Hypertension is a major risk factor for cardiovascular disease in both developed and developing countries. Blood pressure normally decreases at night and a number of studies have indicated that a reduced nocturnal decline in blood pressure (BP) increases the risk for cardiovascular disease. Nocturnal decreases in BP are attenuated in subjects of African as compared to European descent, but the mechanisms of this effect require clarity. In the present study I attempted to identify potentially modifiable factors that contribute toward nocturnal decreases in BP in a random sample of 171 nuclear families comprising 438 black South Africans living in Soweto. Prior studies have suggested that adiposity and salt intake may determine nocturnal decreases in BP. Adiposity and salt intake were considered to be potentially important factors to consider in the present study as 67% of the group studied were either overweight or obese and in 291 subjects that had complete 24-hour urine collections (used to assess salt intake) and BP measurements, Na+ and K+ intake was noted to be considerably higher and lower respectively than the recommended daily allowance in the majority of people. Moreover, a lack of relationship between either hypertension awareness and treatment and Na+ and K+ intake suggested that current recommendations for a reduced Na+ intake and increased K+ intake in hypertensives do not translate into clinical practice in this community. In order to assess whether adiposity or salt intake are associated with nocturnal decreases in BP in this community, ambulatory BP monitoring was performed using Spacelabs model 90207 oscillometric monitors. Of the 438 subjects recruited, 314 had ambulatory BP measurements that met pre-specified quality criteria (more than 20 hours of recordings and more than 10 and 5 readings for the computation of daytime and nighttime means respectively). To identify whether adiposity or salt intake are associated with a reduced nocturnal decline in BP, non-linear regression analysis was employed with indices of adiposity and urinary Na+ and K+ excretion rates and urine Na+: K+ ratios included in the regression model with adjustments for potential confounders. Neither body mass index, skin-fold thickness, waist circumference, waist-to hip ratio, urinary Na+ and K+ excretion rates, nor urine Na+: K+ ratios were associated with nocturnal decreases in systolic and diastolic BP. Indices of adiposity were however associated with 24 hour ambulatory systolic and diastolic BP. Unexpectedly, female gender was associated with an attenuated nocturnal decrease in BP. In conclusion, in the first random, community-based sample with large sample sizes conducted with ambulatory BP monitoring in Africa, I found that neither adiposity nor salt intake are associated with a reduced nocturnal decline in BP. The lack of association between either salt intake or adiposity and nocturnal decreases in BP was despite a high prevalence of excessive adiposity in the community, as well as clear evidence that current recommendations for a reduced Na+ intake and increased K+ intake do not translate into clinical practice in this community. Thus, based on this study, the question arises as to whether primordial prevention programs targeting excess adiposity or inappropriate salt intake are likely to modify nocturnal decreases in BP, in urban, developing communities of African ancestry in South Africa. However, unexpectedly I noted that females were more likely to have an attenuated nocturnal decrease in BP. Thus further work is required to explain this finding.

Accurately distinguishing species in the fossil record is difficult when the extent of osteological variation in many modern animals is unknown. Research into intraspecific variation has been conducted in a number of groups, but has not been conducted for systematics use in most modern artiodactyls. In this dissertation I quantify intraspecific variation of teeth in 14 species of modern artiodactyl, then test how accurately cranial characters diagnose modern, sympatric species of duikers, and use this information to reassess the artiodactyl diversity of a fossil group: the superfamily Merycoidodontoidea in the John Day Fossil Beds. Ultimately, variation is not constant between orders or different size classes, is influenced by morphology, size, and dimorphism, and this variation should be incorporated into fossil diagnoses to avoid both overconfidence of diagnosis and under-recognition of possible intraspecific variation.

Thesis (Ed.M.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

ABSTRACT This study investigated the quality of care provided to children between 0 and 36 months in Limpopo Province. A non-experimental, quantitative, cross sectional descriptive design was used. The researcher developed two research instruments: • a questionnaire which collected information on registration, training, services provided stimulation programs, referral and equipment. • an observation sheet which recorded information on the premises, the staff, equipment and office, toys, outdoor play area, sleeping and dining areas. 111 subjects participated in the study- 19 day mothers in urban areas and 92 caregivers in more rural areas. Descriptive statistics were used to summarize the data in the questionnaire and the mean values for the two samples from the observation were compared using a t test. Results suggest that the quality of care provided by both day mothers and caregivers is below the accepted overall mean of 3 for all variables examined except day mother’s premises. Caregivers at care centres were better trained and offered more stimulation programmes than day mothers. They also scored better than day mothers with respect to staff and equipment with toys and dining areas being significantly better. Day mothers scored marginally higher than caregivers with respect to outdoor play and sleeping areas.

Typescript. / Digitized by Kansas Correctional Industries

In the Portland Metropolitan area, a wide range of programs and facilities, including informal arrangements, are used for the care of children outside their homes during some part of the day. These programs and facilities include those whose primary purpose is child development, education, or recreation (Headstart, Parent and Child Centers, Nursery Schools, Kindergartens, Extended School Services, and Play School). They also include day care provided by non-profit organizations such as churches and hospitals by private proprietory day care operators and independent family day care homes, and by employers and labor unions in addition to cooperatives. These programs involve a large number of personnel of diversified backgrounds and training. They include professionals, paraprofessionals and nonprofessionals. These programs need to be classified in order to facilitate sound planning and development of training programs to meet the needs of such manpower. For purposes of this study, they were viewed as constituting a social system. The emphasis was on the staff working directly with children. In addition to the operators or directors in charge of most facilities, day care centers have at least one other staff member who works directly with children. These include teachers and social workers. The objectives of the study were to describe the manpower elements in the day care centers and to ascertain training needs and present modes of agency training activities. It was expected to develop a training proposal to meet the needs of the manpower elements identified in the day care centers; if it was so determined by the results of the survey

This research was undertaken at the request of the the St. Martin Day Nursery staff and advisory board to assist them in assessing what the consequences of relocating their day care center would be to the present users and possible future users. It was requested that special emphasis be given to where users live and work and the method of transportation they used to bring children to and from the center. Therefore, our research has been exploratory, planned more to search for answers and to attempt to generate hypotheses than to test hypotheses. It was not our purpose to designate where the future location of the St. Martin Day Nursery should be, but rather to point up some things about convenience factors which the Advisory Board might wish to consider in reaching their decision.

Thesis (D.Min.)--Andrews University, Seventh-day Adventist Theological Seminary, 2007. / Vita. Bibliography: leaves 181-197.

<p>The aim of this study was to describe how persons with Whiplash associated disorder experience how the pain affects them in their daily life. The design of the study was descriptive with qualitative, individual interviews, questionnaire with background facts of the examination group, and diary notes from persons with pain of WAD. Method for selection was convenience. Through contact with the association of whiplash group in a county in middle of Sweden, the majority of the examination group for the study was found. Five persons where given information about the study, one of them choose not to take part of the study, and one of the persons did not complete the study. One further person was asked to participate in the study and did take part and completed. Four persons choose to take part and completed the study, all women and between the ages 31-60. The result is presented in categories: To live with pain of WAD, Loss of quality of life, Changes in life after injury, Consequences of activity, Relations and isolation, Pain and sleep. The legible emerge that could be seen in the study was that planning the days was necessary to handle the intensity of pain. The pain controlled the days and the social relations to friends and relatives experience deteriorated because the degree of experienced pain controlled the day. All persons in the examine group emphasized that their injury can not be seen, and because that the acceptance for their injury and pain is low from the society.</p>

Thesis (Ed.D.)--UCLA, 1966. / Vita. Bibliography: leaves 173-179.