CERVIXCHECK: A SPIRITUALLY-BASED SMS TEXT MESSAGING PILOT INTERVENTION TO INCREASE CERVICAL CANCER AWARENESS AND PAP TEST SCREENING INTENTION AMONG AFRICAN AMERICAN WOMEN

African American women account for a disproportionate burden of cervical cancer incidence and mortality rate when compared to non-Hispanic White women. Cervical cancer is one of the most preventable types of cancer, and women can be screened for it with a routine Pap test. Given that religion occupies an essential place in African American lives, framing health messages with important spiritual themes and delivering them through a popular communication delivery channel may allow for a more culturally-relevant and accessible technology-based approach to promoting cervical cancer educational content to African American women. Using community-engaged research as a framework, the purpose of this multiple methods study was to develop, pilot test, and evaluate the feasibility, acceptability, and initial efficacy of a spiritually-based SMS text messaging intervention to increase cervical cancer awareness and Pap test screening intention among African American women. The study recruited church-attending African American women ages 21-65 and was conducted in three phases. Phases 1 and 2 consisted of a series of focus group discussions (n=15), cognitive response interviews (n=8), and initial usability testing that were conducted to inform the intervention development and modifications. Phase 3 utilized a non-experimental one-group pretest-posttest design to pilot test the 16-day text messaging intervention (n=52). Of the individuals enrolled, forty-six completed the posttest (retention rate=88%). Findings provided evidence for the early feasibility, high acceptability, and some initial efficacy of the CervixCheck intervention. There were significant pre-post increases observed for knowledge about cervical cancer and the Pap test (p = .001) and subjective norms (p = .006). Additionally, results post-intervention revealed that 83% of participants reported being either “satisfied” or “very satisfied” with the program and 85% found the text messages either “useful” or “very useful”. 85% of the participants also indicated that they would “likely” or “very likely” share the information they learned from the intervention with the women around them, with 39% indicating that they had already shared some of the information they received with others they knew. A spiritually-based SMS text messaging intervention could be a culturally appropriate and cost-effective method of promoting cervical cancer early detection information to African American women.

The Impact of Education and Socioeconomic and Occupational Conditions on Self-Perceived and Mental Health Inequalities Among Immigrants and Native Workers in Spain

There is limited evidence on the influence of social determinants on the self-perceived and mental health of immigrants settled at least 8 years in Spain. The aim of this study was to examine differences between workers related to migrant-status, self-perceived and mental health, and to assess their relationship to occupational conditions, educational level and occupational social class, stratified by sex. Using data from the Spanish National Health Survey of 2011/12, we computed prevalence, odds ratios and explicative fractions. Mental (OR 2.02; CI 1.39–2.93) and self-perceived health (OR 2.64; CI 1.77–3.93) were poorer for immigrant women compared to natives. Occupational social class variable contributes 25 % to self-perceived health OR in immigrant women. Settled immigrant women workers are a vulnerable group in Spain.

Awareness and prevalence of metabolic syndrome among high-risk individuals attending internal medicine clinics across Jordan

Purpose: To examine the prevalence and awareness of metabolic syndrome (MetS) in high-risk individuals attending 30 internal medicine clinics in Amman, Jordan, and also to evaluate the various factors associated with increased risk of MetS among them. Methods: This retrospective cross-sectional study was carried out across Amman, Jordan from October to December 2014. During the study period, 900 high-risk individuals (with hypertension, diabetes, central obesity and/or dyslipidemia) were recruited from thirty internal medicine clinics in Amman, Jordan. Data collection forms were filled based on patient interview and medical case file. Results: The prevalence of MetS among high-risk individuals was around 40 % (361/900), with around 79 % (284/361) of MetS patients unaware of their condition. Older age, lower income and family history of premature cardiovascular diseases were associated with a higher prevalence of MetS. Conclusion: Although MetS was found to be highly prevalent among high-risk individuals in this study, the awareness of the condition in this group is very poor. These findings support the need for educational programs that involve both health care providers and patients. These programs should especially target those at risk of MetS, in order to improve awareness of the concept of MetS.

