Дисертації з теми "Personal hygiene care"

Hoy en día, no solo las mujeres se preocupan por el cuidado de la piel sino también los hombres. Sumado a esta nueva tendencia, se puede observar el ascenso de la preferencia en productos de origen natural que contribuyen al aporte de beneficios a la piel y a la reducción del daño ocasionado por los químicos. En este sentido, se ha encontrado un mercado potencial, los hombres específicamente del estilo de vida sofisticado, una parte de la población, definida por Arellano Marketing, como preocupados por el status, la moda y la imagen. Partiendo de la imagen, es sabido que en la actualidad el mercado de productos estéticos para hombres se encuentra en crecimiento desde hace algunos años habiendo generado hasta S/1,000 millones en el año 2018. Es por ello que “Spartan Man Care” busca abordar el negocio de los productos naturales especializados en hombres que se preocupan por su aspecto físico. Además, es importante resaltar que hoy en día a pesar del mercado potencial existente en los hombres, no existe una variedad de productos dirigidos a ellos, por lo que hay una oportunidad de negocio latente para trabajar. Actualmente, el total de hombres considerados sofisticados en Lima dentro del rango de 25 a 39 años es de 121, 392. De este total el 14% compra productos de higiene con regularidad, representado por 16,995 habitantes y S/3, 976,830 en soles. Finalmente, se determinó que la ganancia del proyecto, calculada a través del VAN, será de S/126, 316 de retorno sobre la inversión.
Today, not only women care about skin care but also men. In addition to this new trend, you can see the rise in preference in products of natural origin that contribute to providing benefits to the skin and reducing the damage caused by chemicals. In this sense, a potential market has been found, men specifically for the sophisticated lifestyle, a part of the population, defined by Arellano Marketing, as concerned about status, fashion and image. Based on the image, it is known that currently the market for men's cosmetic products has been growing for some years, having generated up to S / 1,000 million in 2018. That is why "Spartan Man Care" seeks to address the business of natural products specialized in men who care about their physical appearance. Furthermore, it is important to note that today despite the potential market for men, there is no variety of products for them, so there is a latent business opportunity to work. Currently, the total of men considered sophisticated in Lima within the range of 25 to 39 years is 121, 392. Of this total, 14% purchase hygiene products regularly, represented by 16,995 inhabitants and S / 3,976,830 in soles. Finally, it was determined that the project's profit, calculated through the NPV, will be S / 126, 316 of return on investment.
Trabajo de investigación

Since women dominate the health care system as consumers, it is important to understand how women want to be treated by medical staff, and the factors that contribute to satisfactory hospital experiences. The present research comprised two separate but integrated studies exploring these issues. The first study adopted an atheoretical approach. Qualitative and quantitative methods were used to examine the importance of hospital experiences in the lives of women, and the role of power within those experiences. Closed answer items about hospital experiences were completed by 124 women who had had a hospital stay of at least one night. In addition, ten of the women provided open-ended oral and written comments about their hospital experiences, which were used as the basis of the qualitative data. The majority of the women were satisfied with their hospital stay, but a small group recalled experiences of powerlessness associated with the non-medical aspects of their treatment, such as behaviours on the part of health professionals that influenced participants� sense of control as hospital inpatients. The qualitative data reflected similar issues to the quantitative data and provided �process� information by demonstrating how health professionals� behaviour could contribute to patients� feelings of powerlessness. The results suggested that hospital experiences were a salient part of these women�s lives. The richness of the qualitative data suggested that qualitative methodology would be a productive way to further study this area. The second study was an extension of the first via in-depth interviews with 19 women who perceived their hospital experiences as life-altering. The interview content and the analysis were based on a narrative approach that used the theoretical framework of McAdams� (1993) Life Story Model of Identity. Using McAdams� methodology enabled the researcher to evaluate how women constructed meaning from their hospital experiences, and the main issues they faced. The life story interview also proved a useful way to explore issues of loss and self-growth in the face of traumatic hospital experiences. Transcripts of descriptions of positive and negative experiences were analysed according to McAdams� themes of agency (sense of power and control) and communion (relationships with others), and sequences of redemption and contamination. Redemption sequences involve the storyline moving from a bad, affectively negative life scene, to a good, affectively positive life scene. In a contamination sequence, the narrator describes a change from a good, affectively positive life scene, to a subsequently bad, affectively negative life scene (McAdams & Bowman, 2001). Participants also rated their experiences according to Hermans� (Hermans & Oles, 1999) list of affects. There was strong agreement between McAdams� coding of agency and communion and Hermans� agentic and communal indices: the women�s hospital stories strongly emphasised the negative or opposite of McAdams� agentic theme �Self Mastery through Control�, which indicated powerlessness, and Hermans� affects, which involved low self-enhancement. It may be useful for future studies to conceptualise McAdams� themes as bipolar by incorporating currently coded themes and their reverse; in particular, by expanding ideas of agency to incorporate powerlessness, as this theme was pervasive in women�s hospital experiences. The rating of affects added to the findings as this showed a latent dimension of communion manifested as isolation. The common agency and communion themes were apparent in the two distinct but related aspects of hospitalisation that affect patients� sense of control: the medical condition and the manner in which patients are treated by medical staff. The findings of the main study built on the pilot study by showing how ideas of control and powerlessness can inform better practice. For example, respectful, dignified and fair treatment by health professionals played a part in determining redemption sequences; women also indicated this was how they wanted to be treated. Due to the vulnerability of the �sick role�, disrespectful or offhand treatment by health professionals had particularly distressing effects evident in contamination sequences, such as negative changes to sense of self and attitudes toward the health care system. In some cases, such treatment led to participants� avoiding subsequent interactions with doctors and to sustained feelings of helplessness. The present thesis demonstrates that doctors, nurses and other health professionals need to allow time to attend to the affective as well as the medical aspects of the encounter. Health professionals need a good bedside manner, compassion, and communication skills, as these characteristics play a part in maintaining female patients� sense of self and their faith in and satisfaction with the health care system.

En la actualidad el país ha ido aumentando el consumo de productos de cuidado e higiene personal, esto sucede por el crecimiento económico, el aumento de los ingresos de la población a lo largo de los años y que las personas buscan más información acerca de qué productos deben consumir según las tendencias. ¿Sabía usted que en un solo día una mujer puede consumir hasta 12 productos de limpieza con aproximadamente 100 ingredientes que son perjudiciales para la salud y el medio ambiente? Cada año se producen 120,000 mil millones de unidades de empaques de cosméticos y de limpieza personal y la mayoría para ser usados una sola vez. Es por eso, que en el mercado han ido ingresando muchas marcas internacionales al país y se han creado nuevas marcas a nivel nacional. Muchas de estas marcas que se encuentran en el mercado se han especializado para diferentes tipos de segmentos específicos, con características específicas como que sus productos están elaborados con insumos que cuiden tanto su bienestar físico como el del medio ambiente. Por este motivo, este trabajo de investigación se basó en proponer una alternativa de idea de negocio en donde los productos están elaborados con insumos y componentes libres de químicos y con un formato innovador.  Q´umir es una empresa encargada de la comercialización y fabricación de jabón, shampoo y acondicionador en sólido para diferentes tipos de piel y cabello (seca, grasa y mixta), le sumamos que utilizamos ingredientes naturales y ecológicos que brindan hidratación y firmeza.
Currently the country has been increasing the consumption of personal care and hygiene products, this is due to economic growth, the increase in the income of the population over the years and that people are looking for more information about what products they should consume according to trends. Did you know that in a single day a woman can consume up to 12 cleaning products with approximately 100 ingredients that are harmful to health and the environment? Every year 120 billion units of cosmetic and personal cleansing packaging are produced, and most are for one-time use. That is why, many international brands have entered the country in the market and new brands have been created at a national level. Many of these brands that are on the market have specialized for different types of specific segments, with specific characteristics such as that their products are made with inputs that take care of both their physical and environmental well-being. For this reason, this research work was based on proposing an alternative business idea where the products are made with inputs and components that are free from chemicals and with an innovative format. Q´umir is a company in charge of the commercialization and manufacture of soap, shampoo and conditioner in solid for different types of skin and hair (dry, oily and mixed), we add that we use natural and ecological ingredients that provide hydration and firmness for women.
Trabajo de investigación

