A questão nutricional ocupa hoje um lugar de destaque no contexto mundial. Deficiências alimentares trazem muitos prejuízos provocando desequilíbrios nutricionais. Os adolescentes são considerados um grupo exposto ao risco nutricional, devido aos seus hábitos alimentares. Estudos apontam que atividades envolvendo alimentação dentro das escolas são muito importantes, pois podem possibilitar aos adolescentes o desenvolvimento de uma relação mais responsável com a própria saúde. Este trabalho tem como objetivos identificar e analisar comparativamente o consumo alimentar de alunos de 5a à 8a séries nas escolas de ensino fundamental das redes municipal, estadual e particular no município de Ribeirão Preto (SP), verificando o que é oferecido como opções pela merenda e pela cantina escolar e discutindo o espaço da escola como alternativa para a educação alimentar de estudantes. Os estudantes responderam a um questionário sobre seu consumo alimentar na escola, foram pesados e medidos. O programa de software Epi Info 2002 foi usado para a organização dos dados. Os questionários foram respondidos por 401 alunos, de 5a à 8a séries, de ambos os sexos. Alunos de diferentes escolas apresentaram um padrão de consumo alimentar muito semelhante. De maneira geral, os estudantes não trazem lanche de casa para a escola. Nas escolas municipais e estaduais a maior parte dos alunos come a merenda oferecida pela escola apenas ocasionalmente. Em média, 70% dos respondentes freqüentam as cantinas pelo menos uma vez por semana, e os alimentos mais consumidos nas cantinas das escolas municipais, estaduais e particulares são balas, refrigerantes, salgados e sucos. A disciplina Ciências foi a mais apontada pelos alunos como aquela na qual os conteúdos sobre alimentação são trabalhados. A classificação do estado nutricional dos estudantes, feita pelos percentis de acordo com o IMC para idade e sexo permitiu verificar que 12,6% dos escolares apresentam sobrepeso e 8,5% apresentam obesidade. Diante do que foi observado no estudo, considera-se que, dentro do contexto de vida dos adolescentes, no qual estão presentes diferentes variáveis como sedentarismo, grande apelo ao consumo, forte influência da mídia, a escola pode exercer um papel fundamental na promoção da educação nutricional, que deve ser abordada pelas diferentes disciplinas e trabalhada em atividades diversificadas, com objetivo de desenvolver atitudes e hábitos saudáveis. A cantina escolar pode constituir-se, também, num espaço de educação nutricional, possibilitando associar teoria e prática. / Currently, questions about nutrition have a prominent place in the worldwide context. Nutritional deficiencies are in the origin of many damages that provoke imbalances. Adolescents are a group exposed to nutritional risks due to their alimentary habits. Studies have pointed out that the activities involving alimentation at the schools, are very important because they can make possible for teenagers the development of a more responsible relation with their own health. The aim of this work is to identify and to analyze comparatively the alimentary consumption of students from 5th to 8th grades of municipal, state, and private fundamental schools in Ribeirão Preto city, São Paulo. Besides, the study has the purpose of verifying what kind of foods is offered as options by the school meals and the school canteen and discussing the school space as an alternative for the student alimentary education. 401 students, male and female, from 5th to 8th grades, answered questions concerning to their alimentary consumption and were evaluated according to their weigh and their height. For the data organization it was used the Epi Info 2002 software program. Students from different schools showed a very similar pattern of alimentary consumption. In general, the students don’t bring their school lunch from home to school. In the municipal and state schools the students eat school meals only occasionally. On the average, 70% of the students go the school canteen at least once a week and the more consumed foods are candies, juices, sugary sodas and salt snacks. Science was the discipline more pointed by the students as the one in which the contents about alimentation are more worked. The classification of the student nutritional state, done by the percentiles according to IMC for age and sex, allowed to verify that 12.6% of the students showed overheight and 8.5% showed obesity. According to what has been observed in the studies, we consider that, in the context of adolescents life, in which different variables are present, like sedentariness, the great influence of the media, the great appeal of consumes, the school can play a basic role in promoting nutritional education. This subject must be approached by the diverse disciplines and worked through diversified activities in order to develop healthy habits and attitudes. The school canteen may also constitute itself a space for nutritional education, making possible to put theory and practice together.

