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.

Methodology of investigation of sexual offences Key words: child abuse, investigation, examination Summary This diploma thesis deals with issues in investigation of sexual crimes, particularly child sexual abuse. Sexual criminality is a very extensive topic, so I decided to aim the thesis for specifics of investigation related to abused children. The aim of the work is to characterise investigation regarding specifics typical for sexual offences. There is difference between adult and child victims. This must be considered in the process of investigation. Each person taking part in investigation should have achieved at least basic course in psychology. It is necessary to apply considerate approach to restrain from secondary victimization. The first chapter describes the term of sexual abuse, fundamental definitions and forms. Current legal regulations in the Czech Republic are analyzed there. The second part is devoted to criminological characteristics. This chapter is about offenders, victims and typical ways of commission. I compare the situation in which the perpetrator comes from the family with the situation of the perpetrator out of the family. Graphs based on police statistics serve for illustration. The next part (chapter 3 - chapter 8) corncerns especially the beginning of investigation, iniciatory...

The classification of adult criminal populations for training, treatment, and security purposes has been time-consuming and expensive. The main purpose of this study was to develop a classification system which considered a wide variety of behavioral, biographical, and psychometric variables and yet was efficient in terms of time and money.

Magister Educationis - MEd / Mathematical Literacy has a dual meaning in South Africa. On the one hand it alludes to an understanding of the role of Mathematics in the real world. On the other hand it refers to a subject that is taken by students who generally do not do well in Mathematics and who do not wish to do a pure Mathematics course, This research focuses on the identification and investigation of errors, misconceptions and alternative ways of working in the responses of students in the final grade 12 Mathematical Literacy examination. The aim was to identify the errors, misconceptions and alternative ways of working and to discuss possible reasons for these errors and misconceptions. This aim was governed by the principle that feedback to students and teachers form a vital component in the teaching and learning process. This analysis only focused questions pertaining measurement in Mathematical Literacy. An analytical framework was constructed based on common errors and misconceptions identified by various researchers’ in the field of Mathematics. This analytical framework was used to classify and analyse the errors, misconceptions and alternative ways of working in Mathematical Literacy. The analysis was done using document analysis on a randomly selected sample of Mathematical Literacy scripts taken from across all education districts in the Western Cape. Great care was taken to prevent bias and cross checking was done by peers to ensure that the categories of errors were agreed on. The results of the analysis revealed that the errors identified for Mathematics are common to those of Mathematical Literacy. The findings in this project suggest that the analysis and feedback of errors and misconceptions may help to improve teaching and learning in Mathematical Literacy.

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.

