Background While an estimated 70%–75% of the health workforce are women, this is not reflected in the leadership roles of most health organisations— including global decision-making bodies such as the World Health Assembly (WHA). Methods We analysed gender representation in WHA delegations of Member States, Associate Members and Observers (country/territory), using data from 10 944 WHA delegations and 75 815 delegation members over 1948–2021. Delegates’ information was extracted from WHO documentation. Likely gender was inferred based on prefixes, pronouns and other gendered language. A gender-to- name algorithm was used as a last resort (4.6%). Time series of 5-year rolling averages of the percentage of women across WHO region, income group and delegate roles are presented. We estimated (%) change ±SE of inferred women delegation members at the WHA per year, and estimated years±SE until gender parity from 2010 to 2019 across regions, income groups, delegate roles and countries. Correlations with these measures were assessed with countries’ gender inequality index and two Worldwide Governance indicators. Results While upwards trends could be observed in the percentage of women delegates over the past 74 years, men remained over-represented in most WHA delegations. Over 1948–2021, 82.9% of delegations were composed of a majority of men, and no WHA had more than 30% of women Chief Delegates (ranging from 0% to 30%). Wide variation in trends over time could be observed across different geographical regions, income groups and countries. Some countries may take over 100 years to reach gender parity in their WHA delegations, if current estimated trends continue. Conclusion Despite commitments to gender equality in leadership, women remain gravely under-represented in global health governance. An intersectional approach to representation in global health governance, which prioritises equity in participation beyond gender, can enable transformative policymaking that fosters transparent, accountable and just health systems.

<p>The purposes of this study are to compare the differences in research utilization among rural and urban nurses working in acute care hospitals and to examine the individual and contextual factors that may be associated with the differences. A quantitative research designed was used to compare the responses of 220 nurses (109 rural and 111 urban) working in a Local Health Integrated Network in South West Ontario, Canada. Data were collected using a modified version of Estabrooks’ (1997) self-report, mail-in, Research Utilization Survey. Results from the data analysis are discussed. Rural and urban nurses reported similar conceptual, instrumental, and persuasive research utilization (RU), with conceptual RU being the most commonly used form. However, rural nurses reported using overall RU significantly less than their urban counterparts did.</p> <p>Rural nurses reported having less access to organizational champions and resources, such as library research journals and computers, than nurses in urban practice had. An analysis of the association between the individual and contextual variables and overall RU indicates that approximately 26% of variance in nurses’ overall RU scores can be predicted from the variance in scores of the following variables: (a) positive RU attitude, (b) organizational relationships supportive of RU, (c) level of competence, and (d) location of nurses. The findings support a multi-dimensional conceptualization of RU and the merits of exploring individual factors as well as organizational and environmental context in future research, theory development, and implementation of strategies to promote RU among nurses.</p> / Doctor of Philosophy (PhD)

Made available in DSpace on 2016-08-19T18:16:09Z (GMT). No. of bitstreams: 1 Marcius Vinicius Goncalves.pdf: 333182 bytes, checksum: 9461ce76e02e9092b4996632accd6369 (MD5) Previous issue date: 2007-05-06 / As the population grows old, there is a proportional increase of cognitive disturbances. Due to the great relevance, this study aims to establish a descriptive study about the cognition level and correlated socio-demographic variables, in women ranging from sixty to eighty years old, in two public health services in the city of São Luís-MA. For a period of four months, a closed questionnaire which contained the socio-demographic variables and the Mental Condition Mini Examination (MEEM), was applied. A number of eighty voluntaries were evaluated in the Neurology clinics of the University Hospital President Dutra and State Hospital Carlos Macieira. The results were: 31,2% were classified by MEEM with cognitive disturbances; 71,4% in the 81-85 age bracket. In the population distribution according to schooling time, 54,9% of those having seven years of school were classified as having cognitive disturbances. As for the referred ethnicity and cognition level, 44.8% of mullatos presented cognitive disturbances. As for income and cognition level, it was observed that 30,4% of the volunteers who presented an income level lower than one to two minimum wage, were classified with cognitive disturbances. From the thirty-three volunteers that had direct care, 57,6% (19) presented cognitive disturbances. As for the referred morbidities, it was observed that 58,75% were referred to as having Systemic Arterial Hypertension; regarding life styles, 12,5% were referred to as smokers. The study becomes relevant because it provides epidemiologic substract for more complex methodological studies in order to promote improvement in the elderly mental public health in the area. / À medida que a população envelhece existe um aumento proporcional dos transtornos cognitivos. Diante desta relevância, busca-se um estudo descritivo do nível de cognição e variáveis sócio-demográficas associadas, no sexo feminino, da sexta à oitava década, em dois serviços públicos, na cidade de São Luís-MA. Foi aplicado, por quatro meses, um questionário fechado com as variáveis sócio-demográficas e o Mini Exame do Estado Mental. Oitenta voluntárias foram avaliadas nos ambulatórios de Neurologia dos Hospitais Universitário Presidente Dutra e Estadual Carlos Macieira. Foram obtidos os seguintes resultados: 31,2% classificadas com transtorno cognitivo ao MEEM; 71,4% na faixa etária de 81-85 anos. Na distribuição da população segundo tempo de estudo, 59,4% com até sete anos de estudo classificadas com transtorno cognitivo. Quanto à etnia referida e nível de cognição, 44,8% pardas com transtorno cognitivo. Nível de renda e cognição, 30,4% com nível de renda menor que um a dois salários mínimos com transtorno cognitivo. Das trinta e três voluntárias que tinham cuidador direto, 57,6% (19) com transtorno cognitivo. Em relação às morbidades referidas foi observado que, 58,75% referiram ter Hipertensão Arterial Sistêmica; quanto ao hábito de vida, 12,5% referiram tabagismo. O estudo torna-se de relevância, pois proporciona substrato epidemiológico para estudos metodológicos mais complexos, visando promover melhoria na saúde pública mental do idoso na região.

