Previous literature showed weak and sometimes contradictory evidence regarding the best interventions to prevent pressure ulcers and the best factors that can serve as predictors for ulceration. The aim of this study was to explore effective interventions and associated risk factors in the area of pressure ulcer. A retrospective approach was used to explore such interventions and risk factors in a more natural clinical environment than found in a prospective study. While retrospective studies have their limitations, one problem of prospective studies, the Hawthorn effect, is not present. In order to meet the aims of the study, a matched case-controlled design was employed. A convenience sampling technique was used to select all patients who matched the study criteria. Two groups of patients were selected. The first group developed pressure ulcer during hospitalization, the other did not. In order to have a sound and robust comparison, each patient from the pressure ulcer groups was matched or at least nearly matched with another patient from the non-pressure ulcer group for a number Waterlow sub-scores. Further criteria for selection included a minimum of three days total length of stay in hospital and being initially free of any pressure ulcer on admission for both of the study groups. Electronic medical records for all patients were revised, and multidimensional data were extracted using a data extraction sheet. Data analyses were carried out using univariate analysis (t-test, Mann-Whitney, Chi-square and Fisher’s exact test) and multivariate analysis (binary logistic regression). In univariate analysis for preventive interventions, the following interventions were significantly associated with pressure ulcer prevention (P≤ 0.05): standard hospital bed, seating cushion, static pressure redistributing mattress, re-positioning every four hours and helping the patient to sit regularly in a chair. When the effect of all interventions was adjusted through the multivariate model, the following interventions were independently associated with prevention: draw sheet, re-positioning every four hours and helping patient to sit regularly in chair (odds ratio = 0.24, 0.06 and 0.13 respectively; P≤ 0.05). In univariate analysis for risk factors related to physical activity and mobility, the following factors were significantly associated with developing pressure ulcer (P≤ 0.05): moving in bed with help, the ability to take a bath only in bed, needing two helpers in performing activities of daily living and moving outside bed only by a hoist. When adjusting the effect of all variables related to physical activity and mobility through the multivariate model, only two factors were independently associated with developing pressure ulcer: moving in bed with help and the ability to take a bath only in bed (odds ratio = 7.69 and 3.67 respectively; P≤ 0.05). In univariate analysis for risk factors related to pressure ulcer intrinsic risk factors, the following factors were significantly associated with developing pressure ulcer (P≤ 0.05): presence of three underlying medical conditions, dehydration, depression, having a blood transfusion, serum albumin <32mg/dl, haemoglobin <130 g/l in males or <115 for females and systolic blood pressure <113 mmHg. When adjusting the effect of all variables related to intrinsic risk factors through the multivariate model, the following risk factors were independently associated with pressure ulcer: presence of two underlying medical conditions, presence of three underlying medical conditions, cognitive impairment, serum albumin <32mg/dl and haemoglobin <130 g/l in males or <115 for females (odds ratio = 13.3, 143, 4.3, 0.10 and 0.14 respectively; P≤ 0.05). Findings from this study suggest a number of interventions to be effective in PUs prevention, and a number of risk factors that can predict risk of PUs. Findings were based on statistical association between acquiring PUs and the independent variables (preventive interventions and risk factors). This cannot constitute a cause and effect relationship due to the retrospective nature of data analyzed; it only supports the association between a number of interventions and risk factors in preventing or predicting PUs. This can guide further research to investigate these interventions and risk factors by employing the same approach used, but in a prospective manner.

This study was undertaken in order to obtain an understanding of how Namibia in general, and the education sector in particular, deal with flood emergencies. The goal of the National Policy for Disaster Risk Management in Namibia (2009) is “to contribute to the attainment of sustainable development in line with Namibia’s Vision 2030 through strengthening national capacities to significantly reduce disaster risk and built community resilience to disasters” (Republic of Namibia, 2009). This goal was the starting point for determining the extent to which the Ministry of Education complies with these national standards, and for gauging, in the light of responses to flood emergencies so far, the Ministry’s preparedness and response capacities, in line with international frameworks that Namibia has ratified. This qualitative study is situated within the theory of resilience, and sustainable resilience particularly. To obtain some of the information sought, a non-probability sampling method was used to ‘hand-pick’ subjects within the Ministry of Education to be interviewed at their respective locations, nationally and regionally. Five education officials who were intimately involved in past responses to flood emergencies were interviewed – three in Oshana and Ohangwena Regions, and two at Head Office in Windhoek – by means of a semi-structured interview. In addition, a literature review was conducted. The conclusions drawn from both the literature review and the information obtained from the respondents accord with the research problem identified: the Ministry of Education does not appear to be adequately prepared for, and does not assign the necessary priority to deal with, flood emergencies in particular. Possible recommendations for uptake within the Ministry of Education include: mainstreaming Disaster Risk Reduction at all decentralized levels; sensitizing all education officials, school community members and relevant stakeholders to policy frameworks and accountability structures to strengthen resilience within school communities; deeming costed contingency planning a priority, and hence strengthening links between decentralized regional structures; and continuously monitoring implementation of designed interventions.

