Low-income first time mothers: Effects on advanced practice nurse (APN) follow up telephone calls on maternal and infant health and health care charges

The United States has over 4 million births annually. Currently healthy women with non-complicated deliveries receive little to no routine postpartum support when discharged from the hospital. This is especially problematic if mothers are first time mothers, poor, have language barriers and little to no social support after giving birth. The purpose of this randomized clinical trial was to compare maternal and infant health outcomes, and health care charges between 2 groups of mothers and newborns. A control ( n = 69) group received routine posthospital discharge care. An intervention group (n = 70) received routine posthospital discharge care plus follow up telephone calls by advanced practice nurses (APNs) on days 3,7,14,21,28 and week 8. Both groups were followed for the first 8 weeks posthospital discharge following delivery to examine maternal health outcomes (perceived maternal stress, social support and perceived maternal physical health), infant health outcomes (routine medical follow up visits immunizations, weight gain), morbidity (urgent care visits, emergency room visits, rehospitalizations), health care charges (urgent care visits, emergency room visits, rehospitalizations) in both groups and charges for APN follow up in the intervention group only. Data were analyzed using descriptive statistics and two-sample t-tests. Study findings indicated that intervention group had significantly lower perceived maternal stress, significantly higher rating of perceived maternal health and higher levels of social support and by the end of the 2nd month posthospital discharge compared to control group mothers. Infants in the intervention group had: increased number of immunizations; fewer emergency room visits; and 1 infant rehospitalization compared to 3 infant rehospitalizations in the control group. The intervention groups' health care charges were significantly lower compared to the control group $14,333/$497 vs. $70,834/$1,068. These study results indicate that an intervention of APN follow up telephone calls in this sample of first time low-income culturally diverse mothers was an effective, safe, low cost, easy to apply intervention which improved mothers' and infants' health outcomes and reduced healthcare charges.

Essays on investment, growth and income distribution

In this dissertation, I examine both theoretically and empirically the relationship between stock prices and income distribution using an endogenous growth model with social status impatience.^ The theoretical part looks into how status impatience and current economic status jointly determine time preference, savings, future economic status, stock prices, growth and wealth distribution in the steady state. This work builds on Burgstaller and Karayalcin (1996).^ More specifically, I look at (i) the effects of the distribution of status impatience levels on the distribution of steady state assets, incomes and consumption and (ii) the effects of changes in relative levels of status impatience on stock prices. Therefore, from (i) and (ii), I derive the correlation between stock prices, incomes and asset distribution. Also, the analysis of the stack market is undertaken in the presence of adjustment costs to investments.^ The empirical chapter looks at (i) the correlation between income inequality and long run economic growth on the one hand and (ii) the correlation between stock market prices and income inequality on the other. The role of stock prices and social status is examined to better understand the forces that enable a country to grow overtime and to determine why output per capita varies across countries. The data are from Summers and Heston (1988), Barro and Wolf (1989), Alesina and Rodrik (1994), Global financial Database (1997) and the World Bank. Data for social status are collected through a primary sample survey on the internet. Twenty-five developed and developing countries are included in the sample.^ The model developed in this study was specified as a system of simultaneous equations, in which per capita growth rate and income inequality were endogenous variables. Additionally, stock price index and social status measures were also incorporated. The results indicate that income inequality is inversely related to economic growth. In addition, increase in income inequality arising from higher stock prices constrains growth. Moreover, where social status is determined by income levels, it influences long run growth. Therefore, these results support findings of Persson and Tabellini (1994) and Alesina and Rodrik (1994). ^

