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Pressure ulcer prevention in Ghana : What is the nurses´knowledge?Jönsson, Amanda, Engman, Erica January 2010 (has links)
Background Although Pressure ulcer is common in high and middle income countries it is rarely researched in low income countries. Evidence based interventions of pressure ulcer prevention are developed but the gap between the evidence and the clinical practice is wide. Aim Describe the nurses‟ knowledge about pressure ulcer prevention at a provincial hospital in Ghana. Design An empirical qualitative approached was used and semi-structured interviews were made with nurses at the Kwahu Governmental Hospital in Atibie, Ghana. A content analysis and a deductive content analysis were used to analyze the material. The evidence based interventions suggested by the North American Nurses Association (NANDA) was used as a theoretical framework. Result / Conclusion The themes Pressure ulcer prevention and Nurses‟ knowledge were found. Most of the evidence based interventions were mentioned by the participants. However, the participants explained massage as a preventive intervention although the evidence advice against massage. The participants did not mention any interventions considering documentation and nutrition. Further the nurses explained that they achieved their knowledge in school by practical demonstrations and examinations. The nurses‟ opinion was that their knowledge is enough to prevent pressure ulcers. / <p>Röda Korsets sjuksköterskeförening stipendium 2011</p>
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'What about the Mother?' : Rising Caesarean Section Rates and their Association with Maternal Near-Miss Morbidity and Death in a Low-Resource SettingLitorp, Helena January 2015 (has links)
In recent decades, there has been a seemingly inexhaustible rise in the use of caesarean section (CS) worldwide. The overall aim with this thesis is to explore the effects of and reasons for an increase in the CS rate at a university hospital in Dar es Salaam, Tanzania. In Study I, we analysed time trends in CS rates and maternal and perinatal outcomes between 2000 and 2011 among different obstetric groups. In Study II, we documented the occurrence and panorama of maternal ‘near-miss’ morbidity and death, and analysed their association with CS complications. We also strived to determine if women with previous CS scars had an increased risk of maternal near-miss, death, or adverse perinatal outcomes in subsequent pregnancies. Studies III and IV explored women’s and caregivers’ in-depth perspectives on CS and caregivers’ rationales for their hospital’s high CS rate. During the study period, the CS rate increased from 19% to 49%. The rise was accompanied by an increased maternal mortality ratio (odds ratio [OR] 1.5, 95% Confidence Interval [CI] 1.2–1.8) and improved perinatal outcomes. CS complications accounted for 7.9% (95% CI 5.6–11) of the maternal near-miss events and 13% (95% CI 6.4–23) of the maternal deaths. Multipara with previous CS scars had no increased risk of maternal near-miss or death compared with multipara with previous vaginal deliveries, and a lower risk of adverse perinatal outcomes (adjusted OR 0.51, 95% CI 0.33–0.80). Both women and caregivers stated they preferred vaginal birth, but caregivers also had a favourable attitude towards CS. Both groups justified maternal risks with CS by the need to ‘secure’ a healthy baby. Caregivers stated that they sometimes performed CSs on doubtful indications, partly due to dysfunctional team-work and a fear of being blamed by colleagues. This thesis raises a concern that maternal health, interests, and voices are overlooked through the CS decision for the benefit of perinatal outcomes and caregivers’ liability. An overuse of CS should be seen as a sign of substandard care and preventing such overuse needs to be among the key actions when formulating new targets for the post-2015 era.
