Thesis (PhD (Interdisciplinary Health Sciences. Human Nutrition))--Stellenbosch University, 2008. / Objectives: To determine the impact of facility-based semi-intensive and home-based intensive counseling strategies to improve exclusive breastfeeding rates and to identify factors associated with exclusive breastfeeding. Methods: This was a randomized trial in which villages in the Kibera slum, Nairobi Kenya were assigned to two intervention groups and a control group. Study participants from among 34-36 week pregnant, HIV-negative women, attending antenatal clinic at Lang’ata health centre, were assigned to study groups and followed up in their homes until 6 months postpartum. Experimental group 1, the Home-Based Intensive Counseling Group (HBICG)] received 7 counseling sessions; 1 prenatally and 6 postnatally. Experimental group 2, the Facility-Based Semi-Intensive Counseling Group (FBSICG) received 1 counseling session prenatally. The control group (Control Group) received irregularly provided health education by health personnel. Information on infant feeding practices, using a validated 24-hour recall questionnaire was collected monthly at participant homes; observations were conducted on a random 10% sub-sample to verify the reported information. Qualitative data from focus group discussions provided information on the rationale for feeding choices. Information on infant morbidity and weight measurements were taken on a monthly basis. Results: At six months, exclusive breastfeeding rate was 23.6% in HBICG; 9.2% in FBSICG; and 5.6% in CG. Mothers from HBICG had a 4.2 increased likelihood to exclusively breastfeed compared to those in the CG (RR=4.20; 95% CI; 1.66-10.64; p=0.002). Cumulative exclusive breastfeeding rate for 6 months was 3.2% in the CG; and 6.9% and 15.6% in the FBSICG and HBICG respectively (p<0.00001). Mothers from HBICG had a 3.4 increased likelihood to practice exclusive breastfeeding for 6 months compared to those in CG (RR=3.4; 95% CI: 1-34-8.80; p=0.010). Exclusive breastfeeding rates in FBSICG were insignificantly higher than those in the CG. The median duration of exclusive breastfeeding was one month in both the CG and FBSICG and three months in the HBICG. The predictors of exclusive breastfeeding were non-giving of post-lacteal feeds; planned long breastfeeding duration; living in smaller households; non-ownership of telephones and televisions; absence of breast health problems; and correct knowledge of breastfeeding duration. The major hindrances to exclusive breastfeeding were: inadequate knowledge of exclusive breastfeeding; cultural perceptions about infant feeding; and absence of mother from home for long periods. The prevalence of acute respiratory infections and diarrhoea were significantly lower among exclusively breastfed infants than those non-exclusively breastfed. The prevalence of underweight was significantly lower among the exclusively breastfed infants than those non-exclusively breastfed at one month (p=0.006) and three months (p=0.005). Conclusions: It is feasible to promote and sustain exclusive breastfeeding for six months in low socioeconomic conditions, using the home-based intensive counseling strategy. Breastfeeding promotion programmes should adopt strategies to allow for wider dissemination of information, targeting both mothers and the community at large, as this study showed family members were major decision-makers in the choice of infant feeding practices. Hospital-based breastfeeding education should offer detailed information on a consistent basis. Breastfeeding promotion messages should be re-packaged to address cultural perceptions in infant feeding practices.

The plea of applying the exhaustion doctrine to intangible copies of copyrighted artistic works has been extensively discussed within scholar circles. Although, the debate substantially concerns provisions of the international treaties and the explanation of the exhaustion doctrine under European Union copyright law, the subject brings more uncertainties. Under the European Union copyright law the distribution right is exhausted after the first sale with the consent of a right holder. However, there is neither explicit regulation nor decision in regard to the exhaustion doctrine to the online resale of digital goods. As the act of distribution is shifting and fulfilled through digital means these days, the application of the first sale doctrine is challenged. The given work provides with the legal, organizational and technological analysis of the exhaustion doctrine under European Union copyright law and possible scenarios in respect to digital secondary market.

Thesis advisor: Susan Michalczyk / Turbulent times always elicit change. Outside forces are constantly shifting, only to affect the lives of the characters that are at their mercy. Only by adapting to these changes can one truly survive in this world. However, unlike these forces of nature, God, or chance, people have to think about changing before they can carry through with it. Questions plague their minds and options torment their souls. What course of action is best for them, and which allows them to maintain some sense of self? These collected stories focus on people in turmoil. People in pain. People who must change. What happens to a man who will truly die if he loses the love of his life? Should you take the advice of a psychic, abandoning your own free will in the process? When the larger forces in the world are trying to destroy you, do you let them, or fight back against literally impossible odds? In the end, everyone must come to a decision. Stagnation and inaction themselves can decide your fate. As Neil Gaiman once said: Everything changes. But nothing is truly lost. / Thesis (BS) — Boston College, 2006. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: College Honors Program.

