Hispanics are the largest minority group in the United States. They are disproportionately affected by diabetes and are twice as likely to develop diabetes then are non-Hispanic white adults. Mexican Americans are the largest subpopulation of Hispanics in the United States and one out of ten has diabetes. The purpose of this qualitative descriptive study was to explore the experiences of adults of Mexican origin who were newly informed of having elevated glucose levels in the diabetes range. This qualitative inquiry was conducted by means of in-depth semi-structured interviews with eight individuals of Mexican origin who had been recently informed of having hyperglycemic values exceeding the threshold of diabetes. A modified version of Kleinman's explanatory model of illness was used to elicit the EM of high blood sugar of the study participants. Qualitative content analysis was utilized to analyze the data. Domains, categories and subcategories were elicited through the immersion and crystallization of thematic units attained through the in-depth, semi-structured interviews. Three overarching domains emerged describing the experience and perception the participants had of being newly informed of having high blood sugar: 1) EM of High Blood Sugar 2) Response to Being Informed of High Blood Sugar 3) Facilitators and Barriers to Seeking Care. The participants describe a Temporal Order of how they responded to being informed of having high blood sugar. Facilitators, barriers and gaps to seeking care was also discussed. This study provides valuable insight that can influence the development of culturally relevant interventions that may promote behavior changes to reduce blood glucose levels and promote healthy outcomes for this population.

Much research relating to children and death has focused on the age-graded developmental model originally proposed by Nagy in the late 1940s. Children are alleged to pass from an infantile to a mature view, seeing death first as separation, then as the result of intervention by a supernatural being, and finally as an irreversible biological process. Accepted theory for thirty years, scholars have since noted difficulty in duplicating Nagy's findings and have come to question the universal application of the developmental model. Bluebond-Langner proposes an alternative model in which all views of death are present in all stages of development. She maintains that the particular orientation a child displays is a result of personal and social experiences.

Introduction: This project explores the links between shared cultural beliefs in the illness domain, specific to lymphatic filariasis, and a support group program implemented in three Haitian towns. The purpose is to introduce an innovative approach to evaluation, the cultural model evaluation technique (CM Evaluation), as well as gain an understanding of the shifting cognitive belief structure around the cultural domain of lymphatic filariasis in the Haitian setting as associated with a support group intervention. Method: The sample population was comprised of 241 women across three sites in Haiti: Archaie, Cabaret, and La Plaine. Data were collected from longitudinal surveys in 2003, baseline, and 2005, outcome. Descriptive statistics and CM Evaluation were utilized to assess the success of the support group program. CM evaluation is a two-pronged approach, comprised of cultural consensus analysis (CCA) and cultural consonance analysis (CC), that differs from standard evaluation tools in that it measures beliefs and behaviors at the shared community level and is culturally contextualized. Results: At baseline, most participants were not single (59%), Catholic (49%), literate (57%), relatively poor (71%), and engaged in selling at home or the market (46%). In the reduced model longitudinal CM comparisons, intervention and control groups, the intervention group had the highest rate of consensus (ER=4.71), significant changes in the culturally correct answer key (chi-sq=5.1, df=1, p<.02) and cultural competence (t=3.63, p<.0006). Alternately, controls exhibited no significant differences in the culturally correct answer key (Fisher’s Exact two-tailed p<1.00) or cultural competence (t=.62, p<.5407) from baseline to outcome. Conclusion: Evidence suggests that support group participation does significantly impact the shared illness beliefs surrounding lymphatic filariasis, and that this format is appropriate for resource poor settings lacking clinical support. Also, this study suggests that the CM evaluation approach is an appropriate and effective evaluation indicator for assessing changes in shared belief, cultural consensus analysis, resulting from public health interventions while the behavioral piece, cultural consonance, requires further refinement.

