p. 1-62 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-24T17:50:33Z No. of bitstreams: 2 55555.pdf: 500341 bytes, checksum: e9fbae04808102f65cc83d872580a6e1 (MD5) 44444.pdf: 43892 bytes, checksum: db269987f1815f019ef22e6ba31e6a14 (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-04T17:02:02Z (GMT) No. of bitstreams: 2 55555.pdf: 500341 bytes, checksum: e9fbae04808102f65cc83d872580a6e1 (MD5) 44444.pdf: 43892 bytes, checksum: db269987f1815f019ef22e6ba31e6a14 (MD5) / Made available in DSpace on 2013-05-04T17:02:02Z (GMT). No. of bitstreams: 2 55555.pdf: 500341 bytes, checksum: e9fbae04808102f65cc83d872580a6e1 (MD5) 44444.pdf: 43892 bytes, checksum: db269987f1815f019ef22e6ba31e6a14 (MD5) Previous issue date: 2010 / A infecção hospitalar (IH) constitui-se em um grave problema de saúde pública. A IH em neonatologia, configura-se como uma grande preocupação desta temática, tendo em vista sua magnitude e relevância. Esta pesquisa teve como objetivo geral conhecer a situação epidemiológica da infecção hospitalar em recém-nascidos assistidos na Unidade de terapia intensiva Neonatal – UTIN de um hospital filantrópico do interior da Bahia no período de janeiro de 2006 a dezembro de 2008. Foi desenvolvido um estudo de morbidade hospitalar, uma coorte histórica (retrospectiva) de pacientes, num hospital de grande porte no interior da Bahia. Foi possível resgatar o número de IH por topografia e de pacientes para os três anos selecionados (2006 – 2008) e descrever as características dos casos no ano de 2008. Foram coletados dados da ficha de Vigilância de IH e dos prontuários dos RNs do hospital em estudo. Foi estimada a densidade de incidência de episódios de IH, utilizando como denominador o número de pacientes-dia. Todos os direitos dos sujeitos e da instituição foram respeitados, observado os princípios éticos. Os dados foram processados em planilhas do programa EXCEL e analisados no programa STATA e Epi Info 3.5.1. De um total de 1.984 RNs internados na UTI neonatal, correspondendo a 29.773 pacientes-dia, 216 RNs apresentaram IH cuja incidência foi de 7,3 casos por 1000 pacientes-dia. Nestes RNs, foram registrados 269 casos de IH, o que correspondeu a uma incidência de 9 episódios por 1000 pacientes-dia. A topografia mais incidente foi a infecção de corrente sanguínea sem confirmação microbiológica – sepse clínica (com a incidência de 5,4 episódios por 1000 pacientes-dia). Foram observadas variações com flutuações da incidência de IH em torno da média para os três anos, revelando redução das taxas de IH na UTI neonatal no período estudado. A incidência encontrada mostrou-se menor que a de outros estudos, sendo possível que os indicadores desta unidade estejam subestimados, assim como deverá se considerar a metodologia utilizada para vigilância epidemiológica das infecções hospitalares e os critérios diagnósticos utilizados pelo serviço. / Salvador

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Currently the state of Rio Grande do Sul (RS) the cultivation of sugar cane is being encouraged for bioenergy. However, there is a lack of information on the performance of agricultural and industrial modern genotypes at conditions of RS. In order to evaluate the growth, development and quality of genotypes of sugar cane cultivation of sugarcane plant (2009/2010) and cane ratoon first year (2010/2011) an experiment was conducted in the municipality of Jaguari Central Depression of RS. The experimental design was randomized blocks with three replications. We evaluated 12 genotypes of 13 early and medium maturity / delayed a total of 25 materials, all of RIDESA. The evaluations were phyllochron, final leaf number on main stem height, leaf area, straw yield and agronomic and qualitative parameters. The phyllochron values between genotypes showed little variation, but the genotypes RB966229, RB947625 and RB008347 significant difference in relation to the cane plant and ratoon cane. The NFT showed no difference between the early-maturing genotypes, only cycle between the mid / late, and some genotypes of mid / late show higher NFT in sugarcane ratoon. The height growth was comprised of three distinct phases for all genotypes, starting with a slow growth after the phase of higher growth and finally there was a decrease in growth due to the start of the maturation process. The leaf area showed a growth pattern similar to the stem, but the last stage corresponded to a decrease in AF. The average yield of stalks of more productive genotypes in early-maturing crops of sugar cane plant and ratoon cane (96.6 and 123.4 TCH) was similar to that obtained with the most productive genotypes cycle mid / late (101.5 TCH and 128.0), with higher productivity in the cultivation of