Methicillin Resistant Staphylococcus aureus (MRSA) is the most commonly isolated multi-drug resistant organism in the hospital setting. MRSA can result in death among people who have no identified risk factors for infection. One-third of MRSA infections are cross-transmitted as Healthcare-Associated Infections (HAIs). It is well known that the single most effective means for decreasing the risk of HAIs is hand hygiene (HH), yet poor performance among registered nurses persists. The theoretical framework used to guide the study was the Health Belief Model (HBM). The purposes of the study were to: explore the RNs’ self-reported HH performance rate; explore the RNs’ knowledge related to MRSA; identify relationships between MRSA knowledge and HBM constructs; explore the RNs’ barriers to HH performance; identify relationships between barriers and self-reported HH performance; explore relationships among HH behaviors and constructs in the HBM; explore predictors of ‘overall HH’ performance; and identify if certain demographic characteristics are related to MRSA knowledge, self-reported HH, and HBM constructs. A cross sectional descriptive study was conducted with a sample of RNs who were randomly selected. The questionnaire mailing, which included the survey, consent, and the return-stamped envelope were distributed to 684 RNs. Completed surveys (n=120) from RNs who met the sample inclusion criteria were returned within four weeks. Self-reported HH were highest during times of increased perceived susceptibility for infection. In addition, nurses were more likely to overcome barriers to HH during ‘moments’ associated with the highest perceived susceptibility. Although MRSA knowledge did not correlate with ‘overall HH’ performance, there was a significant relationship identified with self-efficacy (r=.27, p<.01), which may influence HH behaviors. The most commonly identified barriers to HH performance were system factors (e.g. ‘a high workload’). Self-efficacy and barriers represented 26% of the variability in the regression model when applying significant correlations among HBM constructs and ‘overall HH.’ The phenomenon of the RN’s HH decision making is not completely understood. More research is needed to explain predictors for HH among registered nurses. This understanding will allow researchers to plan interventions aimed at increasing knowledge and understanding about perceived susceptibility, which may in turn improve self-efficacy behaviors for HH, which could decrease HAI rates. / text

Cardiovascular disease (CVD) including coronary artery disease and stroke is a significant health problem in Japan regardless of well established health care and insurance system and various public campaigns and exhibitions in the contemporary Japanese society. Higher and increasing prevalence and incidence of well-known risk factor of CVD may contribute to increasing mortality and morbidity of CVD in the future. However, limited knowledge was available for understanding perceptions of risk for CVD among Japanese adults. This grounded theory study aimed to explore social psychological process in perception of risk for CVD among Japanese adults.There were a total of 26 individuals participated in this study. Participants consisted of 19 Japanese adults with at least one CVD risk factor and 7 Japanese health care providers residing or working in which a consistently high mortality rate of CVD in both men and women.The theory grounded from the data was a process to avoid serious physical, emotional, social, and financial suffering as a consequence of developing CVD or of leaving it untreated and a process to maintain a good relationship with risk for CVD among Japanese adults with CVD risk factors. This grounded theory was consisted of the central concept of perceived risk for CVD, which defined as fear, threats, sorrow, worries, and/or anxiety for possible adverse impacts on their life living with their family and suffering for loss of independence and quality of life consequent upon CVD. This central concept was followed by actions to avoid these adverse and excruciating consequences of CVD including changing behavior, taking measures to manage CVD risk, and continually evaluating their condition. Factors contributed to perception of risk for CVD among Japanese adults were seriousness and severity of consequences of CVD, susceptibility, proneness, and possibility to develop CVD, and Japanese specific contextual factors.This study may contribute to appropriately addressing perception of risk for CVD and behavior change among Japanese adults with risk factors for CVD within the unique social, cultural context of Japan. The results of this study could apply to better nursing practice for CVD risk management and health promotion in Japan.