Extensive amounts of pharmaceuticals and personal care products (organic emerging pollutants) are introduced into the environment mainly through wastewater treatment plants discharges either effluent wastewater reaching into the aquatic environment or sewage sludge which is spread onto agricultural land. These compounds are not regulated and their negative effects on humans and wildlife are unknown. One of the main challenges of analytical chemistry is to develop selective and sensitive methods for the detection and quantitation of pharmaceuticals and personal care products and their transformation products in complex matrices. The research presented in the thesis is focused on the development of new methods based on the use of hollow fiber liquid- phase microextraction (HF-LPME) technique and liquid chromatography for the determination of some of the most consume pharmaceuticals and personal care products in wastewaters, environmental waters and sewage sludge.
Tones de substàncies biològicament actives són alliberades contínuament al medi ambient, a través de la descàrrega d’aigües residuals als medis aquàtics o de biosòlids en l’agricultura. La presència d’aquestes substàncies (contaminants emergents) en el medi ambient ha generat una gran preocupació perquè es desconeix com actuen i quins són els mecanismes implicats en la seva transformació i/o transport. Un dels reptes de la química analítica és dissenyar mètodes selectius i sensibles per a la determinació de contaminants emergents en matrius complexes. La recerca presentada en aquesta tesi es centra en el desenvolupament de nous mètodes analítics basats en l’ús de la microextracció enfase líquida amb fibra buida (HF-LPME) i la cromatografia líquida per a la determinació d’alguns fàrmacs i productes d’higiene personal en aigües residuals, medis aquàtics i biosòlids.

Il est parfois complexe pour les étudiant·e·s en soins infirmiers (ESI) de dispenser des soins d’hygiène corporelle (SHC) pour, sur et avec autrui. Différentes dimensions rendent ce soin complexe, et tout particulièrement, l’imprévisibilité de la rencontre interpersonnelle mais aussi l’inéluctable corporalité (Delomel, 1999; Lawler, 1991/2002; Mercadier, 2002/2008) de la personne prise en soin et des étudiant.e.s. En outre, le contexte institutionnel contemporain où prime désormais la rationalité instrumentale, peut se révéler source de désenchantement pour les ESI (Graber et Haberey-Knuessi, 2017) qui peinent à exprimer leurs valeurs soignantes lors de ces soins de l’intime. Cette recherche vise à questionner le potentiel formatif du jeu vidéo grand public : Les Sims dans le processus de professionnalisation des futur·e·s infirmier·e·s. Le rapport qu’ils établissent, pour certain·e·s, entre ce jeu de simulation du prendre soin dans un univers virtuel et le prendre soin qu’ils élaborent lors de leur pratique soignante pourrait les aider à apprivoiser plus sereinement la complexité de soi et d’autrui lors de la réalisation des SHC.En congruence avec les théories winnicottiennes (1971), le protocole de recherche s’inscrit dans une démarche clinique d’orientation psychanalytique. Il a été proposé à huit ESI de s’adonner à ce jeu vidéo puis de participer à deux entretiens non-directifs. Le premier entretien était consacré à la pratique vidéoludique, et selon la volonté des ESI, il pouvait être médié par le jeu Les Sims 3 ou Les Sims 4 (additionné de l’extension Les Sims au travail, laquelle propose d’évoluer au sein d’un hôpital). Lors du deuxième entretien, il était demandé aux ESI de s’exprimer le plus librement possible sur la thématique des SHC. Il apparaît que le rapport à l’avatar des joueu·r·se·s, mais aussi l’humour et l’immense liberté d’action des Sims confèrent à ce jeu un potentiel de transitionnalité particulièrement intéressant. Le joueu·r·se s’incarne dans et à travers l’avatar, ce qui est une caractéristique du médium vidéoludique. En répondant aux différents besoins de cet être de pixels (s’alimenter, se distraire, se laver, etc.), le joueu·r·se fait l’expérience des fondements du care. Mais le degré d’identification à l’avatar fluctue selon les séquences de jeu. C’est pourquoi, l’ESI peut être amené à expérimenter une e-empathie, dirigée envers lui-même mais aussi envers un autrui numérique. Un dernier point également étayé par la mise en scène des patient·e·s-Sims et/ou des autres avatars potentiellement créés [conjoint·e(s), enfant(s)]. De même, grâce à la prise en soin des différents membres d’une famille avatarielle, le futur·e infirmier·e peut être amené à expérimenter sa biparentalité et/ou sa bigénérationnalité psychiques internes, deux conditions du prendre soin d’autrui. Enfin, l’entretien post-séquence de jeu étaye l’appropriation des expériences subjectives induites par la pratique des Sims et soutient un travail de liaison et de déliaison en direction de la sphère professionnelle. Ainsi, Les Sims permettraient à certain·e·s joueu·r·se·s de s’inscrire dans une aire intermédiaire d’expérience, étayant un processus de réunion, à même de faire découvrir aux ESI leur soi, dans un moment subjectalisant. De ce fait, l’expérimentation, même partielle et numérique, des différentes phases d’un care vidéoludique peut favoriser la mise en œuvre de la créativité (au sens winnicottien) des étudiant·e·s. C’est en cela que l’intégration des Sims, dans leur curriculum de formation, peut étayer la professionnalité des futur·e·s infirmier·e·s et concourir à la qualité des SHC dispensés
It is sometimes difficult for a nursing student (ESI) to provide personal hygiene care (SHC) for, on and with others. Different dimensions make this care complex, and in particular, the unpredictability of the interpersonal encounter and the inescapable corporeality of the person being cared for but also that of the student. In addition, the contemporary institutional context, in which instrumental rationality now prevails, can be a source of disenchantment among students, who struggle to express their caring values when providing intimate care. However, the Sims life simulator can enable certain players to enter an intermediate area of experience, underpinning a reunion process that can help future nurses to discover their true selves in a subjectalising moment.In keeping with Winnicottian theories, my research protocol is therefore part of a psychoanalytically-oriented clinical approach. Eight student nurses were asked to play this video game and then to take part in two interviews, one devoted to the video game and the other to SHC.It seems that the Sims' humour and immense freedom of action give this game a particularly interesting potential for transitionality. Thanks to the incarnation of the player in and through his avatar, characteristic of the video game medium, the student has the feeling of being at the same time the director, the author, the spectator (thanks to the objective view) and the actor (via the avatar) of the images displayed in front of him/her. However, to progress in the digital space, he/she has to take care of his pixels double since the principle of the game is based on the foundations of care. In this way, student experiences e-empathy, directed not only towards himself or herself but also towards a digital other. What’s more, by staging of an avatar family, the future nurse can be led to experience his/her internal psychological bi-parenthood and/or bi-generationality, two conditions for caring for others. Finally, the post-game sequence interview supports the appropriation of the subjective experiences induced by playing The Sims and supports liaison work towards the professional sphere.As a result, experimentation, even partial and digital, of the different phases of video game can promote the implementation of creativity (in the Winnicottian sense) of students who have to provide SHC for, on and with others, and thus contribute to the quality of care.This is why the integration of Sims into their training curriculum can support the professionalization process of future nurses

Medicalization has been discussed at length in the sociology of health and illness literature. Typically, dialogue has centered on the effects of medicalization and the process as a phenomenon in professional fields alone. This work is an attempt to study medicalization using a theoretical model, structuration, that allows for inclusion of the larger social system in understanding health system changes and to include consumers of health services in the process as active agents. The example of oral aesthetics provides an opportunity to identify the agents of change, the process of medicalization in the larger social context, and possible indicators of the phenomenon. An attempt to operationalize the complex concept of medicalization marks a move toward creating testable theoretical models for the variety of behaviors and conditions under study as medicalized. Using content analysis of professional dental journals and lay magazines and a review of system rules and resources, shifts in language use and the emergence of medical frameworks were documented to determine if a medicalization of oral aesthetics had occurred. Results show two distinct periods within the last century when oral aesthetics have been medicalized in the United States. Evidence of turn-taking behavior among the agents is noted as well as the relationship of technology and technological language to the process. A model for future testing is suggested that encompass the identified agents, the language and framework, and the elements of social context.

