Thesis (M.S.)--University of Wisconsin--Madison, 1984. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 84-94).

Thesis (M.A.)--University of Wisconsin--Madison, 1971. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis--Univ. of Michigan. / Bibliography: leaves 106-112.

Dissertation (Ph.D.)--Colorado State University, 1968. / Typescript (photocopy) Bibliography: leaves [101]-106.

L’évaluation psychologique à court, moyen et à long terme des survivants, de séismes démontre que certains symptômes psychiatriques sont courants dans ces populations, notamment le Trouble de Stress Post-Traumatique (TSPT) et la dépression. Les objectifs principaux de ce travail visaient à combler des lacunes de données scientifiques sur les éventuelles relations entre des facteurs pré, péri et post-traumatiques spécifiques et le développement de troubles post-traumatiques dans des groupes vulnérables suite au séisme de 2010 en Haïti. Etude no 1- Objectifs : évaluer les associations entre les croyances sur l’origine du séisme et les psychopathologies post-traumatiques, et la résilience. Les symptômes dépressifs sévères étaient courants chez les personnes d’affiliation vodouisante (x2 = 9.05, df = 1, p <0.01), ainsi que chez les personnes présentant un faible niveau de résilience (<80 au CD-RISC, x2 = 7.49, df = 1, p<0.01). Etude no 2- Objectifs : mesurer une année après le désastre, l’effet d’un support psycho-social offert à des enfants de Port-au-Prince issus des camps d’hébergement comparés à un groupe contrôle vivant sous un toit. Les deux groupes étaient homogènes sur le plan de l’intensité de la détresse péri- traumatique. Il n’y avait pas de différence significative entre eux dans les scores du TSPT, la dépression et l’index de psychopathologie. Etude no 3- Objectifs : explorer 3 années après la catastrophe les propriétés psychométriques de la version créole du PTSD Checklist, auprès de 364 mères survivantes. La prévalence du TSPT probable était de 22,3%. La version créole du PCL-S est un instrument fiable pour la mesure du TSPT chez les femmes créolophones. Etude no 4- Objectifs : Examiner la prévalence des comportements autistiques dans une cohorte de sujets de 3 ans exposés à l’âge foetale au séisme. Ainsi, 8 sur 364 (2.2%) enfants recrutés répondaient aux critères de comportements autistiques sévères. Etude no 5- Objectifs : investiguer les associations statistiques entre l’exposition maternelle prénatale au séisme de 2010 avec les comportements autistiques ou des troubles du comportement global et émotionnels chez des enfants de 3 ans. Les symptômes de TSPT chez la mère était un prédicteur indépendant des comportements autistiques (=. 370, p<. 001) et des problèmes du comportement général et émotionnels (=. 467, p<. 001) chez l’enfant. Etude no 6- Objectifs : analyser qualitativement le portrait singulier de l’évolution d’une dyade rencontrée. La sémiologie autistique s’accompagne depuis la période néo-natale de crises convulsives récurrentes. L’histoire traumatique maternelle anténatale connue et son imbrication à la comorbidité autisme/épilepsie chez la fillette devrait être au coeur de tout dispositif psychothérapeutique futur. / Short-term, mid-range and long-term psychological evaluation of earthquake survivors reveals that certain psychiatric symptoms frequently exist in these populations, specifically PTSD and Depression. The principal objectives of this work were to address current gaps in scientific knowledge related to potential relationships between specific pre, peri and post-traumatic variables and the development of posttraumatic psychopathology in vulnerable groups following the 2010 earthquake in Haiti. Study no 1- Objective : This study examines associations between religious beliefs regarding the origin of the 2010 earthquake in Haiti and posttraumatic symptomatology as well as resilience among survivors. The severity of depressive symptoms was associated with a score <80 on the CD-RISC (x2 = 7.49, df = 1,p <0.01) and were more prevalent among Voodoo Adherents than among their counterparts with different belief systems (x2 = 9.05, df = 1, p <0.01).Study no 2- Objective : This study, conducted one year after the 2010 earthquake, assessed the effect of a psycho-social intervention implemented among children residing in a displacement camp in Port-au-Prince compared with a control group. The two groups were homogeneous in terms of the intensity of the peritraumatic distress they experienced. No significant difference was noted between