In 2013 Burma, the country of origin for many refugees of whom have resettled in the U.S. was in the top three countries for notification of suspected Latent Tuberculosis Infection (LTBI). Approximately 5%-10% of individuals diagnosed with LTBI are at risk of developing active tuberculosis (TB) disease; the highest risk occurs within two years following the diagnosis. Burmese refugees face a high potential of developing LTBI during resettlement in the U.S. and are at high risk for subsequent TB. Currently, we have limited knowledge of the Burmese Chin refugees' explanatory model (EM) of LTBI. Understanding the EM of these refugees is important because one's EM facilitates the recognition and response to illness, including early diagnosis and treatment. In the context of LTBI, this relates to the potential prevention of active TB disease. The purpose of this ethnographic study was to discover the Burmese Chin refugees' EM of LTBI and to describe the barriers experienced in receiving LTBI treatment. Kleinman's EM provided a conceptual framework to guide this study. A Burmese refugee gatekeeper assisted with community immersion and participant recruitment. Purposive and snowball sampling were used to recruit participants. Data were collected through participant observation and semi-structured interviews. Three data analysis strategies for ethnography that were used included domain, taxonomic, and componential analyses. Domain analysis began after open, inductive coding of the data. Data saturation was reached and the research questions were answered with eight participants. Data from 15 key informant interviews were abstracted into three domains: EM of LTBI, Fear and Stigmatization, and Barriers to Receiving LTBI Treatment. The over-arching theme, LTBI: My Shadowbox was derived from these three domains, 11 categories, and 25 subcategories through iterative and inductive data analysis. The analysis revealed the participants' language, behavior patterns, beliefs, values and health seeking experiences of LTBI in the U.S. The findings from this study will help to inform culturally tailored interventions to reduce LTBI and TB health disparities among Burmese Chin refugees and potentially other Burmese refugee subgroups in the U.S. Knowledge of the Burmese Chin refugees' EM of LTBI can inform health policy for reducing LTBI treatment barriers.

El presente estudio tiene como objetivo determinar si las variables satisfacción e inseguridad laboral explican la intención de renunciar al trabajo en jóvenes. Se evaluó a 150 jóvenes de edades entre 20 a 35 años que trabajan en una empresa del rubro de telecomunicaciones. Se aplicó la Escala de Intenciones de Renunciar al Trabajo, Escala de Inseguridad Laboral y, por último, el Índice Breve de Satisfacción Laboral Afectiva, los cuales fueron validados en el contexto peruano. Finalmente, se obtuvo como resultado, mediante el Modelo Explicativo Latente, que la Satisfacción Laboral y la Inseguridad Laboral explican en un 90% y un 100%, respectivamente, la Intención de Renunciar al Trabajo. Estos resultados contribuirán a que se puedan formular estrategias para la retención del personal y reducción de las tasas de rotación en las organizaciones, así también, las escalas validadas podrán ser usadas en futuras investigaciones. / The objective of this study is to determine if the variables job satisfaction and insecurity explain the intent to quit job in young people. 150 young people between 20 and 35 years old who work in a telecommunications company. The Intentions to Quit Work Scale, the Job Insecurity Scale and, finally, the Brief Index of Affective Job Satisfaction were applied, which were validated in the Peruvian context. Finally, it was obtained as a result, through the Latent Explanatory Model, that Job Satisfaction and Job Insecurity explain by 90% and 100%, respectively, the Intention to Quit Work. These results will contribute to the formulation of strategies for staff retention and reduction of turnover rates in organizations, as well as, the validated scales can be used in future. / Tesis

