The purpose of my dissertation is to further our understanding of why some states restricted immigrant access to welfare in the 1990s while other states granted immigrants access to social programs. With the passage of the Personal Responsibility Work Opportunity Reconciliation Act (PRWORA), many states diverged from equal access to welfare programs, such as Temporary Assistance to Needy Families (TANF), for immigrants arriving after 1996. Very little scholarly work examines the variance in immigrants’ access to welfare programs. Current research studying welfare attitudes and policy has largely failed to investigate whether and how the influx of immigrants over the last three to four decades has decreased public support for welfare programs and resulted in policies that both decrease benefit levels and restrict access to programs based on citizenship. This is a serious shortcoming because immigration since the 1970s represents the largest population shift since the early 20th century, a change that has increased the size of the underclass and transformed the cultural and racial makeup of theUnited States. Accordingly, in my dissertation, I will examine how changes to the American political environment, immigration levels and the increasing number of immigration media stories, trigger authoritarian attitudes that in turn form a breeding ground supporting restrictive welfare programs. The results from the individual-level analysis provide strong evidence that authoritarians prefer less welfare spending, fewer immigrants, and a waiting period before immigrants can access welfare programs. In addition, authoritarians view immigrants as a threat due to their perceived failure to socially conform to American society. Building on these individual-level results, I find that states with large authoritarian populations are more likely to adopt restrictive welfare policies.

Hemodializuojamų ligonių skaičius pasaulyje kasmet auga, dializuojama vis daugiau vyresnio amžiaus ligonių, turinčių sunkią gretutinę patologiją. Todėl tenka dažniau juos stacionarizuoti, didėja finansinė šių ligonių gydymo našta visuomenei. Daugelis pasaulyje atliekamų hemodializuojamų ligonių stacionarizavimą vertinančių tyrimų apima atskiras būkles, kaip anemijos, kaulų ir mineralų metabolizmo sutrikimų reikšmę, gretutines ligas ir kitus veiksnius. Mes savo tyrime sujungėme dažniausias hemodializuojamiems ligoniams aprašomas komplikacijas, kad įvertintume bendrą suminę jų reikšmę stacionarizavimui. Tai pirmasis tyrimas, nagrinėjantis Lietuvos hemodializuojamų ligonių stacionarizavimo priežastis ir sąlygojančius veiksnius. Taip pat pirmą kartą nustatytos Lietuvos hemodializuojamų ligonių gydymo išlaidos. Perspektyvusis tyrimas atliktas Kauno Medicinos universiteto Nefrologijos klinikoje. Į tyrimą įtraukti visi galutinės stadijos inkstų nepakankamumu sergantys ligoniai, kurie buvo hemodializuoti visuose Kauno krašto hemodializės centruose 5 metų laikotarpiu (2002-2006 metais). Nustatėme, kad hospitalizavimui svarbūs tiek demografiniai veiksniai, tiek gretutinės ligos, tiek kai kurių laboratorinių rodiklių pokyčiai, tiek ir režimo pažeidimai. / Increasing numbers of hemodialysis patients is influenced by growing life expectancy. increasing burden of diabetes and hypertension. Dialysis population becomes older with heavy comorbidities and high risk for hospitalization. Treatment of those patients is a big financial burden for society. So it is necessary to evaluate the predisposing factors for hospitalization and to assess possibilities of ambulatory treatment optimization and reduction of hospitalization rates in hemodialysis patients. Most of the studies in hemodialysis patients investigate hospitalization risk according to separate conditions, like influence of anemia, bone-mineral metabolism, comorbidities and other factors. In our study we tested together most common complications of end stage renal disease in order to evaluate a combined value of various different factors on hospitalization risk and to discriminate the most important ones. This is the first study which examined hospitalizations rates and factors related to hospitalization in Lithuanian hemodialysis population. Also for the first time treatment expenditures of Lithuanian hemodialysis patients were estimated. Prospective study was performed in the Nephrology department of Kaunas University of Medicine. We enrolled all end stage renal disease patients dialysed in the years 2002-2006 in all centers in Kaunas region. In order to reduce hospitalization risk, a contribution of the doctor and the patient is needed as both treatment failure and... [to full text]