A questão nutricional ocupa hoje um lugar de destaque no contexto mundial. Deficiências alimentares trazem muitos prejuízos provocando desequilíbrios nutricionais. Os adolescentes são considerados um grupo exposto ao risco nutricional, devido aos seus hábitos alimentares. Estudos apontam que atividades envolvendo alimentação dentro das escolas são muito importantes, pois podem possibilitar aos adolescentes o desenvolvimento de uma relação mais responsável com a própria saúde. Este trabalho tem como objetivos identificar e analisar comparativamente o consumo alimentar de alunos de 5a à 8a séries nas escolas de ensino fundamental das redes municipal, estadual e particular no município de Ribeirão Preto (SP), verificando o que é oferecido como opções pela merenda e pela cantina escolar e discutindo o espaço da escola como alternativa para a educação alimentar de estudantes. Os estudantes responderam a um questionário sobre seu consumo alimentar na escola, foram pesados e medidos. O programa de software Epi Info 2002 foi usado para a organização dos dados. Os questionários foram respondidos por 401 alunos, de 5a à 8a séries, de ambos os sexos. Alunos de diferentes escolas apresentaram um padrão de consumo alimentar muito semelhante. De maneira geral, os estudantes não trazem lanche de casa para a escola. Nas escolas municipais e estaduais a maior parte dos alunos come a merenda oferecida pela escola apenas ocasionalmente. Em média, 70% dos respondentes freqüentam as cantinas pelo menos uma vez por semana, e os alimentos mais consumidos nas cantinas das escolas municipais, estaduais e particulares são balas, refrigerantes, salgados e sucos. A disciplina Ciências foi a mais apontada pelos alunos como aquela na qual os conteúdos sobre alimentação são trabalhados. A classificação do estado nutricional dos estudantes, feita pelos percentis de acordo com o IMC para idade e sexo permitiu verificar que 12,6% dos escolares apresentam sobrepeso e 8,5% apresentam obesidade. Diante do que foi observado no estudo, considera-se que, dentro do contexto de vida dos adolescentes, no qual estão presentes diferentes variáveis como sedentarismo, grande apelo ao consumo, forte influência da mídia, a escola pode exercer um papel fundamental na promoção da educação nutricional, que deve ser abordada pelas diferentes disciplinas e trabalhada em atividades diversificadas, com objetivo de desenvolver atitudes e hábitos saudáveis. A cantina escolar pode constituir-se, também, num espaço de educação nutricional, possibilitando associar teoria e prática. / Currently, questions about nutrition have a prominent place in the worldwide context. Nutritional deficiencies are in the origin of many damages that provoke imbalances. Adolescents are a group exposed to nutritional risks due to their alimentary habits. Studies have pointed out that the activities involving alimentation at the schools, are very important because they can make possible for teenagers the development of a more responsible relation with their own health. The aim of this work is to identify and to analyze comparatively the alimentary consumption of students from 5th to 8th grades of municipal, state, and private fundamental schools in Ribeirão Preto city, São Paulo. Besides, the study has the purpose of verifying what kind of foods is offered as options by the school meals and the school canteen and discussing the school space as an alternative for the student alimentary education. 401 students, male and female, from 5th to 8th grades, answered questions concerning to their alimentary consumption and were evaluated according to their weigh and their height. For the data organization it was used the Epi Info 2002 software program. Students from different schools showed a very similar pattern of alimentary consumption. In general, the students don’t bring their school lunch from home to school. In the municipal and state schools the students eat school meals only occasionally. On the average, 70% of the students go the school canteen at least once a week and the more consumed foods are candies, juices, sugary sodas and salt snacks. Science was the discipline more pointed by the students as the one in which the contents about alimentation are more worked. The classification of the student nutritional state, done by the percentiles according to IMC for age and sex, allowed to verify that 12.6% of the students showed overheight and 8.5% showed obesity. According to what has been observed in the studies, we consider that, in the context of adolescents life, in which different variables are present, like sedentariness, the great influence of the media, the great appeal of consumes, the school can play a basic role in promoting nutritional education. This subject must be approached by the diverse disciplines and worked through diversified activities in order to develop healthy habits and attitudes. The school canteen may also constitute itself a space for nutritional education, making possible to put theory and practice together.