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Landowners, developers and the rising land cost for housing, the case of Seoul, 1970-1990Lim, Seo Hwan January 1994 (has links)
A sharp rise in house prices became a political issue in Korea in the late 1980's. It opened a heated debate among scholars and experts on the causes of house price rises. In the debate, a common belief was that high land prices had been one of the main causes of high house prices. In fact, the proportion of land cost in new house prices has steadily increased as the latter has risen in Korea during the past two decades. This research calls into question the notion underlying that common belief that land prices exist independently of housing development. Most policy measures are sought on the basis of this notion. This research argues that land prices are an outcome of conflicts between landowners and developers in the process of housing development. In exploring the idea that the determination of land cost for housing is a result of conflicts between landowners and developers, the research came to the question of what the source of conflicts is, a question of why and how the two actors enter into conflictive relations. It was a suggestion of Marx's concept of rent that surplus profits are the material source of conflicts; the ability of developers to create higher surplus profits provides possibility of landowners to demand more payments for their land; landowners' appropriation of increasingly larger portions of surplus profits then conditions the way developers produce housing; thus both enter into a conflictive and contradictory relationship. It was thus hypothesised that the rising land cost for housing has been primarily a result of that conflicting and contradictory interaction, which is permanently operating in housing development. However, how far and in what forms the conflict affects housing development and the determination of land cost are affected by social mediation of the interaction. Thus the research, the test of the above hypothesis, comprises two parts: the identification of the material aspect of the process by which landowners and developers entered into conflicting relations resulting in increasing land prices for housing as suggested in Marx's concept of rent; and the examination of political and economic circumstances in which social relations between the two actors were conditioned to leave that material process unregulated. This hypothesis was tested with reference to the case of housing development in Seoul during the 1970's and 1980's. The empirical examination disclosed that the rising land cost for housing in Korea has been due to the conflictive nature of the relationship between landowners and developers. Developers have created large surplus profits by exploiting rapidly growing speculative demand for housing and government housing programmes relying on private development; this have provided room for landowners to raise land prices such that increasingly larger portions of new house prices have been allocated to land cost; increasing government intervention have been unsuccessful in controlling this conflictive and contradictory process and the consequent spiral rises in land cost and house prices because of its inability to break from its self-financing housing development strategy; this inability has been due to historical circumstances which, characterised by strong state and weak labour relations and the subordination of finance to industrial capital, have conditioned housing development to be driven by the private appropriation of development gains.
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Food security in New ZealandParnell, Winsome R., n/a January 2005 (has links)
There was growing concern in New Zealand in the 1990�s that Food Security: access by all people at all times to enough food for an active healthy life, was not being achieved, despite an abundant food supply. A study of a convenience sample of 40 families with children (58 adults and 92 children) whose sole income was a government welfare benefit was undertaken. Two-thirds of these households regularly relied on a limited variety of food; one-half did not have a sufficient amount of food because of lack of money and outstanding debts. Over the previous year two-thirds had sourced food from a food bank and one-third had been gifted food from friends or relatives. Women�s intakes were compromised regularly but not children�s. All of the women experienced worry about feeding their household. One-fifth were overweight and over 40% obese despite low reported daily energy intakes (median (SE) 5.7 (0.5) MJ) compared to national data. Six repeated 24-hour diet recalls collected randomly over a two-week period enabled calculation of usual daily intake and the prevalence of inadequate intake for eight micronutrients which were disturbingly high. The children�s growth patterns compared favourably with US population percentiles.
The National Nutrition Survey (NNS97) allowed the adaption of eight questions--developed by Reid using qualitative methods--to eight indicator statements about food security to be addressed by each participant on behalf of them or their household. Prevalence was significantly higher (p<0.05) for females compared to males for the majority of indicator statements among New Zealand European and Others (NZEO) and Maori. NZEO reported the most food security; Pacific people reported the least and Maori fell between the two. There was a significant increasing linear trend of food security with age (p<0.001) after adjusting for gender.
Rasch analysis was performed on 1868 households where participants reported some food insecurity. The responses were ranked according to the proportion and ordering of their positive responses to eight indices of food security, achieving reliability (Cronbach�s Alpha) close to the conventionally accepted level of 0.7. The eight indices were ranked on the same scale; the minimum score -1.66 was achieved by the index �use special food grants/banks� (the index least reported and most severe) and the maximum score 1.86 was achieved by the index �variety of foods eaten limited� (the index most reported and least severe).
