Magister Public Health - MPH / This study explores the challenges faced by nurse counselors in the implementation of HIV and Infant Feeding Policy in Amathole District of the Eastern Cape. Objectives: (i) To describe the demographic characteristics of the study population; (ii) To explore the challenges faced by nurse counselors in the implementation of current HIV and infant feeding policy and guidelines; (iii) To establish the nurse counselors perspectives on the infant feeding policy and guidelines for HIV positive mothers; (iv) To examine the support system available to the nurse counselors who give infant feeding advice to HIV positive mothers. / South Africa

Background: A key innovation in the provision of inpatient services to facilitate the care and treatment of women with severe postnatal mental illness was the introduction of joint mother and baby psychiatric hospitalisations, where both the mother and baby are admitted to hospital together. This study examined the history of the practice of joint mother and baby admissions across the UK and critically explored the processes relevant to the diffusion of joint admissions and patterns of service development to identify the possible and probable causes for significant differences in service provision across the United Kingdom (UK). Aims: The study examined the documented history of the development of practice of joint mother and baby psychiatric hospital admissions across the UK and in doing so, a) Identified the pattern of service and practice development and the likely reasons for the pattern of the chronology. b) Identified the processes involved in the diffusion of joint mother and baby admissions in the UK, and explored why the practice was sustained (or not). c) Contributed new information to the continued development of innovation diffusion theory and research, and its application to health care service and practice development. Methods: A historical method was used in the study and was reported through the use of historical narrative and analysis. Data was collated from primary and secondary sources of documented evidence which was used to inform the history of joint mother and baby admissions across the UK. Data was analysed using the theoretical framework of diffusion of innovation (Rogers, 2003). Findings: Two versions of the same innovation were identified: joint admissions to side rooms of general adult psychiatric wards or annexed areas of the wards and joint admissions to specialist mother and baby units. Neither version of the practice followed the normal S-curve pattern of adoption in terms of frequency and rate of adoption. After a period of approximately 63 years there are 24 facilities for the provision of joint admissions in the NHS in the UK. The main influencers to the adoption of the practice was perception of risk, social networks internal and external to the NHS, the presence of clinical and political champions to drive the adoption and implementation of the innovation and policy entrepreneurship by clinicians working in the clinical field of perinatal mental health. The development of specific policy, guidelines and in Scotland, legislation, has resulted in a move during the last decade from joint admissions being diffused naturally to side room admissions being actively withdrawn and specialist psychiatric mother and baby units actively being disseminated. There is strong evidence that the diffusion process for specialist mother and baby units is still in motion at the time of reporting. Conclusion: Two competing versions of the same innovation had unusual patterns of diffusion. The influencers identified as relevant to the diffusion patterns of each version of the innovation were essentially the same influencers but they were used in different ways to affect change: rejection of one version of the innovation in favour of adoption of the other. The main influencers on the diffusion of joint admissions changed over the time line of the adoption pattern. Barriers to diffusion included the absence of evidence of effectiveness, the absence of economic evaluation, the position in service divisions of perinatal mental health as a field of practice and the absence of succession planning across professional groups. Recommendations are made for future research.

El presente plan de negocio para exportación se plantea a partir de la idea y deseo de querer fabricar ropa con insumos orgánicos que permitan el cuidado de la piel y la protección del medio ambiente para bebés de 0 a 2 años. Se establecen tres importantes mercados objetivos que son Bogotá, Cali y Medellín situados en Colombia. Dichos mercados cuentan con una alta demanda por productos de calidad y de diseños exclusivos que al mismo tiempo sean socialmente responsables con el medio ambiente. Nuestro mercado meta en estas tres ciudades son los niños entre 0 y 2 años que tengan padres de familia con un nivel socio-económico por encima del medio-alto de ingresos y con alta preocupación por el cuidado de la salud del bebé. Además, se evaluarán los diversos canales de distribución donde se desenvolverá la empresa, así como las amenazas y las oportunidades que este mercado colombiano nos ofrece. También se analizarán las ventajas competitivas que se tienen que desarrollar, el manejo con los proveedores y la competencia en el mercado destino para conseguir concretar la situación real del mercado. La finalidad de la empresa es posicionarse en el mercado internacional con innovadoras prendas que logren satisfacer los gustos y necesidades del consumidor. Finalmente, para analizar la viabilidad del proyecto se efectuará una proyección a 5 años que establecerán fases de crecimiento determinadas que presentará la empresa El Arrullo. Para esto se efectúa una proyección de ventas y costos para desarrollar un flujo de caja de estos períodos y obtener el VAN del proyecto y determinar si es o no rentable y definir los riesgos que pudiesen existir. / Trabajo de investigación