Hospital-acquired infections cost hospitals approximately $30.5 billion per year and also result in longer hospital stays, chronic conditions, and even death with associated malpractice costs. According to the Centers for Disease Control and Prevention, hand hygiene is a simple, effective way to prevent illness and infection. The purpose of this research was to determine if visitors to a neonatal intensive care unit (NICU) in a regional medical center comply with hand-washing policies and procedures. If NICU visitors wash their hands properly, they can prevent potentially fatal infections from spreading to patients, healthcare workers, and unaffected family members. Hand-washing compliance has been previously studied in NICU staff and other healthcare workers, but not solely visitors. The researcher observed more than 120 visitors as they entered the NICU to determine the number who washed their hands for the required three minutes. Based on the findings, NICU staff and administration will be encouraged to provide more effective education, post informative signs, and install equipment to encourage visitors to use proper hand-washing techniques. Effective hand-washing should result in lower infection rates among NICU patients and lower health care costs.

Approximately 34% of adolescents are overweight or obese which can be accompanied by physical, psychosocial, and economic consequences. Increasingly, pediatric overweight/obesity research has focused on Health Related Quality of Life (HRQoL) as a health outcome. This study examined differences in HRQoL across weight categories in adolescents, specifically, the sensitivity of using a general versus condition-specific measure. Further, the influence of gender was explored. Data were extracted from Wave 2 of Team Up for Healthy Living, a school-based obesity prevention program targeting adolescents in Southern Appalachia. Participants (N = 918; 50% Female; 93% Caucasian; 90% 9th graders) completed the Pediatric Quality of Life (PedsQL) Inventory (general) and PedsQL Multidimensional Fatigue Scale (condition-specific) measures as part of a larger survey. Body mass index-for-age and -sex percentiles were calculated using actual height and weight, and students were classified as underweight, healthy weight, overweight, or obese according to Centers for Disease Control and Prevention (CDC) criteria. Two 4 (weight category: underweight vs. healthy weight vs. overweight vs. obese) x 2 (gender: male vs. female) factorial analyses of variance (ANOVAs) were calculated to compare mean scores of total HRQoL (both generic and condition-specific). Additionally, 7 factorial multivariate analyses of variance (MANOVAs) were conducted with each measure’s subdomains. Fisher’s Least Significant Difference post hoc analyses were run to assess differences between groups, at a significance level of p<0.05. The current study revealed no interaction effect between total HRQoL (assessed via the generic or condition-specific measure) and weight category and gender; however, main effects were found for both weight category (assessed via a generic measure only) and gender (assessed via both generic and condition-specific measures). Additional research is needed to examine the impact of utilizing different measures and the potential role of gender as well as other factors that may influence HRQoL across weight categories. These issues are important as researchers to date utilize a variety of HRQoL measures making interpretation of findings difficult and often do not consider other variables such as gender that may influence findings.

Meticulously compiled to serve the specific needs of APRNs and nurse executives engaged in doctoral-level research, this text provides evidence-based and practice-based scholarly methods not traditionally taught in PhD or DNP programs. Building on and expanding traditional nursing research methods, the bookfocuses on both existing and evolving methods of clinical inquiry, some of which incorporate technology and knowledge from other disciplines. These are approaches that can be translated into clinical practice, providing the nursing profession with unprecedented opportunities for collaboration in improvinghealth and health care systems. Methods include quality improvement, implementation science, logic models, program planning and evaluation, patient-engaged and community participatory research, dissemination research, big data, comparative effectiveness research, secondary analysis, and systematic reviews. Chapters provide clear guidance on why and how to use a particular method, and are consistently organized to enable a comparison and contrast of different approaches in order to select the one that best fits a particular research need. The text highlights the importance of each approach, and discusses why touse a particular method for doctoral nursing work. Chapters describe how to apply the method along with how to interpret findings and disseminate them. Thedescription of each method concludes with examples from the published literature. Practical tips for impact and success in research and program proposals increase the text value. Key Features: Presents research methods specifically for doctoral-level evidence-based and practice-based clinical research Describes interdisciplinary health care methodologies focused on evidence-based improvement in health care Offers practical information on benefits and use of each method Provides examples of each method from published literature Written by experienced academic and practice scholars from across the United States / https://dc.etsu.edu/etsu_books/1137/thumbnail.jpg

