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Katzenellenbogen, Judith Masha. "Use of data linkage to enhance burden of disease estimates in Western Australia : the example of stroke." University of Western Australia. School of Population Health, 2009. http://theses.library.uwa.edu.au/adt-WU2009.0117.
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[Truncated abstract] The Disability-Adjusted Life Year index, developed by the Global Burden of Disease Study, is used extensively to compare disease burden between locations and over time. While calculation of the fatal component of this measure, Years of Life Lost, is relatively straight-forward, the non-fatal component, Years Lived with Disability, is based on parameters that are challenging to estimate. This thesis pioneers the use of the Western Australian Data Linkage System to enhance epidemiological parameters underpinning Years Lived with Disability, providing, by way of illustration, a robust quantitative profile of burden of stroke in the state of Western Australia at the turn of the 21st century. The principal methodological objective was to utilise data linkage analytic methods for the specific requirements of burden of disease estimation. The principal stroke-related objectives were: 1. To estimate the parameters underpinning the non-fatal burden of stroke (Years Lived with Disability) in Western Australia in 2000. 2. To estimate the total burden of stroke (Disability-Adjusted Life Years) in Western Australia in 2000. 3. To investigate differentials in stroke burden between different sub-populations in Western Australia. 4. To calculate projections of stroke burden for Western Australia in 2016. Years Lived with Disability from stroke were calculated for Western Australia from nonfatal stroke incidence, expected duration and disability (severity) weights. Non-fatal incidence was estimated using linked hospital and death records of first-ever hospitalised stroke 28-day survivors in 2000. This was then adjusted for out-of-hospital cases determined from the population-based Perth Community Stroke Study. iv Analysis of mortality in hospitalised 28-day survivors using linked data revealed that the excess mortality in prevalent, rather than incident cases was the main disease-specific parameter required for modelling stroke duration using DisMod II specialised software. ... Access to data linkage and population-based stroke studies in Western Australia allowed more accurate estimation of non-fatal stroke burden, with previous reports most likely underestimating disability as a contributor to total burden. Although predominantly affecting the growing aged population, stroke also affects a sizable number under the age of 65 years, the age group where differentials in stroke burden are the greatest. The findings highlight the continued need for primary prevention efforts for all ages, targeting especially younger people in disadvantaged groups. The shift to greater disability burden in the future and the needs of disadvantaged groups must be considered when planning stroke services. The multiple studies undertaken for this thesis contribute to ongoing improvement of data quality and methodological refinements underpinning estimates of Years Lived with Disability, specifically for stroke, but applicable also to other diseases. Similar linked data approaches can be used in other Australian states in the future once infrastructure is developed, thereby improving estimates of disease burden for health policy and planning in the future.
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Cooper, Natalie R., and University of Lethbridge Faculty of Arts and Science. "Reduced peri-infarct dysfunction with pre-stroke exercise : molecular and physiological correlates." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Arts and Science, 2003, 2003. http://hdl.handle.net/10133/215.
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The effects of pre-stroke exercise and levesl of brain-derived neurotrophic factor (BDNF) on behavioural and functional recovery were examined following focal cortical ischemic infarct.
Intracortical microstimulation (ICMS) was used to derive topographical maps of forelimb
representations within the motor cortex and ischemia was induced via bipolar coagulation of surface vasculature. One month of excerise prior to ischemia significantly increased the
amount of peri-infarct movement represnetations and initiates vascular changes within motor
cortex. Further, this exercise-induced preservation of peri-infarct movement representations is associated with behavioural recovery and is dependent on BDNF levels in the motor cortex. These results provide further support for the idea that endurance exercise prior to stroke
may enhance functional and behavioural recovery.140 leaves : ill. (some col.) ; 29 cm.
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Hung, Ka-lok Victor, and 洪家樂. "The role of astrocytic endothelin-1 in dementia associated with Alzheimer's disease and mild ischemic stroke." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B42181987.
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Cheng, Lu, and 程璐. "The role of exchange protein directly activated by cyclic AMP 2-deficiency in ischemic stroke." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46945209.
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Fournier, Caroline. "Genetic investigation of vascular diseases in the French-Canadian population." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape2/PQDD_0030/MQ64355.pdf.
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Kirsch, Florian [Verfasser]. "Economic aspects of disease management programs in chronic diseases / Florian Kirsch." München : Verlag Dr. Hut, 2018. http://d-nb.info/1164293648/34.
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Starkie, Helen Jane. "Health economic aspects in the management of Chronic Obstructive Pulmonary Disease." Thesis, University of Glasgow, 2010. http://theses.gla.ac.uk/2154/.
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The broad aim of this thesis on ‘Health Economic aspects in the management of Chronic Obstructive Pulmonary Disease’ (COPD) was to study the natural history of the disease in order to inform the conceptualisation and development of a new economic model. Existing economic evaluations for COPD were critiqued and information on the natural history of the disease gathered though literature searches and analyses of two large datasets, a COPD randomised controlled trial called TORCH and a general population observational dataset called the Renfrew/Paisley (MIDSPAN) study. Particular attention was paid to identifying the COPD population using different diagnostic criteria. The elicitation of utility estimates under a number of circumstances was considered. A regression based prediction model was conceptualised and developed. Significant contributions of this thesis include, but are not limited to: a NICE COPD cohort were identified who were found to be at higher risk of all-cause and COPD mortality than a GOLD defined cohort; a mapping equation was successfully developed that predicts the EQ-5D from the SGRQ; and an entirely new concept for modelling COPD was developed that uses a series of regression equations to predict cost and effect based on lung function, symptoms and exacerbations and weighted by survival probability in order to generate a model with one arm representing current treatment and a second arm representing a comparator treatment. The thesis successfully combined information gathered throughout the period of research on the natural history of COPD with treatment effects in a novel way in order to conceptualise and develop a new economic model for COPD.
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Buckingham, David M. "Coping with a stroke : prediction using the belief constructs of just world, locus of control, attribution and reformulated learned helplessness." Virtual Press, 1986. http://liblink.bsu.edu/uhtbin/catkey/465787.
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Belief constructs appear to govern many aspects of life and may have an influence on coping with severe disability. This study investigated the extent to which coping with a stroke is identified by the belief constructs of just world, locus of control, attribution, and reformulated learned helplessness. The data were collected at a comprehensive rehabilitation center from thirty consenting stroke victims. The sample included 17 women and 12 men with a mean age of 64. The median number of days from the stroke to rehabilitation was 16. Twenty subjects had left hemiparesis and ten subjects had right hemiparesis.In addition to the belief-construct predictor variables, nature-of-stroke and demographic variables were collected during an initial evaluation. Demographic variables included sex, age, marital status, occupation, education, and recreation. Nature-of-stroke variables included period of time since stroke, diagnosis, severity, location, and aphasia as measured by the 'Aphasia Language Performance Scales' (Keenan & Brassell, 1975). The belief constructs were measured by the 'Just World Scale' (Rubin & Peplau, 1975), the 'Internal-External Locus of Control Scale" (Collins, 1974), and an adapted version of the 'Attribution Style Questionnaire' (Seligman, 1984). A coping measure was introduced as the criterion variable. It was administered 21 days following the initial evaluation and is based upon the ratings of the stroke victims' therapists. It includes a scale to more clearly define coping.The results of the study did not produce a clear definition of coping, although cognitive, emotional, and physical factors were evident. In addition, there was preliminary evidence of reliability and validity for measures of this construct. The linear composite of five variables was statistically significant (p < .01) and identified 56% of the variance in the coping measure. The significance of these variables suggests that successful coping is associated with older subjects who had passive premorbid recreation, were admitted relatively soon after their stroke, were rated as having a mild stroke, and made stable attributions about rehabilitation. The fact that one of the belief-construct variables (stability of attribution about rehabilitation) was significant, despite the small sample size, is encouraging and justifies further research in this area.
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Kleineibst, Lynn Jill. "The effectiveness of a caregiver support programme to address the needs of primary caregivers of stroke patients in a low socio economic community." Thesis, Link to the online version, 2007. http://hdl.handle.net/10019/432.
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Li, Jiayan Emma, and 李嘉彦. "Economic evaluations of information and communication technologies (ICTs) for chronic disease management: asystematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45173072.
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Lindholm, Lars. "Health economic evaluation of community-based cardiovascular disease prevention : some theoretical aspects and empirical results." Doctoral thesis, Umeå universitet, Epidemiologi och folkhälsovetenskap, 1996. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-7539.
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This thesis addresses the health economic evaluation of community-based interventions against cardiovascular disease (CVD), with special emphasis on the Västerbotten Intervention Project (VIP), run since 1985. The framework is a simple evaluation model consisting of two parts; the selection and measurement of empirical consequences caused by the project under evaluation (e.g. changes in mortality, well-being, use of resources) and a set of values (e.g. efficiency, equity) aimed at assessing the goodness of these consequences. The project’s effects on CVD were predicted by means of risk factors measured in Norsjö between 1985-1990, applied to an epidemiological model based on a logistic risk equation derived from the Framingham population. Cost per life-years saved ranged from £14 900 to net savings, depending on the assumptions. The favourable cost-effectiveness in this kind of intervention has earlier been predicted from theoretical models, but this is the first study based on real experiences from contemporary community-based interventions against CVD. Furthermore, all social classes have benefited from the intervention. Also potential adverse effects in the form of excess mortality due to low cholesterol levels were investigated, and they were negligible in comparison with the health gains. The value of an intervention from a citizen’s perspective was investigated through an interview study (n≈100) in accordance with the contingent valuation method. Great expectations concerning mortality effects on the community level and future savings in health care were good predictors for assigning the intervention a high value. On the contrary, personal benefits in the form of a decreasing risk for CVD had no positive association with the value of the intervention. Hence, the consequences that the cost-effectiveness analysis accounts for - mortality and savings - coincide with the most valuable consequences from the citizen's perspective. In a democracy, the set of values used to determine the success or failure of a programme like a prevention project must agree with values held by the majority of the citizens. Therefore, the attitudes to ethical values among Swedish politicians (n≈450) responsible for health care have been mapped. The support for the health maximization principle was weak, and a trade-off between efficiency and equity was preferred. About 70% of the respondents were prepared to sacrifice health gains to achieve increased equity.digitalisering@umu
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Andemariam, Ruth Tekle. "Towards a more comprehensive framework to estimating the indirect costs of HIV/AIDS in South Africa." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&.
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This study proposed a modification of the traditional cost-of-illness approach. It considered additional indirect cost parameters that yield a comprehensive cost structure for human capital at a micro level. Although HIV/AIDS is an epidemiological problem, it has enormous direct and indirect economic costs. Arguably, the most important cost associated with HIV/AIDS results from the high rates of morbidity and mortality among working age adults, the vast majority of those infected. These are essentially losses in an economy's existing stock and potential accumulation of human capital, implying lower levels of labor productivity and eventually loss of labor. These impacts are accounted for in existing macroeconomic and microeconomic impact studies. Indirect costs, such as forgone earnings due to illness, are included whereas forgone earnings of caregivers in the household are unaccounted for.
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Arabzadeh, Jamali Hamzeh. "Three essays on the sectoral aspects of economic policy." Thesis, Paris 1, 2016. http://www.theses.fr/2016PA01E027/document.
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L’objectif sous-jacent aux trois chapitres qui composent cette thèse, est une meilleure compréhension de l’incidence des politiques publiques dont les impacts diffèrent entre secteurs hétérogènes. Nous déclinons cette analyse à trois types de politiques publiques au cœur de la macro-économie contemporaine : (i) une politique environnementale (ii) une politique d’aide au développement et (iii) une politique de déficits jumeaux. A travers ces trois chapitres, nous soutenons que les impacts sectoriels des politiques jouent un rôle crucial dans l’évaluation des politiques et dans la détermination de la politique optimale. Le premier chapitre se concentre sur la taxe sur la pollution. Il fournit un modèle théorique qui explique pourquoi il existe une relation négative entre le revenu des ménages et leur soutien pour la taxe sur la pollution. Dans le deuxième chapitre, j’étudie les impacts macroéconomiques d’une politique d’aide au développement et je considère deux secteurs: secteur des biens échangeables (T-secteur) et le secteur des biens non-échangeables (N-secteur). Je considère deux types d’aide étrangère: (i) une aide distribuée par des transferts forfaitaires aux ménages et (ii) une aide destinée à financer les investissements publics. J'étudie l'impact de la libéralisation du marché des capitaux sur la forme optimale et la performance de l'aide au développement. Le troisième chapitre est centré sur les déficits jumeaux : un déficit de la balance courante induit par un déficit de l'équilibre budgétaire. L'analyse économétrique du papier montre que les pays ayant adopté une négociation salariée centralisée présentent des déficits jumeaux plus faibles que les autres. Ce chapitre fournit aussi un modèle théorique pour expliquer ces résultats empiriquesIn this dissertation, I study the implications of policies with heterogeneous sectoral impacts in three separate research fields of macroeconomics: (i) environmental policy, (ii) foreign aid and (iii) the political economy of the twin deficits. Through the three chapters of this thesis, it is argued that, in all these three contexts, the sectoral impacts of policies play important roles in the policy evaluation and in the determination of optimal policy. In the first chapter, the policy of concern is the pollution tax. The paper provides a theoretical model to explain why in top income percentiles, there can be a negative relationship between household's income and their support for pollution tax. In the second chapter, I study the macroeconomic impacts of foreign aid and I consider two sectors: tradable sector (T-sector) and non-tradable sector (N-sector). I consider two forms of foreign aid: (i) aid which is transferred to the households and (ii) aid which is used to finance public investment. I investigate the impact of the liberalization of capital market on the optimal form and on the performance of foreign aid. In the third chapter, I consider the same sectors as in the second chapter : T-sector and N-sector. The focus of this chapter is rather on the political economy of the twin deficits: a deficit in current account induced by a deficit in fiscal balance. Econometric analysis of the paper finds evidence that wage centralization, in a cross-section of industrialized economies, is significantly associated with lower deficits in current account and budget balance. The paper provides a political economy framework to explain this empirical finding
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Ch'ng, Amanda Majella. "Understanding the relationship between coping self-efficacy, coping behaviour and psychological wellbeing during recovery from stroke." University of Western Australia. School of Psychology, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0228.
