Background: Studies have consistently found a high prevalence of vitamin D deficiency in adolescents. Few validated dietary intake assessment tools for vitamin D exist for adolescents. Objective: The aim of this study was to determine if a short food frequency questionnaire (SFFQ) can be used to effectively assess vitamin D intake in adolescents compared to a previously validated long food frequency questionnaire (LFFQ). Participants/setting: 140 healthy 6-12 year old (male n=81) Caucasian and African American (n=94) children from Pittsburgh, Pennsylvania completed a SFFQ and LFFQ at two time points 6 months apart. Main outcome measures: Reliability and validity of a SFFQ by comparison with a previously validated LFFQ for children and adolescents. Statistical analysis: Reliability, validity, sensitivity, specificity, positive, and negative predictive values were assessed using Pearson correlation coefficients. Results: Mean vitamin D intake from the SFFQ (range, 434 to 485 IU) was higher than the LFFQ (range, 320 to 378 IU). Overall association between the SFFQ and the LFFQ for vitamin D intake was modest (r=0.36, P<0.001). When stratified by race, the overall degree of association was weak for African Americans (r=0.26, P=0.001) and moderate for Caucasians (r=0.57, P<0.001). Overall reliability testing results were modest and significant for the LFFQ (r=0.28, P=0.002) and SFFQ (r=0.33, P<0.001). Association between mean vitamin D intake from LFFQs and SFFQs was used to determine validity. The association for validity was found to be modest (r=0.51, P<0.001). Sensitivity, specificity, positive predictive value, and negative predictive value for the SFFQ were 90%, 64%, 0.78, and 0.58, respectively. Conclusion: The SFFQ was found to be modestly valid and reliable in an early adolescent population. Associations between African Americans were not as strong as Caucasians which may be due to errors in reporting dietary consumption related to higher body weight.

Abstract Eco-tourism gives consideration to both ecological conservation and recreation, aiming to protect resources by means of making tourists recognizing the importance of ecosystem."Houbihu Marine Conservation Area "in the National Kenting Park is established for the conservation of biological diversity from protecting sea urchins in 2003 to all marine organisms two years later. Recovery of marine resources encouraged the idea to develop eco-tourism in the area; not only to propagate the benefits from resources conservation by allowing tourists for near contacts to marine ecosystem and sharing the achievements of protection, but also to promote transformation of local fishers and to improve their economic conditions. This study explores the feasibility of this idea, by literature reviews, questionnaire survey and in-depth interview with the six groups of people: tourists, managers, enforcement officials, experts (including scholars), industries and non-government organization. Discussions on the results and recommendations were provided in the study. ¡ikeyword ¡jEco-tourism¡BBiologicaldiversity¡BHoubihuMarine¡Bliterature reviews¡Bquestionnaire survey¡Bin-depth interview

Leadership has been a foundational component of secondary agricultural education and teachers are recognized as the program leader; furthermore, agriculture teachers are expected to develop leadership in their students. However, research examining the leadership style of agriculture teachers has not been fully vetted. The purpose of this study was threefold: to examine transformational leadership in secondary agricultural education from philosophical, qualitative, and quantitative perspectives. The study was conducted through a qualitative case study of an agricultural education program at the local level and through a quantitative study of secondary agricultural educators at the national level. The philosophical portion of the study gave an overview of the agricultural education model and the transformational leadership approach. A dynamic model was developed for agricultural education which places an emphasis on the leadership approach of the agricultural educator. The Transformational Leadership and Community Impact (TLCI) Model was developed to provide a more holistic approach for operating a high quality secondary agricultural education program. The qualitative portion of the study was a case study to examine the leadership styles of two agriculture teachers in a high quality secondary agriculture program. The transformational leadership approach of Bass and Avolio provided the framework to explore the leadership styles of the agriculture teachers as perceived by those closely associated with the agriculture program. The results of this case study suggest that the transformational leadership style of the agriculture teachers was a positive and effective way to lead. The quantitative portion of the study sought to identify the preferred leadership style of a random sample of agricultural educators across the nation who taught secondary agriculture during the 2008-2009 school year. Data were collected online using the Multifactor Leadership Questionnaire (MLQ). Descriptive statistics were used for reporting the demographic and personal characteristics of respondents. Mean scores were calculated to determine the leadership style and leadership factors of the agriculture teachers. The study concluded that secondary agricultural educators were more transformational in their preferred style in contrast to transactional and laissez-faire leadership styles. The highest mean score for a factor in transformational leadership was Individualized Consideration and the highest mean score for a factor in transactional leadership was Contingent Reward.