Objective: To understand the use of evidence-informed decision-making within an interorganizational network, and identify the facilitators and barriers to achieving network goals. Design: Case study. Setting: Rural health district in Nova Scotia, Canada (2006 to 2011). Participants: Members from 4 organizations representing community and hospital groups participating in a regional Baby Friendly Initiative network. Methods: A descriptive mixed methods study using focus group and questionnaire methodology. Data were analyzed using framework analysis and social network analysis (SNA). Results: The SNA results highlighted the role that relationships have on the sharing of knowledge among network members. The findings highlight the need for leadership at multiple levels (community, network members, primary organizations, and the provincial government). A lack of resources to achieve the network’s goals was a key barrier. Conclusions: The role of multi-level leadership is important for future network development and community consideration. The case study methodology facilitated momentum towards the network’s goals.

The purpose of this research is to empirically investigate consumers' health care decision choices in a dynamic market setting. The unprecedented demands on the U.S. health care system coupled with the mounting controversies surrounding health care reform suggest that consumers' health care decisions warrant empirical research attention. Toward this end, this dissertation empirically explored (1) the characteristics of consumers who possess a willingness to use non-conventional treatments over conventional treatments, (2) the characteristics of consumers who elect self-medication in lieu of health care practitioner-directed medication, and (3) the salient dimensions of consumers' channel choice for the procurement of health care products. Each of these decision choice factors were tested across two U.S. generational segments to assess whether differences existed across Baby Boomers' and Gen Yers' health care decision choices. The conceptual framework for empirical assessment is Bandura's (1986) social cognitive theory. From Bandura's social cognitive theory, a general model of healthcare decision choice is proposed to assess consumers' states of mind, states of being and states of action (decision choice). Results indicate that social cognitive factors (e.g., self-efficacy, objectivism) play an important role in each of the decision domains explored in this dissertation. Moreover, health value was found to be an important moderator between the social cognitive factors and health care decision choices. The predictors of the health care decision choices were found to vary across the Baby Boomers and Generation Yers on several dimensions, confirming the notion that generational differences may be a salient dimension of consumers' health care decision choice. The research offers several implications for practitioners, academicians and policy makers. Both descriptive and normative implications are gleaned from the research findings. Most notably, the results indicate that consumers' social cognitive factors and health value may be mechanisms for managing health care decisions.

The purpose of this project is to gain a better understanding of the different market opportunities available to credit unions. The project differentiates the markets by age: Net Generation 2 to 22, Generation X 23 to 34 and the Baby Boomers 35 to 53. Each of these groups are important to the ongoing health of credit unions.

There is a growing understanding of the neural mechanisms of human maternal attachment. Human mothers’ neural responses to infants are associated with their behavioral sensitivity observed during interactions with infants. The current symposium aims to provide understanding of the core neural basis for mother-infant attachment, how prenatal and postnatal risk factors influence the maternal brain, and finally whether the negative changes in the maternal brain may be reversed by an intervention effort. The first paper presents converging evidence on neural, psychological and physiological responses to infants in new mothers across diverse cultural contexts. The paper highlights the common core neural processes of mother-infant attachment, which sets the foundation of understanding maternal brain’s successful and unsuccessful adaptation to parenthood. The second paper presents the role of prenatal risk factors, specifically prenatal maternal anxiety, in maternal brain adaptation to parenthood. This longitudinal study suggests that negative effects of maternal anxiety in mothers’ neural adaptation to parenthood may emerge during pregnancy. The third paper presents evidence that socioeconomic stress may also disrupt mothers’ neural adaptation to parenthood. Low family income is associated with dampened neural sensitivity to positive infant expressions and elevated neural sensitivity to negative infant expressions, which further influence disruptions in maternal behavioral responsiveness to own infants. The last presentation suggests that aberrant neural sensitivity to infants among distressed mothers may be improved via an intervention. Among depressed mothers, interventions to improve mental health reduced parental stress and strengthened neural functional connectivity in response to their infant.

