A alimentação da criança no primeiro ano de vida é essencial para o crescimento e desenvolvimento adequados. A Organização Mundial de Saúde (OMS) recomenda que o aleitamento materno seja exclusivo até os seis meses de vida e que os alimentos complementares sejam introduzidos a partir desta idade. Os objetivos desta pesquisa foram estimar a prevalência do aleitamento materno em crianças menores de 1 ano de idade e descrever a alimentação complementar entre as crianças estudadas. O estudo transversal, descritivo abrangeu 821 crianças menores de um ano de idade vacinadas na Segunda Etapa da Campanha Nacional de Vacinação nos Postos de Saúde da cidade de Guarapuava-PR. A coleta dos dados foi realizada com as mães e/ou responsáveis por crianças menores de 1 ano de idade que compareceram aos Postos de Saúde naquela data. O instrumento utilizado nesta pesquisa foi o questionário elaborado e validado pelo Instituto de Saúde da Secretaria Estadual de Saúde de São Paulo-SP e parcerias. A análise dos dados deu-se através da análise das freqüências simples de todas as variáveis coletadas. Com relação aos indicadores de aleitamento materno, 68,9% das crianças estavam em aleitamento materno, sendo 86,2% e 39,8% entre crianças menores de 4 e 6 meses, respectivamente. Considerando os indicadores de aleitamento materno exclusivo e predominante, verificou-se que entre as crianças menores de 4 meses foi de 46,4% e 41,4%, respectivamente. Para as crianças menores de 6 meses, verificou-se os seguintes percentuais: 37,3% e 18,9%, respectivamente. Entre as crianças menores de quatro e seis meses, 31,9% e 45,3% estavam recebendo outro tipo de leite que não o humano. Entre as crianças menores ou iguais a 4 meses, 5,1% estavam em alimentação complementar, e entre as menores ou iguais a 6 meses 14% , recebendo chá, água, suco, fruta, sopa de legumes e comida de panela nas últimas 24 horas. Este estudo mostrou que os indicadores de Aleitamento Materno – Aleitamento Materno e Aleitamento Materno Exclusivo estão muito aquém do preconizado pela OMS e que a introdução da alimentação complementar é precoce tanto entre crianças amamentadas como em crianças não amamentadas. / What children eat in the first year of life is essential with a view to adequate growth and development. The World Health Organization (WHO) recommends exclusive breastfeeding up to six months of age and that complementary foods be introduced from that age onwards. This study aimed to examine the prevalence of breastfeeding among children under 1 year old, as well as to describe the introduction of complementary foods among the children in this study. A cross-sectional and descriptive study was realized among 821 infants under 1 year old who were vaccinated in the Second Phase of the National Vaccination Campaign at Health Centers in Guarapuava-PR, Brazil. Data collection involved the mothers and/or responsibles for infants under 1 year old who came to the Health Centers on that day, using the questionnaire elaborated and validated by the Health Institute of the São Paulo State Health Secretary and its partners. The collected data were subject to simple frequency analysis of all variables. As to breastfeeding indicators, 68.9% of the infants received breastfeeding, with 86.2% and 39.8% of children under 4 and 6 months, respectively. Exclusive and predominant breastfeeding indicators corresponded to 46.4% and 41.4%, respectively, among children under 4 months old, against 37.3% and 18.9% for children under 6 months of age. 31.9% and 45.3% of children under 4 and 6 months old were receiving nonhuman milk. 5.1% of children aged 4 months or older and 14% of those aged 6 months or older received complementary feeding, having consumed tea, water, juice, fruit, vegetable soup and homemade food during the last 24 hours. This study has shown that Breastfeeding – Breastfeeding and Exclusive Breastfeeding indicators remain much below the levels set by the WHO and that complementary foods are introduced at an early stage for children who are breastfed or not.