STUDIES OF FUNCTIONALIZED NANOPARTICLES FOR SMART SELF-ASSEMBLY AND AS CONTROLLED DRUG DELIVERY

This dissertation is related to the studies of functionalized nanoparticles for self-assembly and as controlled drug delivery system. The whole topic is composed of two parts. In the first part, the research was conducted to design and synthesize a new type of ionic peptide-functionalized copolymer conjugates for self-assembly into nanoparticle fibers and 3D scaffolds with the ability of multi-drug loading and governing the release rate of each drug for tissue engineering. The self-assembly study confirmed that such peptide-functionalized amphiphilic copolymers underwent different self-assembly behavior. The bigger nanoparticles were more easily assembled into nanoparticle fibers and 3D scaffolds with larger pore size, while the smaller nanoparticle underwent faster self-assembly to form more compact 3D scaffolds with smaller porosity but more stable structure. Controlled release studies confirmed the ability of governing simultaneous release of different model drugs with independent release rate from a same scaffold. Cytotoxicity tests showed that all synthesized peptides, copolymers and peptide-copolymer conjugates were biocompatible with SW-620 cell lines and NIH3T3 cell lines. This new type of self-assembled scaffolds combined the advantages of peptide nanofibers and versatile controlled release of polymeric nanoparticles to achieve simultaneous multi-drug loading and controlled release of each drug, uniform distribution and flexibility of hydrogel scaffolds. The investigations in second part were first to design and synthesize organic biocide-loaded nanoparticles for low-leaching wood preservation using a cost-effective one-pot method to synthesize amphiphilic chitosan-g-PMMA nanoparticles loading with ~25-28 wt.% of the fungicide tebuconazole with particle size of ~100 nm diameter by FESEM. FESEM analysis confirmed efficient penetration of nanoparticles throughout the treated wooden stake with dimension of 19 × 19 × 455 mm^3. Leaching studies showed that biocide introduced into sapwood via nanoparticles leached only ~9% compared with the amount leached from tebuconazole solution-treated control, while soil jar tests showed that the nanoparticle-treated wood blocks were effectively protected from biological decay tested against G. trabeum, a brown rot fungus. Copper oxide nanoparticles with and without polymer stabilizers were also investigated to use as inorganic wood preservatives to clarify the factor affecting copper leaching from treated wood. Copper oxide nanoparticles with uniform diameters of ~10 nm and ~50 nm were prepared, and the leachates from southern pine sapwood treated with these nanoparticles were analyzed. It was found by TEM and EDS analysis that significant numbers of nanoparticles leached from the treated wood. The 50 nm nanoparticles leached slightly less than a soluble copper salt control, but 10 nm nanoparticles leached substantially more than the control. The effect of polymer stabilizers on nanoparticle leaching was also investigated. Results showed that polymer stabilizers increased leaching. The trends showed that nanoparticle size was a major factor in copper leaching.

Sex-Positive Curricula: An Investigation of the Relationship Between Physical Fitness, Self-Concept and Sexual Functioning

Despite the well-recognized benefits of exercise, Americans are gaining weight in astounding proportions and levels of physical activity are on the decline. The purpose of this study was to investigate a relationship between physical fitness, self-concept and sexual health. There is a dearth of knowledge on this relationship specifically in the context of sex-negative curricula, which is the dominate discourse in the United States. One hundred and thirty-three participants between the ages of 18 - 50 volunteered for fitness testing and data collection. Physical fitness was assessed through body fat, resting metabolic rate, cardiovascular endurance, muscular strength, muscular endurance and flexibility. Self-reported exercise was measured using the International Physical Activity Questionnaire. Self-concept was measured by the Six Factor Self-Concept Scale, which presented a total self-concept score and as six individual concepts of self (likability, morality, task accomplishment, giftedness, power and vulnerability). Additionally, sexual function was measured by Derogatis Interview for Sexual Functioning and presented as both an aggregate score and five separate constructs of sexual functioning (fantasy/cognition, arousal, orgasm, behavior/experience, and drive/desire). Questions pertaining to sexual partners, sex education, and demographic information were also included. The results of the General Linear Model indicated significant relationships between physical fitness, self-concept and total sexual functioning. The sexual behavior/experience of men was predicted by body fat percentage and flexibility. In women, behavior/experience was predicted by body fat percentage and arousal was predicted by cardiovascular endurance. Total self-concept was related to muscular endurance. When men were isolated in the analysis, likability was positively related to sexual behavior/experience, and task accomplishment was inversely related to sexual behavior/experience. In women, giftedness was related to cognition/fantasy, arousal, orgasm and total sexual functioning. No relationships were found between physical fitness and the number of sexual partners in men; however, both muscular strength and the power self-concept were significantly related to number of sexual partners in women. As a result of these findings, women may be inclined to exercise to improve arousal and sexual functioning. Furthermore, educators should note the findings of a positive relationship between physical and psychological health and sexual well-being because they provide support for the development and adoption of sex-positive curricula that incorporate potential benefits of sexual activity.