Sudden Infant Death Syndrome (SIDS) is a serious public health issue in this country and a major contributor to infant mortality in African American populations. African Americans have one of the highest rates of SIDS, some of which is due to increased risk factors for SIDS, such as prone sleeping and bed-sharing, as well as a lack of adherence to the SIDS risk reducing recommendations. Little is understood about this lack of adherence in the African American population or how to effectively address it but some research suggests a link between parental health beliefs of SIDS and the risk reducing recommendations and the implementation of these recommendations. This study used quantitative methods to gather data about the health beliefs and perceptions of SIDS among African American women living in Service Planning Area (SPA) Six of Los Angeles County to better understand the link between beliefs about SIDS and how this relates to implementation of the safe infant sleeping recommendations, specifically bed-sharing and prone sleeping. A self-administered questionnaire was developed to collect data using the Health Belief Model and several of its concepts as a guiding framework to assist with the construction of the questionnaire. The questionnaire was distributed electronically through the survey software program, Survey Monkey and analyzed using statistical software, SPSS. Exploratory factor analysis found the questionnaire reliable and valid upon the removal of four items, including the construct of cues to action. The new 19-item questionnaire suggested that the women felt that SIDS was a big problem but didn't feel as susceptible. There was also a clear confusion about prone sleeping position. Overall, the data suggests a need for tailored educational campaigns in African American communities to increase awareness of and susceptibility to SIDS and stressing the benefits of supine sleeping position.

Introduction and Rationale: Sudden infant death syndrome (SIDS) continues to be the leading cause of death in infants 28 days to 12 months old and the third leading cause of infant mortality (CDC, 2014; Task Force on SIDS, 2011a). SIDS has no identifiable cause although many hypotheses have existed and there are many known risk factors. Nicotine use is the second most modifiable risk factor for SIDS and to date there is no national public education campaign. Formal education is needed. Written education materials, such as brochures, are an effective way to increase knowledge and awareness of a health topic. Purpose and Objective: The purpose of this DNP Project was to create an educational brochure about SIDS and nicotine as a significant modifiable risk factor. The brochure is directed towards pregnant women and women with infants less than 12 months of age. The objective was to educate and inform mothers about SIDS, nicotine and its relation to SIDS, and the importance of abstaining from nicotine during and after pregnancy. Methods: The brochure was created using the Health Belief Model (HBM) as a framework. The HBM was used to explain health behavior modifications and was used as a foundation for education interventions. The model has successfully been applied to explain other preventative health behaviors and provide health education in various contexts. Results: The brochure was evaluated by two subject matter experts who have published peer reviewed articles using the HBM. Both subject matter experts found the HBM applied to the brochure appropriately. In their opinion, the content of the brochure should have positive impact for health modification in women who use nicotine and are pregnant or have a child less than 12 months of age. Conclusions: This DNP Project demonstrated SIDS as a current significant health problem and identified maternal nicotine use as the second most modifiable risk factor. Due to lack of current public education, a brochure was created using the HBM as a framework. Subject matter experts stated the brochure was created based on the HBM and will likely a have positive health influence on the intended population.

In the current study, children’s understanding of false belief, intention, and their ability to distinguish the appearance of a character from its reality was investigated. Seventy-two three to five years olds were recruited from several preschools in the Silicon Valley in California. During the experiment, children were shown an animated movie in a computer and asked the false belief, intention, and appearance-reality distinction questions. Following the animated movie, children were also asked if they understand 10 mental words that depicted the human mind, such as think, want, believe, etc. The relationship between the children’s knowledge of the human mind and the mental words they understood was explored. Results of the current study revealed that children who were four and half to five performed better than children three and half to four on false belief tasks. Children’s performance on intention and appearance-reality distinction questions did not differ significantly across age. However, girls’ performance was superior to boys’ performance on intention questions. Similarly, girls’ knowledge of overall naïve psychology was also superior to that of boys. Moreover, the order of the naïve psychology concepts that children passed in current study was from intention to appearance-reality distinction and then false belief. Finally, the regression analysis of the data revealed that the mental word vocabulary children processed was closely related to naïve psychology development. More specifically, the number of total mental words that were reported by children or assessed by contextual questions was a significant predictor of naïve psychology knowledge.

