gebruik van alkohol hou direk verband met die voorspelbaarheid van tuberkulose (TB). 4. Nadelige en gevaarlike gebruikers van alkohol en/of problematiese dwelmgebruikers, is meer geneig om psigologiese angsversteurings (angs en depressie), depressie, en laer vlakke van familieondersteuning te rapporteer as hul niegebruiker-eweknieë. 5. Deelnemers wat aan die kriteria vir ernstige depressie voldoen, is aansienlik meer geneig tot nie-nakoming in die gebruik van ARV’s. 6. Daar is gevind dat geslag, depressie, psigologiese angs en PTSV beduidende bydraende faktore is tot die nadelige en gevaarlike gebruik van alkohol. 7. Psigologiese angsversteurings (angs en depressie) is beduidend om direk die nie-nakoming van ARV’s te voorspel. 8. Manlike deelnemers en diegene wat hul ARV’s gestaak het, was meer geneig om laer CD4-tellings te hê as vroulike deelnemers en diegene wat nie die gebruik van medikasie gestaak het nie. 9. Daar is gevind dat PTSV psigologiese angs voorspel het wat aandui dat deelnemers wat trauma ondervind het, meer geneig was om aan psigologiese angsversteurings (angs en depressie) te ly in vergelyking met diegene wat geen PTSV ervaar het nie. Deelnemers met laer vlakke van familieondersteuning was meer geneig om aan psigologiese angsversteurings te ly as diegene met hoë vlakke van familiebystand.
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Schulz, Robinson Shirley Public Health & Community Medicine Faculty of Medicine UNSW. "Contextualizing implementation of the community health program: a case study of the Hunter region, New South Wales 1974 -1989." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/26248.
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How health care is best provided remains topical, contentious, and political. Debates continue over funding allocation and the weighting placed on preventive, curative, institutional and community services. Such debates were evident in 1973 when a new Federal Labor Government began to reform Australia's health system by implementing a national Community Health Program policy. Implementation led to the establishment of community health centres and multi-disciplinary teams. Studies have generally concluded that community health centre teams have ???failed??? to achieve the goals of this policy. This study sought to answer one broad question. How was the community health program policy implemented, in what context did this event occur, what processes were used and why, and how did generalist community nurses participate? This case study of the Hunter Region, New South Wales, between 1974 and 1989, was based on data collected from four sources: over five hundred documents and archives, including relevant literature, epidemiological studies, centre records, official government and newspaper reports; 69 in-depth interviews with practitioners and administrators; and participant observation. The findings revealed that implementation was hindered by political, administrative and professional impediments. However, practitioners established and provided a broad range of relevant new services by changing the way they practised. Generalist community nurses worked with non-government, private and public organisations offering health, educational and social services. As boundary riders they filled structural holes and created social capital. Conclusions drawn were first, that context strongly influenced how public health policies were implemented and the services offered by different discipline groups. Second, teamwork would have been improved had pre-service health professional education fostered a common understanding of the aim of health care and the broader determinants of health. Third, a preventive orientation needed reinforcing via an organisational context, administrative processes, ongoing learning opportunities and leadership. Fourth, generalist community nurses??? commitment to a preventive approach was embedded in a growing understanding of people's circumstances and health problems. Finally, while policy implementation was constrained in the Hunter Region during the study period it achieved what its architects intended, that is, a broader mix of accessible services, and collaboration between organisations and groups as the boundaries that maintained their separation were bridged.
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Walsh, Maurice. "Naturally occurring radionuclides in drinking water supplies in the south west of Western Australia and their potential impact on human health." Thesis, Walsh, Maurice (2010) Naturally occurring radionuclides in drinking water supplies in the south west of Western Australia and their potential impact on human health. PhD thesis, Murdoch University, 2010. https://researchrepository.murdoch.edu.au/id/eprint/12385/.
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Radioactivity in drinking water is a concerning international public health issue. Recently attention has been drawn to this issue by moves in the USA and several other developed countries to lower the permissible levels of naturally occurring radioisotopes in drinking water.
The primary goal of this thesis is to investigate the levels of naturally occurring radioisotopes in drinking water supplies in the South West of Western Australia particularly those that are predominately sourced from groundwater and to determine whether any elevated levels exist. As isotopes, such as Ra-228 and Po-210, are difficult to measure in low concentrations a secondary aim of the project was to develop faster, reliable techniques for measuring them at low levels commonly found in drinking water derived from groundwater.
