The purpose of this study was to examine social workers’ perspectives on the risk factors that are associated with cases of removal of infants. A quantitative survey design was utilized, using self-administered questionnaires that were distributed electronically to social workers located in San Bernardino County. The sample consisted of 94 participants, and the majority of the participants were White, non-Hispanic females. The study found that social workers identified substance abuse, the lack of infant’s physical safety in the home along with the age of the infant, and the lack of parents’ readiness to take part of the safety plan as highest risk factors for the removal of infants. Lastly, a surprising finding in this study was that a child’s ethnicity was indicated as a risk factor that increases the possibility of infant removal. It is recommended that social workers continue to receive trainings and other educational opportunities to enhance the social workers’ knowledge, values, and practice skills, to ensure the safety and well-being of all children.

In the United States, congestive heart failure (CHF) is a cardiac condition with increasing hospitalization and rehospitalization burden to patients, families, and the healthcare system. This chronic condition is expected to affect more than 8 million people by 2030; however, not much is known about the relationship between risk factors and hospital readmissions once CHF patients are discharged to a skilled nursing facility (SNF). Applying a systems theory unbounded systems thinking, coupled with a systems-thinking approach the purpose of this quantitative, retrospective cohort study was to examine CHF hospital readmissions from SNFs within a 90-day period using a secondary data set of gender, age, race, SNF geographic location, length of SNF stay, and home health use risk factors. A binary logistic regression analysis revealed that out of 238 episodes, 99 patients were readmitted; however, no statistically significant relationship between the risk factors and readmission was found. Findings suggest that CHF readmissions from the SNF are not attributed to only quantifiable risk factors. Based on these findings, further research can support social change through multifaceted quantitative and qualitative systemic analyses to identify and inform how healthcare organizations can better assist the elderly population with CHF and improve future post-acute community-based health education and prevention programs.

Acute bacterial skin and skin structure infections (ABSSSI) are common infections within the local community, and they result in higher morbidity and health care costs. While risk factors for skin and soft tissue infections have been previously evaluated, risk factors associated with secondary bloodstream infections (BSI) has not been investigated, especially in an intercity patient population with limited health care resources. In this case control investigation, 392 patients consisting of 196 cases (ABSSSI + BSI) and 196 controls (ABSSSI) were investigated to determine risk for BSI. Both sociodemographic and underlying conditions were evaluated. According to bivariate analysis of cases and controls, individuals with ABSSSI + BSI were significantly older (p < 0.001), more often male (p = 0.008), and had a higher percentage of abnormal symptoms, such as elevated temperature, white blood cell count, and acute renal failure on hospital admission (p < 0.001). Individuals with ABSSSI + BSI also had a higher percentage of chronic renal failure (p = 0.002), diabetes (p = 0.005), congestive heart failure (p = 0.012), intravenous drug use (p =0.012), and a history of prior hospitalization (p < 0.001). Several of these factors remained statistically significant by logistic regression analysis, such as male gender aOR of 1.85, 95% CI 1.11-3.66; acute renal failure aOR 2.08, 95% CI 1.18-3.67; intravenous drug use aOR 4.38, 2.22-8.62; and prior hospitalization aOR 2.41, 95% CI 1.24-4.93. This study contributes to positive social change by identifying patient characteristics that are associated with ABSSSI-related BSI, thus providing health care providers the ability to improve patient outcomes in this underserved patient population.