Introduction: ReadNPlay for a Bright Future is an initiative developed by the East Tennessee State University (ETSU) pediatricians and partners, to promote healthy active living among families with young children. The project includes giving families a packet with a baby book and a tips booklet when they bring their young children to the pediatrician's office for the newborn visit. My Baby Book is based on Bright Futures guidelines and contains age-appropriate advice on keeping babies healthy, sharing books, eating healthy, preventing injury, and being active as a family, as well as space to record special memories and milestones. The vision of this project is to encourage families in the region to Play More, Play Together, Play Safely, and have Fuel to Play. Methodology: In January 2013, anonymous surveys in English or Spanish were administered to a sample of 80 mothers of infants under 24 months of age during well child visits at the ETSU Pediatric Clinic. This served as the pre-intervention survey to assess baseline self-reported behaviors of mothers and infants before the intervention (My Baby Book) was implemented. 3 follow up surveys were carried out in July 2013, April 2014 and July 2015 respectively to collect post-intervention data. Questions centered around screen time, physical activity, injury prevention, and healthy eating. Pre-intervention data was compared to post-intervention data consisting of the 3 follow up surveys combined together to determine the effectiveness of the ReadNPlay project. Data was collected using Epi Info and Excel and analyzed with SPSS. Results: The total sample size was 80 at each time point. Majority of the mothers are beneficiaries of the Women, Infants and Children (WIC) program. Preliminary results include that there was a 5.28% decrease in the number of mothers who reported spending more than 20 hours/week watching TV or videos; 4.22% increase in the number of mothers who spent at least 3 hours/week being engaged in light/moderate recreational activities; 14.35% increase in the number of mothers who spent at least 2 hours engaged in vigorous recreational activities or sports; 3% increase in the number of mothers who spent at least 3 hours/week walking for fun/exercise, and a 3.3% increase in the number of mothers who breastfed their children for at least 6 months. Among infants, a 6.39% decrease in hospital visits for injuries was reported as well as 8.23% increase in the number of infants who had no screen time. Conclusion: Limitations of this study include lack of a control group, potential for cohort effect, and the self-reported nature of the data collection. ReadNPlay for a Bright has subsequently been expanded to include distribution of a ReadNPlay children’s book series, development of a mobile application based on My Baby Book, and development of regular healthy active living community events and support groups to link families to in the region. A longitudinal evaluation of the program including several different clinics in the region is underway.

Nuestro proyecto de negocio llamado Baby Moda Shop se realizó pensando en las necesidades del consumidor, pues actualmente los clientes de ropa para bebé valoran la calidad del producto, así como el diseño de las prendas. Además, se ha determinado la necesidad de aquellos padres que buscan vestir a sus pequeños de manera rápida y práctica. Por ello, ofrecemos un producto con estos tres atributos que son valorados por los padres, pues nuestras prendas están confeccionadas para bebés de 0 a 12 meses, por lo que usamos como tela el algodón pima. Asimismo, ofrecemos los diseños de calidad y el valor agregado de utilizar los broches imantados para facilitar el cambio y darle una mayor practicidad al vestir a los bebés. Nuestro local estará ubicado en el distrito de Surco, Lima, estaremos enfocados a los NSE A, B y C, nuestra fuente de ingreso será la venta de ropa para bebés y para ello trabajaremos con un plan de marketing que nos permita lograr posicionamiento en el mercado objetivo, por medio de publicidad en redes sociales, influencers y página web. / Our business project named "Baby Moda Shop" was made thinking in consumer´s needs, because nowadays baby clothing costumers highly value the product quality as well as the clothing design. Furthermore, have been seen the necessity of parents, who seek to dress their children in a simple and fast way. That’s why, we offer a product with these three benefits that parents cares, our clothing are made for babies for zero to twelve months, so we use Pima cotton fabrics. In addition, we offer quality designs and the value added of using magnetic brooches to make it easier changing clothes and give more practicality when to dress babies. Our main Store will be in Surco, Lima; we are going to focus on NSE A, B and C, our incomes are going to be the sales of baby clothing therefore we are working with a marketing plan that allows us to positioned in the market target, using social media advertising, influencers, and a web page. / Trabajo de investigación

The aim of diploma thesis is occurrence of toxic and essential elements in vegetables and fruit, especially in fruity baby food. The diploma thesis also dedicates processing of vegetables and fruit for production of baby food. Attention is direct to monitoring of baby food quality in the analytical aspects and also to legislative that is in this area. Samples for analysis are prepared using microwave mineralization and ICP-MS for detection. This is described in the experimental part of the diploma thesis.