Radiochemical analysis of samples taken from 52 public drinking water supplies in Western Australia was carried out at the University of Vienna, Austria during 2005- 2006. All samples were analyzed for Ra-226, Ra-228 and Pb-210. Twenty five of the samples were analyzed for Po-210 and twenty three were analyzed for U-234 and U- 238. Ra-224 was only found in one sample.
Radionuclide activities in the drinking water samples ranged from < 5.0 to 77.7 mBq L-1 for Ra-224, 3.2 to 151.1 mBq L-1 for Ra-226, < 4.0 to 296.1 mBq L-1 for Ra-228, < 2.0 to 13.4 mBq L-1 for Pb-210, 0.6 to 21.7 mBq L-1 for Po-210, 0.6 to 12.8 mBq L-1 for U- 234 and 0.4 to 14.3 mBq L-1 for U-238. The mean concentrations were 1.5 mBq L-1 for Ra-224, 32.6 mBq L-1 for Ra-226, 47.3 mBq L-1 for Ra-228, 0.7 mBq L-1 for Pb-210, 7.1 mBq L-1 for Po-210, 3.3 mBq L-1 for U-234 and 2.3 mBq L-1 for U-238. V A comparison was made to determine whether or not the 52 drinking water samples from Western Australia comply with the radiological safety guidelines of other developed countries. Particular attention was paid to potential impacts on children with regard to setting radiological safety parameters for drinking water.
The annual dose received by the population in the sampled Western Australian communities, ranged from 0.002 to 2.059 mSv y-1 with a mean annual dose of 0.15 mSv y-1. The main contributing radionuclides to the annual dose were Ra-226 and Ra-228. These trends are explained in terms of the local geology and groundwater resources, particularly the historical development of the heavy mineral sands industry along the southern coastline and known uranium deposits in Western Australia.
Of the 52 drinking water samples tested, 94% complied with the current Australian Drinking Water Guidelines, 15% complied with the current Canadian, European, United Kingdom and the WHO’s radiological guidelines for drinking water, 12% complied with the US EPA’s radiological guideline for drinking water but none of the samples complied with the new 2006 California EPA’s Public Health Goals for Ra-226 and Ra- 228 in drinking water.
Based on these findings recommendations are made about the need for further monitoring and possible epidemiological studies of communities that have elevated levels of radionuclides in their drinking water supplies.
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De, Jong Michelle. "From ‘cleanliness is next to Godliness’ to ‘without perfect health, there is nothing’: discourses of healthy lifestyle in the construction of young adult identities in urban South Africa." Thesis, Rhodes University, 2019. http://hdl.handle.net/10962/64940.
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This research explores popular constructions of “healthiness” as individual lifestyle choices in the context of contemporary South African consumer culture, and how these constructions relate to formations of subjectivity. This is a qualitative study conducted within a social constructionist, theoretical framework. Data was collected using in-depth, semi structured interviews and are analysed using a Foucauldian inspired version of discourse analysis. A critical stance is taken towards the assumption in these discourses that their version of healthiness is always and unquestionably positive. Special attention is paid to the lifestyle and marketing media discourses appropriated in understandings of personal health through self-management, and of the optimization of health in the pursuit of well-being. The ways in which different discourses of healthiness facilitate the construction of specific identities are considered in order to untangle some of the problems created by the moralism underpinning popular consumer health discourse. How constructions of healthiness and aspirant healthy lifestyles support, and are supported by, the ideologies and practices of neoliberal capitalism are also explored. From this perspective, healthiness as lifestyle consumption choices can be seen as an ideological apparatus that produces the subjects necessary to reproduce the social order (Althusser, 2001), functioning not only positively amongst the social classes with the leisure and economic resources to pursue these options, but also negatively as victim-blaming of those who are excluded. The argument here is not that health is bad or that people should not be bothered with activities aimed at promoting good health, but that in a context where the concept of health is idealised as always positive and beneficial, the potentially harmful consequences of some of the health discourses we make use of may be occluded. This idealisation of health or ‘healthism’ may also function to divert attention away from some of the challenges to health that are not the direct result of personal behaviours and are unlikely to be remedied through individually focussed interventions, for example, inequality and inadequate access to basic resources. Six discourses which were used to construct understandings of health are analysed. These include Happiness, Freedom, Control, Care, Balance and Goodness. The ways in which these discourses played a role in constructing the kinds of subject positions which were made available to participants, and the possible implications this has, are explored in depth.