Submitted by Haroudo Xavier Filho (haroudo.xavierfo@ufpe.br) on 2016-04-19T13:37:12Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Thesis - doutorado - JOSÉ MÁRIO WANDERLEY GOMES NETO - PPGCP.pdf: 3518425 bytes, checksum: 444d5191f5baf897a0a79d96a01bf1c9 (MD5) / Made available in DSpace on 2016-04-19T13:37:12Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Thesis - doutorado - JOSÉ MÁRIO WANDERLEY GOMES NETO - PPGCP.pdf: 3518425 bytes, checksum: 444d5191f5baf897a0a79d96a01bf1c9 (MD5) Previous issue date: 2015-07-15 / Por que o Judiciário decidiria a favor do Executivo e contra as suas próprias decisões? Essa questão é explorada teórica e empiricamente com referência ao pedido de suspensão - um mecanismo pelo qual o Poder Executivo nos diversos níveis federativos pode pedir ao Presidente de um Tribunal para suspender os efeitos concretos de uma decisão proferida por órgão judicial de hierarquia inferior. Para responder a questão de pesquisa um conjunto de hipóteses formuladas à luz dos principais modelos teóricos existentes na literatura sobre os processos decisórios das decisões judiciais– legalista, atitudinal e estratégico – são testadas a partir de em uma base dados contendo uma amostra de 319 decisões sobre o pedido de suspensão no STF no período 1993-2012. Os achados dos modelos econométricos estimados (Logit) na tese são consistentes com a interpretação dos modelos estratégico e atitudinal: os juízes atuam como atores que buscam maximizar sua preferências em um contexto de separação de poder e seu padrão decisório é também marcado pela ideologia dos governos responsáveis por sua nomeação. / Why the Judiciary’s bodies would decide in favor of the Executive and against their own decisions? This issue is explored theoretically and empirically with reference to the writ of suspension - a mechanism by which the Executive branch may request the Chief Justice of a Court to suspend the concrete effects of a judgment given by another court of lower hierarchy. To answer the research question a set of assumptions were made based in the main existing theoretical models in the literature on decision-making processes of judicial decisions – legalistic, attitudinal and/or strategic – and were tested from in a database containing a sample of 319 decisions on writ of suspension filled in the Brazilian Supreme Court (Supremo Tribunal Federal) in 1993-2012 period. The findings of the estimated econometric models (Logit) in this thesis are consistent with the interpretation of strategic and attitudinal models: the judges act as actors seeking to maximize their own preferences in the context of separation of power and its decision-making pattern is also marked by the ideology of governments responsible for their appointment.

Zwangserregtes Kupplungsrupfen ist ein Schwingungsphänomen, dessen Ursache in einer periodischen Modulation der Anpresskraft im Reibkontakt sowie des Drehmoments der Kupplung liegt. Diese periodische Modulation wird im Wesentlichen durch geometrische Abweichungen von der vorgesehenen Gestalt verursacht. Nach wie vor spielt es bei der Entwicklung von Kraftfahrzeugkupplungen eine große Rolle da die davon verursachten longitudinal Schwingungen des Fahrzeugs zu deutlichen Komforteinbußen der Fahrzeuginsassen führen. Obwohl bereits einige Einflussfaktoren des zwangserregten Kupplungsrupfens qualitativ bekannt sind, gibt es noch nicht für alle Einflussfaktoren geeignete, detaillierte Erklärungsmodelle, die Kupplungsentwicklern beim Verständnis der Wirkzusammenhänge von zwangserregtem Kupplungsrupfen unterstützen. Dies liegt unter anderem an den starken Wechselwirkungen, die über verschiedene Systemebenen auftreten und bisher kaum modelliert wurden. Daher werden in diesem Beitrag Gestalt-Funktion-Zusammenhänge auf zwangserregtes Kupplungsrupfen durch geometrische Abweichungen mithilfe des sogenannten C&C²-Ansatzes nach Albers und Matthiessen näher untersucht. Ein bereits vorhandenes Modell wird dabei um geeignete Granularitäten und Perspektiven erweitert und die Wirkzusammenhänge werden zu unterschiedlichen Zeitpunkten als sogenannte Sequenzmodelle dargestellt. In einem iterativen Prozess werden sowohl Hypothesen als auch Modelle entwickelt und es werden experimentelle Untersuchungen abgeleitet. Ausgewählte Einflussfaktoren werden hierzu in Form von Variationen an einem Prüfstand untersucht, um die Hypothesen zu verifizieren oder zu falsifizieren, und es werden erste quantitative Ergebnisse gewonnen. Dies ermöglicht die Erklärung von Ursachen für zwangserregtes Kupplungsrupfen die durch bisherige Erklärungsmodelle noch nicht hinreichend genau beschrieben werden, was durch die zum Teil großen Dynamiken der Wirkzusammenhänge begründet ist.