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Multitouch technology allows the users to use both their hands and multiple fingers to manipulate digital content directly on the screen. This paper attempts to analyze the actual convenience of bimanual and multifinger manipulation on a multitouch display by conducting three observational experiments and studying how a group of volunteers use their hands and fingers when interacting with digital content on a touchscreen surface. In addition, the participants had to fill in a questionnaire where they give some additional insights on how they experienced the use of multitouch-based interface during the experiments. The results suggest that when participants were performing tasks in which they were instructed to manipulate the digital content as fast as they could, a high percentage of them resorted to the use of at least some level of bimanual manipulation of the digital content. However, when participants were told to perform the tasks calmly the big majority of participants decided to move the objects by using only one hand (unimanual). Same-hand multifinger manipulation was also used by a high percentage of participants when moving several objects simultaneously. Nevertheless, in all three experiments the most common way of moving objects across the screen was by dragging them one at a time (sequential move). Finally, in relation to the personal assessment made by the participants, a total of 70% feel that the possibility for engaging in bimanual interaction, that multitouch interface offers, is a clear benefit and advantage over traditional keyboard and mouse. However, 40% of the respondents feel that the use of mouse still is a more effective and natural form of interaction than multitouch technology.

[Truncated abstract] This descriptive study identified correlates of electronic media use among pre-adolescent children (10-12 year olds). It specifically focused on the potential influence of individual factors and the social and physical environment within the family home setting. The prevalence of overweight/obesity in children is escalating. Sedentary behaviour in the form of electronic media use (comprised of television (TV) and video/DVD viewing, video and computer gaming, and computer use) is a contributing and a modifiable risk factor for overweight/obesity. To date, research focused on sedentary behaviour has been largely derived from physical (in)activity data where the absence or observed low levels of physical activity participation or TV viewing only has been used as a proxy for sedentariness. Little is known about the specificities of children's electronic media use; its impact on children's overall leisure and screen-time; and, the potential influencing factors that may operate at the home level. The family home is a context-specific setting where electronic media use is a daily practice for most children. To better understand electronic-based sedentary behaviour among children the following specific aims were addressed; 1) To describe children's leisure time, particularly time spent with electronic media. 2) To explore children and parents' perceptions about electronic-based sedentary behaviour. 3) To determine the prevalence of children's electronic-media use at home. 4) To examine the influence of individual, family social and home physical factors associated with different levels of electronic media use by children. ... The availability and accessibility of a variety of electronic equipment at home, especially in the child's bedroom (particularly among boys), was also associated with children's screen behaviour. Physical aspects of the family home (i.e., lay-out and yard size) had a mixed effect on children's electronic media use. Overall, the nature of electronic media use among children is complex and is influenced by dimensions that present at children's individual, family social and physical home level. The knowledge generated from this study about specific correlates of electronic media use has extended the understanding about its impact on children's discretionary time. Future prospective longitudinal research is warranted given that most studies investigating electronic media and sedentary behaviour are of cross-sectional design. Including other forms of sedentary behaviour such as sitting and talking with friends and family, reading and/or using telephones may provide a more comprehensive measure of sedentariness in the future. Further studies should use multivariate statistical analyses (i.e., modelling) to improve clarity of relationships between multiple variables and gauge mediating factors. This study also calls for future intervention research. Findings on gender-specific correlates of electronic media use provide superior information for the development of tailored behaviour modification strategies aimed at girls and boys respectively. Active involvement of household members in the intervention is also warranted. Utilising this study's findings may strengthen intervention outcomes towards a more directed and sustained behaviour change