Sexually transmitted diseases (STDs) are a growing problem worldwide and young people are especially vulnerable. Every day about 1 million people contract a sexually transmitted disease (STD) and over half of the newly infected are young people aged between 15-24 years. Aim: The aim of this study was to investigate knowledge, attitudes and beliefs related to STDs among adolescents at a secondary school in Ho Chi Minh City, Vietnam, and to compare the genders regarding these issues. Method: This study was a descriptive and comparative cross-sectional study and a quantitative approach was used. The project was carried out at Nhan Dao Vocational Secondary School in Ho Chi Minh City, Vietnam. Two hundred and ten male and female students aged between 15-24 years participated in the study and chose to fill in the questionnaire. The questionnaire consisted of 31 questions regarding the students’ knowledge, attitude and beliefs of STD. Leininger’s Theory of Cultural Care Diversity and Universality was provided as theoretical framework. Results: The Vietnamese students at Nhan Dao Vocational School in Ho Chi Minh City, Vietnam, had low knowledge about STDs and the students’ attitudes to and beliefs about STDs showed that there exists a lot of misconceptions about the subject. The study did not show any major differences between the genders regarding knowledge, attitude or beliefs. Conclusions: Further research about young people’s practice needs to be performed in order to receive a wider perspective on young Vietnamese people’s knowledge, attitudes and beliefs. It is also important in order to be able to draw conclusions concerning whether knowledge and attitudes are related to sexual practice. / Sexuellt överförbara sjukdomar (STD) är ett växande problem världen över och ungdomar är särskilt utsatta. Varje dag smittas ca 1 miljon personer av en sexuellt överförbar sjukdom (STD) och över hälften av de smittade är ungdomar mellan 15-24 år. Syfte: Syftet med denna studie var att undersöka kunskaper, attityder och övertygelser relaterade till sexuellt överförbara sjukdomar bland ungdomar på en gymnasieskola i Ho Chi Minh City, Vietnam, och att jämföra könen i dessa frågor. Metod: Denna studie var en beskrivande, jämförande tvärsnittsstudie med kvantitativ metod. Projektet genomfördes på Nhan Dao Vocational Secondary School i Ho Chi Minh City, Vietnam. Tvåhundra tio manliga och kvinnliga studenter i åldern 15-24 år deltog i studien och valde att fylla i frågeformuläret. Frågeformuläret bestod av 31 frågor om elevernas kunskaper, attityder och övertygelser om STD. Som teoretisk referensram användes Leiningers teori om mångfald och universalitet i kulturrelaterad omsorg. Resultat: De vietnamesiska studenterna hade bristande kunskap om sexuellt överförbara sjukdomar och elevernas attityd till och övertygelser om sexuellt överförbara sjukdomar visade att det finns många missuppfattningar om ämnet. Studien visade inte några större skillnader mellan könen när det gäller kunskap, attityd eller övertygelse. Slutsats: Ytterligare forskning om ungdomars sexuella vanor behöver utövas för att få ett vidare perspektiv på vietnamesiska ungdomars kunskaper, attityder och övertygelser. Det är också viktigt för att kunna dra slutsatser om huruvida kunskap och attityder är relaterade till det sexuella utövandet.