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Although self-efficacy has long been established as an important variable for psychological wellbeing across a range of contexts, coping self-efficacy, a subtype of self-efficacy specific to the function of coping, has only recently begun to receive research attention. In addition, despite support from both self-efficacy theory and coping theory, the relationship between coping self-efficacy and coping behaviour in the face of stressful events has not previously been considered. This thesis explores the importance of coping self-efficacy for psychological wellbeing in a new context, recovery after stroke, and investigates the relationship between coping self-efficacy and coping behaviour in the face of this stressor. Stroke was selected as a suitable context for this exploration given its high incidence, lengthy recovery period and the prevalence of significant post stroke psychological distress. The thesis explores four key questions: (i) is coping self-efficacy related to psychological wellbeing for people recovering from stroke, (ii) what types of coping behaviours are related to coping self-efficacy during recovery, (iii) does coping behaviour mediate the relationship between coping self-efficacy and psychological outcomes, and (iv) what is the role of individual dispositional traits (optimism and trait anxiety) in these relations. The implications of these relationships for clinical intervention were a secondary focus of the project.
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Visagie, Linette (Linette Louise). "The macro-economic impact of HIV/AIDS in South Africa." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/53135.
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Thesis (MComm)--Stellenbosch University, 2002.ENGLISH ABSTRACT: South Africa faces one of the world's most severe HIV/AIDS epidemics. Whereas the disease was initially only regarded as a serious health crisis, it is now clear that the epidemic will also have economic repercussions. The objective of this study is to project the extent of the macro-economic impact of HIV/AIDS in South Africa over the next 10 to 15 years. The study commences with a discussion of the key characteristics of HIV/AIDS and the current status of the epidemic in South Africa. The demographic inputs used are based on projections produced by the HIV/AIDS model of Metropolitan Life (the Doyle model). The methodology and key assumptions behind the Doyle model are described briefly, after which the demographic projections are presented and discussed. The paper contains a summary of previous approaches to modelling the economic impact of HIV/AIDS, as well as a presentation and discussion of their simulation results. In reviewing the available literature on the economic impact of HIV/AIDS, it becomes apparent that researchers have not yet reached consensus on the economic impact of HIV/AIDS in South Africa - estimates of the impact on GDP growth range anywhere between a reduction of 0.3 and 2.0 percentage points over the next 10 to 15 years. The approach that is used in modelling the economic impact of HIV/AIDS in this study comprises the following: Firstly, a no-AIDS forecast of the South African economy is generated using the annual macro-econometric forecasting model of the Bureau for Economic Research. Secondly, the channels through which the epidemic would likely impact on the economy are identified and modelled. These include slower growth in the population and the labour force; higher employee benefit contributions by employers and employees; indirect costs to the private and public sectors (e.g. lower productivity and higher recruitment and training costs); and higher health and welfare expenditure by the government, as well as an increase in tax rates. The economic effects of each impact channel are analysed independently, after which the different impact channels are combined in the model for the aggregated AIDS inclusive simulation. The results are presented in the form of comparisons between "no-AIDS" and "AIDS" projections for key economic variables for the period 2001 to 2015. The paper also contains results from a macro-economic sensitivity analysis, in which seven of the key assumptions are altered in order to test the sensitivity of the model to these changes. Simulation results indicate that the epidemic will have a negative impact on economic growth in South Africa - real GDP growth could fall from a projected average of 3.7% over the period 2002-2015 without HIV/AIDS to between 3.4% and 3.1 % per year with HIV/AIDS. In contrast, real per capita GDP growth is projected to be 0.7 to 1.0 percentage points higher compared to a no-AIDS scenario, as the adverse impact of the epidemic on the population will outweigh the negative impact on real GDP.
AFRIKAANSE OPSOMMING: Suid-Afrika staar een van die wêreld se ernstigste MIV/VIGS epidemies in die gesig. Aanvanklik is die siekte slegs as 'n erge gesondheidskrisis beskou, maar vandag is dit duidelik dat die epidemie ook ekonomiese gevolge sal hê. Die oogmerk van hierdie studie is om die omvang van die makro-ekonomiese impak van MIV/VIGS oor die volgende 10 tot 15 jaar in Suid-Afrika te beraam. Die proefskrif begin met 'n bespreking van die belangrikste eienskappe van MIV/VIGS en die huidige stand van die epidemie in Suid-Afrika. Die demografiese insette wat gebruik word, is gebaseer op projeksies van Metropolitan se MIV/VIGS model (die Doyle model). Die metodiek en die sleutel aannames van die Doyle model word kortliks bespreek, waarna die demografiese projeksies aangebied en bespreek word. Die studie bevat 'n opsomming van benaderings wat van te vore gebruik is om die ekonomiese impak van MIV/VIGS te modelleer, asook 'n voorlegging en 'n bespreking van hul resultate. 'n Oorsig van beskikbare literatuur oor die ekonomiese impak van MIV/VIGS bring aan die lig dat daar in werkilikheid nog geen konsensus oor die omvang van die impak op die Suid-Afrikaanse ekonomie bereik is nie. Beramings van die impak op BBP groei oor die volgende 10 tot 15 jaar wissel van 'n vermindering met 0.3 tot 2.0 persentasie punte. Die benadering wat in hierdie studie gevolg word om die ekonomiese impak van HIV/VIGS te modelleer behels die volgende: Eerstens word 'n vooruitskatting van die Suid- Afrikaanse ekonomie sonder MIV/VIGS gegenereer met die hulp van die makroekonometriese vooruitskattings model van die Buro vir Ekonomiese Ondersoek. Die tweede stap behels die identifisering en die modellering van die verskillende kanale waardeur die epidemie moontlik die ekonomie kan affekteer. Dit sluit onder andere die volgende in: stadiger groei in die populasie en die arbeidsmag; hoër bydraes deur werkgewers en werknemers aan werknemer-bystandfondse; indirekte onkostes vir die privaat en openbare sektore (bv. laer produktiviteit en hoër werwings- en opleidings koste); 'n toename in staatsbesteding op gesondheids en welsyns dienste; asook 'n styging in belastingkoerse. Die ekonomiese implikasies van elkeen van die kanale word individueelontleed, waarna die verskillende kanale saamgevoeg word vir die oorkoepelende simulasie. Die resultate word aangebied in die vorm van vergelykings tussen "geen-VIGS" en "VIGS" projeksies vir sleutel ekonomiese veranderlikes oor die periode 2001-2015. Die proefskrif bevat ook 'n voorlegging van die resultate van 'n makro-ekonomiese sensitiviteits ontleding, waarin sewe van die sleutel aannames verander is met die doelom die gevoeligheid van die model vir hierdie veranderinge te bepaal. Die resultate toon dat die epidemie 'n negatiewe uitwerking op ekonomiese groei in Suid-Afrika sal hê - die gemiddelde groeikoers in die reële BBP oor die periode 2001-2015 mag daal van 'n geprojekteerde 3.7% sonder MIV/VIGS tot tussen 3.4% en 3.1 % met MIV/VIGS. In teenstelling toon die resultate dat die gemiddelde groeikoers in per capita reële BBP tussen 0.7 en 1.0 persentasie punte hoër mag wees vergeleke met die "geen-VIGS" scenario. Die toename in per capita BBP groei kan toegeskryf word aan die skerp daling in die groei van die populasie as gevolg van MIV/VIGS.
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Jacobs, Nandipha. "Catastrophic and impoverishing health care expenditure in households affected by HIV/AIDS." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_4413_1254307304.
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The aim of this study was to capture the intensity and incidence of catastrophic health care expenditures in order to describe the degree to which catastrophic health care payments occur among households. Simultaneously, the study set out to assess the extent to which people are made poor or poorer by health spending, i.e. the impoverishing effects of healthcare spending.
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Rahman, Rosanna, and n/a. "Potential causes of the delayed neural damage observed post-stroke & the effects of epigallocatechin gallate administration." University of Otago. Department of Pharmacology & Toxicology, 2006. http://adt.otago.ac.nz./public/adt-NZDU20070508.122246.
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Stroke is the 3rd leading cause of death and the leading cause of major disability worldwide. Currently, there are no neuroprotective drugs approved for the acute treatment of ischaemic stroke. The vast majority of stroke therapeutics failed in clinical trials due to toxic side effects and/or a clinically irrelevant therapeutic window. This thesis is focused on exploiting the delayed neurodegeneration that occurs in the compromised penumbra, as these cells may be capable of being saved by therapeutic intervention in a clinically obtainable window. In order to investigate the ischaemic cascade and be able to draw conclusions that are applicable to humans, the international gold standard animal model for cerebral ischaemia, the filament insertion middle cerebral artery occlusion (MCAO) model, was established at the University of Otago. This model was validated under new laboratory conditions and employed adult male Sprague Dawley rats. After testing multiple occlusion lengths, it was concluded that a 2hr ischaemic period was sufficient to produce a consistent infarct of optimal size. It has been well documented that neuroinflammation contributes to much of the delayed progression of neural injury post-stroke. Therefore, the catechin (-)-epigallocatechin gallate (EGCG), which is an anti-inflammatory, anti-oxidant and free-radical scavenging agent was investigated in the MCAO model of stroke. 50mg/kg i.p. of EGCG or saline was administered immediately post-MCAO and animals were sacrificed at 72hr post-filament insertion. The results confirmed that treatment with EGCG was neuroprotective and non-toxic. However, EGCG also induced an over 50% increase in the risk of haemorrhagic conversions. The anti-platelet effects of EGCG and lack of toxicity suggests that the catechin may prove to be an efficacious prophylactic for stroke. The contrary findings for EGCG treatment led to the re-evaluation of the neuroinflammatory pathway for alternate mechanisms to target therapeutic interventions.
The temporal profile of the primary inducible enzymes nitric oxide synthase (NOS), cyclooxygenase (COX) and arginase (and their isoforms) were quantified 0, 3 and 7 days post-stroke. In both hemispheres, total NOS activity exhibited a significant and sustained up-regulation to 7 days post-occlusion. In the ipsilateral hemisphere at least half of the total increase was accounted for by inducible NOS (iNOS) expression. Arginase, which competes with NOS for L-arginine, demonstrated a delayed but significant increase in activity by day 7 in the infarcted hemisphere, thereby correlating well with the downward slope of NOS activity (illustrating the switch in the conversion pathway). COX activity was observably increased in the ipsilateral hemisphere, but the up-regulation did not reach significance by day 7. Alternately, the contralateral hemisphere displayed a significant decrease in activity by day 3. These results give conclusive evidence that the contralateral hemisphere is NOT an appropriate internal control and imply that NOS and COX inhibitors may prove to be efficacious for a much longer therapeutic window than current treatments. However, the delayed induction of COX activity may also indicate that this enzyme has a finite therapeutic window, as it may also stimulate remodelling of surviving neural networks. The prolonged up-regulation of inflammatory mediators implies that there may be an induction of an autoimmune component to the response. Therefore, the thymus (T) lymphocyte activation was quantified up to 14 days post-stroke. Cluster of differentiation (CD) 3⁺ T lymphocytes (equally contributed to by CD4⁺ and CD8⁺ T cells) exhibited a significant and sustained up-regulation in the infarcted region from day 3 up to at least day 14 post-ischaemia. Quantitative analysis of all cells present post-stroke determined that immune cells make up an average of 73% of all cells present in the 'peak' ischaemic areas. The CD4⁺ T helper cell response was delineated by double immunohistochemical labelling. Interferon-γ positively labelled with CD4⁺ T cells at days 3, 7 and 14 post-insult detailing a Th1-driven pro-inflammatory response. This evidence indicates that the autoimmune response is critical post-ischaemia and that it may be highly susceptible to modification by anti-inflammatory therapeutic intervention.
The primary downstream effect of the pro-inflammatory/immune cascade is apoptosis. The main organelle responsible for the 'go, no go' response to apoptotic factors is the mitochondria. In order to distinguish whether mitochondrial dysfunction was initiated shortly after ischaemia induction or if it was delayed, like the inflammatory/immune response, to a clinically relevant window, the temporal profile of mitochondrial complex inactivation was studied. It was found that mitochondrial membrane viability was impaired by day 3, followed by a significant decrease in respiratory complex activation and an increase in tissue injury by oxidative stress by 7 days post-ischaemia. These results indicate that targeting the early decrease in membrane viability or mitochondrial permeability transition pore opening combined with anti-apoptotic therapeutics, may attenuate the proceeding mitochondrial impairment in oxidative phosphorylation, reactive oxygen species generation and subsequent cell death cascades. The current investigations into the temporal profile and quantitative contributions of the inflammatory, immune and apoptotic mechanisms post-stroke highlight potential strategies for modulation by acute stroke therapeutics. Furthermore, the general knowledge amassed from these studies dictates the necessity of a new approach to therapeutic intervention. The acknowledgement of so many contributing systems suggests that in addition to a thrombolytic, a combination therapy involving multiple neuroprotectants should be employed to account for the multifaceted nature of the sequelae of ischaemic stroke.