the experimental and control group in their endorsement of PTSD symptoms or in their scores on a depression scale. In three out of the four sub-scales of the Child Behavior Check-List, there was no significant difference noted either. Study no 3- Objective : In this study, we examined the psychometric properties of a Haitian Creole version of the PTSD checklist among 364 mothers exposed to the 2010 earthquake and the prevalence of PTSD symptoms among them, 3 years after the event. Our findings included that 22,3% of our sample would possibly meet the criteria for PTSD even three years after the earthquake. The creole version of PCL-S is a reliable measure of PTSD symptoms among female creole speakers. Study no 4- Objective : This study investigated the prevalence of autistic behaviors in a cohort of young children (n-364) who were exposed in utero to the devastating 2010 earthquake in Haiti, 3 years after theevent. A significant minority (2.2%) of our sample met criteria for severe autistics behaviors. Study no 5- Objective : This study, conducted 3 years after the 2010 Haiti earthquake targeted women who were pregnant during the earthquake and their offspring who were in utero at the time of the event. Specifically, the study assessed the association between maternal exposure to the earthquake with autistic, behavioral, and emotional symptoms of the offspring at age three. Current maternal PTSD symptoms was an independent predictor of the offspring’s autistic behaviors (=. 370, p<. 001) as well as behavioral and emotional problems (=. 467, p<. 001). Study no 6- Objective: This study comprised a qualitative analysis of a single mother and child dyadscreened in the quantitative survey. In addition to displaying symptoms of autism, the young child also suffers from recurrent seizures. Maternal history of physical and psychological trauma has implications forco-morbidity of autism and epilepsy offspring who were in utero at the time of the trauma and such dyadsshould be targeted for therapeutic intervention and follow-up in the future.

Growth is associated with the availability of essential nutrients and it seems possible that these nutrients could affect the growth mechanism involved in skeletal development. To test this hypothesis 76 normal human fetuses aged 9 to 20 weeks were collected from therapeutic abortions. Sex, weight, length, head circumference, foot length and a skeletal index were recorded; developmental age was calculated from crown-rump length, and gestational age estimated from the mother's menstrual history. Bones from the right arm and leg were removed and cleaned for biochemical analysis. Calcium, inorganic phosphorus, magnesium, sodium and collagen content of 60 femora and humeri were determined, after length, fresh weight, constant dry weight and fat-free weight were recorded. Length of ossification in the bones of the left arm and leg was measured via silver radiography. Assuming bilateral symmetry, biochemical and physical data could then be compared. All fetal data were grouped according to developmental age: 9-10, 11-12, 13-14, 15-16, 17-20 weeks. Analysis of variance and Duncan's New Multiple Range Test were performed to determine the significance of group effect. Simple linear regression was executed on the whole range of data to detect which variables best predicted other variables. Maternal information was obtained from an interview and from medical records at Vancouver General Hospital. Age, weight, height, birth weight, parity and gravidity of the mother were recorded. A socio-economic index was calculated. Adequacy of maternal diet during pregnancy was assessed from a daily pattern recall, food frequency and preference questions. These data were used to calculate a total nutrition score and a protein score. Maternal data were coded as potential independent variables and multiple regression analysis performed against fetal dependent variables. As developmental age of the fetuses increased, the fresh length, dry weight and length of ossification also increased in both humerus and femur, as did the calcium and phosphorus content. In most cases long bone growth as measured by these variables advanced proportionately with fetal age. Thus group means of most variables were significantly different from each other when divided into five 2 week age periods. Water content dropped proportionately with age, reflecting bone mineralization. Sodium content fell markedly in fetal bones after 10 weeks. Magnesium and collagen remained