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The prevalence of Hepatitis C Virus (HCV) in the US is estimated at 3.5 million with 18,153 deaths in 2016. It is the most common bloodborne infection, with a higher age-adjusted mortality rate than Hepatitis B Virus or Human Immunodeficiency Virus. Without treatment, nearly 1.1 million people will die from HCV by 2060. About 41,200 new cases of HCV were reported in 41 states in the US in 2016. The reported cases of acute HCV in 2016 is 2.3 per 100,000 in Tennessee, which is more than twice the national goal set by Healthy People 2020. This is a descriptive study to ascertain the HCV prevalence and usefulness of screening in medical outreach settings (MO) compared to indigent healthcare clinics (IHC) in northeast Tennessee. This study period was from April 2017 – February 2019. Participants (n=250), were adults, who engaged in routine, opt-out HCV testing at 4 IHC and 3 MO sites in the Tri-Cities, TN region. During the screening, demographic information- age, gender, race- were collected and the de-identified data were analyzed using Statistical Analysis System (SAS 9.3) to perform a descriptive analysis. Also, several discrete Chi-Square tests of independence between the demographic variables, screening locations, and HCV antibody prevalence was conducted. A total of 250 clients were screened for HCV. The majority of clients screened were non-Hispanic whites 228 (91.20%); females 136 (54.40%); young adults 131 (52.40%) and at IHC clinics 187 (74.80%). Screening showed HCV antibody prevalence of 14.8%. The majority of positive cases were non-Hispanic whites 36 (97.30%; P=0.1561); females 19 (51.35%; P=0.6867) and young adults 23 (62.16%; P=0.286). The prevalence at the IHC clinics and MO settings were 36 (97.30%; P=0.0006) and 1(2.70%) respectively. This analysis shows the higher yield of targeted HCV screening at IHC clinics. Focused HCV screening is critical in the era of opioid epidemic, particularly when direct-acting antiviral agents (DAAs) which offer a Sustained Virologic Response (SVR) rate of more than 90% are available. The use of case control or cohort study designs to establish causality is recommended for improving focused HCV screening.

The purpose of this study was to explore and describe contributing factors that influence the perceptions of women with fibroids from diverse cultures regarding hysterectomy. The area of research was delimited to issues of hysterectomy among women with fibroid uterus. The study employed a descriptive explorative method and data were collected by means of structured questionnaires. The study was conducted in one academic referral hospital, over a period of six months. The respondents were the patients with fibroid uterus and the doctors and nurses in the gynaecological units of the hospital. The majority of the patients indicated that they were afraid of undergoing a hysterectomy because of the social stigma associated with this life-saving procedure, such as alienation or marginalization by members of their respective communities. The nursing staff and gynaecologists in the unit emphasized the deep-seated fear of hysterectomy amongst women from diverse cultures. The study found that women need information about their bodies and how they function. Health education is also needed for women and their communities. Research is needed amongst members of different communities and diverse cultures to voice their perceptions of women undergoing hysterectomy because of ill health. / Health Studies / M.A. (Health studies)

The purpose of this study was to explore and describe contributing factors that influence the perceptions of women with fibroids from diverse cultures regarding hysterectomy. The area of research was delimited to issues of hysterectomy among women with fibroid uterus. The study employed a descriptive explorative method and data were collected by means of structured questionnaires. The study was conducted in one academic referral hospital, over a period of six months. The respondents were the patients with fibroid uterus and the doctors and nurses in the gynaecological units of the hospital. The majority of the patients indicated that they were afraid of undergoing a hysterectomy because of the social stigma associated with this life-saving procedure, such as alienation or marginalization by members of their respective communities. The nursing staff and gynaecologists in the unit emphasized the deep-seated fear of hysterectomy amongst women from diverse cultures. The study found that women need information about their bodies and how they function. Health education is also needed for women and their communities. Research is needed amongst members of different communities and diverse cultures to voice their perceptions of women undergoing hysterectomy because of ill health. / Health Studies / M.A. (Health studies)