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Payne, Linda Gail. "The experience of caring for women with drug or alcohol problems in the general hospital." Thesis, Florida Atlantic University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10154941.
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The purpose of this study was to describe the lived experience of nurses who care for hospitalized women outside of an addiction treatment setting who have a problem with drugs and / or alcohol. The relational experiences of ten registered nurses who had cared for women with drug and alcohol problems were elicited. Heideggerian hermeneutic phenomenology was the method used to interpret the nurse participants’ meaning of their experience. The theoretical framework that was used to explore the nurses’ experience of caring for women who abuse or are dependent on alcohol was Boykin and Schoenhofer’s Nursing as Caring (1993). The relational themes that emerged were: Caring in the dark; Intentionally knowing the woman with AOD as a unique person; and Experiencing sisterhood.
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Thomson, Laura Katherine. "Environmental estrogens and vulnerable bodies: A sociological analysis of activist-initiated collaborative research." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2010. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3390081.
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Banks, Beth Ellen Lawing 1959. "Women and childhood trauma: A handbook for substance abuse counselors." Thesis, The University of Arizona, 1993. http://hdl.handle.net/10150/278366.
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Research indicates that at least half of all women substance abusers were abused in childhood and this trauma negatively impacts substance abuse recovery. Professionals in the field agree that substance abuse counselors need to understand trauma, its effects, and treatment in order to work with their female clients. The purpose of this thesis was to develop a handbook to assist substance abuse counselors in private practice in assessing and treating child abuse trauma in women substance abusers. The handbook was developed through the historical research method and the action method of applied research. The handbook outline and completed manuscript were evaluated by substance abuse counselors in private practice with experience counseling trauma survivors. The evaluations indicated the handbook would be useful for substance abuse counselors. Recommendations for changes suggested by the evaluators will be made prior to publication. Implications for further research on women substance abusers and childhood trauma are presented.
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Nichols, Rebecca Naegle. "Spiritual and physical health habits in middle-aged religious women." [Bloomington, Ind.] : Indiana University, 2005. http://wwwlib.umi.com/dissertations/fullcit/3167796.
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Thesis (Ph.D.)--Indiana University, School of Health, Physical Education and Recreation, 2005.Title from PDF t.p. (viewed Dec. 3, 2008). Source: Dissertation Abstracts International, Volume: 66-04, Section: A, page: 1286. Adviser: Ruth C. Engs.
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Reinschmidt, Kerstin Muller. "Old Colony and General Conference Mennonites in Chihuahua, Mexico: History, representations and women's everyday lives in health and illness." Diss., The University of Arizona, 2001. http://hdl.handle.net/10150/279881.
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During the early 1920s, Old Colony Mennonites emigrated from Canada to Chihuahua, Mexico in order to continue their traditional ways of life in nearly isolated, agricultural communities. As their ancestors had done for centuries, they continued to live in opposition to "the world." While the Old Colony Mennonites basically succeeded in living their distinct, conservative ideology, economic necessities and real world opportunities caused internal disagreements, excommunications and the formation of a new, liberal church, the General Conference, among their midst. North American Mennonite and some European scholars have recorded the history, political economy, socio-religious organization, linguistic and cultural characteristics of these so-called "Mexican Mennonites." What their large-scale perspectives have failed to capture is the everyday lives of the cultural group, the lives of women in particular. Women's worlds have been invisible in the official discourse on Mennonite history, most of which is male-dominated. This dissertation explores the everyday lives of Mennonites in the colonies near Cuauhtemoc, Chihuahua through Mennonite women's eyes. Women's multiple roles at the household level in times of health and illness, and women's moral identities are its focus. Women's habitus and discourses are central in perpetuating Mennonite gendered and moral identities. These identities, expressed in everyday moral living, are the foundation to Mennonite women's health work and local meanings of health. The ethnographic descriptions of women's lives demonstrate how ideology becomes operationalized, and the contrasting of existing literature with my findings exemplifies the articulation of ideology and gender. As an understanding of local Mennonite women's lives requires an appreciation of Mennonite history, socio-economic structure, and the values and norms reproduced by women during their everyday lives, this dissertation has a comprehensive, four-fold structure: Part I summarizes the history of the Mennonites near Cuauhtemoc and analyzes its representational politics; Part II lays out the anthropological processes of fieldwork and writing; Part III describes the contemporary everyday lives of Mennonite women with a focus on their gendered work, including health work, and socializing practice; Part IV discusses the socialization processes of Mennonite women, inherent challenges in Mennonite social structure, and the ways in which Mennonites cope with these challenges.
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Lohn, Christina 1962. "Women's medical knowledge and health care practices concerning the most common respiratory illnesses. A case study of a rural community in northern Germany." Thesis, The University of Arizona, 1991. http://hdl.handle.net/10150/277875.
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In order to stop rising health care expenditures, 81 villagers and their health professionals were interviewed about their medical knowledge (aeteology, symptoms, treatment, illness length, necessity to consult a doctor, etc.) and health care practices concerning common respiratory illnesses. According to informants, sniffles, cough, flu, common cold, sore throat/tonsillitis, bronchitis and sinusitis are the most common respiratory illnesses. All of them are regarded to be caused by several mechanisms of getting cold and/or wet. Despite the general disbelief in the germ theory and the prevention of contagion among household members, informants have an extensive knowledge about effective treatments and consult health professionals when home-remedies fail or a doctor's excuse is needed. Due to the effectiveness of home-treatments and self-containment of most common respiratory infections, this study concludes that health insurance companies should restrict the reimbursement of prescriptions for Bagatellmedizin, inhalation apparatus and home-remedies.
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Savell, Kristin. "Ideal motherideal body." Thesis, McGill University, 1997. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=20545.
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This thesis argues that women's bodies are constituted by discourses about them. It explores the operations of power over women's bodies by analyzing the way in which the maternal body is constructed in the discourses of law, medicine and culture. Chapter One provides a theoretical context for this thesis. It examines the organization of knowledge and its relationship to power within the Western liberal tradition. Power is implicated in the production and dissemination of knowledge about the maternal body in two ways. First, scientific knowledge is privileged in legal and cultural discourses with the effect that knowledge claims based on experience are discredited. Second, scientific knowledge about the fetus, divined through the routine application of diagnostic technologies, has generated new opportunities for scrutinizing the maternal body. This information has been used to create expectations about which bodies are appropriate for reproductive purposes. These points are explored in Chapters Two and Three. Chapter Two is a study of cultural discourses about two women whose pregnancies were condemned on the basis that their bodies deviated from the ideal maternal body. In these stories, each woman was represented as a bad mother for pursuing her pregnancy against medical advice. Chapter Three is a study of the law's response to women who have failed to comply with medical advice deemed necessary for fetal well-being. It analyzes the strategies and implications of legally regulating pregnant women. Overall, this thesis poses a challenge to the way that the maternal body is represented by excavating the partial nature of the claims upon which these representations are based. Further, it argues for a re-conceptualization of the maternal body.
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Huxley, Angie Kay 1963. "The consequences of serum calcium homeostasis, reproductive life history and bone mineral content in postmenopausal women with implications to theories of aging." Diss., The University of Arizona, 1999. http://hdl.handle.net/10150/289006.
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Type I and II osteoporosis will become an increasingly common problem in years to come, since the population structure is changing with the graying of America. This study identifies anthropometric and reproductive variables known to affect bone mineral in a mixed cross-sectional and longitudinal retrospective study. Data were collected from 3120 women and 1222 men throughout Arizona by single photon absorptiometry of the distal third of the radius by Lunar software for bone width, bone mineral content and bone mineral density and anthropometric, reproductive, nutritional and fracture histories. With age-stratified and age-adjusted statistical analyses, important relationships are found to exist between these variables. In females, the anthropometric variables--age, height and weight--are highly correlated with distal third radial width, bone mineral content and density. In males, weight is correlated with distal third radial width; age and weight with bone mineral content; and age, height and weight with bone mineral density. Reproductive variables--age, age at menarche and menopause and total reproductive span--are predictors for women who undergo surgical oophorectomy and hysterectomy, but not those who undergo natural menopause or either surgery. Variables related to pregnancy--age, height, weight, pregnancy duration and span--are predictors of distal third radial width. Only age, height and weight are predictors of bone mineral content. Age, height, weight, age at last pregnancy and one derived ratio are predictors of bone mineral density. When variables related to breastfeeding are incorporated, pregnancy duration and derived ratios are identified for predictors of distal third radial width. Only one ratio is related to bone mineral content, whereas pregnancy number, pregnancy and breastfeeding duration and derived ratios are useful predictors of bone mineral density. These findings suggest that pregnancy and breastfeeding leave lasting effects on bone mineral. While techniques exist to measure bone mineral in various locations, the distal third of the radius is more trabecular than some sites (e.g., the femoral head and vertebral centra). With such changes documented in the radius, more extreme effects are expected at more trabecular locations. Thus, a life's reproductive history is etched in bone.
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Ford, Miriam. "The Process of Mothering Transnationally for Mexican Women Living in New York." Thesis, Adelphi University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3571810.
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The role of mothering has always been an important area for study in nursing. However, transnational mothering, the experience of women mothering from afar, has not been well studied in the discipline. The purpose of this study was to explore the process of mothering by Mexican women in the context of their move to the United States. The conceptual framework of symbolic interaction and the methodology of grounded theory (Glaser & Strauss, 1967) were used to guide the study.
Data were collected through 13 semi-structured interviews of women from Mexico living in New York City who had at least one child under the age of 16 still living in Mexico. The results indicated that the process of transnational mothering was non-linear. Phases emerged from data analysis using Grounded Theory Methods of constant comparative analysis of transcripts, using coding, categorizing, and conceptualizing. Three final phases, each with sub categories, which explained the process of transnational mothering included reconceptualizing mothering, struggling, and embracing hope.
