Thesis (M.S.)--University of Hawaii at Manoa, 2006. / Includes bibliographical references. / xi, 87 leaves, bound ill., maps 29 cm

Thesis (M.S.)--University of Hawaii at Manoa, 2007. / Includes bibliographical references (leaves 32-33). / viii, 39 leaves, bound ill. 29 cm

Thesis (M.A.)--University of Hawaii at Manoa, 2007. / Includes bibliographical references (leaves 271-284). / Also available by subscription via World Wide Web / xi, 284 leaves, bound music 29 cm

Thesis (M.S.)--University of Hawaii at Manoa, 2006. / Includes bibliographical references (leaves 53-58). / vii, 58 leaves, bound col. ill. 29 cm

Thesis (M.S.)--University of Hawaii at Manoa, 2007. / Includes bibliographical references (leaves 16-17). / vi, 17 leaves, bound 29 cm

Thesis (M.S.)--University of Hawaii at Manoa, 2005. / Includes bibliographical references (leaves 66-68). / x, 68 leaves, bound col. ill. 29 cm

Adolescent pregnancy and birth rates in the United States continue to decline, however, approximately four in ten adolescent girls become pregnant before they reach 20 years old (Kirby, 2001). There is a paucity of research on the perceptions of mothers and how they relate to their young pregnant adolescents (15 years old and younger) during pregnancy. This study describes the attitudes, values, beliefs, and cultural meaning from the mothers' perspective of the relationship with their pregnant daughters. A descriptive design and naturalistic approach (Lincoln & Guba, 1985) was taken to allow the researcher to learn from people rather than to simply study them (Spradley, 1979). Audio taped interviews were conducted using a semi-structured interview guide. A non-random, purposive, convenience sample of five mothers of pregnant adolescents (ages 13 to 15) were recruited and interviewed when their daughters were 30 to 35 weeks gestation. Three cultural themes emerged from the analysis: (1) mothers' relationship with their young pregnant adolescent daughter although somewhat conflicted prior to pregnancy, draws them closer together as the pregnancy progresses focusing on caring for and meeting the needs ofthe pregnancy; (2) reactions of mothers to finding out about the pregnancy have qualities similar to the process of grief/loss; and (3) mothers' advice to parents of preteens/young teens is to keep communication open and teach about sex and birth control, however, ifthe teen becomes pregnant, be there for her. This study confirms previous literature and research about the relationship of mothers and daughters and adds groundbreaking new information about how mothers relate to their young pregnant adolescents during pregnancy. This study adds to nursing science insight into changes in the mother-daughter relationship caused by pregnancy and related issues of parenting a pregnant adolescent. The notion that the mother needs to continue parenting her daughter while she is pregnant is important. Further research needs to be done to explore the needs of mothers of young pregnant adolescent daughters. The risk status of mothers needs to be addressed, practice approaches need to be generated and developmental programs for mothers at risk may need to be created and tested.

HIV-positive men face multiple challenges when deciding whether or not to disclose their serostatus to sex partners. This survey design using repeated measures examined disclosure of HIV-positive serostatus to sex partners in an ethnically diverse population of men (N= 93) recruited from the community in O'ahu, Hawai'i. The framework guiding the research was Social Cognitive Theory (Bandura, 1987), with a specific focus on self-efficacy for disclosure decision-making and for negotiating safe sex. The aims of the research were to: 1) describe HIV serostatus disclosure to sex partners; 2) describe self-efficacy for disclosure to sex partners and self-efficacy for negotiating safer sex; 3) determine the relationships between demographic, HIV-illness, drug use history, self-efficacy and sex partner variables (relationship status, serostatus), and self-disclosure, and; 4) determine the relationships between demographic, HIV-illness, drug use history, self-efficacy, sex partner variables, self-disclosure, and condom use by the men in the sample. A convenience sample of HIV-seropositive men was enlisted through both active outreach and passive recruitment (posters and public advertisement). Survey responses were anonymous, as the subject matter being asked was sensitive in nature. Results reveal that self-disclosure to sex partners varied based on sex partner serostatus and relationship status, and was significantly influenced by perceived self-efficacy, by income, education, years since diagnosis and contextual factors including cocaine use before sex. Subjects were least likely to disclose to a sex partner whose serostatus was not discussed. An unknown partner serostatus was also significantly associated with less disclosure. The more committed the relationship, the greater the likelihood that a subject would self­ disclose. The longer the time since initial HIV diagnosis the more likely a subject was to disclose to sex partners. High self-efficacy scores were associated with self-disclosure, and with condom use. Cocaine use before sex was associated with less disclosure and less condom use. Self-disclosure was significantly associated with condom use as well. Although a causal relationship is not implied, self-disclosure practices did influence safe sex behavior. Implications for nursing and for future research are discussed.

Extensive data from O'ahu indicate that all streams on this island consistently exceed the USEPA standards (200 fecal coliform/100 ml, 33 enterococci/100 ml) for water quality. Soil was determined to be the source of the elevated counts of these bacteria. In tropical areas, as Hawai'i, these bacteria are able to survive and multiply in the soil. Thus, these bacteria can end up in nearby streams after heavy rains or due to erosion. As a result, the USEPA recommended indicator bacteria (fecal coliform, enterococci) cannot be used to reliably determine when waters in tropical areas are fecally contaminated. Several alternative indicators have been proposed for such areas such as C. perfringens and FRNA coliphages. Extensive monitoring data does not exist for the other islands of Hawai'i. Kaua'i differs from O'ahu in that it is older, wetter and contains an abundance of cesspools. The Nawiliwili Watershed, on the island of Kaua'i, was chosen for this study. Sampling was conducted over a period of one year, and all samples were assayed for the traditional USEPA indicators (fecal, coliform, enterococci) as well as two alternative indicators (C. perfringens, FRNA coliphages). Of the 14 sites sampled, 12 contained levels of fecal coliform and enterococci that exceeded the USEPA standards (200 fecal coliform/100 ml and 33 enterococci/100 ml. This is similar to what has been documented in O'ahu streams. Based on the concentrations of these indicator bacteria, the USEPA would deem these sites as sewage contaminated. However, monitoring of these same sites for C. perfringens indicated that there was no sewage contamination (geometric mean values fell below the proposed standard of 50 CFU/100 ml). FRNA coliphage data indicate that cesspools may be leaching into nearby streams. Two streams (Nawiliwili, Papakōlea) had geometric mean levels greater than the 50 PFU/100 ml (based on O'ahu streams). Other streams in the watershed may be sporadically contaminated by cesspool because elevated FRNA coliphage levels were detected on occasion. Genotyping these FRNA coliphage isolates furthered supported the theory that cesspools were contaminating these sites because 98% of the FRNA isolates were typed as human while only 2% were typed as of animal origin. Current USEPA standards (fecal coliform, enterococci) are not reliable indicators of sewage pollution in tropical areas, thus, alternative indicators such as C. perfringens and FRNA coliphages may prove to be better indicators in these areas.

Thesis (Ph. D.)--Ohio State University, 2005. / Includes bibliographical references (p. 132-139).