Background: The aims of this qualitative research were to explore a range of challenges encountered by mothers coping with infant sleep difficulties, and subsequent impacts on the transition to becoming a parent. The intention was twofold – to raise awareness amongst practitioner psychologists that “many new mothers experience some level of emotional distress and all deserve systematic and compassionate support” (Boots Family Trust, p.1), with particular reference to early relationship formation, and to encourage opportunities for translation from multidisciplinary research into practice. Method: Five semi-structured interviews were conducted. Four with mothers who were either experiencing, or had in the past experienced sleep difficulties with their babies. The fifth was with a professional ante-natal educator, herself a mother. The interviews were transcribed and analysed according to a constructivist version of grounded theory methodology guided by Charmaz (2006). Analysis: A central narrative of ‘the wearing mask of transition’ was developed from four analytic categories: being me’, ‘being pushed to the limit’, ‘relationships’ and ‘coping, learning and trusting’. The interconnectedness of the categories was conveyed via the visual translation of the proposed pluralistic model – ‘the coping mask of transition’. Conclusion: After having been neglected within mainstream mental health services, perinatal mental wellbeing is currently being prioritised, representing a unique opportunity for multidisciplinary consultation and sharing of expertise and training. The ‘normal’ experiences of the women interviewed were revealed as emotionally complex. They worked through their sleep deprivation and distress feeling largely unsupported, and often unwilling to disclose even to partners the extent of their difficulties. It is hoped that this small-scale study, with its focus on a non-clinical population, and the significance of maternal mental and emotional wellbeing and outcomes for children, will encourage professionals to consider the distressing impacts of ‘normal’ sleep disturbance and deprivation within the broader context of this major life transition.

Sleep loss alters both the concentration and activity of various aspects of the immune system. These alterations lead to increased susceptibility to infection and the progression of pathologies such as insulin resistance and atherosclerosis. Two proposed mechanisms of this alteration in immune function are the changes in both cortisol and sympathetic nervous system activity that accompany sleep deprivation. This work reviewed literature that measured the effects of periods of sleep restriction upon both cortisol and catecholamine concentrations within human subjects. Furthermore, studies which measured the effects of sleep loss upon these hormone levels and the associated changes in immune parameters were included. This thesis asserts that there is no defined pattern in reference to alterations of cortisol levels as a result of sleep deprivation. Furthermore, more evidence must be collected before implementing cortisol as a main effector of sleep loss upon immune system function. This dissertation, although repeatedly noting increased levels of norepinephrine following periods of sleep restriction, similarly argues that more research must be completed in order to declare that altered catecholamine concentrations as a result of sleep loss is a mechanism for altered immune function.

Orientador: Célio Percinoto / Banca: Juliano Pelim Pessan / Banca: Marcelle Danelon / Banca: Cleide Cristina Rodrigues Martinhon / Banca: Adelisa Rodolfo Ferreira Tiveron / Resumo: Investigar o impacto do bruxismo do sono com a qualidade de vida de crianças de 3 a 5 anos. Crianças (n = 75) foram divididas em grupos com bruxismo noturno (n = 33) e aqueles sem o distúrbio (n = 42). Os dados sociodemográficos e os hábitos parafuncionais foram coletados por um questionário estruturado, a qualidade de vida por uma Escala de Impacto sobre a Saúde bucal na Primeira Infância (Early Childhood Oral Health Impact Scale - ECOHIS), aplicada a pais/cuidadores das crianças. Foram realizadas as análises de Regressão de Poisson univariadas com variância robusta, para entrada no modelo final com nível de significância de até 20%. Para variável no modelo final foi considerado um nível de significância de 5%, com intervalos de confiança 95%. Os valores de p foram calculados pelo teste de Wald. As variáveis "renda" e "chupar chupeta" revelaram associação com o bruxismo. Os escores totais do ECOHIS não foram variáveis significativas (p> 0,05). Concluiu-se que a renda familiar e o uso de chupetas foram significativamente associados com o bruxismo noturno em crianças. O bruxismo noturno não revelou impacto na saúde bucal relacionada com a qualidade de vida das crianças. / Abstract: Almeida DL. Ev a luation of oral health related quality of life with