Reconceptualizing mothering was used to name this substantive theory that emerged. The Basic Social Process identified that fit the substantive theory that emerged was "social identity" as social identity is affected by a new understanding of one's role. The women in this study acknowledged the poor fit of their traditional roles of mothering in New York and therefore created new roles. The community that they developed and relied upon assisted with this new role adjustment. Implications for this study in the area of practice include the need for greater client advocacy and assisting transnational mothers to build and foster a community. The importance of the discipline's involvement in the area of health policy cannot be overstated as policies affecting mother child separation and reunification need a nursing voice.
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Spiteri, Mary Carmen. "Postnatal perineal trauma and general health in Maltese women." Thesis, University of Hull, 2009. http://hydra.hull.ac.uk/resources/hull:2384.
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Over the last twenty years there has been an increasing international research interest in women's experience of postnatal perineal trauma and its impact on their physical, psychological and sexual health. To date, however, no research on perineal morbidity and general health has been undertaken in Malta. Using a longitudinal descriptive correlational design, a homogenous systematic sample of 144 Maltese postnatal mothers was recruited with the aim of exploring the relationship between perineal trauma and general health following normal delivery. Self-administered questionnaires within 48 hour s of delivery and again at 10 days, 6 weeks and 13 weeks sought to assess perineal pain, urinary and faecal continence, resumption of sexual intercourse and dyspareunia. The General Health Questionnaire-12 (Goldberg and Williams, 1998) assessed mothers' psychosocial health. Open-ended questions explored further their experience of perineal trauma and general health. The retention rate at the end of time 4 was 86.1%. Following descriptive and inferential statistical analysis, the key findings revealed a constant decline in perineal trauma and an inconsistent but significant rise in general health over time. Mothers sutured by senior hospital officers reported higher scores of well-being, and resumed sexual intercourse earlier than those sutured by registrars and senior registrars. Significant negative correlations persisted between postnatal total perineal trauma and resumption of sexual intercourse at 13 weeks but not at 6 weeks.Qualitative data generated three main themes: experiencing total perineal trauma, resuming sexual intercourse and maintaining general health. Mothers identified tiredness, exhaustion and emotional pain as other burdens alongside a painful perineum. 'Being not ready yet', 'fear of falling pregnant again' and 'caring for the baby and family' were reasons preventing postpartum sexual intercourse. Tedeschi, Park and Calhoun's (1998) post-traumatic growth theory provided an overarching theoretical framework.
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Young, Alana. "The flipside: Young womens' understanding of the risks in skateboarding." Thesis, University of Ottawa (Canada), 2006. http://hdl.handle.net/10393/27430.
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Through the examination of 12 young women skateboarders' narratives, I explore skateboarding as a gendered performance which challenges existing cultural norms about gender through the corporeal display of risk-taking and the ability to withstand pain and injury. Most of the participants construct themselves as 'alternative' women who engage in 'masculine' practices, rejecting dominant notions of femininities. Although skateboarding provides young women with a space to complicate and challenge dominate discourses of gender, skateboarding nevertheless also reinforces dominant constructions of gender. Indeed, young women struggled to establish 'alternative' identities as they are not immune to the ideological power of the dominant codes embedded in the social structures. Using a feminist poststructuralist framework (Lupton, 1999; Weedon, 1997), I explore how discursive power contributes to the construction of women's subjectivities as skateboarders and risk-takers by examining how female skateboarders come to conform to, resist and/or reconstruct dominant notions of 'femininities' and risk.
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Hunt, Kate. "Understanding gender and health : systematically comparing the health and health experiences of men and women." Thesis, University of Glasgow, 2007. http://theses.gla.ac.uk/99/.
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Gender differences in health are the product of a complex interaction between biology and the social world. Our ascribed sex and how this is interpreted in the culture within which we live (gender) have life-long consequences for our life chances, including our health. For many years the aphorism that ‘men die quicker but women are sicker’ was presumed to encapsulate gender differences in health. The first paper presented in the thesis challenged this dominant paradigm. First, an analysis of morbidity in two British data sets showed more similarity than difference between men and women. Secondly, we highlighted earlier research with similar results which had been overlooked and failed to shake the ‘gender orthodoxy’. Thirdly, we stressed the ahistoric and decontextualised way in which research on gender and health had been conducted or reported. The remaining papers in the thesis share two underlying principles; all make systematic comparisons between men and women, and all attempt to also examine diversity within gender. All but one of the papers utilise data from the West of Scotland Twenty-07 Study, a study of the social patterning of health in three age cohorts. The second paper examined the impact of paid and unpaid work on symptoms, treating each domain as being relevant in principle to the health of both women and men. The experience of paid work was the predominant influence on malaise symptoms, and unpaid work in the home did not explain any variation in men’s symptom scores. Similar associations were seen between most aspects of paid work and malaise symptom scores in both genders. The paper highlighted the dearth of literature that had compared systematically either the conditions of men’s and women’s paid work, or the health effects of the paid and unpaid work environment for men and women. Men’s ‘under-usage’ of health care is often constructed as a problem, potentially reinforcing an assumption that women ‘over-use’ health care. On average, women have more consultations with their general practitioner, but this excess is mostly apparent in the reproductive years. The third paper examined whether these gender differences exist when taking account of the underlying nature and perceived severity of illness. Women were no more likely than men to have consulted their GP in the past year amongst those reporting morbidity in any of the five condition groups, and men were more likely to have consulted amongst those who reported digestive conditions. The fourth paper takes as its starting point the strong patterning of cigarette smoking by gender (and class) throughout the twentieth century. In it we examined the relationship between ‘masculinity’ and ‘femininity’ scores using the Bem Sex Role Inventory (BSRI, an instrument developed within social psychology in the 1970s). No relationship was seen between either score and smoking in the youngest cohort, nor amongst men in the middle cohort, and in the oldest cohort there was only a suggestion of an association between higher femininity scores and smoking in men. The strongest relationship was seen between ‘femininity’ score and smoking amongst women born in the 1950s who also had a somewhat elevated risk associated with higher ‘masculinity’ scores. Suicide and suicidal behaviours are strongly patterned by gender, and the dramatic rise in suicides amongst young males in the late 1980s and 1990s in several countries was often attributed to a ‘crisis’ in masculinity. The fifth paper examines the association between serious suicidal thoughts and the same measures of ‘masculinity’ and ‘femininity’ and a measure of gender traditionalism. In both men and women in early and late middle age, we found a negative association between higher ‘masculinity scores’ and serious suicidal thoughts, and a positive association between more traditional gender role attitudes and serious suicidal thoughts at older ages. No such associations were seen in early adulthood, and no relationship was seen between serious suicidal thoughts and ‘femininity’ scores at any age. Gender differences in the pattern of coronary heart disease (CHD) mortality have been described as enigmatic and one of the most striking features of cardiovascular mortality in the twentieth century. In an analysis controlling for many of the classic risk factors for CHD (smoking, blood pressure, body mass index, mental health), we found that higher ‘femininity’ scores (using continuous scores from the BSRI) were associated with a decreased risk of CHD mortality in men. No such association was seen in women, and the continuous ‘masculinity’ scores were unrelated to mortality in both women and men. Some advantages and problems with using these measures of ‘masculinity’ and ‘femininity’ in sociological research on gender and health are discussed. Previous research on one distressing side effect of some cancer treatments, chemotherapy-induced hair loss, has almost exclusively focussed on women. The final paper compares young adults’ experiences of hair loss following chemotherapy. Hair loss was a challenging aspect of the experience of cancer for both women and men which made them acutely aware of their vulnerability and visibility as a ‘cancer patient’. Both recounted negative reactions to their altered image, challenging social norms of interaction. However, there were two notable gender differences: it was only men who discussed the loss of body hair below the eyeline; and only women who spoke of being encouraged to wear wigs or offered ice helmets to delay or disguise hair loss. These differences are discussed in relation to social constructions of hair as a marker social identity, including gender. I argue that the gender-comparative approach taken reveals important commonalities across gender, highlighting a greater need for more support for men with chemotherapy induced alopecia, and makes what is not said in the women’s interviews as revealing as what is said in men’s. The concluding remarks highlight the challenges in researching gender and health, and discuss the complex ways in which gender can influence health and vice-versa.
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Komodromou, Maria Elena. "Women, employment and health." Thesis, University of Essex, 2017. http://repository.essex.ac.uk/20545/.
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The primary aim, as set out in the Introduction, is to explore women’s specific difficulties regarding labour market outcomes in the first decade of the 21st century, related to their dual role as mothers and labour force participants. The overarching context of the thesis is a contemporary profile of the working woman in Great Britain who is struggling to balance motherhood and paid work successfully, with the consequences this might have for her mental health. This thesis contains three empirical chapters exploring women’s employment and health interactions, through the consequences of the 2008/9 economic crisis on the UK gender wage gap, the effects of postpartum depression on maternal employment after childbirth, and the potential long-term impacts of postpartum depression on children’s emotional health and cognitive developmental outcomes. Specifically, this thesis seeks to address the following research questions: Did the great recession affect the wage gender gap? Does postpartum depression affect employment? Does postpartum depression predict emotional and cognitive difficulties in 11 year olds? Recent estimates reveal that 1 in 10 children aged 5-16 years have a diagnosable mental health problem and 1 in 5 mothers suffer from perinatal mental disorders, which highlight how widespread mental health problems are and how important the promotion of good mental health and prevention is at crucial stages in development. The results of the three empirical chapters of the thesis point to the need for an innovative and comprehensive approach to the distinct problems faced by different groups and sub-categories within the population.
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Reyes, Ayllon Andrea. "Impulsivity in men and women: A general population study in the Southwest of Montreal." Thesis, McGill University, 2012. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=110676.
