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Biomedical subjects

L Manderson

Publications and source records attributed to L Manderson.

At least 19 recordsLinked to original sources
PubMed2001

Health issues among Filipino women in remote Queensland.

This paper discusses health issues among Filipinas (women born in the Philippines) living in remote and rural environments in Queensland. The sample was recruited as part of the University of Queensland component of the Australian Longitudinal Study of Women's Health (ALSWH). Most of the women lived in an urban or semi-urban area (391), whereas 90 lived in rural or remote areas. Community perceptions had a much greater impact on health service utilisation in rural and remote areas than in urban areas. The transition between newcomer and old-timer is more difficult for Filipinas than for other rural women because they are visibly different from other members of the community and suffer from stigmatisation associated with perceptions of Filipinas as mail order brides. For these women, concerns about confidentiality and a reluctance to ask for support are major barriers to health service utilisation. The area of greatest concern is mental health, particularly in relation to parenting issues. Improving access may involve providing a greater awareness of what services are available and allowing women to access services in a way that does not require them to label themselves or be labelled by others.

Acculturation↗
PubMed2001

Stigma and rejection: living with AIDS in villages in southern Thailand.

The problems that face HIV/AIDS patients are now fairly well documented. These include experiences of guilt, anger, grief, fear of abandonment, and potential economic hardship and marginalization due to others' fear of infection and associated stigma. However, limited attention has been paid to the effects of AIDS-related stigma on access to, and the provision of, health services. Understanding how the stigma of AIDS affects the processes and experiences of diagnosis, treatment, prevention, and care is critical to effective public health policy and the delivery of health care programs and medical services. In this article, we examine stigma as experienced by people with HIV and AIDS, and by their families, in village Thailand. We also identify areas for improvement pertaining to people with HIV/AIDS and other stigmatizing diseases.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Is equity being sacrificed? Willingness and ability to pay for schistosomiasis control in China.

Decentralization of the health care system in China has led to an increasing need for income generation at all operational levels, both for curative services and for public health programmes. In general, people have accepted the costs of curative services, although the impact of charges on health-seeking behaviour has yet to be assessed. Public health programmes present particular problems in terms of revenue generation, however, because of the less direct impact of these activities on individual health and well-being. In this paper, we report the results of a cross-sectional study of willingness and ability to pay for schistosomiasis control. Questionnaires were administered to household heads of six representative villages in the Dongting Lake Region of Hunan Province, China. A total of 628 valid questionnaires were analyzed. The yearly mean household expenditure on schistosomiasis diagnosis and treatment was RMB 59.50 +/- 146.04 Yuan (US$1 = 8 RMB Yuan), accounting for 0.94% of the total yearly household income. Most household heads (514, 82%) thought schistosomiasis was the greatest health threat in their communities, but only 30.9% of them were willing to pay for screening, diagnosis and treatment of the infection. On the other hand, 72.3% of the respondents were willing to undertake volunteer work for control.

Adult↗
PubMed2001

Developing qualitative databases for multiple users.

Conventionally, anthropological data are collected and analyzed by individuals, and although researchers may use data managers to organize their information, there is little need to classify and code systems to be accessible to others. Recently, however, qualitative and quantitative data have been collected in projects with multiple researchers. Difficulties with the establishment, verification, and management of databases for multiple users, particularly in longitudinal studies, are considerable if the rules underlying coding schemes are difficult to identify or if the documentation is cumbersome. Drawing on the authors' experiences in Australia, the use of computer packages for data management is discussed, and the importance of preserving the integrity of data and maintaining context while facilitating its continued and varied use is emphasized.

Australia↗
PubMed2001

Beliefs and behaviors about Pap and breast self-examination among Thai immigrant women in Brisbane, Australia.