An improved understanding of the costs of diseases is obtained by conducting a case study of the costs associated with end stage renal disease (ESRD). In estimating the costs of ESRD, the costs incurred by both patients and their primary unpaid caregivers are calculated. Most economic studies of the costs of diseases ignore either the patients’ or unpaid caregiver side, focusing on one or the other. From a theoretical standpoint, it is shown unpaid caregiving lowers the costs of diseases to society. Unpaid caregiver lowers the cost, because for unpaid caregiving to occur, the net benefits of unpaid caregiving must be lower than the net benefits of hiring a paid caregiver. Using patients and their primary caregivers at the Gambro Dialysis Center in College Station, Texas as a case study, estimated total ESRD costs range from $84,000 to $121,000 / year / case. The distribution of these costs is positively skewed. Of the total costs, approximately 2% to 25% can be attributed to unpaid caregiving. Excluding direct medical costs in total ESRD costs, unpaid caregiving is 14% to 65% of total ESRD costs. Consideration of unpaid caregiving costs is, therefore, an important component of the costs of diseases. These estimates are conservative as the costs associated with lifestyle changes and health effects are noted, but no monetary value is placed on them. Results also indicate the patients’ and caregivers’ perception of the quantity of caregiving varies. An alternative water supply system to improve the efficiency of water supply systems taking into account water pricing, marketing, and treatment costs is proposed. This system treats and supplies water differently depending on the source of the water and if the end-use of the water is a potable or non-potable use, then may reduce treatment costs. Decreased treatment costs may make more stringent water standards more affordable. More stringent water standards may cause a decrease in the risk of water-related diseases including ESRD induced by water-borne toxins. Reducing the risk of ESRD will reduce society’s costs associated with chronic illnesses. Possible benefits and costs of the proposed system are discussed, but not calculated.

Dissertation (Ph.D.)--Auburn University, 2009. / Abstract. Includes bibliographic references (p.64-85).

The purpose of this study was to gain a better understanding of undergraduates’ metacognitive beliefs about writing and knowledge, ways that those beliefs may change during the semester, and the relationship of beliefs to their persuasive writing. Scales assessing epistemological and writing beliefs were given to students in lower-division rhetoric and writing courses (N=241). Generally, students experienced significant changes in their beliefs about knowledge, learning, and writing across the semester, as assessed by the Epistemological Beliefs Questionnaire (Schommer, 1993) and writing beliefs scales (White & Bruning, 2002). Thus, students at the end of the semester reported beliefs that learning was a slow process and that knowledge was contingent. Although regressions predicting quality of students’ persuasive writing from the belief scales were not significant, qualitative analyses revealed interesting trends in papers from students with different epistemological stances and beliefs about writing, particularly with regard to their use of sources. / text

Efforts to estimate the population prevalence of chemical sensitivities have been limited and have yielded different estimates of the prevalence of affected individuals. Researchers recognize that people differ in their biological susceptibility to environmental contaminants as well as the amount of contaminant to which they are potentially exposed. Lack of information on the population prevalence of people, who report sensitivity to a chemical or many chemicals, as well as variables associated, has been recognized in previous studies (Kreutzer et al., 1999). In a more recent report, Berg et al., in 2007 reported the prevalence and consequences related to inhalation of chemicals in a Danish population. They concluded that the symptoms related to inhalation of airborne chemicals were common, especially among women. A small part of that population reported that these symptoms affected social life or occupational conditions. Details in prevalence on severity of symptoms caused by inhaled odors, chemicals and irritants have not been investigated comparing populations based on ethnical differences. These differences could influence how individuals report their symptoms. This study evaluated the differences between Americans and Hispanics in sensitivity and symptoms related to inhalation of strong odors, chemical and irritants. We also evaluated the differences between both ethnic groups on quality of life due to these symptoms. A cross-sectional descriptive study was conducted between December 2008 and March 2009. A self-administered questionnaire was distributed to a total of 290 adults and 205 were selected for the analysis. American and Hispanic individuals of 16 years old or more were included. The responses were cross-tabulated and comparisons between means were performed using t-test and ANOVA. 29.8% of study population reported being more sensitive than the average person and women reported more than men (75%). These findings were consistent with previous reported in the literature. The reaction more frequent reported was to cigarette smoke (60%). Statistically significant differences were identified between Americans and Hispanics regarding to sensitivity to chemicals, irritants, odors or strong fragrances and reaction to cigarette smoke when history of Allergy is present. Significant differences between both ethnic groups were detected with Lower Respiratory, Neuro-psychological and Non-specific symptoms; and Quality of life. These differences were disclosed when history of Allergy, smoking habit, used steroids or antibiotics within the last 4 weeks, and age were considered. Americans reported being more sensitive with exposure to recognized everyday irritants, react more to cigarette smoke and reported more Non-specific symptoms than Hispanics. Hispanic smokers tend to report Lower Respiratory symptoms more than the Americans. Hispanics between 50 to 59 years old reported more Neuro-psychological symptoms than Americans. Quality of life was more affected among Americans if they are exposed to common irritants, when Allergy history and use of steroids or antibiotics were considered.