Philosophiae Doctor - PhD / Lumbo-sacral radiculopathy (LSR) is clinically defined as low back and referred leg symptoms accompanied by an objective sensory and/or motor deficit due to nerve root compromise. LSR is a common condition encountered by physiotherapists in clinical practice and the assessment and diagnosis remains a challenge owing to the complex anatomy of the lumbo-sacral spine segment and the various differentials. Moreover, LSR imposes a significant impact on patients’ health, functional ability, socio-economic status and quality of life. There are several diagnostic tools and procedures which are commonly utilised in practice, including diagnostic neuropathic pain screening questionnaires, clinical neurological tests, electro-diagnostics and imaging. However, the diagnostic utility and correlation of these tests have not been fully explored and remains debatable among clinicians and researchers in the fields of musculo-skeletal health and neurology. The aim of this study was to determine a correlation of the S-LANSS score, clinical neurological examination (CNE) findings and magnetic resonance imaging (MRI) reports in the diagnosis of LSR among patients who presented with low back and referred leg symptoms. The study was conducted in three phases. In phase one, two systematic literature reviews were conducted; firstly, to establish the evidence-based accuracy of CNE in diagnosing LSR, and secondly, to establish the evidence-based accuracy of MRI in diagnosing LSR. In both systematic literature reviews, the diagnostic tests accuracy (DTA) protocol was used in planning, design and execution of literature search, selection of relevant studies, quality assessment, data analysis and presentation of the results. In phase two, clinical validation of an adopted S-LANSS scale and lumbar MRI reporting protocol were established, and a standardised evidence based lumbar CNE protocol developed.The face and content validity of the original S-LANSS score was established among a sample of Kenyan physiotherapists and patients who presented with low back and referred leg symptoms, using both quantitative and qualitative research designs. This was followed by a test-re-test reliability study on the adapted version of the S- LNASS score. The face and content validity of the adopted lumbar MRI reporting protocol was established among a sample of Kenyan radiologists followed by an inter-rater reliability. An evidence-based lumbar CNE protocol was developed; standardised and inter-examiner reliability was also examined among a sample of Kenyan physiotherapists. Finally, in phase three, a cross-sectional blinded validity study was conducted in six different physiotherapy departments. Participants (patients, physiotherapists and radiologists) were recruited using strict in- and exclusion criteria and data was collected using a pain and demographic questionnaire, the S-LANSS scale, the CNE protocol, the Oswestry Disability Index (ODI) and the MRI lumbar spine reporting protocol. Data was captured, cleaned and analysed using SPSS version 21. Descriptive analysis was done using frequencies, means and percentages, while inferential analysis was conducted using Spearman’s rank correlation coefficient test r to establish the correlation between the diagnostic tests. Cross tabulations, receiver operating curves (ROC) and scatter plots were used to establish the sensitivity and/or specificity of S-LANSS scale and individual CNE tests as defined by MRI. In phase three, which formed the main study of the research project, a total of 102 participants were recruited in this study with a gender distribution of 57% females and 43% males. The majority (67%) had neuropathic pain according to the S-LANSS scale and their pain intensity ranged from moderate (4-6) to severe (7-9) as recorded on a Numeric Pain rating Scale (NPRS), and was more common among manual workers. Similarly, patients whose pain had a neuropathic component had moderate to severe disability. The S-LANSS scale and lower limb neuro-dynamic tests were the most sensitive tests 0.79 and 0.75 respectively, while deep tendon reflexes were the most specific tests (0.87). The S-LANSS and CNE correlated fairly but significantly with MRI (r=0.36, P=0.01).LSR is a common condition and its assessment and diagnosis remains a clinical challenge among physiotherapists. MRI is a high-cost diagnostic tool but is being used by many clinicians in making decisions regarding the management of patients. Rapid and low-cost neuropathic pain screening by the use of the S-LANSS scale, together with use of evidence-based CNE of neuro-conduction and neuro-dynamic tests may be used in confirming nerve-root related MRI findings. These may be used in making a decision on whether to manage a patient conservatively using pharmacological agents and manual physiotherapy and therapeutic exercise, or consider surgery in the initial management of patients with clinical suspicion of LSR. This is especially valuable in the resource-poor settings like Kenya and other sub-Saharan African countries where MRI is costly or unavailable.

Cytogenetic evaluation of human bone marrow cells is one of the principal sources of diagnostic and prognostic information in the evaluation of the myeloid leukemias. In the majority of cases, these diseases are characterized by non-random chromosomal changes in the cells of the malignant clone. The chromosomal abnormalities are present only in the leukemic cells, which are distributed along with normal cells in the bone marrow and throughout the circulation. The objective of this thesis was to test the hypothesis that suitable criteria could be established for automated metaphase detection using human bone marrow preparations. This involved computerized, low resolution scanning of a specimen slide, and the measurement of object features which allowed metaphases to be adequately distinguished from nuclei and debris. Two approaches were investigated. The first used a line-scanning system, in which microscope slides were scanned line by line with a linear CCD detector, and focussing was performed automatically. Eighteen signal features were measured for each detected object. Three group discriminant function analysis was performed on objects from a large number of slides from both types of preparations, in order to distinguish metaphases from nuclei and debris. The second method evaluated the use of a frame scanning system. Objects were detected in a frame-by-frame scan of microscope slides, using a two dimensional CD camera. Feature measurements were performed for all objects within a specified area range, and three group discriminant function analysis was performed on data from a large number of slides. In both approaches, the performance of the discriminant functions was evaluated on independent samples collected from a number of patients, in order to determine the operational error rates of the systems. The sensitivity of the line scan system for metaphase detection was 86%, compared to 92% fror the frame scannning system, while the specificity was 84% for the line scan system, and 86% for the frame scanning system. The frame scan system was shown to be useful for determining the mitotic index of cells cultured for varying periods of time prior to fixation. Four patients with AML were examined, and the results of the analysis show that the mitotic indices could be determined in this way to an accuracy of approximately 5%. The mitotic indices differed as a function of time for different patients. / Science, Faculty of / Physics and Astronomy, Department of / Graduate