Necrotic enteritis (NE), a devastating enteric disease caused by Clostridium perfringens type A, contributes to the losses of 6 billion dollars worldwide per year and is currently being considered as a major global threat to the poultry industry. In past decades, it has been well-controlled by ineed antimicrobial growth promoters (AGPs). The withdrawal of AGPs due to antibiotic-resistance concerns resulted in a spike in NE incidence and led to the re-emergence of NE in the modern broiler production system. To unveil the association of toxin genes of C. perfringens, particularly for netB, with clinical NE, a self-designed qPCR primer set targeting netB was developed to qualify and quantify netB in NE-producing and non-NE-producing isolates. The netB was demonstrated to exist in the majority of C. perfringens type A isolates. The presence and the amount of netB were not significantly different between two types of isolate, indicating that those indicators are insufficient to predict an association with the pathogenicity of NE. The virulence of netB is suggested to be expressed or triggered under certain conditions, further promoting NE. A side by side trial was implemented with different combinations of netB-positive C. perfringens (CP1) and two predisposing factors to assess their role in NE development. Both CP1 and predisposing factor(s) are required for consistent NE reproduction, and particularly, Eimeria exerts significant effects on NE induction. The use of CP1 without a predisposing factor failed to induce NE. The severity and incidence of NE were positively correlated with the number of predisposing factors given in the NE induction. Analyzing gut microbiota in chickens challenged with CP1 and/or Eimeria by metagenomic sequencing, significant overgrowth of Clostridium sensu stricto 1, the genus contains C. perfringens, was associated with NE. Eimeria infection precedent to CP1 challenge had a synergistic effect on the overrepresentation. In addition to C. perfringens, the other member under Clostridium sensu stricto 1 was found to participate in NE development. Given supplementary dose of 0.4 kg/ton in feed, lauric acid neither exerted the inhibitory effect against proliferation of Clostridium sensu stricto 1 and C. perfringens nor reduced the incidence and severity of NE.

As mamites ou mastites, processos inflamatórios da glândula mamária, foram consideradas responsáveis por grandes prejuízos na pecuária leiteira; para a instalação das mamites considerou-se ser necessária a interação de dois fatores etiológicos fundamentais. Os fatores etiológicos predisponentes a instalação de um processo inflamatório da glândula mamária podem ser divididos em: condições ligadas à fisiologia dessa glândula (descida do leite, aumento do volume de leite residual e velocidade de ordenha); condições relacionada à estrutura anatômica do úbere e favorecendo a ocorrência de traumatismos (alterações morfológicas da mama, incluindo os tetos, edema e congestão mamária) e associação a condições predisponentes ligados a enfermidades sistêmicas ou da própria mama (afecções, infestações e infecções). A perfeita descida do leite permite uma adequada ordenha da vaca, restando nestas circunstâncias apenas um pequeno volume de secreção láctea nas cisternas da glândula e no sistema de ductos galactóforos, favorecendo a higidez do órgão. A retenção de maior volume de leite nos ductos e ácinos glandulares foram consideradas por si só indutora de inflamação do tecido epitelial de revestimento interno da mama, sendo por isso considerado significativo fator predisponente à colonização e desenvolvimento de infecções bacterianas intramamárias. Objetivou-se avaliar a influência da retenção láctea nos constituintes físico-químicos, bioquímicos, celulares e microbiológicos da secreção da glândula mamária de bovinos. As vacas utilizadas nesta pesquisa foram selecionadas em um rebanho criado e mantido no Estado de São Paulo (Natividade da Serra), produtor de leite e cujo manejo leiteiro utiliza o sistema manual de ordenha, com duas ordenhas diárias. As vacas selecionadas permitiram a formação de três grupos experimentais seguir: Grupo Experimental - G1, vacas submetidas a 10% de retenção de leite; Grupo Experimental - G2, vacas submetidas a 15% de retenção de leite e Grupo Experimental - G3, vacas submetidas a 20% de retenção de leite. Os parâmetros lácteos estudados foram as determinações físico-químicas (pH, eletrocondutividade, concentração de cloretos e calculo do índice cloreto/lactose); dosagens bioquímicas do leite (teores de gordura, proteína, lactose e sólidos totais); caracterização das células somáticas (avaliação indireta do número de células e contagem eletrônica dessas células) e; avaliação microbiológica das amostras de leite. A análise dos resultados obtidos permitiu concluir que: a retenção láctea determinou variações significativas na constituição físico-químicas, bioquímicas e microbiológica do leite; os valores da eletrocondutividade, das concentrações lácteas de cloreto, do índice cloreto/lactose e a freqüência de isolamentos bacteriológicos positivos aumentaram significativamente com o aumento do período de retenção; em contraposição os teores lácteos de lactose diminuíram; os valores dos teores de cloreto e índice cloreto/lactose aumentaram de forma diretamente proporcional ao aumento do volume da retenção láctea, os demais parâmetros foram influenciados pela retenção, independentemente do volume de leite retido; o número de células somáticas do leite não sofreu variações que pudessem ser atribuídas à retenção láctea; porém a avaliação qualitativa da celularidade determinada pelo CMT demonstrou que a retenção láctea determinava o aparecimento de escores de maior magnitude, retornando aos escores iniciais negativos após a supressão da retenção; a retenção láctea, independentemente do seu volume, determinou aumento marcante da freqüência de isolamentos bacteriológicos positivos, e em muitos casos, o isolamento