constant. Fat extraction did not change the dry weight of the bones. Statistical correlation was found between physical and biochemical data. Generally physical variables were best predicted by other physical variables. Biochemical composition of the femur could best be predicted from corresponding data in the humerus. When gestational age was plotted against physical or biochemical variables, statistical correlation was weaker. The correlation found between fetal variables and maternal age, parity, weight and socio-economic status would indicate a diversity of factors influencing fetal growth. Whereas protein score of maternal diet was not statistically related with fetal parameters, general nutrition score showed a consistent, positive correlation with length and dry weight of the femur and humerus. This relationship was statistically significant when developmental or gestational age remained constant. The results of this study suggest that nutrition of the pregnant woman is positively correlated with some indices of skeletal growth and development of the human fetus. / Land and Food Systems, Faculty of / Graduate

Background: Pregnancy substance use is linked to low birth weight. However, less is known about relative contributions of various substances and whether effects are due to decreased gestational duration, restriction of fetal growth, or both. The study goal was to use causal modeling to evaluate the individual impact of alcohol, tobacco, cocaine, and marijuana on gestational duration and fetal growth. Methods: Participants were 3164 urban black women recruited at entry to prenatal care and followed to delivery, with all gestational dating ultrasound supported. Pregnancy substance use was assessed via self-report (alcohol, tobacco, cocaine, and marijuana). Results: Alcohol, cigarette, and cocaine use were all individually and negatively related to gestational age at delivery. However, only alcohol, cigarette, and marijuana use predicted fetal growth, with effects for alcohol and cigarette greater and more discrepant for older women. Overall, heavy cigarette smoking had the greatest individual impact on birth weight (up to 431 g). Heavy levels of use of all 4 substances by older women decreased birth weight by 26% (806 g). Conclusions: For perhaps the first time, reduced birth weight is apportioned both by type of substance and mechanism of effect. The use of alcohol and/or cigarettes was clearly more harmful to fetal growth than cocaine use. Findings demonstrate the need for continued emphasis on intervention efforts to address legal and illicit pregnancy substance use.

The aim of the first three experiments was to delineate the physical characteristics of an artificial call for which naive Peking X Aylesbury ducklings show the greatest natural preference. In each experiment SO ducklings were tested at 20 ± 2 hrs. posthatching, for following and approach responses to one of four auditory stimulus conditions or a silent model. The responsiveness of subjects was greatest when the call contained tone frequencies of 500, 800, and 1600Hz and was presented at a repetition rate of 4/second with a note duration of 50 milliseconds (Optimal call). In Experiment 4 Peking X Aylesbury eggs were exposed to intermittent prenatal stimulation with the optimal call and the hatchlings were tested for responsiveness to this call at 20 ± 2 hrs. posthatching. Subjects with prenatal auditory experience of the optimal call showed significantly greater responsiveness to this call than non-stimulated control subjects. The aim of the final experiment was to determine whether the natural auditory stimulus preferences of ducklings could be overridden through sheer prenatal experience of a non-preferred call. Ducklings with prenatal experience of the non-preferred call continued to show as strong a preference for the optimal call as non stimulated control subjects. The responses of both stimulated and non-stimulated subjects to the optimal call were significantly stronger than the responses of stimulated and non-stimulated subjects to the non-preferred call. The responses of stimulated subjects to the non-preferred call were only slightly stronger than responses of non-stimulated subjects to the same call. These results indicate that responsiveness to calls for which naive birds show the greatest preference is enhanced by prenatal experience of the preferred call. This effect is not evident, however, when subjects are stimulated prenatally with a non-preferred call.