Studien beskriver aktuell forskning kring hur yngre barn tänker om andra människors tankar och känslor utifrån olika teoretiska perspektiv. Vidare provas ett test som så tidigt som möjligt under barns utveckling möjligen kan belysa förskolebarns förmåga att sätta sig in i någon annans tankar, perspektiv. Inom autismforskningen har begreppet theory of mind använts för att belysa den kognitiva förmåga som krävs för att en person ska kunna sätta sig in i någon annans tankar. Från flera håll har begreppet ifrågasatts eftersom det krävs flera kognitiva komponenter såsom minne och verbal förmåga för att lösa denna typ av uppgifter. Följande studie har genomförts för att undersöka ett test som så renodlat som möjligt försöker belysa förmågan att förstå hur någon annan tänker. Elva barn som utretts för autismspektrumfrågeställning och fått diagnosen autism har fått genomföra testet ”Kicki och Katten” och jämförts med tio typiskt utvecklade barn matchade på mental ålder. Resultatet visar att det inte finns någon skillnad mellan barnen med autism och de typiskt utvecklade barnen och att barn med en mental ålder under fyra år, i båda grupperna, inte klarar av testet Kicki och Katten. Testet Kicki och Katten fungerar inte för att bedöma theory of mind hos yngre barn än fyra år.

Motivation There is international agreement and recognition that the health status of the worlds' population is a cause for concern and that one of the key risk factors for many of the diseases that are increasing at an alarming rate (heart disease, diabetes, cancer) in both developed and developing countries, is diet. Despite many successes (especially in the areas of the eradication and containment of infectious disease and reduced fertility) and the huge advances in scientific research and technology, that have increased both what is known, and what can be done, for prevention and risk management, we still face what many describe as a crisis. Knowledge it seems is not always adequately reflected in public health practice. The objective of the local (Department of Health, Directorate of Food Control) and international (WHO, Codex Alimentarius) drive towards increased and improved food labelling, is that if consumers have reliable nutrition information available at the point of purchase and if they understand how their diet affects their risk of diseases, they will be able to make risk-reducing food choices. This could ultimately have a significant positive public health impact. The food industry has also expressed an interest through the concept of functional foods (food similar in appearance to conventional food that is intended to be consumed as part of a normal diet, but has been modified to subserve physiological roles beyond the provision of simple nutrient requirements), that albeit in reality financially motivated, could provide consumers with the opportunity to reduce their risks of some diseases through readily available, good-tasting diets rather than through the use of curative measures only. For the success of both these initiatives in public health terms, consumers must: o accept the link between the food that they eat and their health o actively look for and trust the messages communicated be able to correctly process and integrate the information o make a purchasing decision. This highlights the importance of in-depth consumer understanding in order to ensure that regulatory, educational and marketing strategies will affect positive behaviour change and improve health status. Little consumer research has been done in South Africa to assist all those involved (government, industry, researchers, nutrition experts I dietitians, educators) in gaining potentially important insights. Objectives Of South Africa's almost 31 million adults, some 11 million live in the metropolitan areas and so have relative exposure to most media and access to the widest range of available food products. This group is also a microcosm of the larger South Africa - being made up of all races, ages and living standards. The overall objective of this study was to investigate the beliefs and practices of South African metropolitan adults, in relation to the food and health link and the health information contained on food packages in order to consider the implications for functional foods. The study design was focussed on four key variables, namely, gender, race, age and living standard measure (LSM). Methods The study was designed to ensure that the results would be representative of the metropolitan adult (>I6 years) population and that they could be weighted and extrapolated. 2000 adults made up of 1000 Blacks. 640 Whites, 240 Coloureds and 120 Indians, with a 50150 gender split were drawn using a stratified, random (probability) sampling method in order to allow for the legitimate use of the mathematics of probability as well as to avoid interviewer bias. The study group were interviewed, face-to-face, in home, in the preferred language from English, Afrikaans, Xhosa, Zulu, Tswana, North Sotho and South Sotho, by trained field workers. A minimum 20% back-check on each interviewer's work was undertaken to ensure reliability and validity of the data. The field worker used a pre-coded questionnaire that included seventeen food related questions designed by a multidisciplinary team of marketers, dietitians, nutritionists and research specialists. The food questions used a 5-point Likert scale in order to measure attitude. The data was captured (3 questionnaire were excluded due to being incorrectly filled in) and the computer software package STATISTICA@ Release 6, which was used to perform the statistical analysis. The data was data was weighted to represent the total metropolitan population prior to analysis. Quantitative data was statistically analysed in order to generate relevant descriptive statistics, cross tabulations and statistical tests. Results The study considered four variables; gender, race (Black, White, Coloured, Indian), age (16-29, 30-44,45+) and living standards measure (LSM 2-3, LSM 4-6, LSM 7-10), to explored four statements: 1. I believe food can have an effect on my health 2. 1 always look for health information contained on the packaging of food products 3. 1 don't take any notice of health information as it is only marketing hype 4. 1 buy food that claims to contribute to my health. The overall response to the belief that food can have an effect on health was positive (54%). There was no practical significant difference between age groups and genders but there were practical significant differences between Blacks and the other race groups (Blacks having the lowest belief in the food and health link) and between the highest LSM group and the other LSM groups (LSM 7-1 0 had the strongest belief in the link between food and health and this belief decreased with decreasing LSM). Forty-two percent of respondents always look for health information on the packaging of food, but there was no practical significant difference between all the variables, however women were more likely than men to always look for health information on food packaging. Over half the respondents (51%) stated that they look for health information and that it is not only marketing hype. There was a small practical significant difference between the top and the bottom LSM group with LSM 7-10 being less sceptical about the health information on food packaging. 67% buy foods that claim to beneffi their health and there was a small practical significant difference between Blacks and Whites, with more Blacks agreeing that they buy foods that claim to contribute to health. CONCLUSION Findings from this study indicate that adult metropolitan South Africans label reading practices are influenced by a number of factors including attitudes, beliefs and practices and that there are differences based on gender, race, age and LSM which must be considered by regulators in drafting food labelling regulations; the food industry when considering and developing functional foods; and nutrition experts when planning education strategies. Whilst the labelling of foods with health information and the development of function foods might indeed potentially empower consumers to effectively reduce their risk of many chronic diseases, on its own it is not enough. Nutrition education is vital and must be planned giving due consideration to the differences in belief and practices that exist within the different gender, race, age and LSM groups found in South Africa. Food consumption patterns are influenced by consumer attitudes, beliefs, needs, lifestyles and social trends and so more multi-disciplinary research in these fields must be encouraged to find ways to improve nutritional intakes that will lead to improved health for all South Africans. / Thesis (M.Sc. (Dietetics))--North-West University, Potchefstroom Campus, 2005.