sleep bruxism in children from Porto Velho - RO [thesis]. Araçatuba: UNESP - Sao Paulo State University; 2016. ABSTRACT Proposition : To investigate the impact of sleep bruxism on the quality of life of children aged 3 to 5 years. Methods : Children (n = 75) were divided into groups with nocturnal bruxism (n = 33) and those without the disorder (n = 42). The sociodemographic data and the parafunctional habits were collected by a structured questionnaire, the quality of life by an Early Chil dhood Oral Health Impact Scale (ECOHIS), applied to parents / caregivers of the children. Univariate Poisson Regression analyzes were performed with robust variance, for input in the final model with a level of significance of up to 20%. For the variable i n the final model, a significance level of 5% was considered, with 95% confidence intervals. The p values were calculated by the Wald test. Results : The variables "income" and "pacifier sucking" revealed an association with bruxism. Total ECOHIS scores w ere not significant (p> 0.05). Conclusion : It was concluded that family income and pacifier use were significantly associated with nocturnal bruxism in children. The nocturnal bruxism revealed no impact on oral health related to children's quality of life. / Doutor

We estimate the effect of regional income inequality on emigration rates of Austrian municipalities using a unique data set that is constructed We estimate the effect of regional income inequality on emigration rates of Austrian municipalities using a unique data set that is constructed based on individual level data from Austrian administrative registers. The register-based data contains information on the municipality of residence of all individuals aged 16 and over that have their main residency in Austria, as well as their income and socio-demographic characteristics. Aggregating this information to the municipality level allows us to assess the role of relative deprivation - a measure of relative income - on top of absolute income in shaping internal migration in Austria. We find that increases in relative deprivation in a municipality lead to higher emigration from the municipality. Allowing for heterogeneous effects across income, education, and age groups reveals that the effect is stronger among those with comparably low levels of income, and among low skilled and young individuals. / Series: INEQ Working Paper Series

My final work recognizes the syndrom known as psychological deprivation and subdeprivation. The theoretical part is aimed at defining the concept of psychological deprivation and subdeprivation and then focused on professor´s Matějček research, on whose methods and results is based the whole work. The empirical part of the research deals with a specific degree of psychological deprivation and subdeprivation in the constitutional institutions and families, and its detailed analysis.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-08-04T14:25:51Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Mestrado REVISÃO PÓSBANCA_FINA_BIBIOCENTRAL_FINAL_25032016_NOVA_FINALLL.pdf: 2238183 bytes, checksum: 8badaa7ab119eec4d05d114cc326bddb (MD5) / Made available in DSpace on 2016-08-04T14:25:51Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Mestrado REVISÃO PÓSBANCA_FINA_BIBIOCENTRAL_FINAL_25032016_NOVA_FINALLL.pdf: 2238183 bytes, checksum: 8badaa7ab119eec4d05d114cc326bddb (MD5) Previous issue date: 2016-03-01 / O regime de plantão noturno, afeta o ciclo circadiano acarretando consequências negativas, causando alterações na vida e saúde dos profissionais de Enfermagem.O sono é uma etapa da fisiologia humana complexa relacionada ao comportamento humano e um dos grandes enigmas da neurociência.Objetivo: Verificar as repercussões da alteração do sono em profissionais de enfermagem com atividade laboral noturna Método: Aplicação de formulário à 179 profissionais (técnicos e enfermeiros), tendo como critério de inclusão possuir 03 anos ou mais de tempo na profissão em plantões noturnos. Foram excluídos desta pesquisa, os trabalhadores de enfermagem que não quiseram participar do estudo ou não responderam ao questionário, e aqueles que possuem menos de 03 anos de tempo na profissão em plantões noturnos. O instrumento de avaliação utilizado foi um formulário com 23 questões de múltiplas escolhas objetivas, no qual abordava perguntas referentes a: dados sócio demográficos (sexo, idade, nível de escolaridade e estado civil), hábitos do cotidiano (rotinas, lazer, alimentação) e morbidades apresentadas (doenças e sintomas). Realizou-se um projeto piloto, com 30 profissionais, os quais foram excluídos da amostra de 179 participantes, para avaliar possíveis dificuldades na compreensão das questões do formulário pelos profissionais e para realizar a calibração do pesquisador responsável pelas entrevistas. Os dados foram digitados em planilha EXCEL 7.0 e posteriormente foram transferidos para