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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
101

Förebyggande tandvård för att främja oral hälsa hos äldre : - En registerstudie bland individer 65 till 70 år i Värmland / Preventive dental care to promote oral health in elderly : - A register-based study among individuals 65 to 70 year, in the Region of Värmland

Seleskog, Birgitta January 2020 (has links)
Bakgrund: Kariessjukdomen hör till en av världens vanligaste sjukdomar med flertalet kända orsaks- och riskfaktorer. För att bevara en god oral hälsa utgör förebyggande tandvård en betydelsefull del bland äldre och kan ha en stor inverkan på en individs livskvalitet. Karies kan förebyggas och behandlas med stöd av patientutbildning och förebyggande tandvård, en hälsoinsats som främjar framförallt individen men även samhället med minskade resurs- och vårdkostnader. Syfte: Övergripande syftet med studien var att kartlägga förekomst och fördelning av registrerade förebyggande åtgärder i relation till karies bland individer 65 till 70 år, bofasta i Värmland 2017. Metod: Studiens design var en tvärsnittsstudie av individdata (n=2738) från 65- till 70-åriga individer bosatta i Värmland och undersökta i tandvården, Region Värmland 2017. Data baseras på Svenskt Kvalitetsregister för Karies och Parodontit (SKaPa) åren 2017 och 2018. Resultat: Närmare trefjärdedelar av individerna hade ingen tillståndskod för karies registrerad (72,1%). Det var ungefär dubbelt så vanligt med tillståndskoder för sekundärkaries jämfört med primärkaries, 684 respektive 291 registreringar. Totalt registrerades 742 sjukdomsförebyggande åtgärder (200-serien) och 3495 sjukdomsbehandlande åtgärder (300-serie). ”Icke-operativ behandling” var den åtgärd som starkast associerades till individer med kariestillstånd (OR 3,83; CI 3,04–4,83). ”Information vid risk för sjukdom” var starkast associerad till individer utan kariestillstånd.  Antalet erhållna förebyggande åtgärder var snedfördelad och kunde variera från en upp till nio behandlingar per individ. Konklusion: Resultatet i denna studie talar för betydelsen av ytterligare studier inom förebyggande tandvård som hälsofrämjande insats för att främja oral hälsa bland äldre individer med kariessjukdom. Beteendemedicinsk prevention är en underutnyttjad åtgärd som behöver övervägas inom den förebyggande tandvården. / Introduction: Dental caries is one of the most common diseases worldwide with well-known risk factors. In order to maintain a good oral health, preventive dental care is an important part for elderly people and impacts on an individual´s quality of life. Dental caries can be prevented and treated with patient support, education and preventive dental care. Health promotion activities within dental care contributes to the individual’s well-being and reduces costs for the society.   Aim: The overall aim was to identify the occurrence and distribution of registered preventive dental care in relation to caries, among individuals aged 65 to 70 years resident in the county of Värmland in 2017.  Method: A cross-sectional register-based study of individual data (n= 2738) from 65 to 70-year-old individuals resident and dental examined, in the county of Värmland in 2017. Data was obtained from The Swedish Quality Registry for Caries and Periodontal Diseases (SKaPa) from years 2017 and 2018.  Results: Nearly three-quarters of the individuals had no caries conditions registered (72,1%). Secondary caries-conditions were about twice as common compared to primary caries, 684 and 291 registrations, respectively.  A total of 742 preventive-treatments and 3495 preventive disease-treatments were registered. “Non-invasive treatment” had the strongest association to individuals with caries conditions (OR 3,83; CI 3,04-4,83). The treatment “information when risk for disease” had the strongest association to individuals without caries conditions. The number of obtained preventive treatments were skewed and could vary from one up to nine treatments per individual. Conclusion; The results of this study indicate the importance of further studies of preventive dental care as a health promotion achievement to promote oral health among older individuals with dental caries disease. Behavioral medical prevention is underused and needs to be considered in preventive dental care in the future.
102

Work-related diabetes distress (WRDD) bland yrkesverksamma diagnostiserade med typ 1 diabetes