Objectives: Risk associated with needlestick injuries (NSI) in health care workers (HCWs) in Taiwan has not been characterized. We conducted this investigation to study 1) the prevalence and yearly incidence of NSI in HCWs in Taiwan, and the risk factors associated with NSIs; 2) reporting behavior when a NSI was sustained; and 3) seroprevalence of blood-borne pathogens among inpatients. Combination of the above information allowed for risk estimation for contracting hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in HCWs. Methodology: A cross-sectional questionnaire survey for life-time experience and frequency of NSI was conducted in a random sample from four strata of accredited hospitals according to the number of employees, from July 1996 to June 1997 in Taiwan. All full time employees, including physicians, nurses, technicians, and supporting personnel were recruited. Seroprevalence was examined for HBV, HCV and HIV among inpatients six years in age or older in one teaching hospital during July 1997 to June 1998. Results: A total of 10,469 health care workers were recruited from 16 out of 132 accredited hospitals and 82.6% (8,645) completed the survey, including nurses (61.0%), physicians (16.1%), medical technicians (14.9%), supporting personnel (7.9%). The prevalence of NSI were 93.1%, 86.6%, 78.3%, 61.0% in nurses, physicians, technicians, and supporting personnel respectively. The reported incidence of needlestick and other sharps injuries was 1.30 and 1.21 times per person in the past 12 months. Of the most recent episodes of NSIs, ordinary syringe needles accounted for 80.3% (95% CI, 79.4% - 81.2%) of hollow-bore needles associated incidents, and 74.1% (95% CI, 72.8% - 75.4%) of them were contaminated. The most frequently reported circumstance was the "Breakdown of Universal Precautions", recapping-related behaviors (81.6%, 95% CI 80.3% - 82.9%) of HCWs. More than a quarter (27.8%, 2,399) of HCWs were unprotected (either not vaccinated or having an unknown serological status) against HBV. Seroconversion in stuck HCWs was reported 1.8% for HBV (135), 0.2% (18) for HCV, 0.2% (15) for both HBV and HCV, 0.1% (5) for syphilis and less than 0.1% (2) for HIV. ^M A total of 81.8% of NSIs were unreported. Similarly, high incidence of NSI and low reporting rate were also found in student nurses. Seroprevalence of HBV, HCV, and HIV among inpatients were found higher than the reported rate in source patients of this survey. Seroprevalence of HBsAg was 16.7% in hospitalized patients, 1.7% positive for HBeAg, 12.7% for Anti-HCV, and 0.8% for Anti-HIV. Different seroprevalence rates of HBsAb (+), HBsAg (+), Anti-HCV (+), Anti-HIV (+) in different seasons were also found significant (p<0.001). The risk of seroconversion to HBV was thus estimated to be 0.003 ~ 0.008 time per person-year, HCV 0.003 ~ 0.007 per person-year, and HIV 0.4 ~ 1.2 /100, 000 person-year. Considering the number of HCWs in Taiwan, a total of 330 ~ 917 HCWs will seroconvert to HBV (+) in a year, 330 ~ 880 HCWs seroconvert to HCV (+), and less than one to two HCWs seroconvert to HIV (+). Conclusions: Needlestick and sharps injuries were highly prevalent among Taiwanese HCW and across job categories. Risk of seroconversion is real and significant. Preventive measures are warranted for reduction of contracting blood-borne pathogens in HCWs in Taiwan.

Sammanfattning Bakgrund: De bakterier som överförs till händerna från omgivningen via föremål och sprider sig vidare mellan individer kan skapa en vårdrelaterad infektion, som i sin tur kan ge ett lidande för den enskilda patienten. Syfte: Syftet med studien var att undersöka följsamheten till basala hygienrutiner och klädregler hos personalen vid patientnära arbete under förberedelserna av patienten på operationssalen. Metod: Metoden av studien genomfördes med en öppen observationsstudie med en kvantitativ design baserad på strukturerade observationsprotokoll. Observationerna av följsamheten till basala hygienrutiner genomfördes när personalen utförde olika arbetsmoment i förberedelserna vid patientnära arbete. Arbetsmoment var positionering av patient inför operation, insättning av urinkateter, perifer venkateter, artärnål, epiduralkateter och intubation av patienten. Observationsstudien genomfördes på en kirurgisk och en ortopedisk operationsavdelning på ett universitetssjukhus i Mellansverige. Resultat: Studien omfattade 10 observationstillfällen per operationsavdelning med totalt 175 observationsmätningar på kirurg- och ortopedoperation angående klädregler, resultatet visade att 98% av personalen på ortopedoperation och 100% på kirurgoperation hade en korrekt följsamhet. Vid samtliga arbetsmoment som observerades förekom det brister vid användning av handdesinfektion före och efter patientnära arbete. Det arbetsmoment där rutinerna brister mest var vid intubation av patienten. Slutsats: I studiens resultat framgår det att personalen har en god följsamhet till klädregler, majoriteten använder engångskläder på båda operationsavdelningarna. När det gäller basala hygienrutiner finns fortfarande arbetsmoment där det finns brister. Vidare forskning och fortsatt utvecklingsarbete kring basala hygienrutiner behövs för att öka kunskap och medvetenhet hos personalen vid patientnära arbete.
Abstract  Background: The bacteria that are transmitted to the hands from the environment through objects and is spreading further among individuals can create a health care associated infection, which in turn can cause a hardship for the individual patient. Purpose: The purpose of this study was to investigate the adherence to basic hygiene and dress code of staff in patient-related work during the preparation of the patient in the operating room. Method: The method of study was conducted with an open observational study with a quantitative design based on structured observation protocol. The observations of adherence to basic hygiene was carried out when the staff performed various tasks in preparation for near patient work. Operations were positioning of the patient before surgery, insertion of urinary catheter, peripheral venous, artery needle, epidural catheter and intubation of the patient. Observational study was conducted in a surgical and orthopedic surgery department at a university in central Sweden. Results: The study involved 10 observation occasions a surgical department with a total of 175 observational measurements on surgical and orthoped operation regarding the dress code, the results showed that 98% of the staff at the orthopedic surgery and 100% in the surgical operation had a proper adherence. In all the operations were observed, there were deficiencies in the use of hand disinfectant before and after patient-related work. The operation in which the routines shortcomings were for intubation of the patient. Conclusion: The results of the study, it appears that the staff has a good adherence to the dress code, the majority use disposable clothing on both operations departments. In terms of basic hygiene are still occupations where there are shortages. Further research and further development work on basic hygiene needed to increase knowledge and awareness of-staff for near patient work.

Thesis (Mphil)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: Political instability involving civil wars which had been prevailing mostly within the African Great Lakes Region caused great numbers since the 1990s of civilian populations to move to and fro within the borders and sometimes beyond its frontiers in search of both safer homes and better living conditions. Socio-economic hardships experienced by these people constrained them to engage in various migration movements, thus making them more vulnerable to a variety of diseases and pandemics, among which Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). Sub–Saharan Africa has been bearing the brunt of HIV pandemic, and South Africa is believed to have the highest HIV prevalence. The present study was a quantitative survey exploring personal perception of HIV infection risk among African émigré communities of the Cape Metropolitan area. Only thirty four heterosexual active participants, who had joined their partners in South Africa after a certain period of temporary separation, were considered for final analysis using descriptive statistics. A relatively high perception of HIV infection risk was found among both males and females. However, the perceived risk did not necessarily determine sexual behaviour. No significant reciprocal relationship was found between the perceived risk and one important sexual risk behaviour. HIV and AIDS related stigma was found to be relatively high and the use of condoms prejudiced by tendencies of personal moralistic values. The present study has made relevant recommendations as to promote more preventive behaviours among the present African émigré community.
AFRIKAANSE OPSOMMING: Politieke onstabiliteit wat burgeroorloë meebring kom sedert die 1990’s meestal in die Groot Mere-streek van Afrika voor en het veroorsaak dat groot groepe van burgerlike bevolkings heen en weer tussen grense beweeg en soms grense oorsteek op soek na beter en veiliger tuistes en beter lewensomstandighede. Die sosio-ekonomiese ontberings wat deur hierdie mense ervaar is het hulle verplig om by verskeie migrasiebewegings betrokke te raak. Dit het hulle kwesbaar gemaak vir ’n verskeidenheid siektes en pandemies, waaronder die menslike immuniteitsgebreksvirus (MIV) en verworwe immuniteitsgebreksindroom (Vigs). Sub-Sahara-Afrika het die ergste van die MIV-pandemie getrotseer en Suid-Afrika het na bewering die hoogste MIV-voorkoms. Hierdie studie is ’n kwantatiewe opname wat die persoonlike persepsie van die risiko van MIV-infeksie onder Afrika-uitgeweke gemeenskappe in die Kaapse Metropoolgebied ondersoek het. Slegs 34 heteroseksuele, seksueel aktiewe deelnemers wat na ’n tydperk van tydelike skeiding by hul (lewens) maats in Suid-Afrika aangesluit het, is vir die finale analise oorweeg met behulp van beskrywende statistiek. Onder mans sowel as vroue is ’n relatief hoë persepsie van infeksierisiko gevind. Die waargenome risiko het egter nie noodwendig seksuele gedrag bepaal nie. Geen beduidende omgekeerde verhouding is tussen die waargenome risiko en een belangrike seksuele risikogedragsaspek gevind nie. Daar is bevind dat MIV en Vigsverwante stigma relatief hoog is en dat daar weens tendense van persoonlike moralistiese waardes vooroordeel teen die gebruik van kondome bestaan. Hierdie studie het relevante aanbevelings gedoen om meer voorkomende gedragspatrone onder die huidige Afrika-uitgeweke gemeenskap te bevorder.