tabela de entrada do SPSS (Statistical Package for the Social Sciences) versão 21. Os dados foram apresentados considerando o grupo total de profissionais, por categorias, tempo de trabalho em plantões noturnos, doenças adquiridas e sintomas associados. A verificação da hipótese de normalidade dos dados foi realizada através dos testes estatísticos de Shapiro-Wilk e da igualdade de variâncias através do teste F de Levene. Os resultados foram expressos através de frequências absoluta e relativa nas variáveis categóricas e das medidas estatísticas: média, desvio padrão e mediana para a variável idade. Para verificar associação entre as repercussões da privação de sono noturno e as categorias profissionais, foi utilizado o teste t –Student com variâncias iguais para a variável idade e nas variáveis categóricas foi utilizado o teste Qui-quadrado de Pearson ou o teste Exato de Fisher quando a condição para utilização do teste Qui-quadrado não foi verificada para avaliar a força da diferença foi obtido o Odds Ratio (OR)Resultados:Observou-se que53,1% dos entrevistados observaram o aparecimento de doenças após plantões noturnos. Destes, as mais citadas foram: distúrbios do sono (26,8%), hipertensão (17,3%) coluna (16,2%), gastrite (11,7%) e vasculares (10,1%). O estudo em questão observou que as doenças com diferenças significativas entre as categorias profissionais foram: Problemas de coluna 6,5% vs 19,5%, Afecções vasculares 2,2% vs 12,8% e Hipertensão 6,5% vs 21,1%, para enfermeiros e técnicos em enfermagem, respectivamente, e a categoria de técnicos em enfermagem é a mais acometida, devido as suas atribuições exigirem mais tempo de vigília, pela sua assistência direta ao paciente, o profissional está sujeito a maior ocorrência de morbidades.Conclusão: entende-se que o plantão noturno tem impacto negativo na saúde desses trabalhadores. / Sleep is a stage of complex human physiology related to human behavior and one of the great puzzles of neuroscience. The night shifts, affects the circadian cycle leading to negative consequences, causing changes in the life and health of nursing professionals. Objective: To investigate the effects of sleep change in nurses with night work activity Method: Form Application to 179 professionals (technicians and nurses), with the inclusion criteria have 03 years or longer in the profession in night shifts. They were excluded from this research, nursing workers who refused to participate in the study or did not respond to the questionnaire, and those with less than 03 years of time in the profession in night shifts. The evaluation instrument used was a form with 23 questions of multiple choice objective, which addressed questions relating to: socio-demographic data (gender, age, education level and marital status), daily habits (routines, leisure, food) and presented morbidities (diseases and symptoms). We carried out a pilot project with 30 professionals, who were excluded from the sample of 179 participants to assess possible difficulties in understanding the professional form of questions and to calibrate the researcher responsible for the interviews. Data were entered into EXCEL 7.0 spreadsheet and were subsequently transferred to SPSS input table (Statistical Package for Social Sciences) version 21. The data were presented considering the total group of professionals, by category, time working in night shifts, acquired diseases and associated symptoms. Verification of the data normality hypothesis by means of statistical tests of Shapiro-Wilk and equal variances by F Levene test. The results were expressed by absolute and relative frequencies for the categorical variables and statistical measurements: mean, standard deviation and median for age variable. To assess the association between the impact of deprivation of nighttime sleep and professional categories, we used the t-Student test with equal variances for the variable age and the categorical variables we used chi-square test or Fisher's exact test when the condition for using the chi-square test was not checked to assess the strength of the difference was obtained Odds Ratio (OR) results: it was observed that 53.1% of respondents noted the emergence of diseases after night shifts. Of these, the most mentioned are: sleep disorders (26.8%), hypertension (17.3%) column (16.2%), gastritis (11.7%) and vascular (10.1%). The study in question noted that diseases with significant differences between occupational categories were: column Problems 6.5% vs 19.5%, vascular disorders 2.2% vs 12.8% and hypertension 6.5% vs 21 1% for nurses and nursing technicians, respectively, and the category of nursing technicians is the most affected, because their duties require more waking time by its direct patient care, the professional is subject to higher occurrence of morbidities . Conclusion: it is understood that the night shift has negative impact on the health of these workers.

