Health-Seeking Behavior in Families

Health-seeking behavior means action based on a personal decision to promote wellness or recovery from an illness or disease. To improve the health of families, one must understand how and why people make decisions that affect their health. Factors that shape health-seeking behaviors in families are socioeconomic (e.g.,age, education, literacy,employment, income), social (e.g.,family,culture), and structural (e.g., availability and access to health care)

The complexity of nonresident father involvement in low-income families : mothers' perspectives

The two studies of this dissertation examined mothers' perspectives of nonresident fathers' involvement in low-income families. The overall goal of these studies was to gain a more comprehensive understanding of nonresident fathers' involvement and its effect on family well-being. In the first study I applied a relatively new methodology, zero-inflated negative binomial regression, to overcome the methodological shortcomings of previous studies. The models (N=1215) examined what factors predicted two aspects, presence and level, of father-child contact and paternal engagement. Different factors were found to influence presence of father-child contact and frequency of contact. Similarly, different factors predicted presence of paternal engagement and level of engagement. Thus, a nonresident father's decision to be involved in his child's life may be a fundamentally different decision than how much he is involved. In addition, parents' positive relationship--romantic relationship and higher quality of relationship--was found to be the major predictor influencing all outcome variables. It appears that a positive co-parental relationship is central to nonresident father involvement. In my second study, I qualitatively examined rural mothers' perceptions of nonresident fathers' involvement (N=83). Specifically, I investigated whether mothers are really "gatekeeping" the father involvement, as suggested by previous research. There was no simple yes/no answer to this question, rather, results suggested that whether a mother acts as a gatekeeper of her children depends on her unique circumstances. Mothers, by at large, wanted the nonresident fathers to be involved in their children's lives and to perform responsible fathering, but mothers' expectations of the fathers' roles may be narrowly defined and, therefore, easily violated. Some mothers did intentionally refuse or limit father-child contact in cases where they believed that father involvement would threaten the safety of their children. In these cases, "gatekeeping" behavior can be viewed as one survival strategy for the mothers. The two studies presented here collectively demonstrate the complexity of non-resident father's involvement and provide insight that will be useful for policy targeted to low-income families

Efeito da suplementação alimentar no uso do espaço pelo marsupial Gracilinanus agilis em fragmentos de Cerradão no Brasil Central

