Problem detection is a critical component in nursing, such that superior detection could lead to quicker intervention, even if the nature of the problem is not yet clear. A critical problem intensive care nurses typically engage in is detecting the threat of an impending hospital-acquired infection. The purpose of this study was to investigate the effects of the presence of risk factors, expertise, and time pressure on problem detection. The results suggested that time pressure seemed to have a detrimental effect on problem detection, and nurses benefitted from the presence of more risk factors. When not under time pressure, nurses were more sensitive in their problem detection judgments, and only needed one risk factor to trigger problem detection. Experienced nurses were more sensitive to the type of infection at detection, and were more likely to identify the problem correctly after information had been accumulated. These results suggest that problem detection was differentially affected by risk factors based on the presence or absence of time pressure. In addition, experienced nurses took a different approach to problem detection when compared to novices. Finally, problem detection and problem identification can in some situations occur simultaneously, but are distinct processes.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012. / Objectives: To determine the prevalence and associated risk factors of low back pain (LBP) in an automotive production company, evaluating the relationship between selected risk factors, type of occupational activity and the prevalence of LBP. Methods : This was a descriptive study at a large automotive production company entailing 200 physical production employees and 200 sedentary employees. Using a cross sectional study design, a retrospective analysis investigated the LBP prevalence, by means of a questionnaire. Individuals reported on demographics, injury location, injury aetiology, injury nature, extent of treatment rendered and time lost from work. Additionally, data was obtained regarding smoking, occupational stress and fitness.Results: A significant difference was found between sedentary and manual employees with regards to age, gender, ethnicity, marital status, education and medical aid. Similarly a significant difference between the groups was found for the point prevalence of LBP, current LBP description (sharp, shooting, dull aching, stabbing and catching pain descriptions), past LBP description (catching pain description), sidedness/ location of pain as well as associated features of the current LBP (viz. pins and needles, pain to the knees, numbness, bed rest, absence from work, pain at work and pain on weekends) and associated features of past LBP (viz. pins and needles, pain to the knees, numbness, bed rest, absence from work, pain at work and pain on weekends). There were no noted psychosocial factor that impacted on a difference between the groups, but there was a significant difference between the manual and sedentary employees with regards to absenteeism. Conclusion: A significant rate of LBP was reported amongst both the sedentary (59.6%) and the manual (89%) employees, implying that the costs to the company are relatively high. It is, therefore, suggested that the company looks at a variety of strategies to reduce the burden of LBP in their employees. / National Research Fund

No description available.

Background: Risk factors for acquired multidrug resistant tuberculosis (MDR TB) are well described but risk factors of primary MDR TB is understudied. We aimed to 1) assess risk factors for primary MDR TB, including diabetes, and 2) determine if diabetes reduced the rate of sputum culture conversion in patients with primary MDR TB. Methods: From 2011-2014 we conducted a prospective cohort study at the National Center for TB and Lung Disease in Tbilisi, Georgia. Adult (≥35 years) patients with primary TB were eligible. MDR TB was defined as resistance to at least rifampicin and isoniazid. Patients with HbA1c ≥6.5% were defined to have diabetes. Polytomous regression was used to estimate the association of patient characteristics with drug resistance. Cox regression was used to compare the hazard rate of sputum culture conversion in patients with and without diabetes. Results: Among 318 patients, 268 had drug susceptibility test results. Among patients with DST results, 19.4% was primary MDR TB and 13.4% had diabetes. In adjusted analyses, diabetes (aOR 2.51 95%CI 1.00 – 6.31) and lower socioeconomic status (aOR 3.51 95%CI 1.56 – 8.20) were associated with primary MDR TB. Among patients with primary MDR TB, 44 (84.6%) converted sputum cultures to negative. The hazard rate of sputum culture conversion was lower among patients with diabetes (aHR 0.34 95%CI 0.13 – 0.87) and among smokers (aHR 0.16 95%CI 0.04 – 0.61). Conclusions: We found diabetes to be associated with an increased risk of primary MDR TB; both diabetes and smoking were associated with a decreased rate of sputum culture conversion.

Aims The overall aim of this thesis was to extend current knowledge about the prevalence of malnutrition, to identify possible risk factors for development of malnutrition, and to describe the consequences of malnutrition in relation to all-cause and cause-specific mortality among older adults admitted to hospital. Methods The prevalence of malnutrition was estimated in a cohort of 1771 older adults (≥65 years) who were admitted to a Swedish hospital during 2008–2009 (15 months) and screened for malnutrition using the Mini Nutritional Assessment (MNA) instrument. Possible risk factors for malnutrition were recorded during the hospital stay (Study I). Dietary intake 10 years earlier (in 1997) was collected for 725 of these older adults (Study II). All-cause (Study III) and cause-specific (Study IV) mortality were followed up after medians of 3.5 and 5.1 years, respectively, for 1767 of the participants. Results The prevalence of malnutrition was 9.4% while 55.1% were at risk of malnutrition. Risk factors for malnutrition was an overnight fast >11 hours, <4 eating episodes a day, and not cooking independently. In middle-aged and older adults with a body mass index <25 kg/m2 in 1997, the risk of malnutrition increased for each additional percentage point of energy from total, saturated and monounsaturated fat at follow-up after 10 years. Malnourished older adults had almost four times higher risk of death during follow-up, while those at risk of malnutrition had a 56% higher risk, compared to well-nourished. Furthermore, well-nourished older adults had consistently lower risk of death, regardless of the cause of death. Conclusions Only 35.5% of older adults admitted to hospital were well-nourished. The identified risk factors could be used in interventions aimed at preventing malnutrition. Normal-weight and underweight middle-aged and older adults should consider limiting the intake of total fat and/or improve the quality of the fat in the diet in order to decrease the risk of becoming malnourished later in life. Malnutrition and risk of malnutrition were associated with increased overall and cause-specific mortality. These relationships emphasize the need for nutritional screening to identify individuals who may require nutritional support in order to avoid preterm death.