Anxiety disorders are among the most prevalent psychiatric disorders in children and adolescents, with ten to fifteen percent of young children experiencing internalising problems (Briggs-Gowan, Carter, Irwin, Wachtel, & Cicchetti, 2004; Egger & Angold, 2006). Researchers have indicated that clinically significant anxiety can exist in preschool aged children and can be sub-typed into patterns similar to that of older children. This early identification of anxiety has lead researchers to recommend that prevention efforts occur early in the life course (Beinvenu & Ginsburg, 2007), before the onset of disorder(s). Research remains scarce as to when the ultimate time to intervene would be, as anxiety research with young children is minimal. The studies presented in this thesis attempt to expand the current literature within in the area of early childhood anxiety. The first objective of this thesis was to extend the literature in the field of early childhood anxiety by examining the aetiology of anxiety and behavioural inhibition (BI) through the investigation of potential risk factors. This study (Study One) represents one of the first investigations within the research to examine risk factors for early childhood anxiety. Two hundred and thirty-six children aged four to six years participated in this study. Parents of the children completed self-report questionnaires at one time point. Results revealed that BI did not significantly predict anxiety, nor did any of the risk factors significantly predict BI. Significant predictors of anxiety included mother’s negative affect and mother’s parenting stress. Father’s parenting stress was found to play a mediating role between mother’s parenting stress and child anxiety. Overall, the findings highlight the importance of both parents (directly or through mediation) in the aetiology of early childhood anxiety. The findings of Study One provide important information regarding the aetiology of early childhood anxiety and provide important implications for the development of preventative intervention programs. Study Two sought to examine the efficacy of a preventative intervention program (Fun FRIENDS; Barrett, 2007a) for preschool aged children, delivered as a school- based, universal intervention. This was the first study conducted evaluating the Fun FRIENDS program and was one of only a few prevention trials cited within the literature examining early childhood anxiety. The study involved a cohort of 263 children enrolled in one of 16 preschool classes. Children were aged between four and six years. Schools were randomly allocated to either an intervention group (IG) or a waitlist control group (WLG). Parents of the children and teachers completed self-report questionnaires at preintervention, postintervention, and at 12-month follow-up (parents in the IG only). Parent report data revealed no significant differences between intervention conditions on anxiety at postintervention, although participants in the IG experienced larger reductions in anxiety than participants in the WLG. Children in both conditions decreased in BI symptoms at postintervention, except for boys in the IG. Significant increases in social-emotional strength were found for girls in both conditions, but not for boys. When examining the IG only over the long-term (pre, post, 12 month follow-up), nearly significant decreases in anxiety were found at postintervention and significant decreases were found again at 12-month follow-up. Improvements in BI were found at all time points for girls but not for boys and improvements on social-emotional strength were found from preintervention to 12-month follow-up, with girls scoring significantly higher than boys. For teacher report, children in the IG improved significantly more on BI compared to the WLG at postintervention indicating that the intervention program may have had a positive impact on these children in learning strategies to manage BI symptoms. However, at pr-intervention, scores on BI were significantly different between the IG and the WLG. Similar to parent report, girls in the IG experienced the largest decrease in BI symptoms at postintervention. On social-emotional strength, children in the IG improved significantly more than children in the WLG at postintervention with girls in the IG experiencing the largest improvement from pre to postintervention. Overall, these findings suggest that the intervention program had a positive impact on some children as evidenced by improvements in anxiety, BI, and social-emotional strength at postintervention and at 12-month follow-up. Parent report indicated that children in the WLG also improved on these measures, making it difficult to contribute positive changes solely to the program. However, teacher report did indicate that children in the IG improved significantly more than children in the WLG. The improvements gained at 12-month follow-up highlight the potential long-term impact of the program although, without a comparison group, it is unknown whether significant differences would exist between both conditions. Implications of these results are discussed along with limitations and directions for future research.

