The purpose of this study was to determine the prevalence of known risk factors associated with diabetes among James Moody Adams (JMA) clinic patients in order to develop and test educational material and clinical interventions to reduce the incidence of pre-diabetes and uncontrolled Type II Diabetes. The research objectives for this study focused on: 1. prevalence of Type II Diabetic patients at the Clinic; 2. pre- and post-test knowledge level of patients regarding their Type II Diabetes; 3. relationship between dependent variables (body mass index [BMI], blood glucose level, blood pressure, waist circumference, level of tobacco use, and level of depression) and the independent variables (age, gender, family history of diabetes, socio-demographical data [education level, level of income], literacy, and exercise regimen, medication, and diabetes knowledge); 4. effectiveness of a nutritional and lifestyle modification intervention program to control Type II Diabetes. Two hypotheses tests: 1. decrease blood glucose levels of Type II Diabetes Mellitus patients; 2. decrease weight by 5 percent among pre-diabetic and Type II Diabetes Mellitus patients. A follow-up survey determined participant's reflection on key dimensions of the study and impact of unforeseen political unrest that occurred during this study. The methodology was a case study with clinical and educational intervention across a 6 months. The population included patients presenting at the JMA clinic at onset of the study; an initial sample of 96 reduced to 48 due in part to political unrest was still within power test specification. Instrumentation include researcher developed, standard of care clinical practice and standardized forms. Analyses utilized descriptive statistics and t-test. Significant gain was determined for diabetic knowledge (p < 0.001); and significant decrease in Type II Diabetic blood glucose with p = 0.031. An important conclusion is that implementing a Type II Diabetic prevention program is feasible and effective in this study. Future recommendations include replication of the study and implementation of protocols and education that were successful in this study. / Ph. D.

Tegucigalpa, the capital of Honduras, has experienced an unsatisfied water demand during the last three decades. The state owned water utility in charge of the water supply of the country, SANAA, has faced this deficit by providing an intermittent water supply. The intermittent water supply has increased the gap between the rich and the poor, who cannot afford water storage facilities. Theories explain water scarcity either by low precipitation or by lack of investment in water structures. This thesis investigates the applicability of both explanations by quantifying the annual precipitation in the sub catchments with water supply potential for Tegucigalpa, and identifying the problems which caused the lack of investment into the water infrastructure. The analysis concluded that even if the annual precipitation is abundant, it is not evenly distributed in time and in space. Furthermore, it is argued that the financial limitations which hindered the lack of investment in water structures originated in the low tariffs imposed, and to the practices of the patronage system. / QC 20111207