ocorria, também, após a supressão da retenção láctea; comprovou-se a existência de correlação positiva e significante entre as seguintes variáveis estudadas: teor de cloreto e eletrocondutividade; índice cloreto/lactose e teor de cloreto; índice cloreto/lactose e eletrocondutividade e; concentração de sólidos totais e de gordura. A correlação foi negativa e significante entre: teor de lactose e eletrocondutividade e concentração de lactose e cloreto; as manifestações clínicas da retenção láctea, detectadas pela determinação de alterações dos elementos constituintes do leite e a freqüência de isolamentos, caracterizou um processo inflamatório incipiente, representando um fator etiológico predisponente à ocorrência de mamites; pelo desempenho das provas utilizadas para a avaliação dos efeitos da retenção láctea na secreção da glândula mamária, recomendou-se para complementação do exame físico da mama a realização dos seguintes exames subsidiando o diagnóstico clínico: prova do CMT, determinações da eletrocondutividade, dos teores de cloreto e lactose, com cálculo do índice cloreto/lactose e isolamento microbiológico com identificação das cepas bacterianas isoladas. / Mastitis, the inflammatory process of the mammary gland is responsible for great losses in dairy production. Factors that predispose the mammary gland to mastitis may be divided into: conditions connected to the physiology of milk (milk release, increase in the volume of residual milk and speed of milking); conditions related to the anatomy of the udder, favoring the occurrence of injuries (morphological changes of the udder and teats, mammary edema and congestion); association with predisposing conditions of systemic or mammary diseases (illnesses, infestation and infections). The perfect release of milk enables adequate milking of the cow. In this kind of circumstance, little residual milk is present in the cistern of the gland and in galactophorous ducts, leading to a healthy udder. Retention of greater volume in ducts and glandular acini have been considered, per se, as capable of inducing inflammation of internal epithelial tissue of the mammary gland, and because of this, retention milk is considered as a significant predisposing factor to the colonization and development of intramammary bacterial infections. The objective of the present trial was to evaluate the influence of milk retention on physical-chemical, biochemical, cellular and microbiological characteristics of bovine milk. Animals used in the present study were selected from a herd bred and kept in the state of Sao Paulo, in the city of Natividade da Serra. Cows were milked manually twice a day. Three experimental groups were formed: G1, with 10% of milk retention; G2, with 15% of milk retention and G3, with 20% of milk retention. The following physical-chemical parameters were studied (pH, electroconductivity, chloride concentration and chloride / lactose rate); biochemical analyses were: fat, protein, lactose and total solid contents; somatic cell characterization (indirect evaluation of the number of cells and electronic cell count) and microbiological evaluation of the samples. The analysis of the results enabled the following conclusions: milk retention determined significant variations in the physical-chemical, biochemical and microbiological characteristics of the milk. Electroconductivity, chloride content, chloride / lactose rate and frequency of samples positive in bacterial isolation significantly increased with greater milk retention periods. On the other hand, increase in milk retention volume led to decreased lactose content and increased chloride content and chloride / lactose rate. The rest of the parameters were influenced by retention, no matter the volume of milk retained. The number of somatic cells in milk was not affected in a way that changes could be attributed to milk retention. However, the qualitative evaluation of cells as determined by CMT demonstrated that milk retention determined greater scores, and initial negative scores were obtained with the suppression of retention. Milk retention, no matter the volume, determined a marked increased in the frequency of positive bacterial isolation, and in many cases, isolation also occurred after retention was suppressed. There was a positive and significant correlation between the following variables: chloride content and electroconductivity; chloride / lactose rate and chloride content; chloride / lactose rate and electroconductivity; total solid and fat content. Negative significant correlations were observed between lactose content and electroconductivity; and lactose and chloride contents. Clinical signs of milk retention as detected by changes in milk constituents and frequency of isolation demonstrated an incipient inflammatory process, and milk retention was then considered to be a predisposing etiological factor to the occurrence of mastitis. Due to the performance of the tests used in the evaluation of the effects of milk retention in the mammary gland, it is recommended that in order to aid clinical diagnosis, physical examination of the udders should be performed together with CMT, electroconductivity, chloride and lactose contents, calculation of chloride / lactose rate and microbiological examination with identification of strains isolated.

