No abstract

No abstract

Increased cost of chronic illnesses in United States is an urgent call to develop a cost effective approach to improve chronic disease self-management, especially among vulnerable populations. An emerging role for professionals and paraprofessionals is the patient navigator. We present an example of a conceptual framework, Transformation for Health, developed to underpin the training of certified community health workers (CHW) to deliver health care, preventive services, and health education for underserved populations to promote chronic disease self-management. Transformacion Para Salud (TPS), a patient navigation model for chronic disease self-management, was a two year demonstration program to develop a culturally sensitive intervention to facilitate patient behavior changes. Patients involved in the TPS intervention showed improvements in clinical and behavioral outcomes after twelve months of intervention. This article describes the conceptual basis and implementation of the TPS and discusses program evaluation, specific intervention outcomes, and implications for practice. Use of CHWs in the patient navigator role demonstrated a cost effective method to improve access to quality, cost-effective, primary health care services as well as to facilitate chronic disease self-management.

No abstract

Preventive and health promoting behaviors in pregnant minority women can be used to develop approaches to encourage healthy lifestyle and optimal utilization of health services, and to obtain better outcomes of pregnancy. Using the Health Promotion Model as a theoretical framework, this study employed a cross-sectional survey design to investigate factors that related to health behaviors of low-income pregnant Mexican American and African American women in selected sites in the southeast portion of the state of Texas. Results showed that Mexican American women had a significantly higher mean on the Powerful Others Locus of Control measure than the African American women. For African American subjects, the strongest effect was exerted by the social support variable, which had a negative effect on the health behavior variable. Findings suggest that more studies are needed to identify specific determinants of health promoting activities during pregnancy in ethnic minority groups. Designing programs that would motivate early involvement of low-income pregnant minority women in health care should be a top priority for professionals in maternity practice.

No abstract

No abstract

In this paper, two interesting eigenvalue comparison theorems for the first non-zero Steklov eigenvalue of the Laplacian have been established for manifolds with radial sectional curvature bounded from above. Besides, sharper bounds for the first non-zero eigenvalue of the Wentzell eigenvalue problem of the weighted Laplacian, which can be seen as a natural generalization of the classical Steklov eigenvalue problem, have been obtained. * Corresponding author MSC 2010: 35P15, 53C20. Key Words: Steklov eigenvalue problem, Laplacian, eigenvalues, spherically symmetric manifolds, Wentzell eigenvalue problem. p ⊆ T p M is a unit vector of the unit sphere S n−1 p with center p in the tangent space T p M. Let D p , a star shaped set of T p M, and d ξ be defined byand d ξ = d ξ (p) := sup{t > 0| γ ξ (s) := exp p (sξ ) is the unique minimal geodesic joining p and γ ξ (t)} respectively. Then exp p : D p → M\Cut(p) gives a diffeomorphism from D p onto the open set M\Cut(p), with Cut(p) the cut locus of p. For ζ ∈ ξ ⊥ , one can define the path of linear transformations A(t, ξ ) : ξ ⊥ → ξ ⊥ by A(t, ξ )ζ = (τ t ) −1 Y (t),