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Chang, Chia-yu Stephanie Celeste, and 張嘉瑜. "Does social-demographic information predict residential outcomes in elderly stroke rehabilitation patients in Hong Kong?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31971520.
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Ramothibe, J. C. (Joseph Colin). "The demographic and socio-economic impact of HIV/Aids on the Khomas region and the implications for the Windhoek local authority." Thesis, Stellenbosch : Stellenbosch University, 2004. http://hdl.handle.net/10019.1/50131.
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Thesis (MBA)--Stellenbosch University, 2004.ENGLISH ABSTRACT: HIV/AIDS is one of the biggest challenges faced by many countries in this century. The rate of infection is rapidly increasing and more and more people are getting ill and dying from AIDS. Of all the people living with AIDS in the world, seven out of ten live in Sub-Saharan Africa. Namibia is one of the top five most HIV/AIDS affected countries in the world. There is therefore no question about the urgent need to accelerate actions to reduce prevalence, expand care and support and extend access to treatment. AIDS is eroding decades of progress made in extending life expectancy; thus hundreds of adults are dying young or in early middle age. The national strategic plan (2004) on HIV/AIDS indicated that the average life expectancy in Namibia is now 42 years, when it could have been 60 without AIDS. A 2003 study on the impact of HIV/AIDS on Windhoek indicated that the antenatal HIV/AIDS prevalence rate in Windhoek for 2002 was 27%, while the national prevalence rate was estimated at 22.3%. The prevalence rate for Windhoek is expected to reach its peak at 38% during 2005. Even though HIV/AIDS will have a diminishing effect on population growth, Windhoek's population is expected to continue growing, particular as a result of inward migration, but at a slower pace. Similarly, HIV/AIDS will have an abating effect on GDP growth as the virus will mainly affect the economic active and available labour force of the population and result in increased labour costs and skilled labour shortages. The impact on the informal sector is potentially more damaging than on the formal economic sector, as the majority of micro- enterprises and informal businesses are build around one individual. As the breadwinner dies, household income and expenditures levels deteriorate and increase poverty levels, because households within the city are very dependent on family structures to support their income levels. Informal settlements are also more volatile to HIV transmission and the majority of HIV infected individuals are likely to be found within these areas as the populations is poorer, crowded, has fewer social services facilities and is more likely migratory compared to those in affluent formal settlements. Considering that the incubation period of HIV/AIDS from infection to death takes about ten years, the real impact of current HIV infections in Windhoek will only be experienced during 2010. Health services will have to attend to a greater demand for curative services as well as to social care and support programs. Social welfare programmes will need to find ways of caring for a large population of HIV/AIDS orphans. Municipalities can playa critically important role in addressing HIV/AIDS at a local level as they are at the interface of community and government. They are ideally placed to playa coordinating and facilitating role that is needed to make sure that partnerships are built to bring prevention and care programmes to every community affected by AIDS. Therefore, in order to succeed in confronting HIV/AIDS, it is important to work closely with all levels of government as well as working with local partners in civil society that are fighting HIV/AIDS at the community level. By taking action against HIV/AIDS, municipalities are securing the future of their towns and communities.
AFRIKAANSE OPSOMMING: MIV/VIGS is een van die grootste uitdagings wat baie lande hierdie eeu in die gesig staar. Die koers van infeksie is vinnig aan die toeneem en al hoe meer mense word siek en sterf as gevolg van VIGS. Van al die mense wat met VIGS lewe in die wêreld, bly sewe uit tien in sub-Sahara Afrika. Namibië is een van die vyf mees MIV/VIGS geaffekteerde lande in die wêreld. Derhalwe is daar geen twyfel rakende die noodsaaklikheid om daadwerklike aksies te bewerkstellig om die voorkoms te verminder, sorg en ondersteuning te verhoog en toegang na behandeling uit te brei. VIGS vernietig dekades van groei behaal in die verlenging van lewensverwagting; dus sterf honderde volwassenes vroeg of gedurende hul middeljare. Die nasionale strategiese plan (2004) rakende MIV/VIGS toon dat die gemiddelde lewensverwagting in Namibië huidiglik 42 jaar is instede van 60 sonder VIGS. 'n Studie onderneem gedurende 2003, rakende die effek van MIV/VIGS in Windhoek, dui aan dat die voorgeboorte MIV/VIGS voorkoms koers 27% vir 2002 was, terwyl die nasionale voorkoms koers slegs 22.3% was. Daar word verwag dat die voorkoms koers vir Windhoek sy maksimum van 38% sal bereik gedurende 2005. Alhoewel MIV/VIGS 'n negatiewe effek op bevolkingsgroei groei gaan het, sal Windhoek se inwoners getalle steeds groei, alhoewel teen 'n stadiger koers, as gevolg van inwaartse migrasie. Terselfdertyd, gaan MIV/VIGS 'n verminderde effek het op die groei van die Bruto Binnelandse Produk (BBP), omdat die virus hoofsaaklik die ekonomiese aktiewe en beskikbare arbeidsmag van die bevolking affekteer wat as gevolg hiervan 'n verhoging in arbeidskoste en tekort aan geskoolde arbeid het. Die effek op die informele sektore is potensieel meer skadelik as op die formele ekonomiese faktore, aangesien die meeste klein en informele besighede rondom een persoon gebou is. lndien die broodwinner sterf, versleg die vlakke van huishoudelike inkomste en uitgawes wat lei tot verhoogde armoede, omdat huishoudings in die stad baie afhanklik is op familie strukture om hulle inkomste te ondersteun. Informele vestigings is meer kwesbaar in die oordrag van MIV en die meerderheid van die MIV geïnfekteerde individue word gewoonlik in hierdie areas aangetref omdat die bevolking armer is, meer persone huisves, minder welsyn dienste fasiliteite het en meer swerwend is in vergelyking met die meer welgestelde formele vestigings. As in ag geneem word dat die ontkiemings periode van MIV/VIGS vanaf infeksie tot en met sterfte omtrent tien jaar neem, sal die werklike effek van die huidige VIGS besmettings in Windhoek slegs ervaar word gedurende 2010. Gesondheidsdienste sal moet aandag skenk aan 'n groter aanvraag vir geneeslike dienste sowel as sosiale sorg en ondersteunings programme. Gemeenskaplike welsyn programme sal maniere moet vind om vir 'n groot populasie van MIV/VIGS weeskinders te sorg. Munisipaliteite kan 'n belangrike rol speel in die aanspreek van die MIV/VIGS epidemie op 'n plaaslike vlak omdat hulle die skakel is tussen die gemeenskap en die regering. Hulle is ideaal geplaas om 'n koordineerende en fasiliterende rol te speel wat nodig is om seker te maak dat vennootskappe gebou word om voorkomings en versorgings programme te lewer aan elke gemeenskap wat deur MIV/VIGS geraak word. Dus, om sukses te behaal in die bekamping van MIV/VIGS , is dit belangrik om nou saam te werk met alle vlakke van die regering sowel as met plaaslike vennote in die gemeenskap wat MIV/VIGS bekamp op gemeenskapsvlak. Deur aksie te neem teen MIV/VIGS , kan munisipaliteite die toekoms van hulle dorpe en gemeenskappe verseker.
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Ketshabile, Lisbon Simeon. "The impact of HIV/AIDS on the socio-economic environment in Botswana with special reference to tourism." Thesis, Cape Peninsula University of Technology, 2010. http://hdl.handle.net/20.500.11838/1624.
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Thesis (DTech (Tourism and Hospitality Management))--Cape Peninsula University of Technology, 2010Purpose: Botswana is one of the countries with the highest HIV/AIDS prevalence rate in the world. This research aims to investigate the impact of HIV/AIDS on the socio-economic environment in Botswana with special reference to the country’s tourism sector. Tourism plays a vital role in the economy of Botswana. It creates employment, earns foreign exchange, markets Botswana internationally, attracts foreign investments and contributes to Gross Domestic Products (GDP).Methodology: This report explains the HIV/AIDS situation and policy framework relative to the tourism sector in Botswana and in selected African countries through conducting an extensive literature review and empirical surveys. This is a quantitative research in which non-probability method is used to indentify the respondents. Here tourism general managers are identified and asked to identify their subordinates who are available and willing to participate in the survey by answering a self-administered questionnaire.Findings: This study indicates that HIV/AIDS threatens the Botswana tourism and the viability of the socio-economic factors. In general, the Southern African region is experiencing the highest rate of HIV infection in the world. The infection rate is particularly high among the young people (aged 15 – 49). This age group constitutes people who are economically active, and a number of them work directly or indirectly in the tourism sector. HIV/AIDS kills the economically active population – people who hold the skills, do the work, pay taxes, raise children, vote in the elections, and provide leadership. HIV/AIDS results in increased mortality and morbidity rates, and it also results in increased health expenditure. It also results in increased poverty level in the country.Practical implications: When observing the prevalence and impact of HIV/AIDS not only in the tourism sector but in general, it becomes evident that the fight against the disease should be a collaborative approach involving various sectors including tourism. Relying only on government and health sector to address the complex and systematic impact of HIV/AIDS cannot effectively combat the disease and its prevalence rate.Originality/value: This report analyses HIV/AIDS situation in Botswana in a creative way, contributing to the understanding of its impacts on the socio-economic environment as well as identifying strategies that can be used in addressing the impacts. This research is important for public policy makers, government officials, and tourism role-players to be aware of implications HIV/AIDS has on the socio-economic environment and take them into consideration in the policy formulation and implementation, business strategies and processes. It is also imperative to academics who would like to expand their knowledge on HIV/AIDS.
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Meintjes, Samuel David. "An investigation to determine the readiness of management at selected manufacturing organisations in the Buffalo City area to manage the HIV/AIDS epidemic." Thesis, Port Elizabeth Technikon, 2002. http://hdl.handle.net/10948/108.
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The present study was conducted to determine the readiness of management at selected manufacturing organisation in the Buffalo City area to manage the HIV/AIDS epidemic. The study was conducted in the Buffalo City area on manufacturing organisations with a workforce greater than 250. The main aims of the present study were: · To provide an overview of relevant literature concerning theoretical key issues related to the management of HIV/AIDS in the workplace. · To assess the readiness of Buffalo City organisations in managing HIV/AIDS in the workplace, and to identify areas of improvement. · In the light of the findings, make further recommendations to manufacturing organisations to further improve their workplace policy, education and awareness programmes; and the accommodation of HIV-infected employees in the workplace. Another objective of the study was to provide additional research as a tool to assist organisations in managing HIV/AIDS in the workplace and to assist in fighting the HIV/AIDS epidemic in the Buffalo City area. The research process entailed: the selection of a test sample of manufacturing organisations in the Buffalo City area, and selecting an appropriate Human Resource manager or representative from these organisations to complete a structured questionnaire. The research tool used in the study was a questionnaire, which was used to extract relevant information on the demographics, policies, education and the accommodation of HIV/AIDS affected and infected employees in the workplace. The results revealed the following: · 73 percent of the selected manufacturing organisations in the Buffalo City have an HIV/AIDS policy in place; · 87 percent of the organisation indicated that their management are committed to the development and implementation of a HIV/AIDS policy; · management and supervisors in these organisations have not been adequately trained to manage the impact of HIV/AIDS in the workplace; · organisations in the Buffalo City area need to collaborate and share information; and · that very few organisations benchmark against best practices. Future research on HIV/AIDS policy can explore the effective implementation of HIV/AIDS policies in these organisations as well as the effective management of HIV/AIDS in the workplace.
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Cheng, Sau-kong, and 鄭守崗. "Diabetic end-stage renal disease (ESRD): can health care costs be saved through blood pressure control?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B39723951.
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Scannell, Alice Updike. "The Longterm Psychosocial Impacts of Caregiving on the Caregivers of Persons with Stroke." PDXScholar, 1989. https://pdxscholar.library.pdx.edu/open_access_etds/1312.
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This study is a Time 4 (T4) follow-up interview of ninety-three caregivers of persons who experienced a first stroke between 2 to 4 years (mean = 36 months) prior to the T4 interview. The first wave of data collection occurred within two months after the stroke. The second and third waves occurred six and twelve months, respectively, after the first interview. The caregivers were identified by the person with stroke as being the person closest to him/her who would be responsible for care after the stroke.
Data were gathered at all four interviews using reliable and valid measures for depressive symptomatology (CES-D; Radloff, 1977), psychological well-being (IPWB; Berkman, 1971), and caregiver burden (Zarit, 1980). The contribution of social support to caregiver well-being was also investigated. Additional areas of investigation at T4 included coping strategies (F-Copes; McCubbin, Larsen, and Olson, 1981), caregiver adjustment, and the respondents' perception of themselves as "caregivers".
