<p>The increasing number of immigrants in Sweden during the past decades has brought the health of different ethnic groups into focus. Many groups of immigrants in Sweden have a higher risk of cardiovascular disease (CVD) and coronary heart disease (CHD) than a Swedish reference group. The objective of this thesis was to study the health status and prevalence of metabolic risk factors among immigrant women from Iran and Turkey in comparison with native-Swedish women. The analyses are based on a cross-sectional study of first-generation immigrant women and women born in Sweden aged 35-64. The women underwent a clinical examination, including blood sampling and anthropometric measurements. Dietary intake was assessed by four repeated 24-hour food intake recalls. </p><p>The results show important ethnic differences in risk factors for CHD and the metabolic syndrome between the immigrant and the Swedish-born women. Immigrant women from Iran and Turkey are heavier, with a higher prevalence of abdominal obesity and an unfavourable lipid profile and a high degree of physical inactivity during leisure-time, which may predispose for a higher incidence of diabetes and atherosclerotic CVD. The associations between dietary variables and metabolic risk factors were generally relatively weak. The degree of underreporting of the energy was significant, especially among immigrant women, which might have attenuated possible associations. The fatty acid profile of the diet and in serum among the immigrant women indicated both favourable and unfavourable features, despite a higher prevalence of obesity and dyslipidemia compared to the Swedish-born women. Signs of oxidative stress and inflammation are evident in the immigrant women from the Middle East. </p><p>With reference to ethnical differences in metabolic risk factors, as demonstrated in this thesis, increased emphasis should be given to modifying the underlying factors such as overweight/obesity and physical inactivity associated with the metabolic syndrome in various immigrant groups. </p>

The increasing number of immigrants in Sweden during the past decades has brought the health of different ethnic groups into focus. Many groups of immigrants in Sweden have a higher risk of cardiovascular disease (CVD) and coronary heart disease (CHD) than a Swedish reference group. The objective of this thesis was to study the health status and prevalence of metabolic risk factors among immigrant women from Iran and Turkey in comparison with native-Swedish women. The analyses are based on a cross-sectional study of first-generation immigrant women and women born in Sweden aged 35-64. The women underwent a clinical examination, including blood sampling and anthropometric measurements. Dietary intake was assessed by four repeated 24-hour food intake recalls. The results show important ethnic differences in risk factors for CHD and the metabolic syndrome between the immigrant and the Swedish-born women. Immigrant women from Iran and Turkey are heavier, with a higher prevalence of abdominal obesity and an unfavourable lipid profile and a high degree of physical inactivity during leisure-time, which may predispose for a higher incidence of diabetes and atherosclerotic CVD. The associations between dietary variables and metabolic risk factors were generally relatively weak. The degree of underreporting of the energy was significant, especially among immigrant women, which might have attenuated possible associations. The fatty acid profile of the diet and in serum among the immigrant women indicated both favourable and unfavourable features, despite a higher prevalence of obesity and dyslipidemia compared to the Swedish-born women. Signs of oxidative stress and inflammation are evident in the immigrant women from the Middle East. With reference to ethnical differences in metabolic risk factors, as demonstrated in this thesis, increased emphasis should be given to modifying the underlying factors such as overweight/obesity and physical inactivity associated with the metabolic syndrome in various immigrant groups.

