The thesis titled A Survey of Pupils' Reading Abilities in the Second Years of Primary School focuses on reading the incidence of the most common deficiencies in initial reading. The thesis is divided into a theoretical part and a research part. The theoretical part deals with reading in terms of the education system, acqua-ints us with the physiological and psychological processes in reading, mentions the his-torical and current methods of teaching reading, types and quality of reading, stage of development of reading skills, reading deficiencies, wrong reading habits and describes working with lagging readers. The research part is devoted to the research, its implementation and evaluation. The main goal is to find out what makes beginning readers the most problems and what the overall level of reading skills, of students of 2nd year, is. The research part mainly interprets the recording of reading performance.

Le système immunitaire muqueux, et plus particulièrement les réponses intestinales IgA sont essentielles non seulement à la défense contre les agents pathogènes, mais aussi au façonnement de la flore intestinale commensale. Dans les modèles murins de déficit en IgA, on observe une dysbiose intestinale majeure associée à une inflammation muqueuse, réversibles après restauration des IgA. Le but de ce travail est de décrire l'impact de l'absence d'IgA chez l'homme sur la composition du microbiote intestinal ainsi que ses conséquences locales et systémiques. L'étude comparative par analyse métagénomique des selles de 17 sujets déficitaires en IgA et de 34 donneurs sains retrouve l'absence de différence majeure en termes de répartition des phyla dominants, de diversité et de richesse génique bactériennes entre les deux groupes. En revanche, en analysant à l'échelon des espèces, on observe dans le déficit en IgA une surreprésentation d'espèces pro-inflammatoires et une sous-représentation d'espèces anti-inflammatoires. En outre, en l'absence d'IgA, nous observons la présence de réponses IgM qui opsonisent partiellement les genres ciblés par l'IgA, mais semblent maintenir la diversité au sein des Actinobactéries. Les patients présentent un biais phénotypique lymphocytaire T circulant (TH17) associé à des stigmates de translocation bactérienne. Enfin, l'absence d'IgA s'associe à une perturbation du réseau bactérien minimal "obligatoire". Ces résultats suggèrent que le déficit en IgA humain s'accompagne d'une dysbiose modérée associée à une altération de l'architecture du réseau bactérien induisant une hyperactivation du système immunitaire, malgré la présence de réponses IgM. / IgA responses play a key role in gut mucosa, defending host against pathogens but also shaping the commensal flora. In order to get insights into the specific contributions of IgA to host/microbial symbiosis in humans, we explored patients that lack only IgA, using gut microbial metagenomics and systems immunology. Microbiota composition was compared between 34 healthy controls and 17 selective IgA deficiency (sIgAd) patients. Contrary to what was observed in murine models of IgA deficiency, we show that human sIgAd is not associated with massive perturbations of gut microbial ecology, regarding phyla distribution, bacterial diversity and gene richness. A clear gut microbial signature is however associated to sIgAd: we found 19 over-represented MGS mainly described to be pro-inflammatory, but also 14 under-represented MGS, mainly known to be beneficial. We also explored local consequences of IgA deficiency, particularly whether IgM could replace IgA at host/bacterial interface. Using a combination of bacterial flow sorting and DNA sequencing, we therefore analysed the composition of IgM-coated microbiomes observed in sIgAd. We show that IgM only partially supply IgA deficiency, as not all typical IgA targets can also be opsonized by IgM, but nevertheless contribute to maintain Actinobacteria diversity. IgA deficiency is associated with a skewed circulating CD4+ T cell profile towards TH17, as well as markers of bacterial translocation. Finally, sIgAd is associated with a perturbation of the minimal bacterial network. Altogether our results suggest that human IgA deficiency is associated with a mild dysbiosis associated to systemic inflammation despite the presence of IgM