sugarcane ratoon. The genotype RB965911 RB925345 and early-maturing genotypes and RB925268, RB975019 RB987935 cycle and medium / late show qualitative variables, maturation rate and productivity of stem indicate that these genotypes as a high potential for the central region of the RS. / Atualmente no estado do Rio Grande do Sul (RS) o cultivo da cana-de-açúcar está sendo incentivado para fins bioenergéticos. No entanto, existe a carência de informações sobre o desempenho agrícola e industrial de genótipos modernos nas condições edafoclimáticas do RS. Com o objetivo de avaliar o crescimento, desenvolvimento e qualidade de genótipos de cana-de-açúcar em cultivo de cana-planta (2009⁄2010) e de cana-soca de primeiro ano (2010⁄2011) foi realizado um experimento no município de Jaguari, Depressão Central do RS. O delineamento experimental foi o blocos ao acaso com três repetições. Foram avaliados 12 genótipos de ciclo precoce e 13 de ciclo médio⁄tardio, totalizando 25 materiais, todos da RIDESA. As avaliações realizadas foram filocrono, número final de folhas na haste principal, estatura, área foliar, produção de colmos e parâmetros agronômicos e qualitativos. Os valores de filocrono entre os genótipos tiveram uma pequena variação, porém os genótipos RB966229, RB947625 e RB008347 apresentaram diferença significativa em relação à canaplanta e cana-soca. O NFT não apresentou diferença entre os genótipos de ciclo precoce, somente entre os de ciclo médio⁄tardio, sendo que alguns genótipos de ciclo médio⁄tardio apresentam maior NFT em cana-soca. O crescimento em estatura compreendeu três fases distintas para todos os genótipos, iniciando-se por um crescimento lento, após a fase de maior crescimento e por fim ocorreu uma diminuição do crescimento em função do inicio do processo de maturação. A área foliar apresentou um padrão de crescimento similar ao do colmo, porém a última etapa correspondeu ao decréscimo da AF. A produtividade média de colmos dos genótipos mais produtivos de ciclo precoce nos cultivos de cana-planta e canasoca (96,6 e 123,4 TCH) foi semelhante aquela obtida com os genótipos mais produtivos de ciclo médio/tardio (101,5 e 128,0 TCH), com maior produtividade no cultivo de cana-soca. O genótipo RB965911 e RB925345 de ciclo precoce e os genótipos RB925268, RB975019 e RB987935 de ciclo médio/tardio apresentam variáveis qualitativas, índice de maturação e produtividade de colmos que indicam esses genótipos como sendo os de maior potencial para a região central do RS.

The goal of the thesis is to describe and analyze methods, which are used in programs in project "Guidance days" in Fryšták. The thesis attempts to describe six basic methods, which form methodologic frame of the programs. These methods are: animation, experimental education, acting roles in education, narrative methods, evaluative methods and group learning. In the practical part, the thesis analyzes one specific course program. For each activity within the course, characteristics and goals of the activity are described. Each program module is then analyzed from methodologic point of view and is referred to the text of first part of the thesis.

A determinação de dias trabalháveis para operações agrícolas de campo é de extrema importância para o dimensionamento de frotas de máquinas agrícolas. Isso é especialmente importante para a cultura da cana-de-açúcar, na qual as operações de campo se estendem por todo o ano, sendo a colheita a operação que mais danos pode trazer aos solos, quando executada sob condições inadequadas, já que essa ocorre por cerca de 8 a 10 meses. Com base nisso, o presente estudo teve como objetivos: definir os critérios para a determinação do número de dias trabalháveis (NDT) para colheita mecanizada da cana-de-açúcar no estado de São Paulo; determinar o NDT de diferentes regiões do estado de São Paulo com base em um critério geral e em critérios específicos para cada região; determinar a probabilidade de ocorrência de sequência do NDT por meio da cadeia de Markov; e elaborar uma planilha modelo para dimensionamento de frota para colheita mecanizada da cana-de-açúcar com base no NDT gerado pelo critério individual e geral. Para a definição dos critérios do NDT foram empregados dados de interrupção da moagem de 30 usinas no estado de São Paulo, para períodos variando de duas a cinco safras. Foram testados critérios de precipitação mínima (PREC), capacidade de água disponível (CAD) e limite da relação entre o armazenamento de água no solo e CAD (ARM/CAD) para se interromper a operação de colheita. De posse dos critérios de PREC, CAD e ARM/CAD para cada região e um critério geral, foram elaborados mapas do NDT para o estado de São Paulo, Posteriormente, definiu-se com base na