In developing countries, several poor infant feeding practices are common, resulting in physical and intellectual developmental impairments. Good feeding practices are crucial, especially in the first year of life. In addition to the malnutrition currently suffered in developing countries, HIV/AIDS has worsened the clinical and nutritional status of both mothers and their children. HIV-infected women face difficulties in choosing among infant feeding options because they must balance the risks of postnatal HIV transmission and infant morbidity and mortality. Many mothers in low-income settings like Rwanda do choose to breast feed but this simply shifts the difficult decision to when to stop. However, few studies have explored feeding practices among HIV-exposed infants during the transition period when breastfeeding is stopped An Infant and Child Feeding Index (ICFI) was created in this study to (1) explore infant feeding practices, (2) assess their association with nutritional status among HIV-exposed infants, and (3) evaluate the magnitude of the association over time in Rwanda. Data analysis, using a cross-sectional time series model, suggests that ICFI is positively associated with Weight for Length Z-score (WLZ) and Weight for Age Z-score (WAZ). However, neither the ICFI nor any of its components were associated with the Length for Age Z-score. Other feeding variables related to behaviors, including initiation of breastfeeding within one hour after birth and ever breastfeeding, were not associated with the anthropometric indices, but these take place much earlier. There was no correlation between changes in the index over time and anthropometric indices. Mean LAZ, WLZ, and WAZ were all lower in male infants. In Rwanda, reorganizing nutritional units at the central level and integrating nutritional services at district and health facility levels are critical to delivering simple and concise nutritional messages that involve all types of orphans and vulnerable children / acase@tulane.edu

Little is known about the effectiveness of HIV testing and counseling programs to inspire behavior change among patients seen at US clinics for Sexually Transmitted Diseases (STDs). We studied changes in gonorrhea incidence from 1989 through 1993 in a historical cohort of 4,031 patients seen at a public STD clinic in New Orleans, Louisiana. To determine if HIV testing and counseling promote risky behaviors, we designed a pretest-posttest observational study which included a treatment group and an untreated comparison group. The frequency, timing, and results of the HIV tests performed during follow-up were taken into account in the analysis. We used Cox's proportional hazard regression techniques for multivariate failure time data to model the occurrence of gonorrhea infections over time. The models adjusted the comparisons for history of gonorrhea, and HIV testing and counseling, as well as important confounding factors. We found that being tested and learning about a negative test result may have prevented up to 1,318 gonorrhea infections (34.7 percent of the expected total number of infections) among individuals who never tested HIV positive. The risk of gonorrhea remained constant at a low level among 911 individuals who were not tested during follow-up (22.6 percent of all patients). The risk of gonorrhea decreased markedly after HIV testing among 2,041 individuals at low baseline risk (50.6 percent of all patients), decreased moderately after each of the first two HIV tests among 672 subjects at intermediate baseline risk (16.7 percent of all patients), but increased after the first test among 358 subjects at high baseline risk (8.9 percent of all patients). Posttest counseling was associated with a marginally significant decline in risk of gonorrhea among subjects at low baseline risk, but had no apparent effect on the other patients. No disinhibition effect was observed after posttest counseling. Our study suggests that HIV testing and counseling promote safer behaviors in most patients diagnosed with gonorrhea in a public clinic for sexually transmitted diseases. Nevertheless, a possible rebound effect was observed after HIV testing among patients who had the highest baseline risk of gonorrhea / acase@tulane.edu

<p>Low back pain (LBP) is a growing health and socio-economic problem worldwide, affecting humans from adolescent to adult age. In developed countries, more than 80% of adults are at risk of suffering a disabling episode of LBP at one point during their life time. In developing countries, particularly in Africa, the life time prevalence of LBP varies in population groups, but the disability due to LBP is increasing. The aetiology of LBP is multifactorial, and there is still no consensus on the exact cause and contributing factors to LBP. In addition, little is known about patients&rsquo / knowledge and beliefs on the contributing factors to their LBP. The current study therefore, aimed to identify patients&rsquo / knowledge, attitudes and beliefs on the contributing factors to LBP, among patients attending physiotherapy outpatient departments in Malawi.</p>

Human capital accumulation and its effect on labour market outcomes have been in the focus of economic research for decades. Traditionally the economic literature suggests that there might exist several forms of human capital, where human capital represents the knowledge, skills and health embodied in individuals. Skills and knowledge are largely acquired through education and experience but may also reflect, in part, innate abilities. In addition, some aspects of motivation and behaviour, as well as attributes such as the physical, emotional and mental health of individuals are also considered as human capital. These activities are referred to as human capital because people cannot be separated from their knowledge, skills and health, in the way they are separated from their physical and capital assets. Human capital accumulation is an important determinant of individuals' earning capacity and employment prospects, therefore plays an important role in determining the level and distribution of income in society. Moreover, the costs of these investments include direct outlays on market goods and the opportunity cost of the time that must be withdrawn from competing uses. Apart from direct investments in human capital people could also invest in constructing a network of relationships for example to find a job. Until now all these aspects have been studied separately, in this thesis I try to reconcile them.