Orientador: Altair Antoninha Del Bel Cury / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-15T22:42:40Z (GMT). No. of bitstreams: 1 Ribeiro_CynthiaValeriaSilvaGomes_D.pdf: 933466 bytes, checksum: 111c5a5651ea2f13249bda0bb110d815 (MD5) Previous issue date: 2010 / Resumo: A Síndrome da Apnéia Obstrutiva do Sono (SAOS) é uma doença crônica, de caráter progressivo, que afeta gravemente a saúde e a qualidade de vida. Entre as suas implicações estão os despertares e microdespertares freqüentes, a fragmentação, desestruturação e redução da eficiência do sono, que resultam em Sonolência Diurna Excessiva (SDE), reconhecida como fator causal do aumento dos riscos de acidentes de trânsito e de trabalho, comprometimento da segurança pessoal e coletiva, além de redução de funções cognitivas como memória, atenção, aprendizado e impacto neuropsíquico. Considerando a importância dessa enfermidade, diversos tratamentos têm sido propostos, dentre os quais se destaca o Aparelho Intraoral de Avanço Mandibular Progressivo (AIAMP). O objetivo do presente estudo foi o de avaliar o efeito do tratamento com o aparelho intraoral de avanço mandibular progressivo, na sonolência diurna excessiva de portadores da síndrome da apnéia obstrutiva do sono. Este estudo foi aprovado pelo Comitê de Ética da FOP/UNICAMP e todos os pacientes assinaram o Termo de Consentimento Livre e Esclarecido. Dez voluntários adultos com idade média de 51 anos, sete do gênero masculino e três do gênero feminino com diagnóstico de SAOS pela polissonografia, foram avaliados quanto a SDE por meio do Teste da Manutenção da Vigília (TMV). Todas as avaliações foram realizadas antes e após o tratamento com o AIAMP- No Snore. Os resultados foram submetidos ao teste de Shapiro-Wilk para testar a homogeneidade e normalidade dos dados. O teste t de Student foi usado para comparar os dados dos testes da manutenção da vigília e índice de apnéia/hipopnéia, entre si; o teste de Wilcoxon das ordens assinaladas foi utilizado para comparar os despertares e microdespertares.O limite de significância foi de 5%. Na amostra, 30% dos pacientes apresentavam SAOS grave, 40% moderada e 30% SAOS leve e todos apresentavam SDE. Após o tratamento, 80% dos pacientes não apresentaram mais SDE; ocorreu redução significativa dos despertares e microdespertares, relacionados com a SAOS (P<0.0078) e do índice de apnéia/hipopnéia (P<0.0001). Os resultados do TMV indicaram diferença significativa antes e após o tratamento (P<0.0047), com um aumento na latência média para o início do sono. Assim, concluiu-se que o aparelho intraoral de avanço mandibular progressivo teve ação importante no controle da SAOS e conseqüente indicação para o tratamento da SDE / Abstract: The Obstructive Sleep Apnea Syndrome (OSAS) it is a chronic disease, of progressive character, that it affects the health and quality of life of those suffering from it. Among their implications they are frequents arousals and micro-arousal, fragmentation, destructuring and reduction of the efficiency of sleep, that result in Excessive Daytime Sleepiness (EDS), recognized as causal factor of the increase of the risks of accidents of traffic and of work, compromising of the personal and collective safety, besides reduction of cognitive functions as memory, attention, learning and neuropsych impact. Considering the importance of that disease , several treatments