The mean scores of depressive symptomatology, perceived burden, negative well-being, and positive well-being did not change significantly over the four points in time. However, the percentage of the sample having CES-D levels of 16 and above (indicating potential diagnosis of clinical depression) decreased by ten percent between T1 and T4. About ten percent of the respondents who were at risk for clinical depression at T4 reported high levels of depressive symptoms at all four interviews.
Respondents who specifically thought of themselves as "caregivers" (sixty-two percent) were significantly more likely to report high levels of depressive symptoms, to experience high levels of strain and caregiver burden, and to be caring for persons who were more severely impaired by the stroke than those who did not.
Caregiver characteristics contributed more to the variance in depressive symptoms and psychological well-being than did characteristics of the stroke. However, depressive symptomatology and perceived burden were significantly associated with both the functional capacity of the person with stroke and with an index of stroke severity comprised of communication impairments and negative personality/behavior changes since the stroke.
The findings from this study have implications for stroke management programs, caregiver intervention planning, and health care policy.
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Mfula, Sindiswa Elk. "An investigation into the impact of HIV and AIDS on municipal management: a case study of George municipality." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1021032.
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The aim of this research was to provide a preliminary investigation of how the HIV and AIDS epidemic will impact on management of municipalities, specifically George Municipality. Municipalities provide a large proportion of essential basic services and also represent one of the primary opportunities for public participation and decision-making at a community level. This paper takes George Municipality in the Western Cape as a case study of the current and potential impact of HIV and AIDS on public demand for services and on the municipality's capacity to govern and provide services. It also reviews the responses of the municipality to HIV and AIDS.The research was conducted using a questionnaire which was distributed to municipal officials in the different departments but also included a review of relevant literature and analysis of quantitative data. The study focused on a single case: An investigation into the impact of HIV and AIDS on municipal management of George Municipality. The study identified strategies utilised by the municipality to reduce the impact of HIV and AIDS. The study drew on people's experiences, perceptions and interpretations of the impact of HIV and AIDS on municipal management, responses and any other related factors that may have impeded the realisation of the reduction of the impact of HIV and AIDS on municipal management in the George Municipality.Fifty questionnaires were distributed, 40 copies by hand delivery and ten copies via e-mail to employees ranging from general worker to senior management. Employees participated in the study through interviews and answering of the questionnaires. An internet search was also conducted using Wed Crawler and by visiting the official website of the George Municipality for all policies, minutes, reports and all other relevant documents regarding HIV and AIDS. The researcher also drew on personal observations because she has been in George for almost six years and is also employed by George Municipality. Participants who were selected by the researcher for interviews purposes were five councillors and five ward committee members because councillors are decision makers in the municipality. The rest were given questionnaires to complete. Data was analysed by using interpretation analysis, namely codes to explain data collected. Results were presented in the form of tables and conclusions warranted by the data are presented. Statistical analysis was done to check correlation between the different aspects in the questionnaire. According to the research findings it can be confirmed that more of the budget needs to be allocated for employment of suitably qualified persons like occupational nurses, who will drive HIV and AIDS education and awareness campaigns. HIV and AIDS mainstreaming should be regarded as a priority in order make people aware about the realities of HIV and AIDS in communities. Leadership and management buy-in should be obtained to win the fight against the epidemic. A comprehensive strategy should be compiled and implemented to reduce the spread and stigma of HIV and AIDS. Proper planning should be done for compiling the strategy. This strategy should specify the budget for HIV and AIDS and how HIV and AIDS is going to be integrated into an IDP. Prevention and management strategies used by the organisation should be explained.
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Podisi, Mpho Keletso. "The socio-economic aspects involved in compliance to antiretroviral therapy : Princess Marina Hospital, Gaborone." Diss., Pretoria : [s.n.], 2005. http://upetd.up.ac.za/thesis/available/etd-01312006-111529.
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Steenkamp, Jacob Cornelus. "The effect of HIV and AIDS on the viability and management of forestry contracting businesses in South Africa." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/735.
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The aim of the research is to quantify the HIV prevalence in human resources of forestry contracting businesses and to develop a management framework to promote economic sustainability of forestry contractors. HIV tests were conducted in the forest industry on the employees of contracting concerns from 2002/2003 to 2004/2005 with an accompanying questionnaire to collect demographic data. The HIV test results were analyzed with the demographic data to determine relationships between HIV prevalence and demographic factors. Contractors responded to a questionnaire on the effect of HIV and AIDS prevalence on (their) contracting businesses. The questionnaire also collected information about HIV and AIDS interventions and assistance to HIV and AIDS affected employees. Key stakeholders of other forestry sub-sectors were interviewed to facilitate comparison of the different sub-sectors and to establish if there were major differences between the sub-sectors, however, the focus was on the human resources of the forestry contracting sub-sector. The research results indicated that the HIV prevalence was increasing for the research period and was, in some regions, exceeding 40 per cent. The highest prevalence was recorded in the Highveld and Zululand regions and the lowest prevalence in the North-Eastern Cape. The HIV prevalence for females was constantly higher than the incidence for males and the ratio of males to females (all regions) approximated 68 per cent to 32 per cent. The high prevalence of HIV results in major social and economic impacts. The economic impact is aggravated through regulation (due to perceived market failure) and a bid for more equal distribution of wealth in the economy. The result of the sum of the impacts alludes to a conversion from labour to capital; however, to make well-informed decisions, various scenarios should be simulated to establish the optimum labour to capital ratio. The research further established that appropriate staffing is increasingly difficult and that the development of human capital is under pressure due to the high prevalence of HIV and AIDS. HIV and AIDS mitigation programmes will make a significant contribution to the return on human capital assets, as the economic life and productivity of such assets will be enhanced by such interventions. The management framework developed was assessed to be visually acceptable and useful by domain experts; however, to realise the full potential of the framework it should be used with anticipation of the research results regarding prevalence and future estimated AIDS releases and in conjunction with industry cost simulation models.
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Thiboutot, Monika. "The Combined Effects of HIV/AIDS and Structural Adjustment Programs on Ugandan Underdevelopment." Honors in the Major Thesis, University of Central Florida, 2004. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/730.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucfBachelors
Arts and Sciences
Political Science
28
Chen, Jing, and 陈静. "Economic evaluation of community pharmacy based smoking cessation on burden of chronic obstructive pulmonary disease (COPD) in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B47157252.
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Background: Chronic Obstructive Pulmonary Disease (COPD) poses a substantial
burden to Hong Kong. Smoking is the single most important risk factor for COPD.
Intensive smoking cessation in COPD patients slows disease progression. Community
pharmacy based smoking cessation in healthy smokers could forestall COPD onset. Each
of these programs has been proven effective and cost-effective worldwide. Currently
there are smoking cessation clinics in Hong Kong. But community pharmacy-based
smoking cessation services are not available. The present study firstly attempts to identify
the disease burden of COPD; secondly, to investigate if community pharmacy-based
smoking cessation services are applicable in Hong Kong; finally, to examine if
establishing the services would be cost effective in reducing the burden of COPD.
Methods: A series of data analysis of mortality, morbidity and cost of hospitalization
(length of stay × standard daily ward cost) was conducted to understand the burden of
COPD in Hong Kong. Cost effectiveness analysis based on a Markov model evaluated smoking cessation strategies against usual care: (1) minimal counseling in smoking
cessation clinics (MiniC) for COPD patients; (2) intensive counseling with
pharmacotherapy in smoking cessation clinics (IC_pharm) for COPD patients; (3)
community pharmacist-assisted service (CPA) for healthy smokers; (4) combination of
CPA and MiniC (CPA+MiniC); (5) combination of CPA and IC_pharm
(CPA+IC_Pharm). The Markov model was constructed by sex, smoking status and
COPD severity to calculate the lifetime cost of COPD, cost of smoking cessation
programs and QALYs. Both effectiveness and cost were discounted at 3%. Incremental
cost effectiveness ratios (ICERs), i.e. cost per one QALY gain, served as the decision
making rule. One way sensitivity analysis, threshold analysis and probabilistic sensitivity
analysis were performed to explore the uncertainty around the parameters.
Results: The overall age adjusted mortality of COPD increased from 28.8 per 100 000 in
1981 to 30.14 per 100 000 in 2008. Numbers of people aged 65+ with known COPD was
projected to be over 100 000 by 2036. There were 3.8 and 7.8 years of life lost (YLL) and
3.6 and 5.6 QALYs lost due to COPD for male and female smokers respectively. Medical
costs of hospitalization were estimated to be over HK$ one billion (US$132 million) in 2008.
Seventy one COPD cases could be avoided in the simulated cohort by CPA. If the
threshold value was HK$247 332 for one QALY gain, CPA was more cost effective than
IC_Pharm, with an ICER of HK$47 717. CPA+MiniC dominated CPA. CPA+IC_Pharm was more cost effective than CPA+MiniC (ICER, HK$36 000). The
probability of CPA+ IC_pharm being the most cost effective strategy was approaching
0.8 if one QALY was worth HK$96 000, and it was associated with the maximum
expected QALYs if societal value for one QALY was no less than HK$80 000.
Conclusion: The model-based economic evaluation demonstrated that CPA+IC_Pharm
would be the most cost-effective smoking cessation strategy. Community pharmacy
based (CPA) smoking cessation services could be applicable and should be proposed in
Hong Kong to reduce the burden of smoking related diseases.published_or_final_version
Public Health
Doctoral
Doctor of Philosophy
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Wentzel, Willem Jacobus Erasmus. "An empirical study into the impact of HIV & AIDS on the Lewis group's market." Thesis, Stellenbosch : Stellenbosch University, 2004. http://hdl.handle.net/10019.1/49229.
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Thesis (MBA)--Stellenbosch University, 2004.ENGLISH ABSTRACT: Why should the Lewis Group be concerned about HIV/AlDS? The answer is quite simple. HIV/AIDS poses a clear and present danger to the twin rationales on which businesses like the Lewis Group are based. The rationales are low-cost labour for own and supply chain purposes, and fast-growing markets. This research focuses more towards the latter and presents a review of the current literature and attempts to estimate the impact of HIV/AIDS on the group's market. Literature on the subject is surprisingly limited (Bloom & Mahal, 200 I: 10) and often dated seen in the light of the fact that it is one of the most oppressing issues in the Southern African business arena today. Amidst a rather slow awakening in the private sector to the effects of HIV/AlDS on markets a lot of resources and time are being spent on research in this area. Although the scope of this research does not encompass the full impact of the epidemic on the company, it provides insight into an area on which very little is known yet. Companies have a high level of control over, and information, about their employees but significantly less about their customers} hence the reason for the use of hypothesising and adopting a tailor-made methodology to quantify prevalence rates and vulnerability. This paper is therefore not a complete assessment of impact of the disease on the group as a whole. AlDS is a bottom line issue for most companies as it impacts on production costs and consumer markets (Ellis & Terwin, 2003: 55). A number of "doom-and-gloom" merchants have come forward with doomsday estimates about the impact of the epidemic on business. As a result, the extent of the problem might have been overstated by some. This sparked a lot of the debates that resulted in many different opinions which have caused a lot of uncertainty. This research will attempt to clarify these issues and fonnulate an unbiased opinion as of the impact of the company. The HIV/AIDS problem is sti ll gathering momentum and prevalence rates are still on the rise. There is currently no cure for HIV / AIDS and chances look diminutive that there will be one within the next decade. If prevention programmes had been successful, this report would never have been written. The problem is aggravated by the fact that the core modes of HN transmission are deeply rooted in social behavioural patterns, value systems and traditional and cultural beliefs. This makes it hard to imagine that the spread of the epidemic will decrease and eventually stop soon (Goldstein, Pretorius, Stuart, 2003). As we are entering a phase where the number of AIDS-related deaths is starting to rise rapidly, it is important to gain sufficient insight into the effect of the disease, especially now that infonnation is becoming more available in the public domain (McClintock & Truen, 2003: 3). AIDS primarily kills young and middle-aged adults during their most productive years. This section of the population is the major source of demand for goods and services. The macro-economic impact of this is expected to influence demand for goods, especially durables, and services. This is aggravated by slower population growth rates that will further slow down the demand for certain goods and services (McClintock & Truen, 2003: 3). HIV/AIDS must be managed proactively. In order to assess and manage this risk, management must have a clear understanding of nature and extent of the risk (Ellis & Terwin, 2003: 1). The Bureau for Economic Research did a survey in 2003 on the impact of HIV/AIDS on business in South Africa. It found that only 8 percent of retail companies surveyed have assessed the impact of the disease on their consumer base (Ellis & Terwin, 2003: 30). A possible reason might be because companies want to see proven input and exit strategies for HIV/AIDS contributions. These are not yet possible for HN/AIDS (Barrett & Ruggie, 2004: 5). The HlV/AIDS prevalence rates estimate for the Lewis Group revealed significantly lower prevalence rates than the national averages. Nevertheless, HlV and AIDS prevalence rates for 2004 are estimated 16.5 percent and 2.5 percent respectively. HIV-prevalence is expected to increase to 17.1 percent and AIDS to 4.7 percent by 2009. There are a number of interventions and strategic responses the company can consider to mitigate the risks entrenched in these estimates. Recommended strategic responses include diversification of profit generators into the higher income group market, focus on areas of growth and building the Lewis Group's brands. It is generally believed that good and responsible corporate citizenship will benefit from involvement in community and charitable projects. The belief is that customers can become predisposed towards the company and that the group can gain goodwill from new and existing customers. It is therefore clear that there are remedies the company can consider to manage and mitigate its risks. It is, however, possible for the company to emerge stronger, more efficient and more competitive if the right responses are implemented.