OBJETIVO: Determinar los principales factores de riesgo para el inicio tardío de la atención prenatal en gestantes que acuden al consultorio de obstetricia del Centro de Salud “Leonor Saavedra” durante los meses de enero a marzo del 2015. METODOLOGÍA: Estudio de tipo observacional con diseño analítico de casos y controles, prospectivo, transversal. En el estudio participaron un total de 80 gestantes las cuales fueron divididas en dos grupos: 37 gestantes que inician tardíamente su atención prenatal (grupo caso) y 43 gestantes que inician tempranamente su atención prenatal (grupo control) en el consultorio de obstetricia del Centro de Salud “Leonor Saavedra” durante los meses de enero a marzo del 2015. Para el análisis estadístico se estimaron frecuencias absolutas, relativas y medidas de tendencia central para el análisis descriptivo. Para el análisis inferencial se calculó la prueba Chi cuadrado, con un nivel de confianza de 95%, y para cálculo del riesgo se calculó el Odd Ratio. RESULTADOS: La mayoría de gestantes (53.8%) evaluadas en el estudio inicia tempranamente su atención prenatal en el centro de salud Leonor Saavedra. Al evaluar los factores de riesgo para el inicio tardío de la atención prenatal, se observan que los factores socioeconómicos no fueron considerados de riesgo para el inicio tardío del control prenatal. Sin embargo en cuanto a los factores personales como: el ser víctima de violencia (p=0.013) (OR=0.013), que la familia muestre poco interés por la salud de la gestante (p=0.003) (OR=0.003), presentar problemas durante el embarazo (p=0.006) (OR=0.006), tener problemas de dinero para costear la atención prenatal (p=0.014) (OR=0.014), tener dificultades de acudir al CPN por su trabajo (p=0.001) (OR=8.11), el antecedente de experiencias negativas durante las consultas en un establecimientos de salud (p=0.001) (OR=2.536) y considerar poco importante la atención prenatal (p=0.027) (OR=2.303), tuvieron frecuencias significativamente diferentes; por tanto, se consideran factores de riesgo asociados al inicio tardío de la atención prenatal. Al respecto de los factores de riesgo obstétricos de las gestantes con inicio tardío y temprano de la atención prenatal, se evidencia que el ser multigesta (I. tardío=67.6%, I Temprano=0%) (p=0.000) presenta frecuencias diferentes en ambos grupos, por tanto se considera como factor de riesgo de inicio tardío de la atención prenatal (OR=4.58). Respecto a los factores institucionales, se encontró frecuencias similares entre el grupo de gestantes de inicio temprano y tardío de la atención prenatal, no encontrándose asociación no riesgo para el inicio tardío de la atención prenatal. CONCLUSIÓN: Los principales factores de riesgo para el inicio tardío de la atención prenatal en las gestantes atendidas en el Centro de Salud “Leonor Saavedra” son: la condición de multigesta, tener problemas de dinero, tener dificultad para acudir al CPN por su trabajo y el antecedente de experiencias negativas en alguna consulta. / OBJECTIVE: To determine the main risk factors for the late onset of prenatal care in pregnant women attending clinics of obstetrics of the Health Center “Leonor Saavedra" during the months of January to March 2015. METHODOLOGY: Observational study with analytical design of case-control and prospective transversal. The study involved a total of 80 pregnant women which were divided into two groups: 37 pregnant women who belatedly begin their prenatal care (case group) and 43 pregnant women who early start their prenatal care (control group) in the office of obstetrics Center health "Leonor Saavedra" during the months of January to March 2015. For statistical analysis, the descriptive analysis, were estimated absolute frequencies, relative frequencies and measures of central tendency. For the inferential analysis Chi square test was calculated with a confidence level of 95%, and was calculated the risk with Odd Ratio. RESULTS: Most pregnant women (53.8%) evaluated in the study early start your prenatal care at health center Leonor Saavedra. To evaluate the risk factors for late entry into prenatal care are observed that socioeconomic factors were not considered at risk for late onset of prenatal care. Though in terms of personal factors such as being a victim of violence (p=0.013) (OR=0.013), that the family show little interest in the health of pregnant women (p=0.003) (OR=0.003), submit problems during pregnancy (p=0.006) (OR=0.006), have problems with money to pay for prenatal care (p=0.014) (OR=0.014), difficulty of going to NPC for his work (p=0.001) (OR=8.11), previous negative experiences during consultations in health facilities (p=0.001) (OR=2.536) and consider unimportant prenatal care (p=0.027) (OR=2.303) were significantly different frequencies; therefore, are considered risk factors associated with late entry into prenatal care. With respect to the obstetric risk factors of pregnant women with late onset and early prenatal care, it is evident that to be multigesta (late I. = 67.6%, R Early =0%) (p=0.000) presents different frequencies both groups thus it is considered as a risk factor for late onset of prenatal care (OR=4.58). With regard to institutional factors, was observed similar frequencies among the group of pregnant women in early and late onset of prenatal care was not found association no risk to the late onset of prenatal care. CONCLUSIONS: The main risk factors for late entry into prenatal care in pregnant women at the Health Center "Leonor Saavedra" are the condition multigesta, having money problems, having difficulty to go to the CPN for his work and history negative experiences with any questions. KEYWORDS: Risk factors, late start, prenatal care. / Tesis