Since the 1800's, technological advances have extended the foundation on which telemedicine could build. With its evolution, telemedicine has proven to be a means of offering effective health care interventions, from a multitude of disciplines. Teledermatology, a specialty application of telemedicine, offers great potential in improving the standard of dermatologic care by bridging the gap between the expert opinion of dermatologists and those without access to basic dermatologic care, particularly in developing nations, where skin disease continues to be a major public health problem. In Honduras, the setting for this study, and other developing nations, technology to support telemedicine is available. Dermatologic disease is among the most common disease presentations in the developing world, which left untreated due to a lack of access to adequate medical care, can progress causing increased morbidity or even death. A potential but untested solution is teledermatology. Teledermatology offers great potential in improving the standard of dermatologic care by bridging the gap between the expert opinion of dermatologists and those without access to basic dermatologic care. The purpose of this study was to evaluate the prevalence and types of dermatologic conditions and the feasibility of a store-and-forward teledermatology system in an underserved area of Honduras, so as to potentially provide more timely diagnosis and treatment, implementation of preventative measures, and offer long term solutions.so as The justification and significance of this study was the potential of store-and-forward teledermatology to improve the standard of dermatologic care by improving access of populations in underserved areas to dermatology specialists through affordable technology. The methodology of this study was primarily case study descriptive. This study was conducted at a public primary care clinic (JMA Clinic) and satellite sites in underserved areas of Francisco Morazán, Honduras. During a four week period in Spring 2011, patients with dermatologic conditions were examined and photos taken of condition. The patient information was sent to 3 U.S. board certified dermatologists, who provided diagnosis and treatment within 24 hours, which allowed the clinic physician sufficient time to review recommendations before patient follow-up. Patients would receive follow-up within 48 hours of initial visit. Diagnostic agreement, image quality, and user satisfaction were evaluated. IRB forms were submitted and clearance given. The data was analyzed with SPSS using descriptive statistics. The primary findings were the types of dermatologic conditions, interobserver agreement, image quality, and patient and physician satisfaction. The findings of this study substantiate the need for dermatologic care, as approximately 1 out of every 5 patients of the JMA Clinic presented with a dermatologic condition. The majority of these patients were children or women in their late 20s and early 30s; many of whom had their condition for more than a year and most had not received prior therapy. The types of dermatologic conditions observed were typical of that seen at a dermatology clinic in the U.S., yet inclusive of tropical and regional differences. Dermatitis, infectious and pigmentary conditions were the most common presentations. The interobserver diagnostic agreement achieved was 78%, and improved when considering differential diagnoses. Image quality received high ratings. Patients and physicians recorded a high level of overall satisfaction. Physicians indicated improved knowledge of teledermatology. Because of the unique environment and circumstances, the results are limited to the setting in which the study occurs. This project was a pilot study limited to 4 weeks of data collection and will be limited in significance by its duration and small sample size with respect to the conclusions that can be drawn about the prevalence and types of dermatologic conditions. This study illustrates that teledermatology is a viable means of providing dermatologic care to those in an underserved area of Honduras, where a lack of or limited access to general healthcare or specialty dermatologic care exists. The data offers insights to draw conclusions and recommendations on the potential for similar models to be implemented in underserved areas throughout Honduras and other similar regions. / Ph. D.

There is a need to counteract economic injustice in the world. As an architect, as a creator, it is my responsibility to make the world a better place. I want to help people to help themselves by concentrating their efforts in a constructive way. I desire to create a prototypical solution for a village in an area with high unemployment and desperate poverty as a means to give work to people and to serve as an example for other groups of people wanting to do the same. The site I've chosen to illustrate this concept of self-help housing is a 300 x 500 meter plateau in Tegucigalpa, Honduras. / Master of Architecture

The scarcity of data poses a challenging obstacle for the study of natural disasters, especially in developing countries where the social vulnerability plays as important a role as the physical vulnerability.  The work presented in this thesis is oriented towards the demonstration of the usefulness of press archives as a data source for the temporal and spatial analysis of landslides in Tegucigalpa, Honduras for the period between 1980 and 2005.  In the last four decades, Tegucigalpa has been characterized by a disorganized urban growth that has significantly contributed to the destabilization of the city’s slopes.  In the first part of the thesis, a description of the database compilation procedure is provided.  The limitations of using data derived from press archives have also been addressed to indicate how these affect the subsequent landslide analyses.  In the second part, the temporal richness offered by press archives has allowed the establishment of rainfall thresholds for landslide occurrence.  Through the use of the critical rainfall intensity method, the analysis of rainfall thresholds for 7, 15, 30 and 60 antecedent days shows that the number of yielded false alarms increases with the threshold duration.  A new method based on the rainfall frequency contour lines was proposed to improve the distinction between days with and without landslides.  This method also offers the possibility to identify the landslides that may only occur with a major contribution of anthropogenic disturbances as well as those landslides induced by high-magnitude rainfall events.  In the third part, the matrix method has been employed to construct two landslide susceptibility maps: one based on the multi-temporal press-based landslide inventory and a second one based on the landslide inventory derived from an aerial photograph interpretation carried out in 2014.  Despite the low spatial accuracy provided by the press archives in locating the landslides, both maps exhibit 69% of consistency in the susceptibility classes and a good agreement in the areas with the highest propensity to landslides.  Finally, the integration of these studies with major actions required to improve the process of landslide data collection is proposed to prepare Tegucigalpa for future landslides.