Regular screening is an important preventive method in reducing morbidity and mortality from cervical and breast cancer. In 1998, a cross-sectional study was conducted in Brisbane, Australia, among 145 Thai immigrant women, to explore cultural and social factors related to their use of Pap smear tests and breast self-examination (BSE). The study aimed at describing women's beliefs and perceptions about the body, breast and cervical cancer, and their perceptions of the causes of the diseases. It explored the women's perception of the severity and the effects of both cancers on aspects of patients' lives, and their chance of developing both cancers. The Thai immigrant women explained the causes of breast and cervical cancer using both traditional beliefs and medical knowledge. They perceived that both cancers affect a patient's health and her daily activities. Some women believed that they would develop cervical cancer if their perineum or vulva was "dirty." Some believed that they would have breast cancer because they had a history of benign tumor or cyst of a breast. Forty-four percent of the women had biennial Pap smears in the past five years and only 25% conducted BSE monthly in the past two years. Information relating to perceived barriers to undertake regular cervical cancer and breast cancer screenings and other health beliefs can be applied by health care personnel to increase Thai immigrant women's preventive health behaviors.

Adolescent↗
PubMed2000

Migration and mainstreaming: matching health services to immigrants' needs in Australia.

The provision of special services for people of non-English speaking background in Australia emerged in the context of the development of policies of multiculturalism. This article documents the trends in state and federal policy development and service provision in the 1990s, as influenced by the sometimes-competing forces of political will, financial resources and community demand. The sustainability of various programmes is examined in the context of the continuing need to provide for people whose access to mainstream health services remains problematic.

Australia↗
PubMed2000

Treatment seeking for malaria in Morong, Bataan, the Philippines.

Early diagnosis and treatment for malaria has a significant impact on the severity of the disease and contributes to the interruption of its transmission. Fourteen high-risk families and nine locality-matched families, with no recent history of malaria, participated in an ethnographic study which aimed to document malaria episodes and to examine treatment paths for fevers locally termed malaria and perceived to be malaria. The study, conducted in Morong, Bataan, a low malaria endemic area in the Philippines, used a combination of qualitative and quantitative methods over a period of 12 months. Six treatment categories were identified; self-treatment with Western medicines and clinic consultations had almost equal frequencies. Twenty-six treatment paths were recognised which consisted of the six categories singly or in combination. More than 80% of the undiagnosed malarya illnesses were treated with antimalarials of inappropriate dosages. More adult men than women self-treated, but there was no significant difference by gender in terms of clinic consultation for illness. The majority of clinic consultations were made for young children. The implications for control are discussed.

Adolescent↗
PubMed2000

The impact of educational videotapes on water contact behaviour of primary school students in the Dongting Lakes region, China.

Multimedia has become increasingly important in educational programmes in schools in all societies, and has potential value for health education. We developed a video and a comic book on the transmission and prevention of schistosomiasis for use in primary schools in endemic areas of China. The material was designed to increase children's knowledge of schistosomiasis as an environmental disease and to encourage them to reduce their contact with unsafe water sources. To test the effectiveness of the video and booklet, a quasi-experimental study was conducted among 1,739 children in 50 primary schools in the Dongting Lake region. A self-administered questionnaire pre- and post-intervention showed a significant increase in knowledge about schistosomiasis in the intervention schools. Significantly, this change was associated with a decrease in contact with unsafe water sources, as established from water contact observations. This behavioural change suggests the value of short, targeted educational interventions to decrease risk of infection.

Adolescent↗
PubMed2000

Indigenous women's perceptions of breast cancer diagnosis and treatment in Queensland.

OBJECTIVE: To identify social, structural and personal factors among indigenous women in Queensland associated with the detection of breast cancer, and the treatment and post-treatment care and support of cancer. METHODS: Qualitative research including interviews, case studies and focus group discussions were conducted, among Aboriginal women and service providers in urban, rural and remote areas of Queensland over nine months in 1998/99. RESULTS: A range of factors were identified as influencing women's willingness to perform BSE, receive screening mammograms, and receive and complete treatment compared to the non-indigenous population. Personal history of health services, provision of information about mammography, the cost of treatment and care, and availability of personal support, all influenced women's willingness to access services and maintain treatment. Indigenous women in Queensland experience various barriers to effective and appropriate detection, treatment and care of breast cancer. CONCLUSION: Barriers to diagnosis, treatment and care can be addressed by increasing women's awareness of breast cancer and the benefits of preventative health behaviour, and improving the quality and appropriateness of health care and counselling services for Indigenous women and their families. IMPLICATIONS: Indigenous women's knowledge and practice relating to the early diagnosis and prevention of breast cancer may improve through outreach work with women, to encourage their confidence in preventative health. Women's commitment to preventive health will also be enhanced by improved quality and access to health care, and improved relationships between practitioners and patients.

