The importance of spirituality in relation to mental well-being and physical health is currently well regarded in the academic literature. Therefore spiritual care is now considered an important aspect of holistic healing practices. However, research is showing that most health care providers do not feel competent or confident in this area of care. In this thesis I explore how spiritual care is understood and experienced by practitioners in aged and palliative care in a regional area on the coast of New South Wales. The 26 participants, whose insights and experiences are depicted in this thesis, were very happy to be involved in this qualitative research project, because they felt that they now had the opportunity to explore spirituality and spiritual care.The participants in this research describe spiritual care as involving doing in the form of religious practices, such as praying or bible readings and non-religious activities that were seen as spiritual such as talking about dying, touching people or reminiscing. Additionally, they also commented about spiritual care as a special way of being with clients, which involved qualities and attitudes that were clearly felt or recognized by the participants as special. Not necessarily labeled as spiritual care, this special way of being was described as not being separate, but being an integral part of the daily acts of caring such as feeding a patient or preparing them for a bath. Participants found it often difficult to elaborate on what made such an interaction spiritual or how to describe the quality of these interactions as there seemed to be no familiar language to share the experiences of spirituality and spiritual care. Additionally, participants commented quite regularly that, although spiritual care was seen as important, there were many factors that inhibited these practices. In reflecting on these issues I put forward that, although the practitioners in this research are familiar with spiritual care, the most important contribution to encouraging health care providers to feel more confident is to continue conversations about spiritual care to increase competency in a non-denominational spiritual discourse in aged and palliative care.

This Reflective Topical Autobiography (RTA) aimed to reflect on and recount my own actual life stories and the life lessons learned, in order to identify patterns, trends and insights from my life and to offer these insights to others. My objectives were to promote personal empowerment as a tool for fulfilling individual potential, and to heal and be healed, by taking personal responsibility and making choices that enhance the individual and thus the collective consciousness.The research questions I posed to myself to assist in reflecting on and recounting my life stories were: What are the key stories of my life? What life lessons have I learned from my experiences? What are the patterns, trends and insights from my life? How can I offer these insights to other people? The RTA activities included writing personal stories, reflecting on my life patterns, trends and insights, and using photographs and a DVD production, to illustrate the main ideas and events.The research process allowed me to move from being reactive to reflective and to answer the research questions. Some of my life lessons learned from my experiences are that: one person can make a difference; lack of money is not lack of personal power; and nothing is impossible. My life patterns and trends include having a high-energy lifestyle, living without fear, learning to deal with disappointments, keeping life records, taking responsibility for action, and creating a morphic field. This RTA also offers insights to other people, with whom they resonate.It became apparent to me, in the process of documenting my personal journey in this RTA, that by suspending judgement and keeping an open mind and open heart, I am able to attune to what I call ‘Divine Intelligence’. It is a deep cellular knowing, that we are all connected. In 32 years of my own development, I have witnessed quantum leaps in the disciplines of science, spirit, ancient wisdom and health, which are acknowledged in the academies of the world. There is a new way of seeing and thinking, which is about a future based on these holistic principles of interconnectedness. It is the contention of this RTA that thoughts and intentions are the tools for personal and global change.

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The primary objective of this study was to evaluate the risk of coronary heart disease (CHD) correlated to total homocysteine (tHcy) levels among Hispanics (25.6%) and non-Hispanic whites (74.4%) with type-2 diabetes. The charts of 39 subjects with type-2 diabetes were selected from one physician’s caseload for a convenience sample. This endocrinologist has been supplementing his patients with 1-3 mg of folic acid daily if their tHcy levels were > 13 pmol/L. We found a significant difference (p < .001) between tHcy levels at baseline, follow-up I and follow-up II with a mean total reduction of 4 pmol/L. The results indicated that tHcy levels could be reduced by 1-2 mg folic acid daily in 2-8 months in subjects with type-2 diabetes. The recommendation generated from this study’s findings is that a folic acid supplement be consumed as part of a long-term management regimen for type-2 diabetics.