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Impulsivity is considered a major contributor to various antisocial behaviours (Nofziger, 2010) and is present in many mental and personality disorders (American Psychiatric Association, 2000). Given that clear sex differences have been observed in such behaviours and disorders (Nofziger, 2010; Struber, et al., 2008), it is of interest to explore whether similar sex differences are observed in impulsivity. This thesis explores sex differences in impulsivity and its sub factors, as well as the potential role of impulsivity in explaining sex differences in antisocial behaviours and affective disorders. Using the Barratt Impulsiveness Scale, 11a version (BIS-11a; Barratt, 1994), a self report measure of impulsivity, we compared men and women on their total BIS total scores and factor scores, and examined whether sex moderated the association between impulsivity and criminal justice involvement, aggression, substance dependence, depression and mania.The analyses were conducted using data gathered through a large Epidemiological Catchment Area study of mental health in Montreal, Canada. The sample was randomly selected among residents living in the southwest of the city and consisted of 2,419 participants, between the ages of 15 and 69. Each participant was administered a variety of assessment measures including the BIS-11a, the Composite International Diagnostic Interview, a self report version of the Modified Overt Aggression Scale and a self-report criminal justice involvement scale. One-way analyses of covariance revealed no sex differences in impulsivity, even after controlling for age and socioeconomic status. In terms of the factors of impulsivity, both careful planning and coping stability were marginally higher in men. Additionally, logistic regression analyses showed that impulsivity was a predictor of criminal justice involvement, aggression and substance dependence but not of depression and mania and that sex was predictive of criminality, self-aggression and substance dependence (both alcohol and drug) in the past twelve months. Sex, however did not moderate the relation between impulsivity and any of the other variables, as was originally anticipated. In conclusion, if men were more prone than women to engage in such behaviours, their propensity is probably due to other factors such as heightened opportunity to engage in antisocial behaviours. Alternatively, the BIS-11a might not measure all components of impulsivity such a sensation seeking trait which may be directly linked to sex differences in antisocial behaviours and affective disorders. Future studies should include additional measures of impulsivity in order to get a clearer picture of the role sex might play in the association between antisocial behaviours, affective disorders and impulsivity as a whole.This large scale epidemiological study is the first to our knowledge in North America to look at sex differences and similarities in the measurement of impulsivity as well as the correlates of the latter. This study will allow us to make inferences about the relation between impulsivity and sex in the general population.L'impulsivité est considérée comme un facteur contribuant fortement aux comportements antisociaux (Nofziger, 2010). Ce trait est également présent dans plusieurs troubles de santé mentale et de la personnalité (American Psychiatric Association, 2000). Prenant compte que des différences inter sexe ont été observés dans ces comportements et troubles mentaux (Nofziger, 2010;. Struber, et al, 2008), il est intéressant d'examiner si ces mêmes différences pourraient être observées en ce qui a trait à l'impulsivité. Cette thèse explore les différences inter sexe dans l'impulsivité et ses sous-facteurs, ainsi que le rôle potentiel que ces différences ont sur les comportements antisociaux et les troubles affectifs. Utilisant l'échelle d'impulsivité de Barratt (BIS-11a; Barratt, 1994), nous avons comparé les hommes et les femmes dans leurs scores totaux et dans les scores de leurs sous-facteurs. Nous avons aussi examiné si le sexe était un facteur modérateur de l'association entre d'une part l'impulsivité et d'autre part, la criminalité, l'agression, la dépendance aux substances, la dépression et de manie. Les analyses ont été effectuées à partir des données recueillies dans le cadre d'une vaste étude Épidémiologique portant sur la santé mentale à Montréal, Canada. L'échantillon aléatoire était composé de 2,419 participants, âgés de 15 à 69 ans, résidant dans le sud-ouest de Montréal. Nous avons administré une série d'instruments aux participants, y compris la BIS-11a, la « Composite International Diagnostic Interview », la « Modified Overt Aggression Scale » et un questionnaire de criminalité auto-rapporté. Une analyse de covariance n'a révélé aucune différence entre les sexes dans l'impulsivité et ce, même en contrôlant l'âge et le statut socio-économique. En ce qui concerne les facteurs d'impulsivité de « planification minutieuse » et « stabilité pour faire face aux problèmes », les résultats étaient légèrement plus élevés chez les hommes. En outre, des analyses de régression logistique ont montré que l'impulsivité était un facteur prédicateur de la criminalité, des comportements agressifs ainsi que de la dépendance aux substances mais pas de dépression et de manie. Le sexe était lui aussi un facteur prédictif de la criminalité, de l'auto-agression et de la dépendance aux de substances. Le sexe, n'était toutefois pas une variable modératrice de la relation entre l'impulsivité et les variables d'intérêt. Nous pouvons donc conclure que si les hommes sont plus aptes que les femmes à perpétrer ces comportements, leur propension est probablement due à d'autres facteurs tels que, l'occasion accrue de s'engager dans des comportements antisociaux. Alternativement, la BIS-11 ne mesure peut-être pas toutes les composantes de l'impulsivité et il s'agit peut-être de d'autres sous facteurs de l'impulsivité comme la recherche de sensations fortes qui sont directement liées aux différences inter-sexe observées dans les comportements antisociaux et des troubles affectifs. Les études futures devraient donc inclure des mesures supplémentaires d'impulsivité dans le but d'obtenir une image plus claire de l'association entre le sexe, les comportements antisociaux et l'impulsivité. Cette étude épidémiologique est la première étude à notre connaissance, en Amérique du Nord à étudier les différences inter sexe dans l'impulsivité, ainsi que l'effet modérateur que ce trait a sur les comportements antisociaux chez les hommes et les femmes. Cette étude nous permettra de faire des inférences sur la relation entre l'impulsivité et le sexe dans la population générale.
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Kull, Merike. "Perceived general and mental health, their socio-economic correlates and relationships with physical activity in fertility-aged women in Estonia /." [Tartu] : Tartu Ülikooli Kirjastus, 2006. http://dspace.utlib.ee/dspace/bitstream/10062/1076/5/kullmerike.pdf.
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Cammaroto, Laura J. "Unexpected : identity transformation of postpartum women /." Full-text of dissertation on the Internet (3.19 MB), 2009. http://www.lib.jmu.edu/general/etd/2009/Masters/Cammaroto_LauraJ/cammarlj_masters_12-11-2009.pdf.
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Tezak, Ann Louise. "“A Wound That Never Heals”: Health-Seeking Behaviors and Attitudes Towards Breast Cancer and Cancer in General Among Women in Nakirebe, Uganda." Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6412.
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The scale and severity of cancer, specifically breast cancer, remains significantly different across the spectrum of low-income to high-income countries. This study explores women’s beliefs about breast cancer and associated prevention and health-seeking behaviors in a rural area of Uganda. Through a critical medical anthropological perspective, the study examines the social, cultural, and economic factors that shape women’s understanding of cancer, and breast cancer specifically, and that influence their use of biomedical services. Data were collected over a three-month period through 35 in-depth interviews and two focus groups with 10 women older than 18 years in the rural setting of Nakirebe within Mpigi District, and through five interviews with health care personnel from a private and a government health care facility in Mpigi District. Quantitative and Qualitative data were analyzed using SPSS version 23 and MAXQDA 12.0.2, respectively. Findings suggest that women in this rural setting have limited access to screening and incomplete knowledge about breast cancer, and cancer in general, and internalize fears of a cancer diagnosis. No women were diagnosed with any type of cancer at the time of this study. Common attitudes towards cancer from the women include inevitable death, cancer is caused by contact with artificial substances and/or germs, and cancer causes pain, wounds that never heal, and the removal of body parts. Recommendations for improving cancer control and management in rural Uganda through awareness initiatives and community health outreach programs are presented.
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Walker, Verlaine E. 1941. "Demographic determinants of women engaging in prompt or delay behavior for breast cancer symptoms." Thesis, The University of Arizona, 1991. http://hdl.handle.net/10150/278036.
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The purpose of this study was to determine salient demographic characteristics of women who exhibited prompt or self-delay behavior for treatment of breast cancer symptoms. The population for this study consisted of 224 adult females between the ages of 25 and 82, residents of Arizona, who were participants in the Self Help Intervention Project: Breast Cancer Treatment Study conducted at The University of Arizona, College of Nursing. The instrument used in this study was the Demographic Data form devised by Carrie Jo Braden, Ph.D., R.N. Women who sought prompt follow up treatment for breast cancer symptoms showed significant differences from those who did not seek prompt help in age, employment, social support, and ethnicity. Significant differences for women who self-delayed treatment from those who did not self-delay were age, education, and ethnicity.
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Abdalrahaman, Naiemh. "The assessment of bone health in young women with childhood-onset type one diabetes mellitus." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8413/.