Nilsson, Linnea January 2023 (has links)
Aims: Work-related diabetes distress (WRDD) can be defined as the combination of anxiety and exhaustion to combine work with diabetes in working life and this is a current problem. The aims of this study were to assess the prevalence of WRDD and covariation between WRDD and working life variables relevant to occupational health among professionals diagnosed with type 1 diabetes in Sweden. Method: This is a quantitative cross-sectional study in the form of a survey. The sample was a closed group on Facebook for people with type 1 diabetes, all members were offered to answer a questionnaire with validated questions about psychosocial working conditions, work requirements, work ability, diabetes acceptance and blood sugar levels. To investigate the occurrence of WRDD, descriptive analyses and cross-tabulation were carried out. Logistic regression analysis was used to investigate associations between the dependent variable (WRDD) and the independent variables (psychosocial working conditions, work requirements, work ability, diabetes acceptance and blood sugar levels). Main result: The survey was answered by 191 respondents. The incidence of WRDD in the sample was 71.7%. The multiple logistic regression analysis showed a significant relationship (p <0.05) between the independent variables work ability, blood sugar level, diabetes acceptance, and the dependent variable WRDD. The odds of having WRDD were three times higher in those individuals who experienced poorer work ability, had difficulty accepting their diabetes or maintained a higher blood sugar level at work. Conclusions: The results showed that WRDD is a problem causing working life consequences and should be given more attention both in healthcare and working life. Increased knowledge and understanding of the challenges WRDD can cause for people with type 1 diabetes in working life is necessary to be able to prevent WRDD. / Syfte: Work-related diabetes distress (WRDD) kan definieras som en kombination av oro för och utmattning av att förena arbete med diabetes i arbetslivet och är ett aktuellt problem. Studiens syfte var att studera förekomsten av WRDD och samvariationen mellan WRDD och andra arbetsrelaterade variabler relevanta för arbetshälsa bland yrkesverksamma diagnostiserade med typ 1 diabetes i Sverige. Metod: Studien var en kvantitativ tvärsnittsstudie i form av en enkätundersökning riktad till yrkesverksamma personer med typ 1 diabetes. Urvalet var en sluten grupp på Facebook för personer med typ 1 diabetes, alla medlemmar i gruppen fick erbjudande om att svara på en enkät innehållande validerade frågor om psykosociala arbetsförhållanden, arbetskrav, arbetsförmåga, diabetesacceptans och blodsockernivå. För att undersöka hur förekomsten av WRDD såg ut genomfördes deskriptiva analyser och korstabulering. Logistisk regressionsanalys användes för att undersöka om det fanns samband mellan den beroende variabeln (WRDD) och de oberoende variablerna (psykosociala arbetsförhållanden, arbetskrav, arbetsförmåga, diabetesacceptans och blodsockernivå). Huvudresultat: Enkäten besvarades av 191 respondenter. Förekomsten av WRDD hos de svarande var 71,7%. Den multipla logistiska regressionsanalysen visade ett signifikant samband (p <0.05) mellan arbetsförmåga, blodsockernivå, diabetesacceptans och WRDD. Oddsen för att ha WRDD var tre gånger högre hos de individer som upplevde sämre arbetsförmåga, hade svårt att acceptera sin diabetes eller höll en högre blodsockernivå på arbetet. Slutsatser: Resultaten visade att WRDD är ett problem med arbetslivskonsekvenser som behöver uppmärksammas mer både inom vården och i arbetslivet. Ökad kunskap och förståelse för de utmaningar WRDD kan medföra för personer med typ 1 diabetes i arbetslivet är nödvändigt för att kunna förebygga WRDD.
103

En stillbild av paraprofessionella : En explorativ studie om skillnader i elever och lärares uppfattningar om sociala aspekter från två olika skonkontexter / A snapshot of paraprofessionals : An exploratory study on differences in students' and teachers' perceptions of social aspects from two different school contexts

Hallin, Joy January 2024 (has links)
I dagens skolmiljö är det alltmer erkänt att skolor kan variera avsevärt i sin struktur, elevsammansättning och personaluppsättning, vilket kan få betydelse för såväl elever som lärares uppfattningar om miljön i skolan. En yrkeskategori som blivit allt vanligare i skolans värld är paraprofessionella. Avsikten med införandet av denna yrkesgrupp och deras arbetsuppgifter kan variera från skola till skola, däremot kan arbetet i många fall innebära att främja sociala aspekter i skolmiljön samt ett elevsocialt arbete. Eftersom vissa skolor har infört paraprofessionella med dessa uppgifter, medan andra skolor inte har gjort det, har denna studie som syfte att med hjälp av data från TIMSS 2019 analysera och beskriva en ögonblicksbild av två olika skolkontexter. Mer specifikt är syftet att undersöka skillnader mellan skolkontexter med och utan paraprofessionella avseende elevernas och lärarnas uppfattningar om sociala aspekter i skolmiljön. För att utforska och beskriva dessa skillnader har en tvärsnitts- och explorativ design med kvantitativ ansats använts. Resultaten indikerar att det kan finnas skillnader i elevernas uppfattningar om klassrumsklimatet, samt i lärarnas arbetstillfredsställelse gällande tidsmässiga villkor. Dessa fynd betonar vikten av att förstå hur olika skolkontexter påverkar skolmiljön och kan bidra till att informera framtida skolutvecklingsinitiativ. / In today's educational environment, it is increasingly recognized that schools can vary significantly in their structure, student composition, and staffing, which can impact both students' and teachers' perceptions of the school environment. One professional category that has become more common in the school setting is paraprofessionals. The purpose and tasks assigned to this group can vary from school to school, but their work often involves promoting social aspects within the school environment and providing social support to students. Since some schools have implemented paraprofessionals with these roles while others have not, this study aims to analyze and describe a snapshot of two different school contexts using data from TIMSS 2019. Specifically, the aim is to examine differences between school contexts with and without paraprofessionals regarding students' and teachers' perceptions of social aspects in the school environment. To explore and describe these differences, a cross-sectional and exploratory design with a quantitative approach has been used. The results indicate that there may be differences in students' perceptions of classroom climate and in teachers' job satisfaction regarding time-related conditions. These findings underscore the importance of understanding how different school contexts affect the school environment and can contribute to informing future school development initiatives.
104

