Six young women from a remote Tarahumara pueblo are functioning as village health workers. Through qualitative research techniques informed by symbolic interactionism, the investigator has sought to determine what it is like for these women living in a pre-Columbian society to develop this new role. Some issues guiding the research were; education, families' reactions to the new role, perceived changes in the health status of the pueblo and current attitudes of village health workers toward their new role. Although it was difficult for these women to respond to abstract questions regarding their feelings and emotions, rich descriptive data emerged outlining the women's perceptions of the village health worker role and its effects on their families and the community. The major themes that emerged during this research were; "wanting to learn more;" "less sickness and death among children;" "personal hygiene has changed lives;" and "medicine is gaining acceptance."

The Breastfeeding Education Support Team (BEST) is a pilot project to promote breastfeeding in WIC clients in Tucson, Arizona. In this study, the control group breastfed their infants significantly longer than the intervention group (p < .006). Ethnicity and perceived support were shown to positively affect breastfeeding longevity in the control group. The intervention did increase the probability that a client receiving it would initiate breastfeeding (p < 0.06). The trimester a client attended the BEST class did significantly affect the longevity of breastfeeding in the intervention group (p < 0.016). The control group appeared to be influenced by cultural norms that favor breastfeeding. The intervention group seems to be functioning under transitional influences that do not favor breastfeeding. Strategies that include the BEST class, homevisiting a new breastfeeding mother, and the formation of breastfeeding support groups could increase the initiation and longevity of breastfeeding in this population.

This thesis investigates several different control techniques as applied to hyperthermia-based models. These control techniques are control switching, Model Reference Adaptive Control, and Self Tuning Regulators. These three techniques are compared to a conventional PI controller. The objective of each controller is to regulate three temperatures associated with models which represent a three region tissue volume using a single input. Consideration is given to different types of blood perfusion levels as well as restrictions placed on the flexibility of the input power. This thesis shows that during simulations of the hyperthermia treatments, the Self Tuning Regulator technique is more effective at regulating the temperatures.

A descriptive study was conducted to investigate the relationship between socio-demographic factors and the immunization status of two year old children. Secondary data were collected from records of 105 two year old children enrolled in the Well Child Clinics of a county health department. Results revealed that 37.5% of the sample had achieved complete immunization status. No statistically significant relationship was found between trimester prenatal care began, maternal age, number of children living in the home, neonatal problems, ethnicity, source of care, referral to Walk-In Clinic, and current visits by a PHN, and the immunization status of two year old children. A statistically significant relationship was found between potential for AHCCCS and incomplete immunization status. The variables that demonstrated significant predictive ability were ethnicity, maternal age, referral to walk-in clinic, potential for AHCCCS and neonatal problems.

<p> <b>Background</b>: In September 2006, the Centres for Disease Control and Prevention (CDC) recommended changing to opt-out screening of HIV for all patients in all health-care settings and for all pregnant women as part of the routine panel of prenatal screening. In opt-out HIV testing, a health care provider verbally informs the patient that the test will be performed and consent is assumed unless they refuse. Earlier opt-in HIV testing guidelines required informed written consent and was targeted at high-risk populations. The objective of this study was to evaluate the impact of opt-out HIV screening in family planning centres. </p><p> <b>Methods</b>: In 2011, data were collected in a pre-post survey design study conducted at 6 Planned Parenthood of Southern New England (PPSNE) clinical centres in Connecticut. The pre-test period used opt-in HIV screening and the post-test period used opt-out HIV screening. Differences in participant characteristics and HIV testing rates, satisfaction, and perceptions of HIV testing were compared between the pre (n=250) and post periods (n=250). Patient characteristics examined were gender, age, race, language, income, family size, insurance status, previous HIV and STD testing at Planned Parenthood. </p><p> <b>Results</b>: The mean age of patients offered HIV screening was 26 years old, 58% were white, 26% were black, 12% were Hispanic, and 3.2% were other races. Three-quarters of participants were female. Characteristics of patients receiving opt-in and opt-out screening did not significantly differ for all variables except income (p>0.05 for all except income). HIV testing rates (74% and 75%, respectively) and satisfaction with HIV testing (75% and 77%) were similar between both opt-in and opt-out groups (p>0.05 for both). However, patients receiving opt-in versus opt-out screening differed significantly with respect to their opinions of HIV opt-out screening (93% vs. 98% agreed that HIV screening should be routine for the general population). Patients accepting versus refusing opt-out HIV testing in the post-period differed significantly based on gender, testing centre, and reason for visit (p&lt;0.05 for all). Those accepting opt-out testing were more likely to be male, tested in Hartford North, and seeking care for an asymptomatic STD test. At an alpha level of 0.05, both the full and reduced multivariate logistic regression models revealed that individuals who were tested in Danielson were less likely to accept opt-out HIV testing (as compared to reference categories). Hispanics and individuals seeking care for asymptomatic STD visits were more likely to accept opt-out HIV testing (as compared to reference categories). </p><p> <b>Conclusion</b>: In family planning centres, opt-in and opt-out HIV screening have similar outcomes in patients' characteristics, HIV testing rates and satisfaction. Testing rates were high in the pre-test period, which may have resulted in a ceiling effect on the HIV testing rates in the post-test period. Opt-out testing was less effective for some groups and further studies should be conducted to understand this phenomenon.</p>