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Ludick, Christopher Vernon. "Assessing the micro-economic impact of HIV/AIDS on a South African pharmaceutical manufacturer as well as evaluating their policy on HIV/AIDS." Thesis, Stellenbosch : Stellenbosch University, 2004. http://hdl.handle.net/10019.1/49857.
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Thesis (MBA)--Stellenbosch University, 2004.ENGLISH ABSTRACT: HIV infection has increased sharply in SA over the past decade, from almost zero to a level where between 4-6 million citizens are estimated to be HIV positive (i.e. around Il percent of the total population). Given the considerable lag and link between the HIV and AIDS epidemic, the mortality consequences of this exponential increase in HIV infection over the 1990s are more or less matter-of-fact over the coming decade; even drastic interventions can do little to avoid this reality, albeit possibly impactingfurther beyond. The health care industry, and more specifically the pharmaceutical industry, is the only industry that can have a direct impact on the outcome of the epidemic in terms of provision of antiretroviral drugs. More importantly, the decision by multinational companies to provide voluntary licensing to local SA pharmaceutical manufacturers for the manufacturing of generic ARVs has gone a long way into achieving the World Health Organisations' objective of providing an ARV cocktail for less than $1,00 per day. The mam aim of the study is to establish and study the micro-economic effect of HIV/AIDS on a South African pharmaceutical manufacturer and to evaluate their HIV/AIDS Policy with the framework of the mV/AIDS & SID Strategie Plan for South Africa 2000-2005. Both qualitative and quantitative methods were used to obtain data from various key informants, manufacturers and market survey companies. The analysis of quantitative data was done using Excel software and a descriptive analysis method was used to interpret the data. The key findings from the study are that Aspen Pharmacare will experience a 20,8 % HIV prevalence rate in 2005, which will progressively increase to a 25,6 % level in 2015. This prevalence level will be severely experienced in the skilled, semi-skilled and unskilled employment of the company during the 2010 period and will start to stabilise in the latter part of 2015. The AIDS prevalence in the company will increase from a 2,0 % level in 2005 to a 4,4 % level in 2015. This increase is largely due to the increase in the prevalence rates in the semi-skilled and unskilled employees. At a senior management level the forecasted number of employees that will have clinical AIDS after 2010 is between 6 and 8. This clearly indicates that mv/AIDS prevalence at this level is independent of race and is lifestyle dependent. If the company were to have the full responsibility for the provision of benefits, based on the current expected employee benefit structures, the direct cost to company would add 10 % to salary and wages by 2005 and around 20 % by 2010. Indirect costs to company, such as recruitment and training, increased labour turnover, lost skills and intellectual property, etc. are estimated to be 2,5 % by 2005 and 5 % by 2010. With the high HIV/AIDS prevalence rates, especially amongst the unemployed, companies will have to carry the costs of their mv/AIDS patients for longer and register then with Aid for AIDS when it becomes too costly. More importantly employers will have to investigate the cost implication of assisting employee dependents, as this will have a direct impact on the morale of the employees. Aspen Pharmacares' mv/AIDS Policy goes beyond the requirements of the mv/AIDS Strategic Plan for SA in terms of the legal and social requirements. The company also has a Corporate Social Investment division that assists many NGOs, clinics, hospitals and communities. Based on the intellectual property, the pharmaceutical competencies and the continuous dialogue that exists between the pharmaceutical industry and the department of health, the researcher concludes, that pharmaceutical companies have an advantage over nonpharmaceutical companies in dealing with the mv/AIDS issues. The paper concludes by suggesting recommendations that companies can adopt to ensure that their mv/AIDS policy can form a significant component of their skills retention strategy.
AFRIKAANSE OPSOMMING: MIV infeksie het skerp gestyg in SA oor die laaste dekade, vanaf amper geen tot 'n vlak waar tussen 4-6 miljoen inwoners beraam word om MIV positiefte wees (minstens 11% van die totale bevolking). Gegee die aansienlike vertraging en skakel tussen die MIV en VIGS epidemie, word die eksponensiële toename in die sterfte syfer as gevolg van MIV infeksies gedurende die jare negentig as vanselfsprekend aanvaar in die komende dekade. Selfs ingrypende veranderinge kan min doen om hierdie katastrofe te keer. Die gesondheidsorg industrie, en meer spesifiek die farmaseutiese industrie is die enigste industrie wat 'n direkte slag kan slaan om die uitkoms van die epidemie te beinvloed, in terme van voorsiening van antiretrovirale medisyne. Die besluit van die multinasionale maatskappye om vrywillige lisensiëring aan plaaslike farmaseutiese maatskappye te bied, vir die vervaardiging van generiese antiretrovirale medisyne, is een stap vorentoe om by die doelwit van die Wereld Gesondheidsorg Organisasie se doelwit van die voorsiening van 'n daaglikse toediening van antiretrovirale medisyne van minder as $1.00 per dag. Die primêre doelwit van hierdie projek is om te bepaal wat die mikro-ekonomiese effek van MIV/VIGS op 'n Suid Afriakaanse farmaseutiese vervaardiger is en hul MIV/VIGS beleid te evalueer binne die raamwerk van die MIV/VIGS en SOS Strategiese Plan vir SA 2000-2005. Beide kwalitatiewe en kwantitatiewe metodes is gebruik om data te verkry vanaf verskeie bronne, vervaardigers en marknavorsings maatskappye. Die kwantitatiewe inligting was geanaliseer deur gebruik te maak van "Excel" sagteware en 'n beskrywende analitiese metode was gebruik om die data te interpreteer. Die hoof bevindinge van die studie is dat Aspen Pharmacare 'n MIV infeksie vlak van 20.8 % in 2005 sal ondervind, wat progressief sal toeneem tot 25,6 % in 2015. Hierdie infeksie vlak sal in die geskoolde, semi-geskoolde en ongeskoolde arbeid die ergste voorkom gedurende die 2010 periode en sal dan stabiliseer in die latere gedeelte van 2015. Die VIGS infeksie vlak in die maatskappy sal toeneem vanaf 2,0 % in 2005 tot 'n 4,4 % in 2015. Hierdie toename kan toegeskryf word aan die toename in die infeksie vlakke van die semi-geskoolde and ongeskoolde arbeid. Op die senior bestuurs vlak word beraam dat tussen 6 en 8 werknemers VIGS onder lede sal hê na 2010. Hierdie beraming toon duidelik aan dat MIV/VIGS op hierdie vlak onafhankilik van kleurgroup is en direk leefstyl verwant is. Gebaseer op die huidige verwagte werknemer voordele struktuur, en die feit dat die maatskappy volle verantwoordelikheid sou aanvaar vir die voorsiening van voordele, word beraam dat die direkte koste as gevolg van MIV/VIGS 'n toename van 10 % in 2005 en 20 % in 2010 by salarisse en lone sal voeg. 'n Toename van 2,5 % in 2005 en 5 % in 2010 word beraam vir indirekte koste (werwing van personeel, opleiding, ens.)as gevolg van MIV/VIGS. Met die hoë MIV/VIGS infeksievlakke, veral onder werkloses, sal maatskappye die kostes vebonde aan hul MIV/VIGS werknemers vir langer moet verduur en dan later sulke werknemers registreer by "Aid for AIDS" indien dit onbekostigbaar word. Belangriker is die feit dat werknemers die koste implikasie bepaal in die verband, omdat dit 'n direkte invloed sal hê op werknemer selfvertroue. Aspen Pharmacare se MIV/VIGS beleid bied meer as die wettige en sosiale vereistes soos uiteengesit in die MIV/VIGS en SOS Strategiese Plan vir SA 2000-2005. Die maatskappy het ook 'n Korporatiewe Maatskaplike Beleggings afdeling wat 'n bydra lewer by NGOs, klinieke,hospitale en gemeenskappe. Gebaseer op die intelligensie eiendom, die farmaseutiese bekwaamheid en die aanhoudende gesprekvoering wat bestaan tussen die farmaseutiese bedryf en die department van gesondheid, oortuig die navorser dat farmaseutiese maatskappye 'n voordeel het bo nie-farmaseutiese maatskappye in die hantering van die MIV/VIGS strydvraag. Hierdie studie sluit af met aanbevelings wat maatskappye kan toepas om te verseker dat hul MIV/VIGS beleid 'n betekenisvolle komponent van hul bekwaanheids retensie strategie is.
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Ganesh, Aravind. "The clinical epidemiology of acute ischaemic stroke and its long term health economic outcomes." Thesis, University of Oxford, 2017. https://ora.ox.ac.uk/objects/uuid:aafa38c4-bde5-452d-a4d9-1bdcec816760.
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This thesis examines 5-year clinical and health-economic outcomes of ischaemic stroke, and their relationship to short-term post-stroke disability, as captured by the 3-month modified Rankin Scale (mRS) - the favoured primary outcome measure in acute stroke trials. I use data from the Oxford Vascular Study (recruited 2002-2014), a population-based prospective cohort for which I followed patients in-person and via medical records until 15-May-2017. I demonstrate that 3-month mRS strongly predicts 5-year post-stroke disability and mortality, including in clinically-relevant groups (treatable major strokes, atrial fibrillation-related strokes, and lacunar strokes), reaffirming its use as a trial outcome measure. About one in four patients experience functional recovery between 3-12 months post-stroke, and mortality follow-up beyond 1-year by stroke trials can show translation of early disability gains into lower mortality. Contrary to previously reported apparent sex-differences, I find no evidence of worse outcomes in women after accounting for differences in age and pre-stroke mRS. I find that late recovery between 3-12 months occurs more often in lacunar strokes, supporting the focus of restorative therapies in this group, but highlighting that uncontrolled studies cannot assume that improvements after 3-months are treatment-related. In addition, I demonstrate that like death/disability, outcomes of institutionalization, post-stroke dementia, health/social-care costs, and quality-adjusted life expectancy (QALE) also show meaningful differences with each step up the mRS ladder. Consequently, ordinal analysis of the 3-month mRS (capturing transitions across the scale's range) better predicts long-term outcomes than dichotomous approaches, which also foster high exclusion rates of relevant patient segments from trials owing to their pre-morbid disability. However, the mRS should be weighted in ordinal analyses, as different state transitions carry different implications for long-term outcomes. Using 3-month mRS-stratified data for clinical endpoints, care costs, and QALE, I derive mRS weights that could be used for meaningful ordinal analyses, clinical prognostication, and cost-effectiveness analyses of stroke therapies.
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Mberengo, Sarah. "The relationship between socio-economic status and the practice of HIV self-protective/preventive behaviours among the residents of Maruapula, Gaborone." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/79948.
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Thesis (MPhil--Stellenbosch University, 2013.ENGLISH ABSTRACT: The incidence of HIV/AIDS in Botswana is one of the largest in the world taking its toll on many lives and posing developmental challenges to the nation. Nearly 25% of the population is living with HIV and 14% are newly infected; AIDS is acknowledged as the major cause of death. Most HIV and AIDS studies have been dominated by surveillance, biomedical and ethical methodologies. These approaches failed to stem the tide of HIV infection because they did not follow-up with the tracking of risky behaviours and the underlying causes of the behaviours. This research scrutinized socio-economic factors in relation to the spread of the epidemic. Available literature showed that little or no attention has been paid to the socio-economic backgrounds in which individuals exist in connection with understanding HIV and AIDS. This study used an economic model of risky sexual behaviour to explore the link between socio-economic status and the practice of HIV self-protective/preventive behaviours in Maruapula, Gaborone, Botswana. The research is vital as it goes beyond surveillance in an effort to establish why the community of the study is susceptible to HIV infection. This research l used both collected data and that from BAIS II.
AFRIKAANSE OPSOMMING: Die navorsing is oor die verhouding tussen sosio-ekonomiese status en die praktyk van MIV self-protective/preventive gedrag binne Maruapula distrik. Die doel van die studie is om vas te stel of daar 'n verband tussen sosio-ekonomiese status en die praktyk van MIV-voorkomende gedrag onder die inwoners, van Maruapula, Gaborone, Botswana. Data is ingesamel deur die gebruik van vraelyste en die ontleding van die statistiek het getoon dat die is geen verwantskap tussen sosio-ekonomiese status en die praktyk van MIV self-protective/preventive gedrag onder die inwoners. Aanbevelings gebaseer op die bevindinge is gemaak met betrekking tot MIV-voorkoming in die woongebied in die besonder en in die land in die algemeen.
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Van, der Walt I. C. "The impact of HIV/AIDS on the South African labour market." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51980.