Este trabalho apresenta o impacto de medidas de gestão como a implantação das faixas exclusivas no tráfego da cidade de São Paulo que, associada à reestruturação semafórica, tem melhorado a mobilidade urbana em São Paulo. Para tanto, traça-se o cenário da mobilidade urbana e, em seguida, analisa-se o quanto a implantação de mais de 400 km de faixas exclusivas nos últimos dois anos impacta no aumento da velocidade média dos ônibus e na redução do crescimento da lentidão do tráfego. A experiência de outras grandes cidades indica que a adesão a novas ferramentas de gestão é alternativa viável para a promoção de avanços qualitativos no transporte coletivo urbano e no transporte em geral, bem como na integração entre modais de transporte motorizado e não motorizado, no deslocamento de pessoas e cargas com mais eficiência e segurança. Por fim, apontam-se outras possibilidades tecnológicas que poderão ampliar os resultados positivos obtidos na mobilidade paulistana. / This work presents the impact of management measures such as the establishment of exclusive tracks in the city of São Paulo traffic that is associated with the semaphore restructuring, has improved urban mobility in São Paulo. To do so, construct the scenario of urban mobility and then analyzed how much the deployment of more than 400 km of exclusive tracks for the past two years impacts on increasing the average speed of buses and reduced growth of traffic slowdowns. The experience of other major cities indicates that membership of the new management tools is a viable alternative to the promotion of qualitative advances in urban mass transit and transportation in general, as well as in the integration between motorized transport modal and non-motorized, the displacement of people and cargo with more efficiency and safety. Finally, point out other technological possibilities that can magnify the positive results obtained in mobility in Sao Paulo.

As doses de radiação ionizante para os trabalhadores no transporte de material radioativo devem ser tão pequenas quanto razoavelmente exequível. As doses médias dos motoristas e carregadores amostrados neste trabalho devem ser diminuídas. A demonstração do controle das doses em veículo rodoviário com material radioativo, requisitada pelo regulamento brasileiro atual, norma CNEN NE 5.01, é apresentada em formulário próprio com valores de exposição obtidos em posições de ocupação regular de indivíduos do público e de trabalhadores, mesmo quando se expede veículo sem a necessidade de uso exclusivo (&sum; IT 50). Este trabalho mostra, por meio de pesquisa bibliográfica, elaboração de modelos e pesquisa de campo, que esta demonstração do controle com a obtenção dos valores de exposição nesta situação, para um método de controle melhor, deve ser realizada pela apresentação do registro do acúmulo de cargas, limitado (&sum; IT 50), a fim de evitar a obtenção destas medidas, para que haja padronização com regulamentos estrangeiros e para que os custos e os tempos, importantes para expedição de radiofármacos com meia-vida curta, e também as atuais doses laborais dos técnicos de radioproteção sejam todos diminuídos. Os valores de exposição dos parâmetros utilizados com esse método são menores do que seus limites regulamentares. Para contribuir com essas finalidades devem ser apresentadas pelo regulamento brasileiro atualizado as distâncias de segregação entre as cargas e as cabines dos veículos. / The radiation doses to workers in the transport of radioactive material should be as low as reasonably achievable. The average doses of drivers and loaders, sampled in this thesis should be decreased. The demonstration of doses control in a road vehicle with radioactive material required by the current Brazilian regulation, CNEN NE 5.01 should be written in its own printed form with exposure values obtained in normally occupied positions from workers and members of the public, even when the consignment does not need \"exclusive use\" (&sum; IT 50). Through bibliographic research, modeling and field research, this research work shows that this demonstration of the control should be done by writing the registration accumulation of load, limited (&sum; IT 50), also in the own printed form. It is for a better control method, in order to avoid the use of measuring equipment, to build standardization with foreign regulations, to the current occupational doses of radioprotection technicians, the costs and time, (important for consignment with radiopharmaceuticals short half-life) would be all smaller. Exposure values of the parameters used with this method are smaller than regulatory limits. The segregation distances between loads and the cabins of vehicles shall be showed by Brazilian regulation updated to contribute to these aims.