Anxiety disorders are among the most prevalent psychiatric disorders in children and adolescents, with ten to fifteen percent of young children experiencing internalising problems (Briggs-Gowan, Carter, Irwin, Wachtel, & Cicchetti, 2004; Egger & Angold, 2006). Researchers have indicated that clinically significant anxiety can exist in preschool aged children and can be sub-typed into patterns similar to that of older children. This early identification of anxiety has lead researchers to recommend that prevention efforts occur early in the life course (Beinvenu & Ginsburg, 2007), before the onset of disorder(s). Research remains scarce as to when the ultimate time to intervene would be, as anxiety research with young children is minimal. The studies presented in this thesis attempt to expand the current literature within in the area of early childhood anxiety. The first objective of this thesis was to extend the literature in the field of early childhood anxiety by examining the aetiology of anxiety and behavioural inhibition (BI) through the investigation of potential risk factors. This study (Study One) represents one of the first investigations within the research to examine risk factors for early childhood anxiety. Two hundred and thirty-six children aged four to six years participated in this study. Parents of the children completed self-report questionnaires at one time point. Results revealed that BI did not significantly predict anxiety, nor did any of the risk factors significantly predict BI. Significant predictors of anxiety included mother’s negative affect and mother’s parenting stress. Father’s parenting stress was found to play a mediating role between mother’s parenting stress and child anxiety. Overall, the findings highlight the importance of both parents (directly or through mediation) in the aetiology of early childhood anxiety. The findings of Study One provide important information regarding the aetiology of early childhood anxiety and provide important implications for the development of preventative intervention programs. Study Two sought to examine the efficacy of a preventative intervention program (Fun FRIENDS; Barrett, 2007a) for preschool aged children, delivered as a school- based, universal intervention. This was the first study conducted evaluating the Fun FRIENDS program and was one of only a few prevention trials cited within the literature examining early childhood anxiety. The study involved a cohort of 263 children enrolled in one of 16 preschool classes. Children were aged between four and six years. Schools were randomly allocated to either an intervention group (IG) or a waitlist control group (WLG). Parents of the children and teachers completed self-report questionnaires at preintervention, postintervention, and at 12-month follow-up (parents in the IG only). Parent report data revealed no significant differences between intervention conditions on anxiety at postintervention, although participants in the IG experienced larger reductions in anxiety than participants in the WLG. Children in both conditions decreased in BI symptoms at postintervention, except for boys in the IG. Significant increases in social-emotional strength were found for girls in both conditions, but not for boys. When examining the IG only over the long-term (pre, post, 12 month follow-up), nearly significant decreases in anxiety were found at postintervention and significant decreases were found again at 12-month follow-up. Improvements in BI were found at all time points for girls but not for boys and improvements on social-emotional strength were found from preintervention to 12-month follow-up, with girls scoring significantly higher than boys. For teacher report, children in the IG improved significantly more on BI compared to the WLG at postintervention indicating that the intervention program may have had a positive impact on these children in learning strategies to manage BI symptoms. However, at pr-intervention, scores on BI were significantly different between the IG and the WLG. Similar to parent report, girls in the IG experienced the largest decrease in BI symptoms at postintervention. On social-emotional strength, children in the IG improved significantly more than children in the WLG at postintervention with girls in the IG experiencing the largest improvement from pre to postintervention. Overall, these findings suggest that the intervention program had a positive impact on some children as evidenced by improvements in anxiety, BI, and social-emotional strength at postintervention and at 12-month follow-up. Parent report indicated that children in the WLG also improved on these measures, making it difficult to contribute positive changes solely to the program. However, teacher report did indicate that children in the IG improved significantly more than children in the WLG. The improvements gained at 12-month follow-up highlight the potential long-term impact of the program although, without a comparison group, it is unknown whether significant differences would exist between both conditions. Implications of these results are discussed along with limitations and directions for future research.

More than 25 years have passed since the first cases of HIV/AIDS were reported and a decade since highly active antiretroviral therapy (HAART) was introduced as part of the continuum of care for people living with HIV/AIDS (PLWHA). The introduction of HAART as a continuum of care for PLWHA positively changed the characteristics of HIV/AIDS epidemic, contributing for significant declines of HIV/AIDS-related morbidity and mortality rates. Thus, a new era began with HAART, often referred as the “HAART era”. However, HAART also brought with it new challenges and issues for researchers working in the field of HIV/AIDS. This thesis comprises several studies that were designed to gain understanding of some issues on prevention and management of HIV/AIDS that emerged in the current HAART era. The review of the literature points out for many emergent issues in HAART era, but only some issues were researched and presented in this thesis.