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Thesis (MBA)--Stellenbosch University, 2000.ENGLISH ABSTRACT: No disease in modern times has created as much fear and panic as HIV/AIDS - undoubtedly one of the most formidable public health problems facing South Africa today. Traditionally, HIV/AIDS has not been regarded as a workplace issue, except for "high-risk" professions such as surgeons, dentists and emergency medical technicians. The stark reality is that HIV/AIDS will have an impact on all sectors of society and all aspects of human activity throughout South Africa. Because of the nature of the spread of the disease, it hits predominantly sexually active people. These are the people that make up the workforce. It can therefore be expected that HIV/AIDS will impact directly on the patterns of employment in South Africa. Furthermore, the economic consequences of the epidemic will result in pressures on the South African economy, which again will influence employment. Apart from affecting the general population, HIV/AIDS will have a direct impact on businesses in various areas. HIV/AIDS will also have a significant impact at community level that will, in turn, impact on businesses. If business in South Africa is to survive, these impacts have to be managed so that productivity can be maintained and costs can be contained. The objective of this study is to explore the impact of HIV/AIDS on employment by examining the South African labour market. From the study, it is clear that South Africa is certain to experience severe consequences arising from the HIV/AIDS epidemic. Even without taking the immense impact of HIV/AIDS into account, there are various problems facing the' South African labour market. Specific problems discussed are unemployment, low productivity and a shortage of skills. These are not the only problems associated with the South African labour market, but the extent of these problems is further exacerbated by the impact of HIV/AIDS. All sectors of the society need to be mobilised into action. This action must encompass both prevention of the spread of the disease, as well as caring for the sick and dying.
AFRIKAANSE OPSOMMING: Geen ander siekte in die moderne tyd het al soveel vrees en paniek geskep as MIV/VIGS nie ongetwyfeld een van die mees formidabele gemeenskapsgesondheidsprobleme wat Suid-Afrika huidiglik in die gesig staar. Oorspronklik was MIV/VIGS slegs met die werksplek geassosieer in terme van "hoë-risiko" beroepe soos dokters, tandartse en nood mediese personeel. Die naakte waarheid is dat MIV/VIGS 'n impak sal hê op alle sektore en aspekte van die samelewing in Suid-Afrika. As gevolg van die aard van die verspreiding van die siekte, tref dit hoofsaaklik seksueel aktiewe persone. Hierdie persone is die lewensaar van die arbeidsmag. Dit kan dus verwag word dat MIV/VIGS 'n direkte impak op werkverskaffingspatrone in Suid-Afrika sal hê. Die ekonomiese gevolge van die epidemie sal verdere druk veroorsaak op die Suid-Afrikaanse ekonomie, wat op sy beurt werkverskaffing sal beïnvloed. Buiten die impak van MIV/VIGS op die algemene bevolking, sal die siekte ook in verskeie areas van die besigheidsektor 'n uitwerking hê. Verder sal MIV/VIGS 'n aansienlike impak op gemeenskapsvlak hê, wat op sy beurt weer 'n uitwerking sal hê op besighede. As besighede in Suid-Afrika wil oorleef, moet hierdie aanslae so bestuur word dat produktiwiteit gehandhaaf word en kostes onder beheer gehou word. Die oogmerk van hierdie studie is om die impak van MIV/VIGS op werkverskaffing te ondersoek deur na die Suid-Afrikaanse arbeidsmark te kyk. Van die studie is dit duidelik dat Suid-Afrika ernstige konsekwensies as gevolg van die MIV/VIGS epidemie kan verwag. Selfs sonder om die ontsaglike impak van MIV/VIGS in ag te neem, is daar verskeie probleme wat die Suid-Afrikaanse arbeidsmark in die gesig staar. Spesifieke probleme wat bespreek word is werkloosheid, lae produktiwiteit en 'n tekort aan gespesialiseerde vaardighede. Alhoewel hierdie nie die enigste probleme is wat met die Suid-Afrikaanse arbeidsmark geassosieer word nie, word die spesifieke probleme vererger deur die impak van MIV/VIGS. Wat vereis word is dat alle sektore van die samelewing moet oorgaan tot aksie. Hierdie aksie moet beide die voorkoming van die verspreiding van die siekte, sowel as die versorging van die siekes en sterwendes omvat.
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Erstad, Ida. "The resurgence of tuberculosis in South Africa: an investigation into socio-economic aspects of the disease in a context of structural violence in Grahamstown, Eastern Cape." Thesis, Rhodes University, 2007. http://hdl.handle.net/10962/d1002653.
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This thesis is an investigation into the socio-economic constraints that influence the decisions of tuberculosis sufferers in the health seeking process and therapeutic management of tuberculosis in Grahamstown, the Eastern Cape. It is shown that structural violence influences experiences and perceptions of tuberculosis at all levels. Management of tuberculosis in the formal health sector is explored at local levels and related to national and global strategies of health care. The role of health workers, and particularly voluntary health workers, is explored and it is shown that they work within a context of growing burden of sickness and co-infections and a lack of government commitment to deal with increasing TB and HIV incidences. Kleinman’s notion of explanatory models is explored and it is evident that although knowledge of the aetiology of tuberculosis is well-known to patients and general members of the communities, they are nevertheless victims of increased stigmatisation and marginalisation as a result of illness. The importance of social support in curing tuberculosis is explored using Janzen’s concept of therapy managing groups. Social capital is a fundamental component in adhering to biomedical therapy, but is commonly weak among the structurally poor. The availability of temporary social grants for people living with TB influences health seeking behaviour. In a context of structural poverty the sick are faced with what Nattrass terms “perverse incentives”, having to choose between the right to health and the right to social security, both guaranteed in the South African Constitution, for him/herself and dependants. Although adherence to biomedical therapy is essential in curing tuberculosis, it is shown throughout this thesis that ignoring wider structural causes of disease limits the patient’s ability to get well. The ethnography shows that the right to health is a social and economic right which is not the reality for most South Africans.
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Hughes, Edward Peter Clive. "The strategic impact of HIV/AIDS on first level component suppliers to the motor industry, located in the Nelson Mandela Metropole." Thesis, Port Elizabeth Technikon, 2001. http://hdl.handle.net/10948/d1006722.
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HIV/AIDS is undoubtedly the single most important and daunting health problem facing Africa. Globally too, this is one of the most serious health, medical and social preoccupations of our time (Chinery-Hesse, 2000: 1). The aim of this research study is to evaluate the strategic impact of HIV/AIDS on first level component suppliers to the motor industry located in the Nelson Mandela Metropole. To achieve this aim a literature study was undertaken to determine the patterns of development, the infection statistics and to explore strategic options and actions for dealing with the effects of the disease. An empirical study has been conducted to assess the opinions of senior management within first level component suppliers. The results from the study indicate that most companies in the selected group believe that HIV/AIDS will have a serious impact on their organisations. In conclusion, various recommendations have been made with regards to the findings ascertained in the literature review and empirical study.
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Burt, Mary. "An exploration of the impact of AIDS-related losses and role changes on grandmothers." Thesis, Rhodes University, 2004. http://hdl.handle.net/10962/d1006487.
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The US Bureau of the Census (1999) projected that by 2004, 14 million people in sub-Saharan Africa will develop full blown AIDS, making this region by far the largest disease burden in the world (World Health Organization, 2002). The United Nations AIDS Programme judged South Africa to have the leading number of people living with HIV/AIDS worldwide (World Health Organisation, 2002). To date there has been extensive research conducted on the socio-economic impacts of HIV/AIDS on families in Africa. However an area of investigation that has remained largely underreported is the inquiry into the psychological impacts of HIV/AIDS on elderly caregivers. In African families older women increasingly have to provide care to their adult children with AIDS and their orphaned grandchildren. However few research studies have assessed the experience of parental caregiving and its psychological impacts on these women. This qualitative research study hypothesised that the role of primary parental caregiver in fact causes a range of psychologically distressing states, which serve to compromise the psychological well-being of these caregivers. To investigate this hypothesis three Xhosa speaking women living in informal settlements in Grahamstown, in the Eastern Cape Province of South Africa were selected for the study. The women were interviewed by means of semi-structured interviews, which consisted of questions related to their caregiving experiences, their experiences of loss, their choice of coping strategies, the role of support networks and their experiences of foster care responsibilities. The interviews were transcribed and analysed using a grounded hermeneutic approach. The research results confirmed the working hypothesis. The research revealed that although it was considered culturally appropriate for older women to care for their children and grandchildren, their caregiver roles caused significant psychological distress. Their distress was related to: emotional and physical exhaustion, complicated grief reactions and ongoing emotional and physical upheaval related to foster care responsibilities. Based on the results, the research recommendations emphasised the need for continual awareness of the psychological implications of caregiving for older African women with the aim to preserve their capacity to function as the primary caring resource to families struck by HIV/AIDS.
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Tladi, Jack Moeketsi. "The potential impact of HIV/AIDS on the financial performances of S. A. companies." Thesis, Stellenbosch : Stellenbosch University, 2005. http://hdl.handle.net/10019.1/50509.
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Thesis (MPhil)--Stellenbosch University, 2005.ENGLISH ABSTRACT: Despite the seriousness of HIV and AIDS affecting productivity at workplaces, little attention is being paid to the special needs of the infected people in the world of work and the ultimate reality this will have on the companies’ financial health. HIV/AIDS retards economic development and business growth. The epidemic influences the workforce and markets in which business operates. Business must play a leading part in the internal response to HIV/AIDS pandemic. This is both an ethical imperative and the key to business success. Most research conducted on the subject mainly concentrated on the effects of HIV and AIDS on productivity, emphasizing absenteeism as the direct cause of low productivity. The costs of HIV and AIDS will be felt beyond the direct effect of the disease. The indirect costs include the following: The increased costs of recruiting and training, given the extra deaths and disabilities expected. The negative effect on staff morale Loss of time as a result of management and labor meetings to discuss the AIDS crisis as it develops, this resulting in loss of turnover and profits. With the rising prevalence of HIV/AIDS, businesses should be increasingly concerned about the impact of the disease on their organizations-concerns that should be well founded. At the broadest level, businesses are dependent on the strength and vitality of the economies in which they operate. HIV/AIDS raises the costs of doing business, reduces productivity and lowers overall demand for goods and services. The research process in this article focused particularly on workplace issues, which are a key dimension of the relationship between corporations and HIV/AIDS. Data collection was by both structured questionnaires and unstructured interviews, interviews with both management and workers’ representatives and structured questionnaires with the general workforce. The questions asked were open-ended: “Is HIV/AIDS a problem for your company now or in the future?” and “If HIV/AIDS impacted on your company’ financial performance would you act and why?” The research group consisted of four companies in different areas of operations: retail, service and manufacturing and the participants were chosen on the basis of certain inclusive criteria: The number of employees employed. Length of service operation. Willingness to share certain financial information. A qualitative method of data analysis was used in the study and is described in detail. The qualitative research method looks at the subjective meanings attached, descriptions, metaphors, symbols and descriptions of specific cases. It was found that despite the differences from one company to the other, the potential impact of HIV/AIDS on companies’ financials went beyond the direct costs of productivity. As the debate over the availability of cheaper generic anti-retroviral drugs rages in the background, business is faced with the dilemma of significant investment to keep their labour force healthy and alive. This has to be weighed up against the high costs involved in rehiring, retraining and re-incentivising their replacements.
AFRIKAANSE OPSOMMING: Ten spyte van tekens dat MIV en VIGS produktiwiteit in die werkplek affekteer, word daar nog baie min te doen aan die behoeftes van die werkers wat deur die epidemie getref word. Verder, word min aandag geskenk aan die potensiële uitwerking van die epidemie op die finansiële gesondheid van maatskappye. MIV/VIGS vertraag ekonomiese ontwikkeling en besigheidsgroei. Die epidemie het ‘n negatiewe impak op die arbeidsmag en die market waarin besigheid plaasvind. Besigheid moet dus die leiding neem in die interne respons op die MIV/VIGS pandemie. Dit is eties belangrik en die sleutel tot die sukses van besigheid. Die meeste navorsing oor die onderwerp het tot dusver gekonsentreer op die effek van MIV en VIGS op produktiwiteit met die klem op afwesigheid as ‘n direkte oorsaak van lae produktiwiteit. Die koste van MIV en VIGS behels egter veel meer as net die direkte gevolge van die siekte. Die indirekte koste sluit die volgende in: Die koste verbonde aan opleiding en die soeke na nuwe personeel weens sterftes en siekte van personeel. Die negatiewe effek op die moraal van personeel. Verlore tyd as gevolg van bestuurs- en arbeidsvergaderings om die VIGS-krisis te bespreek namate dit ontwikkel en winste negatief beïnvloed. Besigheid behoort meer bekommerd te wees oor die toename in MIV/VIGS gevalle en die impak wat dit op organisasies sal hê. MIV/VIGS verhoog die kostes van besigheid doen, verminder produktiwiteit en verlaag die algemene vraag na goedere en dienste. Die navorsingsbenadering in die artikel fokus op daardie werkplek-aangeleenthede wat ‘n sleuteldimensie is van die verhouding tussen organisasies en MIV/VIGS. Data is ingewin deur middel van gestruktureerde vraelyste en ongestruktureerde onderhoude. Onderhoude is met beide bestuurslui en verteenwoordigers van werkers gevoer, en gestruktureerde vrae met die werkers. Die vrae gestel was oop vrae soos “Is MIV/VIGS `n problem vir u onderneming huidiglik of in die toekoms? En “Indien MIV/VIGS ‘n negatiewe impak het op die onderming se prestasie sal jy optree en waarom?” Die navorsingsgroep het bestaan uit vier ondernemings in die kleinhandels-, dienslewerings-, en vervaardigingssektor. Die deelnemers is gekies op die basis van inklusiwiteit met die volgende criteria: Die getal werkers in diens. Hoe lank is onderneming in besigheid? Die bereidwilligheid om inligting te deel. `n Kwalitatiewe metode van data analise is gebruik wat breedvoerig verduidelik en beskryf word. Die navorsingsmetode kyk veral na subjektiewe betekenisse, omskrywings, metafore, simbole en omskrywings van spesifieke gevalle. Navorsing het getoon dat MIV/VIGS ‘n impak het op ondernemings se finansiële omstandighede en produktiwiteit. Terwyl die debat oor goedkoper generiese anti-retrovirale middele aan die gang is, word ondernemings of besighede konfronteer met die keuse tussen beduidende investering om die arbeidsmag gesond en lewendig te hou of die hoë koste van herindiensneming, heropleiding en insentiewe.