Background: Not only does IBD lead to nutritional deficiencies, but also nutrients influence its pathophysiology: exclusive enteral nutrition (EEN) is an effective primary treatment in Crohn's disease; and vitamin D (VitD) is involved in its pathogenesis and course. Aims: We hypothesised that nutrients impact on the course of IBD. We therefore studied the effect of EEN i) on long term clinical course in children; ii) on CD58, a costimulatory molecule at the intestinal epithelial cell (IEC) lines, iii) adults with Crohn's disease. We examined the possible effect of serum vitamin D levels on the course of IBD and also the possible role of ethnicity in our paediatric and adult populations that were treated with EEN but also in our general adult population. Results Chapter II: 56 paediatric patients with Crohn's disesase were followed up for 5 years. 57% of patients achieved remission after 6 weeks of EEN. Achievement of clinical remission within 6 weeks of EEN was significantly associated with a longer time to relapse and to treatment escalation. VitD deficiency was common; and those patients who were deficient were significantly more likely to require corticosteroids and also needed thiopurines sooner. Chapter III: CD58 was expressed in the IEC isolated from IBD patients and healthy controls. EN down-regulated the expression of CD58 on IEC lines. Chapter IV: 22 adult patients with Crohn's disease with a mean age of 30.8 years were given EEN and followed up for a mean time of 1.9 years. 22.7% of patients went into clinical remission and 77.3% experienced a clinical response. By the end of follow up 63.6% (14/22) of patients had clinically relapsed and 36.4% required surgery during their follow up. There was no difference between South Asian and Caucasian patients in the disease outcomes after administration of EEN. Chapter V: Bangladeshis were more often vitamin D deficient than white Caucasian patients; however vitamin D status was not associated with the course of IBD. Bangladeshis developed perianal disease and required thiopurines earlier in their disease course. Bangladeshi patients with UC had more extensive disease. Conclusions: EEN, when successful, improves the long term outcome of Crohn's disease in children, possibly in part, by down-regulating CD58 on the IEC. VitD deficiency may influence the clinical course of IBD; however our results were contradictory between children and adults and significantly limited by the assessment of the vitamin D level at a single time point.

Este trabalho apresenta o impacto de medidas de gestão como a implantação das faixas exclusivas no tráfego da cidade de São Paulo que, associada à reestruturação semafórica, tem melhorado a mobilidade urbana em São Paulo. Para tanto, traça-se o cenário da mobilidade urbana e, em seguida, analisa-se o quanto a implantação de mais de 400 km de faixas exclusivas nos últimos dois anos impacta no aumento da velocidade média dos ônibus e na redução do crescimento da lentidão do tráfego. A experiência de outras grandes cidades indica que a adesão a novas ferramentas de gestão é alternativa viável para a promoção de avanços qualitativos no transporte coletivo urbano e no transporte em geral, bem como na integração entre modais de transporte motorizado e não motorizado, no deslocamento de pessoas e cargas com mais eficiência e segurança. Por fim, apontam-se outras possibilidades tecnológicas que poderão ampliar os resultados positivos obtidos na mobilidade paulistana. / This work presents the impact of management measures such as the establishment of exclusive tracks in the city of São Paulo traffic that is associated with the semaphore restructuring, has improved urban mobility in São Paulo. To do so, construct the scenario of urban mobility and then analyzed how much the deployment of more than 400 km of exclusive tracks for the past two years impacts on increasing the average speed of buses and reduced growth of traffic slowdowns. The experience of other major cities indicates that membership of the new management tools is a viable alternative to the promotion of qualitative advances in urban mass transit and transportation in general, as well as in the integration between motorized transport modal and non-motorized, the displacement of people and cargo with more efficiency and safety. Finally, point out other technological possibilities that can magnify the positive results obtained in mobility in Sao Paulo.

As doses de radiação ionizante para os trabalhadores no transporte de material radioativo devem ser tão pequenas quanto razoavelmente exequível. As doses médias dos motoristas e carregadores amostrados neste trabalho devem ser diminuídas. A demonstração do controle das doses em veículo rodoviário com material radioativo, requisitada pelo regulamento brasileiro atual, norma CNEN NE 5.01, é apresentada em formulário próprio com valores de exposição obtidos em posições de ocupação regular de indivíduos do público e de trabalhadores, mesmo quando se expede veículo sem a necessidade de uso exclusivo (&sum; IT 50). Este trabalho mostra, por meio de pesquisa bibliográfica, elaboração de modelos e pesquisa de campo, que esta demonstração do controle com a obtenção dos valores de exposição nesta situação, para um método de controle melhor, deve ser realizada pela apresentação do registro do acúmulo de cargas, limitado (&sum; IT 50), a fim de evitar a obtenção destas medidas, para que haja padronização com regulamentos estrangeiros e para que os custos e os tempos, importantes para expedição de radiofármacos com meia-vida curta, e também as atuais doses laborais dos técnicos de radioproteção sejam todos diminuídos. Os valores de exposição dos parâmetros utilizados com esse método são menores do que seus limites regulamentares. Para contribuir com essas finalidades devem ser apresentadas pelo regulamento brasileiro atualizado as distâncias de segregação entre as cargas e as cabines dos veículos. / The radiation doses to workers in the transport of radioactive material should be as low as reasonably achievable. The average doses of drivers and loaders, sampled in this thesis should be decreased. The demonstration of doses control in a road vehicle with radioactive material required by the current Brazilian regulation, CNEN NE 5.01 should be written in its own printed form with exposure values obtained in normally occupied positions from workers and members of the public, even when the consignment does not need \"exclusive use\" (&sum; IT 50). Through bibliographic research, modeling and field research, this research work shows that this demonstration of the control should be done by writing the registration accumulation of load, limited (&sum; IT 50), also in the own printed form. It is for a better control method, in order to avoid the use of measuring equipment, to build standardization with foreign regulations, to the current occupational doses of radioprotection technicians, the costs and time, (important for consignment with radiopharmaceuticals short half-life) would be all smaller. Exposure values of the parameters used with this method are smaller than regulatory limits. The segregation distances between loads and the cabins of vehicles shall be showed by Brazilian regulation updated to contribute to these aims.

