6 research outputs found
From Expectation to Action: The Interplay of Health Expectations, Care Quality, and Socio-demographic Moderators in Health-Seeking Behaviour of Health workers
No full textHealth-seeking behaviour among health workers is a crucial yet often overlooked aspect of healthcare systems, especially in developing nations. This study investigates the impact of health expectations and perceived health care quality on health-seeking behaviour (HSB) among Nigerian health workers. A cross-sectional survey was conducted among 108 health workers in Ibadan, Nigeria. Structural equation modelling (SEM) was used to assess the relationships between health expectations and health-seeking behaviour (HSB). Health expectations positively predicted perceived health care quality (β = 0.410, p < .001) and HSB (β = 0.268, p = .003). Perceived care quality strongly influenced HSB (β = 0.652, p < .001) and mediated the relationship between health expectations and HSB (β = 0.267, p < .001). Age moderated the effect of health expectations on HSB (β = 0.366, p = .003), indicating a stronger association among older health workers. Ethnicity moderated the relationship between care quality and HSB (β = 0.211, p = .038), while marital status moderated the link between health expectations and HSB (β = -0.320, p < .001). The model demonstrated acceptable fit indices: SRMR = 0.072, NFI = 0.915, and Rms theta = 0.102, indicating a good fit between the hypothesized model and the observed data. The findings underscore the significant roles of health expectations and perceived care quality in shaping HSB among health workers, with socio-demographic factors influencing these dynamics. Tailored interventions that enhance care quality and consider individual expectations and demographic contexts are essential to promote proactive health-seeking behaviours within the health workforce.KeywordsHealth expectations, care quality, socio-demographic factors, health-seeking behaviour, health worker
Women in African Drama: Representation and role
No full textThe purpose of this study is to examine the representation and role of women in African theatre. The discussion is based on published and unpublished plays by African writers selected from a pan-African perspective.
The thesis is divided into two major parts: Women in Society; The Portrayal of Women by Major Playwrights. Part I follows a thematic approach aimed at examining the position of women in three different areas which form the chapters for the part : Women, Tradition and Social
Change; The Urban Woman and Women in Politics. Part II of the thesis analyses major African playwrights' presentation of women characters. This part discusses not only the characterization of women by major playwrights but also these writers' attitude towards women and women's issues. Examined here in two chapters are The Portrayal of Women by
Major Male Playwrights and The Portrayal of Women by Major Female Playwrights.
Chapter 1, 'Women, Tradition and Social Change' discusses selected playwrights' examination of African women's experiences in the traditional African setting as a major foundation of the present and future socio-political situation of the continent; this chapter is the springboard
of the study.
From the traditional milieu the study then moves on to the
relatively new urban environment. This Chapter examines the predicaments in which the African woman finds herself as she struggles to survive in a world which differs significantly from the traditional one. Survival in the urban environment demands a certain degree of autonomy
from communal ties on the part of the individual. Yet in the case of the African woman, society does not hesitate to censure her movements and even to point an accusing finger at her for failing to satisfy traditional expectations when she is genuinely trying to meet the challenges presented by life in towns.
The myth that a woman's place is exclusively in the kitchen is a widespread one the world over. A more negative myth found in Africa is that participation of women in public affairs leads to social disaster. The third chapter of this study examines the role of African women in politics in the traditional and contemporary periods.
The fourth chapter discusses the portrayal of women by major male playwrights. Of great significance in this analysis is the attitude of these male writers towards women and also towards issues affecting women. It is for this reason that cross-references are made between these male writers and the female playwrights examined in Chapter 5.
Very negligible research has been done on drama by African women. It is in recognition of this unfortunate situation that the fifth and last chapter of this thesis is dedicated to women's self-perception as reflected in their portrayal of fellow-women in theatre. This chapter examines only major female playwrights; the minor female playwrights
are examined alongside the male in the appropriate areas in Chapters 1 to 3
Prevalence of visual impairment and severity of diabetic retinopathy in various ethnic groups in the UK
No full textDiabetic Retinopathy (DR) is a leading cause of visual impairment (VI) in the working population. Minor ethnic groups are at increased risk of diabetes. Diabetic Retinopathy In Various Ethnic groups in the United Kingdom (DRIVE UK) is a cross-sectional study to estimate the prevalence of DR, VI and associated risk factors for sight threatening diabetic retinopathy (STDR) in Afro-Caribbeans (AC) and South Asians (SA) compared to Caucasians. People with diabetes in two regions in the United Kingdom who were screened and/or treated for DR from September 2008 to September 2009 were included in this study. VI and severe visual impairment (SVI) were defined as Snellen visual acuity of ≤ 6/18 and ≤ 6/60 respectively. DR was graded according to National Screening Committee (NSC) for diabetes guidelines UK.