Categories of food security were assigned using scale cut points: �fully/almost fully food secure�; �moderate food security�; �low food security�. Category status was associated with consumption of recommended number of daily serves of fruit, vegetables, fruits and vegetables, consumption of leaner meats, fatty meats and daily serves of bread. By ANOVA and controlling for sex, ethnicity, Index of Deprivation, urban/rural location, age, level of education, income, and household size, category of household food security was associated with the level of daily intake of total fat, saturated, monounsaturated and polyunsaturated fat, cholesterol, glucose, fructose, lactose, vitamin B6, vitamin B12, and vitamin C. Dietary data were from the primary 24-hour diet recall of respondents. Participants in the fully/almost fully food secure category of households had a mean BMI of 28.7 compared to those moderately secure (29.2) and of low food security (29.5) (p=0.015 for difference among categories).
In the Children�s Nutrition Survey 2002 (CNS02) data set, the same eight indices were used and food insecurity was experienced significantly more often by children in the largest households, those in the most deprived areas of residence (NZDep01 Quintile) and those of Pacific and Maori ethnicity compared to NZEO children. Rasch analysis was performed on responses for 1561 households with children which reported some food insecurity. Subject reliability was close to 0.7 (the conventionally acceptable level). The distribution of the eight indices on the Rasch scale was similar to that observed among the NNS97 households and almost identical to the sub-set of households with children, from that dataset. Categories of food security status were assigned as in the NN5S97 and they predicted daily nutrient intake levels of children: total sugars, lactose, vitamm A, β-carotene, vitamin B12 and calcium. A more rigorous assigning of categories at the low/moderate scale cut-off, resulted in a further association with level of intake of glucose, fructose and folate. Mean BMI across categories of food security did not differ.
Collectively these data provide unequivocal evidence that food insecurity exists in New Zealand, that it can be quantified and associated with nutrition outcomes. It has a negative impact on the nutrient intakes of both adults and children and a negative impact on the body weight status of adults.
These data have implications for nutrition and health professionals and policy makers in New Zealand. They also add to the world-wide body of knowledge of the experience of, and the measurement and predictive potential of food security in populations where the food supply appears plentiful.
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Structure and consequences of socioeconomic segregation in poor Buenos Aires settlementsSuárez, Ana Lourdes. January 2007 (has links)
Thesis (Ph. D.)--University of California, San Diego, 2007. / Title from first page of PDF file (viewed January 24, 2008). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 290-304).
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"As a family we are going to be here" : Mexican immigrant mothers' experiences with parenting in distinct community contexts /Feeney, Sarah L. January 1900 (has links)
Thesis (M.S.)--Oregon State University, 2008. / Printout. Includes bibliographical references (leaves 113-118). Also available on the World Wide Web.
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Parent training for caregivers of typically developing, economically disadvantaged preschoolers : an initial study in enhancing language development, avoiding behavior problems, and regulating family stress /Fanning, Jessica Lena, January 2007 (has links)
Thesis (Ph. D.)--University of Oregon, 2007. / Typescript. Includes vita and abstract. Includes bibliographical references (leaves 238-249). Also available for download via the World Wide Web; free to University of Oregon users.
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Strategic responses to low-cost-country competition : conceptual and empirical analysis of manufacturing industries in Germany and the United States /Körte, Peter. January 2006 (has links)
Zugl.: Vallendar, Wiss. Hochsch. für Unternehmensführung, Diss., 2006. / Hergestellt on demand.
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Measuring food deserts : a comparison of models measuring the spatial accessibility of supermarkets in Portland, Oregon /Sparks, Andrea Leigh. January 2008 (has links)
Thesis (M.C.R.P.)--University of Oregon, 2008. / Typescript. Includes vita and abstract. Includes bibliographical references (leaves 73-75). Also available online.
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Indentification of Hispanic American students and students of poverty for gifted and talented programsHageman, Katherine E. January 2008 (has links) (PDF)
Thesis (M.Ed.)--Regis University, Denver, Colo., 2008. / Title from PDF title page (viewed on Feb. 02, 2009). Includes bibliographical references.
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