El presente proyecto se crea con el principal propósito de implementar un negocio factible para la creación de una empresa que comercializa muebles organizadores de bicicletas, patines, y scooters; a través de dos productos: DISOR Kids y DISOR Adults. En estos mercados, se observó la problemática del desorden generado en los hogares al no tener asignado un espacio específico a dichos vehículos sobre ruedas. Asimismo, existe la necesidad por mantener su hogar con una decoración atractiva y armoniosa tanto en el interior como en el exterior, incluso más cuando se trata de espacios pequeños. Por esta razón que se observa una oportunidad para un producto que combine atributos de un diseño innovador y funcional. Se considera, además, que uno de los aspectos determinantes para el público es la exclusividad en productos tan personales como lo son los muebles del hogar. Para que el negocio se lleve a cabo de manera factible, se plantearon estrategias que permitirán que DISOR se desenvuelva en un mercado altamente competitivo dentro del rubro mobiliario y diferenciar a DISOR como un producto que todos los posibles clientes deberían tener, así como mantenerlos fidelizados gracias a un servicio de venta y post venta personalizado. / The present project has been created with the main purpose of implementing a feasible business for the creation of a company that commercializes furniture organizers of bicycles, skates, and scooters; through two products: DISOR Kids and DISOR Adults. The problem of the disorder generated in the homes was observed in this market due to not having assigned a specific space to said vehicles on wheels. Also, there is a need to keep their home with an attractive and harmonious decoration both inside and outside, even more when it comes to small spaces. For this reason, an opportunity is observed for a product that mix attributes of an innovative and functional design. It is also considered that one of the determining factors for the public is the exclusivity in products as personal as the home furniture. In order for the business to be carried out in a feasible way, strategies were proposed that will allow DISOR to develop in a highly competitive market within the furniture industry and differentiate DISOR as a product that all potential customers should have, as well as keep them loyal thanks to a personalized service and post service. / Trabajo de investigación

Breastfeeding confers immunological, physiological and psychological benefits for the infant and mother as well as social and economic benefits to the nation. The United States Department of Health and Human Servcies (HHS), Healthy People 2020 has established national objectives for the initiation and duration of breastfeeding at 82% initiation, 61% at six months and 34% at one year. In addition, they have set goals for exclusive breastfeeding at 3 months to be 46% and 25% at 6 months of infant's age. Currently breastfeeding initiation is at the highest recorded level of 76.9%, yet significant disparities exist (CDC, 2012). The purpose of this study was to examine the association of acculturation and self-efficacy on breastfeeding behavior of a sample of Hispanic women. Initially the plan was to focus on women from Mexican, Cuban and Puerto Rican countries of origin. However recruitiment goals for only the Mexican population were reached. Two valid and reliable bidimensional instruments were used in addition to collecting contextual information to foster a more comprehensive understanding of the acculturation process. The roles of self-efficacy and social support and their relationship with acculturation measures and breastfeeding behavior was explored. The Non-Hispanic domain subscale of the Bidimensional Acculturation Scale scores were significantly different for those breastfeeding compared to those formula feeding, indicating higher levels of Non-Hispanic domain acculturation associated with not breastfeeding. Acculturation and self efficacy (general and parental) were not found to be related. Breastfeeding outcomes and parental self-efficacy were found to have a significant negative correlation, a finding that was in an unexpected direction, with higher parental self-efficacy associated with decreased breastfeeding intensity. Mixed feeding or Las Dos, is a common finding among Hispanic women especially for the Mexican origin community and exclusivity may not have been perceived as higher value then mixed feeding or formula feeding (Bunik et al., 2006). Rates for exclusive breastfeeding at three months are 33% for both the US as well as for Hispanic/Latino ethnicity (National Immunization Survey, 2007). At six weeks the practice of exclusively breastfeeding (not giving formula) was 17% and this is about half of the 46% goal set for exclusive breastfeeding at three months by (HHS) Healthy People 2020. Of those that were exclusively breastfeeding in the hospital only three were still exclusively breastfeeding at the six week follow up call. This presents a unique opportunity in which targeting Hispanic mothers after discharge may assist in increasing further the rates of exclusive breastfeeding and recommendations are provided.