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Weyer, Dylan James. "Assessing linkages between local ecological knowledge, HIV/AIDS and the commercialisation of natural resources across Southern Africa." Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1007180.
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That natural resources (NRs) are important to those experiencing adversity, and, especially, vulnerability associated with HIV/AIDS, is well documented, particularly with respect to food and energy security. What is unclear is where HIV/AIDS ranks in terms of its significance in comparison to other household shocks, the role local ecological knowledge may (LEK) play in households' response to shock, a propos the types of coping strategies that are employed. Consequently, this research aims to bridge the knowledge gap between HIV/AIDS and the degree to which it is contributing to the expansion of NR commercialisation and to explore the unknowns surrounding the influence of LEK on people's choice of coping strategy. A two phase study was designed to provide quantitative rigour with qualitative depth. Phase one was an extensive, rapid survey of NR traders within urban and rural settings in five southern Africa countries. The principle objective was to profile the trade, the livelihoods of those involved and their reasons for entering the trade, to ultimately establish to what degree HIV/AIDS may have been a catalyst for this. Almost one third of the sample entered the trade in response to illness and/or death in their households, with 80% of deaths being of breadwinners. The findings illustrated considerable dependence on the sale of NRs; for almost 60% of the sample it was their household's only source of income. There was evidently increased blurring of the lines between rural and urban NR use with a greater diversity of products being traded in urban areas. Phase two involved in-depth interviews and work with a smaller sample at two sites selected based on the findings from the first phase. It incorporated three groups of households; non-trading, inexperienced trading and experienced trading households. Key areas of focus were household shocks, coping strategies employed in response to these and the role LEK may be playing in the choice of coping strategies. Within a two year period, 95% of households registered at least one shock, of which 80% recorded AIDS-related proxy shocks. Non-trading households were significantly worse-off in this regard, while in the case of non-AIDS proxy shocks, there was no such difference between groups. The most frequently employed coping strategy was the consumption and sale of NRs and was of particular importance when households were faced with AIDS proxy shocks. Trading households emerged as having superior levels of LEK in comparison to non-trading households, even for non-traded NRs, suggesting that prior LEK of NRs opened up opportunities to trade in NR as a coping strategy. Further inspection of the latter group however revealed that the portion of non-trading households who traded on a very ad hoc basis actually had comparable levels of LEK to the trading households. Despite the ad hoc trading households' vulnerable state and their disproportionately high level of AIDS proxy measures, they had at their disposal, sufficient LEK to unlock certain key coping strategies, namely the NR trade. In this sense there are apparent linkages between LEK, HIV/AIDS and the expansion of the commercialisation of NRs.
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Clarke, Caryn Lee. "Responses to the linked stressors of climate change and HIV/AIDS amongst vulnerable rural households in the Eastern Cape, South Africa." Thesis, Rhodes University, 2013. http://hdl.handle.net/10962/d1003818.
Full textAbstract:
Climate change and the HIV/AIDS epidemic are two of the most critical long-term global challenges, especially for Africa and even more so Southern Africa. There is great concern that the poor will be unable to adapt to the impacts of climate variability and change while HIV/AIDS will exacerbate the impacts of such stressors and deepen the insecurities of many communities already affected by this disease. Studies that consider the interlinked effects of climate change and HIV/AIDS along with other multiple stressors are increasingly needed. This study, located in two rural communities in the Eastern Cape Province of South Africa, namely Lesseyton and Willowvale, assessed the responses of vulnerable households to the linked shocks and stressors of climate change and HIV/AIDS. This involved assessing, through household surveys, life history interviews and Participatory Learning and Action (PLA), the way in which multiple stressors interacted and affected vulnerable households, the way in which these households responded to and coped with such shocks and stressors, and the barriers which prevented them from coping and adapting effectively. Unemployment emerged as the dominant stress amongst households. The lack of development and having too few opportunities for employment has limited vulnerable households from being able to invest in assets, such as education or farming equipment. This, in combination with the impacts of increased food and water insecurity from recent drought, has created an extremely vulnerable environment for these households. They rely largely on two important safety-nets, namely social capital and the use of natural and cultivated resources; however the latter has been limited due to the impacts of water scarcity and an inability to farm. It was evident that there was little planned long-term adaptation amongst households and from government. Maladaptive short-term coping strategies, such numerous household members depending on one social grant and transactional sex, were too often relied upon, and although they may have helped relieve the stress of shocks momentarily, they did not provide for the long-term well-being of individuals and households. Poor communication and capacity between the different levels of government and between the government (especially at the local level) and the two rural communities has created an environment full of uncertainty and lacking in advocacy. Local government needs increased human, informational, and financial capacity and a clear delegation of responsibilities amongst the different departments in order for the two communities to benefit from the implementation of support strategies. There is also a great need for educational programmes and capacity development within the two rural communities, particularly based on improved coping and longer-term adaptation strategies in response to climate change in order for households to better prepare themselves for the future.
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Linderts, Gavin Sebastian. "Estimating the HIV prevalence among permanent employees of Old Mutual (SA) : a case study." Thesis, Stellenbosch : University of Stellenbosch, 2008. http://hdl.handle.net/10019.1/885.
Full textAbstract:
Thesis (MBA (Business Management))--University of Stellenbosch, 2008.AFRIKAANSE OPSOMMING: Menslike immuungebrekvirus (MIV) en Verworwe immuniteitsgebrek sindroom (VIGS) is een van die grootste uitdagings waarvoor werkgewers vandag te staan kom, en behoort die stukrag te wees vir ’n deeglike ondersoek om die voorkoms van hierdie toestand in die werkplek so akkuraat as moontlik te bepaal. So ’n ondersoek kan lig werp op toekomstige demografiese arbeidsmagtendense en verwante koste, byvoorbeeld verlies aan produktiwiteit en dienslewering weens afwesigheid, ’n toename in aftredes, en stygende sieke- en pensioenfondseise wat waarskynlik ingedien sal word. Daarbenewens kan so ’n ondersoek die werkgewer in staat stel om noukeuriger vir die toekoms te beplan, vanuit die oogpunt van finansies sowel as menslike hulpbronne. Daar is egter ’n neiging by werkgewers om MIV/VIGS steeds as ’n maatskaplike of samelewingsprobleem eerder as ’n besigheidspesifieke risiko te beskou. Onkunde is meestal die rede hiervoor. Werkgewers neig om weg te skram van direkte risikobestuur, dikwels met die argument dat dit die regering se plig is om MIV/VIGS-opleiding en gesondheidsorg te voorsien. Sodoende word die bestaande verhouding van ‘ekwilibriumkonvergensie’ tussen die staat, sakesektor en arbeid verydel. MIV/VIGS moet soos ander groot geïdentifiseerde sakerisiko’s beskou, gemeet en proaktief bestuur word, net soos met wisselkoers wisselvalligheid, politieke en infrastrukturele risiko’s, en persoonlike en batesekuriteit. Hoewel hierdie risikofaktore dwarsoor die wêreld bestaan, en sommiges in ander wêrelddele groter is, het hul gekombineerde uitwerking veral in Suider-Afrika ernstige implikasies vir investering en die koste om hier sake te doen. Soos alle ander sakerisiko’s moet die hantering daarvan multidimensioneel wees: • Identifiseer, meet en bestuur die risiko; plaas MIV/VIGS eerste op die direksie se agenda. • Stel senior beamptes aan om die risiko te bestuur. • Evalueer bestuurstrukture en intervensie stappe gereeld. • MIV/VIGS opleiding is die sleutel, vir bestuurslede sowel as werknemers. Risikobestuur moet holisties wees. So byvoorbeeld is dit nutteloos om gesondheidsorg sonder proaktiewe pasiëntebestuur te voorsien. En net soos wat behandelingsplanne sonder befondsing sinloos is, is dit futiel om goed befondsde voordeelplanne te skep as behandeling nie toeganklik is nie. Die doel van hierdie studie is om die proses wat Old Mutual (SA) gevolg het om die voorkoms van MIV onder sy 13 000 permanente werknemers landwyd te eksploreer. Die statistiese uitkoms sal dan gebruik word om te bepaal of Old Mutual (SA) wel sy doelwitte in terme van werknemersgelykheid sal bereik en behou, gegewe die MIV/VIGS pandemie. Vooruitskouings oor die implikasies van MIV/VIGS vir Old Mutual (SA) moet met die nodige omsigtigheid benader word, alhoewel hierdie studie aandui dat dit moontlik implikasies kan inhou vir werkverskaffing in die toekoms, gegewe die wetlike vereistes vir die verskeie aangewese groepe. MIV/VIGS lei nie net tot siekte, ongeskiktheid en dood onder Old Mutual (SA) se werknemers nie. Tesame met ernstige ekonomiese en emosionele ontwrigting vir hul gesinne, verhoog dit ook die koste om in Suid-Afrika sake te doen. Hierdie koste sluit die volgende in: • verhoogde gesondheidsorgkoste; • meer eise vir aftree-, pensioen- en doodsvoordele; • laer produktiwiteit namate afwesigheid van die werk styg weens siekte, hetsy eie of siek familielede na wie omgesien moet word; en • verhoogde koste vir personeelwerwing, arbeidsomset en opleiding weens die verlies van ervare personeel.
ENGLISH ABSTRACT: Human Immunodeficiency Virus infection and the Acquired Immune Deficiency Syndrome (HIV/AIDS) is one of the greatest challenges facing employers today, and should provide the impetus for a thorough investigation among employees in order to arrive at an estimate of HIV prevalence within the workplace. Such an investigation could shed light on future demographic workforce trends as well as related costs, e.g. loss in productivity and service delivery due to absenteeism, increased retirement and a rise in medical aid and pension fund claims that the employer is likely to encounter. Furthermore, this investigation could enable the employer to plan better for the future – both from a financial and human resources viewpoint. In the ‘real’ world though, employers still perceive HIV/AIDS as a social or community problem rather than a business specific risk. Employers, largely through ignorance, tend to shy away from direct risk management – often using the argument that it is the government’s responsibility to provide HIV/AIDS education and healthcare. In this way they nullify the existing ‘equilibrium convergence’ relationship between the state, business and labour. HIV/AIDS must be measured and proactively managed and should be regarded in the same light as other major identified business risks, e.g. personal and asset security, exchange rate volatility, and political and infrastructure risks. While it is true that all of these particular risk factors exist across the globe, and may be greater in other parts of the world, nowhere else do they seem to combine with such severe implications to deter investment and raise the cost of doing business than in Southern Africa. As for any other business risk, the response should be multi-dimensional: • Identify, measure and manage; place HIV/AIDS at the top of board agendas. • Appoint senior executives to manage the risk. • Regularly evaluate management structures and interventions. • HIV/AIDS education is key to both management and employees. Risk management should be holistic. For example, providing healthcare without proactive patient management is pointless. Similarly, treatment plans without funding are futile, and well-funded benefit plans without practical access to treatment are a waste of time. The aim of this study is to explore the process Old Mutual (SA) followed in estimating the HIV prevalence among its 13 000 permanent employees nationally. The resultant statistics would then be used to project whether or not Old Mutual (SA) will be able to achieve and sustain its employment equity targets, given the HIV/AIDS pandemic. Predictions on the implications of HIV/AIDS for Old Mutual (SA) should be approached with due caution, although this study suggests that it could probably seriously impact on shortages in the supply of labour in future, given the legislative requirements for the various designated groupings. HIV/AIDS not only causes illness, disability and death among Old Mutual (SA) employees, coupled with severe economic and emotional disruption for their families, it also increases the cost of doing business in South Africa. These costs include: • increased healthcare expenses; • increased retirement, pension and death benefit claims; • decreased productivity as worker absenteeism rises owing to personal illness, or absence from work to care for sick relatives; and • increased recruitment, labour turnover and training costs due to loss of experienced workers.
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Ng, Wai-leung Weland, and 伍偉良. "A study of the impact of SARS on air transport demand in Hong Kong: the case of Cathay Pacific Airways." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B29831489.
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Stadler, Leigh Tessa. "Assessing household assets to understand vulnerability to HIV/Aids and climate change in the Eastern Cape, South Africa." Thesis, Rhodes University, 2013. http://hdl.handle.net/10962/d1001655.