Risk of repeated self-harm and associated factors in children, adolescents and young adults

Background: Repeated self-harm represents the single strongest risk factor for suicide. To date no study with full national coverage has examined the pattern of hospital repeated presentations due to self-harm among young people. Methods: Data on consecutive self-harm presentations were obtained from the National Self-Harm Registry Ireland. Socio-demographic and behavioural characteristics of individuals aged 10–29 years who presented with self-harm to emergency departments in Ireland (2007–2014) were analysed. Risk of long-term repetition was assessed using survival analysis and time differences between the order of presentations using generalised estimating equation analysis. Results: The total sample comprised 28,700 individuals involving 42,642 presentations. Intentional drug overdose was the most prevalent method (57.9%). Repetition of self-harm occurred in 19.2% of individuals during the first year following a first presentation, of whom the majority (62.7%) engaged in one repeated act. Overall, the risk of repeated self-harm was similar between males and females. However, in the 20–24-year-old age group males were at higher risk than females. Those who used self-cutting were at higher risk for repetition than those who used intentional drug overdose, particularly among females. Age was associated with repetition only among females, in particular adolescents (15–19 years old) were at higher risk than young emerging adults (20–24 years old). Repeated self-harm risk increased significantly with the number of previous self-harm episodes. Time differences between first self-harm presentations were detected. Time between second and third presentation increased compared to time between first and second presentation among low frequency repeaters (patients with 3 presentations only within 1 year following a first presentation). The same time period decreased among high frequency repeaters (patients with at least 4 to more than 30 presentations). Conclusion: Young people with the highest risk for repeated self-harm were 15–19-year-old females and 20–24-year-old males. Self-cutting was the method associated with the highest risk of self-harm repetition. Time between first self-harm presentations represents an indicator of subsequent repetition. To prevent risk of repeated self-harm in young people, all individuals presenting at emergency departments due to self-harm should be provided with a risk assessment including psychosocial characteristics, history of self-harm and time between first presentations.

Changing the servicescape : The influence of music, self-disclosure and eye gaze on service encounter experience and approach-avoidance behavior

The purpose of this thesis is to investigate and understand the effect of a servicescape’s ambient and social conditions on consumers’ service encounter experience and their approach/avoidance behavior in a retail context. In three papers, with a total sample of over 1600 participants (including 550 actual consumers) and seven experiments, the author investigates the effect of music (ambient stimuli), employees’ self-disclosure (verbal social stimuli) and employees’ gazing behavior (nonverbal social stimuli) on consumers’ service encounter experience and approach/avoidance behavior in a retail store. Paper I comprised two experiments, and the aim was to investigate the influence of music on emotions, approach/avoidance behavior. Paper II comprised two experiments, and the aim was to investigate the effect of frontline employees’ personal self-disclosure on consumers’ reciprocal behavior. Paper III comprised three experiments, and the aim was to investigate the influence of employee’s direct eye gaze/ averted eye gaze on consumer emotions, social impression of the frontline employee and encounter satisfaction in different purchase situations. The results in this thesis show that music affects consumers in both positive and negative ways (Paper I). Self-disclosure affects consumers negatively, in such a way that it decreases encounter satisfaction  (Paper II) and, finally, eye gaze affects consumers by regulating both positively – and in some cases also negatively – consumers’ social impression of the frontline employee and their encounter satisfaction (Paper III). The conclusions of this thesis are that both ambient and social stimuli in a servicescape affect consumers’ internal responses, which in turn affect their behavior. Depending on the purchase situation, type of retail, and stimuli, the internal and behavioral responses are different.

