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Background: Selected factors place Dominican female adolescent and adults at risk for sexually transmitted infections (STIs) such as Chlamydia, causative organism Chlamydia trachomatis, and Gonorrhea, causative organism Neisseria gonorrhoeae. The purpose of this study was to determine the prevalence of Chlamydia and Gonorrhea among adolescent and adult females that utilize the clinic in Veron, Dominican Republic. Clinical standards of care for these STIs and educational programs for prevention were developed from the data gathered from this study. Significance at 0.05 ά of the relationship of educational level, management of risk factors and other selected independent variables on prevalence rate of Chlamydia and Gonorrhea in the clinic population of Veron, Dominican Republic were determined. The objectives of the study were to 1) determine the prevalence of adolescent and young adult females diagnosed with Gonorrhea and Chlamydia who visit the clinic for prenatal visits, annual pap smear exams and gynecological complaints; 2) determine the extent to which educational level is a predictor of positive diagnosis or risk for infection of Chlamydia and Gonorrhea and; 3) determine which selected demographic and risk factors are associated with positive test results for Gonorrhea and Chlamydia. Methods: All adolescent and adult females ages 15 years and older visiting the clinic in Veron for prenatal exams, pap smear exams and gynecological complaints between January 28, 2008 – March 3, 2008 were invited to participate in this prevalence study. Of the 90 invited, the accepting sample was 90 who signed an informed consent form. Prior to STI testing each patient completed a verbal interview and questionnaire on sociodemographic characteristics as well as knowledge, attitudes, and beliefs related to Chlamydia and gonorrhea, sexual experiences and behaviors and illicit drugs use. Specimens collected from the endocervical canal of each female were tested and results provided within two hours, followed by immediate treatment by a licensed Dominican physician and follow-up care based on the guidelines and standards of care. The data were analyzed using descriptive statistics, chi square, t-test and logistic regression. Results: A total of ninety women participated in the study. Chlamydia was detected in 6.7% of the patient population and Gonorrhea was detected in 22.2% of the patient population. Co-infection of both Chlamydia and Gonorrhea was present in 2 cases. Among the positive Chlamydia tests results, 50% had less than a six-year education and 50% had more then six years of education. In addition, 83.3% of the patients with positive Chlamydia results answered "yes", they could read and 16.6% stated they could not read, while 83.3% of the patients with positive Chlamydia results stated they could write and 16.6% stated they could not write (P>0.05). Among the patients that tested positive for Gonorrhea, 55% stated they had less than six years of formal education and 45% had more than six years of formal education (P>0.05). There were 75% of the patients that tested positive for Gonorrhea that stated they could read and 25% who stated they could not read (P>0.05); while 85% of the patients with positive Gonorrhea results stated they could write and 15% stated they could not write (P> 0.05). Conclusion: Educational level and other selected demographic characteristics and risk factors in this study are not a significant predictor of positive diagnosis or risk of infection for Chlamydia or Gonorrhea. We cannot conclude that specific risk factors are associated with positive test results for Gonorrhea and Chlamydia. For the physicians involved in the clinical decision-making regarding the female patients at the Veron clinic, more data are needed to determine appropriate populations for screening of Gonorrhea and Chlamydia as well as appropriate educational tools on sexually transmitted infections. / Ph. D.

Hand transmitted vibration (HTV) is one of the most common hazards faced by workers in the construction industry. A major source of HTV is hand held percussion tools, such as pneumatically driven chipping hammers and rock drills. This thesis presents a new approach to measuring the vibration from these tools using an experimental hand arm model to which the tools are attached. The experimental hand-arm model has been designed to have similar dynamic characteristics to that of a human hand-arm system. This approach addresses the issue of repeatability as HTV measurements suffer from variability between cases. The measured acceleration of the hand-arm system is in range or close to range of the measured accelerations of the test subjects with superior repeatability. Further, the thesis presents a nonlinear numerical model of a pneumatic impact hammer. Fundamentally, the numerical model was made up of two different sub-models, 1) a fluid flow model and 2) a structural dynamic model. The fluid flow model was based on the equations for mass flow rate of air though a bleed orifice assuming an isentropic process. The second sub-model deals with modeling the structural components of the impact hammer consisting of the major hammer like the center body, handle, piston and chisel as well as the human hand and the ground. Time domain simulations of the hammer were carried out by using a state space formulation to get displacements, velocities and accelerations of the each component as well as the exhaust jet velocities. Experiments were carried out to measure the handle response and exhaust jet velocities as well as pressure profiles. The results obtained from the numerical model were then validated using these experimental results. Finally, a parametric study using the numerical model was carried out to explore different vibration control techniques. / Master of Science

Selection of a nondestructive evaluation method for inspection of composite materials is a difficult process due to their multilithic nature and complex failure. Development of new techniques, which are more cost-effective and practical, are needed. Transmitted light intensity has the potential to satisfy these criteria. By measuring light intensity transmitted through a composite sample during fatigue testing, changes in the intensity were correlated to damage development within the sample. By applying image enhancement and analysis techniques, damage development due to matrix cracking and delamination, was detected and presented in images that were easy to understand. / Master of Science