Matens klimatpåverkan och näringsinnehåll : En kvantitativ studie om skillnader i matvanor mellan olika kosthållningar och kön bland högskolestudenter

Hakopian, Ani January 2017 (has links)
Svenskarnas matkonsumtion är inte hållbar utifrån ett klimatperspektiv. För en mer hållbar konsumtion krävs en minskning av animaliska livsmedel. Tidigare studier visar att det är möjligt att äta klimatsmart och fortfarande nå upp till näringsrekommendationerna. Syftet med studien är att undersöka vilken klimatpåverkan och näringsinnehåll studenters matvanor har och skillnader mellan olika kosthållningar och kön. Studien har genomförts utifrån en kvantitativ ansats med en tvärsnittsdesign genom semistrukturerade intervjuer. Urvalet bestod av 21 högskolestudenter, elva män och tio kvinnor med en fördelning på sju deltagare inom varje kosthållning. Metoden som använts är retrospektiva 24-timmarsintervjuer för att få en bild av en grupps matvanor. Resultatet visar att lunch är den måltidsform med högst klimatpåverkan och näringsinnehåll. Lunch har närmare tre gånger så hög klimatpåverkan jämfört med frukost. Allätare har högst klimatpåverkan och proteinintag, medan veganer har högre kolhydrats- och energiintag samt lägst klimatpåverkan. Vegetarianer och veganer har högst intag av vitamin C. Mäns måltider bidrar med högst klimatpåverkan och de har högst intag av protein, energi och kolhydrater, medan kvinnor har ett högre intag av vitamin C. Det teoretiska perspektivet som användes för att diskutera resultatet är social-ekologiska modellen. / The food consumption of Swedish people is not sustainable from a climate perspective. For more sustainable consumption it requires a reduction of meat and dairy products. Previous studies show that it is possible to eat climate smart but still reach nutrition recommendations. The aim of this study is to investigate the students´ eating habits, nutritional content, impact on the climate, and study if there are differences between diets and between men and women. The study is based on quantitative approach with a cross sectional study through semi-structured interviews. The used method is retrospective 24-hour recall interviews to get at picture of the groups eating habits. The participants comprised of 21 students from Mälardalen University, eleven men and ten women with a distribution of seven participants in each diet. The result shows that lunch is the meal with the highest climate impact and nutritional content and that lunch has almost three times higher climate impact compared to breakfast. Individuals who eat both meat and dairy have the highest climate impact and protein intake, while vegans have the lowest climate impact and highest carbohydrate and energy intake. Vegetarians and vegans have the highest intake of vitamin C. Mens´ meals have the highest climate impact and nutritional content of protein, energy and carbohydrate, while women have a higher intake of vitamin C. The social ecological model is the theoretical perspective used to discuss the result.
105

Intellektuellt kapital : En jämförelse av årsredovisningar mellan svenska företag / Intellectual capital : Comparison of annual reports by Swedish companies