English language study abroad program : an investigation of Hong Kong pre-service teachers’ experiences of a language immersion program

There has been minimal research focused on short-term study abroad language immersion programs, in particular, with home-stay families. The importance of authentic intercultural experience is increasingly clear and was acknowledged as central to the process of language learning (Liddicoat, 2004). In Hong Kong, education programs for pre-service language teachers have significantly emphasised language and intercultural training through short-term study abroad, and these short overseas language immersion courses have become a compulsory component for teacher training (Bodycott & Crew, 2001) in the last decade. This study aims to investigate eight Hong Kong pre-service teachers’ and their home-stay families’ experiences of a short-term (two months) language immersion program in Australia. The focus is on listening to commentaries concerning the development of communicative competence, intercultural competence and professional growth during the out-of-class study abroad experience. The conceptual framework adopted in this study views language and intercultural learning from social constructivist perspectives. Central to this framing is the notion that the internalisation of higher mental functions involves the transfer from the inter-psychological to the intra-psychological plane, that is, a progression process from the socially supported to individually controlled performance. From this perspective, language serves as a way to communicate about, and in relation to, actions and experience. Three research questions were addressed and studied through qualitative methodology. 1. How do the pre-service teachers and their home-stay families perceive the out-of-class component of the program in terms of opportunities for the development of language proficiency and communicative competence? 2. How do the pre-service teachers and their home-stay families perceive the out-of-class component of the program in terms of the development of intercultural competence? 3. How do the pre-service teachers and home-stay families perceive the outof- class component of the program in terms of teachers’ professional growth? Data were generated from multiple data collection methods and analysed through thematic analysis from both a “bottom up” and “top down” approach. The study showed that the pre-service teachers perceived that the immersion program influenced, to varying degrees, their language proficiency, communication and intercultural awareness, as well as their self-awareness and professional growth. These pre-service teachers believed that effective language learning centres on active engagement in the target language community. A mismatch between the views and evaluations of the two groups – the pre-service teachers and the home-stay family members – provides some evidence of misalignments in terms of expectations and perceptions of each other’s roles and responsibilities. The study has highlighted challenges encountered, and provided suggestions for ways of meeting these challenges. The inclusion in the study of the home-stay families’ perceptions and commentaries provided insights, which can inform program development. There is clearly further work to be done in terms of predeparture orientation and preparation, not only for the main participants themselves, the students, but also for the host families.

Reflective Practice in the Arts

In creative disciplines, reflective practice is an integral and cumulative form of learning. Reflective learning generates knowledge that is specific to oneself and is a form of evidence upon which to analyse and change one’s practice. Critical reflection requires a deep knowledge of the discipline and an awareness of one’s positioning within that discipline and in relation to one’s creative performance. Meaning making through performative expression allows for personal transformation through acute awareness of and reflection on one’s own beliefs, knowledges and values through the process of creating artistic work. Self-awareness and identity are significant both in the study of the arts and in becoming an artist, as aesthetic inquiry and performance are constituted by subjective self-expression in relation to objective conditions. Reflection can be expressed using symbols or semiotic systems other than language. Depending on the disciplinary context, particular modes or forms of expression will be privileged, including material forms of practice, still and moving images, music and sound, live action and digital code. This chapter explores the problematics of what counts as reflection in the arts and how reflection is represented, expressed and performed in discursive and non-discursive ways in becoming arts literate.