published_or_final_version / abstract / Medicine / Master / Doctor of Medicine

Over one million high school students drop out of school each year in this country. Dropping out of school is a serious problem for the student, community, and the nation. Often dropouts are unable to compete in an increasingly technological society and face numerous consequences from their decision to leave school early including higher levels of poverty, unemployment, public assistance, incarceration, and poor health. Dropping out is a gradual process of school disengagement and related to individual, family, and school factors. In the past, it has been difficult to track individual student's progress through school and to determine accurate dropout and graduation rates. In 2005, the National Governors Association made a commitment to implement a uniform method to calculate and report graduates and dropouts as well as better data collections systems.This study intended to replicate aspects of other major studies around the county to determine the best early predictors of dropping out of school in this large school district in southern Arizona and use this information to build an early warning system. Student data were obtained from the district's Research and Accountability office for a cohort of students (n=6751) who began the ninth grade in fall 2006 and graduated or should have graduated in 2010. Data collected included general demographic information, academic data, number of schools attended, and school withdrawal codes.The intent of this research was to determine if there were statistically significant differences between dropouts and graduates in the variables collected and which variables yielded the highest effect sizes and should be included in the district's early warning system.Two analyses were used to determine significance differences between dropouts and graduates. Then four analyses were performed to determine the highest-yield variables for this district. Consistent with recent research in the field, the variables of ninth grade attendance, ninth grade English and Math grades, and GPA were the strongest predictors of student dropouts.Local educators can use this early warning information to help identify potential high school dropouts as early as possible and intervene more efficiently and effectively with these students.

<p>The aim of this study was to assess the factors associated with HIV risk behaviours in women in Livingstone, Zambia. A cross-sectional analytical survey using a structured questionnaire was carried out in two sites in Livingstone, which were selected on the basis of differences in socio-economic status. Married women and women in the urban community are at high risk of contracting HIV and every effort should be made to ensure that HIV/AIDS programmes help to reduce their vulnerability to HIV infection.</p>

<p>Physical inactivity is one of the leading risk factors for major non-communicable diseases, which contribute substantially to the global burden of chronic diseases, disability and death. The burden of disability, morbidity and mortality, attributable to non-communicable diseases, is currently enormous in the developed countries and is increasingly growing in the developing countries. The purpose of this study was to investigate the relationship between participation in physical activity and health risk behaviours among high school students in the Mtwara region, Tanzania. The objectives of this study were to identify the physical activity levels among high school students in Mtwara region, Tanzania, to identify health risk behaviours among the above mentioned high school students, to identify the factors that influenced them to engage in health risk behaviours and to establish the relationship between physical activity and health risk behaviours.</p>

Over the past several decades abdominal obesity and physical inactivity have increased at an alarming pace. Since both are related to adverse health risk it is important to determine their independent influence. It is well established that cardiorespiratory fitness (CRF, the ability to perform physical activity) and physical activity (PA) are negatively associated with cardiometabolic risk factors (commonly obtained risk factors for disease, e.g: TG, HDL, etc.). In other words, the higher a person’s levels of PA and fitness, the lower that person’s likelihood of developing cardiometabolic risk factors. Abdominal obesity is positively associated with cardiometabolic risk factors which means the more abdominally obese a person is, the more prone that person is to develop cardiometabolic risk factors. However, it is unknown whether PA influences cardiometabolic risk factors independent of fitness level and/or abdominal obesity. My study objective was to examine whether PA is associated with cardiometabolic risk factors independent of cardiorespiratory fitness and/or abdominal obesity in inactive abdominally obese women. The study enrolled 141 inactive abdominally obese women. PA, cardiorespiratory fitness, and cardiometabolic risk profile were measured in all participants. A novel feature of this study was the use of the accelerometer to objectively measure PA and to divide exercise into different levels of intensity, such as: low PA, moderate to vigorous PA (MVPA), etc. My findings revealed that abdominal obesity was positively associated with cardiometabolic risk independent of PA or CRF. I also observed that CRF was inversely related to cardiometabolic risk independent of PA or abdominal obesity. MVPA explained cardiometabolic risk factors by itself, but with insulin resistance measurements (2-hour glucose, and homeostasis model of assessment) this relationship was abolished when abdominal obesity and CRF were also taken into consideration. The findings of this study provide further support for the recommendation that waist circumference and CRF be included as routine measures screening for cardiometabolic risk factors in inactive obese women. Our findings also support the suggestion that even modest amounts of daily MVPA that are below the recommended threshold of 30 minutes/day convey health benefit. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2013-07-23 13:46:57.088