La deuxième phase du programme d’amélioration de la santé des mères et des enfants au Burkina Faso a développé et implanté une formation portant sur l’approche centrée sur la personne dans les soins maternels pour les professionnels de la santé afin d’améliorer la qualité des soins. Il a aussi prévu d’évaluer cette formation qui fait l’objet de ce travail. L’objectif est : 1) d’évaluer la fidélité de l’implantation de la formation ACP, 2) d’évaluer les déterminants contextuels (les facteurs ayant influencés l’implantation et le résultat du projet) et 3) d’évaluer les effets immédiats. Elle a été réalisée à l’aide de trois modèles : le « Conceptual Framework for Implementation Fidelity », « The presage, process and product (3P) model of learning and teaching » et le modèle intégré. Cette évaluation a été conduite dans une perspective d’évaluation participative afin de renforcer l’utilisation des résultats de l’évaluation et de permettre le renforcement des capacités des acteurs. Il s’agit d’une recherche évaluative qui a combiné des méthodes qualitatives et quantitatives. La composante qualitative est basée sur une analyse documentaire et des entrevues auprès de sept (7) acteurs impliqués dans le projet. La composante quantitative a été faite à l’aide des questionnaires : 1) de satisfaction, 2) d’apprentissage et 3) le DPC-Réaction. Les résultats de la composante qualitative ont montré que l’approche participative utilisée a permis des ajustements dans l’implantation de la formation. Les résultats de la composante quantitative ont aussi montré une satisfaction élevée des participants à la formation ACP, une augmentation des connaissances acquises après la formation ACP et une intention élevée de changement de comportement des professionnels de la santé. Ces résultats présentent aussi les recommandations des participants afin d’améliorer la formation.
La deuxième phase du programme d’amélioration de la santé des mères et des enfants au Burkina Faso a développé et implanté une formation portant sur l’approche centrée sur la personne dans les soins maternels pour les professionnels de la santé afin d’améliorer la qualité des soins. Il a aussi prévu d’évaluer cette formation qui fait l’objet de ce travail. L’objectif est : 1) d’évaluer la fidélité de l’implantation de la formation ACP, 2) d’évaluer les déterminants contextuels (les facteurs ayant influencés l’implantation et le résultat du projet) et 3) d’évaluer les effets immédiats. Elle a été réalisée à l’aide de trois modèles : le « Conceptual Framework for Implementation Fidelity », « The presage, process and product (3P) model of learning and teaching » et le modèle intégré. Cette évaluation a été conduite dans une perspective d’évaluation participative afin de renforcer l’utilisation des résultats de l’évaluation et de permettre le renforcement des capacités des acteurs. Il s’agit d’une recherche évaluative qui a combiné des méthodes qualitatives et quantitatives. La composante qualitative est basée sur une analyse documentaire et des entrevues auprès de sept (7) acteurs impliqués dans le projet. La composante quantitative a été faite à l’aide des questionnaires : 1) de satisfaction, 2) d’apprentissage et 3) le DPC-Réaction. Les résultats de la composante qualitative ont montré que l’approche participative utilisée a permis des ajustements dans l’implantation de la formation. Les résultats de la composante quantitative ont aussi montré une satisfaction élevée des participants à la formation ACP, une augmentation des connaissances acquises après la formation ACP et une intention élevée de changement de comportement des professionnels de la santé. Ces résultats présentent aussi les recommandations des participants afin d’améliorer la formation.
The second phase of the Maternal and Child Health Improvement Program in Burkina Faso has developed and implemented training on the person-centred approach (PCA) in maternal care for health professionals to improve quality care. It also planned to evaluate this training, which is the subject of this work. The objective is: 1) to evaluate the implementation fidelity of the PCA training, 2) to evaluate the contextual determinants (the factors that influenced the implementation and the outcome of the project) and 3) to evaluate the immediate effects. It was carried out using three models: the Conceptual Framework for Implementation Fidelity, the presage, process and product (3P) model of learning and teaching and the integrated model. This evaluation was conducted in a participatory evaluation perspective in order to strengthen the use of the evaluation results and to enable the capacity building of the actors. It is an evaluative research that has combined qualitative and quantitative methods. The qualitative component is based on a documentary analysis and interviews with 7 actors involved in the project. The quantitative component was done using questionnaires: 1) satisfaction, 2) learning and 3) CPD-Reaction. The results of the qualitative component showed that the participatory approach used allowed adjustments in the implementation of the training. The results of the quantitative component also showed a high satisfaction of PCA training participants, an increase in knowledge gained after PCA training and a high intention of behavioural change among health professionals. These results also present participants’
The second phase of the Maternal and Child Health Improvement Program in Burkina Faso has developed and implemented training on the person-centred approach (PCA) in maternal care for health professionals to improve quality care. It also planned to evaluate this training, which is the subject of this work. The objective is: 1) to evaluate the implementation fidelity of the PCA training, 2) to evaluate the contextual determinants (the factors that influenced the implementation and the outcome of the project) and 3) to evaluate the immediate effects. It was carried out using three models: the Conceptual Framework for Implementation Fidelity, the presage, process and product (3P) model of learning and teaching and the integrated model. This evaluation was conducted in a participatory evaluation perspective in order to strengthen the use of the evaluation results and to enable the capacity building of the actors. It is an evaluative research that has combined qualitative and quantitative methods. The qualitative component is based on a documentary analysis and interviews with 7 actors involved in the project. The quantitative component was done using questionnaires: 1) satisfaction, 2) learning and 3) CPD-Reaction. The results of the qualitative component showed that the participatory approach used allowed adjustments in the implementation of the training. The results of the quantitative component also showed a high satisfaction of PCA training participants, an increase in knowledge gained after PCA training and a high intention of behavioural change among health professionals. These results also present participants’

The overall aim of the present thesis was to investigate experiences of living with multidrug-resistant bacteria (MDRB), using methicillin-resistant Staphylococcus aureus (MRSA) colonization as an illustration, and to develop and validate a tool to describe healthcare personnel’s attitudes towards patients with MDRB. A further objective was to study MRSA-colonized persons’ and healthcare personnel’s experiences of patient-professional interactions and responsibilities for infection prevention. Four empirical studies were conducted. A total of 18 MRSA-colonized persons and 20 healthcare personnel were interviewed regarding their experiences, and a total of 726 RNs responded the MDRB Attitude Questionnaire. The findings revealed the difficulties associated with living with MRSA colonization, which was described as something uncertain, and as an indefinable threat that has to be managed in both everyday life and in contacts with healthcare. Interactions with healthcare personnel were described as unprofessional owing to personnel’s inappropriate behaviour and insufficient information provision. According to the personnel, achieving adequate patient-professional interactions required having knowledge and experiences of MRSA. They also experienced difficulties in providing tailored information to patients. The MRSA-colonized persons described their unwanted responsibility to inform healthcare personnel about the colonization, but also felt responsible for limiting the spread of infection to others. Furthermore, responsibility for infection control was regarded as shared between healthcare personnel and patients. The personnel described such responsibility as a natural part of their daily work, although it was not always easy to adhere to hygiene precautions. The MRSA-colonized persons felt that healthcare personnel have insufficient knowledge of the bacteria and of hygiene precautions. The MDRB Attitude Questionnaire showed that registered nurses do have knowledge deficiencies. The MDRB Attitude Questionnaire has adequate psychometric properties. In conclusion, MRSA colonization constitutes a psychological strain for carriers, and interactions with healthcare personnel resulted in feelings of stigmatization. The present thesis indicates that there is a need to improve healthcare personnel’s knowledge, behaviour and emotional response in relation to patients with MDRB, in order to ensure patient safety and address patients’ needs. The heads of department is responsible for such improvements, and the MDRB Attitude Questionnaire is useful in identifying areas in need for improvement.