The perspectives of older drivers on the impact of feedback on their driving behaviours : a qualitative study

Self-regulation is a coping strategy that allows older drivers to drive safely for longer. Self-regulation depends largely on the ability of drivers to evaluate their own driving. Therefore the success of self-regulation, in terms of driving safety, is influenced by the ability of older drivers to have insight into their declining driving performance. In addition, previous studies suggest that providing feedback to older adults regarding their driving skills may lead them to change their driving behaviour. However, little is currently known about the impact of feedback on older drivers’ self-awareness and their subsequent driving regulatory behaviour. This study explored the process of self-regulation and driving cessation among older drivers using the PAPM as a framework. It also investigated older adults’ perceptions and opinions about receiving feedback in regards to their driving abilities. Qualitative focus groups with 27 participants aged 70 years or more were conducted. Thematic analysis resulted in the development of five main themes; the meaning of driving, changes in driving pattern, feedback, the planning process, and solutions. The analysis also resulted in an initial model of driving self-regulation among older drivers that is informed by the current research and the Precaution Adoption Process Model as the theoretical framework. It identifies a number of social, personal, and environmental factors that can either facilitate or hinder people’s transition between stages of change. The findings from this study suggest that further elaboration of the PAPM is needed to take into account the role of insight and feedback on the process of self-regulation among older drivers.

Origens da interioridade: autoconhecimento e externalismo

O objetivo da tese é investigar a constituição da interioridade a partir de uma abordagem externalista. Os processos pelos quais o autoconhecimento é constituído são considerados como estando associados ao desenvolvimento da perspectiva da primeira pessoa. Adotar uma perspectiva de primeira pessoa é tornar-se capaz de fazer referência a si mesmo e conhecer seus próprios estados mentais e corporais. A autoconsciência e o autoconhecimento foram tradicionalmente subsumidos à idéia de Descartes da autoridade da primeira pessoa. Segundo a tese cartesiana, teríamos acesso privilegiado e não-empírico aos nossos estados mentais que se expressaria por meio de um conhecimento. A tese central do externalismo afirma, ao contrário, que o conteúdo dos estados mentais é constituído, em parte, pelas relações com o ambiente. A adoção da tese externalista coloca em dúvida a suposição cartesiana de que temos acesso privilegiado aos conteúdos de nossos pensamentos, restringindo, assim, a autoridade da primeira pessoa. O externalismo perceptivo de Davidson, por exemplo, oferece uma solução ternária eu-intérprete-mundo para as origens do autoconhecimento. A tese de Davidson é apresentada como reconciliando o autoconhecimento e as idéias centrais do externalismo. São apresentados dois modelos da gênese externa do eu:1) os modelos ecológicos que propõem um desenvolvimento do sentido de eu como uma função das interações do eu com o ambiente; 2) o modelo psicológico de Winnicott que propõe a emergência do sentido de eu a partir de uma relação ternária entre o eu, os outros e os objetos transicionais. Defendemos a tese de que o modelo psicológico de Winnicott é o mais adequado para descrever a conceitualização epistemológica de Davidson das origens externalistas do autoconhecimento.

平面几何问题解决过程中的元认知实验研究

This study was based on the cognitive-metacognitive model of mathematical problem solving established by Lester & Garofalo(1985). The method of protocal analysis was used and 19 excellent students(9 male and 10 female) & 19 learning-disabled students(11 male and 8 female) in middle school(grade 3)were tested and interviewed during they solved plane geometry problems. The main results showed as follows: (1) There was a significant difference between excellent students and learning-disabled students on time-assignment when they solved plane geometry problems. Excellent students used more time on phase organization and less time on phase execution. There was no difference on phases orientation and verification. (2) Excellent students showed higher metacognitive level than learning-disabled students. The deference existed in phases orientation and organization. Excellent students reported more metacognitive sentences in phases orientation and organization than learning-disabled students. They had more self-awareness and goal-awareness. They had more "knowledge about what they know" and "knowledge about what they should use". They designed more globle goal and subgoals and made more self-evaluation. (3) Both the excellent students' and learning-disabled students' self-checking level should be improved.