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The risk of hip fracture in people with type one diabetes mellitus (T1DM) is reported to be 7 to 12 times greater than in those without T1DM, and this increased risk is evident in both children and young adults. This fracture risk is higher than expected bone mineral density (BMD) measurements, which indicates the likelihood that other skeletal factors, not captured by DXA, may contribute toward increased fracture risk. There is increasing evidence that alteration in trabecular bone microarchitecture and increased bone marrow adiposity (BMA) are causes for excess skeletal fragility, yet these data are lacking in people with T1DM. Recent technological advances in magnetic resonance imaging (MRI) have allowed the quantification of trabecular bone architecture. In addition, MRI can quantify the amount of intra-abdominal fat, and magnetic resonance spectroscopy (MRS) can also be used to assess BMA. These advances may enhance our understanding of the underlying causes of diabetic osteopathy which may lead to improved fracture risk predictors and preventive measures in patients with T1DM beyond that provided by dual energy x-ray absorptiometry (DXA). The overall objective of this thesis was to improve the understanding of the bone pathology of young adult women with childhood-onset T1DM by using high resolution MRI. A cross-sectional study was first carried out to assess trabecular bone microarchitecture of the tibia, vertebral BMA and abdominal adiposity in patients with childhood onset T1DM (n=30) compared with healthy controls (n=28). Additionally, the biochemical markers of bone turnover, adiposity and GH/IGF-1 axis (IGF-1, IGFBP3, and ALS) were examined to evaluate the underlying mechanism that might result in bone deficit in this group of people. We found that young women with childhood onset T1DM had reduced apparent trabecular bone volume (appBV/TV) and apparent trabecular number (appTbN) and greater apparent trabecular separation (appTbSp) than women without T1DM. Interestingly, these differences remained significant after adjustment for multiple confounders. Furthermore, these abnormalities were markedly obvious in those with microvascular complication compared with those without microvascular complication. Although women with T1DM had greater abdominal adiposity compared with healthy controls, there was no significant difference in BMA between the groups. However, BMA showed positive significant association with current glycaemic control (r= 0.45, p=0.02). Women with T1DM had lower bone turnover and decreased GH/IGF axis compared with healthy controls. Osteocalcin and ALS were negatively correlated with trabecular separation in women with T1DM. III Next, a one-year prospective study was conducted in a subset (n=28) of the participants involved in the cross-sectional study. The aim of this study was to compare one year changes in trabecular bone microarchitecture and BMA in women with and without T1DM. Additionally, the study aimed to evaluate the effect of glycaemic control on these changes over this period. After adjustment for relevant confounders, the cases (n=17) had a lower median appTbN and a higher median appTbSp at baseline and 12 months compared with healthy controls (n=11). Although the sample size was small at follow-up, the trabecular bone deficits were clearly noticeable in those with retinopathy compared with those without retinopathy. Similarly, there was no difference in median BMA which was 26.2% (12.1, 62.1) and 22.4% (9.6, 41.9) in cases and controls, respectively (p=0.57). Additionally, over the 12 month period, there was no significant change in MRI-measured parameters in cases or in controls, and no differences in the change of these variables between the two groups. Mixed model effect analysis showed that age was a negative predictor of percent changes of appBV/TV, appTbN and appTbSp in both cases and controls (p=0.02, p=0.02, p=0.002, respectively). Interestingly, there was a strong correlation between change in HbA1c and change in BMA (r=0.8; p=0.002). In the third study, we aimed to assess adiposity-based determinants of bone mineral density and bone microarchitecture in healthy young women and women with T1DM. Additionally, we aimed to compare the feasibility of using DXA and MRI-measured bone parameters to differentiate women with and without T1DM. In addition to high resolution MRI we used DXA scans to measure BMD and body composition from the same participants (n=26) involved in the longitudinal study. Vertebral BMA was positively correlated with VAT. Additionally, we demonstrated evidence of an inverse association of vertebral BMA and DXA-measured bone parameters of femoral neck, lumbar spine and total body independent of demographics and body composition in healthy young women and women with T1DM. These finding support the hypothesis that BMA is linked with low bone density, and may contribute to excess bone fragility. Moreover, this study suggested that MRI-measured trabecular bone measurements were able to differentiate between T1DM with and without microvascular complication compared with DXA-measured BMD. In summary, differences in MRI-measured trabecular microarchitecture parameters identified in this body of work provide preliminary explanations for elevated fracture risk in young women with childhood onset T1DM. Additionally, these findings provide potential insight into a number of possible underlying mechanisms of diabetic osteopathy.
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Bartholomew, Michelle L. "Health experiences of older African Caribbean women living in the UK." Thesis, University of Huddersfield, 2012. http://eprints.hud.ac.uk/id/eprint/17501/.
Full textAbstract:
This thesis examines older (60-75 years) African Caribbean migrant women‟s experiences of health and the extent to which these connect with identity across the life-course. It draws on their accounts to consider how gender, migrant and ethnic identity are produced and constructed in later life. The thesis considers the religious experiences of older African Caribbean women and how these influence health and well-being. The relationship between past and present homeland experiences, traditions and homeland produce such as food and medicine, is further examined. The aim here is to identify how the maintenance of ethnic and cultural identities influences their perceptions of health, western healthcare and medical practices. The key theories examined relate to identity construction and how identity categories are inter-dependant, constantly changing and made up of boundaries that are not totally fixed. In addition to this, the formation of religious identity is examined to see the extent to which religion and its practices are contained within certain parameters and constraints which can structure the nature of both self-representation and subjectivity. The gendered nature of knowledge is also examined to ascertain how knowledge influences individual power and how power can influence the connections between the body, surveillance and health. A qualitative and in depth interpretative analysis guided by feminist epistemological and ontological thought is used. A methodological aim was to deconstruct the universal categories of women‟s experiences, in order to enable insight into the different types of regulation that define the individual experiences of older migrant African Caribbean women living in the UK. A second aim within the research process was to explore how the researcher‟s biography influences and is influenced by the biographies of the research participants. The key findings suggest past experiences have impacted on the health and well-being of African Caribbean women in later life. For instance, life-course inequalities had a direct impact on their health and life-fulfilment as they grew older. The experiences of older African Caribbean women link to the construction of both their ethnic and cultural identity, and these identities are constructed in such a way as to maintain the self and identity boundaries. Religion and its practices are of immense importance to older African Caribbean women. It is through such activities that many were able to cope with hardship and the effects of multiple oppressions. These have influenced how older African Caribbean women perceive and maintain their health and well-being. In understanding the lives of older African Caribbean women, it is important to consider the ways in which cultural, migratory and social experiences shape their experiences of health and well-being in later life; in order to acknowledge diversity through the recognition and acceptance of difference.
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Wu, Salene M. "Relationship of General and Health-related Anxiety and Worry to Markers of Inflammation in Women with Advanced Cancer." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1356624916.
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Pham, Thi Kim Loan Wirat Kamsrichan. "Perception toward domestic violence against women of health providers of the Thahn Nhan general hospital in Hanoi, Vietnam /." Abstract, 2006. http://mulinet3.li.mahidol.ac.th/thesis/2549/cd387/4838005.pdf.
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Boulay, Evelyne. "Test-retest reliability of shoulder functional characteristics using measures from the Simulator II in a healthy adult population of women." Thesis, McGill University, 2009. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=67018.
Full textAbstract:
Shoulder Musculoskeletal Disorders (MSDs) are prevalent conditions particularly among women. Obtaining accurate measurements of shoulder range of motion (ROM) is a major concern for the clinical setting. The purpose of this project was to obtain reference data and assess test-retest reliability of shoulder ROM using the BTE simulator II (Simulator II, BTE technologies™) in a healthy adult population of women. Shoulder ROM was assessed from thirty female right-handed subjects (20-52 years old) in flexion, extension, external rotation and abduction, on two separate days. ROM measurements were slightly different from those of the literature, were not associated with age or anthropometric characteristics, similar between left and right sides except for abduction, and independent from handedness scores. Test-retest reliability was moderate to excellent (above 0.77 for almost all movements and 0.56-0.73 for external rotation). Standard error of measurement and minimal detectable change were smaller than values reported for goniometric measurements. Patient studies are needed to implement the Simulator II in clinical settings.Les blessures musculo-squelettiques de l'épaule représentent une condition répandue chez les femmes. Obtenir des valeurs précises d'amplitude de l'épaule est une priorité en clinique. Le but de ce projet était d'obtenir des valeurs de références et d'évaluer la fidélité test-retest des amplitudes de l'épaule en utilisant le "BTE simulator II (Simulator II, BTE technologies™)" sur une population de femmes en santé. Les amplitudes de l'épaule ont été mesurées chez trente sujets droitières (âgées de 20-52 ans) en flexion, extension, rotation externe et abduction, à deux jours différents. Les amplitudes avaient quelques différences avec celles de la littérature, n'étaient pas associées aux mesures démographiques ou anthropométriques, étaient similaires entre les côtés gauche et droit sauf pour l'abduction, et étaient indépendantes des scores de latéralité. La fidélité test-retest était modérée à excellente (supérieure à 0,77 pour presque tous les mouvements et entre 0,56-0,73 pour la rotation externe). L'erreur standard et le changement minimum détectable étaient plus petits que ceux rapportés pour des mesures goniométriques. D'autres études sont recommandées pour l'implantation du "Simulator II" dans le milieu clinique.
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Costa-von, Aesch Zoë. "Not wanted in the study: an ethical, medical and political analysis of the exclusion of pregnant women from clinical research studies." Thesis, McGill University, 2007. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=18306.
Full textAbstract:
Review and analysis of current clinical research practice suggests a general trend towards excluding pregnant women from clinical research studies. Although exclusionary research practices are premised upon concerns for the well-being of the fetus and the pregnant women, such practices can also produce various inadvertent harms to both parties. In particular, exclusion of pregnant women from clinical research limits the quality of care provided to pregnant women by impeding individual access to innovative research protocols and by limiting data collection applicable to the pregnant population. A review and analysis of relevant historical, legal, ethical, clinical, scientific and political documents suggests that various changes should be made to current clinical practice. To produce many such changes there is a need for a comprehensive, progressive Canadian health policy to be used to guide and direct researchers and research ethics boards in the appropriate inclusion of pregnant women in clinical research studies.La revue et l’analyse des procédures courantes dans la recherche clinique suggèrent une tendance générale d’exclure des femmes enceintes des études cliniques. Bien que ces pratiques de recherche exclusives soient basées sur la protection des fétus et de la femme enceinte, ces pratiques peuvent aussi amener des conséquences néfastes pour la femme et son fétus. L’exclusion des femmes enceintes de la recherche clinique limite particulièrement la qualité des soins donnés à ces femmes parce que l’accès individuel au protocole de la recherche innovatrice est proscrite et la compilation des données concernant la population des femmes enceintes est limitée. La revue et l’analyse des documents historiques, éthiques, cliniques et politiques pertinents suggèrent la nécessite d’apporter des modifications importantes aux protocoles courants de recherche clinique. Une politique de santé canadienne claire et progressive aurait pour but apporter les changements nécessaires et de guider les chercheurs et les comités d’éthique de recherche sur l’insertion appropriée des femmes enceintes dans les études cliniques.