Dissertação (mestrado)—Universidade de Brasília, Instituto de Ciências Biológicas, Departamento de Ecologia, Programa de Pós-Graduação em Ecologia, 2017.A forma com que animais utilizam uma área proporciona diversas informações ecológicas. Eles utilizam o espaço para encontrar alimento, abrigo e para reprodução, mas estão sujeitos a sofrerem os efeitos de predação, competição e de outras interações bióticas. Estudos geralmente mostram que há uma associação negativa entre o uso do espaço e disponibilidade de recurso, mas poucos estudos neotropicais avaliam o efeito da introdução direta e contínua de alimento em populações naturais. O aumento na oferta de alimento pode causar um aumento da densidade populacional associado com uma diminuição da área de uso, devido a necessidade de se percorrer um menor espaço para conseguir alimento. Uma maior concentração de recurso em determinado estrato também pode direcionar a movimentação dos indivíduos escansoriais em uma escala vertical. Eu investiguei possíveis alterações no uso do espaço, pelo marsupial Gracilinanus agilis, causadas por uma introdução experimental contínua de alimento. Para isso, amostrei quatro áreas de cerradão usando grades de captura e armadilhas no estrato do solo e sub-bosque. Duas dessas áreas tiveram adição de alimento através de comedouros que restringiam a entrada de animais maiores do que as do porte de G. agilis. A área de uso média, estimada pelo método dos Mínimos Polígonos Convexos, foi de 0,202 ha ± 0,02, similar ao encontrado por outros estudos com a espécie e com o gênero. A introdução de alimento não influenciou diretamente a área de uso nem a sobreposição destas entre indivíduos vizinhos. No entanto, essa suplementação alimentar levou a um aumento na densidade das populações e uma redução do uso do solo por esses marsupiais. Para G. agilis, o alimento parece não influenciar primariamente o uso do espaço horizontal. Esses pequenos marsupiais se alimentam principalmente de recursos adensados, o que poderia possibilitar a G. agilis não precisar se deslocar por um espaço muito grande para buscar alimento e levar a uma não-redução do mesmo em função da suplementação alimentar. Uma possível redução na área de uso possibilidade pela complementação alimentar pode ter sido compensada pela necessidade dos indivíduos de se descolarem por uma área maior, devido ao aumento na densidade advindo dessa mesma complementação. Além disso, esses pequenos marsupiais são semélparos promíscuos, o que ressalta a importância da busca por parceiros, que pode ser mais determinante para o uso do espaço do que a busca por alimento.The way animals use an area provides many ecological information. They use space to find food, shelter and mating partners, besides suffering from the effects of predation, competition, and other biotic interactions. Studies generally show that there is a negative association between home range and resource availability, but there are few studies in the neotropics evaluating the effect of direct and continuous food supplementation on natural populations. The increase in food supply can cause an increase in population densities associated with a decrease in the home range, caused by a reduction in the foraging area needed for obtaining the individual food requirements. A higher concentration of resource in a given stratum can also direct the movement of scansorial individuals on a vertical scale. I investigated possible changes in the use of space by marsupial Gracilinanus agilis caused by a continuous experimental introduction of food. To do so, I sampled four areas of dry woodland using capture grid and live traps in the ground and understory. Two of those areas had food supplementation through feeders which restrict access from bigger animals then G. agilis. The mean area of home range, estimated by the Minimum Convex Polygon method, was 0.202 ha ± 0.02, similar to that found for congeneric species in other studies. The food supplementation did not directly influence home range size or the overlap of individuals’ home range. This supplementation led to an decrease, however, in ground captures of these marsupials. For G. agilis the food supply did not seem to influence home range primarily. These small marsupials feed mainly on aggregated resources, which could enable G. agilis not to move through large distances when foraging and also resulting in a lack of home-range size reduction after food supplementation. A potential reduction in home-range size caused by the food complementation may have been compensated by the need for a larger foraging area caused by the increase in density caused by this same supplementation. In addition, these small marsupials are promiscuous semelparous, which highlights the importance of searching for partners, which may be more determinant for home range than searching for food

Wellbeing Among Rural Grandfamilies in Two Multigenerational Household Structures

Multigenerational households are an understudied type of grandfamily. In rural communities, these households are likely to be economically disadvantaged and underserved. Drawing from a subset (N = 63) of low-income multigenerational households in a multistate research study, Rural Families Speak About Health, the present study compares demographic characteristics, parent and child wellbeing, and family processes in two types of multigenerational household structures: one-parent/grandparent families and two-parent/grandparent families. Research on these multigenerational household configurations is rare despite the potential for different needs, strengths, and services. Results indicate no differences in economic hardship or disadvantage by household type. Children in one-parent/grandparent households were older, and mothers reported providing more elder care than in two-parent/grandparent homes. There were no statistically significant differences in mother or child wellbeing across these family structures. Differences in family processes emerged. Specifically, mothers’ reports of parenting alliances and family routines varied by household type such that mothers in one-parent/grandparent households reported stronger parenting alliances and more stable family routines than those in two-parent/grandparent families. Implications of the findings for service professionals seeking to design and implement family support and prevention programs for grandfamilies, particularly in rural areas, are discussed

Adrenocorticotropic hormone at pathophysiological concentration modulates the proliferation and differentiation of bone cells

SummaryBackground/purposeAdrenocorticotropic hormone (ACTH) plays a vital role in maintaining the function of the hypothalamic–pituitary–adrenal axis. Recent studies have demonstrated that ACTH directly affects the proliferation and differentiation of bone cells. However, the ACTH concentrations used in these studies appear to be markedly higher than the physiological concentrations. Here, we investigated whether ACTH at pathophysiological concentration affects the proliferation and differentiation of osteoblasts and osteoclasts.Materials and methodsWe evaluated the effect of ACTH at pathophysiological concentration on osteoclasts using tartrate-resistant acid phosphatase staining and on osteoblasts using alkaline phosphatase activity assay. Additionally, we conducted reverse transcriptase-polymerase chain reaction analysis.ResultsWe found that at pathophysiological concentration, ACTH does not affect osteoblast proliferation and inhibits osteoblast differentiation. Moreover, we showed that at pathophysiological concentration, ACTH does not affect the proliferation of bone marrow macrophages, but promotes differentiation of osteoclasts and induces expression of genes involved in bone resorption.ConclusionTaken together, our findings suggest that ACTH modulates the proliferation and differentiation of bone cells in vitro at pathophysiological concentration

