Thesis (M.S.)--University of Michigan, 1991.

Thesis (M.S.)--University of Michigan, 1983.

Thesis (M.S.)--University of Michigan, 1983.

Thesis (M.S.)--University of Michigan, 1991.

Although the incidence of breast cancer is high among Caucasian women, African American women continue to experience higher breast cancer mortality and lower survival rate in comparison to Caucasian women of the same age. Research regarding breast cancer screening among ethnic minority women from lower socioeconomic groups is extensive, but there is a lack of research that investigates barriers to breast cancer screening among African American women of higher socioeconomic status. The purpose of this study was to compare health beliefs of African American and Caucasian women regarding perceived barriers to breast cancer screening. The sample for this study consisted of 80 women, 40 African American and 40 Caucasian women, who were between the ages 40 to 80 years. The study was conducted at two local community churches located in Tampa, Florida. The barriers subscale from the Health Belief scale was used for data collection. Descriptive statistics were used to analyze demographic data, and independent t-test were used to compare the two groups in their perceived barriers. Results revealed that both groups perceived barriers to breast cancer, there were more similarities than differences. However, African American women were significantly more likely to indicate that having a mammogram would make them worry about breast cancer (p= 0.39). Although previous research has shown differences African American and Caucasian women, this study did not support those results. The two groups of women were similar in age, education, and marital status and all were active in their churches. Perhaps these similarities led to the lack of differences in perceived barriers scores between the two groups. This finding lends support to the idea that socioeconomic status more than race leads to disparities in breast screening.

Thesis (M.S.)--University of Wisconsin-Madison, 1992. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 36-42).

Thesis (Ph.D.)--Memorial University of Newfoundland, 2004. / Bibliography: leaves 272-291.

FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / Objetivou-se avaliar uso da cartilha educativa virtual como ferramenta para promover a autoavaliaÃÃo ocular subsidiada pelo pressuposto da aprendizagem significativa. Estudo quase experimental, desenvolvido em uma universidade pÃblica federal brasileira, com alunos regularmente matriculados em cursos de graduaÃÃo. A amostra foi composta por 324 estudantes, entre janeiro a maio de 2014, por uma equipe de treze acadÃmicos de enfermagem e dois enfermeiros. Para coleta, utilizaram-se quatro instrumentos, durante o procedimento a equipe realizava observaÃÃo, e, ao seu tÃrmino, o exame ocular. Para anÃlise estatÃstica utilizou-se o software SPSS versÃo 19.0, bem como para medir o grau de concordÃncia entre os resultados dos exames, foi realizado o teste Kappa, considerando-se nÃvel de significÃncia de 5% e p-valor de 0,05. A fim de verificar a relaÃÃo entre o seguimento dos passos no autoexame, utilizou-se teste de Qui-quadrado ou exato de Fisher, e seguiu-se as recomendaÃÃes Ãticas propostas pela ResoluÃÃo 466/12. A maioria dos participantes era do sexo masculino 193 (59,6%), sendo 294 (91,0%) solteiros, 279 (86,1%) procedentes do interior do PiauÃ, idade mÃdia de 21 anos, com renda familiar mÃdia de R$ 737 mensais. Apesar do desconhecimento sobre problemas oculares, 98 (30,2%), constatou-se que o erro de refraÃÃo foi o principal problema ocular, 175 casos (54,0%). Um nÃmero expressivo, 321 (99,1%), concordou que a realizaÃÃo do exame ocular nÃo se restringia apenas ao mÃdico e mesmo nÃo substituindo a consulta com oftalmologista, 222 (68,8%), o autoexame deveria ser adotado como prÃtica regular, 266 (82,4%), tendo a cartilha virtual apontado corretamente sua forma de realizaÃÃo, 273 (84,6%). Reiterada pela percepÃÃo de que a cartilha està organizada de forma lÃgica e clara, 305 (94,4%), os materiais para o exame sÃo fÃceis de serem encontrados, 319 (98,8%), bem como sua linguagem simples, 313 (96,6%). Comprovou-se ser possÃvel a aprendizagem significativa mediada pela cartilha virtual, pois comparativamente os resultados dos exames mostraram-se similares, obtendo-se apenas nos exames da acuidade visual para perto e visÃo perifÃrica Ãndice de concordÃncia considerado razoÃvel, os demais foram superiores, com Ãndice Kappa>0,2. Apenas a inobservÃncia da higiene das mÃos antes do procedimento, 52 (16,3%), e o posicionamento da escala de Snellen, 144 (44,4%), foram realizados de forma incorreta, sendo o segundo fator determinante para comprometimento do teste da acuidade visual. A cartilha virtual sobre autoexame ocular promove aprendizagem significativa, funcionando como organizador da estrutura cognitiva, possibilitando aprendizado por descoberta dirigida e autÃnoma. / This study aimed to evaluate the use of a virtual educational leaflet as an instrument to promote eye self-examination based on the assumption of meaningful learning. A quasiexperimental study conducted in a Brazilian federal university with students regularly enrolled in undergraduate courses. Data collection occurred with 324 students, between January and May 2014, by a team of thirteen nursing students and two attending nurse. For collection, we used four instruments, during the procedure, the team performed observation; and later, the eye examination. The data were submitted analysis by the SPSS software version 19.0. To measure the degree of agreement between the test results, we applied the Cohenâs kappa, considering a significance level of 5% and p-value of 0.05. To verify the association between following the steps in self-examination, we used the chi-square or Fisherâs exact test. We followed the ethical recommendations proposed by Resolution 466/12. Most participants had a mean age of 21 years; were single, 294 (91.0%); male, 193 (59.6%); came from the interior of the state of PiauÃ, Brazil, 279 (86.1%); with an average family income of R$737 per month. Despite the lack of knowledge about eye problems, 98 (30.2%), the majority reported being able to name at least one visual problem, 226 (69.8%), mainly refractive error, 175 (54.0%), still, 310 (95.7%) agreed that the routine eye exam was very necessary. A significant share agreed that performing the eye examination was not restricted only to the doctor, 321 (99.1%), and despite not replacing an ophthalmology consultation, 222 (68.8%), self-examination should be adopted as a regular practice, 266 (82.4%), where the virtual leaflet correctly presented its accomplishment, 273 (84.5%). Reiterated by the perception that the leaflet is organized logically and clearly, 305 (94.4%), the materials for the examination are easy to find, 319 (98.8%), and it has a simple language, 312 (96.6%). A meaningful learning mediated by the virtual leaflet has proved possible, since the compared test results were similar, obtaining a concordance index considered reasonable only in tests of near visual acuity and peripheral vision, others were higher, with Cohenâs kappa>0.2. Only the lack of hand hygiene before the procedure, 52 (16.3%), and the positioning of the Snellen chart, 144 (44.4%), were performed incorrectly, the latter being a determining factor for compromising the visual acuity test. This type of technology is proven effective and works as an organizer of cognitive structure, enabling learning by directed and autonomous discovery.

FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / Uma proporÃÃo significativa de indivÃduos em estÃgios diferenciados de evoluÃÃo da infecÃÃo pelo HIV apresenta alteraÃÃes oculares irreversÃveis, por falta de diagnÃstico e tratamento precoces, por vezes essas alteraÃÃes ocasionam perda da acuidade visual. Portanto, uma cartilha impressa sobre autoexame ocular foi desenvolvida, e pensando em ampliar o acesso deste material foi desenvolvido para um ambiente digital, o qual se justifica pela necessidade de ampliar o conhecimento sobre o autoexame ocular e aumentar a adesÃo a esta prÃtica. Assim objetivou-se avaliar tecnologia educacional a distÃncia para a promoÃÃo da saÃde ocular; adequar material impresso ao meio virtual; analisar o uso do ambiente virtual da cartilha virutal sobre Autoexame Ocular e avaliar a Cartilha Virtual sobre Autoexame Ocular com juÃzes especialistas de aspectos pedagÃgicos e tÃcnicos. Trata-se de estudo de elaboraÃÃo de material educacional digital proposto por Falkembach, com as seguintes fases: elaboraÃÃo do material educativo digital, fase de modelagem, implementaÃÃo, distribuiÃÃo e avaliaÃÃo. Foi desenvolvido no LaboratÃrio de ComunicaÃÃo em SaÃde da Universidade Federal do Cearà no perÃodo compreendido de 2009 a 2010. Na primeira fase seguiu-se a elaboraÃÃo do material digital. Na segunda etapa foi a submissÃo do material ao julgamento inicial de acadÃmicos de enfermagem no intuito de se identificar dificuldades de uso do material criado, e realizado adequaÃÃo da linguagem do material educativo digital. Na terceira etapa submeteu-se o material à avaliaÃÃo por juÃzes especialistas da Ãrea de educaÃÃo e informÃtica. Como resultados foi possÃvel identificar falhas iniciais na estruturaÃÃo das pÃginas, e os comandos tiveram de ser recolocados, unificados e dispostos em local de fÃcil visualizaÃÃo. Portanto, reformulou-se o material digital no sentido de adequÃ-lo ao ambiente virtual, reestruturando inclusive a linguagem. A escolha pelo vÃdeo tutorial revelou ser uma ferramenta eficaz na capacitaÃÃo individual, e promoveu maior autonomia pelo fato de subsidiar a realizaÃÃo dos exames oculares pelo usuÃrio. Na avaliaÃÃo dos entrevistados o material se mostrou de fÃcil navegaÃÃo e com capacidade de despertar a curiosidade e interesse em acessar o conteÃdo considerado pelos avaliadores de fÃcil compreensÃo. à fundamental o uso de novas tecnologias do cuidado com enfoque nas aÃÃes educativas, entretanto, à necessÃrio uma avaliaÃÃo de suas limitaÃÃes, benefÃcios e uma adequaÃÃo Ãs necessidades dos usuÃrios, jà que a avaliaÃÃo à um processo contÃnuo de aperfeiÃoamentos e ajustes necessÃrios, e assim propor um caminho inovador que gerem atitudes conscientes e intencionais, alÃm da valorizaÃÃo e reconhecimento do exercÃcio de cidadania. Espera-se que, a cartilha virtual sobre autoexame ocular facilite a identificaÃÃo de alteraÃÃes visuais e tambÃm proporcione incentivo na busca de uma assistÃncia oftalmolÃgica, aspecto indispensÃvel na AIDS. / A significant proportion of individuals at different stages of evolution of HIV infection presents irreversible eye changes due to lack of early diagnosis and treatment, sometimes these changes cause loss of visual acuity. Therefore, a printed guide on eye self-examination was developed, and aiming to increase the access to this material it was developed for a digital environment, which is justified by the need to increase the knowledge on eye self-examination and the adherence to this practice. Thus it was aimed to assess the distance education technology for the eye health promotion; match the printed material to the virtual; assess the Virtual Guide on Eye Self-examination of expert judges on pedagogical and technical aspects. It is a study to develop digital educational material proposed by Falkembach, with the following stages: preparation of digital educational material, modeling phase, implementation, distribution and assessment. It was developed at the Laboratory of Health Communication, Federal University of Cearà from 2009 to 2010. In the first phase the development of digital material was done, then it was submitted to the initial trial of nursing students in order to identify difficulties in the use of material created, and the language adjustment of the digital educational material was made. In the final stage it was submitted to the assessment by expert judges in the area of education and IT. As a result it was possible to identify flaws in the initial structuring of pages, and commands had to be replaced, unified and arranged in places of easy viewing. Therefore, the digital material was reformulated in order to be appropriate to the virtual environment, including restructuring the language. The choice for the tutorial video was proved to be an effective tool for individual training, and promoted greater autonomy for the fact that supports the achievement of eye examinations by the user. In the assessment of interviews the material was proved to be easy to navigate and able to arouse curiosity and interest in accessing the content considered by the evaluators easy to understand. It is important to use new care technologies focused on educational actions, however, it requires a complete assessment of its limitations, benefits and an adjustment to the needs of users, once it is a continuous process of improvement and adjustment, and so propose an innovative way to generate conscious and intentional attitudes, as well as appreciation and recognition of the exercise of citizenship. We hope that the virtual guide on eye self-examination facilitates the identification of visual changes and also provides stimulus to search for eye care, indispensable aspect in AIDS.