Made available in DSpace on 2014-12-17T14:46:47Z (GMT). No. of bitstreams: 1 LucianaMR_DISSERT.pdf: 3077063 bytes, checksum: 33dba30f3f983ca2c3893ca88edc953a (MD5) Previous issue date: 2010-10-07 / This is an exploratory descriptive study with quantitative approach, aiming to verify the nurses' knowledge concerning the epidemiological surveillance activities at the Onofre Lopes hospital (HUOL), in Natal, Rio Grande do Norte. The study was performed with 63 nurses from the hospital and the data were collected through a questionnaire. All data were analyzed using descriptive statistics. The results were discussed and organized into four sections: nurses' knowledge on hospital epidemiological surveillance; procedures of the professional nurse through compulsory notification diseases; difficulties found by nurses to register the compulsory notification diseases and suggestions of strategies to joint epidemiological surveillance service with the care practices of nurses. The results showed that 55.55% of nurses know the main action of epidemiological surveillance, compulsory notification of diseases, and that 42.86% reported to the Hospital Epidemiology Center , while 57.14% did not allocate the information for this service. Most nurses found it difficult to perform notification for not knowing its flow; for the surveillance service does not operate 24 hours and for vagueness on diagnostic of disorders. Suggestions of strategies to improve the quality of epidemiological information are focused on training of nurses in hospital epidemiological surveillance; working in partnership with the surveillance center; diffusion of information on surveillance and conducting a daily active search. It comes to conclusion that most nurses don't notify the Surveillance Center about Compulsory Notification Diseases and it wasn't observed the incorporation of integrality values between the hospital surveillance and all nurses, since this principle guides the actions of health services based on dialogue, listening, ethical commitment, sharing of knowledge among professionals of various services and respect towards other professionals. Therefore, the integrality gap in the actions of the nurses studied, as well as in the surveillance service does not mobilize the potential of such services to changes in the sense of achievement of practices aimed at a special attention model that combines preventive and corrective actions, proposed and desired by SUS. Through the difficulties presented, it becomes important to recommend educational processes with strategy to transform the conducts, besides proposing actions under the principle of integrality provide responses agile and effective, as the purpose of VE hospital emergency care by the current epidemic / Trata-se de um estudo descritivo explorat?rio com abordagem quantitativa, com objetivo de verificar o conhecimento dos enfermeiros sobre as a??es de vigil?ncia epidemiol?gica no Hospital Universit?rio Onofre Lopes (HUOL), no Munic?pio de Natal, Estado do Rio Grande do Norte. O estudo foi desenvolvido com 63 enfermeiros do referido hospital e os dados foram coletados atrav?s de um question?rio. Todos os dados foram analisados atrav?s de estat?stica descritiva. Os resultados foram organizados e discutidos em quatro se??es: conhecimento dos enfermeiros sobre vigil?ncia epidemiol?gica hospitalar; procedimentos do profissional enfermeiro mediante as doen?as de notifica??o compuls?ria; dificuldades dos enfermeiros para registrar as doen?as de notifica??o compuls?ria e as sugest?es de estrat?gias para articular o servi?o de vigil?ncia epidemiol?gica com as pr?ticas assistenciais dos enfermeiros. Os resultados mostraram que 55,55% dos enfermeiros conhecem a principal a??o de vigil?ncia epidemiol?gica, a notifica??o compuls?ria de doen?a, e que 42,86% notificaram ao N?cleo Hospitalar de Epidemiologia, enquanto 57,14% n?o destinaram as informa??es para esse servi?o. A maior parte dos enfermeiros revelou dificuldades para realizar notifica??o por desconhecerem o fluxo de notifica??o; pelo servi?o de vigil?ncia n?o funcionar 24 horas e por indefini??o diagn?stica das doen?as. As sugest?es de estrat?gias para melhorar a qualidade da informa??o epidemiol?gica est?o voltadas para capacita??o do enfermeiro em vigil?ncia epidemiol?gica hospitalar; trabalho em parceria com o n?cleo de vigil?ncia; divulga??o das informa??es sobre vigil?ncia e realiza??o de busca ativa di?ria. Conclu?-se que a maioria dos enfermeiros n?o notifica ao N?cleo de Vigil?ncia as Doen?as de Notifica??o Compuls?ria e n?o se percebe a incorpora??o dos valores da integralidade entre a VE hospitalar com todos os enfermeiros, posto que este princ?pio norteia a??es dos servi?os de sa?de fundamentadas no di?logo, na escuta, no comprometimento ?tico, compartilhamento de saberes entre os profissionais dos diversos servi?os e respeito quanto ao trabalho dos outros profissionais. Assim, a lacuna da integralidade nas a??es dos enfermeiros estudados, bem como no servi?o de VE n?o mobiliza o potencial desses servi?os para mudan?as, no sentido de realiza??o de pr?ticas voltadas para um modelo de aten??o integral que articula a??es preventivas e curativas, proposto e desejado pelo SUS. Mediante as dificuldades apresentadas torna-se importante recomendar processos educativos com estrat?gia de transforma??o das pr?ticas, al?m de proposta de a??es ? luz do princ?pio da integralidade possibilitando respostas ?geis e efetivas, conforme prop?sito da VE hospitalar mediante as urg?ncias e emerg?ncias epidemiol?gicas atuais