Holm, Olof, Haglund, Alexander, Sukhin, Jonas January 2019 (has links)
Paraplybegreppet intellectual capital (IC) innefattar alla former av tillgångar som saknar fysisk substans och som utgör skillnaden mellan ett företags redovisade värde och deras marknadsvärde. Två noterade företag med identiska tillgångar på balansräkningen kan alltså värderas till helt olika priser. Anledningen är att det finns mer abstrakta former av tillgångar som är svåra att kvantifiera och redovisa. I en årsredovisning finns det utrymme för företag att delge information som de anser viktig. Syftet med studien är att redogöra hur svenska företag inom olika branscher rapporterar och kommunicerar förekomsten av IC genom årsredovisningar. Studien baseras på en kvantitativ innehållsanalys. Utifrån resultatet gör vi en ansats att identifiera eventuella mönster inom branscherna och diskuterar om dessa mönster kan förklaras av branschernas olika egenskaper. Den teoretiska modell som används i denna studie utvecklades av James Guthrie. Med hjälp av Guthries kodschema och definitioner för IC identifierar vi skillnader mellan fyra olika branscher inom Sverige. Dessa branscher är läkemedel, IT-konsult, bank samt fastighetsbranschen. IC delas in i tre huvudkategorier, internal capital, external capital och human capital, vilka i sin tur består av ett antal underkategorier. Kategorierna används som begrepp för att representera de tillgångar i verksamheten som inte kan fångas av den traditionella redovisningen. Insamlingen av data gör vi genom en tvärsnittsstudie bestående av ett teoretiskt urval, där vi analyserar fyra företag inom respektive bransch med högst P/B-tal. Resultatet av vår studie leder till slutsatsen att det finns skillnader mellan branscher vid rapporteringen av IC, genom fördelningen mellan olika underkategorier och framförallt i omfattningen av rapporteringen - skillnader som inte alltid är självklara eller uppenbara. Dessa skillnader framträder inte om fokus ligger på antal och fördelningen av de olika kategorier av IC, utan uppkommer vid en djupare nyanserad analys av hur företagen kommunicerar sitt IC. Därför har vi i vår studie presenterat materialet med citat från de olika företagens årsredovisningar, för att belysa hur IC uttrycks samt för att få med dess kontext. Resultatet visar på att svenska företag inom läkemedelsbranschen kommunicerar mest om internal capital och att bank-, It-konsult- samt fastighetsbranschen kommunicerar mest om external capital. Läkemedelsbranschen rapporterar relativt mycket om IC, jämfört med de resterande branscherna. Det största företaget inom respektive bransch är också det som rapporterade mest IC. / The generic term intellectual capital (IC) contains all forms of assets that lacks the aspect of a physical substance and makes the difference between a company’s book value and market value. Two stock-listed companies with identical assets on the balance sheet can thus be valued at notably different share-price. The reason for this is the presence of more abstract forms of assets that are more difficult to quantify and account for. An annual report contains given space for companies to communicate information that they consider important and relevant. The purpose of this paper is to examine how Swedish companies in different sectors report and communicate the occurrence of intellectual capital by analyzing annual reports. The study is based on a qualitative content analysis. Based on the result, we have made an effort to identify any patterns within the sectors and discuss whether these patterns can be explained by the different characteristics of the sectors. The theoretical model used in this study is developed by James Guthrie. With help of Guthrie’s code scheme and definitions for intellectual capital, we examine differences between four different sectors in Sweden. These sectors are pharmaceuticals, IT consultants, banks and the real estate sector. IC is divided into three main categories, which in turn consist of a number of subcategories. The categories are used as a concept to represent the assets in the business that cannot be seized by the traditional accounting. We have collected the data through a cross-sectional study consisting of a theoretical sample, where we analyze four companies within each sector with the highest price to book value. The results from our research lead us to the conclusion differences exists in between the different sectors when it comes to their reporting of intellectual capital, differences regarding the distribution between different subcategories and particularly in the magnitude of the reports. Differences that sometimes do not come across as obvious or self-evident. These differences will not show if one only focuses on how many numbers there are and allocation of the different categories of IC, but arises from a deeper nuanced analysis of how companies communicate their IC. Therefore, in our study, we have presented the material with quotes from the various companies’ deductions, in order to illustrate how IC is expressed and to capture its context. The result shows that Swedish companies in the pharmaceutical sector communicate mostly about internal capital and that the banking, IT consultancy and real estate sector communicates mostly about external capital. The pharmaceutical sector reports relatively much about IC, compared to the remaining sectors. The largest company in each sector is also the one that reported the most IC.
106

Body mass index and vigorous physical activity in children and adolescents: an international cross-sectional study.

Braithwaite, Irene E, Stewart, Alistair W, Hancox, Robert J, Murphy, Rinki, Wall, Clare R, Beasley, Richard, Mitchell, Edwin A 01 August 2017 (has links)
Aim: To examine the relationship between reported vigorous physical activity (VPA) and body mass index (BMI) in children (6–7 years) and adolescents (13–14 years). Methods: In the International Study of Asthma and Allergies in Childhood Phase Three, 75 895 children's parents and 199 502 adolescents answered questions relating to VPA, height and weight. The association between VPA and BMI was analysed using general linear models, adjusting for country gross national index. Results: Compared to children who undertook no VPA, those in the infrequent group (once or twice per week) and those in the frequent group (three or more times per week) had mean (95% CI) BMI values 0.07 kg/m 2 (0.03–0.11) and 0.09 kg/m 2 (0.03–0.15) greater, respectively (p = 0.001). Compared to adolescents reporting no VPA, those in the infrequent group had a BMI 0.19 kg/m 2 (0.15–0.23) greater while those in the frequent group had a BMI 0.01 kg/m 2 (−0.03–0.05) greater (p < 0.0001). Conclusion: Reported VPA is not associated with lower BMI among children and adolescents. Investigation of VPA and BMI may be best undertaken in conjunction with other variables in the energy expenditure equation. A focus on VPA alone may be an inefficient way to manage BMI. / Revisión por pares
107