Thesis (MA (Industrial Psychology))--University of Stellenbosch, 2007.
Overview of previous work: Previous research on call centres has identified the inherent stressful nature of the call centre agent job. In fact researchers have gone so far as to name call centres ‘sweatshops of the new millennium’, (Crome, 1998; Fernie, 1998). Comparative studies between human service work and burnout have often featured in current literature as have studies concerning the correlations between call centre work and job satisfaction, the effects of shift work, and stress in the call centre environment. Purpose: However, the purpose of this study, avoiding a comparative approach, is to focus on one organisation in particular, in order to assess the varied work dysfunctions present in its call centre. The study is particularly important in the light of the proposed development of the call centre industry in South Africa at this time. A more comprehensive understanding therefore, of the pitfalls of call centre work, would be beneficial to those currently running call centres as well as those planning their implementation. At the outset, stress was considered a pivotal dysfunction within the call centre, from which other maladies often ensued such as substance abuse, depression and eating pattern disruptions. Work challenges too, manifest in the field data, namely insufficient training and managerial / system problems. The research therefore includes the exploration of these factors serving to highlight both the more socio-cultural and emotional issues, as well as on-the-job grievances encountered by call centre agents. Design / methodology / approach: Owing to the exploratory nature of the study, a focus group methodology was used, allowing for in-depth qualitative research which catered for a far reaching and comprehensive understanding of current work issues. As the study concerns only call centre agents, the roles of supervisors and managers were not included. The sample comprised four different groups, of randomly selected call centre agents, with a total of 27 participants. Demographics revealed male and female participants of differing marital status, educational qualifications, but with tenure at a call centre between 2 and 6 years, and aged between 20 and 40 years. Findings: Support was found for the following dysfunctions in the process, with stress as primary harbinger of other dysfunctions, many exacerbated by the stressful nature of shift work, and the resultant work-life imbalance. Stresses encountered due to ineffective systems, training processes, and call centre management were also significant. On a positive note, of interest was the unanimous agreement that within this particular field study, workspace ergonomic considerations were thought not to add to call centre dysfunction. Research limitations / implications: Even though four groups from two different call centres were observed, they were part of the same organisation, in Cape Town in the Western Cape. In this way commonalities in terms of reactions to systems, policies etc were thought likely to be similar, however owing to the shift work nature of call centres through out South Africa, it is believed that significant correlations could be determined, in any organisation. A comparative study across various differing organisations and locations therefore could be investigated. Originality / value: Owing to the very stressful nature of call centre work, the focus groups revealed themselves to be cathartic in nature as participants thoroughly embraced the process, and personal experiences were often disclosed by participants which facilitated realistic discussions. In this way, meaningful qualitative data was collected, and can be used to ameliorate current call centre conditions, and to allow better planning for future implementation. Furthermore, the research has exposed a number of further study options, as e.g. owing to their significance, each dysfunction could be investigated further and covered individually in separate research papers, as could the role in management, and training within the call centre milieu.

Complexity in Home and Personal Care appears in several forms – the product, the substrate, and their interactions. The aim of this thesis is to investigate strategies for selecting effective surface-active agents (surfactants) that can be used in combination with other active ingredients in industry-relevant formulations deployed in the personal care sector. This thesis is composed of three parts, each of which involves a study of a complex natural system as it is affected by the addition of a complex chemical mixture. This is done in an effort to expose key features of the design rules for engineering the chemical mixture to enhance baseline performance via synergistic interactions of the formulation components and the natural system components. The first topic is an investigation on how the effectiveness of surface-active agents for removing a mixture of hydrophobic and hydrophilic soils from fabrics is related to the surfactants' physical-chemical features. The second topic is an exploration of compatible surfactant-enzyme systems that can be used in various industrial applications, where the behavior at a variety of interfaces is concomitantly important. Here, the focus is on the effect of surfactant structure and properties on enzyme function (i.e., activity), structural mobility and stability. The third topic is an investigation on the usefulness of micro-Raman spectroscopy for determining in situ chemical information that relates to the effects of a variety of surfactants on the mechanical and textural features of skin.

This dissertation consists of three empirical essays investigating different aspects of health care for children and families. The first essay examines the effectiveness of adherence to American Academy of Pediatrics guidelines for preventive pediatric health care. Using a national longitudinal sample of children age two years and younger, we investigate whether compliance with prescribed periodic well-child care visits has beneficial effects on child health. We find that increased compliance improves child health. In particular, higher compliance lowers future risks of fair or poor health, of some history of a serious illness and of having a health limitation. The second essay examines child health care utilization in relation to maternal labor supply. We test the hypothesis that working-mothers trade off the advantages of greater income against the disadvantages of less time for other valuable tasks, such as seeking health care for their children. This tradeoff may result in positive, negative, or no net impacts on child health investment. We estimate health care demand regressions that include separate variables for mother’s labor supply and her labor income. Our results indicate that higher maternal work hours reduce child health care visits; higher maternal earnings increase them. In addition, wage-employment, as opposed to self-employment, is detrimental to child health investment. A further finding is that preventive care demand for younger children is less sensitive to maternal time and income changes. We also find that detrimental time effects dominate beneficial income effects. The third essay studies intra-household resource allocation as it pertains to its demand for preventive medical care. We test the income-pooling hypothesis of the common preference model by using individual specific medical care consumption data and present evidence on the allocation of household resources to the medical needs of the child, husband and wife. Our results are in line with the findings of previous studies that emphasize the ongoing importance of the traditional gender role of woman as the primary caregiver. We find that the resources of the wife have a greater positive impact on child’s and her own preventive care demand than does the resources of the husband. In contrast to most studies from developing countries, we find that US families do not exhibit differential health care demand based on child gender. It is also noteworthy that the wife’s education level has a greater positive impact than that of her husband does on both the husband’s and her own preventive care utilization.
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This thesis endeavours to explore, describe and portray the author's attempt to work with the people of Vanuatu, a small island nation in the South Pacific, establishing a preventative eye care project. The goal of this study is to offer a contribution to the understanding of cross-cultural health work in Vanuatu.
thesis (PhD)--University of South Australia, [2000]

Submitted in fulfilment of the requirements for the Master’s Degree in Technology: Somatology, Durban University of Technology, 2014
The beginning of the 20th century presented the Somatology profession with unprecedented challenges of acquiring a scientific base and achieving professionalisation. It is in this milieu that a few research studies were previously undertaken with regard to Somatology education however, none particularly focused in relation to areas that are preparing graduates for industry. The current study was a national study that explored the existing National Diploma offering through the lens of students, educators and members of the Durban University of Technology’s Advisory Board. In particular, it focused on developing broad guidelines to guide academics on what further content was required to be integrated into the current Somatology education. A triangulated approach using both quantitative and qualitative methods was used to guide the operationalisation of the research process. Five Universities of Technology participated in the study, viz. Cape Peninsula University of Technology, Central University of Technology, Durban University of Technology, Tshwane University of Technology and the University of Johannesburg. Third year and B.Tech students were surveyed with regard to the current Somatology Programme and what further aspects needed to be integrated into it to better prepare graduates for industry. In addition, in-depth interviews were also held with ten academics, two from each University of Technology, to examine what they thought needed to be included in education to strengthen the current programme. The same was done through a focus group discussion with members of the Durban University of Technology Advisory Board. A programme analysis of current content being taught at the five Universities was also undertaken. The results reflected that although most of the samples were satisfied with the current educational programme, they still believed that gaps existed and that graduates were still not adequately prepared for industry. It was found that both students and educators saw the need for more therapies to be included in the training. Both educators and the Advisory Board sample also saw the need for a stronger emphasis to be placed on practical skill development. The Advisory Board sample also strongly articulated for training to occur in an industry context as opposed to the University based experiential setting. Using data from these multiple samples, a set of guidelines was developed and presented. These guidelines were based on what further therapies needed to be integrated into education. The Duke Integrative Medicines Wheel of Health was adopted as the theoretical framework of the study. It was also utilised to identify specific areas that needed to be interwoven into education to further strengthen graduates’ preparedness for industry.