cadeia de Markov, as probabilidades condicionais e, por meio dessas, as probabilidades de sequência de dias trabalháveis para cada decêndio do ano. Finalmente, foi elaborada uma planilha Excel® para o dimensionamento de frota de colhedoras de cana, com base no NDT. Os resultados mostraram que houve variação no critério para definição do NDT nas diferentes regiões do estado. No entanto, o uso de um critério geral para todo o estado, considerando-se a PREC de 3 mm, CAD de 40 mm e ARM/CAD de 90%, proporcionou resultados muito similares. O mapa de NDT gerado a partir do critério individual para cada região resultou em um erro médio de 24,9 dias por ano, ao passo que o mapa gerado a partir do critério geral resultou em um erro médio de 4,4 dias por ano, sendo este último mais adequado para a determinação do NDT médio para a colheita mecanizada de cana-de-açúcar. Com relação à probabilidade de sequência de dias trabalháveis, observou-se que nas regiões a oeste, noroeste e norte do estado há, em média, maiores probabilidades de ocorrência de dias trabalháveis, sendo que as maiores probabilidades ocorreram entre abril e setembro, com o primeiro decêndio de julho sendo o que tem os maiores valores. A probabilidade de o dia ser trabalhável dado que o anterior foi trabalhável manteve-se sempre com o mínimo em torno de 50% de probabilidade e com o máximo próximo de 90% em todas as regiões avaliadas. Finalmente, observou-se que a variação do NDT em função do critério usado (individual ou geral) não teve impacto expressivo nos custos de produção e totais. Com base nos resultados apresentados, conclui-se que a determinação correta do NDT é fundamental para o dimensionamento de sistemas de colheita da cana-de-açúcar. / The determination of workable days for agricultural field operations is of extreme importance for dimensioning agricultural machinery fleets. This is especially important for sugarcane cultivation, in which field operations extend throughout the year, from 8 to 10 months per year. Based on this, the present study had as objectives: to define the criteria for determining the number of workable days (NWD) for sugarcane harvest in the state of São Paulo; to determine the NWD of different regions of the state of São Paulo based on general criteria and on specific criteria to each region; to determine the probability of a given NWD sequence by means of the Markov chain; and to elaborate a spreadsheet model for sizing the fleet to harvest sugarcane based on the NWD generated by the individual and general criteria For the definition of NWD criteria, the data from harvest interruption of 30 mills in the state of São Paulo, for periods ranging from two to five harvests, were used. The following criteria were tested: minimum precipitation (PREC); soil water holding capacity (SWHC) and the limit of the relationship between soil moisture storage and SWHC (ARM/SWHC), to define the harvest interruption. Based on these criteria for each region and also a general criteria, NWD maps were prepared for the state of São Paulo.. Afterwards, the conditional probabilities were defined on the basis of the Markov chain, and based on them the probabilities of sequences of working days were defined for all year long for each 10-day periods. Finally, an Excel® spreadsheet was programmed for dimensioning sugarcane harvest machines, based on the NWD. The results showed that there was variation in the criteria for the definition of NWD in the different regions of the state. However, the use of a general criteria for the whole state, considering PREC of 3 mm, SWHC of 40 mm and ARM/SWHC of 90% provided very similar results. The NWD maps generated from the individual criteria for each region generated an average error of 24.9 days per year whereas the map generated from the general criteria resulted in an average error of 4.4 days per year, being the last map the most suitable for determining the average NWD. Regarding the probability of sequences of workable days, it was observed that in the western, northwestern and northern regions of the state there is, on average, a greater probability of workable days, with the periods of greatest probability of workable days being between April and September. The probability of the a day be workable considering that the previous one was workable, always remained between 50% and 90% probability in all regions. Finally, for dimensioning havest mechines, it was observed that the variation of NWD as a function of the criteria used (individual or general) had no significant impact on production and total costs, but affected the total investment. It was concluded that the correct determination of NWD is fundamental for the design of sugarcane harvesting systems.

FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / O presente trabalho objetivou caracterizar as alteraÃÃes fÃsicas, fÃsico-quÃmicas, quÃmicas e bioquÃmicas durante o crescimento dos frutos de mangueira (Mangifera indica), cv. Tommy Atkins, da antese atà a colheita comercial, visando à definiÃÃo do ponto de colheita ideal em unidades de calor. Os frutos foram colhidos aos 35, 49, 63, 70, 77, 84, 91, 98, 105 e 112 dias apÃs a antese (DAA), sendo feitas as seguintes determinaÃÃes: aspectos morfolÃgicos externos; diÃmetros longitudinal, ventral e transversal; produto dos diÃmetros; massas fresca, seca e de Ãgua; teor de Ãgua; escalas de coloraÃÃo da casca, de Blush para coloraÃÃo da casca e de coloraÃÃo da polpa; luminosidade, croma e Ãngulo Hue da polpa; firmeza; unidades de calor (UC); sÃlidos solÃveis totais (SST); acidez total titulÃvel (ATT); pH; relaÃÃo SST/ATT; amido; aÃÃcares solÃveis totais, redutores e nÃo redutores; nitrogÃnio total, nÃo protÃico e protÃico; proteÃnas bruta e verdadeira; vitamina C; clorofila e carotenÃides totais; fenÃlicos polimÃricos, oligomÃricos e dimÃricos; pectinas total, solÃvel, de alta metoxilaÃÃo e de baixa metoxilaÃÃo; protopectina; percentagem de solubilizaÃÃo de pectina; atividade das enzimas pectinametilesterase, poligalacturonase, polifenoloxidase, peroxidase, amilase total, &#945;- e &#946;-amilases, &#945;- e &#946;-galactosidases extraÃdas de citosol e de parede celular; proteÃnas extraÃdas de citosol e de parede celular. O trabalho indicou que as mangas âTommy Atkinsâ atingiram a maturidade fisiolÃgica aos 98 DAA, que equivale a 1.685,09 UC. O croma da polpa foi o melhor indicador do estÃdio de desenvolvimento do fruto da mangueira cultivada sob irrigaÃÃo no sub-mÃdio SÃo Francisco, considerando-se o seu alto coeficiente de determinaÃÃo, R2=0,9832 (P < 0,01) e seu alto coeficiente de correlaÃÃo com pH, aÃÃcares solÃveis totais e carotenÃides totais, R=0,95; 0,93; e 0,93, respectivamente (P < 0,01). / The objective of this work was to characterize the physical, physicochemical, chemical and biochemical changes during the development of mango (Mangifera indica), cv. Tommy Atkins from anthesis to harvest, identifying the optimum harvest maturity stage in heat units. The fruits were harvested at 35, 49, 63, 70, 77, 84, 91, 98, 105 and 112 days after the anthesis (DAA), being made the following determinations: fruit external morphology; longitudinal, ventral e transverse diameters; product of the diameters; fresh and dry mass; water content and percentage; skin, Blush skin and pulp color scales; pulp luminosity, Hue angle and chroma; firmness; heat units (HU); total soluble solids (TSS); total titratable acidity (TTA); pH; TSS/TTA ratio; starch; total, reducing and nonreducing soluble sugars; total, protein and nonprotein nitrogen; crude and true protein; C vitamin; total chlorophyll and carotenoids; polymeric, oligomeric and dimeric phenolics; pectin total, soluble and high/low metoxilation degree; protopectin; solubilization pectin percentage; pectin metyhylesterase, poligalacturonase, polyphenol oxidase, peroxidase, total amylase, &#945;- and &#946;-amylases, &#945;- and &#946;-galactosidases enzymes activities; cell wall and cytosol proteins. This work has indicated that mango âTommy Atkinsâ reached the physiological maturity at 98 DAA, that is equivalent to 1.685,09 HU. The pulp chroma was the best fruit development stage indicator in the cultivated conditions of this study (SÃo Francisco valley), taking into account the high coefficient of determination, R2=0,9832 (P < 0,01) and excellent correlation coefficients with pH, total soluble sugars and total carotenoids, R=0,95; 0,93; e 0,93, respectively (P < 0,01).