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Louis, Ashleigh C. "The ra roller coaster| A grounded theory study of how young adult women experience life with rheumatoid arthritis." Thesis, Capella University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3612596.
Full textAbstract:
The present study utilized the microanalysis techniques for grounded theory described by Strauss and Corbin (1998) to better understand the lived experience of having rheumatoid arthritis (RA) as a young adult woman. The sample consisted of eight women between the ages of 25-36, each of which participated in a 60-90 minute telephone interview that explored how they feel, think, and behave in terms of their RA. A theory emerged from the data that reflected the process of moving from diagnosis to acceptance for the participants. This process was described as being akin to a roller coaster because of the myriad of ups and downs associated with the RA experience. The findings from this study may help to inform the understanding of how young adults experience life in terms of their RA and, therefore, has potentially positive implications for other young adults with RA as well as their health care professionals, family, and friends.
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Stephens, Quiona C. "Effect of exercise training on total peripheral resistance, heart rate variability, and prehypertension in apparently healthy African American women." The Ohio State University, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=osu1110223806.
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Sue, Caron Anne. "HEALTH BENEFITS AND QUALITY OF LIFE IN POSTMENOPAUSAL WOMEN ON HORMONE REPLACEMENT THERAPY." University of Cincinnati / OhioLINK, 2000. http://rave.ohiolink.edu/etdc/view?acc_num=ucin976028221.
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Wells, Gemma. "Older women as occupational beings : exploring the meanings of occupations within the home environment for older women living alone." Thesis, Canterbury Christ Church University, 2017. http://create.canterbury.ac.uk/16841/.
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There is a discrepancy between the life expectancy of men and women of approximately two and a half years (Taylor Nelson Sofres 2014). This suggests that women are likely to spend a period of time in the latter years of their life living alone. It is anticipated that this will lead to a unique experience of later life for women, which to date has received little attention. This study is concerned with exploring the experience of living alone for 11 women aged 70-80 years from the South East of England. A particular emphasis is placed upon the experience of being an older woman, the activities that they engage in when they are at home alone, and the environment of home as a place for occupational engagement. Influenced by interpretive phenomenology and feminist principles, this study focuses on capturing the lived experiences of the 11 women in their own images and words. To achieve this, the methods of unstructured interviews and photo-elicitation are used. The women in this study describe a predominantly positive experience of living alone in later life. They value being busy, engage in a range of meaningful activities, and maintain their independence in everyday life. They provide compelling evidence that later life is a time for self-growth and development. This appears to link to the decline in the gender related roles and occupations which are expected of them in later life. This indicates that it is essential to provide bespoke support to older women that focuses on prevention of future decline but in a way that values their ongoing abilities.
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Barrios, Yasmin V., Bizu Gelaye, Qiu-Yue Zhong, Christina Nicolaidis, Marta B. Rondon, Pedro J. Garcia, and Pedro A. Mascaro Sanchez. "Association of Childhood Physical and Sexual Abuse with Intimate Partner Violence, Poor General Health and Depressive Symptoms among Pregnant Women." PLoS ONE, 2015. http://hdl.handle.net/10757/344059.
Full textAbstract:
This research was supported by an award from the National Institutes of Health (NIH), the
Eunice Kennedy Shriver Institute of Child Health and Human Development (R01-HD-
059835). The NIH had no further role in study design; in the collection, analysis and interpretation
of data; in the writing of the report; and in the decision to submit the paper for publication.
The authors wish to thank the dedicated staff members of Asociacion Civil Proyectos en
Salud (PROESA), Peru and Instituto Materno Perinatal, Peru for their expert technical assistance
with this research.Objective We examined associations of childhood physical and sexual abuse with risk of intimate partner violence (IPV). We also evaluated the extent to which childhood abuse was associated with self-reported general health status and symptoms of antepartum depression in a cohort of pregnant Peruvian women. Methods In-person interviews were conducted to collect information regarding history of childhood abuse and IPV from 1,521 women during early pregnancy. Antepartum depressive symptomatology was evaluated using the Patient Health Questionnaire-9. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI). Results Any childhood abuse was associated with 2.2-fold increased odds of lifetime IPV (95%CI: 1.72–2.83). Compared with women who reported no childhood abuse, those who reported both, childhood physical and sexual abuse had a 7.14-fold lifetime risk of physical and sexual IPV (95%CI: 4.15–12.26). The odds of experiencing physical and sexual abuse by an intimate partner in the past year was 3.33-fold higher among women with a history of childhood physical and sexual abuse as compared to women who were not abused as children (95%CI 1.60–6.89). Childhood abuse was associated with higher odds of self-reported poor health status during early pregnancy (aOR = 1.32, 95%CI: 1.04–1.68) and with symptoms of antepartum depression (aOR = 2.07, 95%CI: 1.58–2.71). Conclusion These data indicate that childhood sexual and physical abuse is associated with IPV, poor general health and depressive symptoms in early pregnancy. The high prevalence of childhood trauma and its enduring effects of on women’s health warrant concerted global health efforts in preventing violence.
: This research was supported by an award from the National Institutes of Health (NIH), the Eunice Kennedy Shriver Institute of Child Health and Human Development (R01-HD-059835). The NIH had no further role in study design; in the collection,
Revisión por pares
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Schwarz, Imogen University of Ballarat. "(Re)creating spaces within rural general practice : women as agents of change at the organisational and practitioner levels." University of Ballarat, 2005. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/12764.
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This thesis examines how women, as agents of change, contest the male-dominated structures at the organisational and practitioner levels of rural medicine in Australia. The premises for this study are that females now outnumber males as medical graduates and general practice trainees, yet women are significantly less likely than men to occupy rural and remote practice positions in Australia. Furthermore, the organisation of medicine remains strongly patriarchal. A feminist qualitative design underpins this empirical study involving: in-depth interviews with seventeen women activists and thirteen rural women general practitioners; grounded theory analysis of transcribed interviews; and interpretation of findings through a feminist poststructural lens. Findings uncover the gendered organisational and practitioner environment through which change is negotiated. At the organisational level, male exclusionary practices – played out through the ‘male as norm’ and the ‘problem is women’ discourses – position women in highly contradictory ways and marginalise their voices. Yet simultaneously, activists are challenging entrenched interests through individual and collective strategies of change which include: initiating gender-awareness projects; claiming legitimacy by using male-centred tactics and women-defined discourses; developing female-friendly initiatives; and mentoring of and building alliances between women. At the practitioner level, results reveal how women’s everyday lives as rural general practitioners are shaped by oppositional tensions. However, beyond the struggle of ‘fitting in’, women are altering rural medicine by (re)shaping meanings and (re)constructing work practices. Furthermore, their narratives suggest that rural spaces are integral to ways women carve out women-defined practice. A key innovation of this thesis is analysis of change at dual levels, both organisational and practitioner. This thesis marks a significant advancement upon the usual themes that attend only to the marginalisation of women and rural areas. It highlights the transformative process through which women (re)create the discursive spaces of rural general practice.Doctor of Philosophy
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Schwarz, Imogen. "(Re)creating spaces within rural general practice : Women as agents of change at the organisational and practitioner levels." Thesis, University of Ballarat, 2005. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/35479.
Full textAbstract:
This thesis examines how women, as agents of change, contest the male-dominated structures at the organisational and practitioner levels of rural medicine in Australia. The premises for this study are that females now outnumber males as medical graduates and general practice trainees, yet women are significantly less likely than men to occupy rural and remote practice positions in Australia. Furthermore, the organisation of medicine remains strongly patriarchal. A feminist qualitative design underpins this empirical study involving: in-depth interviews with seventeen women activists and thirteen rural women general practitioners; grounded theory analysis of transcribed interviews; and interpretation of findings through a feminist poststructural lens. Findings uncover the gendered organisational and practitioner environment through which change is negotiated. At the organisational level, male exclusionary practices – played out through the ‘male as norm’ and the ‘problem is women’ discourses – position women in highly contradictory ways and marginalise their voices. Yet simultaneously, activists are challenging entrenched interests through individual and collective strategies of change which include: initiating gender-awareness projects; claiming legitimacy by using male-centred tactics and women-defined discourses; developing female-friendly initiatives; and mentoring of and building alliances between women. At the practitioner level, results reveal how women’s everyday lives as rural general practitioners are shaped by oppositional tensions. However, beyond the struggle of ‘fitting in’, women are altering rural medicine by (re)shaping meanings and (re)constructing work practices. Furthermore, their narratives suggest that rural spaces are integral to ways women carve out women-defined practice. A key innovation of this thesis is analysis of change at dual levels, both organisational and practitioner. This thesis marks a significant advancement upon the usual themes that attend only to the marginalisation of women and rural areas. It highlights the transformative process through which women (re)create the discursive spaces of rural general practice.Doctor of Philosophy
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Schwarz, Imogen. "(Re)creating spaces within rural general practice : women as agents of change at the organisational and practitioner levels." University of Ballarat, 2005. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/15386.