Adult↗
PubMed1999

Local knowledge and treatment of malaria in Agusan del Sur, The Philippines.

Information about local knowledge of malaria, its transmission, treatment and prevention were gathered at the outset of a Malaria Control Program in order to incorporate this information into community interventions. Data were collected using focus groups and indepth interviews with caretakers of children who had had a recent episode of malaria. These were supplemented as baseline data through a survey and the ongoing participation of researchers in the intervention. Local knowledge of malaria was influenced by clinical diagnosis and was based on the coexistence of signs of illness. People conventionally self-medicated or used herbs for symptomatic relief prior to seeking clinical diagnosis and treatment, with treatment delay influenced by the logistic difficulties within the region, direct and indirect costs associated with treatment seeking, and delays in the return of results once a blood film for diagnosis was made. People were familiar with mosquito control activities conducted by the Malaria Control Service and, as a result, most respondents associated malaria with mosquitos. However, the role of the mosquito as the sole vector, and the means by which malaria was transmitted, were not well appreciated.

Adolescent↗
PubMed1999

Mosquito avoidance and bed net use in the Greater Accra Region, Ghana.

Qualitative research and cross-sectional survey methods were used in a study conducted in rural and urban areas of the Greater Accra Region, Ghana, to explore people's understanding of the cause of malaria and patterns of mosquito avoidance, in particular bed net ownership and use. The study indicated far higher bed net ownership and use in rural than urban areas, which was related partly to perceived affordability and partly to the different contexts of and reasons for avoiding mosquitoes. Knowledge of an association between mosquitoes and malaria, the most common cause of illness in both areas, was related to residence but not to literacy or formal education, and this knowledge did not predict bed net use. The paper points to the complexity of social and personal factors implicated in behavioural interventions for malaria control, and questions behavioural models that assume a linear relationship between knowledge and practice.

Adult↗
PubMed1999

The Transtheoretical Model and cervical screening: its application among culturally diverse communities in Queensland, Australia.

OBJECTIVES: To apply the Transtheoretical Model of Behaviour Change (TTM) to cervical cancer screening to determine and report on the level of support required by different language and cultural groups in Queensland to enhance participation. The model consists of six stages: Pre-contemplation (no intention to be screened, no past action), Contemplation (intention to be screened, no past action), Action (intention to be screened, initial screening), Maintenance (intention to be screened, regular screening), Relapse (no intention to be screened, initial screening) and Relapse Risk (no intention to be screened, regular screening). DESIGN: Focus groups and structured interviews were used to classify women in terms of the model and collect information regarding knowledge, health service contact barriers and enhancing factors and sources of information in relation to cervical cancer screening. The sample was recruited by bi-cultural workers for each community using snowball techniques. RESULTS: The interview sample consisted of Australian South Sea Islanders, Chinese, German, Greek and Moslem women. There was no evidence of significant differences in TTM stage according to ethnicity. Women who intended to be screened in the future were more likely to have positive decisional balance scores and higher knowledge scores than women who did not. Women who had had Pap tests were significantly more likely to have received information from their general practitioner (GP) than women who had not had Pap tests. Women in Action and Maintenance were also more likely to have had their last Pap test by a female GP compared to women in relapse categories. Women in Pre-contemplation were more likely than women who had Pap tests to agree that they would travel a long way to see a practitioner who spoke their own language. CONCLUSION: Classification based on the model was supported both by the decisional balance scale and measures of knowledge. Women in earlier stages of the model were more likely to express preferences for the provision of services in their own language and by a female. Cervical cancer screening among women in Action and Maintenance appeared to be better supported by GPs. Cervical cancer screening promotion for women of diverse cultures and ethnicities has tended to focus on Pre-contemplation and Contemplation stages, however, as most women in this sample were in Action or Maintenance, as are most Australian-born women, structuring cervical cancer screening promotion in terms of the TTM may significantly improve the effectiveness of interventions for women of diverse cultures and ethnicities.

Adult↗
PubMed1999

Towards evidence-based health promotion and service provision for new migrants to Australia.