No / In this study, we assessed if the superimposition of incident sexually transmitted infections (STIs) on HIV phylogenetic analyses could reveal possible sexual behaviour misclassifications in our HIV-infected population. HIV-1 sequences collected between 1997 and 2014 from 1169 individuals attending a HIV clinic in Antwerp, Belgium were analysed to infer a partial HIV transmission network. Individual demographic, clinical and laboratory data collected during routine HIV follow-up were used to compare clustered and non-clustered individuals using logistic regression analyses. In total, 438 (37.5%) individuals were identified in 136 clusters, including 76 transmission pairs and 60 clusters consisting of three or more individuals. Individuals in a cluster were more likely to have a history of syphilis, Chlamydia and/or gonorrhoea (P < 0.05); however, when analyses were stratified by HIV transmission risk groups (heterosexual and men who have sex with men [MSM]), this association only remained significant for heterosexuals with syphilis (P = 0.001). Under closer scrutiny, this association was driven by six heterosexual men who were located in six almost exclusively MSM clusters. A parsimonious conclusion is that these six individuals were potentially misclassified as heterosexual. Improving the accuracy of sexual behaviour reporting could improve care.

Thesis advisor: Christopher S. Lee / Background: Genital hair removal is a popular practice in Westernized cultures and has been associated with the belief that removal is necessary for hygiene. A body of literature exists that has found that genital hair removal is associated with adverse health outcomes, including sexually transmitted infections (STIs). This dissertation aims to detail the history of the practice, why the hygiene belief exists, and to systematically review the existing literature that assesses genital hair removal and STIs. Methods: Historical, socio-cultural analysis from the feminist perspective was performed on the literature to outline why genital hair removal was adopted at a population level. The STI/genital hair removal literature was systematically reviewed and analyzed utilizing PRISMA guidelines. The data generated did not support meta-analysis. Results: Genital hygiene removal has been normalized in Westernized culture as a compulsory component of genital hygiene, particularly for women. Genital hair removal decreases pubic lice infestations. Genital hair removal increases the incidence of gonorrhea and chlamydia infections in women. The data does not support that genital hair removal is necessary for genital hygiene and may be harmful to genital health. Conclusions: Healthcare providers should ask about genital hair and genital hygiene practices when taking a sexual health or preventative care history. Health care providers can educate patients that genital hair removal is not necessary for genital health. New research inquiries on this topic must account for the normalization of the genital hygiene belief. / Thesis (PhD) — Boston College, 2024. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Health care service providers in South Africa and elsewhere in the world are increasingly faced with an enormous challenge of modeling their approach to health care to meet the needs and expectations of the diverse societies they serve. The norms and customs that are inherent in these indigenous cultures are fundamental to the day-to-day existence of the people concerned and may hold a key to the understanding of many aspects of their lives, including the understanding of disease, in the case of this thesis, those transmitted sexually. A grounded theory study was used based on its theory of symbolic interactionism to explore the indigenous knowledge and health practices of the Vhavenda in sexually transmitted diseases. Data was collected through in-depth interview with traditional healers and key informants. Snowball sampling was used to idenify key informants as categories continued to emerge. Dara was analyzed using three basic types of coding namely, open coding, axial coding and selective coding. The findings of the study revealed a variety of terms used to identify SDs. Also emerging from the results was that cultural gender roles in the Vhavenda society justify women as sole agents of STDs. In accordance with grounded theory the decriptions of types of diseases, disease patterns, signs and symptoms culminated in "dirt" as the core category. It came out clear that dirt in the form of women'svaginal discharges and moral dirt is the main course of a STDs. It was also evident that strategies for combating STDs will have to take into account popular beliefs and attudes regarding views on STDs as well as the role and influence of traditional healers. Based on the above findings guidelines for designing a module for teaching health professionals has been formulated to aid them in understanding the beliefs and practices of people they serve. / Health Studies / D. Litt et Phil. (Health Studies)

This study explored preparatory students’ perceptions of the risk of contracting the Human Immuno-deficiency Virus (HIV) and sexually transmitted infections (STIs) in Ethopia. It utilised a non-experimental exploratory survey methodology. A range of findings was revealed. Most respondents (67.14%) were knowledgeable about HIV/AIDS and more than half of the respondents knew about STIs. A significant number of respondents (67.1%) were able to describe HIV transmission prevention methods. Twenty one percent of respondents were sexually active and 17.0% of these reported to have used condoms. Twenty nine percent and 4.25% of the respondents had selfperceived risk of contracting HIV infection and STIs respectively. In spite of increased awareness of HIV/AIDS, school youths still engage in high-risk sexual activities and believe that they are unlikely to contract the disease. The study findings have implications for practice, and recommendations are offered for further research / Health Studies / M.A. (Public Health)