Cultural and linguistic diversity in Australia, mainly attributed to the Government’s migration programs, is increasing with 49% of the population having been born overseas or having either one or both parents born in a foreign country. Notably, women account for a significant proportion of the total Australian female population, and women account for half of all migrants to Australia. Women from refugee and backgrounds often experience poor sexual and reproductive health (SRH) outcomes and face several barriers in accessing SRH care at individual, provider and system levels in host countries. In Australia, barriers to SRH services for refugee and migrant women and perspectives on improving access to and the utilization of SRH care are addressed exclusively from end-user perspectives. Understanding the views and experiences of health care professionals (HCPs) in providing SRH care to refugee and migrant women is crucial in helping to ensure the SRH needs of these women are met. This study involved a sequential mixed methods design to examine the views and experiences of HCPs in providing SRH care to refugee and migrant women in Australia. Commencing with a thematic meta-synthesis of the experiences of refugee and migrant women in accessing SRH care in Australia, an online survey to identify HCP reported barriers and facilitators of providing SRH care to refugee and migrant women followed which was completed by seventy-nine HCPs. Concurrently, forty-six of these HCPs undertook a Q study exploring refugee and migrant women’s SRH in Australia to identify the challenges HCPs perceive in providing SRH care to these women. Then, twenty-one HCPs from this initial sample participated in a semi-structured interview to explore in further depth the barriers and facilitators in providing SRH care to refugee and migrant women that had been identified from the previous stages of the project. Finally, the findings of the systematic review, survey, Q and qualitative analyses were combined through a process of triangulation that enables these data sets to be connected and interpreted simultaneously through convergence and corroboration. The study was informed by the socio-ecological model, situated within a critical realist epistemological paradigm. Overall, three overarching themes were identified across the socio-ecological framework as barriers that impact refugee and migrant women’s access and utilisation of SRH care, as well as care provision: The Vulnerable Woman, The “Unprepared” Health Care Provider, and Healthcare System Gaps. HCPs reported vulnerabilities related to refugee and migrant women such as country of origin experiences, resettlement priorities, linguistic and cultural barriers to communication, culture and gender roles, poor knowledge about their body, SRH and available services significantly influence their access and utilisation of SRH care and care provision in several ways. Furthermore, HCPs’ lack of preparedness in relation to their knowledge, training and confidence to provide SRH care to refugee and migrant women was a barrier to the SRH care of refugee and migrant women. Participants also reported on factors associated with the health system such us lack of services and resources and difficulty of navigating the system that further compromised refugee and migrant women’s access and utilisation of SRH care. The implications of the research findings suggest that interventions to improve refugee and migrant women’s access and utilisation of SRH care could focus on the provision of culturally sensitive SRH education to the women, reduction of cross-cultural communication barriers, and engagement of HCPs in an ongoing process of improving cultural competency. It is also argued that further research is needed to understand refugee and migrant men’s perspectives about gender roles, cultural norms and joint family planning decisions including their knowledge and attitude towards SRH.

Contexte: Les résultats de plusieurs recherches mettent en évidence dans la population immigrante, une prévalence élevée des maladies bucco-dentaires, une faible accessibilité aux soins bucco-dentaires ainsi qu’un faible niveau de connaissances en matière d’hygiène bucco-dentaire, par rapport aux citoyens nés au Canada. L’amélioration des connaissances et des habiletés en matière d’hygiène bucco-dentaire, constitue un moyen efficace pour réduire les inégalités dans le domaine de la santé bucco-dentaire. La rareté des études, ainsi que la présence de nombreuses lacunes méthodologiques dans le domaine de la littératie en santé bucco-dentaire, notamment au sein de la population immigrante, a conduit à réaliser cette nouvelle étude. Objectifs : Le but de ce projet était de développer et évaluer l’impact d’une intervention sur les compétences en matière de santé bucco-dentaire pour promouvoir des attitudes positives en matière d’hygiène bucco-dentaire chez les immigrants Punjabi. Quatre études séparées ont été menées pour atteindre les quatre objectifs suivant : i) Faire une revue de la littérature pour identifier et synthétiser les données et les lacunes de connaissances actuelles dans le domaine des connaissances et habiletés en matière de santé bucco-dentaire; ii) Développer du matériel éducatif (roman-photo) culturellement et linguistiquement approprié pour les immigrants Punjabi en utilisant une approche communautaire participative; iii) Développer une intervention de littératie sur les compétences en matière de santé bucco-dentaire, fondée théoriquement, pour la promotion des compétences en matière de santé bucco-dentaire chez les immigrants Punjabi; iv) Évaluer l’efficacité de l’intervention de littératie en santé orale sur les compétences en matière de santé bucco-dentaire de promotion des comportements personnels de bonne hygiène bucco-dentaire chez les immigrants Punjabi. Résultats : Les principaux résultats de nos quatre études se répartissent de la façon suivante : 1) Les résultats de la première étude mettent l’emphase sur le besoin de développer de nouveaux outils d’évaluation afin de mesurer les niveaux de connaissance et d’habileté en matière d’hygiène bucco-dentaire et soulignent la rareté des interventions pour la santé bucco-dentaire. De plus, il a été confirmé que des compétences en matière de santé bucco-dentaires limitées sont positivement et significativement liées à de plus faibles connaissances bucco-dentaires et des indicateurs de santé bucco-dentaires plus faibles. En outre, nous avons constaté un déficit d'études sur les interventions parmi les populations vulnérables, en particulier chez les immigrants. 2) Dans la deuxième étude les réunions de groupe de discussion ont révélé quatre thèmes identifiant les perceptions sur les comportements personnels en matière d’hygiène bucco-dentaire chez les immigrants Punjabi : i) manque de compréhension sur les facteurs de risques et sur les connaissances reliées aux comportements personnels en matière d’hygiène bucco-dentaire; ii) manque d’habilités et de routines reliées aux pratiques personnelles d’hygiène bucco-dentaire; iii) manque de compréhension de l’importance de la prévention; et iv) les barrières perçues pour accéder à la santé bucco-dentaire. Les résultats de cette étude ont été utilisés pour développer du matériel éducatif (roman-photo) pour les immigrants Punjabi. 3) La troisième étude a permis de développer une intervention de littératie en santé orale fondée théoriquement sur les comportements personnels d’hygiène bucco-dentaire en utilisant la méthode « Behaviour Change Wheel (BCW) » (la roue du changement de comportement). En utilisant la méthode BCW, nous avons d’abord identifié les barrières et les facilitateurs et les relier aux fonctions d’intervention, des catégories de politiques et techniques par les de changement de comportement spécifique identifié parmi la gamme d'options fournies par la méthode BCW. 4) Dans la quatrième étude une analyse « Linear Mixed Model pour Repeated Measures (LMMRM) » à deux niveaux comparant les groupes d’intervention et contrôle avant et après l’intervention, a montré que les participants qui ont reçu l’intervention « Sauvegarde Ton Sourire » ont eu une amélioration significative de leur routine de brossage et d’utilisation de la soie dentaire, de leurs indices de plaques dentaire et gingivaux, et de leurs compétences en matière de santé bucco-dentaires. Conclusions: L’approche novatrice de la présente étude qui a pour but de développer et d’évaluer une intervention communautaire fondée sur une base théorique, pour la promotion des compétences en matière de santé bucco-dentaire chez les immigrants Punjabi, a abordé son déficit et proposé un modèle d’intervention qui peut être adapté à d’autres communautés ayant un faible niveau de connaissance et de pratique quotidienne en matière d’hygiène bucco-dentaire, afin réduire les inégalités de santé bucco-dentaire. Mots-clés : La littératie en santé orale, comportement personnel en matière d’hygiène bucco-dentaire, intervention, immigrants Punjabi.
Background: Research shows that immigrants have higher rates of oral diseases, poorer access to dental care services and lower levels of health literacy than their Canadian-born peers. Recently, oral health literacy has emerged as a potential pathway to reduce oral health disparities. Existent scarcity and methodological shortcomings of studies on oral health literacy interventions particularly among immigrants lent urgency to our present research study. Objectives: The overarching goal of present research study was to develop and evaluate the effectiveness of an oral health literacy intervention aimed to promote positive oral hygiene self-care behavior among Punjabi immigrants. To achieve this goal, we conducted four separate studies having following objectives: i) To conduct a scoping review to identify and synthesize the current evidence and knowledge gaps on the topic of oral health literacy. ii) To develop a culturally and linguistically appropriate educational material (photonovel) for Punjabi immigrants using a community based participatory approach. iii) To develop a theoretically grounded oral health literacy intervention aimed to improve oral hygiene self-care behavior among Punjabi immigrants. iv) To evaluate the effectiveness of the developed oral health literacy intervention aimed to promote positive oral hygiene self-care behavior among Punjabi immigrants. Results: The main findings of our four investigations were: 1) Findings of the first study affirmed a need to develop new assessment tools to capture all dimensions of oral health literacy and highlighted scarcity of oral health literacy interventions among vulnerable populations particularly among immigrants. Also, it affirmed that low oral health literacy is positively and significantly related to poor oral health knowledge, poor oral health behaviour and poor oral health outcomes. 2) In the second study, the focus group meetings revealed four themes identifying following perceptions held by Punjabi immigrants regarding oral hygiene self-care: i) lack of understanding about oral hygiene self-care related knowledge and risk factors; ii) lack of oral hygiene self-care related adequate skills and routine; iii) lack of emphasis on prevention by oral health care providers; and iv) perceived barriers to access dental health. Findings of the focus group discussions were used to develop an educational material (photonovel) for Punjabi immigrants. 3) The third study developed a theoretically grounded oral health literacy intervention aimed to improve oral hygiene self-care behavior by employing “Behaviour Change Wheel” (BCW) method. Using the BCW method, we first identified various barriers and enablers and linked those with specific intervention functions, policy categories and behavior change techniques identified from the range of options provided by the BCW. Six intervention functions (education, training, modeling, restriction, environmental restructuring and enablement) were subsequently mapped to two policy categories (communication and service provision) since they met the APEASE criteria. 4) In the fourth study, linear mixed model analysis for repeated measures comparing the intervention and control groups at pre-and post-intervention reported that participants who received “Safeguard Your Smile” intervention showed significant improvement in their adequately brushing and flossing routine and in their plaque and gingival indices and oral health literacy than control group participants. Conclusions: The novel attempt of the present research study of developing and evaluating a theoretically grounded and community based oral health literacy intervention among Punjabi immigrants has addressed a deficit in this field and proposed a model of oral health literacy intervention that could be adapted among other low oral health literate communities to reduce the oral health disparities.