abstract: This dissertation discusses the findings of a descriptive study of early childhood teachers' musical practices in the state of Arizona. Drawing from socio-cultural and cultural-historical activity theory perspectives, this study utilized an online survey design for 2 months in which 312 participants from distinctive types of programs responded to 42 items that addressed early childhood teachers' music practices, perceived role of music, the teachers' preparation, challenges and needs for teaching music in their programs. The study uses the findings to explore how music is incorporated into the curriculum, its role, challenges and needs for teachers as well as inform policy makers of the effectiveness of music in early childhood curriculum that might bring about a resurgence of thinking about funding opportunities to promote music in different programs that serve children. These results reflected the diversity of most early childhood programs in the U.S in areas of scheduling, types of programs, working environments and curricular approaches used as well as in the duration and frequencies of music activities. However, there was a significant difference between how music was used in elementary versus early childhood centers. The results revealed that, although teachers used music at various times, for various reasons, planned or unplanned and as an integral part of other content areas, there was great variance in the manner in which music was emphasized in the total curriculum. In this study context, music in early childhood education centers was mostly teacher led and its value was geared towards specific behavioral outcome such as enhancement of language development rather than sheer enjoyment and relaxation. Although teachers used music on a daily basis, they were inadequately prepared and most teachers were looking for opportunities to improve their music abilities including required courses and workshops on ways of effectively incorporating music into curriculum/classroom. Funding, time and lack of confidence remain top challenges for early childhood and elementary teachers. The study recommends that music courses be required in teacher education programs and refresher workshops for in-service teachers about how to effectively use music in classrooms be more widely available. / Dissertation/Thesis / Ph.D. Curriculum and Instruction 2011

Made available in DSpace on 2012-09-06T01:11:04Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 99.pdf: 2691977 bytes, checksum: 3fa2eff2b005ba0c1d8204b7a0ffaf2c (MD5) Previous issue date: 1998 / Descreve um estudo de Coorte Descritivo Retrospectivo, realizado com dados obtidos através de prontuários de pacientes internados no Instituto Estadual de Infectologia Säo Sebastiäo, no período de 11/96 a 06/97, que tiveram diagnóstico definitivo de meningite bacteriana ou viral. Procedeu-se às estimativas das gravidade e letalidade, de ambas as meningites, comparando-as entre si, bem como dos respectivos agentes etiológicos específicos. Com base nos 204 pacientes, 141 dos quais, portadores de meningite bacteriana e 63, de meningite viral, viu-se que as primeiras se apresentaram mais graves e mais letais que estas últimas, com excessos de risco de 17,6 e 7,8 por cento, respectivamente. Também evidenciou-se que, apesar de todas as infecçöes bacterianas apresentarem casos graves e incidência de óbitos, a que teve maior número destes desfechos foi a meningite pneumocócica, enquanto que, dentre as virais, a meningite por Herpes simples vírus, foi a única a apresentar tais eventos. Os maiores preditores para a gravidade foram a meningite pneumocócica, a meningite por Herpes simples vírus e a idade de 15 anos ou mais. Já para a letalidade, os preditores, além destes patógenos, foram os menores de 1 ano e evoluçäo clínica para o coma, na meningite bacteriana, e a idade de 15 anos ou mais e evoluçäo para torpor ou coma na viral. Ainda constatou-se que as características liquóricas seguem um padräo bem definido para cada uma das meningites em estudo. / This is a Retrospective Descriptive Cohort study, accomplished through reference book, with patients interned at the São Sebastião State Institute of Infectology, in Rio de Janeiro City, Brazil, in the period from 11/96 to 06/97, with definitive diagnosis of bacterial or viral meningitis. It was proceeded to the estimates of the severity and mortality, of both meningitis, comparing them to each other, as well as the respective pathogens. Based on the 204 patients, 141 of the which, carriers of bacterial meningitis and 63, of viral meningitis, the first ones came more severe and more lethal than these last ones, with excesses of risk of 17,6 and 7,8%, respectively. It was also evidenced that, in spite of all the bacterial infections they present severe cases and obits incidence, the one that had larger number of these was the pneumococcal meningitis, while, of the viral ones, the meningitis for Herpes simplex virus, was the only to present such events. The most importants predictores for the severity were pneumococcal meningitis, herpes simplex virus meningitis and the 15 years-old age or more. Already for the mortality, the predictores, besides these pathogens, was last then 1 year old and clinical evolution for the coma, in the bacterial meningitis, and the 15 years-old age or more and evolution for torpor or coma, in the viral one. It was still verified that the cerebrospinal fluid (CSF) characteristic follows a pattern very defined for each one of the meningitis in study.

