Does Pregnancy Intent Impact the Decision to Breastfeed?

Current literature overwhelmingly supports the benefits of breastfeeding for mothers and infants. Numerous studies significantly correlate specific demographics and background factors of breastfeeding and non-breastfeeding mothers. However, little research has focused on the intendedness of the pregnancy and its association with breastfeeding. The goal of this study was to examine the association between pregnancy intendedness and breastfeeding plans and behavior. The first question of interest examined was whether pregnancy intent was associated with a woman’s intent to exclusively breastfeed when asked during the third trimester, after control for potentially confounding differences between the two groups. The second question of interest was whether pregnancy intendedness predicted exclusive breastfeeding initiation after control for potentially confounding background variables. Data analysis was completed on a group of women who were part of the Tennessee Intervention for Pregnant Smokers (TIPS) program. The participants were recruited from six prenatal provider offices in Northeast Tennessee. There were 509 women who participated but only 379 women were used in this study due to lack of data on the variables of interest. The study showed that pregnancy intendedness was significantly associated with intent and initiation of breastfeeding after controlling for background factors. Women who planned their pregnancies were two thirds more likely than those who did not to indicate intent to exclusively breastfeed. Also, women who planned their pregnancies were one third more likely to initiate breastfeeding in the postpartum period than women who did not plan their pregnancies. This association is important in the clinical setting because usually women decide whether or not they will breastfeed before delivery. Therefore, healthcare providers can intervene by providing patients with education on the benefits of breastfeeding early in the prenatal period to support increased rates of breastfeeding initiation

Doctor of Philosophy

dissertationIn a society that is becoming more dynamic, complex, and diverse, the ability to solve ill-structured problems has become an increasingly critical skill. Emerging adults are at a critical life stage that is an ideal time to develop the skills needed to solve illstructured problems (ISPs) as they are transitioning to adult roles and starting to think differently about the world around them. Individuals who are exposed to immediately relevant environments, a change in cognitive equilibration, and supportive and collaborative learning environments show an improvement in ISP-solving skills. These environments can lead to an increase in creative thinking, cognitive flexibility, and tolerance for novelty, all which support ISP-solving skills. One of the places where these types of environments are found is in the Extended Wilderness Education Experience (EWEE). These experiences serve as a place for students to engage in the critical practice of solving problems and challenging assumptions and norms in a context where students and instructors are able to use one another as resources to practice problem solving. The purpose of this study was to measure the effects of an Extended Wilderness Education Experience on emerging adults' ability to solve ill-structured problems when compared to peers in a traditional classroom setting. This study looked at the students' ability to represent problems, develop and justify solutions, monitor and evaluate problem spaces and solutions, and recognize all the phases of the ill-structured problemsolving process. Students in this study were emerging adults (average age 21) who were in enrolled in either an EWEE or in a traditional classroom experience with leadershipfocused curriculums. In order to assess their development, two ill-structured scenarios were developed for students to work through and answer questions about. This study used a multivariate analysis of variance test to examine the differences in ill-structured problem-solving performance for each student between the precourse and postcourse scores. Results of this study suggested that students who were engaged in an EWEE showed significant gains in their ill-structured problem-solving skills when compared to their peers. Gains for each problem-solving skill are discussed as well as implications for outdoor education research and practice

Effect of repeated exposure to AQUI-S® on the viability and growth of Neoparamoeba perurans

Peer reviewedPublisher PD

The Health Insurance Provisions of the 2009 Congressional Health Reform Bills: Implications for Coverage, Affordability, and Costs

Analyzes the House and Senate healthcare reform bills for the number of people likely to gain coverage and the implications for federal financing, families' insurance premium and out-of-pocket costs, employers, and the potential for price competition

Starting on the Path to a High Performance Health System: Analysis of Health System Reform Provisions of Reform Bills in the House of Representatives and Senate

Compares the reform bills' reform provisions, with a focus on closing the coverage gap by creating an insurance exchange of public and private plans, strengthening Medicare, and expanding Medicaid. Examines implications for the budget and coverage rates

How Health Care Reform Can Lower the Costs of Insurance Administration

Examines the sources of U.S. insurance administration costs and estimates potential cost savings from the creation of a national insurance exchange to replace the individual and small-group markets as part of a public-private approach to reform

Are life-extending treatments for terminal illnesses a special case? Exploring choices and societal viewpoints

Criteria used by the National Institute for Health and Care Excellence (NICE) to assess life-extending, end-of-life (EoL) treatments imply that health gains from such treatments are valued more than other health gains. Despite claims that the policy is supported by societal values, evidence from preference elicitation studies is mixed and in-depth research has shown there are different societal viewpoints. Few studies elicit preferences for policies directly or combine different approaches to understand preferences.Survey questions were designed to investigate support for NICE EoL guidance at national and regional levels. These ‘Decision Rule’ and ‘Treatment Choice’ questions were administered to an online sample of 1496 UK respondents in May 2014. The same respondents answered questions designed to elicit their agreement with three viewpoints (previously identified and described) in relation to provision of EoL treatments for terminally ill patients. We report the findings of these choice questions and examine how they relate to each other and respondents' viewpoints.The Decision Rule questions described three policies: DA – a standard ‘value for money’ test, applied to all health technologies; DB – giving special consideration to all treatments for terminal illnesses; and DC – giving special consideration to specific categories of treatments for terminal illnesses e.g. life extension (as in NICE EoL guidance) or those that improve quality-of-life (QoL). Three Treatment Choices were presented: TA – improving QoL for patients with a non-terminal illness; TB – extending life for EoL patients; and TC – improving QoL at the EoL.DC received most support (45%) with most respondents giving special consideration to EoL only when treatments improved QoL. The most commonly preferred treatment choices were TA (51%) and TC (43%). Overall, this study challenges claims about public support for NICE's EoL guidance and the focus on life extension at EoL and substantiates existing evidence of plurality in societal values