The acculturation of middle income Hispanic households

Research on the consumer behavior of the Hispanic population has recently attracted the attention of marketing practitioners as well as researchers. This study's purpose was to develop a model and scales to examine the acculturation process of Hispanic consumers with income levels of $35,000 and above, and its effects on their consumer behavior. The proposed model defined acculturation as a bilinear and multidimensional change process, measuring consumers' selective change process in four dimensions: language preference, Hispanic identification, American identification, and familism. A national sample of 653 consumers was analyzed. The scales developed for testing the model showed good to high internal consistency and adequate concurrent validity. According to the results, consumers' contact with Hispanic and Anglo acculturation agents generates change or reinforces consumers' language preferences. Language preference fully mediates the effects of the agents on consumers' American identification and familism; however, the effects of the acculturation agents on Hispanic identification are only partially mediated by individuals' language preference change. It was proposed that the acculturation process would have an effect on consumers' brand loyalty, attitudes towards high quality and prestigious brands, purchase frequency, and savings allocation for their children. Given the lack of significant differences between Hispanic and Anglo consumers and among Hispanic generations, only savings allocation for children's future was studied intensively. According to these results, Hispanic consumers' savings for their children is affected by consumers' language preference through their ethnic identification and familism. No moderating effects were found for consumers' gender, age, and country of origin, suggesting that individual differences do not affect consumers' acculturation process. Additionally, the effects of familism were tested among ethnic groups. The results suggest not only that familism discriminates among Hispanic and Anglo consumers, but also is a significant predictor of consumers' brand loyalty, brand quality attitudes, and savings allocation. Three acculturation segments were obtained through cluster analysis: bicultural, high acculturation, and low acculturation groups, supporting the biculturalism proposition. ^

Demographic effects of thatch harvest and implications for sustainable use of irapai palm (Lepidocaryum tenue, Mart.), by riverine communities in the Peruvian Amazon

Lepidocaryum tenue Mart. (Arecaceae) is a small, understory palm of terra firme forests of the western and central Amazon basin. Known as irapai, it is used for roof thatch by Amazonian peoples who collect its leaves from the wild and generate income from its fronds and articles fabricated from them. Increasing demand has caused local concern that populations are declining. Cultivation attempts have been unsuccessful. The purpose of this study was to investigate market conditions and quantify population dynamics and demographic responses of harvested and unharvested irapai growing near Iquitos, Peru. ^ Ethnobotanical research included participant surveys to determine movement of thatch tiles, called crisnejas, through Moronacocha Port. I also conducted a seed germination trial, and for four years studied five populations growing in communities with similar topography and soils but different land tenure and management strategies. Stage, survival, leaf production, and reproductive transitions were used to calculate ramet demographic rates and develop population projection matrices. ^ Weavers made an average of 20–30 crisnejas per day (90–130 leaves each), and earned US$0.09 to 0.70 each (US$1.80 to 21.00 per day). Average crisnejas per month sold per vendor was 2,955 with a profit range of US$0.05 to 0.32 per crisneja. Wholesalers worked with capital outlay from US$100 to 400, and an estimated ten to twenty vendors could be found at a given time. Consumers paid between US$0.23 to 1.20 per crisneja. Although differences in demographic rates by location existed, most were not significant enough to attribute to management. ^ After 60 months, mean seed germination rate was 19.5% in all media (37.9% in peat). Seedling survival was less than two percent after twelve months. Annual palm mortality was three percent, and occurred disproportionately in small (<50 cm) palms. Small palms grew more in height. Unharvested palms grew less than harvested palms. Large palms (≥50 cm) produced more leaves, were more likely to reproduce, and collectors harvested them more frequently. Reproductive potentials (sexual and asexual) were low. Population growth rates were greater than or not significantly different from 1.0, indicating populations maintained or increased in size. Current levels of irapai harvest appear sustainable. DNA analysis of stems and recruits is recommended to understand population composition and stage-specific asexual fecundity. ^

Three essays on labor liberalization and its effects on world economy

This dissertation consists of three theoretical essays on immigration, international trade and political economy. The first two essays analyze the political economy of immigration in developed countries. The third essay explores new ground on the effects of labor liberalization in developing countries. Trade economists have witnessed remarkable methodological developments in mathematical and game theoretical models during the last seventy years. This dissertation benefits from these advances to analyze economic issues related to immigration. The first essay applies a long run general equilibrium trade model similar to Krugman (1980), and blends it with the median voter ala-Mayer (1984) framework. The second essay uses a short run general equilibrium specific factor trade model similar to Jones (1975) and incorporates it with the median voter model similar to Benhabib (1997). The third essay employs a five stage game theoretical approach similar to Vogel (2007) and solves it by the method of backward induction. The first essay shows that labor liberalization is more likely to come about in societies that have more taste for varieties, and that workers and capital owners could share the same positive stance toward labor liberalization. In a dynamic model, it demonstrates that the median voter is willing to accept fewer immigrants in the first period in order to preserve her domestic political influence in the second period threatened by the naturalization of these immigrants. The second essay shows that the liberalization of labor depends on the host country's stock and distribution of capital, and the number of groups of skilled workers within each country. I demonstrate that the more types of goods both countries produce, the more liberal the host country is toward immigration. The third essay proposes a theory of free movement of goods and labor between two economies with imperfect labor contracts. The heart of my analysis lies in the determinants of talent development where individuals' decisions to emigrate are related to the fixed costs of emigration. Finally, free trade and labor affect income via an indirect effect on individuals' incentives to invest in the skill levels and a direct effect on the prices of goods.