Thesis (M.E.)--University of Canterbury, 2001. / Typescript (photocopy). Includes bibliographical references (leaves 134-144). Also available via the World Wide Web.

La proprioception permet de fournir des informations spatio-temporelles pour calibrer un espace moteur, ajuster la trajectoire des mouvements, l'équilibre, la direction des mouvements, et la coordination intermembres et multiarticulaires. Nous prenons à partir des récepteurs sensoriels une information liée à la vitesse du geste, à sa direction, à son amplitude et à son orientation. Bien que les muscles soient définis comme étant les récepteurs sensoriels contribuant principalement à fournir une information proprioceptive, les récepteurs cutanés avec l'étirement de la peau au cours du mouvement montrent des capacités à fournir une information redondante aux récepteurs musculaires. Cependant au regard de la contribution des récepteurs musculaires, le poids attribué aux informations cutanées est relativement faible hormis dans des situations précises où la contribution des récepteurs musculaires est altérée comme en situation de fatigue musculaire ou minimisée comme lors de l'évaluation du sens de la position articulaire. Le champ de la médecine sportive suggère que les différents supports de prévention des traumatismes améliorent l'acuité proprioceptive par une stimulation des récepteurs cutanés. Il reste néanmoins quelques points à éclaircir, en particulier comment pouvons nous stimuler la peau ? Au cours de trois expérimentations, nous avons testé deux moyens, la pression et les forces de cisaillement pour améliorer l'acuité proprioceptive. Dans l'ensemble nos résultats montrent une amélioration de la pertinence des informations cutanées par une diminution de l'incertitude dans le choix de la position articulaire ce traduisant par une amélioration de la précision de nos mouvements. Cette amélioration est indépendante du niveau de pression et serait en lien avec la création de force de cisaillement là où la peau s'étire le plus avec le mouvement. / Proprioception can provide spatiotemporal information for calibrating a motor space, adjust the trajectory of movement, balance, direction of movement, and coordination and Inter multiarticulaires. We take from the sensory receptors of information related to the speed of movement, its leadership, its amplitude and its direction. Although the muscles are defined as sensory receptors contributing primarily to provide information proprioceptive receptors in the skin of the tethering of the skin during movement show a capacity to provide redundant information to muscle receptors. However, in view of the contribution of muscle receptors, the weight given to information skin is relatively low except in specific situations where the contribution of muscle receptors is altered as experiencing muscle fatigue or minimized as in the evaluation of the meaning of joint position. The field of sports medicine suggests that different media Injury Prevention im prove proprioceptive acuity by stimulation of cutaneous receptors. It remains to clarify some points, especially how can we stimulate the skin? In three experiments, we tested two methods, pressure and shear forces to improve proprioceptive acuity. Overall our results show an improvement in the adequacy of the information skin by reducing the uncertainty in the choice of this joint position resulting in improved accuracy of our movements. This improvement is independent of pressure level and be linked with the creation of shear force where the skin stretches over with the movement.

The objective of this graduation thesis was making a review of the most occurrenced ectoparasitic diseases and note the efectivity of medical preparation in the most risk groups. From February 2005 to December 2007 there was an observation of individuals apperance specialized in ectoparasitic diseases of miscellaneous origin in the Veterinary Clinic Vltava, which is interested in illnesses of small animals. This observation comprehended usually home breeded animals only. Total of checkuped animals was 6468 individuals. From that in category of race dogs acknowledged by FCI was on record 54 what counted 4702 individuals. Other animals numbering 1756 we have included in category of cats with acknowledged origin and European kind of cats without any origin. There was marginally treated with attendance of ectoparasits 5 rabbits and 5 guinea pigs. Between the most frequently medicaly groups the Yorkshire terriers 603 times belonged, hybrids untill the 10 kg of weight 525 times and Retrievers 512 times. Their age interface was different, what responding to their social popularity. At other individuals was the most recorded counts of parasitosis of European cats without any acknowledged origin 1402 times, mostly wild. Thanks to observation it we were able to analyze risky groups and their scalable treatment. The most frequently ectoparasits belouged for cats european kind Otodectes cynotis , numering about 869 pcs, for yorkshire terriers fleas numering about 295pcs and hubrid dogs up to 10kg fleas numering about. The next freguency occurrence of fleas and ticks we notea by the golden retriever. In spite of the komplex attitude in struggle with ectoparasits has beed prefered, by far not the owners proceeded by the advises of the veterinary. So that all precuation can be successfull in the long term, the owners would have to start to solve the problem with wild cats in their surroundings. This cats forms the most usually treated individuals and continually they contaminate their vicinage with ectoparasits with their contact way of life. In 10 disobedience cases the disease expanded not only to the other individuals in animal breeding but to the owner himself. So the necessity of prevention and through medication had been confirmed so that posibility of dangerous disease transmision would be eliminated.