have been proposed and among these stands out the intraoral progressive mandibular advancement appliance. Thus, the object of this study was to evaluate the effect of treatment with an intraoral progressive mandibular advancement appliance - No Snore (IPMAA - No Snore) in EDS in patients with OSAS. This study was approved by the Research Ethics Committee and patients signed a written, informed consent. Ten adult patients with a mean age of 51 years, 7 men and 3 women with diagnosis of OSAS by polysonograph exam were evaluated with regard to EDS by means of the Maintenance of Wakefulness Test (MWT). The results were submitted to the Shapiro-Wilk test to verify normality and homogeneity. Comparison of the MWT, apnea/hypopnea index data was performed by the t-paired test; Wilcoxon signed-ranks test was used to compare the arousals and micro-arousals. All the evaluations were made before and after the use of the IPMAA - No Snore and the significance limit was set at 5%. 30% of the patients presented OSAS severe, 40% OSAS moderate and 30% OSAS mild and all presented SDE. After treatment, 80% of the patients did not present EDS; there was a significant reduction in OSAS symptoms related to arousals and micro-arousals (P<0.0078), and in the apnea/hypopnea index (P<0.0001). The results of MWT indicated a significant difference before and after the treatment (P<0.0047) with an increase in mean latency for the onset of sleep. Thus, it was concluded that the progressive mandibular advancement appliance has an important action in the control of OSAS and consequent indication for the treatment of excessive daytime sleepiness / Doutorado / Protese Dental / Mestre em Clínica Odontológica

Traditionally seaside resorts have been one of the least understood of Britain’s ‘problem areas’. This thesis breaks new ground by reporting on an exploratory data analysis to probe the influence of resort decline on social exclusion in England’s seaside resorts. Drawing on a wide range of socio-economic datasets and quantitative methods of data analysis and GIS software, the study investigates the scale, nature and extent of multiple deprivation in English seaside resorts, differences in socio-economic structure between deprived and non-deprived resorts and the factors that may explain these differences, and the nature and incidence of localised problem complexes. A combination of univariate, bivariate and multivariate empirical analyses, undertaken at several geographic scales, illuminates the differential incidence of deprivation. The study findings reveal that the majority of seaside districts, small areas and resorts are experiencing similar types and high levels of multiple deprivation. Various facets of population composition (worklessness, education and skills, health, family stability, connectivity, and poverty) and place factors (employment base, economic prosperity, housing, and community safety) are significant for deprivation in seaside resorts. Four types of highly deprived resort areas emerged from the cluster analysis. Not only are the research findings of paramount importance in understanding both the pattern of socio-spatial disadvantage and the prospects for socio-economic regeneration, but they also contribute to an understanding of the outcomes of post-mature resort development, particularly in relation to the internal dynamics of resort change.