Made available in DSpace on 2016-06-02T19:46:14Z (GMT). No. of bitstreams: 1 DissAPA.pdf: 2070463 bytes, checksum: eb4fe602241a58c2ccd28e375ae2ee2f (MD5) Previous issue date: 2004-08-31 / Universidade Federal de Minas Gerais / Social skills have been considered essential in the process of social adjustment for all individuals whether or not they have special education needs. This research used direct (videotaping) and indirect (parent interviews, empathetic discrimination behavior registration and teacher questionnaires) observational methodology to investigate the verbal and non-verbal social behavior repertoires of a group of ten adolescents with Down s Syndrome. A predominance of pro-social behaviors were found for participants in contrast to the self assertiveness responses exhibited, showing a weak relationship (r = 0,260, p > 0,05) between these two classes of skills, which may be due to their being distinct classes of behavior skills acquired under specific learning contingencies. A prevalence of reactive responses was found for the majority, with the exception of four participants. One participant demonstrated a balance in pro-active and reactive responses to the environment in his repertoire (51,3% and 48,7%, respectively), one participant showed a homogeneous frequency distribution for both these classes. A strong relationship between pro-active responses and self-assertiveness behavior (r = 0,866, p < 0,01) was found for the participants, confirming that the greater the frequency of pro-active conduct by individuals, the greater the frequency of self-assertiveness skills. In the structured situations used for this research, a majority of the participants presented a deficit in self-assertiveness responses in their behavior repertoire. This may indicate the need for preventive educational interventions to guarantee an improved performance in situations which demand self-assertiveness behaviors. In the structured situation, eight participants showed inconsistent responses in discrimination of facial expressions in figures with caricatured faces, indicating a deficit in empathetic social skills for perception and recognition of emotions felt by others. No relation was found between the social skills repertoire for participants and variables such as age, gender, and socio-economic class. / Habilidades sociais vêm sendo consideradas essenciais para os processos de ajustamento social das pessoas, portadoras ou não de necessidades educativas especiais. O objetivo desta pesquisa consistiu em investigar, a partir da metodologia observacional, direta (filmagens) e indireta (entrevistas semi-estruturadas com pais, registro do comportamento de discriminação empática, e aplicação de questionário junto às professoras), do repertório de comportamentos sociais, tanto verbais como não verbais, de um grupo de dez indivíduos adolescentes com síndrome de Down. Foi observada uma predominância de desempenhos pró-sociais no repertório dos participantes em detrimento às respostas de enfrentamento exibidas, havendo, portanto, uma relação muito fraca (r = 0,260, p > 0,05) entre estas duas classes de habilidades, o que pode ser explicado por se tratar de comportamentos distintos que são adquiridos em contingências específicas de aprendizagem. Verificou-se a prevalência de respostas reativas no repertório da maioria, com exceção de quatro deles. Um participante demonstrou certo equilíbrio de respostas pró-ativas e reativas ao ambiente em seu repertório (51,3% e 48,7%, respectivamente), ao passo que outro apresentou uma distribuição homogênea de freqüência para estas duas classes. Constatou-se existir uma relação forte (r = 0,866, p < 0,01) entre as respostas pró-ativas e de enfrentamento apresentadas pelos participantes, o que nos permitiria afirmar que quanto mais freqüente o uso do repertório de condutas pró-ativas pelos indivíduos, mais freqüente será o uso de suas habilidades de enfrentamento. Nas situações estruturadas investigadas, a maioria apresentou um déficit de respostas assertivas de enfrentamento em seu repertório Comportamental, o que poderia ser indicativo da necessidade de intervenções preventivas e educacionais que assegurem a eles um melhor desempenho em situações de demandas para a emissão de comportamentos de enfrentamento. Oito participantes exibiram respostas inconsistentes na situação estruturada de discriminação de expressões emocionais diante de figuras com faces caricaturadas indicando possível déficit de habilidades sociais empáticas de percepção e reconhecimento das emoções experimentadas por outras pessoas. Não foi observada a existência de nenhuma relação entre o repertório de habilidades sociais dos participantes e variáveis do tipo: idade, sexo ou nível socioeconômico de suas famílias.

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