This thesis examines the role of the public in Flood Risk Management (FRM) service provision at a time when the perceptions of the distribution of benefits provided by FRM interventions are in flux, and the role the public should play in FRM highly contested among stakeholders. Two schemes have marked the revised role of the public in FRM - Partnership Funding and Flood Re - both of which challenge existing judgments of the excludability and rivalry of benefits delivered by FRM interventions. The Partnership Funding scheme allocates capital for FRM projects proportionately to the public benefits they provide, allowing communities to top-up grants through local contributions. In comparison, by increasing accessibility to affordable insurance through cross-subsidies and pricing signals, Flood Re highlights a growing recognition that the distribution of gains as a result of widespread insurance uptake is greater than the benefits received by the policyholder alone. Following the identification of these schemes, we tested their social feasibility, examining both the scale and distribution of benefits. Due to the different stages of implementation of each scheme at the time of writing this thesis, two distinct methods were developed. The Partnership Funding Chapter used field data to examine how public-private funding of flood defences has changed service provision and the public acceptance of this transition. Whereas the Flood Re chapter used computer-based experiments to hypothesize how Flood Re may make the purchase of insurance a more or less attractive investment for different types of consumer. We found that Partnership Funding enabled more FRM projects to go ahead, raised public awareness of flood risk, and improved collaboration between stakeholders, but encouraged lower-cost projects, which, in the longer term, could transfer the expense of managing residual risk to the householder. In comparison, Flood Re provided peace of mind to householders struggling to afford rises in insurance premiums, but disproportionately benefited those who annually purchased insurance. Combining this proposed inequity in Flood Re with increasing residual risks, we identify a gap in service provision for the public who cannot afford household mitigation measures. We propose that loss mitigation and flood defence should become increasingly collaborative in line with the complexities of flooding within a community. We seek a move away from the information asymmetry which currently exists between insurance providers and policyholders, and yet simultaneously call for local authorities to recognise the capacity of the public to participate in FRM, and sustain resilience in the face of rising flood risk.

Introduction: The diploma thesis deals with the topic of prevention of civilization diseases by the eyes of the generation 50+. The incidence of civilization diseases in the Czech Republic is still on the rise. Therefore, the timely and consistent prevention is essential, especially in the areas of healthy eating, appropriate physical activity, and prevention of stress or risky behaviour. Aim: The aim of this work is to point out the knowledge of generation 50+ in the Hradec Králové Region on the risks and prevention of civilization diseases, the generation's attitude to prevention, how they assess their health condition and how they describe their own lifestyle. Methodology: A qualitative approach using a semi-structured interview was used in the research. The research sample consisted of 24 informants at the age of 51 to 79 years. Of these, 16 were women and 8 men. Results: The results showed that the generation 50+ in the Hradec Králové Region has certain knowledge in the area of prevention. Most informants think that the civilization diseases are specific diseases, especially cardiovascular diseases, oncological diseases or diabetes mellitus. In the area of risk factors, the informants predominantly correctly included risk factors for the development of civilization diseases. The most frequently mentioned factors were the lifestyle risk factors, especially diet, physical activity and risky behaviour such as smoking or alcohol. Regarding the area of prevention, most informants think it is important, but not all informants go to regular preventive examinations or preventive screening examinations. The change of opinion on prevention in informants changes with age and after the diagnosis of a disease. Among the informants, the information concerning prevention is most often obtained from doctors, the media or the press and to a lesser extent from general nurses. In the area of health, most informants emphasize the condition of being painless, self-sufficient and mobile. In the area of lifestyle, the research shows that most informants are not interested in a healthy lifestyle very much. However, they try to observe certain principles of a healthy lifestyle, especially in the area of appropriate eating and physical activity. Conclusion: The results indicate areas of prevention about which people should be repeatedly informed and alerted to their importance and possible consequences if they do not observe them. In particular, it is important to place greater emphasis on primary prevention, especially on lifestyle in the form of appropriate diet, physical activity, stress prevention and risky behaviour. Equally important is secondary prevention and preventive examinations and preventive screening examinations, and tertiary prevention, with a focus on eliminating or mitigating the consequences of diseases and improving the quality of life.