This paper presents a study of deficiencies in sanitation ambient`s evaluation at Ilha do Ouro village, city of Porto da Folha, located at Sergipe’s semi-arid, 196km away from the northwest of its capital, Aracaju. It has an approach population of 711 people who inhabits the edge side of São Francisco river. The socioeconomics and ambient conditions the in the place are adverse with the great part of its inhabitants living under subsistence condition, culture farming short duration cycle subjected to the climate’s irregularity which influences the quality of life, when 85% of the family has income of until one minimum wage, that is reflected in the lack on health appearing diseases of poverty and the children in state of malnutrition. The lack of jobs, the low level of schooling and the long period without rains, makes the population depend on government’s social programs. The habitation conditions are precarious and a great part of residential units present an inadequate distribution of rooms with living room, bedroom, kitchen and bathroom, with bad illumination and ventilation, which connect themselves through long halls. These habitations are deficient on basic sanitation and the water consumed is out of drinkable patterns, the trash is collected by municipal agency, although on an irregular way with inadequate disposition, which threats the environment and the domestic sewer that is thrown up to the open air to yards or leaded to the septic tank which are built in flats grounds making harder the infiltration of liquid part in subsoil, causing the overflow to surface and contributing to the domestic and public environment contamination and sprouting of diseases vectors. Most of the population is conscientious about the importance of sanitation in other to have salubrious environment and they identify the problems and detach the positive points, partnership and actions to improve their condition of life and of natural environment and social in according to the results obtained in questionnaires, interviews and answers of the fast participative diagnosis, applied with the help of the public intuition and civil segments answers given by the population. / O trabalho apresenta um estudo de avaliação da deficiência de saneamento ambiental do povoado Ilha do Ouro, Município de Porto da Folha, localizado na região do semi-árido sergipano, distante 196 Km ao Noroeste da capital, Aracaju, e conta com uma população aproximada de 711 pessoas, que habitam a margem esquerda do rio São Francisco. As condições socioeconômicas e ambientais do povoado são adversas, com a maioria de seus moradores vivendo do cultivo de lavouras de curta duração, sujeitas à irregularidade do clima, o que influencia na qualidade de vida. A renda mensal de 85% das famílias é de até um salário mínimo, reflete na saúde, com surgimento de doenças provenientes da carência alimentar, como a desnutrição infantil. A falta de emprego e a baixa escolaridade, em conjunto com as longas estiagens, fazem com que a população dependa dos programas sociais do governo. As condições habitacionais são precárias: a maioria das unidades residenciais apresenta uma distribuição dos seus cômodos de forma inadequada, compostos de sala, quartos, cozinha e banheiro, mal iluminados e arejados, que se ligam através de longos corredores. São deficientes em relação às condições de saneamento básico, a água consumida pela população está fora dos padrões de potabilidade; o lixo é recolhido pelo órgão municipal, de forma irregular, com disposição inadequada, o que agride o ambiente; os esgotos domésticos são lançados a céu aberto para os quintais, ou conduzidos para fossas que são construídas em solos rasos, o que dificulta a infiltração da parte líquida no sub-solo, provocando o transbordamento para a superfície e contribuindo para a contaminação do ambiente doméstico e público e o surgimento de vetores transmissores de doenças. A maioria da população é consciente da importância do saneamento para se ter um ambiente salubre e saudável e identifica os problemas, destaca os pontos positivos, parcerias e ações para o melhoramento das condições do meio físico natural, social e de vida das famílias, conforme resultados obtidos nos questionários, entrevistas e nas respostas do Diagnóstico Rápido Participativo, aplicados com os representantes das instituições públicas dos setores civis organizados do povoado ribeirinho.

