Magister Curationis - MCur / Background: In the South Africa, the number of HIV- positive pregnant women is rising and has resulted in more than 70,000 babies being born with HIV infection annually since the year 2000. In response to the escalating number of HIV-positive pregnant women, the Department of Health of South Africa, decided, in 2002, to implement the Prevention of Mother to Child Transmission (PMTCT) programme at 18 pilot sites in the country. An effective PMTCT programme could reduce the incidences of maternal and child mortalities in the country. An evaluation of the effectiveness of the PMTCT programme that was done in 2010 showed that, although the programme was rendered effectively during pregnancy and labour, there were still irregularities that appeared, especially during the postnatal period. Khayelitsha was the first pilot site in South Africa to provide Antiretroviral Therapy and initiate the Nurse Initiated Management of Antiretroviral Therapy (NIMART) at primary care level in the public sector. Midwives are the health professionals who render the PMTCT services to HIV-positive mothers and their babies until six weeks post-delivery. They have managed to test almost 100% of pregnant women during the antenatal period and the HIV-positive women were started on the PMTCT programme during their first visit. Aim: The aim of this study was to explore the challenges that midwives faced in rendering care to postnatal HIV-positive mothers enrolled in the PMTCT programme at the Khayelitsha Community Health Clinic in the Western Province of South Africa. Method: An exploratory design and qualitative approach was followed. The study population consisted of midwives who were rendering PMTCT services to HIV-positive mothers and their infants during the postnatal period. Purposive sampling was conducted until data saturation was reached. Six participants were included in the sample. The participants were informed about the study by means of an Information Sheet, advised that the study was voluntary and reminded that they could withdraw from the study at any time, without prejudice. In-depth, unstructured individual interviews were conducted with each of the participants. With the permission of participants, an audio tape recorder was used during the interviews to collect data, while the researcher took field notes to supplement and verify the voice recordings, after the interviews. The seven steps of Colaizzi were used to analyse the data. Six themes and sixteen sub-themes emerged during the data analysis. Trustworthinesswas maintained by using the criteria of Guba’s model, i.e. credibility, transferability, conformability and dependability. Permission to conduct the study was obtained from the appropriate ethical committees; the Department of Health, the Khayelitsha Community Health Clinic, as well as, the Senate Research Committee of the University of the Western Cape. Participants were asked to sign Informed Consent forms before participating in the study. The ethical principles of privacy, anonymity, withdrawal, confidentiality and consent were strictly adhered to. Findings: The study found several challenges faced by midwives while implementing the PMTCT programme during the postnatal period. These challenges included: the shortage of NIMART-trained staff attending to the high number of clients per day; the lack of manpower with data base systems to trace mothers who did not come back after delivery; and mothers who did not come back for postnatal appointments because of denial, non-disclosed HIV status and socioeconomic reasons. Furthermore, the participants also reported on midwives experiencing ‘burnout’ as a result of the hectic working environment at the Khayelitsha Community Health Clinic. Recommendations: There is an urgent need for all midwives in the MOU’s to be NIMART-trained. NIMART should be standardize and be the part of the curriculum that taught in all the tertiary institutions and be updated in a yearly basis as part of the in-service training or education for all practising midwives. The South African Government should introduce home visits in the PMTCT programme. Data-bases of all MOU’s and facilities that offer PMTCT services need to be synchronized and these MOU’s and facilities should all follow the same PMTCT guidelines. Further research should be done on the same topic at other clinics and MOU’s that render the PMTCT programme in the Western Cape.

Tesis para optar al grado de Magíster en Gestión y Políticas / En esta tesis, se estudió el impacto en las remuneraciones de las madres trabajadoras que generó la extensión del periodo de descanso por maternidad chileno a través de la implementación del permiso postnatal parental (PPP). En lo específico, se buscó identificar la cuantía del efecto sobre los salarios de las mujeres trabajadoras beneficiarias, tanto como si la implementación del beneficio generó en el mismo grupo, efectos diferenciados según su nivel de ingresos. Lo anterior, se realizó mediante una evaluación cuasi experimental que explota una ventana temporal ocasionada por la implementación del beneficio, a través de la metodología de diferencias en diferencias (DD), utilizando como grupo de tratamiento a las trabajadoras beneficiarias del permiso postnatal parental recién creado (168 días) y como grupo de control a las trabajadoras beneficiarias sólo del descanso postnatal sin la extensión (84 días). De esta manera, se buscó el efecto del mencionado permiso en los salarios de las madres trabajadoras a 6, 8, 12, 18 y 24 meses después del nacimiento del hijo. Para esto, se vincularon y utilizaron los registros administrativos de la Superintendencia de Seguridad Social (SUSESO) y de la Sociedad Administradora de Fondos de Cesantía de Chile (AFC). El presente estudio concluye que la implementación del permiso generó un impacto negativo en las remuneraciones de las madres beneficiarias a corto plazo (6 y 8 meses), observándose impactos positivos a largo plazo (12, 18 y 24 meses). A su vez, el análisis por rango de remuneración arrojó como resultado que la implementación del PPP provocó una disminución en las remuneraciones de las trabajadoras pertenecientes a los rangos de remuneración más altos. La magnitud de estos resultados no supero el 10% del ingreso mínimo de cada tramo.

No description available.