Uso de manobras de reanimação neonatal e internação em unidade de cuidado intensivo entre recém-nascidos de termo: análise secundária dos dados do estudo Nascer no Brasil / Use of neonatal resuscitation maneuvers and hospitalization in an intensive care unit among term newborns: a secondary analysis of data from the Birth in Brazil study

Leonor Ramos Pinheiro 03 July 2017 (has links)
Introdução: A assistência ao parto no Brasil tem enfrentado desafios nos últimos anos, no sentido de reduzir práticas desnecessárias e inseguras. No entanto, medidas utilizadas para acelerar o trabalho de parto e demais intervenções durante o trabalho de parto e parto ainda são frequentes e podem impactar negativamente as condições de vitalidade do recém-nascido. Objetivos: Analisar a associação entre os fatores sociodemográficos, organizacionais, obstétricos e assistenciais e desfecho neonatal desfavorável entre RNs de termo e estimar sua frequência. Método: Estudo transversal, a partir dos dados do inquérito nacional Nascer no Brasil, referentes à região Sudeste. A amostra foi composta por puérperas que tiveram RNs vivos, natimortos (peso 500 gramas e/ou idade gestacional 22 semanas), nascidos em hospitais com 500 partos em 2011 e 2012. Foram excluídos os recém-nascidos prematuros, gemelares e aqueles com malformações. A variável dependente desfecho neonatal desfavorável foi construída por meio da composição das variáveis intubação traqueal, massagem cardíaca, uso de drogas na reanimação neonatal, internação em UTI neonatal e Apgar <7 no 5.o minuto de vida no período pós-natal imediato. A associação entre as variáveis de interesse e a variável desfecho foi estimada por meio de regressão logística binária univariada e múltipla, calculando-se Odds ratio (OR) brutas e ajustadas com intervalos de confiança de 95 por cento (IC 95 por cento ). Resultados: A amostra foi composta por 8.783 mulheres e seus RNs. A proporção de RNs que apresentou desfecho neonatal desfavorável foi de 9,6 por cento (844). Ensino fundamental incompleto (OR=2,139; IC 95 por cento 1,292-3,540), baixo peso ao nascer (peso 2.500g; OR=2,822; IC 95 por cento 1,641-4,851), intercorrência obstétrica (OR=1,421; IC 95 por cento 1,055-1,914) e parto fórceps (OR=3,761; IC 95 por cento 1,824-7,754) constituíram fatores associados ao desfecho neonatal desfavorável. Discussão: Os fatores independentemente associados ao desfecho neonatal desfavorável na Região Sudeste do Brasil foram em sua maioria condições clínicas que têm influência sobre a condição do recém-nascido no período pós-parto imediato. Recém-nascidos com baixo peso e aqueles filhos de mulheres com problemas obstétricos têm condições como líquido amniótico reduzido ou insuficiência placentária que resultam em alterações da vitalidade. Mulheres com baixa escolaridade têm maior dificuldade em acessar os serviços de saúde, o que pode dificultar a identificação e tratamento de problemas obstétricos e baixo peso ao nascer. O parto fórceps pode representar a resolução de trabalhos de parto distócicos e também ser um marcador para os fetos cuja vitalidade encontrava-se alterada durante o trabalho de parto. Conclusões: Fatores clínicos e associados a desigualdades sociais têm impacto negativo sobre a vitalidade dos recém-nascidos. Os desfechos neonatais desfavoráveis ainda são pouco investigados, por isso ações que visem à melhoria da atenção pré-natal e do trabalho de parto, principalmente entre mulheres com baixa escolaridade e aquelas com complicações obstétricas, podem resultar em melhores desfechos de saúde para o recém-nascido. Encontramos uma proporção de 9,6 por cento (844) entre os recém-nascidos no termo gestacional que apresentaram desfecho neonatal desfavorável. Neste estudo foi possível observar a existência de associação entre fatores sociodemográficos, clínicos e assistenciais maternos e desfechos neonatais desfavoráveis entre os RNs de termo / Introduction: Childbirth care in Brazil has faced challenges in recent years to reduce unnecessary and unsafe practices. However, measures used to accelerate labour and other interventions during labour and delivery are still frequent and may negatively impact the vitality of the newborn. Objectives: To analyze the association between sociodemographic, organizational, obstetric and care factors and unfavorable neonatal outcomes among term newborns and to estimate the frequency of these outcomes. Method: A cross-sectional study, based on data from the national survey \"Birth in Brazil\" in the the Southeast region of Brazil. The sample consisted of mothers who had live births, stillbirths (weight 500 grams and / or gestational age 22 weeks) in hospitals with 500 births in 2011 and 2012. Premature babies, twins, preterm newborns and those with malformations were excluded from the analysis. The dependent variable \"unfavorable neonatal outcome\" was constructed through the composition of the variables tracheal intubation, cardiac massage, drug use in neonatal resuscitation, neonatal ICU admission, and Apgar <7 at the 5th minute of life in the immediate postnatal period. The association between the variables of interest and the outcome variable was estimated using univariate and multiple binary logistic regression, calculating crude and adjusted Odds Ratio (OR) with 95 per cent confidence intervals (95 per cent CI). Results: The sample consisted of 8,773 women and their newborns. The proportion of newborns who presented an unfavorable neonatal outcome was 9.6 per cent (844). Incomplete primary education (OR = 2.139, 95 per cent CI 1.292-3.540), low birth weight (weight 2.500g, OR = 2.822, 95 per cent CI 1.641-4.851), obstetric complication (OR = 1.421, 95 per cent CI 1.055-1.914) and Forceps (OR = 3.761, 95 per cent CI, 1.824-7.754) were factors associated with unfavorable neonatal outcome. Discussion: Factors independently associated with unfavorable neonatal outcomes in the Southeast Region of Brazil were mostly clinical conditions that influence the condition of the newborn in the immediate postpartum period. Infants with low birth weight and those of women with obstetric problems have conditions such as reduced amniotic fluid or placental insufficiency that result in changes in vitality. Women with low schooling have greater difficulty in accessing health services, which make it difficult to identify and treat obstetric problems and low birth weight. Forceps delivery may represent resolution of dystocic labor and was also be a marker for fetuses whose vitality was altered during labor. Conclusions: Clinical factors associated with social inequalities have a negative impact on the vitality of newborns. Negative neonatal outcomes are still poorly investigated, so actions aimed at improving prenatal care and labor, especially among women with low schooling and those with obstetric complications, may result in better health outcomes for the newborn. We found a proportion of 9.6 per cent (844) among neonates in the gestational term who presented an unfavorable neonatal outcome. In this study it was possible to observe the existence of an association between sociodemographic, clinical and maternal care factors and unfavorable neonatal outcomes among the term newborns
108