Carências nutricionais são ocorrências comuns em grande proporção de crianças do mundo e reconhecidamente um dos grandes problemas da saúde pública brasileira. Alguns estudos têm relatado que os escores mental e motor de crianças com carências nutricionais são mais baixos do que aqueles obtidos pelas crianças sem carências. As Escalas Bayley, publicadas pela primeira vez em 1969 e revisadas em 1993, constituem-se em instrumento adequado para a avaliação de crianças de um a quarenta e dois meses de idade, e são amplamente utilizadas em estudos que avaliam efeitos de carências nutricionais. Desta forma, o objetivo deste trabalho foi verificar a aplicabilidade da Escala de Avaliação do Comportamento Infantil (BRS), uma das três escalas que constituem as Escalas Bayley, na avaliação de crianças de creche com carência nutricional. A amostra foi constituída por 50 crianças de ambos os sexos, com idades que variaram entre 7 e 41 meses, provenientes de duas creches filantrópicas do município de Ribeirão Preto – SP. Um grupo de 23 crianças com deficiência proteico-calórica ou de ferro, consideradas de leve a moderada, segundo o Z-score < +1, proposto pela OMS e níveis de hemoglobina acima de 8 mg/dL, foi comparado a outro de 27 crianças sem estas deficiências. Através da avaliação do comportamento foram obtidos índices referentes ao comportamento geral, o controle emocional, a atenção/exitabilidade, a orientação/engajamento e a qualidade motora das crianças. Tais índices são apresentados em forma de percentil, sendo possível, segundo Bayley (1993), a classificação em: comportamento dentro dos limites normais (índice ? percentil 26), ou seja, esperado para sua idade; comportamento questionável (índice entre o percentil 11 e o 25), que sugere possível prejuízo e merece maior investigação; e comportamento não-ótimo (índice ? percentil 10), que evidencia atraso ou prejuízo em uma ou mais áreas importantes. Os resultados obtidos revelaram que o grupo controle era de maior faixa etária (30 meses) que o grupo carente nutricional (23 meses), e que as crianças do grupo controle apresentavam um comportamento geral frente a situação de teste melhor que do que as crianças do grupo carente nutricional (p=0.03), principalmente no fator Orientação/Engajamento (p=0.01): Afeto positivo (p=0.03), Energia (p=0.005), Entusiasmo acerca das tarefas (p=0.04), Engajamento social (p=0.03); e nos itens Afeto negativo (p=0.04) e Movimento lento e atrasado (p=0.005). Estes resultados são consistentes com aqueles já apresentados na literatura, nos quais as crianças com carências nutricionais são descritas como menos ativas, mais inibidas e tímidas, menos responsivas, atentas, vocalizando e movimentando-se menos. Concluiu-se que os itens relacionados à avaliação comportamental, aplicados e cotados como proposto originalmente, foram sensíveis para diferenciar grupos com e sem alterações nutricionais leves ou moderadas, embora as Escalas Bayley do Desenvolvimento Infantil requeiram ainda adaptação às condições sociais e culturais brasileiras. Tais resultados sugerem ainda que esta escala pode ser útil em outras condições clínicas, assim como para a avaliação do desempenho de grupos pós procedimentos de recuperação nutricional. / Nutritional deficiencies are common occurrences among a large proportion of children all over the world and are recognized to be one of the great public health problems in Brazil. Some studies have reported that the mental and motor scores of children with nutritional deficiencies are lower than those of children with no deficiencies. The Bayley Scales, first published in 1969 and revised in 1993, are an appropriate instrument for the evaluation of children aged one to forty months and are widely used in studies that evaluate the effects of nutritional deficiencies. Thus, the objective of the present study was to determine the applicability of the Behavioral Rating Scale (BRS), one of the three scales forming the Bayley Scales, for the evaluation of day-care center children with nutritional deficiencies. The sample consisted of 50 children of both sexes aged 7 to 41 months, from two philanthropic day-care centers in the municipality of Ribeirão Preto – SP. A group of 23 children with protein-calorie or iron deficiency considered to be mild to moderate according to a Z-score < +1 proposed by the WHO and with hemoglobin levels above 8 mg/dL, was compared to a group of children without these deficiencies. Indices referring to general behavior, emotional control, attention/excitability, orientation/engagement, and motor quality of the children were obtained by behavioral evaluation. These indices are presented in percentile form and, according to Bayley (1993), it is possible to classify them as behavior within normal limits (index ? 26th percentile), i.e., expected for age, questionable behavior (index between the 11th and 25th percentile), suggesting possible impairment and requiring more investigation, and non-optimal behavior (index ? 10th percentile), which demonstrates delay or impairment in one or more important areas. The results obtained revealed that the control group was in an older age range (30 months) than the group with nutritional deficiency (23 months), and that the children in the control group presented a better general behavior in the test situation than the children in the group with nutritional deficiency (p=0.03), especially regarding the Orientation/Engagement factor (p=0.01): Positive affect (p=0.03), Energy (p=0.005), Enthusiasm about tasks (p=0.04), Social engagement (p=0.03); and in the items Negative affect (p=0.04) and Slow and delayed movement (p=0.005). These results are consistent with those reported in literature studies in which children with nutritional deficiencies are described as less active, more inhibited and shy, less responsive and attentive, and vocalizing and moving less. We conclude that the items related to behavioral evaluation, applied and scored as originally proposed, were sensitive in differentiating between groups with and without mild or moderate nutritional alterations, although the Bayley Scales for Childhood Development still require adaptation to the Brazilian social and cultural conditions. These results also suggest that this scale can be useful for other clinical conditions and for the evaluation of performance of groups submitted to procedures or nutritional recovery.

