Self-reported participation and perceived barriers to exercise in South Texas Hispanic adults

National data show that Hispanics report low levels of physical activity. Limited information on barriers to exercise in this population exists in the literature. Surveys were administered to 398 Hispanic participants from two colonias in South Texas to investigate self-reported levels of and perceived barriers to exercise. Results show that 67.6% of respondents did not meet physical activity recommendations of at least 150 minutes per week, as compared to 55.6% nationally. Overall, the most frequently reported barriers included “lack of time”, “very tired” and “lack of self-discipline” to exercise. An exploratory factor analysis of the barriers reported by participants not meeting physical activity recommendations resulted in a three-factor structure. A unidimensional scale was found for participants meeting recommendations. Findings suggest that future interventions should be specific to gender and exercise level to address the high prevalence of inactivity in this population. ^

Barriers to adolescent and young men's access of reproductive health care

Purpose. The purpose of this study was to identify the health needs and barriers that young men face in accessing health care and family planning services and to identify what health centers can do to attract young men to the clinic. A focus group format was used to elicit ideas from participants. ^ Methods. Forty-eight young men participated in nine focus groups. The young men were asked about the health issues they have, the barriers they face in accessing reproductive health care, and what clinics can do to attract young men to the clinic. Thematic analysis principles were used to identify the main themes that emerged in the focus groups. ^ Results. Sexually transmitted infections (STIs), mental health problems, and drug use were the major health issues that were mentioned in the majority of the focus groups. The main barriers discussed in the focus groups were attitudinal factors such as young men thinking it is unmanly to seek help, emotional factors such as young men not seeking help because of their ego or pride, and institutional factors such as the location of the clinic. The main suggestions for improvements in the health clinic included decreasing waiting times, emphasizing the fact that the clinics are free for males, having more female nurses, and encouraging clinic staff to treat the young men with respect. Young men suggested advertising and promoting the clinic in schools, in the community, and through the media. Focus group participants also provided their input about the design and format of the clinic flyer. ^ Conclusions. Many studies focus on the reproductive health care needs of adolescent and young females. This study has helped to show that young men also have health care needs and face barriers to accessing reproductive health care services.^

A qualitative and quantitative assessment of cancer patients' perceptions of barriers to treatment

This study examined barriers that cancer patients experience in obtaining treatment. The principal aim of the study was to conduct a comprehensive quantitative and qualitative assessment of barriers to cancer treatment for Texas cancer patients. The three specific aims of the study were to: (1) conduct a review and critique of published and unpublished research on barriers to cancer treatment; (2) conduct focus groups for the qualitative assessment of cancer patients' perceived barriers to cancer treatment; and (3) survey a representative sample of cancer patients regarding perceived barriers to treatment. The study was guided by the Aday and Andersen access framework of predisposing, enabling, and need determinants of care-seeking.^ To address the first specific aim, a total of 732 abstracts were examined, from which 154 articles were selected for review. Of these 154 articles, 57 that related directly to research on barriers to cancer treatment were chosen for subsequent analysis. Criteria were applied to each article to evaluate the strength of the study design, sampling and measurement procedures. The major barriers that were consistently documented to influence whether or not cancer patients sought or continued required treatment included problems with communication between the patient and provider, lack of information on side effects, the cost of treatment and associated difficulties in obtaining and maintaining insurance coverage, and the absence of formal and informal networks of social support. Access barriers were generally greater for older, minority women, and patients of lower socioeconomic status.^ To address the second specific aim, a total of eight focus groups (n = 44) were conducted across the State of Texas with cancer patients identified by the Texas Community Oncology Network, American Cancer Society, and community health centers. One important finding was that cost is the greatest hurdle that patients face. Another finding was that with the health care/insurance crisis, an increasing number of physicians are working with their patients to develop individually-tailored payment plans. For people in rural areas, travel to treatment sites is a major barrier due to the travel costs as well as work time forfeited by patients and their family members. A third major finding was the patients' family and church play important roles in providing social and emotional support for cancer patients.^ To address the third aim, a total of 910 cancer patients were surveyed during October and November, 1993. Approximately 65% of the cancer patients responded to the survey. The findings showed that the major barriers to treatment included costs of medications and diagnostic tests, transportation, lack of social support, problems understanding the written information regarding their disease as well as losing coverage or having higher premiums or copayments once they were diagnosed (particularly among blacks).^ Significant differences in reported barriers were found between racial groups. The minority respondents (i.e., blacks and Hispanics) tended to experience more barriers to treatment compared to the white respondents. More specifically, Hispanics were more likely to report transportation as a barrier to treatment than both white and blacks. Future research is needed to better understand the problems that minority cancer patients experience in receiving treatment. (Abstract shortened by UMI.) ^

Hearing aid use and adherence: A systematic review of the literature concerning the socioeconomic and psychological influences on hearing aid use and barriers to use