Full textAbstract:
Livelihood stressors in southern Africa, such as HIV/Aids and climate change, do not act in isolation but rather interact concurrently in complex socio-ecological systems with diverse, interrelated and compounded affects. Households experience differential vulnerability to such stressors based on contextual factors such as geographical location, income level and the gender and age of its members. Households’ differential experiences of vulnerability are further defined by the households’ use of their capital stocks: the human, social, natural, financial and physical capital available to the household to form livelihoods and resist the detrimental effects of a stressor. The capital stocks of 340 households were measured in two sites in the Eastern Cape, South Africa, using a household survey. These data were analysed to determine differences between the sites, households with heads of different gender and households of different income levels. Further data relating to the drivers and interactions of stressors over temporal and spatial scales, as well as the perceived value of various forms of capital by different social groups in the two sites, were collected via Participatory Learning and Action (PLA) methods including timelines, mental modelling and pair-wise ranking. Although the two sites have similar levels of income and fall within the same province, many significant differences emerged. The two sites showed different distributions of household head genders and different stressors and perceptions of vulnerability, perhaps owing to differences in their capital stocks, acting alongside the influence of culture and access on a shifting rural-urban continuum. These discrepancies further transpired to reflect crucial differential experiences along gender lines and income levels in each site. Vulnerability was often context specific, not only because of unique drivers of stress in different areas, but also because socio-economic groups and localities often had characteristics that could potentially exacerbate vulnerability, as well as characteristics that can potentially facilitate adaptive capacity. Stressors were found to have depleted multiple forms of capital over time, while new stressors were emerging, raising concerns over the most appropriate means of social protection within these contexts.
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White, Stephen Mark. "Assessing the impact of the Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome on Volkswagen of South Africa." Thesis, Port Elizabeth Technikon, 2001. http://hdl.handle.net/10948/40.
Full textAbstract:
This treatise takes the form of an impact study. It is based on a three-month period of research involving literature review, interviews with VWSA officers and a survey of 111 of the 5500 workers who comprised the workforce of the VWSA plant in Uitenhage at that time. The author has attempted to portray the general views of experts in the field of HIV/AIDS corporate impact and impact management. In addition he has attempted to assay the current and forecast policies and practices in respect of the management of the epidemic by VWSA. The workers in the plant were consulted by survey and a variety of insights into the level of understanding of the epidemic, tolerance levels, expectations and so on were made. The quantification of these insights must be viewed with caution since the survey sample of 111 was relatively low for a workforce of circa 5500. Calculations in respect of representativity are included to facilitate calculated caution. It has been shown that the HIV/AIDS epidemic has a considerable current impact on the company and that this impact can be expected to grow considerably in the future. It has been suggested that an active intervention program would be well timed if implemented immediately
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Kaschula, S. A. H. "The impact of HIV and AIDS on household food security and food acquisition strategies in South Africa." Thesis, Rhodes University, 2009. http://hdl.handle.net/10962/d1007137.
Full textAbstract:
How should the impact of HIV and AIDS on rural livelihoods be factored into efforts to monitor and stabilise household food security? With both HIV and AIDS and food security at the top of the global development agenda, this is a question posed by many scholars, practitioners, donor agencies and government departments. However, while there is an excess of discourse outlining the theoretical bases for how HIV and AIDS can, and is, radically transforming household food acquisition; there is a lack of empirical evidence from the South African context that demonstrates if, and how, HIV and AIDS changes household-level strategies of food acquisition and intake. This thesis explores the association of household-level mortality, chronic illness and additional child-dependent fostering with household experience of food security and food acquisition strategies, in three rural villages in the Eastern Cape and KwaZulu-Natal Provinces of South Africa. Qualitative and quantitative methods of data-collection were applied to 307 households in the three sites. For twelve months, both HIV and AIDS-afflicted and non-afflicted households were repeatedly visited at 3-month intervals, in order to be assessed for levels of food security, dietary intake and method of food procurement (purchased, cultivated, wild or donated). Overall, HIV and AIDS-afflicted households showed a significantly higher experience of food insecurity, probably attributable to shortages in food quantity. Dietary composition and overall diversity, however, was not significantly different. Although households with chronic illness and recent mortality showed a heightened investment in cultivation sources, the success of these strategies were to a great extent mediated by household income, and the level of medical treatment received by those who were chronically ill. Chronic illness was also associated with more donations, but these required considerable investments in social capital networks. Finally, use of wild leafy vegetables was not associated with household HIV and AIDS status, despite the financial, nutritional and labour-saving properties of these foods. Overall, the study suggests that there was little evidence of long-term planning and strategy in household food security responses. There was no evidence for shifts to labour-saving crops or foods and, in some instances, child labour was being used to ameliorate prime-adult labour deficits. Moreover, given that the vast majority (89.2%) of food groups were sourced through purchase, it is questionable whether investing in diverse food acquisition strategies would be advisable. Unless supported by medical treatment and steady earned household income, policies to promote intensified household agricultural subsistence production in the wake of HIV and AIDS are unlikely to provide households with anything more than short-term safety-nets, rather than long-term, sustainable food security solutions.
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Abu-Basutu, Keitometsi Ngulube. "Relative contribution of wild foods to individual and household food security in the context of increasing vulnerability due to HIV/AIDS and climate variability." Thesis, Rhodes University, 2014. http://hdl.handle.net/10962/d1010864.
Full textAbstract:
Wild foods are an integral component of the household food basket, yet their quantified contribution to food security relative to other sources in the context of HIV/AIDS, climate change and variability remains underexplored. This study was carried out in Willowvale and Lesseyton which are rural communities in the Eastern Cape province of South Africa. Willowvale is a relatively remote, medium-rainfall coastal community, while Lesseyton is a peri-urban low rainfall inland community. Qualitative and quantitative methods were used to collect data from 78 HIV/AIDS afflicted households with 329 individuals and 87 non-afflicted households with 365 individuals in the two study sites. Households were visited quarterly over 12 months to assess food acquisition methods, dietary intake and quality, and levels of food security, and to determine strategies employed by households to cope with droughts. The wild foods investigated were wild meat, wild birds, wild fish, wild mushrooms, wild leafy vegetables and wild fruits. Diets were moderately well-balanced and limited in variety, with cereal items contributing 52 % to total calorie intake. Mid-upper arm circumference measurements showed that all respondents were adequately nourished. The bulk of the food consumed by households was purchased, with supplementation from own production, wild vegetables and wild fruits. In Willowvale, wild vegetables comprised 46 % of overall vegetable consumption for afflicted households and 32 % for non-afflicted households, while own fruit production comprised 100 % of fruit consumption. In Lesseyton, wild vegetables comprised only 6 % and 4 % of vegetable consumption for afflicted and non-afflicted households, while wild fruit comprised 63 % and 41 % for afflicted and non-afflicted households. More than 80 % of respondents from both afflicted and non-afflicted households had sufficient daily kilocalories, although the majority of afflicted households felt they were food insecure and sometimes collected wild foods as one of their multiple coping strategies. Hunting and gathering of wild foods was associated with site, household affliction status, gender, age and season. More than 80 % of respondents ate wild vegetables and said they were more drought tolerant than conventional vegetables, making them the most consumed wild food and approximately 16 % of respondents ate wild birds, making them the least consumed wild food. Approximately 14 % of respondents from afflicted households in Willowvale sold wild fish, whilst 34 % of respondents from afflicted households and 7 % from non-afflicted households sold wild fruits in Lesseyton. Strategies adopted by households to cope with droughts were different between the two study sites, and households in Willowvale used a wider range of strategies. Given the devastating effects of HIV/AIDS coupled with the drawbacks of climate change and variability on food security, wild foods represent a free and easy way for vulnerable households to obtain food.
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Mulonya, Rodrick K. A. R. "The political economy of development aid: an investigation of three donor-funded HIV/AIDS programmes broadcast by Malawi television from 2004 to 2007." Thesis, Rhodes University, 2010. http://hdl.handle.net/10962/d1002926.
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Development aid in most of the developing countries can sometimes compromise the principles of public service broadcasting (PSB). This may be true when reflected against the tension between donor financed programmes in Malawi and the mandate of Television Malawi (TVM). Although the donor intentions are noble, the strings attached to the funding are sometimes retrogressive to the role of PSBs. A case in point is how donors dictate terms on the HIV/Aids communication strategies at TVM. Producers receive money from donors with strings attached on how the money should be used and accounted for. If producers deviate they are sanctioned through withholding funding, shifting schedules and reducing the funding frequency. The donors also dictate who to interview on what subject, how to conduct capacity building. Some scholars have researched much on the impact of commercialisation of the media. This study is a departure from these traditional interferences; it interrogates the interest of philanthropy tendencies by international donors in the three chosen HIV/Aids programmes broadcast by TVM. The study investigates the extent of pressure exerted by donors on the producers of HIV/Aids programmes in Malawi. Thus, the study seeks to illicit specifics in the power relationship between the donor and the producer hence the study employs the political economy of development aid as applied to the public service broadcasting and communication for development. The study employed qualitative research methods and techniques (in-depth interviews, case study and document analysis). The study reveals how donor ideologies dominate the Aids messages-content output of the texts constructed. The study argues that cultural alienation of the Malawian audiences retards efforts of donors in combating HIV infection rate.
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Mailula, Gaefele Simon. "Listening to the unheard stories of children affected by HIV and AIDS in a bereavement process in the Mamelodi Township of Tshwane a narrative research study /." Thesis, Pretoria [s.n.], 2009. http://upetd.up.ac.za/thesis/avaialble/etd-09252009-011209/.
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"Socioeconomic development and stroke mortality in the world." Thesis, 2008. http://library.cuhk.edu.hk/record=b6074575.
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In conclusion, SED is a predictor of stroke mortality. Both childhood and adulthood SED were related to the risk of stroke. Stroke mortality increased with improving SED at a lower stage of development, while it decreased with SED improvement at a higher stage of development. The analysis was conducted among middle- or high-income countries/regions as data only available there. Investigation for low-income countries is warranted as data become available.Keywords. Socioeconomic development; stroke; mortality
Socioeconomic development (SED) relates to the prevalence of risk factors of stroke and influence health policy. We aim to explore the association of (SED) in childhood and adulthood with stroke mortality among countries/regions, and to examine its impact on time trend of stroke mortality.
The ecological study used data on stroke mortality in five-year age group among countries/regions with death registry covering > 70% population provided by the World Health Organization. SED was measured by Human Development Index (HDI), a composite indicator with longevity, education and standard of living, obtained from the United Nations. Mortality rates (1950-2003) were averaged over three years and in logarithmical scale. HDI from 1960 to 2003 were available for this analysis. The effect of HDI on stroke mortality was analyzed and the major confounders, such as prevalence of hypertension, smoking, diabetes, obesity, and the level of dietary fat and alcohol consumption were adjusted for using regression model.
The results revealed that stroke mortality was inversely associated with HDI in childhood and adulthood respectively. Childhood HDI explained 36% of variance of stroke mortality among countries/regions in men and 35% in women; while adulthood HDI interpreted 34% in men and 52% in women (P < 0.01); annual change of stroke mortality was inversely associated with that of HDI. The peak of stroke mortality was exhibited at HDI = 0.79-0.83 for men and 0.80-0.83 for women. Stroke mortality increased with HDI where HDI < 0.79 for men and 0.80 for women, while it decreased with HDI improvement where HDI > 0.83 for men and women. Controlling for confounders did not materially change the results.
Wu, Shenghui.
Adviser: Xin-Hua Zhang.
Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3468.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2008.
Includes bibliographical references (leaves 189-218).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts in English and Chinese.
School code: 1307.
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"Depression and quality of life in stroke: a magnetic resonance imaging study." Thesis, 2011. http://library.cuhk.edu.hk/record=b6075402.
Full textAbstract:
Lu, Jinyan.Thesis (Ph.D.)--Chinese University of Hong Kong, 2011.
Includes bibliographical references (leaves 75-86).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstract also in Chinese; some appendixes in Chinese.
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Naidu, Veni. "The economic impact of HIV/AIDS on urban households." Thesis, 2004. http://hdl.handle.net/10413/4301.
Full textAbstract:
The overall objectives of the study are to analyse the economic impact of
HIV/AIDS on income-earning urban households and in so doing to develop a
methodology for HIV/AIDS household surveys. The study started with 125
households in the first wave. Of these, 113 households were followed over 4
waves (2), over a 12-month period, and across two cohorts referred to as affected (3) and non-affected (4) households. Data on the household were collected from the financial head (5) using the diary method. The methodology for this study was done after a review of 33 HIV/AIDS economic studies conducted around the world. The study obtained buy-in and support from various stakeholders in government, nongovernment organisations, community, academic and funding institutions as from people living with HIV/AIDS. Due to the comprehensive design of the research instrument, the study is able to draw relationships between the various facets of the household and the possible influence that HIV/AIDS has on them. Methodologically, the study found that there are "hidden" costs of morbidity and mortality that needs to be quantified. The costs of health care and funerals are higher in the affected cohort, as expected, due to the frequency of illness or death and not necessarily because there are cost differences as a result of whether a household member has HIV/AIDS or not. The key finding is that affected households re-organise themselves in terms of household size, composition and structure as well as through transfers in, income from grants and other non-market sources, especially to pay for funeral costs. Surviving members are affected not only socially and economically but also psychologically and the needs of this group should not be ignored. (2) Each visit is referred to as a wave
(3) Affected household is a household where at least one person is HIV positive
(4) Non-Affected household is a household where the index case is HIV negative and no other members presented with an HIV/AIDS-related symptom
(5) The person responsible for the finances in the household.Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2004.