Philosophiae Doctor - PhD / Cancer is a major public health concern in both developed and developing countries; it accounts for 13% of all deaths globally, of which 70% occur in middle- and low-income countries. In Nigeria, over 10 000 cancer deaths and 250 000 new cases of cancer are recorded yearly. Breast cancer is the second most common cancer worldwide, after lung cancer. It is the most common type of cancer diagnosed in women and the most common cause of death worldwide. Late detection and diagnosis of breast cancer leads to high mortality rate. In Nigeria certain cultural taboos are associated with breast cancer, which lead to poor information dissemination to women in rural communities. Breast self-examination (BSE) provides an inexpensive method for early detection of breast tumours. Knowledge and awareness about Breast Self-Examination are critical to promote consistent practices when the people concerned are empowered with the needed information to acquire the knowledge and skills which will inform practice of any health issue. In Nigeria it was reported that the number of women at risk of breast cancer increased progressively from 24.5 million in 1990 to about 40 million in 2010. This number is projected to rise to over 50 million by 2020, should the trend continue unabated. The current study explored the understandings of breast cancer and prevention, with particular emphasis on BSE practice among rural women, and developed an empowerment programme to promote uptake of this practice in a rural community in a south-western state of Nigeria. The study was framed in the Health Belief Model and Kieffer’s empowerment process. Participatory action research was used as study design and approach; and utilized both qualitative and qualitative methods. The sample for quantitative phase comprised 345 women aged 20 to 60 years, selected from 5 communities using a cross-sectional procedure. Data gathering instrument was a questionnaire. Summative statistics were calculated using the SPSS program. The sample for qualitative phase comprised of 95 women who were selected from the respondents to the quantitative phase. The data was collected through focus group discussion. The qualitative data was subjected to thematic analysis. Three themes that emerged for qualitative analysis which are: knowledge/awareness of BSE, practice and appeal for intervention, and misconception and fear. The survey results showed that a large proportion of the respondents (75.1% and 76.5%) had low levels of knowledge about BSE and did not practice BSE. Also, about 77% of the respondents expressed one form of barrier or another to BSE practice. However, despite these inadequacies, 87% of the respondents were ready and willing to improve their health if empowered with the right information and motivation. The empowerment program informed by the quantitative and qualitative phases and the stages of change with the full participation of the women. The program consisted of hands-on physical demonstrations, BSE pamphlets, and mnemonic songs were identified media of disseminating knowledge and practice of BSE. These media became the platforms for the empowerment programme developed for the women. A day was also set aside, just as is done for immunisation, for BSE practice and other women’s health issues to promote the prevention of breast cancer in the community. The “Physical demonstration” intervention resulted in an increase in the correct BSE practice from 23.5% at the beginning of the study, to 85.3% post the intervention. The “other intervention” resulted in 80% to 94.7% of participating women being able to practice correct physical step-by-step performance of BSE. The participatory approach contribute to a high levels of participation by women in Iddo local Government which led to the increase in the correct Breast Self–Examination as stated above.