Full textAbstract:
This thesis examines how women, as agents of change, contest the male-dominated structures at the organisational and practitioner levels of rural medicine in Australia. The premises for this study are that females now outnumber males as medical graduates and general practice trainees, yet women are significantly less likely than men to occupy rural and remote practice positions in Australia. Furthermore, the organisation of medicine remains strongly patriarchal. A feminist qualitative design underpins this empirical study involving: in-depth interviews with seventeen women activists and thirteen rural women general practitioners; grounded theory analysis of transcribed interviews; and interpretation of findings through a feminist poststructural lens. Findings uncover the gendered organisational and practitioner environment through which change is negotiated. At the organisational level, male exclusionary practices – played out through the ‘male as norm’ and the ‘problem is women’ discourses – position women in highly contradictory ways and marginalise their voices. Yet simultaneously, activists are challenging entrenched interests through individual and collective strategies of change which include: initiating gender-awareness projects; claiming legitimacy by using male-centred tactics and women-defined discourses; developing female-friendly initiatives; and mentoring of and building alliances between women. At the practitioner level, results reveal how women’s everyday lives as rural general practitioners are shaped by oppositional tensions. However, beyond the struggle of ‘fitting in’, women are altering rural medicine by (re)shaping meanings and (re)constructing work practices. Furthermore, their narratives suggest that rural spaces are integral to ways women carve out women-defined practice. A key innovation of this thesis is analysis of change at dual levels, both organisational and practitioner. This thesis marks a significant advancement upon the usual themes that attend only to the marginalisation of women and rural areas. It highlights the transformative process through which women (re)create the discursive spaces of rural general practice.Doctor of Philosophy
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Hillard, Sara A. "Perceived barriers to physical activity among women with arthritis." Thesis, Manhattan, Kan. : Kansas State University, 2008. http://hdl.handle.net/2097/797.
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ZHENG, SHAN. "PROSPECTIVE ASSESSMENT OF CORONARY HEART DISEASE RISK FACTORS IN WOMEN PARTICIPATING IN THE NHANES 1 16-YEAR FOLLOW-UP STUDY DATA." University of Cincinnati / OhioLINK, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=ucin983461033.
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Ozden, Asli. "Can Reproductive Health Program Empower Women? A Feminist Post-development Critique Of European Union Funded Reproductrive Health Program In Turkey." Master's thesis, METU, 2010. http://etd.lib.metu.edu.tr/upload/3/12612107/index.pdf.
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Whithin the recent human centered development approach, the mission of development's declared aims are alleviating poverty, increasing choices by reducing '
risks'
and empowering women. In line with the human development framework, Reproductive Health program aims at improving women'
s health, enlarging women'
s chices and engendering reproductive rights. The scope of '
empowerment'
is conceptualized as strenthening their capabilities to prevent sexual reproductive health risks, thereby enlarging their reproductive choices whithout reflecting on the role of general political economic structures. this thesis argues that while general health indicators and life choices and rights of poor women are decreasing due to neoliberal shrinkage of social policy and flexible working regimes, the sole focus on reproductive health and rights by development agents is irrelevant. In line with this argument, this study draws upon post-development theory in order to argue that development is a historically specific representation of social reality which permits particular modes of knowing while disqualifying others for perpetuating gobal hegemonic regimes.
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Jansen, Natalie R. "Comparison of Health-Related Quality of Life Between Heterozygous Women with Fabry Disease, the General Population, and Patients with Chronic Disease." University of Cincinnati / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1109182046.
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Nickerson, Michika R. MPH. "The Association of Appearance Satisfaction with Measures of Adiposity and Health Behaviors Among African American Adult Women." The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1524120512606168.
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Ruzicka, Amelia. "Considering the influences of the physician-patient relationship on the patient's quality of life| An interpretive phenomenological analysis of the experience of being dismissed by one's physician among women with autoimmune diseases." Thesis, Institute of Transpersonal Psychology, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3589680.
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This study used Interpretive Phenomenological Analysis to explore the lived experiences of women with autoimmune diseases who felt dismissed by their physicians when seeking diagnosis of their symptoms. Six women with medically diagnosed autoimmune diseases were each interviewed twice in a semi-structured format. Participants reported lasting harm from negative emotional and psychological states that resulted from disruptions in intrapsychic processes, including challenges to embodied material reality and self-concept due to physicians' dismissive attitudes. A description of a unique phenomenon, named here as physician dismissiveness, emerged from the data. Participants also reported that experiencing physician dismissiveness made coping with symptoms more difficult during the quest for accurate diagnosis. These findings raise important questions regarding mind-body awareness, the nature of embodiment, authority over the body, and the role of expert others in holistic functioning. Background of the study includes elements of healing theory put forth by Rogers, as well as theory of the body as described by Merleau-Ponty.
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Rauschenbach, James. "A Comparative Analysis of the Effects of Positive Specific Feedback & Positive General Feedback on the Bowling Scores of College Age Men & Women." TopSCHOLAR®, 1989. https://digitalcommons.wku.edu/theses/2750.
Full textAbstract:
This study was conducted to examine the effects of positive specific feedback and positive general feedback on the bowling scores of subjects enrolled in two beginning bowling classes. Experimental groups were formed from two intact bowling classes, and a group of fifteen volunteers who made up the control group. The PSF group which contained twenty-eight subjects, was provided with positive specific feedback throughout the course of the study. The PGF group which contained thirty-five subjects, was provided with positive general feedback throughout the course of the study. Subjects were administered a pretest at the start of the study which consisted of the average score obtained after completing four games of bowling. Following the pretest, subjects in the PSF and PGF groups received eleven sessions of bowling instruction and twelve sessions of bowling competition. Subjects in the control group received no bowling instruction or practice. At the completion of the study subjects were administered a post-test which consisted of the average score obtain after completing tour games of bowling.
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Gurney, Sarah. "Gender, work-life balance and health amongst women and men in administrative, manual and technical jobs in a single organisation : a qualitative study." Thesis, University of Glasgow, 2010. http://theses.gla.ac.uk/1641/.
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There is increasing interest in how people manage the multiple demands of paid work, home and personal life, and the consequences that failure to achieve ‘balance' between these domains may have on health. There has been limited qualitative research exploring the meanings and connections people attach to gender, ‘work-life balance’ and health; this is particularly so for workers who do not occupy managerial or professional jobs. To fill this gap in the literature this qualitative study examined narratives about ‘work-life balance’ amongst women and men working in ‘non-professional’ jobs in a single organisation. Forty semi-structured interviews were carried out with women and men working in administrative, technical and manual jobs within a single organisation based in various cities across the UK. As with the wider labour market, jobs were largely segregated by sex; all the administrative workers were women, whilst all but one of the manual employees were men. The sample included people who worked full-time and part-time, along with participants who also had other employment or were in further education. The sample was diverse in relation to age and family situation. The study was framed within the context of Clark’s (2000) work/family border theory, which aims to explain how individuals balance paid work and family, and construct the borders between these domains. The thesis focused on paid employment, family, leisure, and reported experiences of work-life balance amongst the sample. It concludes by revisiting Clark’s work/family border theory, considering the importance of different domains and borders for this sample, and the role of gender within the theory. The accounts of work-life balance given by these participants differed from those reported in studies of professional employees. Whilst much of the literature problematises paid work as being the main source of conflict, within this sample experiences varied. Due to the relatively low-paid nature of the work carried out amongst the sample, in many instances the necessity of work in providing for self and family predominated over considerations of work-life balance. Borders surrounding the leisure domain were highly permeable, meaning this domain was often compromised by work and family demands. Participants generally held traditional attitudes to gender roles, particularly in relation to the domestic sphere. This influenced choices constructed around paid work, and experiences of work-life balance. Health was not a key concern, although high levels of strain in different spheres, particularly in relation to the home and family sphere, led to stress for some participants.
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Maimaiti, Yasheng. "Women’s education and work in China : the menstrual cycle and the power of water." Thesis, University of Birmingham, 2010. http://etheses.bham.ac.uk//id/eprint/790/.
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This study investigates the joint impact of menstrual cycle and poor access to water on women’s education and labour market outcomes. The research context is chosen to be rural China. Two parallel hypotheses that are tested in this study are as follows: (1) Girls have less probability of school enrolment and shorter schooling duration due to the joint impact of poor access to water and menarche presumably because that poor access to water may raise time/health/psychic costs of school enrolment for girls post-menarche. (2) Women have less probability of participating in work for wages due to the joint impact of poor access to water and menstrual cycle presumably because that poor access to water may generate lower productivity and raise time/health/psychic costs of wage work participation for women pre-menopause. For testing, the researcher uses the data from rural villages in the China Health and Nutrition Survey. This study conducts two sets of empirical tests on each of the above hypotheses using regression models and propensity score matching estimators. It is found that the joint impact of poor access to water and menstrual cycle is indeed largely adverse on women’s education and wage work participation. When the impacts of other confounding factors such as poverty and backward geographical location are controlled for, access to poor water is found to decrease the probability of school enrolment of post-menarche girls by 20 – 25 percentage points, and the probability of wage work participation of women premenopause by about 10 percentage points. This study concludes that a major benefit of policies to improve water supplies may not be the obvious household or industrial benefit, but rather an unseen benefit, the improvement in the position of women
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Oliver, Tracy L. "CROSS-SECTIONAL AND LONGITUDINAL COMPARISON OF SELF-REPORT VERSUS OBJECTIVE MEASUREMENT IN PHYSICAL ACTIVITY AMONG WOMEN." Diss., Temple University Libraries, 2009. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/23756.
Full textAbstract:
KinesiologyPh.D.
Physical activity improves health while combating the obesity epidemic. However, quantifying physical activity through self-report questionnaires or objective measures can provide varying results. The purposes of these studies were to determine if time, body mass index, or treatment assignment could affect the validity of physical activity measurements. The data were part of a larger physical activity promotion study conducted at the Miriam Hospital/Brown Medical School in Providence, Rhode Island and in communities in Southeastern Massachusetts from 2002 to 2005. In this trial, 280 women, with a mean age of 47.1 years, were randomly assigned to one of three intervention groups: Choose to Move (n=93), Jumpstart (n=95) and Wellness (n=92). A randomly selected sub sample of participants simultaneously wore an ActiGraph accelerometer and completed a 3-Day Physical Activity Recall questionnaire at baseline, 3 months and 12 months. Body mass index and treatment assignment were also used in-group comparisons. The results indicated that all components of time, BMI and treatment assignment influenced the accuracy of self-reported measurements when compared to objective accelerometer data. Additional research is essential to uncover the independent aspects considered influential to these physical activity measurements to enhance study design and participant outcomes in future trials.