The importance of spirituality in relation to mental well-being and physical health is currently well regarded in the academic literature. Therefore spiritual care is now considered an important aspect of holistic healing practices. However, research is showing that most health care providers do not feel competent or confident in this area of care. In this thesis I explore how spiritual care is understood and experienced by practitioners in aged and palliative care in a regional area on the coast of New South Wales. The 26 participants, whose insights and experiences are depicted in this thesis, were very happy to be involved in this qualitative research project, because they felt that they now had the opportunity to explore spirituality and spiritual care.The participants in this research describe spiritual care as involving doing in the form of religious practices, such as praying or bible readings and non-religious activities that were seen as spiritual such as talking about dying, touching people or reminiscing. Additionally, they also commented about spiritual care as a special way of being with clients, which involved qualities and attitudes that were clearly felt or recognized by the participants as special. Not necessarily labeled as spiritual care, this special way of being was described as not being separate, but being an integral part of the daily acts of caring such as feeding a patient or preparing them for a bath. Participants found it often difficult to elaborate on what made such an interaction spiritual or how to describe the quality of these interactions as there seemed to be no familiar language to share the experiences of spirituality and spiritual care. Additionally, participants commented quite regularly that, although spiritual care was seen as important, there were many factors that inhibited these practices. In reflecting on these issues I put forward that, although the practitioners in this research are familiar with spiritual care, the most important contribution to encouraging health care providers to feel more confident is to continue conversations about spiritual care to increase competency in a non-denominational spiritual discourse in aged and palliative care.

Crude foliar extracts of sixty species from six subfamilies of Australian Lamiaceae were screened by whole organism contact toxicity on the polyphagous mite Tetranychus urticae Koch (Acari: Tetranychidae). In addition, cytotoxicity assessments against insect cell lines from Spodoptera frugiperda J.E.Smith (Lepidoptera : Noctuidae) and Drosophila melanogaster Meigen (Diptera: Drosophilidae) were also made. The findings indicated that the Spodoptera cell line was more susceptible to extracts than the Drosophila cell line and no direct correlation was observed between the two screening methods. However, several interesting relationships were identified. Extracts from sub-families Ajugoideae, Scutellarioideae, Chloanthoideae, Viticoideae and Nepetoideae showed acaricidal activity, whilst only those from Ajugoideae and Nepetoideae displayed potent cytotoxic effects. A range of activities was observed for the 25 species of Plectranthus, 14 of which showed moderate to high contact toxicity against T. urticae. Overall, least promising bioactivity was observed for extracts from the plant subfamily Prostantheroideae, which showed little contact toxicity or cytotoxicity for the 18 extracts studied. Greatest cytotoxicity was observed from a methanol extract of leaf material of Glossocarya calcicola Domin. Bioassay guided fractionation led to the discovery of three novel clerodane diterpenes, which were not present in the stems or at all in the closely related species G. hemiderma. Compound 1 was characterised as (rel)-10âH-trans-12î-(2-methylbut-2(E)-enoyl)-1â-(isobutanoyl)-6á,13î-dihydroxyclerodan-4(20),8(18)-dien-7,15-dione-15,16-oxide, to which the trivial name calcicolin-A was assigned. The other two compounds had the same skeletal structure and C-12 substituent but in compound 2 (calcicolin-B), the C-1 esterifying group became 2-methylbut-2(E)-enoic acid and in 3 (calcicolin-C) it became 2-methylbutanoic acid. Although insect antifeeding activity was not observed for G. calcicola, cytotoxicity against insect and human carcinoma cell lines was detected. Greatest acaricidal activity was observed for Plectranthus diversus S.T.Blake when topically applied (LC50 = 0.25% (w/v)). The major compound present in the extract of P. diversus was identified as the known compound 7á,18-dihydroxy-isopimara-8(14),15-diene. These findings were of chemotaxonomic significance as this is the first known occurrence of a pimarane diterpene in Plectranthus, a genus characterised by abietane diterpenes. A number of abietanes were isolated and identified in this study, though none of which were novel. Promising cytotoxicity was observed from P. fasciculatus P.I.Forst., which was attributed to coleon U, a known abietane diterpene with cytotoxic activity. Other species of Plectranthus showed potential acaricidal activity as a crude extract in particular P. graveolens R.Br. (LC50 = 0.76% (w/v)). Bioassay guided fractionation did reveal some interesting behavioural effects on mites but in general the fractions were less toxic than the whole extract. The hexane-soluble components of the methanol extract were extremely effective against mites and while the mode of action was not fully understood, it is possible that a smothering effect could be the cause. A potted plant trial was also carried out for this species to determine the effects of crude extract. At time = 112 h post treatment, a concentration response in mite mortality was observed. The control and 0.5% (w/v) treatment were not significantly different to one another but had significantly larger numbers of mites than the 1.0 and 1.5% (w/v) treatment. These results showed that the crude methanol extract of Plectranthus graveolens showed acaricidal efficacy against Tetranychus urticae in a leaf disc and a potted plant trial at concentrations of 1% (w/v) or above with no phytotoxic effects. The repellency and antifeeding effects of some plant extracts were evaluated against Plutella xylostella L. (Lepidoptera: Plutellidae) in a choice and no-choice bioassay. The most outstanding results were observed for Ajuga australis L. against both second and third instar larvae. The active constituents were present as minor compounds, thus detailed spectroscopic analysis was not adequately performed. However, the compounds were believed to be known clerodane diterpenes that have been previously isolated from this and other species of Ajuga.