Maternal mortality remains a severe problem in many parts of the world, despite efforts to reach MDG 5. Assessing progress towards this goal is difficult because maternal mortality is difficult to measure and the information available at country level does not generally permit the establishment of good baseline data. Countries with high maternal mortality ratios neither have adequate vital registration systems nor adequate resources to carry out surveys. Only few low-income countries have been able to establish a comprehensive reporting system and even where such vital registration systems are in place, maternal deaths are often underreported or misclassified as non-maternal even in large well developed cities. <p>Ghana belongs to the group of low-income countries with high maternal mortality ratios (point estimate 560, lower bound 200 and upper bound 1300) per 100,000 live births and inadequate data on maternal deaths. Previous studies have demonstrated that most of these deaths could be prevented with existing effective practices.<p><p>In this dissertation, we looked at the registration system of births and deaths in the Greater Accra Region of Ghana. We assessed completeness of registration of maternal deaths and data quality. We also looked at the degree of underreporting of maternal deaths, assessed causes of maternal deaths and substandard care of these cases through a confidential enquiry. This enabled us to identify problems associated with measuring of maternal mortality in Ghana and the standard of care of the cases. Through our findings we were able to make recommendations to achieve MDG 5 in the country by 2015 if implemented. Other maternal and child health (MCH) interventions were also looked as working to improve MCH is a continuum, and no aspect should be neglected. The first relates to seeking evidence based practice in presence of potentially complicated obstetrical conditions like premature rupture of membranes and the second pertains to preventive activities in MCH and concentrates on the results of tetanus immunisation of women in their reproductive age in the Northern Region of Ghana.<p><p>Objectives<p>1.\ / Doctorat en Sciences de la santé publique / info:eu-repo/semantics/nonPublished

本研究主要在探討會計師事務所查帳人員在面臨時間壓力的情況下，對其查帳工作態 度的影響。根據以往的研究，查帳人員面臨時間壓力時，生理上、心理上有重大變化 。本研究則主要著重於在時間壓力下，查帳人員於查帳工作本身的影響。在心理學上 ，人格特質對個人工作態度會有重大影響，故本研究將此變數納入，藉以測試在不同 人格特質下，於不同工作壓力情境下，對查帳工作態度之影響，至所謂工作態度，本 研究係指以下三項變數： ヾ低報查帳時間（Underreporting chargeable time） ゝ挪報查帳時間（Shifting chargeable time） ゞ降低查帳品質（Reducing audit quality） 研究結果：發現人格特質愈傾向Ａ類型者，在時間壓力大時，較不會有這三種情形出 現，反之，人格特質為Ｂ類型者，較易有這三種情形出現。但如果時間壓力不大時， 則無論人格特質為何，則三種情形皆不顯著發生。

L’objectif de la présente étude est de documenter la fécondité des Indiennes inscrites au Canada en fonction du traité historique d’affiliation. Les traités historiques sont des ententes légales qui lient le gouvernement du Canada et certains membres des Premières Nations et qui décrivent, notamment, les dispositions prévues à leur égard pour compenser la cession de leurs terres. Mêmes si les traités ont principalement une fonction légale, ils regroupent aussi des individus qui partagent des caractéristiques communes sur le plan culturel, linguistique, socioéconomique, territorial et historique. À partir de données extraites du Registre des Indiens, nous avons produit l’indice synthétique de fécondité (ISF) pour chacune des populations affiliées aux traités historiques pour les périodes 1994-1998, 1999-2003 et 2004-2008. Nous voulions savoir si la fécondité des Indiennes inscrites différait en fonction du traité d’affiliation, si on observait des changements dans le temps et si de grandes tendances pouvaient être identifiées selon les régions couvertes par les traités. Des différences importantes sont relevées, particulièrement entre les traités numérotés qui couvrent les Prairies et les traités de l’est du pays. Étant donné l’absence dans le Registre des Indiens, d’informations sur les caractéristiques sociales, culturelles et économiques des populations affiliées aux différents traités, il n’est pas possible d’avancer des explications précises concernant ces écarts. Toutefois, il est possible de proposer une association entre la fécondité du moment et certaines caractéristiques des populations affiliées aux traités historiques et les dimensions géographique et historique des traités. / This research aims to document the fertility of registered Indians in Canada in relation to their affiliation with historic treaties. The historic treaties are legal agreements, between the government of Canada and certain members of the First Nations, which describe lands surrendered and related compensation. Although the treaties have mainly a legal role, they apply to Indigenous peoples sharing similar characteristics along cultural, linguistic, socioeconomic, territorial and historical lines. We used anonymized data extracted from the Indian Register to produce the total fertility rate (TFR) for the population concerned by each historic treaty for the periods 1994-1998, 1999-2003 and 2004-2008. We wanted to know if the fertility of registered Indians differed by treaty memberships, if we observed changes over time and if notable trends could be identified depending on the regions covered by the treaties. Our analyses show that important differences exist, particularly between the numbered treaties, which cover the Prairies provinces, and the treaties populations of Eastern Canada. Since the data collected by the Indian Register do not contain information on social, cultural and economic characteristics of Indigenous peoples that could explain these differences, it is not possible to develop precise explanations of these variations. However, it is possible to propose an association between the fertility rate and the geographical and historic aspects of the treaties populations.