The bariatric surgery is regarded as the most effective treatment method of dangerous forms of obesity. Since the bariatric surgery is closely related to nutrition, it is thus necessary to emphasize the importance of good nutritional knowledge of patients that have undergone this type of surgery. The aim of this thesis was to examine the nutritional knowledge of patients that are at least one year after the surgery, or reoperation. To get relevant data, patients were examined using an anonymous questionnaire. The survey indicates that the patients have insufficient knowledge regarding the recommended protein intake. Furthermore, the examination exhibited, surprisingly, that men have statistically worse knowledge than women do as well as that the majority of patients does not know what the dumping syndrome is. The survey confirmed that the patients operated more than two and a half years ago have worse nutritional knowledge than the ones operated within such a period of time. Moreover, the examination did not identify problems regarding the correct food preparation, post- operational diet, and inappropriate eatables. In addition, it was discovered that about fifty percent of all the examined patients have sufficient knowledge of the post-bariatric surgery eating habits. Since the importance of...

Bakgrund: 100 000 vårdskador uppstår i Sverige varje år. Patienter som vårdas på intensivvårdsavdelningar löper störst risk att drabbas. För att minska riskerna och höja patientsäkerheten krävs kunskap om vilka risker som finns och vilka misstag som begås. Syfte: att beskriva i vilka sammanhang intensivvårdssjuksköterskor upplever att patientsäkerheten brister. Metod: en empirisk studie med kvalitativ design har utförts. Datainsamlingen har skett i två fokusgrupper med intensivvårdssjuksköterskor. Materialet analyserades och presenteras i form av teman och kategorier. Resultat: brister sågs i organisationen och sjuksköterskorna. Sjuksköterskorna upplevde även att brister i samarbetet och kommunikationen uppstod mellan individer samt mellan individer och organisationen. Slutsats: organisationen måste bistå med patientsäkra lokaler och lyfta patientsäkerheten på avdelningen. Sjuksköterskorna i sin tur måste följa författningar och lokala rutiner. Detta för att skydda patienter och för att inte själva straffas för vårdskador. Organisationen och sjuksköterskorna måste därtill tillsammans förbättra samarbetet och kommunikationen dem emellan. Klinisk betydelse: studien kan användas i ett förbättringsarbete på den undersökta avdelningen samt stärka gruppsamhörigheten för intensivvårdssjuksköterskorna. / Background: 100 000 adverse events occur annually in Swedish hospitals. Patients being treated in intensive care units are most at risk. To reduce risks and improve patient safety requires knowledge of the risks involved and the mistakes made. Aim: to describe in which context intensive care nurses experience that patient safety fails. Method: an empirical study with a qualitative design has been made. Data has been collected in two focus groups with intensive care nurses. The material was analyzed and presented in terms of themes and categories. Results: patient safety deficiencies were found in the organization and among the nurses. The nurses also described deficiencies in the cooperation and communication between individuals and between individuals and the organization. Conclusion: the organization must give priority to patient safety issues and provide facilities well adapted to carry out safe care. As for the nurses, they must follow regulations and local procedures in order to prevent harm to patients and to avoid being punished for adverse events. The organization and the nurses must together improve cooperation and communication to promote patient safety. Clinical importance: this study can be used to improve patient safety at the investigated intensive care unit and strengthen the group cohesion among the critical care nurses.

The aim of this study was to determine the knowledge of critical care nurses regarding ventilator waveforms in order to develop an educational programme on this topic. A quantitative, descriptive, contextual research design was used, and convenience sampling implemented. A survey, using a questionnaire as measuring instrument, was conducted among critical care nurses in selected private hospitals in Gauteng. The response rate was 69%. Cronbach’s alpha indicated that the questionnaire was fairly reliable. The total average percentage achieved by the group of 111 respondents was 40,28%, which is 19.72% below the set competency indicator of 60%. Only 15 respondents achieved a percentage of or above the competency indicator. Results proved that the respondents required intensive training on the topic. A user-friendly education programme in the format of a PowerPoint presentation was developed to address knowledge deficiencies in critical care nurses’ interpretation of ventilator graphics. / Dissertation (MCur (Clinical))--University of Pretoria, 2007. / Nursing Science / MCur / unrestricted

This study analyzes the procedures and operations of the Quartermaster, Ordnance, Commissary, and Medical Departments during Scott's campaign to determine the efficiency of the prevailing logistical system. Unpublished and published government documents, official records, manuscript collections, memoirs, diaries, and newspapers provide the data. The first chapter describes the logistical departments interworkings; the remaining chapters detail the operations of the bureaus during the expedition's assembly and campaign against Mexico City. The evidence revealed organizational deficiencies which caused severe shortages, particularly in transportation, for Scott's army. The shortages severely hampered the expedition. Because of .the numerous victories over 'Mexican forces, however,. American leaders ignored the organizational deficiencies, These shortcomings reappeared to .impede operations during the Civil War.