The current hearing health situation in the United States does not provide adequate support to individuals with hearing loss. More research is needed to give more support to these individuals. By conducting a systematic review of relevant literature from 1990 to present, I identified many factors that influence an individual's use of hearing aids. There are two research questions in this study: 1. Does the provision of screening and access to hearing aids decrease the negative effects of hearing loss? 2. Why is it difficult for people with hearing loss to adapt to and use hearing aids? The population of interest was adults (>18 years old) with hearing loss. Factors that influenced use of hearing aids for this population included age, gender, socioeconomic status, education, perceived severity of hearing loss, cost of hearing aids, screening, perceived benefit, stigmatization, perceived control, cognitive capability, personality, and social support. Research suggests that more efficient screening of at-risk individuals and the provision of better access to these individuals would prevent many of the negative effects of hearing loss.^

Let their voices be heard: Understanding the barriers to seeking early prenatal care for low-income non-Hispanic Black women

Background: Receipt of early prenatal care, care during the first three months of pregnancy, is the standard in the United States. Sixty percent of non-Hispanic Black women who had a live birth in the Sunnyside community of Houston did not obtain early prenatal care in 2009. ^ This study's aims were to: 1) Describe the barriers to obtaining early prenatal care in non-Hispanic Black women who live in the Sunnyside community of Houston; and, 2) Describe the actions that could encourage non-Hispanic Black women who live in the Sunnyside Community to obtain early prenatal care. The goal was to provide information to organizations that promote early prenatal care use in non-Hispanic Black women in Harris County that may aid in developing interventions. ^ Methods: The Participatory Learning for Action rapid assessment qualitative method was used in a group setting to answer the research questions on behalf of women in the community. Women who participated in the group sessions also participated in an in-depth interview. Key informants who work in the community with pregnant women, or promote the use of prenatal care services, were also interviewed. An inductive analysis of the data was conducted to identify common themes that address the study's aims. ^ Results: Aim 1: Group participants identified fear of the reaction from family and/or the baby's daddy and shame, not having insurance or money, and lack of knowledge of the pregnancy and resources as the top three barriers to early prenatal care for women in the community. Aim 2: Group participants stated that to help women to overcome these barriers, communication, awareness and support; help, resources and services; and information and early education are needed. Participant in-depth interviewees echoed the themes of fear of the reaction from family and/or the baby's daddy and not knowing of the pregnancy. Key informants mentioned these themes as well, though not at the same priority level. Participants and key informants also mentioned similar themes for helping women to overcome barriers to early prenatal care. ^ Conclusion: A comprehensive approach is needed to improve early prenatal care use in the Sunnyside community. Education efforts must include all members of the community, young and old, to promote support for pregnant women. Community members must be a part of the process for developing education campaigns. Engaging the community builds a relationship with organizations that serve the community, which may promote use of the organizations' services, and build trust with the community. All efforts must be ongoing so that women and men of all ages in the community understand the importance of prenatal care and support women obtaining care early in the pregnancy.^

Attitudes and other barriers to the utilization of clinical research findings by American physicians: A systematic review

Background: The Institute of Medicine estimates that only a maximum of 25% of clinical research findings are incorporated into practice by physicians. To improve clinical practice, efforts have been made to promote evidence-based medicine and the use of clinical guidelines. Despite these efforts, the gap between research and clinical practice remains wide.^ Objective: To systematically review the literature describing the factors which influence the use of clinical research recommendations by American physicians.^ Hypothesis: Barriers exist in the application of clinical research into clinical practice, and are multifactorial. The establishment of the Clinical and Translational Awards (CTSA; special federal grants awarded to selected institutions to support clinical and translational research) has reduced the effect of these barriers and improved the process of clinical research translation into practice among American physicians.^ Aims: Identify barriers and facilitators of the use of research findings in clinical practice by American physicians. Contrast studies published six years before and after the creation of the CTSA.^ Methods: The sources of data include published literature from Medline, PubMed and PsycINFO. Selected studies must be qualitative, a survey of American clinicians, based on evidence-based medicine practice, clinical guidelines or treatment pathways. Systematic reviews and reports were excluded, as well as studies with less than 100 respondents.^ Results: In total, 1036 abstracts were reviewed; 115 full text potential articles were identified and reviewed, and a total of 31 studies met all criteria for inclusion in the final review.^ Conclusions: The barriers against the application of clinical research findings, in the forms of clinical guidelines, evidence-based medicine guides and clinical pathways, can be divided broadly into physician barriers, practice/system barriers and patient barriers. Physician barriers are the most common barriers, especially the lack of familiarity with guidelines and the lack of time. Of the factors which improve the use of research based guidelines, physician factors such as younger age, lower duration of clinical practice, specialty training, and practice in large group Health Maintenance Organization (HMO) settings with fewer patients seen were the most commonly cited.^

A new approach to change detection in multispectral images by means of ERGAS index

In this letter, we propose a novel method for unsupervised change detection (CD) in multitemporal Erreur Relative Globale Adimensionnelle de Synthese (ERGAS) satellite images by using the relative dimensionless global error in synthesis index locally. In order to obtain the change image, the index is calculated around a pixel neighborhood (3x3 window) processing simultaneously all the spectral bands available. With the objective of finding the binary change masks, six thresholding methods are selected. A comparison between the proposed method and the change vector analysis method is reported. The accuracy CD showed in the experimental results demonstrates the effectiveness of the proposed method.