京都大学 / 新制・論文博士 / 博士(医学) / 乙第13533号 / 論医博第2273号 / 新制||医||1065(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 川口 義弥, 教授 斎藤 通紀, 教授 遊佐 宏介 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Pythons are a well-studied model of postprandial physiological plasticity. Consuming a meal has been shown by past work to evoke a suite of physiological changes in pythons and elicit one of the largest documented increases in post-feeding metabolic rates relative to resting values. However, little is known about how this plasticity manifests in the brains of ball pythons, Python regius. Previous work using the cell-birth marker 5-bromo-12’-deoxyuridine (BrdU) has shown that cell proliferation in the python brain increases six days following meal consumption. This study aimed to confirm these findings and build on them in the long term by tracking the survival and maturation of these newly created cells across a two-month period. We investigated whether these cells differentiated into neurons using double-immunofluorescence for BrdU and a reptile-specific neuronal marker (Fox3). We did not find significantly greater rates of cell proliferation in snakes six days after feeding, but we did observe more newly created cells in neurogenic regions in fed snakes two months after the meal. Feeding did not influence neurogenesis, but feeding does appear to have a neuroprotective effect. More newly created cells survived in fed snakes two months later, particularly in the olfactory bulbs and lateral cortex. These findings shed light on the extent of postprandial plasticity and regional differences in the creation of new neural cells in the brains of ball pythons.

No description available.

Tidigare forskning visar att vårdpersonalen har en viktig nyckelroll i att främja nyblivna mödrars hälsa den första tiden efter barnafödandet. Detta eftersom hälsofrämjande arbete i form av individanpassad informationsförsörjning och kunskapsstöd kan påverka nyblivna mödrars hälsa avsevärt. Uppsatsen har följaktligen fokuserat på att studera hur barn- och distriktssköterskor på barnavårdscentraler arbetar hälsofrämjande med nyblivna mödrar. För att kunna undersöka sköterskornas hälsopedagogiska funktion inom den postnatala vården har studien utgått från ett salutogent perspektiv på hälsa samt ett sociokulturellt perspektivet på lärande. Totalt genomfördes 11 semistrukturerade intervjuer med barn- och distriktssköterskor på barnavårdscentraler i Sverige. För att analysera data användes en kvalitativ konventionell innehållsanalys. Resultatet visade att nyblivna mödrars hälsa kan stärkas genom salutogena och pedagogiskt anpassade tillvägagångssätt under den postnatala perioden. Sköterskornas pedagogiska och hälsofrämjande arbete förutsätter förtroendeingivande relationsbyggande gentemot mödrarna och innefattar individ- och behovsanpassat samtalsstöd, informationsförsörjning, tillgänglighet och samarbete med externa resurser. Sköterskornas hänsynstagande insatser hjälper mödrar, oavsett socioekonomiska förutsättningar och etnisk tillhörighet, att hantera sin nya livssituation och stärka ett autonomt moderskap. Sammantaget ökar detta förutsättningarna för en mer jämlik mödravård. För vidare forskning rekommenderas att studera hur båda föräldrarnas hälsa kan främjas i den postnatala perioden.

Imprinting studies have traditionally stressed the importance of visual features in the formation of early postnatal attachments. However, recent studies by Johnston & Gottlieb (1981, 1985) have demonstrated that visually imprinted preferences can be altered by the maternal call. Thus, in the present study the interaction between natural visual and auditory stimulation in the control of filial behavior was examined in bobwhite quail chicks during the first 4 days of postnatal life. Previous research has revealed that bobwhite quail hatchlings are differentially responsive to their species-specific maternal call in the period right before and immediately following hatching (Heaton, Miller & Goodwin, 1978). Results from this study indicate that quail chicks begin to lose this naive preference for their maternal call over a non-conspecific call (a domestic chicken maternal call) by 72 hrs following hatch, and do not respond to either the bobwhite call or chicken call by 96 hrs following hatch. However, differential responsiveness to the bobwhite call can be reinstated in bobwhite chicks at 72 hrs and 96 firs following hatching if the birds are provided with integrated audiovisual stimulation (i.e., a quail hen model emitting the maternal call). These results suggest that in the initial stages of postnatal development, species identification in bobwhite quail is based primarily on the auditory component of maternal stimulation. Later in development, combined auditory and visual stimulation appears necessary to control species-specific filial behavior despite the fact that auditory cues remain dominant over visual cues. These findings conform well to what is known about the neuroembryological development of sensory systems, in that the auditory system of birds (and mammals) develops in advance of the visual system. This prenatal sequence of sensory system development appears to influence the sequence of early postnatal perceptual preferences in precocial avian neonates. / Master of Science

Yes / Vulnerable migrant women are at an increased risk of developing postnatal depression, compared with the general population. Although some symptoms are the same as in other pregnant women, there are specific reasons why vulnerable migrant women may present differently, or may not recognise symptoms themselves. Factors associated with migration may affect a woman’s mental health, particularly considering forced migration, where a woman may have faced violence or trauma, both in her home country and on the journey to the UK. Vulnerable migrant women engage less with maternity care than the average woman for reasons including a lack of knowledge of the UK healthcare system, fear of being charged for care, or fear that contact with clinicians will negatively affect their immigration status. This article explores the issues surrounding vulnerable migrant women that increase their risk of developing postnatal depression and presents reasons why this may go unrecognised by health professionals such as midwives.

Yes / Women are discharged home from hospital increasingly early, but there is little evidence examining the postnatal hospital discharge process and how this may impact on the health of women and babies. In particular, there is little on sepsis prevention advice, despite it being the biggest direct cause of maternal mortality. Aim To explore the perceptions of women and senior student midwives related to the postnatal hospital discharge process and maternal sepsis prevention advice. Methods Three focus group interviews were undertaken, involving 9 senior student midwives and 14 women attending paid or specialist classes for vulnerable migrant women. Findings All participants believed that the postnatal hospital discharge process was inadequate, rushed and inconsistent. Sepsis advice was patchy and the condition underplayed. Conclusions Cost effective, time-efficient and innovative ways to impart vital information are required to support the postnatal hospital discharge process.