Uso de manobras de reanimação neonatal e internação em unidade de cuidado intensivo entre recém-nascidos de termo: análise secundária dos dados do estudo Nascer no Brasil / Use of neonatal resuscitation maneuvers and hospitalization in an intensive care unit among term newborns: a secondary analysis of data from the Birth in Brazil study

Pinheiro, Leonor Ramos 03 July 2017 (has links)
Introdução: A assistência ao parto no Brasil tem enfrentado desafios nos últimos anos, no sentido de reduzir práticas desnecessárias e inseguras. No entanto, medidas utilizadas para acelerar o trabalho de parto e demais intervenções durante o trabalho de parto e parto ainda são frequentes e podem impactar negativamente as condições de vitalidade do recém-nascido. Objetivos: Analisar a associação entre os fatores sociodemográficos, organizacionais, obstétricos e assistenciais e desfecho neonatal desfavorável entre RNs de termo e estimar sua frequência. Método: Estudo transversal, a partir dos dados do inquérito nacional Nascer no Brasil, referentes à região Sudeste. A amostra foi composta por puérperas que tiveram RNs vivos, natimortos (peso 500 gramas e/ou idade gestacional 22 semanas), nascidos em hospitais com 500 partos em 2011 e 2012. Foram excluídos os recém-nascidos prematuros, gemelares e aqueles com malformações. A variável dependente desfecho neonatal desfavorável foi construída por meio da composição das variáveis intubação traqueal, massagem cardíaca, uso de drogas na reanimação neonatal, internação em UTI neonatal e Apgar <7 no 5.o minuto de vida no período pós-natal imediato. A associação entre as variáveis de interesse e a variável desfecho foi estimada por meio de regressão logística binária univariada e múltipla, calculando-se Odds ratio (OR) brutas e ajustadas com intervalos de confiança de 95 por cento (IC 95 por cento ). Resultados: A amostra foi composta por 8.783 mulheres e seus RNs. A proporção de RNs que apresentou desfecho neonatal desfavorável foi de 9,6 por cento (844). Ensino fundamental incompleto (OR=2,139; IC 95 por cento 1,292-3,540), baixo peso ao nascer (peso 2.500g; OR=2,822; IC 95 por cento 1,641-4,851), intercorrência obstétrica (OR=1,421; IC 95 por cento 1,055-1,914) e parto fórceps (OR=3,761; IC 95 por cento 1,824-7,754) constituíram fatores associados ao desfecho neonatal desfavorável. Discussão: Os fatores independentemente associados ao desfecho neonatal desfavorável na Região Sudeste do Brasil foram em sua maioria condições clínicas que têm influência sobre a condição do recém-nascido no período pós-parto imediato. Recém-nascidos com baixo peso e aqueles filhos de mulheres com problemas obstétricos têm condições como líquido amniótico reduzido ou insuficiência placentária que resultam em alterações da vitalidade. Mulheres com baixa escolaridade têm maior dificuldade em acessar os serviços de saúde, o que pode dificultar a identificação e tratamento de problemas obstétricos e baixo peso ao nascer. O parto fórceps pode representar a resolução de trabalhos de parto distócicos e também ser um marcador para os fetos cuja vitalidade encontrava-se alterada durante o trabalho de parto. Conclusões: Fatores clínicos e associados a desigualdades sociais têm impacto negativo sobre a vitalidade dos recém-nascidos. Os desfechos neonatais desfavoráveis ainda são pouco investigados, por isso ações que visem à melhoria da atenção pré-natal e do trabalho de parto, principalmente entre mulheres com baixa escolaridade e aquelas com complicações obstétricas, podem resultar em melhores desfechos de saúde para o recém-nascido. Encontramos uma proporção de 9,6 por cento (844) entre os recém-nascidos no termo gestacional que apresentaram desfecho neonatal