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Moore, James Nicholas. "An examination of a possible health education and lifestyles strategy for staff of the Department of Social Security (DSS) in South Australia /." Title page, contents and synopsis only, 1990. http://web4.library.adelaide.edu.au/theses/09MO/09mom822.pdf.
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van, der Heide George, and n/a. "Effective strategies for conducting school development in health education programs." University of Canberra. Professional & Community Education, 1998. http://erl.canberra.edu.au./public/adt-AUC20060427.131945.
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Thesis Statement
The thesis argument is that theory can be developed about the
implementation, maintenance and dissemination of school health education
based on a school development approach. Such theory development can
assist teachers to design programs appropriate to the needs of their
classrooms, schools and communities.
Thesis Setting
The implementation and maintenance of school health education programs
has not usually been the focus of research and as a consequence is rarely
reported in the literature. The research in this thesis draws upon many
disciplines and fields but in order to answer the thesis questions
methodological processes were required that were consistent with current
school situations. The earlier School Development in Health Education
(SDHE) program's work in research, development and dissemination provided
the setting for the thesis.
Methodology of the Research
The methodology of the research study involved a case study approach using
both multiple and single case studies. Data have been drawn from SDHE
schools in South Australia undertaking health, sexuality and drug education.
The methodology adopted for the studies in this thesis is a case study design
incorporating an iterative theory-study-theory sequence in which an initial
theory statement derived from the literature guides the development of a
multiple case study which, in effect, 'tests' the theory in a qualitative way. The
finding of the case study then informs development and elaboration of the
theory statement in its second version. This is then used to test the next
multiple case study which leads to further development of the theory in its third
version. The third iteration of the theory is tested in a single case study that
leads to the fourth and final version of the theory.
Data analysis was aided by the use of the Q.S.R. NUD.IST computer package
that helped to manage and explore the thesis ideas about the data. In
establishing these syntheses the chain of evidence in the data sets was
maintained. The analysis also allowed the thesis findings to be used to test
theories about the data that answered the thesis questions.
Thesis Findings
The findings of the thesis are contained in the final version of the theory. The
theory is structured around program drivers, phases, types and processes that
together produce implementation, maintenance and dissemination. This final
theory statement is the basis for drawing the thesis conclusions.
Thesis Conclusions
It was concluded that patterns of factors that enhance and inhibit the
implementation, maintenance and dissemination of school health education
programs could be placed in a theoretical framework that can guide practice in
school health education.
To be successful school health education programs have to include three
critical elements: leadership, action research and funding. Leaders or program
drivers need to be identified and resourced; they may be principals or
designated teaching staff with access to decision making, policy processes
and resource allocation in schools. Teachers need to engage in a reflective
action research process to develop, modify and sustain their curriculum
development work. Programs require adequate funding resources for
teachers' professional development, including action research, and the
purchase of human and material resources. Schools planning to introduce
programs may learn from the experience of others but they must themselves
engage in the critical and essential program features identified in the final
version of the theory.
Implications
The thesis conclusions imply the need to use more efficient ways of bringing
schools' and teachers' hidden competence to the fore to support school health
education program through varied patterns of professional development,
technical support and curriculum development and implementation, and
through funding of enhanced professional practice for health literacy.
A major implication for the health sector is that many health workers need to
learn collaborative skills since there is a tendency to take control and attempt
to direct what teachers should do rather than work with and support them.
An implication for programs in complex social environments is the need for
careful planning in collaboration with other stakeholders. The critical elements
developed in this thesis also apply - leadership, action research and funding.
Evaluation can adopt a case study approach as a more suitable method for
examining what happens in programs than an overly simplistic approach of
assessing goals and objectives which ignores the differences in program
implementation for different sites with the necessary localisation.
Further Research
Further research suggested by the thesis findings are in the areas of school
health education in the changing administrative and management environment
today, and of the use of various types of case study research in tandem to
answer comprehensive and complex program performance questions.
39
Brophy, Trista. "Environmental and Community Health in South San Diego County: A Behavior Analysis of Recreational Ocean Users Along Imperial Beach, California." Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6186.