Objectives: After mild traumatic brain injury (mTBI), psychological factors can contribute to persisting post-concussion symptoms (PCS). Consistent with constructive theories of memory, negative expectations for increased symptoms after mTBI may contribute to misattributing symptoms to the mTBI and underestimating pre-injury symptoms, called the “good old days’ bias” (Gunstad & Suhr, 2001). The good old days’ bias is not thought to be a general retrospective recall bias but studies to date have largely not controlled for normative memory processes including those that lead to a biased, more positive recall of the past. Therefore, the current study examines whether there is a good old days’ bias after mTBI above and beyond normal memory biases. This study also examines how soon after mTBI the good old days’ bias affects recall of pre-injury symptoms in the first month after mTBI in adolescents as well as whether the good old days’ bias causes pre-injury symptom severity to be underestimated or if symptoms are entirely forgotten. Finally, the clinical significance of symptom recall biases is investigated. Method: The sample is 42 adolescents who sustained an mTBI (ages 13-18 years; 24 males) and 42 uninjured adolescents (ages 13-18 years; 24 males, ). The mTBI group rated current and retrospective post-concussion symptom ratings within one week and again, at one month, post-injury. The control group rated current and retrospective post-concussion symptoms at baseline and one month later. Cross-sectional and longitudinal comparisons using non-parametric statistical tests were used. Results: Wilcoxon signed-rank tests showed that, by one month post-mTBI, adolescents report fewer total, physical, and emotional pre-injury symptoms than they had reported within one week of their concussion. The control group did not demonstrate this good old days’ bias. There were no between-group differences in retrospective PCS ratings at either time point. Chi-square analyses found that the mTBI group was as likely as the control group to recall “no” pre-injury/past symptoms one month post-injury after having initially reported some pre-injury symptoms. Only four more adolescents were classified as “recovered” if their one-month PCS ratings were compared with pre-injury PCS ratings made within 1-week post-concussion rather than pre-injury ratings from 1-month post-injury. Discussion: There was mixed evidence for a good old days’ bias by one month post-concussion. This bias was not demonstrated in healthy adolescents, suggesting that the good old days’ bias is found specifically after concussion. During the acute post-injury period, the good old days’ bias may only be apparent by studying changes in concussed individuals’ own PCS ratings. The good old days’ bias leads to underestimating the severity of pre-injury symptoms rather than forgetting them entirely. The good old days’ bias does not greatly affect symptom recovery tracking by one month post-concussion. Future studies should directly examine expectations about concussion and their effect on current and retrospective symptom reporting. / Graduate / 2019-07-10

Entrevistas envolvendo técnicos ligados à área de confinamento são frequentemente utilizadas com o intuito de descrever as práticas nutricionais e de manejo em diversos países. Desta forma foi elaborado e aplicado um questionário com 78 questões pela ferramenta SurveyMonkey&reg;. Este questionário foi dividido em seis seções: (i) informações sobre o entrevistado (n = 2); (ii) critérios de abate (n = 35); (iii) informações sobre preço (n = 9); (iv) opções de manejo dos animais (n = 21); (v) distribuição dos animais nas baias (n = 5); e (vi) formulação de dietas (n = 6). Os entrevistados constituíram três grupos, sendo nutricionistas consultores (NC; n = 23), proprietários de confinamento (PC; n = 21) e gerentes de confinamento pertencentes a frigoríficos (GF; n = 8). A maioria dos entrevistados possuíam ensino superior, de acordo com 86% dos respondentes, e no total, eram responsáveis por 1.104.990 cabeças confinadas em 2015. Cerca de 58% dos entrevistados realizavam dois ciclos de confinamento por ano, cada ciclo com um período entre 80 e 100 dias de acordo com 44% dos entrevistados. Mais de 80% dos animais confinados pelos entrevistados eram machos, de acordo com 65% dos respondentes. Estes machos eram inteiros para 73% dos entrevistados, predominantemente da raça Nelore (75%). Os animais confinados possuíam idade média de 24,7 ± 0,84 meses e entraram com 378,1 ± 8,9 kg, saíram com 511,4 ± 10,7 em 107,6 ± 11,1 dias de confinamento. Na formação inicial dos lotes, o peso foi a característica mais usada (75%), entretanto, aproximadamente 71% dos entrevistados utilizaram uma combinação de critérios, como por exemplo, o sexo, a raça e o peso. Ferramentas computacionais foram utilizadas para gerenciamento do confinamento (71%) e na formulação das dietas (69%). Entretanto, 61% dos entrevistados não usaram nenhum software específico para caracterizar os animais na entrada do confinamento. O principal custo operacional (retirando os alimentos e o boi magro) foi a mão de obra (69%). As consultas sobre preços de itens alimentares e não alimentares foram realizadas diretamente com fornecedores finais por 59% dos entrevistados. Altos custos dos alimentos (52%) e os baixos preços do boi gordo (42%) eram motivadores da redução do número de animais ou da não realização do confinamento. Critérios econômicos mostraram-se determinantes na definição do período de confinamento, como a espera por melhores preços do boi gordo (36%) ou por bonificação em razão de melhor acabamento (29%). Os confinadores verificam o preço de mercado do boi terminado principalmente através da internet (61%). O destino dos animais era o mercado interno para 69% dos entrevistados e 60% dos respondentes também vendiam para o mercado externo por meio dos frigoríficos. O momento do abate foi