Toward standardization of “reasonable accommodation” for students with disabilities by evaluating its validity

障害学生支援における合理的配慮の妥当性評価を行い，その結果で基準案を作成することを目的とする。障害学生支援または保健管理に携わるスタッフ７名が，仮想事例５事例（聴覚，肢体不自由，発達障害２例，内部障害）に対して，合理的配慮例（授業の情報保障，欠席時の対応，履修基準に関わること，連絡，実習（教育実習，臨床実習），グループ学習・実験，試験，生活支援にも係ること，課外活動，研修会など計80例）について，合理的配慮として妥当性を評価した。妥当性は９段階評価で採点し，「１点：妥当でない ←→５点：中間 ←→９点：妥当」とし，それぞれのスタッフが独立して絶対評価した。さらに，回答者は，全員の１回目の集計結果を見て，再度回答し，デルファイ法に準じて集約を試みた。その結果いずれの仮想事例においても共通して妥当性が「中位」以上とされた事項は，「病院受診のための欠席時には講義の資料が欲しい」，「レポート課題の期限延長」，「重要事項，急な予定変更は，学生用電子掲示板システムへの掲示又は文書で明示」，「事前に作業工程，制限時間，注意事項等を文書で具体的に明示」，「申請，書類作成等に関する助言」，「就労移行支援事業所と連携した就労支援」，「支援関係学生教職員に啓発講習会を開催」であった。その他個々の事例に応じたものがあった。支援の対象も，内容・範囲もますます多様となり，障害学生支援を，より効果的に実施するためには，本人・関係者間での建設的な相談・対話が重要である。その前提として，支援者側はどのような支援が必要であるかの一般的知識と，必要度の定量的評価も知っておくことが有用と考えられた。The purpose of this study was to evaluate the validity of the rational consideration of reasonable accommodations to be made for students with disabilities and to draft an appropriate standard. Seven health management or student support professionals involved in this study. Five fictional cases of disabilities (auditory impairment, physical disability, developmental disorder (2 cases), internal disability) and 80 examples of reasonable accommodations were prepared. The participants evaluated the validity of each example on a scale of 1 to 9. The results were revised and aggregated in accordance with the Delphi method. Examples of reasonable accommodations commonly evaluated as “moderately or highly valid” among the participants were as follows. “Providing lecture materials in absence due to hospital visit”, “Extending the deadline for submission of papers”, “Notification of schedule changes online or by sending notes”, “Prior notification in writing of processes, time limits, and precautions”, “Giving necessary advice on filling out application and other forms”, “Providing transition support for employment”, and “Holding workshops on disability support for faculty, staff, and students”. Constructive dialogue with students with disabilities is important to determine the most effective support methods. Moreover, it is also useful to know which reasonable accommodations are considered highly “valid” or “reasonable” based on quantitative evaluations.本研究の一部はJSPS科研費15K01683「心身の疾病・発達障害等のある学生への合理的配慮の基準に関する検討」の助成を受けた。また，本研究の一部は第46回中国四国大学保健管理研究集会（H28.8.26，広島市），第47回中国四国大学保健管理研究集会（H29.8.25，高知市），第55回全国大学保健管理研究集会（H29.11.29，沖縄県宜野湾市）において発表した

Adjustment process of reasonable accommodation for students with disability

本研究の一部はJSPS科研費15K01683の助成を受けた。 本研究の一部は第45回中国四国大学保健管理研究集会（平成27年８月，徳島市），並びに第53回全国大学保健管理研究集会（平成27年９月，盛岡市）で発表した