Full textAbstract:
Garbage & sewage runoff into the Pacific Ocean at the shoreline along the U.S./Mexico Border region poses serious health and environmental threats. The purpose of this study was to analyze the current beach users’ behavioral factors that may be linked to illness prevalence from Coronado Island to the U.S./Mexico border at Imperial Beach in San Diego County. It is a continuation of a study completed by Wildcoast and Imperial Beach Clinic in 2011. The study tried to answer the following two major questions: How have the number of illnesses reported by users along South San Diego County beaches changed in the last 5 years? What relationships exist between reported illness and beach user behavior, if any? To accomplish this, a 2-page self-reporting survey was administered asking about demographics, beach recreation habits, illness and exposure information, and allowed for comments. Surveys were distributed to beach users along Imperial Beach northward to Coronado Island during May, June, and July of 2014. Quantitative as well as qualitative data were collected. The results show that the majority of respondents did not report suffering from an illness, however, for those who did report an illness, frequency of water entry, seasonality of water entry, entry during beach closures, and primary means of water contact were significantly correlated to illness prevalence.
40
Ajam, Razaana. "The need for conflict management in organisations (a health insurance company, Port Elizabeth)." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/3852.
Full textAbstract:
Conflict is evident in many spheres of life, however this study concentrated more specifically on conflict relating to organisations. Organisational conflict is seen “as any social collectivity, organisations such as private sector companies, government departments, schools and universities, non-governmental organisations, and political parties all experience internal conflict in varying degrees” (Bradshaw, 2008: 22). Each individual coming into a workplace has created his or her own set of challenges especially in the brutal arena of business. Conflict has destructive and productive qualities that can diminish or elevate processes within an organization (Stone, 1999). If it is not harnessed properly or dealt with in the correct manner, it can damage the reputation of a business; resulting in its downfall and this in turn contaminates and affects peripheral businesses associated with the organisation downstream. This study explored the following key aspects: Background of organisational conflict and its management; Background of the organization; Whether these two areas mentioned above can work together to create a cost effective and efficient outcome when dealing with conflict. The research adopted a mixed method approach with predominant focus on qualitative research methodology. The main focus of this study was conflict management within organisations and to probe and determine whether companies see the need to employ the field of conflict management as a strategy in times of fluctuating dispositions. It is evident that the organisation may not be fully aware or make use of alternative conflict resolution strategies and that the main causes of conflict can be eliminated such as poor communication, ill-defined job descriptions and objectives and differing of opinions. The need to employ alternative methods of conflict management may be emphasised by looking at the costs that conflict produces and the use of limited vital resources and the loss of human capital.
41
Disler, Sally Ann. "Health related lifestyles of adolescents : a study of smoking, alcohol and habit-forming drug use, and sexual activity, in a group of high-school students in Cape Town." Master's thesis, University of Cape Town, 1991. http://hdl.handle.net/11427/26570.
Full textAbstract:
The AIM of the study from which the empirical data were obtained for this thesis, was the collection of basic demographic information and selected health related data from a group of adolescents at high-school in Cape Town. 1.2 The OBJECTIVES were Description of the demographic features of the pupils in Standards 8, 9 and 10 at a specific co-educational high school in Cape Town; Determination of the prevalence of smoking, and the attitudes to, and knowledge of the health risks of smoking; Determination of the prevalence of alcohol use, and the attitudes to, and knowledge of the health risks of consuming alcohol; Determination of the prevalence of habit-forming drug use, and the attitudes to, and knowledge of the health risks of using drugs; Determination of the sexual experience of the pupils, attitudes to and knowledge of the health risks of sexual activity, and knowledge of contraception and venereal disease; Examination of whether the above habits correlated within individuals i.e. whether those who smoked were more likely to use drugs or be sexually active, and vice versa.
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Fenton, Sarah-Jane Hannah. "Mental health service delivery for adolescents and young people : a comparative study between Australia and the UK." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/7111/.
Full textAbstract:
This thesis explores policy and service delivery for adolescent and young adult or ‘transition age’ mental health service users aged 16-25 across different jurisdictions in the UK and Australia. The study explores the implications that policy formulation and implementation have for service delivery in these different contextual settings; and examines how young people (who are at a vulnerable stage developmentally in terms of mental health), have their access to services affected by the existing policy framework. A policy analysis was conducted along with qualitative interviews in six case sites (three in the UK and three in Australia). The thesis adopted a critical realist approach using a laminated cross-sectional interview strategy that was developed to include interviews with national policy makers; local policy makers and service managers; staff working within services; and the young people whom were accessing services as the recipients of policy. Findings from this thesis explore how young people use risk escalation as a way of managing delays to treatment and how practitioners identify particular difficulties for young people transitioning in services when they are due to ‘step up’ into more acute services, or ‘step down’ to a less intensive service. The thesis explores the implications and unintended consequences for young people of policy including processes of ‘cost-shunting’ and ‘resource envy’ at local and national levels. Finally, the thesis offers some learning for systems working to support 16-25 year olds through demonstrating the importance of the dual role of ‘curing’ and ‘caring’ in mental health services.