The research study proposed in this report reviews and integrates the literature on client/parent satisfaction with Therapeutic Assessment. Specifically, the importance of parent collaboration and the intervention potential of child assessment are highlighted. The result is the development of a parent self-report measure that could be utilized in multiple settings to assess the interpersonal and collaborative experiences of parents. It is these experiences of parents which have been shown to be more highly related to general satisfaction than outcomes or demographics. The methodology includes Confirmatory Factor Analysis to revise the scale and MANCOVA to compare traditional assessment with collaborative/therapeutic assessment practices in multiple settings. / text

Clinical professionals in South Africa are generally unaware of the impact of obstructive sleep apnoea (OS A). The cost to the state of untreated apnoea may be extremely high. In primary health care encounters OSA often goes undiagnosed. The cascade of symptoms linked to OSA is profound, placing patients at risk for debilitating problems impacting on self and others. The aim of this study was to validate a questionnaire, which could be used at a primary health care level to identify patients with OSA thus cutting costs and improving efficient, effective and ethical service to patients. The Berlin Questionnaire (BQ) (Netzer et al. 1999) was administered to a clinical sample of consenting patients at a private sleep laboratory in Durban, South Africa (N = 119)(completed n = 110). Home-based sleep studies (n = 116) on a portable cardio-respiratory screening device were also obtained for objective comparison. From the results obtained in this South African sample, the BQ showed low validity and reliability (Cronbach a = 0.62 - 0.84) to individual items of the BQ. The total BQ score and high-risk symptom category analysis showed mildly significant correlations with internationally approved protocols. The BQ identified 60% of the high-risk group (AHI >5). Furthermore, risk categories were useful in predicting AHI ratings in 64% of moderate OSA cases and 25% of severe OSA cases. The BQ therefore has useful psychometric properties as an adjunct assessment tool to screen for high-risk OSA cases where resources are scant. Clinical health psychologists are in an ideal position to recognise the risk factors and symptoms of OSA. The clinical assessment and the value of the correct diagnosis will alleviate the treatment of psychological symptoms at a superficial level in primary health care facilities. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.

Atlikus tyrimą nustatyti dažniausi pagyvenusio amžiaus žmonių, hospitalizuotų į vidaus ligų skyrių, sveikatos sutrikimai: depresijos simptomai, dauginė patologija, atminties ir pusiausvyros sutrikimai, sensorinių pojūčių pokyčiai, judėjimo, suvokimo sutrikimai bei mažesnis arba didesnis funkcinis nesavarankiškumas. Vyresnių pacientų amžius, lytis bei potencialūs rizikos veiksniai neigiamai susiję su daugeliu pagyvenusio amžiaus žmonių fizinės ir psichinės sveikatos aspektų. Vyresnis amžius didino pagyvenusio amžiaus žmonių fizinės sveikatos bei funkcinės ir pažinimo funkcijų sutrikimus. Moterys dažniau nei vyrai nurodė svorio kritimą ir skundėsi skausmu. Pacientai, turėję atminties sutrikimų, dažniau patyrė griuvimą, atsirado pragulos, buvo nesavarankiški kasdienėje veikloje, turėjo depresijos ir delyro simptomų, nelaikė šlapimo ir išmatų bei skundėsi dvigubu nelaikymu. Nepakankamos mitybos, nelaikantys išmatų, turėję atminties, judėjimo sutrikimų ar ilgai negalėję vaikščioti dažniau turėjo pragulų (p<0,05). Staiga pablogėjus sveikatai gydymas stacionare nevienareikšmiai įtakojo paciento sveikatos būklę: sumažėjo (ar išnyko) ryškūs psichinės sveikatos sutrikimai. Bendravimo sutrikimai ir kasdienė funkcinė veikla nepakito, šlapimo nelaikymas išliko. Instrumentinė kasdienė veikla, lyginant paciento gebėjimus iki hospitalizavimo ir tyrėjo numatytus gebėjimus išrašant iš ligoninės, pablogėjo. Išrašant pacientus iš ligoninės, sumažėjo antibiotikų ir padidėjo psichotropinių... [toliau žr. visą tekstą] / Most common health problems of the hospitalized elderly are the following: symptoms of depression, polypathology, memory and balance disorders, changes of sensory organs, disorders of locomotion, disorders of perception, and the functional dependence of lower or higher degree. The older age of the studied subjects, gender and the potential risk factors had a negative influence on physical and mental health of the elderly.The disorders of physical health, functional and cognitive functions of the elderly increased with the older age. Women more frequently reported weight loss and complained of pain. Patients with memory disorders, more frequently had falls, were dependent in activities of daily living, had bedsores, symptoms of depression and delirium, bladder and bowel incontinence, and double incontinence. Patients with insufficient intake of diet, having bowel incontinence, disorders of memory or being confined to bed more frequently had bedsores (p<0.05). Treatment of acute health deterioration in in-patient clinic had the positive influence on patient‘s health condition: dramatic disorders of mental health (symptoms of delirium, disorders of perception, thinking, memory) reduced (or disappeared). Disorders of communication (self-expression and ability to understand others), problem of bladder incontinence, daily functional dependence did not change. Instrumental activities of daily living deteriorated for discharge period if compared to patient‘s abilities prior to... [to full text]