<p> Breast cancer is the most prevalent cancer among women (apart from skin cancers). African American (AA) women have lower rates of breast cancer, but higher mortality from the disease. Tertiary prevention may play a role in improving survivorship. Lifestyle changes after diagnosis have been studied, with conflicting evidence on the direction of behavior change, as well as the successful maintenance of outcomes. In this secondary data analysis study, we utilized the Behavior Change data set of The Women's Circle of Health Study (WCHS), with 1599 cases of breast cancer diagnoses among women (both AA and European American (EA) in the New York City metropolitan area and northern New Jersey). Raw data from the `Behavior Change Section'--a survey subset from the WCHS--was converted into scores of `healthy/positive behavior change'. While both groups made positive behavior changes, a significantly greater percentage of AA made positive/healthy dietary (intake of fruits, vegetables, fats, meat) behavior changes compared to EA women (p&lt;0.001). More AA women made positive changes related to tobacco use (p&lt;0.001) and alcohol consumption (p=0.029). The current analysis did not assess an intervention, motivations for change, or health outcomes. Programs promoting decreased tobacco and alcohol consumption and healthy weight management may be an impetus for such change. Future research may focus efforts on AA, with additional attention to health care issues apart from lifestyle--including access to health care-- as this group has higher rates of breast cancer mortality. Characterizing the behaviors before and after diagnosis may be even more useful in determining the course of change for women with breast cancer.</p>

O estudo analisa relações sociais e de poder em uma micro-unidade penitenciária de hospital geral, no Rio Grande do Sul, no período compreendido entre julho a outubro de 2004. Para tanto, examina o processo de atendimento à saúde do preso doente que necessita internação hospitalar, destacando o modo como ele chega ao hospital, como é atendido e recebe alta. Focaliza o caso do Hospital Vila Nova, embora também examine o modo como esse atendimento era feito anteriormente, quando ainda funcionava o Hospital Penitenciário do estado. Os dados coletados e analisados referem-se, principalmente, às dinâmicas sociais estabelecidas através das práticas de atendimento médico hospitalar, das práticas de vigilância e das estratégias dos presos doentes na busca de ampliar sua capacidade de negociação e aumentar seu grau de liberdade. Desse modo, verificou-se como a disciplina funcionou como técnica de controle sobre o preso, revelando a supremacia do poder médico no processo de atendimento ao preso doente hospitalizado na micro-unidade penitenciária em foco. O estudo também permite uma apreciação crítica das condições de saúde, a qual a população encarcerada está submetida. / This paper analyzes the social and power relations in a micro-unit of prisoners of a general hospital in Rio Grande do Sul State during the period from July to October 2004.Thus, it examines the hospital attendance process of sick prisoners who need hospitalization, focusing on how they arrive at the hospital, how they are cared and discharged. It focuses on Vila Nova hospital, although it also examines the way how these patients attendance used to happen previously, when the State Prison Hospital was open. The collected and analyzed data is mainly concerned with the social dynamics established through medical hospitalar care practices, surveillance practices and strategies of the sick prisoners who aim at expanding their capacity of negotiation and having a higher degree of freedom.Thus, the discipline worked as a control technique on prisoners, demonstrating the supremacy of the medical power in the attendance process of the prisoners hospitalized in the micro-unit in focus.This study also allows a critical appreciation of the health conditions faced by prison population.

O estudo analisa relações sociais e de poder em uma micro-unidade penitenciária de hospital geral, no Rio Grande do Sul, no período compreendido entre julho a outubro de 2004. Para tanto, examina o processo de atendimento à saúde do preso doente que necessita internação hospitalar, destacando o modo como ele chega ao hospital, como é atendido e recebe alta. Focaliza o caso do Hospital Vila Nova, embora também examine o modo como esse atendimento era feito anteriormente, quando ainda funcionava o Hospital Penitenciário do estado. Os dados coletados e analisados referem-se, principalmente, às dinâmicas sociais estabelecidas através das práticas de atendimento médico hospitalar, das práticas de vigilância e das estratégias dos presos doentes na busca de ampliar sua capacidade de negociação e aumentar seu grau de liberdade. Desse modo, verificou-se como a disciplina funcionou como técnica de controle sobre o preso, revelando a supremacia do poder médico no processo de atendimento ao preso doente hospitalizado na micro-unidade penitenciária em foco. O estudo também permite uma apreciação crítica das condições de saúde, a qual a população encarcerada está submetida. / This paper analyzes the social and power relations in a micro-unit of prisoners of a general hospital in Rio Grande do Sul State during the period from July to October 2004.Thus, it examines the hospital attendance process of sick prisoners who need hospitalization, focusing on how they arrive at the hospital, how they are cared and discharged. It focuses on Vila Nova hospital, although it also examines the way how these patients attendance used to happen previously, when the State Prison Hospital was open. The collected and analyzed data is mainly concerned with the social dynamics established through medical hospitalar care practices, surveillance practices and strategies of the sick prisoners who aim at expanding their capacity of negotiation and having a higher degree of freedom.Thus, the discipline worked as a control technique on prisoners, demonstrating the supremacy of the medical power in the attendance process of the prisoners hospitalized in the micro-unit in focus.This study also allows a critical appreciation of the health conditions faced by prison population.