A retrospective study of invasive pneumococcal disease in patients from Greater Göteborg in 1964- 1980 identified 125 cases of meningitis, 305 of pneumonia, 61 of septicemia with unknown focus, and 17 with other manifestations, all verified by cultures from normally sterile body fluids. The incidence was several times higher in infants and in the elderly than in any other age-group. A wide variety of underlying conditions were present in 23% of the infants, 34% of the children, and 81% of the adults. In adults alcoholism was known in one third of the cases. The case fatality rate was 24% among patients with underlying conditions and 9% among previously healthy individuals. The case fatality rate was 50% in patients with hospital-acquired infection. Twohundred-fifteen pneumococcal strains, isolated from blood or CSF from 1971 to 1983 at the laboratories of clinical bacteriology of Göteborg, Malmö, and Umeå were serotyped by coagglutination (COA). Of all isolates, 89% belonged to serotypes represented in the 23-valent vaccine. In a separate study COA was compared with counterimmunoelectrophoresis (CIE). COA was found to have several advantages; rapidity, lower cost, and ability to disclose serotypes with neutral charge, which constituted 19% of all strains. In a prospective study the etiology was determined in 196 hospitalized patients with pneumonia, most of them community-acquired. Culture of specimens from blood, transtracheal aspirate (TTA), sputum, and nasopharynx, assays of antigen in sputum, urine, and TTA, and assays of pneumococcal antibodies to capsular polysaccharide, C-polysaccharide, and pneumolysin in paired sera were performed. The etiology was established in 64% of the patients. Streptococcus pneumoniae was the most common agent (32%). In a serological study of patients with pneumococcal infection, diagnosed by culture of CSF, TTA, or blood, IgG antibodies against C-polysaccharide and pneumolysin were determined by ELISA. The diagnostic sensitivity was only 51% and 60%, respectively. In conclusion, invasive pneumococcal disease is strongly overrepresented at tender and high age and in patients with concomitant conditions, notably alcoholism. S. pneumoniae remains a predominant causative agent of community-acquired pneumonia in adults needing hospitalization. Due to the low sensitivity and/or specificity of individual microbiological techniques, a combined use of several techniques is necessary when trying to assess the relative importance of pneumococci and other agents in pneumonia. Extended use of the currently available pneumococcal vaccine and development of improved pneumococcal vaccines seem highly warranted. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1993, härtill 5 uppsatser.</p> / digitalisering@umu.se

As mamites ou mastites, processos inflamatórios da glândula mamária, foram consideradas responsáveis por grandes prejuízos na pecuária leiteira; para a instalação das mamites considerou-se ser necessária a interação de dois fatores etiológicos fundamentais. Os fatores etiológicos predisponentes a instalação de um processo inflamatório da glândula mamária podem ser divididos em: condições ligadas à fisiologia dessa glândula (descida do leite, aumento do volume de leite residual e velocidade de ordenha); condições relacionada à estrutura anatômica do úbere e favorecendo a ocorrência de traumatismos (alterações morfológicas da mama, incluindo os tetos, edema e congestão mamária) e associação a condições predisponentes ligados a enfermidades sistêmicas ou da própria mama (afecções, infestações e infecções). A perfeita descida do leite permite uma adequada ordenha da vaca, restando nestas circunstâncias apenas um pequeno volume de secreção láctea nas cisternas da glândula e no sistema de ductos galactóforos, favorecendo a higidez do órgão. A retenção de maior volume de leite nos ductos e ácinos glandulares foram consideradas por si só indutora de inflamação do tecido epitelial de revestimento interno da mama, sendo por isso considerado significativo fator predisponente à colonização e desenvolvimento de infecções bacterianas intramamárias. Objetivou-se avaliar a influência da retenção láctea nos constituintes físico-químicos, bioquímicos, celulares e microbiológicos da secreção da glândula mamária de bovinos. As vacas utilizadas nesta pesquisa foram selecionadas em um rebanho criado e mantido no Estado de São Paulo (Natividade da Serra), produtor de leite e cujo manejo leiteiro utiliza o sistema manual de ordenha, com duas ordenhas diárias. As vacas selecionadas permitiram a formação de três grupos experimentais seguir: Grupo Experimental - G1, vacas submetidas a 10% de retenção de leite; Grupo Experimental - G2, vacas submetidas a 15% de retenção de leite e Grupo Experimental - G3, vacas submetidas a 20% de retenção de leite. Os parâmetros lácteos estudados foram as determinações físico-químicas (pH, eletrocondutividade, concentração de cloretos e calculo do índice cloreto/lactose); dosagens bioquímicas do leite (teores de gordura, proteína, lactose e sólidos totais); caracterização das células somáticas (avaliação indireta do número de células e contagem eletrônica dessas células) e; avaliação microbiológica das amostras de leite. A análise dos resultados obtidos permitiu concluir que: a retenção láctea determinou variações significativas na constituição físico-químicas, bioquímicas e microbiológica do leite; os valores da eletrocondutividade, das concentrações lácteas de cloreto, do índice cloreto/lactose e a freqüência de isolamentos bacteriológicos positivos aumentaram significativamente com o aumento do período de retenção; em contraposição os teores lácteos de lactose diminuíram; os valores dos teores de cloreto e índice cloreto/lactose aumentaram de forma diretamente proporcional ao aumento do volume da retenção láctea, os demais parâmetros foram influenciados pela retenção, independentemente do volume de leite retido; o número de células somáticas do leite não sofreu variações que pudessem ser atribuídas à retenção láctea; porém a avaliação qualitativa da celularidade determinada pelo CMT demonstrou que a retenção láctea determinava o aparecimento de escores de maior magnitude, retornando aos escores iniciais negativos após a supressão da retenção; a retenção láctea, independentemente do seu volume, determinou aumento marcante da freqüência de isolamentos bacteriológicos positivos, e em muitos casos, o isolamento ocorria, também, após a supressão da retenção láctea; comprovou-se a existência de correlação positiva e significante entre as seguintes variáveis estudadas: teor de cloreto e eletrocondutividade; índice cloreto/lactose e teor de cloreto; índice cloreto/lactose e eletrocondutividade e; concentração de sólidos totais e de gordura. A correlação foi negativa e significante entre: teor de lactose e eletrocondutividade e concentração de lactose e cloreto; as manifestações clínicas da retenção láctea, detectadas pela determinação de alterações dos elementos constituintes do leite e a freqüência de isolamentos, caracterizou um processo inflamatório incipiente, representando um fator etiológico predisponente à ocorrência de mamites; pelo desempenho das provas utilizadas para a avaliação dos efeitos da retenção láctea na secreção da glândula mamária, recomendou-se para complementação do exame físico da mama a realização dos seguintes exames subsidiando o diagnóstico clínico: prova do CMT, determinações da eletrocondutividade, dos teores de cloreto e lactose, com cálculo do índice cloreto/lactose e isolamento microbiológico com identificação das cepas bacterianas isoladas. / Mastitis, the inflammatory process of the mammary gland is responsible for great losses in dairy production. Factors that predispose the mammary gland to mastitis may be divided into: conditions connected to the physiology of milk (milk release, increase in the volume of residual milk and speed of milking); conditions related to the anatomy of the udder, favoring the occurrence of injuries (morphological changes of the udder and teats, mammary edema and congestion); association with predisposing conditions of systemic or mammary diseases (illnesses, infestation and infections). The perfect release of milk enables adequate milking of the cow. In this kind of circumstance, little residual milk is present in the cistern of the gland and in galactophorous ducts, leading to a healthy udder. Retention of greater volume in ducts and glandular acini have been considered, per se, as capable of inducing inflammation of internal epithelial tissue of the mammary gland, and because of this, retention milk is considered as a significant predisposing factor to the colonization and development of intramammary bacterial infections. The objective of the present trial was to evaluate the influence of milk retention on physical-chemical, biochemical, cellular and microbiological characteristics of bovine milk. Animals used in the present study were selected from a herd bred and kept in the state of Sao Paulo, in the city of Natividade da Serra. Cows were milked manually twice a day. Three experimental groups were formed: G1, with 10% of milk retention; G2, with 15% of milk retention and G3, with 20% of milk retention. The following physical-chemical parameters were studied (pH, electroconductivity, chloride concentration and chloride / lactose rate); biochemical analyses were: fat, protein, lactose and total solid contents; somatic cell characterization (indirect evaluation of the number of cells and electronic cell