The purpose of this quantitative study was to examine possible risk factors that predict asthma among adult, foreign-born African Americans in California. A total of 794 foreign-born African Americans (87 asthma cases) were included from the 2017-2018 California Health Interview Survey database. Data analysis included both descriptive and inferential statistical methods including chi-square analysis and multiple logistic regression techniques. The socioeclogical model was used to help understand and interpret the findings. The dependent variable was asthma status and the independent variables were the risk factors (tobacco smoking, alcohol use, health insurance, income level, and education level). Confounders included in the analysis were age, gender, and marital status. Findings yielded no statistically significant relationship between asthma status and tobacco smoking (p = 0.19, x2 = 1.74, OR = 0.59, 95% CI = 0.27-1.30), alcohol use (p = 0.92, x2 = 0.01, OR = 0.98, 95% CI = 0.61-1.58), health insurance (p = 0.63, x2 = 0.23, OR = 0.85, 95% CI = 0.44-1.65), income level (p = 0.99, x2 = 0.00, OR = 0.99, 95% CI = 0.44-2.24), or education level (p = 0.47, x2 = 0.52, OR = 1.51, 95% CI = 0.49-4.59). Although this study did not find significant associations between asthma and study variables, study limitations, mainly the small sample size, may have prevented the detection of small associations. Future research should involve a larger sample size to investigate whether the findings reported remain true. This study is a step in the exploration of the problem and has the potential to promote positive social change by increasing asthma awareness among foreign-born African Americans in California and among public health policy makers.

Autism spectrum disorders (ASD) constitute life-long neurodevelopmental conditions. Globally, ASD risk for males remains 2 to 4 times greater than for females. Critical exposure mechanisms, their timing on ASD risk, and associations with the ASD gender differential remain elusive. The purpose of this study was to describe the relationship between preconception, pregnancy, recalled lactation practice, and infant traits, on ASD risk and the gender differential of ASD. A recently published temporal framework was adapted to study effects of maternal smoking and vitamin use, and recalled lactation practice on offspring ASD diagnosis with adjustment for preconception health and infant breathing traits. A retrospective case-control analysis using 733 child data records from U.S. autism registry characterized child gender-stratified relationships of 9 study variables. Logistic regression results showed prior maternal smoking, male gender, and maternal recollection of lactation practices were associated with offspring ASD diagnosis. Exposure factors associated with ASD did not differ by child gender or maternal vitamin use. Infant respiratory distress at birth was a covariate and collinearly related to obstetric risks. Maternal smoking was antecedent to respiratory distress and lactation practice. Study limitations included incomplete responses without repeated measures for recalled lactation practice and maternal diet variables. The implications for positive social change include a better understanding of reproductive, preconception, and prenatal risk factors of ASD. The study results have implications for reproductive health, smoking cessation programs, family planning, and prenatal care for women of reproductive age.

Research shows that risk factors may be useful clues for predicting students' potential for engaging in weapon-carrying behavior. Law makers on every level-federal, state, and local- deem the presence of weapons on school grounds to be a serious problem and a violation of school policy. A large, urban school system has put forth sustained and costly efforts to prevent students from carrying weapons to school; yet students continue to carry weapons to school in this district. The purpose of this study was to use archival data collected as part of the school system's everyday practice to identify risk factors for students carrying weapons to school. Bandura's social learning theory guided this quantitative ex-post facto study. Six risk factors related to students' weapon-carrying behavior were examined: gender, prior fights, suspensions, race, academic achievement, and time of school day/year. Risk factors were compared for identified weapon carriers (n = 605) and non-weapon carriers (n = 605) using chi-square tests and a logistic regression analysis. Results showed that gender, prior fights, suspensions, and race were significant risk factors for weapon carrying. Students in this district who received 5-14 suspensions had a 1 in 4 chance of being a weapon carrier. Males as well as Black students and White students were 3 times more likely to carry a weapon to school. A pattern of fighting also correlated with an increased incidence of carrying a weapon to school. These data may help this school district and other school districts like it to provide better prevention strategies and enhance policy decisions by identifying students who are at high risk of carrying a weapon on school grounds.