A variety of faecal examination methods have shown variable sensitivity in identifying larvated Spirocerca lupi (S. lupi) eggs. The purpose of this study was to determine which faecal examination method, including a novel modified centrifugal flotation method, was most sensitive in the diagnosis of spirocercosis. Faeces were collected from 33 dogs diagnosed with spirocercosis by oesophageal endoscopy at the Onderstepoort Veterinary Academic Hospital between 2008 and 2009. If the first evaluation was negative, a second faecal sample was evaluated 24-48 h later. Ten faecal examinations using 1 g aliquots of faeces were performed per sample. Four faecal examination methods were evaluated; direct faecal examination using saline, direct faecal flotation, a modified faecal centrifugal flotation and a laboratory performed faecal sedimentation/flotation. The direct and modified centrifugal flotation methods were each performed using four faecal flotation solutions; NaNO3 (Specific gravity (SG) 1.22), MgSO4 (SG 1.29), ZnSO4 (SG 1.30) and saturated sugar (SG 1.27). The sedimentation/flotation method utilized MgSO4 (SG 1.29). The modified centrifugal flotation method required centrifugation (1400 G) of a prepared faecal suspension (1 g faeces suspended in 5 ml of flotation solution) after which 0.1 ml of the supernatant was aspirated from the surface using an adjustable volume micropipette for microscopic examination. The 10 faecal examination tests were statistically analysed using the Friedman test (nonparametric equivalent of analysis of variance) p=0.000, z value = 0.05. The sensitivity of the tests ranged between 42 % and 67 %, with the NaNO3 solution showing the highest sensitivity in both the direct and modified centrifugal flotation methods. The modified NaNO3 centrifugal method ranked first with the highest mean egg cell count (45.24 ± 83). The modified centrifugal NaNO3 method was found to be superior (i.e. higher egg counts) and significantly different (p<0.001) compared with the routine saturated sugar, ZnSO4 and MgSO4 flotation methods. The direct flotation method/technique using NaNO3 flotation fluid was also superior and significantly different (p<0.001) when compared to the same technique using ZnSO4 or MgSO4 flotation fluids. Neoplastic transformation of oesophageal nodules was confirmed in 15 % (n=5) of dogs and a further 18 % (n=6) had both neoplastic and non-neoplastic oesophageal nodules. S. lupi eggs were demonstrated in 40 % of dogs with neoplastic nodules and in 72.9 % of dogs with non-neoplastic nodules. The mean egg count in the non-neoplastic group (61) was statistically greater (p=0.02) than that of the neoplastic group (1). The results show that faecal examination using the direct and modified centrifugal flotation methods with the NaNO3 flotation fluid are the most sensitive methods in the diagnosis of spirocercosis. The modified centrifugal flotation method using this solution has the highest mean egg count. The study also found that dogs with neoplastic nodules shed significantly fewer eggs than dogs with non-neoplastic nodules. Copyright / Dissertation (MMedVet)--University of Pretoria, 2011. / Companion Animal Clinical Studies / unrestricted

Screening and early detection are essential for the management and control of most diseases. It is important for women to practice routine health care that includes both clinical and self examinations. Today, many women go without health care due to barriers which prevent them from obtaining adequate care. The present study was designed to investigate, using the Health Belief Model, whether there is a difference between heterosexual and lesbian women in obtaining gynecological exams. Responses from 23 8 participants, 70 heterosexuals and 168 lesbians, indicated that the Health Belief Model was a significant predictor of whether women complied with recommended guidelines for Pap smears. Further analyses indicated that the most predictive components of the model were self-efficacy and perceived barriers. The more self-efficacy the women reported, the more likely they were to comply; whereas, the more barriers the women reported, the less likely they were to comply. Surprisingly, there were no interactions between sexual orientation and the components of the Health BeliefModel with respect to compliance. Thus, the model predicts compliance in the same way for both lesbian and heterosexual women. The results are consistent with past research indicating that the Health Belief Model is a good predictor of health behavior for some groups. Suggestions for future studies are discussed.