<p> The capstone project reports the risk factors causing unplanned hospital readmission of vascular patients as well as the effects on healthcare cost. The methods for determining the risk factors include clinical indicators for risk prediction process, and the STAAR (State Action on Avoidable Rehospitalization) initiatives, which can be used as healthcare improvement projects to facilitate the cross-continuum team. The findings indicate a relationship between the patient&rsquo;s engagement in the lower extremity vascular procedure, and effectiveness of follow-up after surgery in the reduction of hospital readmission and healthcare cost. Potential strategies to prevent the risk factors for readmission of vascular patients and to reduce the healthcare cost are discussed. Presenting unplanned readmission for vascular patients and reducing the cost associated with readmission is important for senior leaders and policy makers to improve health care outcome.</p>

The prevalence of hypertension is 2 to 4.5 times higher among blacks than whites. Rates of severely elevated pressures are 6 times higher for blacks. In addition, blacks are among the least likely to obtain treatment for this disease. While research suggests that meditation may be useful in lowering blood pressure, the results reflect a good deal of variability between patients. It was hypothesized that a large portion of this variance may be due to differences in compliance to the meditation regimens. / To test this hypothesis, an experiment was conducted with 51 black adults. Compliance was defined as attendance to the weekly meditation or educational training sessions. To increase compliance individuals were assigned to one of three groups; individual meditation, group meditation, or a didactic control group. Each participant was given a questionnaire to assess their degree of comfort with the condition to which they were assigned. / The data support the claim that greater compliance to a meditation program leads to greater decreases in blood pressure. Determination of differences in degree of satisfaction and its subsequent effect on attendance to specific programs was not possible, probably because of structural problems in the phenomenological questionnaire. / Source: Dissertation Abstracts International, Volume: 50-06, Section: B, page: 2617. / Major Professor: Wallace A. Kennedy. / Thesis (Ph.D.)--The Florida State University, 1988.

Research has shown that teaching of behavioral techniques is successful in helping willing smokers to quit, only to return to smoking within a short time period. A sizable minority (20-50%) do not quit at all. This study investigated the hypothesis that the current emphasis on particular techniques for change (i.e. behavioral modification) rather than examining other potentially crucial variables (i.e. health beliefs) is responsible for the aforementioned results. Quitting smoking was conceived as a two phase process: (1) developing a set of specific health beliefs, hypothesized to be associated with non-smoking behavior and (2) learning behavioral techniques. The goal was to combine a persuasive message, based on the Health Belief Model, aimed at smoking related attitudes with a behavioral treatment program. Four treatment conditions were tested: persuasive message with behavioral techniques, persuasive message with placebo program, a placebo message with behavioral program, a placebo message with placebo program. Treatment was conducted in 17 groups (186 subjects total). Each group met for 10 sessions over a 9$1\over2$ week period. Data was collected at 5 points: before and after the first session, immediately before the second session, after the ninth session and after the last section. The results, analyzed by a path analysis, did not support the hypothesis. The persuasive message was not effective in changing health beliefs. However, subjects with stronger perceptions of the seriousness of the smoking consequences and lower perceptions of the number of cigarettes that could be safely smoked each day smoked fewer cigarettes. As in prior research, the behavior treatment was effective in reducing smoking, with 51% abstinent at the end of treatment, confirmed by respiratory air measurement. / Source: Dissertation Abstracts International, Volume: 50-05, Section: B, page: 2207. / Major Professor: Daniel Boroto. / Thesis (Ph.D.)--The Florida State University, 1989.

The purpose of this study was to examine the personality characteristics of male smokeless tobacco users. The study objective was to determine any differences in personality characteristics between smokeless tobacco users, former users of smokeless tobacco, and non-users of tobacco. An additional comparison was made between cigarette smokers and smokeless tobacco users. A survey in the Houston, Texas vicinity provided a sample of 724 males, 202 smokeless tobacco users, 22 former smokeless tobacco users, 200 non-tobacco users, and 100 cigarette smokers. Each subject was administered a smokeless tobacco questionnaire, the Eyesenck Personality Questionnaire and the Spielberger State-Trait Anxiety Scale. The results of the study indicated that smokeless tobacco use is primarily a white male phenomenon; few black or other racial groups consumed smokeless tobacco amoung their population. Significant (p $<$ 0.05) personality differences were found between non-users of tobacco and smokeless tobacco users. Cigarette smokers reported experiencing more stress, but are less sociable, optimistic and impulsive compared to the smokeless tobacco users. Practical implications and future research considerations are suggested. / Source: Dissertation Abstracts International, Volume: 51-07, Section: B, page: 3606. / Major Professor: Wallace A. Kennedy. / Thesis (Ph.D.)--The Florida State University, 1990.

<p> In response to the growing need for early disease detection and diagnosis, Mastergene aims to provide genetic testing services ranging from new born screening to diagnostic screening for individuals up to 65 years of age to gain insight into their genetic information &amp; understand their own health &amp; personal information. This information will assist individuals in making treatment decisions for healthy living. Through Indian healthcare market analysis, it is evident that there exists a huge gap between hospitals and patients when it comes to understanding genetic testing and its benefits. Mastergene, with its innovative in-house laboratory, will arise awareness amongst the general population and will facilitate early detection of highly prevalent diseases in the Indian community. As a stand-alone diagnostic laboratory, Mastergene will outsource genetic testing kits from a supplier, send it to its patients on order and obtain patient&rsquo;s sample in that genetic test kit for testing purposes. In conclusion, Mastergene will bring this enormous breakthrough to diagnose the disease from its root cause rather than symptoms alone.</p><p>