Temple University--Theses
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Smyth, Catherine Jane. "How health visitors from one healthcare organisation in the north of England endeavour to meet the perceived needs to Pakistani mothers living with violence and abuse and the challenges they encounter in keeping such women safe." Thesis, University of Huddersfield, 2016. http://eprints.hud.ac.uk/id/eprint/30278/.
Full textAbstract:
Domestic abuse is a public health issue with long term health and social consequences for its victims. The prevalence of domestic abuse among women seeking healthcare is higher than in the general UK population and often begins or worsens in pregnancy. Health visitors, because of their role with pregnant women and mothers are in a key position to offer both supportive interventions and to play a preventative role in domestic abuse. The aim of this research is to improve understanding of issues health visitors face when working with Pakistani mothers living with domestic abuse. The study is set in the north of Britain in an area that has experienced chain migration and settlement from the Mirpur and Faisalabad regions of Pakistan since the 1970s. Taking a qualitative approach and informed by a critical realist perspective, first-hand accounts from health visitors working in the area are used. The findings of the study confirm that domestic abuse perpetrated against some Pakistani mothers is a complex aspect of health visiting practice compounded by deep rooted cultural and social practices within many Pakistani families. The key challenge health visitors face appears to be non-disclosure of abuse by many Pakistani women and the main approach taken by health visitors in this situation is predominantly one of harm minimisation. Inconsistencies in practice were however noted. Three overarching themes were found from the analysis of the data which depict the challenges health visitors face and the endeavours they take to keep women safe. The theme of Presence depicts a range of actions linked to ‘seeing’ or ‘being with’ women and includes carrying out repeated enquiry into abuse. Role Strain describes how the health visitors express difficulty in fulfilling the various demands and expectations of the role. The term Covert Actions encompasses a range of seemingly hidden or concealed activities undertaken by health visitors in an endeavour to maintain Presence. The study provides useful insight into the forms of evidence many health visitors deem can legitimately inform their clinical interventions when working with this population group and succeeds in extending current understanding of the types of knowledge health visitors draw from to inform their decisions in this specific area of practice. It also provides awareness of the wider challenges health visitors can encounter when working more generally among collectivist and honour-based communities and raises questions about some of the philosophical assumptions usually associated with Western models of healthcare. Implications for practice are that mainstream domestic abuse interventions should be used with sensitivity to the different cultural contexts in which many Pakistani mothers live, and attempts should be made to develop appropriate interventions that derive from those contexts. This includes holistic assessment tools that are flexible enough to allow clinical judgements to be informed by the more subjective elements of evidence gathering and which take into consideration the impact of the multiple oppressions some women encounter. Recommendations for service providers are that they should take a broader view of domestic violence that recognises ‘difference’ and therefore enables health visiting interventions to be flexible and responsive to differing need. This includes considering more community-based interventions among certain population groups.
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White, Ian, and n/a. "Prescribed psychotropic drug use in the Australian Capital Territory : a study of the prevalence and patterns of use in women and the prescribing habits of general practitioners - implications for health education." University of Canberra. Education, 1990. http://erl.canberra.edu.au./public/adt-AUC20061110.130512.
Full textAbstract:
Psychotropic drugs are mind affecting compounds. They range in type
from illegal narcotic analgesics such as heroin, to prescribed major
tranquillisers used for treatment of psychotic states, to prescribed
minor tranquillisers such as the benzodiazepines, Valium and Mogadon,
to the freely available, over the counter drugs, Aspirin and Panadol.
Overseas and Australian data show the minor tranquilliser group,
benzodiazepines, first introduced on the pharmaceutical scene in
the early 1960s, to be the most commonly prescribed psychotropic
drugs. Their popularity with medical practitioners as prescription
drugs for conditions of anxiety, stress, insomnia and some forms
of epilepsy, arises from the advertised inference by drug companies
that they are free from any side effects in the patient such as
dependence, tolerance and on termination of treatment, absence of
withdrawal syndrome. Benzodiazepines were first introduced as a
substitute for the well known dependence producing barbiturate based
sedatives.
Overseas and Australian data show women are prescribed psychotropic
drugs, particularly benzodiazepines, twice as often as men and in
many instances for conditions unrelated to those for which the drugs
are recommended.
Australian data comes from two sources, official statistics such
as the Pharmaceutical Benefits Scheme and from surveys of drug use.
Both sources of data are incomplete, inaccurate and in many cases
misleading. The true picture of prescribed psychotropic drug use
in Australia therefore lacks resolution and in all probability
underestimates prevalence and patterns of use in the community.
There is no data on the prevalence and patterns of use of prescribed
psychotropic drugs in the Australian Capital Territory. It was therefore
deemed appropriate to conduct a survey to determine their prevalence
and patterns of use. The survey was confined to women for several
reasons: Women are a target group in the Commonwealth and State
Government 'Drug Offensive'; evidence from studies overseas and in
Australia shows that women are prescribed psychotropic drugs,
particularly benzodiazepines, twice as often as men; Australian data
suggests that this trend is uniform and therefore the Australian
Capital Territory should be no different.
Data shows that doctors, particularly General Practitioners, are
the main source of prescribed psychotropic drugs. The main psychotropic
drugs prescribed by general practitioners are benzodiazepines. It
was therefore deemed appropriate to conduct a survey of general
practitioner's attitudes, knowledge and beliefs about the appropriate
use of benzodiazepines as these factors carry weight in a doctor's
prescribing habits.
The survey of women was conducted using a standardised, structured,
telephone survey on a random sample of 120 women in the Australian
Capital Territory.
The results of the survey show that 40% of the sample had used
prescribed psychotropics at some stage in their lives. Most users
were older women, married, well educated and working full time. Level
of knowledge about the drug was low, compliance with respect to use
was high. Most prescribed psychotropic drugs were obtained from a
doctor. There appears to be little drug sharing or concurrent drug
use. Half of the prescribed psychotropics were benzodiazepines the
other half were mostly anti-depressants. Use of over the counter
psychotropics was very high.
The survey of general practitioners was conducted using a standardised,
structured mailed questionnaire distributed to a random sample of
25 general practitioners in the Australian Capital Territory.
The results show the majority of doctors prescribe the drugs for
common indications (anxiety, stress, insomnia and some forms of
epilepsy) in excess of one week. For specific anxiety states however,
most prescribe the drugs along with some form of counselling. The
majority of doctors (77%) think counselling is not as effective as
drug treatment. All doctors surveyed think patients should be advised
of the drugs effects on driving and machinery operation; the drugs
should not be shared with others; that the drugs should not be
terminated abruptly; the drugs should not be used concurrently with
alcohol. The majority (92%) believe benzodiazepines are over prescribed
and most doctors (77%) believe the drugs produce dependence in patients.
The majority (58%) believe women of child bearing age are at risk
using benzodiazepines while 50% think pregnant women are at risk.
The majority of doctors did not believe that people older than 60
years of age are at risk but most believe children are at risk.
The findings of both surveys have implications for health educators
and others with a concern for drug education in the community.
Recommendations arising from this study have been made. They are
presented at the conclusion of this thesis.
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Jansson, Pernilla. "Hard Muscle, Slim Body : A Systemic Functional Analysis of the Covers of Men’s and Women’s Fitness Magazines." Thesis, Stockholms universitet, Engelska institutionen, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-113170.
Full textAbstract:
Magazine covers are multimodal texts designed to draw the attention of potential readers. Health and fitness magazines, in particular, make up a large portion of the publishing industry, and previous research has pointed to their influence on readers’ perceptions of health and fitness. In order to interpret the multimodality of magazine covers, a different approach other than the purely linguistic one needs to be employed. Following the theoretical frameworks of Systemic Functional Linguistics and Social Semiotics, this study set out to investigate the verbal and visual construction of health on eight covers of Men’s Health and Women’s Health. The findings indicate that there are significant differences in how health is constructed on the men’s and women’s edition of the magazines. These differences mainly concern the way in which health is achieved, and the relationship between the viewers and the magazine. This not only indicates that different strategies were used to attract viewers, but also reveals something about the relationship the viewer is supposed to have with their bodies as well as their perceptions of health.
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Sylla, Daouda. "Essays on Culture, Economic Outcome and Wellbeing." Thesis, Université d'Ottawa / University of Ottawa, 2014. http://hdl.handle.net/10393/31202.
Full textAbstract:
Chapter 1: The Impact of Culture on the Second-Generation Immigrants’ Level of Trust in Canada
Trust is one of the main elements of social capital; it determines the extent to which an individual cooperates with others. In this chapter, I assess whether cultural factors influence the level of trust in the population of second-generation immigrants in Canada. This paper is related to two strands of empirical literature. The first analyses the determinants of trust and the second studies the cultural transmission of values, attitudes and beliefs. I follow closely the literature on the cultural transmission and use an epidemiological approach to assess whether trust of second-generation immigrants is affected by their cultural heritage. This approach consists of comparing information about the outcomes of second-generation immigrants with that of the country of origin of their ancestry. We apply this approach using the Ethnic Diversity Survey (EDS), the World Value Survey (WVS) and the European Value Survey (EVS). Estimation results show that the average level of trust in the countries of origin of the ancestors of the second-generation immigrants has a strong significant impact on their level of trust. Thus, individual whose country of ancestry displays a high level of trust, tend to have a high level of trust. This provides evidence that individuals’ level of trust is not only explained by their personal experiences, characteristics, and the environment in which they live; but also by the culture in their country of ancestry. This means that culture does matter! I find that the results remain robust even if certain key countries are omitted or a different data set is used.