This Reflective Topical Autobiography (RTA) aimed to reflect on and recount my own actual life stories and the life lessons learned, in order to identify patterns, trends and insights from my life and to offer these insights to others. My objectives were to promote personal empowerment as a tool for fulfilling individual potential, and to heal and be healed, by taking personal responsibility and making choices that enhance the individual and thus the collective consciousness.The research questions I posed to myself to assist in reflecting on and recounting my life stories were: What are the key stories of my life? What life lessons have I learned from my experiences? What are the patterns, trends and insights from my life? How can I offer these insights to other people? The RTA activities included writing personal stories, reflecting on my life patterns, trends and insights, and using photographs and a DVD production, to illustrate the main ideas and events.The research process allowed me to move from being reactive to reflective and to answer the research questions. Some of my life lessons learned from my experiences are that: one person can make a difference; lack of money is not lack of personal power; and nothing is impossible. My life patterns and trends include having a high-energy lifestyle, living without fear, learning to deal with disappointments, keeping life records, taking responsibility for action, and creating a morphic field. This RTA also offers insights to other people, with whom they resonate.It became apparent to me, in the process of documenting my personal journey in this RTA, that by suspending judgement and keeping an open mind and open heart, I am able to attune to what I call ‘Divine Intelligence’. It is a deep cellular knowing, that we are all connected. In 32 years of my own development, I have witnessed quantum leaps in the disciplines of science, spirit, ancient wisdom and health, which are acknowledged in the academies of the world. There is a new way of seeing and thinking, which is about a future based on these holistic principles of interconnectedness. It is the contention of this RTA that thoughts and intentions are the tools for personal and global change.