count) and microbiological evaluation of the samples. The analysis of the results enabled the following conclusions: milk retention determined significant variations in the physical-chemical, biochemical and microbiological characteristics of the milk. Electroconductivity, chloride content, chloride / lactose rate and frequency of samples positive in bacterial isolation significantly increased with greater milk retention periods. On the other hand, increase in milk retention volume led to decreased lactose content and increased chloride content and chloride / lactose rate. The rest of the parameters were influenced by retention, no matter the volume of milk retained. The number of somatic cells in milk was not affected in a way that changes could be attributed to milk retention. However, the qualitative evaluation of cells as determined by CMT demonstrated that milk retention determined greater scores, and initial negative scores were obtained with the suppression of retention. Milk retention, no matter the volume, determined a marked increased in the frequency of positive bacterial isolation, and in many cases, isolation also occurred after retention was suppressed. There was a positive and significant correlation between the following variables: chloride content and electroconductivity; chloride / lactose rate and chloride content; chloride / lactose rate and electroconductivity; total solid and fat content. Negative significant correlations were observed between lactose content and electroconductivity; and lactose and chloride contents. Clinical signs of milk retention as detected by changes in milk constituents and frequency of isolation demonstrated an incipient inflammatory process, and milk retention was then considered to be a predisposing etiological factor to the occurrence of mastitis. Due to the performance of the tests used in the evaluation of the effects of milk retention in the mammary gland, it is recommended that in order to aid clinical diagnosis, physical examination of the udders should be performed together with CMT, electroconductivity, chloride and lactose contents, calculation of chloride / lactose rate and microbiological examination with identification of strains isolated.

Background: The aim of this study was to explore the experience and sense making oftherapists working with clients who present with a PTSD diagnosis. The study engaged with therapists experience and understanding of predisposing factors to PTSD and how they incorporate this understanding into the therapy process. Further to this the experience of the therapists understanding of the influence of predisposing factors on the expression of PTSD was explored. Literature Review: A literature review is presented identifying core research relating to PTSD, predisposing factors to the development of PTSD and the treatments used when working with PTSD as a presenting issue. Methodology: To address the aims of the study 9 therapist participants were interviewed. Semi-structured, one to one, in-depth interviews were utilised to elicit participant’s experience of the issues outlined within the aims. Interpretative Phenomenological Analysis (IPA) was used to identify re-current themes across the interviews and analyse the data, which emerged. Findings: The main findings present thirteen sub-ordinate themes that reflect the essence of the participant’s experience of the phenomenon under investigation. These were based around eight Super-ordinate (master) themes of Previous history, Therapy relationship, Psychoeducation and Normalisation, Identity, Culture, Attachment, Presenting Therapy Themes, and Support Systems. Discussion and Conclusion: The study identified the participant’s experience of predisposing factors on the expression of PTSD. There was consensus from the participant’s in relation to the significant impact of client’s previous life experience on their expression of PTSD. The participants further identified that the client’s previous life experience influenced their formulation and treatment of PTSD. Significant issues that were described by all of the participants regardless of their theoretical or therapeutic perspective were (1) the central importance of the therapeutic relationship, (without a strong, trusting and safe relationship the participants would not engage the therapy work), (2) the importance of in-depth history taking (identification of previous life experience and its impact on the current response to the trauma), (3) the impact of previous trauma(s), and (4) the impact of support systems, environment and identity. These issues are discussed alongside the existing literature around this topic. Additionally, suggestions for future directions of research and recommendations for practice are presented.

