<p> Proper hand hygiene is the most effective and efficient method to prevent over 1.3 million deaths annually from diarrheal disease and Acute Respiratory Infections (ARIs). Hand hygiene is also indispensable in achieving the fourth Millennium Development Goal (MDG) to reduce the childhood mortality rate by 2/3rds between 1990 and 2015. Handwashing has been found in a systematic review of studies to reduce diarrhea by 47% and is, thus, capable of preventing a million deaths (Curtis et. al., 2003). Despite this evidence, hand washing rates remain seriously low in the developing world (Scott et al., 2008). </p><p> This study developed and implemented a comprehensive monitoring strategy of five usage variables (i.e., soap usage, functionality, presence of cleansing agent, ground wetness under station, amount of water in the jug) for 42-64 appropriate technology handwashing stations. These stations were monitored throughout 2011-2013 in two communities in Mali, West Africa. Statistically significant (p &lt; 0.05) results include: 1) a 29% decrease in soap usage from dry (October&ndash;June) to rainy seasons (July&ndash;September), 2) 35% decrease in stations with presence of cleansing agent between 2011 and 2012, 3) higher station usage for stations in households with higher scores on the Progress out of Poverty Index^&reg;, 4) 27% less of the stations far from a water source (35 meters&ndash;172 meters away) had a cleansing agent present than stations close to a water source (less than 35 meters) during the rainy season. Station usage also differed based on gender of the handwashing station owner in the two communities where stations built by women were used more in Zeala than those in Nci'bugu. In contrast to Zeala, handwashing stations built by men in Nci'bugu had higher soap usage and usage variable proportions than those built by women. Handwashing training and promotions resulted in 98% of households reporting that they wash their hands with soap in 2012 from 0% in 2011. Altogether, this study designed and implemented a robust monitoring system that succeeded in quantifying handwashing station usage for over two years. In-depth analysis of the data established six sustainability factors for handwashing stations (gender, training, water, seasonality, wealth, and monitoring) that are critical for lasting handwashing behavior change and successful hygiene interventions to save lives.</p>

<p> The purpose of this project was to create a tool to evaluate web-based educational sources that are geared towards Latino parents with preschool children to combat childhood obesity and to promote healthy lifestyles. The goals of this project were to increase awareness of the Latino childhood obesity problem and provide a tool to web developers to aid in the development of culturally appropriate nutrition education websites for preschool Latino children. </p><p> The primary evaluation tool is organized into eleven groups: site content, site functionality, site design, layout, readability, user learning experience, type style, use of color, photos and illustrations, non-English site development, and site evaluation. All criteria were included based on evidence-based research and a review of literature. A feasibility study was conducted to review the primary evaluation tool and a content evaluation form for users provided feedback. </p>

<p> Infant mortality rate has long been an important factor when measuring a country's overall health status. The lower the infant mortality rate the better the country's health status. This study examines the variation of infant mortality in Hispanic/Latinos, Black/African Americans, and Medicaid beneficiaries in the United States. Secondary data was drawn from the National Hospital Ambulatory Medical Care Survey for the year 2011-2012. Results of the study did not reveal or support the demographic or socioeconomic factors that influence the outcome of infant mortality. Future research should include data from the neo-natal intensive care unit, and not just the emergency department, where infant mortality is better recorded.</p>

<p> The objective of this study was to examine the associations of socioeconomic factors on young children's health insurance status based on their parent's health care coverage. Variables considered were educational attainment, annual household's income, citizenship status, and race.</p><p> Secondary data analysis was performed using a subset of data (excluding 65 years olds) from the 2011-2012 CHIS survey. Chi Square and One-way ANOVA tests were conducted through the use of SPSS. Results demonstrated a highly significant relationship between income and employer- based insurance, in addition to educational attainment and employer-based insurance. Income is interpreted in terms of federal poverty level due to the important use of this measure during the determination of eligibility for public health care program, such as Medi-Cal. Health care is transforming and additional initiatives need to take place to reduce the number of uninsured children and to improve the overall health status of children.</p>

<p> Forty years after Kramer's (1974) seminal work, Reality Shock, new graduate nurses continue to have difficulty transitioning to the registered nurse (RN) role. The purpose of this phenomenological study explores the lived experience of new graduate nurses who completed a Veterans Affairs externship program in their senior year of nursing coursework and its perceived impact on their successful transition into the practice role 3-24 months following graduation. Benner's (1984) Novice-to-Expert Model, Karmer's (1974) Reality Shock Theory, and Selder's (1989) Life Transition Theory support a framework for this study. Twelve telephone interviews were conducted using van Manen's (1990) method for researching the lived experience. One overarching theme "feeling confident" and three main categories, "transitioning to the RN role," "making decisions," and "interacting with professionals," were identified from the data. Externship programs assist the student to comfortably and smoothly transition as a new graduate nurse by offering additional clinical and practice experiences. Given the complexity of today's health care environment, there is a growing need to better prepare the graduate nurse for their transition into nursing practice. Externship programs can serve this purpose. </p>