Notre thèse de pharmacie clinique est une contribution à l’optimisation de l’efficience du traitement antirétroviral (TAR) par des méthodes de modélisation en Côte d’Ivoire. La première étude a été consacrée à une modélisation de la réponse antirétrovirale par taxonomie des trajectoires de taux de CD4 en utilisant un modèle de méta-apprentissage des trajectoires d’indicateurs biomédicaux. Ce modèle appliqué à la taxonomie des trajectoires des taux de CD4 a montré son intérêt dans la mise en évidence de classes distinctes de patients avec des caractéristiques particulières justifiant et/ou déterminant le profil particulier de méta-trajectoires de leur marqueur immunologique au cours du traitement. La deuxième tâche a consisté en une évaluation de l’impact de principaux déterminants des méta-trajectoires de taux de CD4 sur divers types de réponse immunologique à partir d’un modèle explicatif avec une équation de régression logistique. Les réponses immunologiques considérées ont été exprimées en termes d’absence de gain de CD4, de gain sub-optimal et de gain optimal de CD4 à différentes périodes de suivi du TAR. Enfin l’évaluation de l’efficience des stratégies antirétrovirales de première ligne en Côte d’Ivoire, a été abordée dans la dernière partie avec un modèle pharmaco-économique. Nous avons effectué une étude préliminaire ouvrant des perspectives pour encourager la mise en oeuvre d’évaluations pharmaco-économiques complètes par modélisation en Côte d’Ivoire. Elle a permis de mettre en exergue les parties méthodologiques pouvant être sujettes à caution dans une étude de modélisation pharmaco-économique des TAR de première ligne dans un contexte de ressources limitées / Our thesis of Clinical pharmacy is a contribution to optimize the efficiency of antiretroviral therapy (ART) by modeling methods in Côte d'Ivoire. The first study was devoted to modeling the antiretroviral response from taxonomy of CD4 counts trajectories, using a meta-learning model of biomedical markers trajectories. This model applied to the taxonomy of the CD4 counts trajectories showed its interest in the identification of distinct classes of patients with particular characteristics justifying and/or determining the specific profile of meta-trajectories of the immunological marker during treatment. The second task was an assessment of the impact of key determinants of CD4 counts meta-trajectories on various types of immune response from an explanatory model with a logistic regression equation. Antiretroviral immune responses considered were expressed in terms of absence of CD4 gain, sub-optimal gain and optimal gain of CD4 at different periods of follow-up of ART. Finally the evaluation of the efficiency of first-line antiretroviral strategies in Côte d'Ivoire, was discussed in the last part with a projective pharmaco-economic model. We conducted a preliminary exploratory study opening up prospects to encourage the implementation of comprehensive pharmaco-economic assessments by modeling in Côte d'Ivoire. This study helped to highlight the unreliable methodological sections in a pharmaco-economic modeling of first-line ART in resource-limited settings

This report examines the risk and protective factors that the students who live and attend school in a particularly vulnerable area have, according to the “school personnel”, that are linked to antisocial and norm-breaking behavior. A particular targeting has been made for the girl’s risk- and protective factors. Semi-structured interviews have been conducted at a school for children between 6-12 years old, which is presented and analyzed using a thematic analysis and literature. The report uses the ecological explanatory model as a theoretical background. The conditions are different for children living and attending school in a particularly vulnerable area, where the students risk factors significantly outnumber their protective factors, that increase the student’s risk of developing anti-social and/or norm-breaking behavior such as drug use, violence and criminality. School personnel are positive about their own work and the school's role as a protective factor but illustrate several challenges for their work. In the discussion, the student’s risk- and protective factors are problematized, and the Swedish language is presented to be the factor that has the greatest impact on the student’s future without antisocial and/or norm breaking behavior. / Denna rapport undersöker risk- och skyddsfaktorer, kopplade till antisocialt och normbrytande beteende, som skolpersonal identifierar hos sina elever, som bor och går i skolan i ett särskilt utsatt område. En särskild fördjupning görs gällande flickornas risk- och skyddsfaktorer. Detta görs genom semistrukturerade intervjuer på en låg- och mellanstadieskola, som redovisas och analyseras med hjälp av en tematisk analys och befintlig litteratur/forskning. Rapporten har den ekologiska förklaringsmodellen som teoretisk bakgrund. Förutsättningarna är annorlunda för de barn som bor och går i skolan i ett särskilt utsatt område. Dessa elever exponeras för betydligt fler riskfaktorer än skyddsfaktorer, vilket ökar risken för eleven att utveckla antisocialt och/eller normbrytande beteende såsom droganvändning, våld och kriminalitet. Skolpersonalen förhåller sig positiva till sitt eget arbete och skolans roll som skyddsfaktor men belyser även ett flertal utmaningar i sitt arbete. I diskussionen problematiserats elevens risk- och skyddsfaktorer och det svenska språket redovisas vara den faktor som har störst betydelse för elevens framtid utan ett antisocialt och/eller normbrytande beteende.