definido, majoritariamente (71%), pelos gerentes do confinamento. Os resultados demonstraram que 65% dos entrevistados utilizaram o peso e o acabamento, ambos estimados visualmente, para indicar o momento do abate. Um feedback sobre a carcaça foi repassado ao responsável por essa decisão (71%) e 61% dos entrevistados ressaltaram a importância desta informação na melhoria da decisão. Dificuldades na identificação do momento ideal para o abate foram desafios descritos pelos entrevistados e 84,6% dos respondentes reconheceram que o método atual pode ser melhorado. Apenas um terço dos entrevistados (33%) vendia animais utilizando contratos futuros. O rendimento de carcaça (38%) e o preço da arroba (25%) foram os principais fatores na utilizados pelos entrevistados para escolha do frigorifico para abate. Os principais critérios mencionados como bonificação na carcaça foram: idade e sexo, adequação para exportação, rastreabilidade e características da carcaça (como gordura subcutânea, peso, área de olho de lombo e gordura) e raça. Em contraposição, segundo os entrevistados, as principais penalidades nos valores da carcaça ocorrem por condenação pelo serviço de inspeção federal, características da carcaça, lesões por vacinas, contusões, idade, sexo e resíduos de medicamentos. Verificou-se que parâmetro de qualidade da carne (e.g. maciez, marmoreio) não foi critério relevante nem para bonificação (5%) nem para penalização (3%). Os resultados deste trabalho descreveram vários parâmetros do manejo e da comercialização dos confinamentos nacionais. Os entrevistados fazem pouco uso das ferramentas de hedge, bem como utilizam poucas ferramentas computacionais para otimizar a atividade. A determinação do ponto de abate é feita com grande subjetividade, baseando-se quase que exclusivamente em avaliações visuais tanto para peso quanto para acabamento. / Interviews with feedlot managers are used to describe nutritional and management practices in several countries. In this way, a questionnaire containing 78 questions was structured and applied through the SurveyMonkey&reg; web tool. The questionnaire was divided into six sections: (i) general information (n = 2); (ii) slaughter criteria (n = 35); (iii) pricing information (n = 9); (iv) animal handling options (n = 21); (v) animal\'s allotment in feedlot pens (n = 5); and (vi) diet formulation (n = 6). Three groups comprised the interviewees: consultant nutritionists (NC; n = 23), feedlot owners (FO; n = 21) and packers feedlot managers (FP; n = 8). Most respondents had a bachelor degree (86% of the respondents) and were responsible for feeding approximately 1,104,990 animals in 2015. About 58% of the interviewees worked with two cycles of animals per year. The most usual feeding period was between 80 and 100 days (44% of respondents). More than 80% of the animals were males, 65% with 73% of the respondents feeding intact males. Most of the cattle were of Nellore breed (75% of respondents). The feeder animals had an average age of 24.7 ± 0.84 and 378.1 ± 8.9 kg, with final weight of 511.4 ± 10.7 kg and 107.6 ± 11.1 days respectively. Among the criteria used for pen formation, weight was the most used (75%), however, approximately 71% of respondents used a combination of different criteria primarily weight, gender and breed. The use of computational tools for feedlot management (71%) and diet formulation (69%) were common among respondents, however, interviewees (61%) did not use any software to characterize animals at the feedlot entry. According to the interviewees, the main cost of the feedlot, (excluded feeder and feed cost), was labor (69%). Products used were acquired directly with the final suppliers (59%). High feed costs (52%) and low finished cattle prices (42%) made interviewees reduce the number of animals fed shutting down the feedlot for that particular year. Economic criteria defined the feedlot period, with respondents waiting for an increase in finished cattle prices (36%) or for greater fat deposition (29%). Finished cattle prices were obtained through the internet (61%) and 69% of respondents sold to the domestic market. About 60% of respondents sold cattle for the international market through the meatpackers. The feedlot manager was responsible in most cases for the slaughter decision (71%). The results showed that 65% of the interviewees used weight and fat cover, both visually estimated, to decide the time of slaughter. The person making the decision to slaughter received feedback information from the packers about carcass traits in 71% of the cases. This information improved the decision to slaughter according to 61% of respondents. They considered identifying the optimal time for slaughter a great challenge and 85% of the respondents recognized that their current slaughter endpoint identification method could be improved. Only one third of all respondents (33%) sell cattle using futures contracts for finished cattle. Carcass dressing (38%) and price (25%) were the main reasons to elect a meatpacker to slaughter their animals. Criteria most frequently mentioned to reward the beef producer were: age and gender, suitability for export, traceability and carcass characteristics (including subcutaneous fat, weight, ribeye area and carcass fat) and breed. In contrast, according to the interviewees, criteria quoted for penalties were Federal Inspection Service condemnations, carcass characteristics, vaccination injuries, bruises, age and gender, and drug residues. Meat quality parameters (e.g. tenderness, marbling) were not relevant criteria for the Brazilian meatpackers, neither for bonus (5%) neither for penalty (3%). The interviewees make little use of hedge options, and use almost no computational tools to optimize their activity. The determination of the time of slaughter is made with great subjectivity, relying almost exclusively on visual evaluations for both weight and degree of finish.