<p> Users play a key role in many training strategies, yet some organizations often fail to understand the users&rsquo; perception after a simulation training implementation, their attitude about acceptance or rejection of and integration of emerging simulation technology in medical training (Gaba, 2007, and Topol, 2012). Several factors are considered to contribute to the acceptance level of simulation training by the users, including cost, the existing training and certification policies, technical issue, realism of training, values of it, concerns about it, and its effect on the patients outcome, and medical errors (Clever, 2011and Dawson, 2006).An often overlooked factor in the success of a simulation training merger is the impact on the users and medical profession (Dickemen, 2007). This qualitative phenomenological research study explored the lived experiences of a purposeful sampling of medicals simulation training users in the decision and none decision making roles, who had been involved in simulation training at least for one year. The study obtained their perceptions, their lived experiences, feelings associated with the experience, and interactions. And then how those feelings, perception, opinions, attitudes, and interactions evolved. Data suggested that the presence of feelings attached to experience, preconceived views, existing training policies, affect the level of effectiveness, users&rsquo; view of its outlook, impact on the decisions, and the medical profession. In addition the users&rsquo; perception, beliefs, and feelings all affect the interpersonal dynamics, interactions, communications, of simulation training users during adoption of simulation technology and its implementation. Understanding the medical simulation training phenomena through the understanding of users&rsquo; perspective can redefine how they communicate, interact, share, learn in simulated environment , and from one another that help with the subsequent additions and modifications to the existing simulation training strategies. </p>

<p> Lowered motivation can influence the involvement of adults with brain injury in the rehabilitation process, ultimately affecting the extent of their progress. This within-subject, pretest/posttest design examined the effects of an education program focusing on concepts of neuroplasticity on 34 adults with brain injury. Quantitative data was taken from pre-presentation and post-presentation surveys and was analyzed for significant change. Results indicated that the presentation was successful in increasing (a) the knowledge of neuroplasticity as evidenced by significant change in two out of three items, and (b) level of motivation as evidenced by significant change in six out of nine items. Effects of age, education level, and time post-injury were discussed. Study conclusions validate the use of education to increase motivation in people with brain injury, and provides new information about the use of neuroplasticity in education.</p>

<p> <b>Background:</b> Approximately 25% of newly hired nurses are deficient in critical thinking skills. <b>Purpose:</b> The purpose of the study was to determine if the hybrid design course assisted nursing students to improve critical thinking skills as compared to the traditional face-to-face lecture. <b>Methods:</b> This quasi-experimental study utilized pre- and post-test Assessment Technologies Institute, LLC (ATI) score analyses, course grades, and a demographic survey for students in the hybrid design course and students in the traditional course. The sample size consisted of 26 students in the hybrid design course and 25 students in the traditional lecture course. <b>Results:</b> No statistically significant differences were found between the critical thinking skills of students in the hybrid design section versus the traditional lecture section of the medical-surgical course. Course grades were statistically higher in the hybrid design course when compared to the traditional lecture section of the course.</p>

<p> Research has shown a link between sexual risk taking among college women and a decrease in self-esteem. The primary purpose of this study is to explore the sexual risktaking practices occurring within the academic achieving, more affluent, Caucasian and female college student population. The secondary purpose of this study is to explore what sexual risk-taking patterns exist within behavioral and sociocultural constructed variables and demographic information among college women. The variables examined are religion, self-esteem and reported depressive symptoms. Additional variables used during analysis are body weight and race and/or ethnicity of college women. There are three primary research questions being examined in this study: (a) Do college women with higher academic achievement report more sexual risk-taking practices than those with lower academic achievement? (b) Do women of a higher socioeconomic status choose birth control over disease prevention in their sexual encounters? (c) Do behavioral and sociocultural variables make a difference in risky sexual behavior of college women? The American College Health Association (ACHA) National College Health Assessment II (NCHA-II) has been used to measure the college student health habits and practices at over 540 college and universities in the United States and Canada. The instrument was administered online in spring 2010 and received 872 responses, of which 542 were from female students. The data is analyzed through multiple logistic regressions. Findings of statistical significance were found between academic achievement and sexual risk taking, the number of partners a college woman has and sexual risk taking, and increase in human papillomavirus (HPV). This study also affirmed prior research that there was a significant difference in the sexual risk taking between college women who had been diagnosed with depression in the last year. The study demonstrates the connection between depressive symptoms and sexual risk taking. The research does not present a judgment about sex&mdash;but rather, evidence regarding the lack of disease prevention, the long-term implications, and possible causes of increases in casual sex on college campuses.</p>

<p>The use of high fidelity simulation to educate health care professionals is becoming more common, especially in nursing education. This innovative teaching method bridges the knowledge gaps that are often present in nursing students related to limited clinical experiences and the transition of healthcare to the community setting. In addition, there are limited opportunities to practice in specialty clinical experiences such as pediatrics. This is particularly the case with pediatric immunizations. However, accrediting boards for colleges and future employers expect students to be able to function in these specialty roles despite the lack of clinical opportunities. Therefore, a pediatric immunization and parent education simulation was designed to address this knowledge gap and evaluate student anxiety, knowledge acquisition, satisfaction, and self-confidence with this innovative teaching method. The sample consisted of 21 senior nursing students enrolled in a community health nursing course in a rural baccalaureate nursing program in Illinois. The study design was a one-group, pre-test, post-test repeated measures design guided by Jeffries&rsquo; Nursing Education Simulation Framework. Participants completed a researcher designed demographic questionnaire, the State-Trait Anxiety Inventory Scale for Adults (STAI), a researcher-designed knowledge test, and the Student Satisfaction and Self-Confidence in Learning scale. Results were analyzed with SPSS, Version 20 using descriptive statistics, paired <i>t-tests</i>, and Pearson&rsquo;s Correlation Coefficient. The study results demonstrated that high fidelity simulation was an effective teaching modality that decreased students&rsquo; anxiety, enhanced their knowledge, and increased their self-confidence with administering pediatric immunizations and providing parent education. </p>