The quantification of athlete pre-competitive sleep behaviour is of interest owing to the possibility that sleep loss may have a negative effect on health and performance. The purpose of this study was to monitor and quantify the sleep/wake patterns of South African cyclists prior to competitive races. A total of 336 cyclists, male and female and of differing competition levels, cycling in either the 2015 Tsogo Sun Amashova or the 2016 Telkom 94.7 Cycle Challenge completed an altered version of the Competitive Sports and Sleep Questionnaire. The questionnaire asked cyclists to report on precompetitive sleep over the past year. A subset of 92 cyclists also recorded a Core Consensus Sleep Diary for the three nights leading up to the races. The questionnaire showed that 67% of the cyclists reported worsened sleep at least once prior to competition within the past 12 months. The sleep diary found that the cyclists’ average sleep duration the night before the races was 6h19min (±1h38min), which was significantly less than two and three nights prior to the races. Sleep quality was also shown to deteriorate significantly the night before the races. The contributing factors leading to worsened pre-competitive sleep were the time the cyclists had to wake-up as well as perceived increases in sleep latency and awakenings after sleep onset. Anxiety was found to be the major cause of sleep disturbances. While females were found to be significantly more likely to report having experienced poorer sleep before competition in the past year, the sleep diary showed no difference in sleep the night before the races between the sexes. Females were significantly more likely to report instances of unpleasant dreams and waking up during the night. Again, the sleep diary data did not corroborate these findings. Females were also found to report significantly more accounts of nervousness or thoughts about competition as being the cause of sleep problems. There was no difference in sleep loss the night before competition when comparing competition-level groups. The only significant difference was that recreational cyclists were more likely to report sleeping in foreign environments as a cause of sleep disturbances. Despite a large percentage of cyclists experiencing pre-competitive sleep loss, over half (55%) perceived sleep loss to have no impact on their performance. Analysis of pre-sleep behaviour also revealed that the cyclists engaged in several practices that may have a negative effect on subsequent sleep. The vast majority of the cyclists (61%) indicated having no specific strategy to help them sleep the night before competition. Fifteen percent of cyclists reporting using media devices to help them fall asleep, a practice that has been shown to disrupt sleep. In conclusion, most cyclists, regardless of sex and level of competition experience precompetitive sleep loss attributed largely to anxiety but with the perception that this loss in sleep does not negatively impact their performance.

M.A. / In the social work field of chemical substance abuse the success of rehabilitation of drug-dependent adolescents is greatly influenced by the support and involvement of their families. Experience in this field showed that the mothers of these adolescents are usually involved in the treatment programme, whereas the fathers are emotionally distant. This is often the way in which these families function. The researcher wanted to find out which aspects influence the dynamics of the relationship between an emotionally distant father and his chemically dependent adolescent. Subsequently, the following question was formulated as a research question: “what influences emotional involvement in the relationship between the emotionally absent father and his chemically dependent adolescent that causes it be emotionally distant?” In this study the researcher will aim to determine that aspects which contribute to emotional distance in the relationship between the emotionally absent father and his chemically dependent adolescent. In doing so the researcher will achieve the following objectives: • To improve professional skill and knowledge by providing new information; • To use qualitative data collection method; • To define and study an emotional absent father, a chemically dependent adolescent and the relationship between them; • To collect data about the causes of emotional absence in the relationship between an emotional absent father and a chemically dependent adolescent; • To explain and understand the relationship between an emotionally absent father and his chemically dependent adolescent in the context of the Systems theory; • To compare the findings of the study with relevant literature; • To understand the forces which influence the relationship between an emotional absent father and his chemical dependent adolescent; and • To get permission of the different role-players to conduct the study. The study is of a qualitative nature. Data was collected by using in-depth, guided interviews and field notes. Data was recorded by using audio recordings and transcriptions. The sample was collected using purposeful sampling. It was divided in two parts, namely adolescents and parents. The researcher used the QSR Nudist program to assist with data analysis. After data collection and analysis, a literature control was done as one of the ways of ensuring validity and reliability. The researcher concluded that various aspects contributed to emotional distance and absence on the father’s side. The relationship between father and child had been distant before the adolescent had been drugging, as early as early childhood. The adolescent’s drugging had little to do with the fact that there is emotional distance between father and child. Although both parties hoped for change, neither of them was sure that it could be obtained. Lastly, based on t he results of the study, the researcher made the following recommendations: 1. Further research be done with regards to aspects such as developing a practice model that will address the emotional distance between an emotionally absent father and a chemically dependent adolescent; 2. To incorporate the results of the study in treatment programmes where applicable in both in-patient and out-patient programmes as well as to act preventatively with regard to this particular relationship; and 3. The professional community can be trained in the dynamics of this particular relationship in order to address similar problems in other fields, for instance pastoral counsellors and psychologists. / Dr. W.J.H. Roestenburg