Opioid use disorder (OUD) and opioid overdose are pervasive public health problems in the U.S. Medications for opioid use disorder (MOUD) have been shown effective to reduce OUD morbidity and mortality. Two distinct approaches to MOUD are currently used: agonist therapy (methadone or buprenorphine) or antagonist therapy (naltrexone). Limited information is available about the patterns of use, adherence to therapy, and characteristics of those who use agonist vs. antagonist therapy. The objective of this study is to assess recent trends in MOUD, adherence in use of MOUD, and the characteristics of those who use agonist vs. antagonist therapy in a nationally representative population of commercially insured patients in the U.S. This retrospective descriptive study utilized data from Truven Marketscan Commercial Claims and Encounters database from years 2011 to 2016. All individuals aged 18 years and older who have a diagnosis of OUD and utilize MOUD at any point during the study period were included. Demographic characteristics of interest included age, gender, geographic region, and type of insurance coverage. Clinical characteristics of interest included diagnosis of OUD and type of MOUD used, including extended – release naltrexone for injection, oral naltrexone, buprenorphine in combination with naloxone, and buprenorphine alone. Descriptive analyses were employed to understand utilization patterns and trends over time and proportion of days covered was used to measure adherence. Frequency and percentage are presented for categorical variables. Adherence of MOUD will be estimated by measuring proportion of days covered. As this study uses de-identified commercial health claims data, it has been determined as not human subjects research by the University of Kentucky’s Office of Research Integrity. Agonist therapy with buprenorphine or buprenorphine/naloxone was the most common treatment, representing 75.7% of those receiving treatment. Between 2011 and 2016, the percentage of individuals receiving treatment with partial agonist therapy decreased 16.5% to 9.2%, respectively. Meanwhile, the percentage of individuals receiving treatment with antagonist treatment increased from 0.1% in 2011 to 0.3% in 2016. In the analysis of proportion of days covered, all MOUD reported a decrease at both 180 and 365 days. In the commercial population, younger female patients were more likely to be treated with injectable naltrexone. Specifically, in the North Central geographic region, commercial adult patients were more likely to be treated with buprenorphine monotherapy. Overall, this study found a decrease in use of agonist therapy from 2011 through 2016, with an increase in use of antagonist therapy in the same time period. However, the increase in use of antagonist therapy does not fully account for the decrease in use of agonist therapy, suggesting that since 2011 many patients with OUD still remain untreated. All MOUD types were analyzed and saw a decrease in proportion of days covered, as a measure of adherence, from 2011 to 2016 putting patients at an increased risk for relapse, further complications, emergency visits, and hospitalizations. More information is needed about characteristics of patients who not only seek out treatment for OUD, but also maintain their treatment overtime.

<div>The first 1000 days of life, from conception until the child’s second birthday, constitute a critical window for child growth and development. During infancy and early childhood, significant and rapid physical changes occur, including increases in weight, height, and brain size and organ development accompanied by cognitive and psychomotor development. Adequate infant feeding, including breastfeeding and complementary feeding, that meets the infants’ energy and nutrient requirements can help protect against growth faltering, infant and child morbidity and mortality, and delayed mental and motor development. Adequate nutrition during this critical period can also protect against adverse health outcomes and chronic diseases later in life according to the hypothesis of developmental origins of health and disease.</div><div><br></div><div>A web of factors that are country- and culture- specific influence infant feeding practices and child growth. Further, the microbiome has been suggested as a strong potential player in the association between infant nutrition and child growth. Therefore, the overarching theme of the current dissertation is to investigate hypotheses that can provide evidence to inform the paradigm linking socio-demographic, maternal, and child determinants including prenatal intake to infant feeding, the breast milk and infant gut microbiome, and child growth within the first 1000 days of life. Specifically, aims one and two examine the socio-demographic, maternal, and child determinants of child growth and breastfeeding in a cross-sectional survey of mother-child dyads in Lebanon, a middle-income country undergoing nutrition transition in the Middle East. The third aim focuses on the CHILD cohort study, a multi-center longitudinal prospective birth cohort study, to examine the associations between prenatal diet and supplement intake and the breast milk microbiome. Finally, the fourth aim is to review the evidence for the potential of the infant gut microbiome as a promising target linking complementary feeding to child undernutrition in low- and middle- income countries (LMIC) with the highest burden of undernutrition.</div><div><br></div><div>The results for aim one revealed sex-specific determinants of child growth in Lebanon. The determinants examined through a hierarchical conceptual framework included: maternal and paternal education among boys and crowding index among girls at the distal sociodemographic level, and maternal obesity among girls at the intermediate maternal level. The proximal child determinants included birth length, number of children in the household and breastfeeding duration among girls, birthweight among boys and child’s age among boys and girls.