O estudo analisa relações sociais e de poder em uma micro-unidade penitenciária de hospital geral, no Rio Grande do Sul, no período compreendido entre julho a outubro de 2004. Para tanto, examina o processo de atendimento à saúde do preso doente que necessita internação hospitalar, destacando o modo como ele chega ao hospital, como é atendido e recebe alta. Focaliza o caso do Hospital Vila Nova, embora também examine o modo como esse atendimento era feito anteriormente, quando ainda funcionava o Hospital Penitenciário do estado. Os dados coletados e analisados referem-se, principalmente, às dinâmicas sociais estabelecidas através das práticas de atendimento médico hospitalar, das práticas de vigilância e das estratégias dos presos doentes na busca de ampliar sua capacidade de negociação e aumentar seu grau de liberdade. Desse modo, verificou-se como a disciplina funcionou como técnica de controle sobre o preso, revelando a supremacia do poder médico no processo de atendimento ao preso doente hospitalizado na micro-unidade penitenciária em foco. O estudo também permite uma apreciação crítica das condições de saúde, a qual a população encarcerada está submetida. / This paper analyzes the social and power relations in a micro-unit of prisoners of a general hospital in Rio Grande do Sul State during the period from July to October 2004.Thus, it examines the hospital attendance process of sick prisoners who need hospitalization, focusing on how they arrive at the hospital, how they are cared and discharged. It focuses on Vila Nova hospital, although it also examines the way how these patients attendance used to happen previously, when the State Prison Hospital was open. The collected and analyzed data is mainly concerned with the social dynamics established through medical hospitalar care practices, surveillance practices and strategies of the sick prisoners who aim at expanding their capacity of negotiation and having a higher degree of freedom.Thus, the discipline worked as a control technique on prisoners, demonstrating the supremacy of the medical power in the attendance process of the prisoners hospitalized in the micro-unit in focus.This study also allows a critical appreciation of the health conditions faced by prison population.

This thesis examines how patterns of time use change in later life and how the way in which older people use their time is related to well-being. Arguing that maintaining balance in time use concerns not only people of working age but matters for people of all ages, we propose an alternative theoretical framework of life balance. This consists of two conceptual models: The Life Balance Triangle and Multidimensional Life Balance (MLB). Using UK time use data, the thesis demonstrates the empirical applicability of these two models in enhancing our understanding of older people's daily lives. The life balance model, which we built by modifying the theoretical categorisation of time use by &Aring;s (1978) and the work-leisure triangle of Gershuny (2003), identifies and presents alteration in time use across the life course as changes in balance between constraints (committed time) and freedom of choice (discretionary time), controlling for time spent on biological/physiological maintenance (regenerative time). We find the balance shifts towards greater discretionary, and less committed, time in later life, with a significant gender gap. Life stage, which reflects social structure and expectations, rather than biological ageing, was found to be the most influential factor for life balance dynamics. Findings suggest that men may find it more difficult to adjust to life beyond work because of abrupt and greater changes in life balance, which may disrupt their daily time structure. The multidimensional life balance model challenges the assumption of a linear relationship between the level of activity and well-being of older people. Adapting the Alkire-Foster method (Alkire and Foster, 2011), we propose a threshold-based approach that takes the heterogeneity of older people and multidimensionality of daily life into account, and emphasises overall balance in the level of activities across various activity domains. Results show MLB is associated positively with better self-assessed health, suggesting a threshold effect. We also identify the demographic/socio-economic groups more likely to lack MLB, as well as domains in which most people are deficient. The thesis contributes to work-life balance research by moving beyond paid-work centrality, and to ageing research by providing a multidimensional approach to activities and well-being in later life.

<p> <b>BACKGROUND: </b> Though significant gains have been made in preventing cervical cancer over the past 30 years, it continues to cause morbidity and mortality among women in the United States, particularly among those women who are screened infrequently or not at all. More than half of cervical cancer deaths in the U.S. are among immigrants, and the incidence and mortality from cervical cancer is increasing among foreign-born women. Arab and Hispanic women living in the U.S. continue to have cervical cancer screening rates that are lower than the general population. Understanding what factors influence their cervical cancer screening practices and what new screening options may overcome their barriers to preventive screening may be effective in reducing disparities in the disease burden of cervical cancer. </p><p> HPV DNA testing has taken on a larger role in cervical cancer screening, and there is increasing evidence and support for the use of HPV testing alone as a primary cervical cancer screening test. Novel health screening devices have been developed that allow women to self-screen for HPV, which may offer opportunity to simplify the cervical cancer screening protocol and reach women who are not receiving recommended cervical cancer screening services. </p><p> <b>OBJECTIVE: </b>Because self-administered screening devices are not yet available and most women have not had exposure to them, there are limited quantitative and qualitative assessments of women's attitudes towards and likelihood to use such devices, particularly in the U.S. This study informs the development of culturally appropriate interventions and policies intended to improve cervical cancer screening rates among Arab and Hispanic women in the United States, and discusses implementation challenges and policy implications associated with incorporating self-administered HPV testing into the cervical cancer screening protocol in the U.S. </p><p> <b>METHODS:</b> A paper-based survey (n = 476) and individual interviews (n = 31) were used to explore Arab and Hispanic participants' screening behaviors, their likelihood to use HPV self-administered tests to screen for cervical cancer, their perceived self-efficacy in using self-screening tests, and the major concerns they have about self-screening. </p><p> <b>RESULTS:</b> Participants who were 1) uninsured, 2) knowledgeable about HPV and cervical cancer, 3) had high self-efficacy in their ability to use a self-screening test; and 4) had no concerns about the self-screening test were significantly more likely to use a self-screening test. Hispanic participants (74.0%) were significantly more likely than Arab participants (43.8%) to report they would be likely to use a self-administered cervical cancer screening test if it were available. Approximately half of uninsured (52.7%) and underscreened (47.1%) participants reported they would be more likely to get screened for cervical cancer if an at-home self-screening test were available. </p><p> <b>CONCLUSIONS:</b> A majority of participants responded positively to the option for HPV self-testing as a cervical cancer screening option, suggesting that it may an effective screening modality to reach women who are not accessing routine screening. More research is needed on implementing a self-screening option, particularly among underscreened populations.</p>