Thesis (PhD. (Agricultural economics)) --University of Limpopo, 2013 / Declining rural livelihood and coping strategies in the Caprivi region have for some time been blamed on climate risk factors alone. Prominent climate risk factors are drought and floods. While the indignation of many speculators about the devastating effects of climate risk factors on annual harvests may be valid, the truth is that there are now new constraints on the livelihoods of rural households. Multi-stage cluster and stratified random sampling were used in identifying respondents. Data was collected by means of face-to-face interviews with a structured questionnaire that was applied on a sample of 253 respondents. The respondents resided in three constituencies, namely Kabbe, Katima Rural and Linyanti, which are classified as floodplains. With regards to the analytical framework, the thesis used descriptive statistics, factor analysis, a logistics regression model, as well as an unconstrained multivariate regression model. The objective of the thesis is to suggest mitigating strategic policy prescriptions that will enhance the livelihoods of rural communities in the Caprivi region. The results revealed that albeit agriculture is the main livelihood strategy, it is on a declining path in the context of livestock numbers (cattle, goats and chickens) and crop harvest (maize, millet and sorghum). Of the respondents, a substantial number (31%) of rural households are headed by people who are ≥ 56 years of age. Notwithstanding the damage caused to crop fields by other factors, the main causative factor to the poor harvest in 2007 was wild animals. The biannual harvesting approach has been abandoned for a single approach owing to climate risk factors and changes in the natural environment attributed to climate change and destruction of crop field by wild animals. The average annual rainfall at Katima Mulilo is 653 mm, but volatility in annual rainfall often results in drought or floods. Malaria, Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome are to blame for reduced availability of labour to maintain livelihood activities that sustain rural households. The results further show that five factor components make rural households eligible for receiving food aid. The first is the capacity to farm, the second is climate risk awareness, the third is household economic status, the fourth is past economic opportunities, and the last factor is household labour fitness. Salient to a rural farming household’s decision to farm are three variable, namely food cost, age of the head of the household and the value of food aid. Using income as a proxy to the de factor inadvertent climate risk occurrences and damage to crops by wild animals, pension in the hands of heads of rural households, the value of livestock owned by rural households and, the value of food aid provided to rural households proved to have a significant relationship with rural household income. In order to enhance rural livelihoods in the study area, the government and development partners should work towards establishing a repository for indigenous knowledge which rural communities have employed in the past. This knowledge should be improved on in order to use it in tackling related challenges in future. There is a need to invest more in agricultural infrastructure such as water-catchment facilities and irrigation infrastructure to assist communities to embark on irrigated vegetable farming in dry seasons; establish health facilities close to rural communities that are remote; address the lack of access to finance in the study area; and as an illustration of the lack of government projects in the study area, the green scheme should be rolled out in the area. The opening up of conservancies in areas where rural communities eke out their living from the agricultural livelihood strategy has caused unintended consequences for farming rural households. Thus the policy interface gap between the opening up of community conservancies and the agricultural policy affecting the agricultural livelihood strategy need to be addressed.

Thesis (M.Dev.) --University of Limpopo, 2015 / In preparation for the launch of the Flemish Interuniversity Council-Institutional Cooperation (VLIR-IUC) in 2010, the Development Facilitation and Training Institute (DevFTI), University of Limpopo, conducted a scoping exercise with community members in villages within Dikgale in the Limpopo Province. The purpose of the exercise was to identify both the assets within the community — as well as the challenges being experienced in the area. During discussions with leaders of the Community Based Organisations (CBOs) it became apparent that mental health related issues were an emerging issue of concern — with special emphasis placed on the levels of stigma that existed towards mental illness in the area. It is against this backdrop that the researcher was motivated to conduct a study with the aim of finding out the opinions and knowledge of the lay people about mental illness in Dikgopheng community, situated within the broader Dikgale area, in Polokwane Local Municipality in the Limpopo Province. The study used a quantitative descriptive survey research design in which participants answered questions administered through questionnaires. A random sampling strategy was used to secure a representative sample size of 249 respondents out of the total population of 700. IBM’s Statistical Package for Social Sciences for Windows (SPSS version 20) was used to analyse the descriptive statistics. Inconclusive results were found about formal knowledge of the psychosocial risk factors associated with the onset of mental illness. In contradistinction, patterns of cultural associations linked to the onset of mental illness were significant. Furthermore, an overwhelming majority of the community (75.1%) of the community members were found to have ‘stigmatisation’ opinions about people with mental illness. Due to the lack of the psychosocial knowledge about risk factors and the onset of mental illness, it is recommended (i) that there is a need for education and training to raise awareness about risk factors associated with the onset of mental illness and (ii) that further qualitative research be undertaken to explore issues relating to mental illness and stigma in more depth in the area that specifically focuses on ameliorative measures that address stigma that could be implemented within the community.