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Baatjes, Tashrique. "The physical activity and health-related fitness of female students at a South African university." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/5575.
Full textAbstract:
Physical inactivity and resultant chronic diseases of lifestyle (CDLs) are becoming a global epidemic as secular modernization and the sedentary lifestyles it brings with it become universal. The importance of physical activity (PA) in reducing morbidity and mortality from CDLs and related conditions has been well established. Since it is generally significant that the onset of many CDLs lies in childhood through to adolescence, preventative strategies should start as early in life as possible. Currently, university students are failing to engage in the levels of PA recommended for better health outcomes over the short and long term. To make matters worse, there is increasing evidence of a decrease in PA during the transitional phase from adolescence to adulthood. This study aimed to determine the physical activity (PA) levels, sedentary behaviour and health-related fitness (HRF) characteristics of female university students. In addition, the participants‘ perceived barriers to PA were investigated. The study was exploratory-descriptive and employed a quantitative research design. Five hundred and thirty-one full-time female students, between the ages of 18 and 46, studying at Nelson Mandela Metropolitan University‘s (NMMU) South, North, Second Avenue and Missionvale campuses participated in the study. The participants (n=531) completed an online survey which determined their PA levels, sedentary behaviours and perceived barriers to PA participation. A health-related fitness (HRF) assessment was also administered to 68 participants who completed the online survey. Their height, weight, and waist and hip circumferences were measured, as well as their cardiovascular fitness (CF). The majority (88 percent) of the participants reported low and minimal levels of PA, and 44 percent were either overweight or obese. The participants had a low-risk waist-to-hip ratio (WHR) (M=0.70). The majority of the population (94 percent) had poor cardiovascular fitness (CF). A high prevalence of sitting time was recorded among the participants: on average 855 minutes (14 hours) on a usual weekday and 720 minutes (12 hours) on a usual weekend day. Students reported the greatest length of sitting time at work/attending lectures/studying. Cross tabulations and Chi2 tests indicated no significant relationships among PA and HRF (BMI, WHR and CF) and sedentary behaviour and HRF. The ANOVA and t-test results for PA, sedentary behaviour and HRF related to various demographic variables, found small (0.19 < d < 0.50) and medium (0.49 < d < 0.80) significant differences by race (d=0.43; d=0.52), home language (d=0.41; d=0.44) and living arrangement (d=0.38; d=0.28). No significant relationship was found to exist between age, year of study and faculty of registration and sedentary behaviour or HRF. The participants listed: Not enough time; too expensive to exercise; and, no friends who can exercise with me as the most important barriers to participation in PA. Academic obligations (3.08 mean) was found to be the most important barrier to PA.
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Rozani, Veliswa Celestine. "Measuring brand loyalty in the medical device industry of South Africa : a study across the public and private health-care system." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/d1021070.
Full textAbstract:
Brands are major role-players in the organisational business strategy; and they are recognised as one of the most valuable assets a company can possess. The entry of low-cost competitors has redefined the entire competitive landscape of the health-care industry through their ability to transform their value chain, in order to drastically reduce prices. With the fierce rivalry amongst the competitors, and a quest for companies to achieve competitive advantage, companies must design their strategies better than their competitors. For a company to be successful in such an environment, customer-brand loyalty is a critical issue. The main objective of this study was to measure brand loyalty in the medical-devices industry of South Africa, and to establish the key influencing factors of brand loyalty in this industry. The measurement of brand loyalty in the medical devices industry is founded on a conceptual brand-loyalty framework for the Fast Moving Consumer Goods (FMCG) industry developed by Moolla (2012). The 12 brand loyalty factors identified by Moolla are: customer satisfaction; switching costs or risk aversion; brand trust; involvement; repeat purchases; relationship proneness; commitment; perceived value; brand relevance; brand affect; brand performance and culture. The empirical study was conducted among 250 medical practitioners across the private sector and public sector health-care system of South Africa. The methodology adopted in the study included the sampling procedure, the data collection, the questionnaire development and the statistical techniques used to analyse the results. The results were analysed with regard to: Factor analysis; Cronbach’s Alpha coefficients, mean values and inferential statistics. The results were presented in a conceptual framework, in order to measure brand loyalty in the medical devices industry of South Africa. The results of this study concluded that the brand loyalty influences, as identified by Moolla, are important for measuring brand loyalty in the medical devices industry. The empirical results focused on the demographic profile of the respondents, the validity of the questionnaire, the reliability of the results obtained, as well as the importance of the research variables. The analysis enabled certain conclusions to be drawn relating to the significant factors of brand loyalty in the medical devices industry in South Africa. A comparison was conducted relating to age group, gender profile, the health-care sector and the medical specialization – to determine whether there were any significant differences in the influence of the brand-loyalty factors identified. The chapter concluded with a conceptual framework for the medical-devices industry adapted from Moolla (2012) framework.