Assessment methodology applied to demand measures to change urban mobility behavior

In order to minimize car-based trips, transport planners have been particularly interested in understanding the factors that explain modal choices. Transport modelling literature has been increasingly aware that socioeconomic attributes and quantitative variables are not sufficient to characterize travelers and forecast their travel behavior. Recent studies have also recognized that users’ social interactions and land use patterns influence travel behavior, especially when changes to transport systems are introduced; but links between international and Spanish perspectives are rarely dealt with. The overall objective of the thesis is to develop a stepped methodology that integrate diverse perspectives to evaluate the willingness to change patterns of urban mobility in Madrid, based on four steps: (1st) analysis of causal relationships between both objective and subjective personal variables, and travel behavior to capture pro-car and pro-public transport intentions; (2nd) exploring the potential influence of individual trip characteristics and social influence variables on transport mode choice; (3rd) identifying built environment dimensions on travel behavior; and (4th) exploring the potential influence on transport mode choice of extrinsic characteristics of individual trip using panel data, land use variables using spatial characteristics and social influence variables. The data used for this thesis have been collected from a two panel smartphone-based survey (n=255 and 190 respondents, respectively) carried out in Madrid. Although the steps above are mainly methodological, the application to the area of Madrid allows deriving important results that can be directly used to forecast travel demand and to evaluate the benefits of specific policies that might be implemented in the area. The results demonstrated, respectively: (1st) transport policy actions are more likely to be effective when pro-car intention has been disrupted first; (2nd) the consideration of “helped” and “voluntary” users as tested here could have a positive and negative impact, respectively, on the use of public transport; (3rd) the importance of density, design, diversity and accessibility underlying dimensions responsible for land use variables; and (4th) there are clearly different types of combinations of social interactions, land use and time frame on travel behavior studies. Finally, with the objective to study the impact of demand measures to change urban mobility behavior, those previous results have been considered in a unique way, a hybrid discrete choice model has been used on a 5th step. Then it can be concluded that urban mobility behavior is not only ruled by the maximum utility criterion, but also by a strong psychological-environment concept, developed without the mediation of cognitive processes during choice, i.e., many people using public transport on their way to work do not do it for utilitarian reasons, but because no other choice is available. Regarding built environment dimensions, the more diversity place of residence, the more difficult the use of public transport or walking.

Gender differences of the spanish adult population in barriers to active living

Proyecto I+D+i DEP19801: Gender differences of the spanish adult population in barriers to active living

Gender differences of the spanish adult population in cultural barriers to active living

Proyecto I+D+i DEP19801: Gender differences of the spanish adult population in cultural barriers to active living

Gender differences of the spanish adult population in barriers to active living

Social research on the needs, barriers and innovations in sport and physical activities to adult women in Spain

Barriers to the adoption of photovoltaic systems: The state of the art

Although photovoltaic (PV) systems have become much more competitive, the diffusion of PV systems still remains low in comparison to conventional energy sources. What are the current barriers hindering the diffusion of PV systems? In order to address this, we conducted an extensive and systematic literature review based on the Web of Science database. Our state-of-the-art review shows that, despite the rapid development and maturity of the technology during the past few years, the adoption of PV systems still faces several barriers. The wide adoption of PV systems-either as a substitute for other electricity power generation systems in urban areas or for rural electrification-is a challenging process. Our results show that the barriers are evident for both low- and high-income economies, encompassing four dimensions: sociotechnical, management, economic, and policy. Although the barriers vary across context, the lessons learned from one study can be valuable to others. The involvement of all stakeholders-adopters, local communities, firms, international organizations, financial institutions, and government-is crucial to foster the adoption.

Barriers to recombination between closely related bacteria: MutS and RecBCD inhibit recombination between Salmonella typhimurium and Salmonella typhi

Previous studies have shown that inactivation of the MutS or MutL mismatch repair enzymes increases the efficiency of homeologous recombination between Escherichia coli and Salmonella typhimurium and between S. typhimurium and Salmonella typhi. However, even in mutants defective for mismatch repair the recombination frequencies are 102- to 103-fold less than observed during homologous recombination between a donor and recipient of the same species. In addition, the length of DNA exchanged during transduction between S. typhimurium and S. typhi is less than in transductions between strains of S. typhimurium. In homeologous transductions, mutations in the recD gene increased the frequency of transduction and the length of DNA exchanged. Furthermore, in mutS recD double mutants the frequency of homeologous recombination was nearly as high as that seen during homologous recombination. The phenotypes of the mutants indicate that the gene products of mutS and recD act independently. Because S. typhimurium and S. typhi are ≈98–99% identical at the DNA sequence level, the inhibition of recombination is probably not due to a failure of RecA to initiate strand exchange. Instead, these results suggest that mismatches act at a subsequent step, possibly by slowing the rate of branch migration. Slowing the rate of branch migration may stimulate helicase proteins to unwind rather than extend the heteroduplex and leave uncomplexed donor DNA susceptible to further degradation by RecBCD exonuclease.