Chapter 2: Decomposing Health Achievement and Socioeconomic Health Inequalities in Presence of Multiple Categorical Information
This chapter presents a decomposition of the health achievement and the socioeconomic health inequality indices by multiple categorical variables and by regions. I adopt Makdissi and Yazbeck's (2014) counting approach to deal with the ordinal nature of the data of the United States National Health Interview Survey 2010. The findings suggest that the attributes that contribute the most to the deviation from perfect health in the United States are: anxiety, depression and exhaustion. Also, I find that the attributes that contribute the most to the total socioeconomic health inequality are ambulation, depression and pain. The regional decomposition results suggest that, if the aversion to socioeconomic health inequality is high enough, socioeconomic health inequalities between regions are the main contributors to the total socioeconomic health inequality in the United States. Chapter 3: Accounting for Freedom and Economic Resources in the Assessment of Changes in Women Poverty in Sub-Saharan Africa
This chapter assesses the importance of freedom in women’s wellbeing in twelve Sub-Saharan Africa countries by using data from Demographic Health Surveys. This paper presents a poverty comparison by using the stochastic dominance approach and relies on the economic resources and freedom as the two aspects of wellbeing which evokes the multidimensionality of poverty. This study is related to the following three pieces of literature: the sequential stochastic dominance, the multidimensional poverty, the Sen’s capability approach which is based on freedom. This paper is built on Makdissi et al. (2014) but differs from it in a number of respects. First, it focuses on poverty instead of welfare. Secondly, it applies the Shapley decomposition to determine the contributions of the economic resource distribution and the incidence of the threat of domestic violence to poverty changes over time. Consistent with previous work on the importance of freedom, I find that more freedom, i.e. less threat of domestic violence, affects women’s wellbeing positively since it decreases women’s poverty. The results indicate that women’s wellbeing has improved in Burkina Faso, Ghana, Kenya, Lesotho, Madagascar, Malawi, Rwanda, Senegal, and Zimbabwe and deteriorated in Ethiopia, Nigeria and Tanzania.
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Wittjen, Susan McPhail. "Caring differently: Sexual difference and the ethics of health care relationships." Thesis, 1999. http://hdl.handle.net/1911/19459.
Full textAbstract:
The ethical issues that are associated with interprofessional relationships in health care affect the care that patients receive in an institutional setting. There are many components of difference that affect relationships, but this work focuses on sexual difference and how it is revealed in the discourse of health care. Since the ethical obligations of health care providers historically have been derived from the roles of those professionals, the patient and provider relationship is described to establish the obligations of nurses, physical therapists, and physicians to patients. Because health care principles traditionally have been narrowly interpreted and applied, as well as limited in choosing ethical cases for analysis, the traditional ethical frameworks of principlism and casuistry have been insufficient in addressing the ethical concerns that arise from interprofessional relationships. A feminine ethic of care is also inadequate in addressing these concerns because it is not sensitive to sexual difference and because it involves the possibility of promoting self-sacrifice. Luce Irigaray uses a technique of mimesis to expose and undermine sexual indifference in several western texts to explain how woman's voice has been overlooked in a culture based on masculine discourse. Her phenomenological interpretation of woman's body as being fluid, multiple, and intermediate is associated with those health care professions that are grounded in maternal nurturing and touching. These qualities are also revealed in the gendered discourse that permeates health care. Using Irigaray's work on feminine imaginary and gendered discourse, health care ethical issues can be analyzed at a deeper level than via principlism, casuistry, or care. By recognizing how the gendered nature of health care discourse prevents the female voice from contributing to the decision-making process, new and creative possibilities for approaching ethical issues can be developed to provide the patient with care based on a broader interpretation of the issues. A case study based on a patient at the end-of-life is used to illustrate how the recognition of the role of sexual difference in ethical analysis can affect how decisions about patient care are made.
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Escobar, Maria Luisa. "Demand for health services in Colombia: The choice of provider by women of child-rearing age." Thesis, 1991. http://hdl.handle.net/1911/16438.
Full textAbstract:
This research analyzes the factors influencing choice and the determinants of women's health services demand. Demand for health services in Colombia is practically unexplored, and there appear to be no studies of demand for health services by women of child rearing age in Colombia. The Colombian National Health Study of 1980 (Estudio Nacional de Salud-1980) is the data base used, supplemented by hospital data from the Ministry of Health. After a description of the Colombian Health System, the choice between traditional and modern care is studied for prenatal care, and for child's delivery assistance, emphasizing differences among insured and non-insured women. The first part of the study estimates demand schedules through a logistic specification. The choice of institutional setting for child's delivery assistance, conditional upon the prior decision of using modern care, is studied through a nested multinomial logit specification for women in different regions of the country and for urban and rural women as well. Expected prices for a delivery are estimated for all choices women face.
Only few recent studies have found demand for modern health services to be price elastic and dependent on income level; this is also the case in some of the regions of Colombia. Moreover, demand for health services becomes less price elastic as income increases. Demand for Private care is generally more price elastic than demand for other types of care, and in some cases demand for Public care is significantly price elastic at lower income levels. Lower income women rely on Public hospitals when they have decided against traditional care. Then, price changes for Public care would have larger welfare effects on lower income groups.
Urban women of high income groups often use Public care, indicating that government subsidies are favoring better-off sectors of the population. Meanwhile, rural women rely heavily on home care, even at higher income levels.
A more rational price system for services at social security hospitals would not reduce significantly women's welfare; higher prices would help to provide better quality services and/or permit cost recovery for those institutions which very often find themselves in financial trouble.
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"Impact of performance-based financing on the quantity and quality of maternal health services in Rwanda." Tulane University, 2009.
Find full textAbstract:
Resource poor countries, particularly in sub-Saharan Africa, face many challenges improving maternal health due to financial and human capital constraints, lack of motivation among health providers and lack of physical resources. One of the key policies implemented in Rwanda in response to these issues is Performance Based Financing (PBF). PBF provides bonus payments to providers for improvements in performance measured by indicators of specific types of utilization (e.g. prenatal care) and quality of care. While the approach promises to improve health system performance, there is little rigorous evidence of its effectiveness, especially in low-income settings This study examines the impact of the incentives in the Rwandan PBF scheme on prenatal care utilization, the structure and process quality of prenatal care, institutional delivery, and modern contraceptive use. The analysis uses data produced from a prospective quasi-experimental design nested within the program's rollout. The rollout was implemented in two phases: in 2006, 86 facilities (treatments) in rural areas enrolled in the PBF, and another 79 facilities (control) enrolled two years later. In order to isolate the incentive effect from the resource effects, the control facilities were compensated by increasing their traditional budgets with an amount equal to the average PBF payments to the treatment facilities. Baseline and endline data were collected from all of the facilities and a random sample of 14 households in each facility's catchment area Using a different approach, PBF had a large and significant impact on the quality of prenatal care measured by process indicators of the clinical content of care and deliveries in facilities. However, no such effect was found on prenatal care visits or on the use of modern contraceptives The results provide evidence to support the hypothesis that financial performance incentives can improve both the use and quality of maternal health services. Policy recommendations include increasing incentive for prenatal care service, complementary training to increase quality and combining PBF with a demand-side intervention such as conditional cash transfer involving community health workersacase@tulane.edu
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Williams, DM. "Learning to manage : a substantive grounded theory of large bodied women's interactions with medical professionals." Thesis, 2012. https://eprints.utas.edu.au/14810/10/whole_williams_thesis.pdf.
Full textAbstract:
A qualitative research approach using constructivist grounded theory methodology was used to further understanding and generate dialogue about the experiences of overweight and obese female healthcare consumers. Participants included 22 women, all of whom identified as large bodied. Data was collected from two major sources: semi structured interviews with participants and current literature. The value of this study lies in the documentation of a substantive theory which elucidates the issues facing overweight and obese female healthcare consumers, and the strategies they employ to manage these issues.
The substantive grounded theory of ‘Learning to Manage’ details what large bodied women viewed as the salient concerns that face them as healthcare consumers, and how they resolve these issues. They identified their interactions with medical practitioners, specifically with general practitioners (GPs) as the most challenging. The women in this study felt extremely vulnerable when they became healthcare consumers. They believed they were negatively branded by their body size which worked to create a one dimensional identity – that of an overweight or obese patient. Once they were labelled their weight became the central focus of the consultation, often obscuring the reason they had sought help. Consequently, the shared social problem of women was identified as ‘being defined’. Feeling like ‘just a fat body’ (as described by participants) was common to all participants, and left women battling feelings of invisibility, shame, guilt, responsibility and fear. For large bodied female patients, being defined by their size was something which had significant ramifications both on the women themselves and on the clinical interaction. Being defined was comprised of three categories – ‘feeling invisible’, ‘expecting the worst’ and ‘feeling judged’.
In order to manage or counteract the issues and feelings associated with ‘being defined’ participants developed a range of strategies which have been conceptualised as the basic social psychological process ‘Learning to Manage’. Women believed that the weight commentary from medical professionals was usually inappropriate and frequently hurtful; however they felt they had limited recourse because of the power held by medical professionals. Subsequently they learnt to manage their interactions with medical professionals in ways which blocked out or minimised the consequences of embodying the identity of an obese patient without having to overtly challenge their doctor. They believed that if they openly challenged their doctor they risked further sullying their already marked identity. Logically women knew that they could not be refused what they needed, however they felt that it was easier to manage from an emotional perspective if they engaged in strategies which pretended compliance or apology for their fat bodies.
This research adds to the limited body of health science literature which has investigated weight through a framework which is cognisant of the multilayered meanings attached to fat female bodies. It also adds to the ever increasing research which recognises the impact of stigma in addressing public health crises such as obesity.