There were 57,144 people on the diabetic register, of which retinopathy data was available from 50,285 (88.1%) subjects (type 1 n=3,323, type 2 n=46,962). In type 1 and type 2 diabetes, any DR was detected in 53.1%, 39.5%, diabetic maculopathy in 13.1%, 8.4% and STDR in 9.91%, 4.0% of people respectively. STDR was significantly more prevalent in the SA (10.3%) and AC (11.5%) populations compared to Caucasians (5.5%). Overall VI was significantly higher in the ethnic minority population. A total of 7.5% (95% CI 7.3, 7.8) people with diabetes were not eligible for driving based on their visual acuity, 3.4% (95% CI 3.2, 3.5) were classified as VI and 0.4% (95% CI 0.33, 0.44) as SVI. Risk factors for STDR were found to include longer duration of diabetes and higher mean HbA1c.
This study provides information that could be used to help develop future service frameworks and guidelines for local health bodies responsible for delivery of end userservices. The study also supports the need to explore the role of inflammatory, genetic and epigenetic factors as markers for ethnic differences in DR and potential treatment avenues for diabetic retinopathy
Depression: Can we predict who will relapse?
No full textThis thesis addresses risk factors and proposed mechanisms to explain relapse to depression. Volume 1 comprises three parts: Part 1 is a literature review consisting of meta-reviews of systematic and non-systematic reviews of studies reporting on risk factors for relapse to depression, and a systematic-review of neuroimaging and experimental studies investigating risk factors for relapse and potential mechanisms of action of these risk factors. The reviews found that only residual symptoms of depression at the end of treatment and childhood maltreatment were sufficiently evidenced as predictors of relapse and neither have great clinical utility. A number of psychological and neuropsychological factors were suggested to play a role in conferring risk for relapse. Considering the inter-relationships between these factors the reviews were used to propose a conceptual framework which may be used to help guide future research into relapse to depression in adults. Part 2 is an empirical paper in which data were analysed from service users of a primary care mental health service to identify risk factors for relapse and for the presence of residual symptoms, and survival analysis methods were used to determine when relapses occur most often and what factors impact survival. In addition, a prospective cohort study was formed to investigate the relationship between cognitive control and depressive symptoms. The findings confirmed that cognitive control can be used to predict residual symptoms of depression post-treatment and therefore potentially to predict relapse. Part 3 is a critical appraisal focussing on the theoretical reasons as to why studying relapse in a manner as used in the prospective study is so important and discusses the logistical difficulties conducting such research in the current context of NHS services and of the D.Clin.Psy research project. Methodological decisions made that impacted upon the research process are discussed and reflective conclusions are offered
An integrated map of genetic variation from 1,092 human genomes
No full textBy characterizing the geographic and functional spectrum of human genetic variation, the 1000 Genomes Project aims to build a resource to help to understand the genetic contribution to disease. Here we describe the genomes of 1,092 individuals from 14 populations, constructed using a combination of low-coverage whole-genome and exome sequencing. By developing methods to integrate information across several algorithms and diverse data sources, we provide a validated haplotype map of 38 million single nucleotide polymorphisms, 1.4 million short insertions and deletions, and more than 14,000 larger deletions. We show that individuals from different populations carry different profiles of rare and common variants, and that low-frequency variants show substantial geographic differentiation, which is further increased by the action of purifying selection. We show that evolutionary conservation and coding consequence are key determinants of the strength of purifying selection, that rare-variant load varies substantially across biological pathways, and that each individual contains hundreds of rare non-coding variants at conserved sites, such as motif-disrupting changes in transcription-factor-binding sites. This resource, which captures up to 98% of accessible single nucleotide polymorphisms at a frequency of 1% in related populations, enables analysis of common and low-frequency variants in individuals from diverse, including admixed, populations
A global reference for human genetic variation
No full textThe 1000 Genomes Project set out to provide a comprehensive description of common human genetic variation by applying whole-genome sequencing to a diverse set of individuals from multiple populations. Here we report completion of the project, having reconstructed the genomes of 2,504 individuals from 26 populations using a combination of low-coverage whole-genome sequencing, deep exome sequencing, and dense microarray genotyping. We characterized a broad spectrum of genetic variation, in total over 88 million variants (84.7 million single nucleotide polymorphisms (SNPs), 3.6 million short insertions/deletions (indels), and 60,000 structural variants), all phased onto high-quality haplotypes. This resource includes >99% of SNP variants with a frequency of >1% for a variety of ancestries. We describe the distribution of genetic variation across the global sample, and discuss the implications for common disease studies