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Mills, David. "The role of goal setting in the diabetes case management of aboriginal and non-aboriginal populations in rural South Australia /." Title page, table of contents and abstract only, 2005. http://web4.library.adelaide.edu.au/theses/09MD/09mdm6571.pdf.
Full textAbstract:
Thesis (M.D.)--University of Adelaide, Dept. of General Practice, 2005.Includes publications published as a result of ideas developed in this thesis, inserted at end. "April 2005" Includes bibliographical references (leaves 210-242).
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Kewley, Christopher. "How do health beliefs of African refugees influence attribution of mental illness and help-seeking behaviour following resettlement in Australia?" Thesis, 2018. http://hdl.handle.net/1959.13/1392682.
Full textAbstract:
Research Doctorate - Doctor of Philosophy (PhD)Background: Refugees from Sub-Saharan Africa, including Ethiopia, Somalia, Sudan and South Sudan, constitute a significant percentage of refugees globally that continue to settle in Australia and other western countries. The dualism of African pluralistic medicine and western scientific biomedicine is no more obvious than when comparing beliefs concerning psychiatric aetiology. Ethno-culture, religion and spirituality are recognised to heavily influence indigenous beliefs concerning mental illness. However, there is minimal research addressing how this dualism and complex interface between phenomenologically constructed African belief systems, and scientifically rationalised conventional western medicine, influence African refugees’ help-seeking behaviour on settlement in a western country. Aim: The aim of this critical ethnographic study was to gain an understanding of how the health beliefs of refugees from Ethiopia, Somalia, Sudan and South Sudan influence attribution of mental illness and help-seeking behaviour on settlement in Australia. Method and analysis: The study used semi-structured interviewing, naturalistic participatory and non-participatory observation. Data were obtained from three sources: 1) African refugees that entered Australia via the offshore humanitarian program; 2) specialist workers in cross-cultural and refugee health; and 3) African diaspora registered health professionals practicing in Australia and native to one the aforementioned African countries. Data saturation was achieved at 35 interviews. Interviews were transcribed verbatim and subjected to a four-step process of thematic analysis using NVivo 10 software. Internal validity was addressed through triangulation of the data and the use of a cultural informants group of community leaders who advised on issues surrounding lexical, contextual and conceptual equivalence. Findings: The study identified four main themes and a number of sub-themes. Each theme constitutes a significant intercultural tension point that acts as a barrier to therapeutic engagement between African refugees and mainstream Australian mental health services. Collectively, the tension points create an impervious barrier to the penetration of western psychoeducation within the Ethiopian, Somali, Sudanese and South Sudanese refugee communities. The four major themes are: 1.Tension between African spiritual explanatory concepts and western theories of mental illness 2.Tension between faith-based and western biopsychosocial models of treatment and recovery 3.Tension between African culture, language and belief systems on the individual’s health literacy and engagement with western mental health services 4.Tension between African cultural collective and western individualistic orientation and effect on health and mental wellbeing. Discussion: The majority of refugees from Ethiopia, Somalia, Sudan and South Sudan were not engaging with mainstream mental health services until they are acutely unwell. Their explanatory models of mental illness were influenced by their traditional animistic and spiritual beliefs, regardless of length of residency in Australia or level of educational attainment. Traditional and faith-based treatment was the preferred option for many repatriated by family, including post-diasporic African/Australian youth, for traditional animistic and faith-based healing. Repatriation commonly resulted in violation of the individual's human rights through involuntary genital mutilation/cutting, forced marriage and other ritualistic practices.