Background: Healthcare workers’ hand hygiene remains a key pillar because it prevents and controls healthcare associated infections. Healthcare Workers’ hand hygiene compliance is suboptimal. Aim: The study developed contextualised guidelines for Healthcare Workers’ hand hygiene and infection control in patient care. Methods: The Precede-Proceed model with Theory of Planned Behaviour guided the study. The study was conducted following the mixed methodology approach, observational survey, exploratory, descriptive and contextual in nature study with mixed thematic analyses in a research wheel process. Data were collected through direct participant observation of hand hygiene opportunities through observing (n=95 Healthcare Workers; n=570 practices). Self-administered questionnaires were used to collect data from Healthcare workers (n=189) regarding challenges they faced in achieving hand hygiene. Structured interviews were conducted with patients (n=574). Retrospective reviews of healthcare associated infections and their associated mortalities were carried out from mortality records. Data were analysed retrospectively. Partly the data were statistically and mixed thematically analysed. Guidelines were developed using intervention alignment throughout, mapping, matching, pooling, patching and validation corroborated with Precede-Proceed models’ best practices. The study was ethically reviewed and approved by University of South Africa and the Medical Research Council of Zimbabwe project numbers, 6067662 and MRCZ/B/208. Results: Hand hygiene non-compliances were mostly found in the following contexts, after touching patients’ surroundings, and before doing an aseptic procedure. A non-hand hygiene compliance of Healthcare workers 167(29.3%) and compliance 403(70.7%) in context was suboptimal with sad patients and challenges faced by Healthcare workers. Conclusion: Healthcare Workers had gaps in hand hygiene compliance and availability of required resources. Gaps were also noted in ongoing hand hygiene promotion educational strategies and guidelines to comply and prevent. Guidelines to enhance hand hygiene included, attend to hand hygiene strictly after touching patient surroundings, bed linen, lockers and curtains to prevent gastroenteritis; follow standard precautions against HCAIs from spreading to patients' environments; and comply with hand hygiene guidelines, policies and regulations for best practice with patients. The study contributes generalisable knowledge.
Health Studies
D. Litt et Phil. (Health Studies)

5 Abstract Five substances from the group of so-called personal care products, known for their low degradability and regular environmental detection, were tested for toxicity using two fish tissue lines (RTgill-W1 a RTG-2) isolated from rainbow trout (Oncorhynchus miykiss). The tested substances were hexadecylpyridinium chloride (HDP), chlorhexidine (CHX), octenidine (OCT), thymol (THM) and triclosan (TCS). A cell viability assay was performed with each of these compounds using Alamar Blue ™ (AB), 5-carboxyfluorescein diacetate acetoxymethyl ester (CFDA-AM) and neutral red (NR) protocols. The results were used to construct dose-response curves along with an EC50 value for each of these substances. The EC50 values ranged from 0,51 (HDP) to 33,75 µg.ml-1 (THM) for RTgill-W1 and from 0,31 (HDP) to 33,37 µg.ml-1 (THM) for RTG-2. The theoretical LC50 estimation was calculated according to Tanneberger et al. (2013). For all substances, cytochrome P450 1A activity was monitored using 7-ethoxyresorufin-o-deethylase (EROD), four out of five tested chemicals were statistically positive for EROD, the highest EROD response was observed for the most toxic compound - HDP. Only TCS did not show statistically significant cytochrome P450 1A activity. In addition, oxidative stress was measured with the fluorescent dye...

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The purpose of this research was to investigate occupational health and safety challenges and their impact on health care workers (HCWs) in selected public hospitals from the Gauteng Province, South Africa. Method: A quantitative descriptive cross-sectional survey was conducted among HCWs in the study sites. A two-staged sampling that include purposive sampling of study sites and census sampling of 2000 HCWs was used. Self-administered questionnaires were used to obtain data from HCWs. In addition, two different checklists were used to conduct retrospective records reviews to assess occupational health and safety (OHS) policy compliance and occupational injuries and diseases occurrence. The SAS Release 9.3 was used to analyse data. The Fischer Exact test and Chi-square were also used to determine the association of variables and P-value was set at <0.05 to indicate significant association. Results: A total of eight public hospitals and 926 (46.3%) HCWs who were all females nurses participated in this survey. Major occupational health hazards reported by the participants include: needle-stick injuries 275 (54.67%), slips trips and falls 67 (13.32%) and splashes 57 (11.33%). The analysis of open-ended responses indicated increased workloads, long hours of work and shift work as the most reported psychosocial hazards among HCWs. The reviewed records indicated that back injuries 22 (4.37%), tuberculosis (TB) 17 (3.38%) and asthmatic reactions 8 (1.59%) were the commonly reported occupational injuries and diseases among the HCWs. The records review also revealed a lack in the conducting of adequate medical surveillance among participants. The results showed poor compliance with the OHS policy and a negative impact of biological and psychosocial hazards on the HCWs. Conclusion: There was a high risk of exposures to biological hazards whilst providing care to patients, thus warranting the implementation of robust preventive measures. As a result, the guidelines were developed to promote the health and safety of HCWs with a view to promoting policy compliance and preventing the occurrence of occupational injuries and diseases as well as their impact among HCWs.
Health Studies
D.Litt et Phil. (Health Studies)