Inquiring into perspective transformation in university education

My Portfolio of Exploration tackles the difficult question as to whether adult mental development can be accelerated and if so how. Rooted in constructive-developmental ideas, adult mental development is explained as an evolutionary unfolding of human capability. Going beyond this I look at the possibility of advancing development as transformational growth in adulthood in the belief that a broader perspective leads to increased effectiveness in professional life. Initially I explored my own meaning making, to make sense of my experiences, knowledge, relationships and my own motivations. This exploration has provided me with a ‘developmental bridge’ between my current way of knowing and a new more enlightened way. I have come to view my way of making meaning in the world as an evolving and progressive sequence of emotional and cognitive development. Through the formation of new stretching experiences, increased self - awareness and reflection my previous perspective has been overtaken by a more complex form of being aware of myself, others and the world. I refer to this process of growth as transformation. As part of my own transformational work I have conducted an inquiry into transformational growth and learning in the early academic life of university undergraduates. The result shows how accelerated adult mental development can be achieved in an academic environment ably preparing students for the workplace. This new model of education is part of a truly unique and exciting model signalling ground-breaking change for the undergraduate experience. The overhaul of a traditional BA degree in Economics into a world-class transformational programme is discussed through-out my Portfolio. Central to my broadening awareness is the challenge and nurturing required to awaken the student’s ‘internal authority’ . This involves stimulating students to take ownership for their own thinking, steering them away from the passivity and complacency of thinking through the minds of others. In doing so, the ultimate aim of renewing the BA is to narrow the developmental ‘mismatch’ which exists for m any college students between them and the world of work, by encouraging and inviting them to take on the challenge of thinking independently. Mindfulness, awareness, and personal authority are treated with reverence throughout the exploration as I consider them core parts of the students engaging with development. Engagement is construed as an active and open-minded process of awareness involving planning and reviewing one’s own goals and performance, engaging in constructive feedback, reflection and new action. I conclude with a view that the journey of adult mental development is relentless and that undergraduate education represents a crucial beginning. The value and relevance of transformational education rooted in developmental principles provides a significant opportunity in advancing development and perspectives at the start of adult life.

Right-left discrimination among medical students: Getting it right all of the time?

Objective To determine medical students’ self awareness and ability to discriminate right from left; to identify characteristics associated with this ability; and to identify any techniques used to aid discrimination. Design Questionnaire and psychometric study. Setting Undergraduate medical school, Northern Ireland. Participants 290 first year undergraduate students. Main outcome measure Medical students’ ability to discriminate right from left using the Bergen right-left discrimination test. Results Test scores ranged from 31 to 143 on a scale of 0- 144 (mean 112 (standard deviation 22.2)). Male students significantly outperformed female students (117.18 (26.96) v 110.80 (28.94)). Students who wanted to be surgeons performed significantly better than those who wanted to be general practitioners or medical doctors (119.87 (25.15) v 110.55 (27.36) v 112.50 (26.88)). The interaction effect for sex and career wishes was not significant (P=0.370). Students who used learnt techniques to help them discriminate scored significantly less than those who did not (P

Influence of personality factors on the consumption of personal care products

This research was undertaken with the primary objective of explaining differences in consumption of personal care products using personality variables. Several streams of research reported were reviewed and a conceptual model was developed. Theories on the relationship between self concept and behaviour was reviewed and the need to use individual difference variables to conceptualize and measure the salient dimensions of the self were emphasized. Theories relating to social comparison, eating disorders, role of idealized media images in shaping the self-concept, evidence on cosmetic surgery and persuasibility were reviewed in the study. These came from diverse fields like social psychology, use of cosmetics, women studies, media studies, self-concept literature in psychology and consumer research, and marketing. From the review three basic dimensions, namely self-evaluation, self-awareness and persuasibility were identified and they were posited to be related to consumption. Several personality variables from these conceptual domains were identified and factor analysis confirmed the expected structure fitting the basic theoretical dimensions. Demographic variables like gender and income were also considered.It was found that self-awareness measured by the variable public self-consciousness explain differences in consumption of personal care products. The relationship between public self-consciousness and consumption was found to be most conspicuous in cases of poor self-, evaluation measured by self-esteem. Susceptibility to advertising also was found to explain differences in consumption.From the research, it may be concluded that personality variables are useful for explaining consumption and they must be used together to explain and understand the process. There may not be obvious and conspicuous links between individual measures and behaviour in marketing. However, when used in proper combination and with the help oftheoretical models personality offers considerable explanatory power as illustrated in the seventy five percent accuracy rate of prediction obtained in binary logistic regression.