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Nunn, Julie M. "A sample of female Australian tourists' travel health intentions and behaviour while holidaying in south east Asia." Thesis, 2001. https://vuir.vu.edu.au/17918/.
Full textAbstract:
Over 456,000 Australians spend time holidaying in South East Asia each
year; it is Australia's top tourist destination. Much of the attraction of South
East Asia is the novelty of exotic tropical environments. However, these can
result in strange and diverse health hazards.
This exploratory research used sequential in-depth interviews to explain
the relationship between the travel health advice tourists receive and their
behaviour while holidaying in South East Asia. When providing travel
health advice to tourists travel health advisers need to understand the
psychology underlying reasoned behaviours such as travel health behaviours
if they want to persuade tourists to practice preventative health measures.
After review of the relevant literature it would appear that this is the first
time that the theory of reasoned action, developed by Ajzen and Fishbein in
1980, had been used to explore travel health beliefs, attitudes, intentions and
behaviours.
The research found that the travel health advice received by tourists had marginal effect on their travel health behaviours as the source, extent and
relevance of the advice was left wanting. The tourists hoped to relax and
desired a good time on their holiday by entering into the 'holiday spirit'
offered by South East Asia. This impeded their ability to recognise the very
real travel health risks they faced.
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Rogers, G. D. "Feeling queer : can a primary health care approach mitigate health inequity experienced by homosexually active South Australian men ?" 2005. http://hdl.handle.net/2440/37819.
Full textAbstract:
Health inequity refers to differences in health status between populations ( health inequalities ) that are unnecessary and avoidable and, additionally, are considered unfair or unjust. The history of the concept is reviewed and the mechanisms by which inequity affects health surveyed, with a focus on multi - level models of health production. The origins and development of the Primary Health Care approach is then considered with an emphasis on the Australian setting and on HIV / AIDS policy. The construct of homosexuality is then explored and concepts of sexual attraction, ' orientation ', identity and behaviour differentiated. What is known about the health characteristics of homosexually active men in the First World is then surveyed by means of a systematic literature review. It is concluded that there is evidence that they are affected by substantial health inequality in a range of areas including mortality, suicidality, depressive disorders, anxiety disorders, report of childhood sexual abuse and problematic substance use. Few of these inequalities have been confirmed in the Australian context, however, and almost none have been confirmed specifically in South Australia. The background to the development of a Primary Health Care programme focused on homosexually active men, is then described. The baseline health characteristics of the programme ' s cohort of 542 homosexually active South Australian men ( including their sexual behaviour in the context of HIV transmission ) are described and compared with other samples of men to identify inequalities. It is concluded that men in the cohort were subject to health inequality in a wide range of health parameters including mortality, suicidality, sexually transmitted infections, depressive and anxiety disorders, levels of substance use and self - rated health on the short - form 36 ( sf36 ) instrument. The relationships between these characteristics and factors indicative of disadvantage and victimisation are then explored. It is concluded that many of the health inequalities identified were related to sociohistorical factors such as emotional withdrawal by one ' s father, low income, unemployment, reduced educational attainment, and recent experience of violence and abuse from strangers. It is argued that some of these factors can be considered to be examples of unfairness and injustice and that, as a consequence, at least some of the health inequality experienced by this population is also health inequity. The elements of the Primary Health Care programme devised to meet the needs of homosexually active men is described and the trajectory of health characteristics of its participants over three time points is examined. 210 homosexually active men had reached Second Review, an average of thirty - six months after enrolment, by the time of analysis. Among this group, significant sustained improvement in a range of health outcomes, including prevalence of depressive disorders, sf36 scores and rate of recent suicidal ideation, is reported in association with involvement in the programme. Participant ' s subjective satisfaction with the programme is then described and their beliefs about the causes of their improved health explored using a qualitative methodology. It is concluded that the programme had largely met the needs of participants and they believed that it had been responsible for their improved health. Limitations of the study are considered and discussed. Limitations of the investigation to identify health inequality include questions of external validity arising from the absence of a perfect comparator group and concerns with construct validity related to the possibility of geographical and cultural variation in definitions of ' homosexually active men '. In the investigation to determine the extent to which health inequalities were also examples of inequity, issues of conclusion validity are discussed particularly in relation to multiple comparisons and the balance between Type I and Type II errors. In the evaluation of the impact of the Primary Health Care programme, there are concerns about internal validity resulting from the absence of randomisation and an uncontrolled design. The components of this issue are discussed and some support for internal validity is found in the reported subjective beliefs of participants about the cause of their health improvement and the outcomes of critical reflection by the programme team. The implications of the findings for policy, practice and further research are explored. It is argued that the health inequity experienced by people of sexual diversity will require profound social change for complete resolution. In the meantime, however, focused Primary Health Care with a community of sexual diversity has the potential to mitigate the health inequity its members experience and to help them to survive and function while they wait for a fairer and kinder society.Thesis (Ph.D.)--School of Population Health and Clinical Practice, 2005.