This phenomenological study examined the experiences of women in midlife. The primary purpose of the study was to develop and describe a model of health promotion that will facilitate self-care of women in midlife to support them in the attainment of wholeness. A theory-generative, qualitative, explorative, descriptive and contextual design was utilized to achieve the objectives of the study, namely to explore and describe women's experience of midlife transition; classify concepts of the model; describe the structure and process of a model for support of women during midlife transition, and develop guidelines for operationalization of the model. The study was undertaken in one of the northwest states of the United States of America. Purposive sampling of eight women included women between the ages of 40 and 55 years of age. Women who had undergone surgical menopause were excluded as the influence of prolonged hormone replacement therapy was seen as a bias. Data was collected by using an unstructured interview technique. Data was analyzed according to Tesch's protocol (in Cresswell, 1994:155). Guba's model (in Krefting 1991:215) was utilized to ensure the trustworthiness of the study. Ethical issues were considered throughout and these are reflected in chapter one of the thesis. The study identified two themes: (1) how the women experienced midlife and (2) how they managed it. The experiences of midlife were expressed in physical, psychosocial and spiritual changes while the management of the process was accomplished in two ways, namely self-care and the services of healthcare professionals. The researcher identified that health promotion was essential to facilitate the self-care practices of women in midlife. Essential and related attributes of health promotion were identified, analyzed and synthesized to define health promotion. The process of health promotion was then defined with a description of the structure and process of the model. Concepts identified were classified, defined and placed into relationship statements after which the model was described and evaluated. Guidelines to operationalize the model were then formulated to assist health professionals to support women in self-care for the attainment of wholeness.
Health Studies
D.Litt et Phil (Health Studies)

The purpose of the study was to describe the determinants and practice of HIV self-testing among health care workers (HCWs) in Nyeri provincial hospital, Kenya. A descriptive cross-sectional study was conducted to determine the rate of HIV self-testing, explore the factors influencing the practice and describe access to HIV psychosocial support, care and treatment. The study was guided by the concepts of the protection motivation theory. Data was collected from 348 HCWs and analysed by means of logistic regression. Results showed that 65.8% of the HCWs had practiced HIV self-testing among themselves. Age, self efficacy and response efficacy were found to be significant predictors of HIV self-testing. Willingness to access HIV psychosocial support (71.3%) and care and treatment (73.9%) was high. Self-testing is highly practiced by HCWs.
HIV self-testing among health care workers at Nyeri Provincial Hospital in Kenya
HIV self-testing among health care workers
Public Health
M.A. (Public Health)

The purpose of the study was to describe the determinants and practice of HIV self-testing among health care workers (HCWs) in Nyeri provincial hospital, Kenya. A descriptive cross-sectional study was conducted to determine the rate of HIV self-testing, explore the factors influencing the practice and describe access to HIV psychosocial support, care and treatment. The study was guided by the concepts of the protection motivation theory. Data was collected from 348 HCWs and analysed by means of logistic regression. Results showed that 65.8% of the HCWs had practiced HIV self-testing among themselves. Age, self efficacy and response efficacy were found to be significant predictors of HIV self-testing. Willingness to access HIV psychosocial support (71.3%) and care and treatment (73.9%) was high. Self-testing is highly practiced by HCWs.
Public Health
M.A. (Public Health)

Indiana University-Purdue University Indianapolis (IUPUI)
While the majority of chronic pain patients report receiving inadequate care, there is evidence that female and Black patients receive less analgesic medications and treatment for their chronic pain compared to male and White patients, respectively. While treatment disparities have been evidenced in the literature, there is little understanding of provider-factors, such as their decision-making awareness and attitudes, which may contribute to the differences in treatment. This investigation employed quantitative and qualitative procedures to examine the relationship between patient demographics and chronic pain treatment variability, providers’ awareness of these non-medical influences on their decisions, and the extent to which providers’ gender and racial attitudes associate with their treatment decisions. Twenty healthcare trainees made pain treatment decisions (opioid, antidepressant, physical therapy, pain specialty referral) for 16 computer-simulated patients presenting with chronic low back pain; patient sex and race were manipulated across vignettes. Participants then selected among 9 factors, including patient demographics, to indicate which factors influenced their treatment decisions for the simulated patients and completed gender and racial attitude measures. After online study completion, follow-up semi-structured interviews were conducted to discuss the medical/non-medical factors that influence trainees’ clinical treatment decisions. Quantitative analysis indicated that 5%-25% of trainees were actually influenced (p<0.10) by patient sex and race in their treatments, and on the whole, trainees gave higher antidepressant ratings to White than Black patients (p<.05). Fifty-five percent demonstrated concordance, or awareness, between their actual and reported use of patient demographics. Follow-up McNemar’s test indicated trainees were generally aware of the influence of demographics on their decisions. Overall, gender and racial attitudes did not associate with trainees’ treatment decisions, except trainees’ complementary stereotypes about Black individuals were positively associated with their opioid decisions for White patients. During qualitative interviews, aware and unaware trainees discussed similar themes related to sex and racial/ethnic differences in pain presentation and tailoring treatments. We found that (1) a subset of trainees were influenced by patient sex and race when making chronic pain treatment decisions, (2) trainees were generally aware of the influence of patient demographics, and (3) trainees discussed differences in pain presentation based on patients’ sex and ethnic origin. These findings suggest trainees’ are influenced by patient demographics and hold stereotypes about patient populations, which may play a role in their decision-making.

Background Plasmodium falciparum malaria during pregnancy poses a substantial risk to mother and foetus. In recent years, convincing evidence has shown that preventive methods such as the use of insecticide treated bed nets (ITNs) and intermittent preventive treatment (IPT) in pregnancy with sulphadoxine-pyrimethamine (IPTp-sp) can greatly reduce the adverse effects of malaria during pregnancy. Purpose The main purpose of the study was to assess the knowledge and use of Intermittent Preventive Treatment of Malaria among pregnant women receiving Antenatal Care at the primary health centers of the Federal Capital Territory, Abuja Nigeria. Methods A quantitative, descriptive, cross-sectional study was conducted Structured questionnaires were administered to 300 pregnant women aged between 18 and 49 years. Data was analysed using Statistical Package for Social Sciences (SPSS) 22. Results The results revealed that most of the respondents had knowledge about IPT, majority of the respondents had received IPT drugs, in the clinic, but unfortunately none of them were supervised by a health worker during taking of the drug. Few of the respondents did not take the drugs at all for fear of complication, some of them did not know exactly how many tablets were given to them and there was poor adherence to the Directly Observed Therapy (DOT) scheme. Conclusion Knowledge of malaria and IPT was good and many pregnant women received the drugs and used it, but some of them had challenges and did not use the drugs.
Health Studies
M.P.H.

Indiana University-Purdue University Indianapolis (IUPUI)
Oral health is crucial to overall health and a focus of the U.S. Health Center program, which provides preventive dental services in medically underserved communities. Dental hygiene is an oral health profession whose practice is focused on dental disease prevention and oral health promotion. Variations in the practice and regulation of dental hygiene has been demonstrated to influence access to dental care at a state level; restrictive policies are associated lower rates of access to care. Understanding whether and to what extent policy variations affect availability and access to dental care and the oral health of medically underserved communities served by grantees of the U.S. Health Center program is the focus of this study. This longitudinal study examines dental service utilization at 1,135 health center grantees that received community health center funding from 2004 to 2011. The Dental Hygiene Professional Practice Index (DHPPI) was used as an indicator of the state policy environment. The influence of grantee and state level characteristics are also considered. Mixed effects models were used to account for correlations introduced by the multiple hierarchical structure of the data. Key findings of this study demonstrate that state policy environment is a predictor of the availability and access to dental care and the oral health status of medically underserved communities that received care at a grantee of the U.S. Health Center program. Grantees located in states with highly restrictive policy environments were 73% less likely to deliver dental services and, those that do, provided care to 7% fewer patients than those grantees located in states with the most supportive policy environments. Population’s served by grantees from the most restrictive states received less preventive care and had greater restorative and emergency dental care needs. State policy environment is a predictor of availability and access to dental care and the oral health status of medically underserved communities. This study has important implications for policy at the federal, state, and local levels. Findings demonstrate the need for policy and advocacy efforts at all levels, especially within states with restrictive policy environments.