Vaccination, one of public health’s greatest disease prevention tools, is broadening to focus on adolescents. Now that there are more vaccines targeted specifically for adolescents, it is time to give more focus to vaccine delivery in this population. This research will increase the knowledge base to support informed changes in adolescent vaccine delivery by identifying knowledge and attitudes of adolescents toward vaccination within the context of barriers and solutions. Perceived susceptibility to disease, benefits and barriers to vaccination and other constructs were collected through a survey to 1368 high school students. In this population, a scheduled adolescent healthcare visit is feasible, vaccine education can diminishes health misconceptions, and vaccination mandates are ways to reach some students.

We examined the spatiotemporal dynamics underlying the processing of a false belief task using magnetoencephalography (MEG). Twenty adults performed a false belief task adapted for MEG. Regions of interest were selected based on source analyses on the contrast between false and true belief, and MEG source time-course reconstructions were generated and analyzed to determine the temporal architecture of neural activations specific to false belief reasoning. We found frontal, temporal and parietal regions to activate during false belief processing, confirming prior findings. We also extend previous findings by adding information about the temporal profile of neural activity during theory of mind processing, an area lacking in the literature. We found that increased frontal activity began at 100 ms bilaterally, followed by parietal regions from 200 to 330 ms and temporal regions at 350 ms, at which point frontal activity became lateralized to the right hemisphere.