OBJECTIVES: To examine patterns of health utilization and health information dissemination among immigrants to Australia in the first 6 months of immigration using data from the Longitudinal Study of Immigrants to Australia (LSIA). METHODS: The population for the LSIA consists of 5178 principal applicants making their first arrival to Australia on a migrant visa between 1 September 1993 and 31 August 1995, inclusive, and who are aged 15 years or over at the time (96% of all principal applicants). The influence of immigration category, country of birth, health status and age on the likelihood of receiving information about health, sources of health information and use of general practitioners were explored using separate logistic regressions for men and women. RESULTS: Women who received health information were older and less likely to have a chronic illness than women who did not. Men who received health information were older and more likely to be in the Business visa category. Younger women, those in Preferential Family visa categories and bilingual women were more likely than other women to have received health information from an NGO. For men, the only significant predictor of source of health information was being in the Independent visa category. Women who used health services were younger, more likely to have a chronic illness, be proficient in English and less likely to be in the Independent visa category than women who did not. Men who used health services were older, more likely to have a chronic condition and have limited English than men who did not. Men who used health services were more likely to be in the Humanitarian visa class and less likely to be in the Concessional Family or Business visa categories than men who did not use health services. They were also more likely to have been born in Oceania, Middle East and North Africa and Africa. CONCLUSIONS: The results of this study indicate that there are important differentials in knowledge of and use of the health system and these differences are unlikely to be captured by using measures based on ethnicity or country of origin alone. Predictors of health service utilization were different for men and women. In particular, age and lack of English proficiency appeared to be barriers to health service use for women. Visa category and country of birth were more important determinants of health service use for men.

Adult↗
PubMed1999

"Part and parcel of being a woman": female urinary incontinence and constructions of control.

This article draws on extensive interviews with middle-aged Australian women experiencing urinary incontinence. Our discussion derives from the difficulties women face in seeking advice on the management of incontinence, as a consequence of their perception that the condition is an inevitability, a "normal" part of being female. Women do not, on the whole, support a single cause for incontinence but, rather, explain its incidence in terms of personal history, which may include childbearing and parturition, menopause and aging, and early socialization. In addition, women link their own continence problems with perceived personal failings (e.g., lack of exercise, being overweight) and, hence, see the condition as a symbol of their lack of moral worth. Following this, women's understandings of the relationship of incontinence to their social membership extend far beyond the difficulties of disguising their physical problems.

Adult↗
PubMed1999

Public health developments in colonial Malaya: colonialism and the politics of prevention.

In both African and Asian colonies until the late 19th century, colonial medicine operated pragmatically to meet the medical needs first of colonial officers and troops, immigrant settlers, and laborers responsible for economic development, then of indigenous populations when their ill health threatened the well-being of the expatriate population. Since the turn of the century, however, the consequences of colonial expansion and development for indigenous people's health had become increasingly apparent, and disease control and public health programs were expanded in this light. These programs increased government surveillance of populations at both community and household levels. As a consequence, colonial states extended institutional oversight and induced dependency through public health measures. Drawing on my own work on colonial Malaya, I illustrate developments in public health and their links to the moral logic of colonialism and its complementarity to the political economy.

Africa↗
PubMed1998

Patterns of treatment for malaria in Tayabas, The Philippines: implications for control.

This paper describes local understandings of illness and documents treatment-seeking behaviour in Tayabas, Quezon, The Philippines. Data were collected using focus group discussions and narrative interviews with adults and with mothers of children, who had had confirmed malaria during a two-month surveillance period. Signs and symptoms of malaria are important in directing individual diagnosis, treatment-seeking and therapy. Household therapy with antimalarials, and more commonly antipyretics and herbs, as used before seeking care from either the formal or informal sector. Care outside the home was sought where symptoms continued and/or worsened, with an average period of time from onset of symptoms to presentation to a clinic of six days. Accessibility to clinics is not a problem in the study area and hence the primary reason for delay was propensity to self-treat first and to discontinue medication when feeling better. These factors affect the control of malaria and the potential to reduce transmission. Better advice to the community regarding the importance of diagnosis and compliance with antimalarial therapy is indicated.

Adult↗