Thesis (MPH.) -- University of Limpopo, 2021 / Background: Malnutrition has become a problem in the world, with 2.2 million deaths of children under five years of age globally have been linked to growth retardation, stunting and severe wasting, while other 600 000 children in the same age group are said to have died due to deficiencies in Vitamin A (Black, Allen, Bhutta, Caulfield, De Onis, Ezzati, Mathers, Rivera, and Maternal and Child Undernutrition Study Group, 2008 ). Objectives: This study aimed at determining the prevalence of malnutrition in children below 5 years of age, and to quantify stunting, underweight, wasting, overweight and obesity of children in the same group. Methods: This was a descriptive quantitative study. The data for the study was collected from 10 clinics, situated in the Ba-Phalaborwa District Municipality, using a standardized questionnaire. Stratified random sampling was used and stata program was used to analyse the data. Results: A total of 404 of mothers gave positive responses for children to participate in the current study, yielding to 97.1% response rate. Fifty-two-point-two percent of these children were females. The average age of the mothers of these children was 28.3 ±7.0 years Fifty-three-point-four percent of the mothers were single, 27% were divorced, 18.6% were married and 0.5% were widowed. The overall prevalence of malnutrition among the children was 26.7%. Males had higher percentage of underweight with 19.1%, compared to females (9.9%). The highest prevalence of malnutrition in females occurred in the age group 48-59 months, at 40.0%, followed by the age groups 0-11 months, 36-47 months, 24-35 months and 12-23 months at 26.9%, 25.0%, 24.0% and 17.5%, respectively. Of the different types of malnutrition, the occurrence of obesity was the lowest among the children. Conclusion The results of the findings are consistent with the findings of other studies. However, this study could not find that characteristics such as education, type of residence or financial background contribute immensely to child malnutrition.

Dagens mångkulturella samhälle avspeglas inom vården där vårdpersonal dagligen möter patienter från olika kulturer. Kommunikationssvårigheter relaterade till språkbrister kan uppkomma i mötet med patienter som inte förstår och talar svenska. I omvårdnadsarbetet ställs detta på sin spets, i synnerhet när det gäller vård vid livets slutskede. Denna studie syftade till att kartlägga och tolka vårdpersonalens upplevelser av möjligheter och svårigheter i omvårdnaden av denna patientgrupp. I studien har en kvalitativ metod med en hermeneutisk forskningsansats använts. Totalt åtta semistrukturerade djupintervjuer genomfördes med undersköterskor och sjuksköterskor som arbetade på en hospiceavdelning i södra Sverige. Studien resulterade i tio deltolkningar som sedan bildade tre nya deltolkningar på en högre nivå. Slutligen gjordes en huvudtolkning: att en individanpassad vård kan ses som en möjlighet för att överbygga svårigheter och problem som uppkommer i mötet med patientgruppen. Möjligheterna och svårigheterna för att åstadkomma en individanpassad vård återfanns i yttre faktorer, hos patienten och hos personalen. Culture Care teorin användes för att skapa en djupare förståelse för delar av studiens resultat. Vidare multidisciplinär forskning och utbildning krävs för att vården ska kunna leva upp till hälso- och sjukvårdslagens krav om vård på lika villkor. / Today’s multicultural society is reflected in healthcare as professionals encounter patients from different cultures on a daily basis. Communication problems related to language deficiencies consequently occur in interactions with these patients. This can lead to inadequate care delivery at the end stage of life. The aim of this study was to identify and interpret health care professionals’ experiences of opportunities and challenges in delivery of nursing care to this patient group. A qualitative method was used with a hermeneutic approach. Eight semi-structured in-depth interviews were conducted with healthcare professionals working at a hospice in Southern Sweden. The results identified ten sub-interpretations which were distilled into three over-arching interpretations which lead to the following singular conceptual interpretation: Individualized care is viewed as an opportunity to overcome problems that arise when meeting this group of patients. The possibilities and challenges to achieve individualized care came from a combination of external, patient and staff factors. Cultural Care Theory was applied to parts of the study results to achieve greater understanding of the subject. Furthermore, multi-disciplinary research and education is necessary to ensure that health care providers can live up to The Act of Health Care requirements for care delivery on equal terms.