Background The incidence of hypertension is increasing in developing countries such as Thailand (Chaiteerapan et al 1997; Ministry of Public Health 2001; National Library of Thailand Cataloguing in Publication Data 2001) as a result of sociological, political and economic changes. These changes are producing enormous alterations in people�s lifestyles, following similar trends in western countries (National Economic and Social Development Board 1997). Negative changes in food consumption, alcohol consumption, level of physical activity, smoking, stress and tension have led to an increase in chronic health problems for Thai people (National Economic and Social Development Board 1997). Age, gender, ethnicity, genetic background, family health history and hyperlipidaemia are likely to influence hypertension (Kaplan, Lieberman & Neal 2002; Mancia et al 2002; Manger & Gifford 2001; National Heart Foundation of Australia 2003). It has been found that health care professionals and patients with chronic disease have increased their use of complementary therapies to help relieve uncomfortable symptoms and suffering (Long, Huntley & Ernst 2001). Foot reflexology is a well known complementary therapy which claims to help the body achieve homeostasis (Byers 2001; Dougans 2002). It is believed that pressing specific areas on the feet related to specific glands or organs of the body can help these glands and organs to function at their peak, allowing the body to heal itself (Byers 2001; Dougans 2002). The principle difference between massage or touch and foot reflexology is that foot reflexology provides not only the relaxation effect obtained from massage or touch is said to also improve body�s immunity contributing to healing process (Byers 2001;Dougans 2002). Foot reflexology has been scientifically researched in many studies to explore the claimed benefits (Bishop 2003; Kohara et al 2004; Oleson & Flocco 1993; Siev-Ner et al 2003; Yang 2005). Some studies have supported its ability to reduce anxiety and pain (Gambles, Crooke & Wilkinson 2002; Launso, Brendstrup & Arnberg 1999; Stephenson, Dalton & Carlson 2003; Stephenson, Weinrich & Tavakoli 2000). However, there has been little scientific evidence to support the claim that foot reflexology can reduce blood pressure and serum lipids, and can improve the quality of life in patients with hypertension (Hodgson 2000; Milligan et al 2002; Park & Cho 2004). The purpose of this study was to begin to fill this gap by investigating the influence of foot reflexology on blood pressure, serum lipids and quality of life. Aim The aim of this study was to investigate the effect of foot reflexology on reducing blood pressure in patients with hypertension. To this end, patients receiving reflexology were compared with patients receiving a light foot massage, thus controlling for any effects contributed by massage or touch alone. Null hypotheses 1. There is no difference in mean blood pressure level between the foot reflexology group and the light foot massage group at the end of four weeks of treatment. 2. There is no difference in mean low density lipoprotein (LDL) cholesterol and triglyceride levels between the foot reflexology group and the light foot massage group at the end of four weeks of treatment.3. There is no difference in mean quality of life scores between the foot reflexology group and the light foot massage group at the end of four weeks of treatment. Sample A sample size of 128 was required to yield a power of 80%, if the difference in mean diastolic blood pressure between the two groups was 5 mmHg. One hundred twenty eight patients with hypertension who attended the hypertensive clinic in the medical outpatients department of Phramongkutklao Hospital, Bangkok, Thailand were enrolled and participated in the study. Methods Data collection This study used a randomized controlled trial design. Participants were randomly allocated into one of two groups � 64 participants in the foot reflexology group (intervention) and 64 in the light foot massage group (control). Data collection took place over 4� months between 26 July and 9 December 2004. Ethics approval was obtained from both the university and hospital ethics committees. Prior to randomization, participants were asked to complete a demographic data questionnaire and the World Health Organization Quality of Life-BREF (WHOQOLBREF) (World Health Organization 1996) questionnaire. Blood was drawn to test LDL cholesterol and triglyceride levels. Using an intervention protocol based on previous literature (Byers 2001), participants in the foot reflexology group received their usual medical treatment and a 50-minute foot reflexology treatment twice a week for four weeks. Participants in the light foot massage group received their usualmedical treatment and a 30-minute light foot massage session without pressure on specific reflexology areas twice a week for four weeks. Blood pressure was recorded before and after each treatment. At the end of the study, participants were asked to complete the WHOQOL-BREF (World Health Organization 1996) again and blood was once more drawn to test LDL cholesterol and triglyceride levels. Data analysis An independent samples t-test followed by analysis of covariance was used to test for difference in mean diastolic blood pressure between treatment groups both unadjusted and adjusted for baseline values respectively. Descriptive statistics were used to present the demographic data. Results Demographic data Control and intervention groups were similar in gender, age, educational background, economic factors, lifestyle characteristics, co-morbidities and medical treatments. Demographic data which were substantially different between groups were marital status, the length of time experiencing hypertension and the length of time having treatment for hypertension. The study showed that fewer participants in the foot reflexology group (57.8%) were married than in the light foot massage group (70.3%). The foot reflexology group also had a higher rate (32.8%) of �divorced/separated/widowed� compared with the light foot massage group (20.3%). Participants in the light foot massage group had almost nine times the number of participants who had had hypertension for more than 15 years, and almost eight times the number of participants who had been having treatment for hypertension for more than 15 years, compared with those in the foot reflexology group. Outcome variables For both the unadjusted and adjusted analyses, there was no statistically significant difference between treatment groups post-intervention. Conclusions The results from this study did not support the claim that foot reflexology can decrease blood pressure, LDL cholesterol and triglyceride levels. Similarly, there was no evidence that it could improve the quality of life in patients with hypertension.