acase@tulane.edu

Orientador: Eliane Chaves Jorge / Resumo: Introdução: A retinopatia da prematuridade (ROP) é uma doença vaso proliferativa multifatorial e uma das principais causas de cegueira infantil no mundo. O exame oftalmológico seriado identifica a forma grave da doença, porém pode causar estresse e instabilidade cardiorrespiratória nos neonatos prematuros. O algoritmo ROPScore, aferido na sexta semana de vida é efetivo em predizer o risco de ROP e diminuir o número de exames necessários para o diagnóstico. No entanto, nos casos em que a doença grave é precoce ou se desenvolve em neonatos mais maduros, o ROPScore seria mais efetivo se aferido antes da sexta semana de vida. Objetivo: avaliar a acurácia do ROPScore aferido na segunda semana de vida quando comparada com a da sexta semana. Métodos: Realizou-se um estudo coorte prospectivo de neonatos pré-termos com peso ao nascimento (PN) ≤1500 g e / ou idade gestacional (IG) ≤ 32 semanas. O ROPScore foi aplicado na 2ª e na 6ª semanas de vida. Curvas ROC foram utilizadas para determinar os melhores valores de sensibilidade, especificidade e seus valores preditivos positivos (VPP) e negativos (VPN) para o desenvolvimento de ROP em qualquer estágio (RQE) e ROP grave (RG). Resultados: Dos 282 RNPT, 40 (14,2%) desenvolveram ROP e 27 (9,5%) a sua forma grave. A sensibilidade do ROPScore na 2ª semana para prever ROP em qualquer estadiamento foi de 92,5% e de 92,8% na ROP grave. Na 6ª semana foi de 90% e 92,6% respectivamente. O VPN foi alto tanto na 2ª (99%) como na 6ª (98%) semanas, pa... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Background: Retinopathy of prematurity (ROP) is a multifactorial proliferative vessel disease and one of the leading causes of childhood blindness in the world. Serial ophthalmic examination identifies the severe form of the disease but may cause cardiorespiratory stress and instability in preterm infants. The ROPScore algorithm, measured in the sixth week of life, is effective in predicting ROP risk and decreasing the number of tests required for diagnosis. However, in cases where the severe disease is early or develops in more mature neonates, ROPScore would be more effective if measured before the sixth week of life. Objective: to evaluate the accuracy of ROPScore measured in the second week of life when compared to the sixth week. Methods: A prospective cohort study of preterm newborns with birth weight (BW) ≤1500 g and/or gestational age (GA) ≤ 32 weeks was performed. ROPScore was applied in the 2nd and 6th weeks of life. ROC curves were used to determine the best values of sensitivity, specificity and positive predictive values (PPV) and negative predictive value (NPV) for the development of ROP at any stage (RQE) and severe ROP (RG). Results: Of the 282 preterms, 40 (14.2%) developed ROP and 27 (9.5%) developed their severe form. The sensitivity of ROPScore at 2nd week to predict ROP at any stage was 92.5% and 92.8% at ROP. In the 6th week, it was 90% and 92.6% respectively. The NPV was high in both the second (99%) and the sixth (98%) weeks, for ROP in any stage and s... (Complete abstract click electronic access below) / Mestre