49
Rogers, Gary David. "Feeling queer : can a primary health care approach mitigate health inequity experienced by homosexually active South Australian men ?" Thesis, 2005. http://hdl.handle.net/2440/37819.
Full textAbstract:
Health inequity refers to differences in health status between populations ( health inequalities ) that are unnecessary and avoidable and, additionally, are considered unfair or unjust.
The history of the concept is reviewed and the mechanisms by which inequity affects health surveyed, with a focus on multi - level models of health production. The origins and development of the Primary Health Care approach is then considered with an emphasis on the Australian setting and on HIV / AIDS policy.
The construct of homosexuality is then explored and concepts of sexual attraction, ' orientation ', identity and behaviour differentiated. What is known about the health characteristics of homosexually active men in the First World is then surveyed by means of a systematic literature review. It is concluded that
there is evidence that they are affected by substantial health inequality in a range of areas including mortality, suicidality, depressive disorders, anxiety disorders, report of childhood sexual abuse and problematic substance use.
Few of these inequalities have been confirmed in the Australian context, however, and almost none have been confirmed specifically in South Australia.
The background to the development of a Primary Health Care programme focused on homosexually active men, is then described. The baseline health
characteristics of the programme ' s cohort of 542 homosexually active South Australian men ( including their sexual behaviour in the context of HIV transmission ) are described and compared with other samples of men to identify inequalities. It is concluded that men in the cohort were subject to health inequality in a wide range of health parameters including mortality, suicidality, sexually transmitted infections, depressive and anxiety disorders,
levels of substance use and self - rated health on the short - form 36 ( sf36 ) instrument.
The relationships between these characteristics and factors indicative of disadvantage and victimisation are then explored. It is concluded that many of the health inequalities identified were related to sociohistorical factors such as
emotional withdrawal by one ' s father, low income, unemployment, reduced educational attainment, and recent experience of violence and abuse from strangers. It is argued that some of these factors can be considered to be examples of unfairness and injustice and that, as a consequence, at least some of the health inequality experienced by this population is also health inequity.
The elements of the Primary Health Care programme devised to meet the needs of homosexually active men is described and the trajectory of health
characteristics of its participants over three time points is examined.
210 homosexually active men had reached Second Review, an average of thirty - six months after enrolment, by the time of analysis. Among this group, significant sustained improvement in a range of health outcomes, including prevalence of depressive disorders, sf36 scores and rate of recent suicidal ideation, is reported in association with involvement in the programme.
Participant ' s subjective satisfaction with the programme is then described and
their beliefs about the causes of their improved health explored using a qualitative methodology. It is concluded that the programme had largely met
the needs of participants and they believed that it had been responsible for their improved health.
Limitations of the study are considered and discussed. Limitations of the investigation to identify health inequality include questions of external validity arising from the absence of a perfect comparator group and concerns with
construct validity related to the possibility of geographical and cultural variation in definitions of ' homosexually active men '. In the investigation to determine the extent to which health inequalities were also examples of inequity, issues of conclusion validity are discussed particularly in relation to multiple comparisons and the balance between Type I and Type II errors.
In the evaluation of the impact of the Primary Health Care programme, there are concerns about internal validity resulting from the absence of randomisation and an uncontrolled design. The components of this issue are discussed and
some support for internal validity is found in the reported subjective beliefs of participants about the cause of their health improvement and the outcomes of critical reflection by the programme team.
The implications of the findings for policy, practice and further research are explored. It is argued that the health inequity experienced by people of sexual diversity will require profound social change for complete resolution. In the
meantime, however, focused Primary Health Care with a community of sexual diversity has the potential to mitigate the health inequity its members experience and to help them to survive and function while they wait for a fairer and kinder society.Thesis (Ph.D.)--University of Adelaide, School of Population Health and Clinical Practice, 2005.
50
Wakefield, Melanie. "Psychology in the public health arena : smoking control as an example." Thesis, 1988. http://hdl.handle.net/2440/112643.
Full text