Compensatory effects of parent and peer support on well -being and achievement during pre- and early adolescence

The current study was designed to explore the salience of parent and peer support in middle childhood and early adolescence across two time periods as indicated by measures of achievement (grade point average (GPA), Stanford Achievement Test (SAT) scores and teacher rated school adaptation) and well-being (loneliness, depression, self-concept and teacher-rated internalizing behaviors). ^ Participants were part of an initial study on social network relations and school adaptation in middle childhood and early adolescence. Participants at Time 1 (in the spring of 1997) included 782 children in grades 4 and 6 of eight lower and middle income public elementary schools. Participants (N = 694) were reinterviewed two years later in the spring of 1999 (Time 2). ^ Multivariate analyses of variance (MANOVA) were used to investigate the change in salience of parent and peer support from Time 1 to Time 2. In addition, Tukey-HSD (Honestly Significant Difference) post hoc tests were used to test the significance of the differences among the means of four support categories: (1) low parent-low friend, (2) low parent-high friend, (3) high parent-low friend, and (4) high parent-high friend. ^ Compensatory effects were observed for loneliness and self-concept at Time 1, as well as for SAT scores, self-concept and overall achievement at Time 2. Results were consistent with existing findings that suggest a competitive model of parent/peer influence on achievement during adolescence. This study affirms the need for a more contextual approach to research examining competing and compensatory effects on adolescent development. ^

Effects of nutrition education on the nutrition knowledge of future aerobic dance instructors

The effectiveness of nutrition education on the nutrition knowledge of future aerobic instructors was studied. Forty-seven subjects participated in the study. The experimental group (n=31) chose to and paid for a two-hour per week session of structured nutrition education for four weeks, the control group (n=16) did not. A nutrition knowledge test was completed by all subjects before and after the intervention. Results were analyzed for relationships between subject's nutrition knowledge and age, gender, educational background, income, and body mass index. No significant differences were found between the groups. The results showed that prior to any formal nutrition education, fitness instructors in the experimental and control groups had low nutrition knowledge (8.06%±16.4% and 4.38%±4.12%, respectively). Post-intervention nutrition knowledge significantly improved (p

The acculturation of middle income Hispanic households

Research on the consumer behavior of the Hispanic population has recently attracted the attention of marketing practitioners as well as researchers. This study's purpose was to develop a model and scales to examine the acculturation process of Hispanic consumers with income levels of $35,000 and above, and its effects on their consumer behavior. The proposed model defined acculturation as a bilinear and multidimensional change process, measuring consumers' selective change process in four dimensions: language preference, Hispanic identification, American identification, and familism. A national sample of 653 consumers was analyzed. The scales developed for testing the model showed good to high internal consistency and adequate concurrent validity. According to the results, consumers' contact with Hispanic and Anglo acculturation agents generates change or reinforces consumers' language preferences. Language preference fully mediates the effects of the agents on consumers' American identification and familism; however, the effects of the acculturation agents on Hispanic identification are only partially mediated by individuals' language preference change. It was proposed that the acculturation process would have an effect on consumers' brand loyalty, attitudes towards high quality and prestigious brands, purchase frequency, and savings allocation for their children. Given the lack of significant differences between Hispanic and Anglo consumers and among Hispanic generations, only savings allocation for children's future was studied intensively. According to these results, Hispanic consumers' savings for their children is affected by consumers' language preference through their ethnic identification and familism. No moderating effects were found for consumers' gender, age, and country of origin, suggesting that individual differences do not affect consumers' acculturation process. Additionally, the effects of familism were tested among ethnic groups. The results suggest not only that familism discriminates among Hispanic and Anglo consumers, but also is a significant predictor of consumers' brand loyalty, brand quality attitudes, and savings allocation. Three acculturation segments were obtained through cluster analysis: bicultural, high acculturation, and low acculturation groups, supporting the biculturalism proposition.