A research report submitted to the Faculty of Health Sciences in partial fulfilment of the requirements for the degree of Master in Family Medicine Department of Family Medicine University of the Witwatersrand, Johannesburg, 2017. / Background Research has shown that women who do not obtain adequate prenatal care significantly reduce their chances of a favourable pregnancy outcome. Despite antenatal care services being provided free of charge in South Africa, only 53.9% of women attend antenatal care before the gestational age of 20 weeks or less as recommended by the World Health Organisation (WHO) and National Department of Health (NDOH).The interventions aimed at reducing unfavourable pregnancy outcomes are most effective during prenatal care, it is crucial to identify factors that prevent pregnant mothers from presenting early. It is believed that the findings of this study will give us an insight into the rate of early ANC attendance and will also be useful to policymakers and facility managers, especially at the Primary Health Care (PHC) level, in optimising patient care and improving healthcare services. Aims and objectives Therefore, the objectives of this study were: 1 To establish the gestational age at which pregnant women present to first antenatal visit in Maquassi Hills sub district. 2 To describe participants’ socio-demographic profile, health status and obstetrical characteristics 3 To explore knowledge and attitudes that affect timing of first presentation. 4 To determine any association between first ANC presentation and socio-demographic, obstetric factors, knowledge and attitudes towards ANC. 5 To determine predictors for first antenatal attendance. Method This was a cross-sectional study conducted in four publicly funded primary health facilities in the Maquassi Hills sub district, between August and October 2015. A total of 127 participants were directly interviewed using a structured questionnaire to obtain information about their socio-economic characteristics, ANC and services rendered. Most of the information required for the study was obtained from the Maternity booklet. This included demographic data, obstetric history, medical history, and gestational age. Data analysis was done using Microsoft Excel 2014. A chi-square test was used to determine associations between time of the first presentation and each variable; and a multiple variable regression was used to determine predictors of early attendance. Results Most participants interviewed were: Tswana speaking (72.4%), with a mean age of 26.5 years (SD = 5.9), had a high school education (84.6%) and were mostly single (70.6%). This study showed that 68.9% of the respondents presented to their first antenatal booking within the recommended time of less than 20 weeks. The average period of presentation was 16.3 weeks (SD = 6.0). No statistically significant association was found between socio- demographic, obstetrical characteristics and the timing of the first antenatal visit. All the participants knew that the right time to book an appointment was before 20 weeks as the best perceived time for initiation of ANC. However, there was a statistically significant difference in the best perceived time between those who booked early (2 months [1.99 months (SD =1.145)]) compared with those who booked later (3 months [2.83months (SD = 1.595)]) (p = 0.006). The multivariate analysis showed that participants who perceived three months as the best time for booking were 1.5 times more likely to book later (OR= 1.589, 95% CI 1.227-2.059) compared with those who perceived that the best time was at two months. The most frequent reason given for booking early was to confirm pregnancy (64.0%) and (31.1%) initiated ANC because they were ill. Long waiting times and staff attitude were reported by participants (91.3%) and (5%) respectively as barriers to early ANC visit. Conclusion The findings of this study show that most participants booked antenatal care timely and all participants knew the right time to initiate ANC. However, there is incongruity between knowledge and practice for the 30% who presented late. This could be attributed to the long waiting time and staff attitude mentioned by some of the participants. There is a need therefore to address the demotivating factors such as long waiting time, and staff attitude in order to promote early ANC booking/attendance. / LG2018