Traumatic Brain Injury (TBI) affects approximately 1.7 million persons in the United States annually, 75% are categorized as mild (mTBI). Most persons who experience mTBI will recover, however an estimated 10% will develop Postconcussion Syndrome (PCS). Evidence supports a relationship between perceived stress, salivary cortisol, and depressive symptoms in persons after TBI; however, there are no known studies exploring these relationships in the PCS patient population. A sample of 17 men and women diagnosed with PCS were recruited from Southwest and Central Virginia. Data collection included the Rivermead Postconcussion Questionnaire, Perceived Stress Scale-10, Center for Epidemiological Studies-Depression Scale and the PROMIS Emotional Distress (ED)- Depression Short form (SF). Salivary cortisol was collected with a SalivaBio Oral Swab Collection System. Data were analyzed with Wilcoxon Rank-Sum and Pearson’s Chi Square. Spearman’s Rank Order Correlation Coefficients were used to compare variables for correlation. We found a statistically significant relationship between stress and depression (Spearman rho=0.87; p <0.0001); however, we did not find a statistically significant relationship between stress and cortisol (Spearman rho=-0.11; p =0.6887) or depression and cortisol as measured by the CES-D (Spearman rho=-0.10; p=0.6989) and the PROMIS ED-Depression SF (Spearman rho= -0.40; p=0.1327). While perceived stress may impact report of depressive symptoms in persons diagnosed with PCS, much is unknown about the influence of other factors in the development of this syndrome. More research is needed to identify mechanisms behind the presence of PCS to further inform our understanding of this condition, and to apprise the development of nursing interventions.

Thesis (Ph. D.)--UCLA, 2009. / Vita. Description based on print version record. Includes bibliographical references (leaves 145-167).

Thesis (M.S.W.)--University of Hong Kong, 1985.

The purpose of this dissertation was to examine factors associated with cardiovascular disease (CVD) risk among emerging adults in college aged 18-25 years. CVD risks that develop during this period often persist into adulthood making it an ideal time to target CVD prevention. The specific aims of this dissertation were to 1) explore perceptions of cardiovascular risk among emerging adult men in college; 2) compare differences in unhealthy behaviors and obesity between emerging adults in college living in rural, Appalachian Kentucky and urban Fayette County, Kentucky; and 3) compare measures of general and abdominal obesity in predicting blood pressure among emerging adults in college. Specific Aim One was addressed by a qualitative study of perceptions of cardiovascular risk in 10 emerging adult males in college. Specific Aims Two and Three were addressed by a study of emerging adult college students living in rural, Appalachian and urban Fayette County, Kentucky. We hypothesized that students in rural, Appalachian Kentucky would engage in more unhealthy behaviors and be obese due to living in an austere environment with barriers to healthy behaviors. Although obesity and hypertension are known to be related, researchers have not determined whether body fat distribution, general vs. abdominal, is predictive of blood pressure in emerging adults. Knowing which body fat distribution is the strongest predictor of blood pressure may help in evaluating cardiovascular risk in emerging adults. Emerging adult men emphasized difficulty engaging in CVD health behaviors while attending college and choose to ignore long-term CVD risk. Overcoming college-specific and developmental barriers to engaging in healthy behaviors is critical to reducing cardiovascular risk in this population. Students living in rural, Appalachian Kentucky had more CVD risk behaviors and more were obese compared to those in urban Fayette County, Kentucky. Reducing CVD risk behaviors and obesity among students in rural Appalachian Kentucky may help decrease the high burden of CVD in this region. Findings suggest that waist circumference was the best predictor of systolic blood pressure among emerging adults in college.

The Austrian mental health care system has been characterized by reform initiatives since the 1970s. The reform strategies can be summarized under the term 'community mental health care'. The thesis focuses on an analysis of the reform (context) and the related challenges for mental health care financing with respect to its interdependencies with service provision in the process of change. In a qualitative research process, firstly, reform documents and transcripts of qualitative interviews have been analyzed via a discourse-analytical approach. Secondly, secondary data on mental health care financing in Austria and in western European countries have been collected. An analytical framework was, finally, applied to analyze the interrelations between mental health care financing and reform discourse with respect to its impact on the micro-level and on the macro-level of the mental health care system. The results show that the reform discourse reflects broader welfare state transformation processes. Yet, financing issues have hardly been addressed in reform discussions. Nevertheless, discursive elements are either explicitly or implicitly associated with financing issues or are even linked to specific financing models. A central impact from the restructuring processes on the micro-level is an increasing (financial) responsibility for people who are affected by a mental disorder and/or their relatives. On the macro-level, the processes of change are related to decreasing (financial) responsibility for the sector 'state' while responsibility for the sectors 'family' and 'voluntary/community' is rising. The international development shows similar characteristics. The thesis finishes with some recommendations for developing an alternative financing model and provides a guideline for a comprehensive discussion of alternative mental health care financing approaches. (author´s abstract)