</div><div><br></div><div>In the analysis for aim two, breastfeeding practices were suboptimal in Lebanon as less than half (41.5%) of the infants were exclusively breastfed during the 40-day rest period and 12.3% were exclusively breastfed during the 6-month duration recommended by the World Health Organization. Higher socioeconomic status, as reflected by a larger number of cars owned, and C-section delivery were consistently inversely associated with lower odds of exclusive breastfeeding for 40 days and 6 months. Belonging to a family with more children was associated with higher odds of exclusive breastfeeding for 40 days; while maternal overweight and obesity were associated with lower odds of exclusive breastfeeding for 6 months.</div><div><br></div><div>Findings from aim three suggested that prenatal supplement use, but not prenatal dietary quality and patterns, modulate the breast milk microbiota composition in the CHILD cohort in Canada. This project was exploratory and utilized one of the largest birth cohort studies with available breast milk microbiome data. Specifically, use of vitamin C and D supplements plus multivitamins during any trimester in pregnancy was consistently associated with milk microbial diversity and genus composition before and after adjustment for socio-demographic, maternal, and child covariates. Use of other supplements such as fish oil, folate, and calcium was less consistently associated with the breast milk microbiome.</div><div>The fourth aim of the review chapter focused on the infant gut microbiome. The effects of complementary feeding on the infant gut microbiome are less commonly studied than those of breastfeeding, with most research conducted in high-income countries but not LMIC. In contrast, associations between inadequate complementary feeding and undernutrition have been examined in LMIC where undernutrition is most prevalent. Further, a disrupted gut microbiota has been associated with child undernutrition. Indeed, animal studies have suggested a causal association although the direction of the causality is not clear and is potentially bi-directional depending on genetic and environmental conditions. In light of the current state of knowledge described in our review supporting the potential of the gut microbiota as a key player in the relation between complementary feeding and undernutrition, the development of microbiota-directed interventions during the complementary period offers a promising route for undernutrition management.</div><div><br></div><div>Findings from the studies presented in this dissertation highlight several culture-specific determinants of child growth and breastfeeding in Lebanon. The findings also highlight the need for future research using longitudinal prospective cohorts, intervention trails and animal models to provide evidence for the proposed links to enhance the understanding of the paradigm. Such a holistic view of the determinants of and pathways between infant feeding and child growth are of great public health significance to improve the health of children throughout their lives.</div>

Magister Artium (Psychology) - MA(Psych) / While community health workers possess valuable insight into health care delivery in South Africa, their voices and experiences are seldom sought in the acquisition of knowledge surrounding relevant social concerns. This research aimed to explore community health workers’ perspectives of mother–infant bonding within the first 1000 days of life. The first 1000 days of a child’s life are a delicate yet highly consequential period affecting future physical, cognitive, and socio-emotional growth. The bond between mother and infant within the first 1000 days is especially critical as it is within the bounds of this relationship that a child is fed, cared for, and kept safe. Furthermore, mother–infant bonding lays an essential foundation for future development. However, there is a paucity of contextualized literature, particularly regarding mother–infant bonding in the first 1000 days. In practice, mother–infant interventions are often delivered by community health workers. Through their work, community health workers gain a wealth of knowledge and information about the experiences and practices of bonding within their community. Their insights are a potentially untapped resource which could be used to supplement research and interventions with local, contextualized wisdom. The aim of this research was to explore community health workers’ perspectives of mother–infant bonding within the first 1000 days in Khayelitsha, South Africa. The study utilized a qualitative methodological framework and an exploratory research design. Semi-structured individual interviews were conducted with 15 experienced community health workers, who were purposively selected from a non-governmental organization located in Khayelitsha, South Africa. Data were thematically analysed, and five primary themes emerged from the analysis, namely: (1) the importance of the first 1000 days; (2) the centrality of mother–infant bonding within the first 1000 days; (3) effective approaches to bonding are simple, natural, and free; (4) the inhibitors of mother–infant bonding; and (5) the need for support. Trustworthiness and researcher reflexivity practices were integrated throughout the research process. Ethics considerations were prioritized, and included providing informed consent, ensuring confidentiality and anonymity, and informing participants of their rights as stipulated by the University of the Western Cape Biomedical Research Ethics Committee.