This study aimed to determine how CMs used by surgical patients are managed in the hospital system by doctors and pharmacists and what patient and practitioner influences affect this management. Research design and method Five systematic reviews were conducted to investigate the peer-reviewed literature for information about Australians use of CM; overseas and Australian doctors and CM; surgical patients use of CM and safety information about CMs in surgery as a basis to design and conduct three surveys. Surveys of hospital doctors, pharmacists and surgical patients were used to obtain measurement of people's attitudes, perceptions, behaviours and usage of CMs. For healthcare practitioners, knowledge of complementary medicines (CMs), past training, current practice and interest in future practice of complementary therapies (CTs) and education was also investigated. Approximately 50% of surgical patients reported taking CMs in the 2 weeks prior to surgery and approximately 50% of these patients intended to continue use in hospital. The most commonly used CMs were: fish oil supplements, multivitamins, vitamin C and glucosamine supplements as well as some CMs considered to potentially increase bleeding risk or induce drug interactions. It was not uncommon for CMs to be used at the same time as prescription medicines. Most surgical patients in general self-prescribe their CMs or have them recommended by family and friends whereas medical practitioners were the main prescribers to cardiac surgery patients. Nearly 60% of patients using CMs in the 2 weeks prior to admission did not tell hospital staff about use. The main reason for non-disclosure was not being asked about use whereas fear of a negative response was rarely a concern. The most common sources of information surgery patients refer to were GPs, pharmacists and health food stores. Hospital doctors and pharmacists did not routinely refer to information sources about CMs safety. The majority of doctors and pharmacists did not routinely ask patients about CMs, or record usage information. They had little training and knowledge of the evidence of commonly used CMs and lacked confidence in dealing with CMs-related issues. Their attitude to CMs is moderately negative and many are wary of safety, efficacy and cost-effectiveness issues. The majority of practitioners considered some CTs as potentially useful, particularly acupuncture, massage and meditation whereas the medicinal CTs and chiropractic were considered potentially harmful. Most practitioners were interested in future education about CMs and CTs and some would consider practising CTs. Personal usage of CTs was low although there was substantial interest in receiving future treatment. Despite many strategically orientated initiatives developed in Australia to promote evidence based medicine (EBM) and quality use of medicines (QUM), it appears that CMs have been largely ignored and overlooked in the practice of Medicine and Pharmacy within the hospital system. Furthermore, it appears that in regards to CMs a 'don't ask, don't tell, don't know' culture exists within hospitals and that evidence based patient-centred care and concordance is not being achieved and potentially patient safety and wellbeing is being compromised.

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2007. / Title from title screen (site viewed Dec. 5, 2007). PDF text: xi, 166 p. : ill. ; 9 Mb. UMI publication number: AAT 3273922. Includes bibliographical references. Also available in microfilm and microfiche formats.

<p>Illamående och kräkning är förekommande biverkningar hos patienter med cancer som behandlas med cytostatika och är därmed tillstånd som sjuksköterskan kommer i kontakt med. Om patientens illamående och kräkning inte förebyggs kan det leda till konsekvenser som att patienten blir dehydrerad, tappar aptiten, blir undernärd och försvårar skadad vävnad att återhämta sig från cytostatikabehandling. Trots att de flesta patienter får antiemetika lyckas inte deras illamående och kräkning förebyggas. Syftet var att belysa komplementära behandlingsmetoder vid cytostatikarelaterat illamående och kräkning. Studien är utförd som en litteraturstudie och baserad på 14 vetenskapliga studier. Resultatet visar att komplementära behandlingsmetoder har ett visst vetenskapligt stöd och är ett bra komplement till antiemetika. Akupressur är den behandlingsmetod som är effektivast för att förebygga cytostatikarelaterat illamående och kräkning. Även akustimulation, elektroakupunktur och avslappning minskar patienternas illamående och kräkning. Mer forskning behövs för att ge mer styrka åt de olika komplementära behandlingsmetoder, eftersom sjuksköterskans arbete måste utföras utifrån vetenskap och beprövad erfarenhet. Genom att sjuksköterskan får ökad kunskap om hur cytostatikarelaterat illamående och kräkning förebyggs kan patientens lidande minska.</p>

The parasitic components of MOS switches at high speeds affect the linearity and resolution of CMOS sample and hold circuits. CCD-based circuit design can offer good performance at high speeds. This thesis presents the design of sample and hold circuits using charge-coupled device structures in a standard CMOS process. Three sample and hold circuits have been built and tested for linearity and speed performance. The CCD S/Hs have been characterized using a continuous-time integrator and a Δ∑ ADC. The CCDs, with a switched capacitor amplifier at the output, achieve an SFDR of 54dB for an input signal V[subscript in]=2.6V+0.4Vpp at f[subscript in]=10.1KHz. / Graduation date: 2003

This thesis presents an automated methodology to calibrate the substrate profile for accurate prediction of substrate parasitics using Green's function based extractors. The technique requires fabrication of only a few test structures and results in an accurate three layered approximation of a heavily doped epitaxial silicon substrate. The obtained substrate resistances are accurate to about 10% of measurements. Advantages and limitations of several common measurement techniques used to measure substrate z-parameters and resistances are discussed. A new and accurate z-parameter based macro-model has been developed that can be used up to a few GHz for P��� for contacts that are as close as 2��m. This enhanced model also addresses the limitations of previous models with regards to implementation aspects and ease of integration in a CAD framework. Limitations of this modeling approach have been investigated. The calibration methodology can be used along with the scalable macromodel for a qualitative pre-design and pre-layout estimation of the digital switching noise that couples though the substrate to sensitive analog/RF circuits. / Graduation date: 2004