desfavorável. Neste estudo foi possível observar a existência de associação entre fatores sociodemográficos, clínicos e assistenciais maternos e desfechos neonatais desfavoráveis entre os RNs de termo / Introduction: Childbirth care in Brazil has faced challenges in recent years to reduce unnecessary and unsafe practices. However, measures used to accelerate labour and other interventions during labour and delivery are still frequent and may negatively impact the vitality of the newborn. Objectives: To analyze the association between sociodemographic, organizational, obstetric and care factors and unfavorable neonatal outcomes among term newborns and to estimate the frequency of these outcomes. Method: A cross-sectional study, based on data from the national survey \"Birth in Brazil\" in the the Southeast region of Brazil. The sample consisted of mothers who had live births, stillbirths (weight 500 grams and / or gestational age 22 weeks) in hospitals with 500 births in 2011 and 2012. Premature babies, twins, preterm newborns and those with malformations were excluded from the analysis. The dependent variable \"unfavorable neonatal outcome\" was constructed through the composition of the variables tracheal intubation, cardiac massage, drug use in neonatal resuscitation, neonatal ICU admission, and Apgar <7 at the 5th minute of life in the immediate postnatal period. The association between the variables of interest and the outcome variable was estimated using univariate and multiple binary logistic regression, calculating crude and adjusted Odds Ratio (OR) with 95 per cent confidence intervals (95 per cent CI). Results: The sample consisted of 8,773 women and their newborns. The proportion of newborns who presented an unfavorable neonatal outcome was 9.6 per cent (844). Incomplete primary education (OR = 2.139, 95 per cent CI 1.292-3.540), low birth weight (weight 2.500g, OR = 2.822, 95 per cent CI 1.641-4.851), obstetric complication (OR = 1.421, 95 per cent CI 1.055-1.914) and Forceps (OR = 3.761, 95 per cent CI, 1.824-7.754) were factors associated with unfavorable neonatal outcome. Discussion: Factors independently associated with unfavorable neonatal outcomes in the Southeast Region of Brazil were mostly clinical conditions that influence the condition of the newborn in the immediate postpartum period. Infants with low birth weight and those of women with obstetric problems have conditions such as reduced amniotic fluid or placental insufficiency that result in changes in vitality. Women with low schooling have greater difficulty in accessing health services, which make it difficult to identify and treat obstetric problems and low birth weight. Forceps delivery may represent resolution of dystocic labor and was also be a marker for fetuses whose vitality was altered during labor. Conclusions: Clinical factors associated with social inequalities have a negative impact on the vitality of newborns. Negative neonatal outcomes are still poorly investigated, so actions aimed at improving prenatal care and labor, especially among women with low schooling and those with obstetric complications, may result in better health outcomes for the newborn. We found a proportion of 9.6 per cent (844) among neonates in the gestational term who presented an unfavorable neonatal outcome. In this study it was possible to observe the existence of an association between sociodemographic, clinical and maternal care factors and unfavorable neonatal outcomes among the term newborns
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Comparing the BDI II and the HADS (HADS-D) as a screening tool for depression amongst HIV infected individuals attending a public health clinic