<p>Using the literature on Baumrind&rsquo / s theory of Parenting Styles and how perceptions of these are associated to adolescent at-risk behaviour, this study set out to examine whether any parenting style increased or decreased adolescent substance use. The central aim of this study was to examine the association between perceived parenting styles and adolescent substance use. To further this, 239 grade 10 and 11 adolescent participants were drawn from 3 schools in Mitchell&rsquo / s Plain, a suburb in the Western Cape (with permission granted from the Education Department). This particular suburb was chosen due to the high rates of substance use and substance related crime within the area. A quantitative research design was implemented within this study. The participants were required to complete the Drug Use Disorders Identification Test (DUDIT), a questionnaire aimed at measuring drug use, and the Parental Authority Questionnaire (PAQ), aimed at measuring perceived parenting styles and a Biographical Questionnaire to provide additional information. Informed consent was obtained and the confidentiality of the schools and participants were protected. Data analysis was conducted using SPSS, a data analysis programme available at the University of the Western Cape. Results show that substance use reduction was significantly related to a perceived authoritative parenting style. However, no significant relationships could be found between perceived permissive and authoritarian parenting style. Significant difference was found in the results obtained for male and female adolescents, with males generally appearing to use more substances. It can be concluded that perceived authoritative parenting styles have an important role to play in the prevention of adolescent substance abuse</p>

Handwashing is a well known practice to prevent the hospital-acquired infections, and it is also a basic procedure of the nosocomial infection control programs. This research is conducted to use PRECEDE model to investigate the factors affecting nurses¡¦ performance in handwashing practices. We conducted a cross-sectional study to investigate 212 nurses working patients` heaithcare from a medical center of north Taiwan, and a quota sampling method was used to analyze nurses¡¦ handwashing practices. The results of this research includes (1) the major causes affect nursing staffs¡¦ performance in handwashing practices include attitudes (enthusiastic and passive), encouragements from colleagues, and feedback of the nosocomial infection rate or density. (2) different perfessional department and different ward type also affect the performance of nurses¡¦ handwashing practices. (3) nurses washed their hands often after contacting patients¡¦ body substances, and they usually forget to wash their hands after checking patients¡¦ medicine charts. (4) seif-reported factors for poor adherence with handwashing are heavy work loading and taking patients¡¦ needs priority. The suggestions of this research are (1) providing nurses the routine feedback information regarding the changes in nosocomial infection rate versus their performance in handwashing practices. (2) making nursing supervisors and their colleagues to understand the importance of handwashing practice as well as encouragement, reminding, and supporting. (3) the above two suggestions should be executed continually. From the positive feedback, it shall enhance nursing staffs` attitudes to improve their handwashing practices, and then, nursing staffs will be willing to keep excellent performance in handwashing practices.

<p>Using the literature on Baumrind&rsquo / s theory of Parenting Styles and how perceptions of these are associated to adolescent at-risk behaviour, this study set out to examine whether any parenting style increased or decreased adolescent substance use. The central aim of this study was to examine the association between perceived parenting styles and adolescent substance use. To further this, 239 grade 10 and 11 adolescent participants were drawn from 3 schools in Mitchell&rsquo / s Plain, a suburb in the Western Cape (with permission granted from the Education Department). This particular suburb was chosen due to the high rates of substance use and substance related crime within the area. A quantitative research design was implemented within this study. The participants were required to complete the Drug Use Disorders Identification Test (DUDIT), a questionnaire aimed at measuring drug use, and the Parental Authority Questionnaire (PAQ), aimed at measuring perceived parenting styles and a Biographical Questionnaire to provide additional information. Informed consent was obtained and the confidentiality of the schools and participants were protected. Data analysis was conducted using SPSS, a data analysis programme available at the University of the Western Cape. Results show that substance use reduction was significantly related to a perceived authoritative parenting style. However, no significant relationships could be found between perceived permissive and authoritarian parenting style. Significant difference was found in the results obtained for male and female adolescents, with males generally appearing to use more substances. It can be concluded that perceived authoritative parenting styles have an important role to play in the prevention of adolescent substance abuse</p>