This study was undertaken to determine Rastafarian infancy and childhood feeding practices and to analyze the effects of this vegan diet on the nutrient intake and growth of Rastafarian infants and children. The Rastafarian cult originated in Jamaica, West Indies. Rastafarians have special religious, dietary and social guidelines, including many dietary prohibitions. The daily spiritual ritual includes smoking marijuana. Forty children of immigrant Rastafarians living in Miami were assessed to analyze their vegan diet and its effects on their nutrient intake and growth. All children had been breast-fed for an average of two years in conjunction with the early addition of foods. Bush teas were preferred to soy formulas and were used medicinally. Excluding the three infants, the children were grouped according to age; one to three years old, n=ll; four to six years old, n=16; over six years, n=10. Among all groups, calories, calcium and B12 intakes were below 100% of the RDA. In the two older groups, B12 intake was less than 67% of the RDA and in the oldest group, calories were also less than 67% of the RDA. Z-scores were used to compare anthropometric data obtained at various ages. Although weights, lengths and weight of length were above the means, there was a negative correlation of weight for length with age. Growth percentile categories for weight, weight for length, and triceps skinfold decreased with age. The B12 intake and weight of one to three year olds were correlated (p=.01). Among four to six year olds, there was a correlation between B12 intake and both length (p=.01) and weight for length (p=.04). Among the oldest group, there are a negative correlation between B12 and weight (p=.O4); calories and length (p=.O3); and calories and weight for length (p=.006). Sub-optimal nutrient intakes of B12, calories and calcium in this population are similar to findings in other vegan groups.

The purpose of this study was to determine which Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (lADLs) Black non-Hispanic elderly in South Florida reported having difficulty performing and what were their sources of assistance. One hundred and five Black and 288 White non-Hispanic elderly were compared based on their ADL and IADL difficulties and caregiving behaviors. This study was based on the dataset from a larger (1900 subjects) Dade County Needs Assessment. Blacks reported significantly less difficulty (p These findings demonstrated that occupational therapists need to be aware of the importance of informal networks in the Black community. A better understanding will allow therapists to develop better intervention and treatment plans for this population.

The objective of this study was to determine if offering larger portions of fluids with medications, i.e., at “med pass,” would increase fluid intake in nursing home residents. In a Latin square design, thirty-four residents of a 180-bed nursing facility received 4 and 8 oz servings of water and juice during distribution of medication. Fluid remains were weighed after 90 minutes. Larger portions and juice offerings were both found to increase fluid intake. Average fluid intakes increased from 80 to 140 mL when 8 oz servings of fluid were served instead of 4 oz servings (ps <.01). When juice was served in place of water, average intakes increased from 90 to 130 mL (ps <.01). Evaluation of the interaction between portion size and fluid type revealed that juice potentiated the increased intakes seen with 8 oz portions of fluid (ps <.01). Providing larger servings of fluid and offering juice with medications can be effective strategies to increase fluid intake in nursing home residents.

The availability of attenuated, bitypic, genetic recombinant strains of herpes simplex virus (HSV) made possible the following investigations. The recombinant virus, D5E1, exhibited limited, short-lived replication in the central nervous system of mice and guinea pigs. Nevertheless, this virus was sufficient to stimulate substantial levels of neutralizing antibody and localized cellular immunity in genital tissue. Immunization with D5El protected mice and/or guinea pigs against (HSV) type l and 2 infections when the challenge virus was given by a variety of pathways. In particular, it reduced vaginal virus shedding, inflammation, and acute and latent infection of the regional ganglia. The degree of protection in mice was influenced by the strain of rodent, the route of challenge and type of wild virus. Vaccination of newborn mice with live, attenuated virus also resulted in protection against HSV-2 subsequently inoculated into the footpad. The ability of recombinant HSV strains to establish latent ganglionic infection was related to their virulence, the route of inoculation and the genetic strain of the mouse. The D5E1 vaccine failed to establish latent disease by itself, but nevertheless conferred good protection against HSV type 1 or 2 challenge of immunized mice or guinea pigs.

Purpose: The purpose of this work was identify key factors associated with inpatient physical therapy utilization and length of stay for patients with low back pain (LBP) in Florida hospitals. Rationale: Little is known about factors associated with inpatient physical therapy or length of hospitalization for patients with LBP. This group of works identified the key factors associated with inpatient physical therapy and long lengths of hospitalization for this patient population. Since physical therapy and reduced length of stay are known cost-reducers, identifying key factors may represent significant cost savings to the health care system. Methods: Several mixed method procedures were utilized to examine physical therapy utilization and length of hospitalization between the years of 1992 and 2014. Policy, patient and hospital characteristics, as well as, hospital procedures during a patient’s stay were examined as contributors to either physical therapy utilization or length of hospitalization. Conclusion: Many factors are associated with inpatient physical therapy utilization and length of stay for patients with LBP in Florida hospitals.

Information on nutrition and aging research in Brazil, Chile and Mexico was compiled. The questionnaire was adapted from one published by the United Nations Population Fund. The Pan American Health Organization (PAHO) provided the initial contact list. A search of online library databases was also done. Databases yielded a total of 149 journal articles, 21 books, 9 dissertations and 17 theses on nutrition and aging published between 1983 and 2000. The information showed that nutrition and aging is an area in the process of policy and program development and that aging is an important public health issue because of the current and projected growth of this population group. In line with the PAHO goal of improving the possibilities for healthy aging, this study may help strengthen the integration of multidisciplinary nutrition and aging research with public health policy.