Le Fleur, Celeste Catherine January 2011 (has links)
Magister Psychologiae - MPsych / This study utilised secondary data from a larger study that looked at individuals that are already infected by HIV which is entitled Implicative personal dilemmas and cognitive conflicts in health decision making in HIV positive adults and adults with AIDS. The primary aim of the larger study was to examine the cognitive construction of the individual and how they utilised their individual resources to construct who they are and how they perceived the difficulties and challenges that they face and the decisions they make regarding their health. HIV and AIDS is a debilitating disease and it affects millions worldwide. South Africa, presently, has the largest burden of this disease with those between the ages of 15 – 49 years of age being most affected. As previously mentioned the decisions that individuals make can impact on their health. Decisions to take necessary precautions such as protected sex during sexual intercourse can decrease the progression of the disease. Decisions made regarding abstinence of risky behaviour as well as being committed to taking medication could also positively impact health. People living with HIV and AIDS find it difficult to adjust to the challenges that this disease presents. Depression is often experienced due to the changes in self image and perception. Studies show that females are twice more likely to experience depression than men. There has however been no conclusive evidence showing the reason for this, however, the perception of stress based on gender could shed some light on this matter and how these perceptions can increase the likelihood of women being more vulnerable to depression. Due to the limitation of this study, it will only look at depression as it relates to HIV and AIDS. Psychological problems such as depression can hamper the adjustment process and the effect of depression is evident in that it can lower the CD 4 + cells. Not only are those living with HIV and AIDS affected by depression, but they also have a lifetime prevalence to depression. It is important to have an effective screening tool for depression so that the detection of this disease can be made and effective treatment can be implemented to enhance health. The sample consisted of 113 adult participants that have already been diagnosed with HIV and AIDS. The primary aim of this study was to compare the Beck’s Depression Inventory II (BDI II) and the Hospital Anxiety and Depression Scale –(the Depression component) (HADS-D) as a screening tool for depression. Exploratory Factor Analysis revealed a 5 factor structure which accounted for 60.14 % of the total variance. The HADS yielded one factor accounting for 14.33% of total variance. The BDI II has proven to be more a reliable measure of depression with 0.89 according to the Cronbach’s Alpha co efficient opposed to 0.375 as per the HADS-D. The secondary aim was to establish the sociodemographic and disease profiles of the participants under study. / South Africa
110

Comparing the BDI II and the HADS (HADS-D) as a screening tool for depression amongst HIV infected individuals attending a public health clinic

Le Fleur, Celeste Catherine January 2011 (has links)
<p>This study utilised secondary data from a larger study that looked at individuals that are already infected by HIV which is entitled Implicative personal dilemmas and cognitive conflicts in health decision making in HIV positive adults and adults with AIDS. The primary aim of the larger study was to examine the cognitive construction of the individual and how they utilised their individual resources to construct who they are and how they perceived the difficulties and challenges that they face and the decisions they make regarding their health. HIV and AIDS is a debilitating disease and it affects millions worldwide. South Africa, presently, has the largest burden of this disease with those between the ages of 15 &ndash / 49 years of age being most affected. As previously&nbsp / mentioned the decisions that individuals make can impact on their health. Decisions to take necessary precautions such as protected sex during sexual intercourse can decrease the&nbsp / progression of the disease. Decisions made regarding abstinence of risky behaviour as well as being committed to taking medication could also positively impact health. People living with HIV and AIDS find it&nbsp / difficult to adjust to the challenges that this disease presents. Depression is often experienced due to the changes in self image and perception. Studies show that&nbsp / females are twice more likely to experience depression than men. There has however been no conclusive evidence showing the reason for this, however, the perception of stress based on&nbsp / gender could shed some light on this matter and how these perceptions can increase the likelihood of women being more vulnerable to depression. Due to the limitation of this study, it will&nbsp / only look at depression as it relates to HIV and AIDS. Psychological problems such as depression can hamper the adjustment process and the effect of depression is evident in that it can lower the CD 4 + cells. Not only are those&nbsp / living with HIV and AIDS affected by depression, but they also have a lifetime prevalence to depression. It is important to have an effective screening tool for depression so that the detection of this&nbsp / disease can be made and effective treatment can be implemented to enhance health. The sample consisted of 113 adult participants that have already been diagnosed with HIV and AIDS. The&nbsp / primary aim of this study was to compare the Beck&rsquo / s Depression Inventory II (BDI II) and the Hospital Anxiety and Depression Scale &ndash / (the Depression component) (HADS-D) as a screening tool&nbsp / &nbsp / for depression. Exploratory Factor Analysis revealed a 5 factor structure which accounted for 60.14 % of the total variance. The HADS yielded one factor accounting for 14.33% of total variance. The BDI II has proven to be more a reliable measure of depression with 0.89 according to the Cronbach&rsquo / s Alpha co efficient opposed to 0.375 as per the HADS-D. The secondary aim was to establish&nbsp / the sociodemographic and disease profiles of the participants under study. </p>

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