THESIS (D.N.P. (Doctor of Nursing Practice))--School of Nursing, University of San Francisco, 2009. / Bibliography: leaves 41-43 (first series)

Thesis (M.A.)--University of Canterbury, 2009. / Typescript (photocopy). Includes bibliographical references (leaves 146-158). Also available via the World Wide Web.

<p> The purpose of this study was to determine if students learn clinical judgment as effectively using computer-based simulations as when using high-fidelity mannequin simulations. There was a single research questions for this study: What is the difference in clinical judgment between participants completing high-fidelity human simulator mannequin simulation or computer-based simulation? A convenience sample of 50 associate degree nursing students in the last medical-surgical nursing course of their program were invited to participate in this study. Analysis of the demographic data confirmed the similarity of the two groups in terms of the potentially important confounding variables such as age, sex, education and prior healthcare experience. The score for each participant from the computer-based simulation (Simulation 2) and the percent of interventions completed in the high-fidelity human simulator simulation (Simulation 3) by each participant was added together to obtain an aggregate clinical judgment score for participants in Group C and Group M. Two-tailed <i> t</i> test for independent means was used to determine if a significant difference existed between the aggregate clinical judgment score for Group C and the aggregate clinical judgment score for Group M. Results from the test indicated that there was no difference between groups at the 95% confidence interval. The similarity of the clinical judgment scores of the computer-based simulation group to the scores of the high-fidelity mannequin simulation group indicates similar utility of the two instructional methods. The use of carefully planned and well-designed computer-based simulations can allow students to practice skills and develop confidence, self-efficacy and clinical judgment independently, freeing faculty for other instructional tasks.</p>

<p> This study utilized a multi-case, bounded case, single-site case study research design to examine how well instructional designers perceive themselves able to practice ID in health care industries. Questions central to this study focused on how instructional designers perceive their preparation to practice, usefulness of professional development organizations or affiliations in which they participated while practicing ID, both academic and non-academic curricula, and utilization of ID practices when designing and developing ID projects in health care environments. </p><p> The site selected for this study was a teaching hospital in Southeast Metropolitan Detroit, Michigan. Sampling size was limited to five instructional designers who had been working in the health care environment. Using a case study approach, convenient sampling was utilized to obtain detailed information about the experiences of instructional designers in the health care sector. Upon completion of interviews, participants had the opportunity to show completed work projects and were provided an opportunity to reflect on ID practice via journal entries over a two week time period. The constant comparative method was utilized for data analysis whereby a within-case analysis was conducted followed by a cross case analysis. Findings of this research showed that participants felt well prepared to practice ID in their respective health care environment and offered a variety of ways in which an instructional designer can explore the field of health care, how academic program administrators can collaborate with health care organizations to provide ID opportunities for students, and ways in which health care administrators can explore additional learning opportunities for their ID employees.</p>

<p> The purpose of this study was to examine why diabetes is persistent in Native Americans using demographic characteristics, physical activity, self-reported health status, socio-economic status, and race. This study used secondary data from the California Health Interview Survey. There were 47,614 adults who participated in the survey, of which 1,369 participants identified themselves as American Indians. </p><p> Chi square analysis was used to substantiate the association between diabetes in Native Americans with diet, exercise, obesity, self-reported health status, and socioeconomic status. Statistical test results found that there was an association between all independent variables suggesting that diabetes in Native Americans is more complex than other races. There were limitations to the study. due to the small number of Native Americans participating in the survey. A further study is recommended at a national level to look more closely at underlying causes of the persistence of diabetes in Native Americans. </p>

<p>Low back pain (LBP) is a growing health and socio-economic problem worldwide, affecting humans from adolescent to adult age. In developed countries, more than 80% of adults are at risk of suffering a disabling episode of LBP at one point during their life time. In developing countries, particularly in Africa, the life time prevalence of LBP varies in population groups, but the disability due to LBP is increasing. The aetiology of LBP is multifactorial, and there is still no consensus on the exact cause and contributing factors to LBP. In addition, little is known about patients&rsquo / knowledge and beliefs on the contributing factors to their LBP. The current study therefore, aimed to identify patients&rsquo / knowledge, attitudes and beliefs on the contributing factors to LBP, among patients attending physiotherapy outpatient departments in Malawi.</p>