Die vorliegende Arbeit untersucht die Steroidogenese und die Expression Leydig-Zellspezifischer Gene in Kulturen postnataler fetaler Leydig-Zellen (PFLC). Die Stimulation von PFLC mit hCG und (Bu)2cAMP bewirkt eine Steigerung der Testosteronproduktion in vitro. Es wurde eine zeitabhängige Abschwächung der Testosteronproduktion durch (Bu)2cAMPstimulierte PFLC beobachtet. Diese war begleitet von einer Akkumulation von Progesteron im Kulturmedium und einer Suppression der Expression von P450c17 auf dem translatorischen Level. Während der Kultivierung verloren PFLC ihre Fähigkeit der Expression Leydig-Zell-spezifischer Gene (z.B. 3βHSD, P450c17, Insl3). Dieses Phänomen konnte durch Stimulation mit (Bu)2cAMP rückgängig gemacht werden. Außerdem zeigte sich, dass PDGFα allein und in Kombination mit (Bu)2cAMP signifikant die Proliferation der PFLC in vitro stimulierte. Die vorliegende Arbeit deutet darauf hin, dass cAMP-aktivierte Signalkaskaden eine wichtige Rolle in der Regulation von Differenzierung und Funktion von PFLC spielen.

Long-term outcome of extremely preterm neonates depends on many endogenous and exogenous factors. Long-term follow-up of extremely preterm neonates during childhood and analyses of IGF1 gene polymorphisms may help to better understand the problems connected with delayed postnatal growth and the progression of cardiovascular diseases and diabetes mellitus type 2 in adulthood. The aim was the long-term follow-up of anthropometric parameters in children born at 22−25th and 26−27th week of gestation and to study the association between postnatal growth of extremely preterm children, children small for gestational age (SGA) and children born at term with appropriate birth weight/length (AGA) and IGF1 gene polymorphisms: (CA)10-24 repetitive polymorphism in promoter, microsatellite marker D12S318 and 185 bp in 3'UTR, (CT)n polymorphism (CA)n polymorphism 216 bp in the intron 2. Methods. 242 infants born at 22-27+6 weeks were enrolled. Anthropometric parameters were measured at the ages of 2 and 5 years in 72 children born at 22-25+6 week (group I) and 85 children born at 26-27+6 week (group II). Polymorphisms of IGF1 were analysed in 51 extremely preterm, 208 AGA and 59 SGA children using fragment analyses. The data of postnatal growth data in AGA children were obtained at 18 months, in SGA and extremely...

No description available.

Syfte: Att kartlägga mammors erfarenheter av amningsstöd på BB.Metod och Material: Webbaserad tvärsnittsstudie med kvantitativ ansats. Inklusionskriterier; mammor som fått barn och vårdats på en specifik BB-avdelning i Mellansverige under åren 2019–2021 samt valt att amma. Enkäten bestod av 60 slutna frågor och 5 fritextfrågor. Redovisas med deskriptiv statistik samt kvantifiering av fritextsvaren. Resultat: Baserades på n=146 mammor. Både positiva och negativa erfarenheter beskrevs av mammorna. En majoritet av deltagarna önskade högre närvaro av barnmorskan och mer stöd i samband med amning. Det rapporterades erfarenheter av att ha blivit lämnade ensamma med barnet större delen av vårdtiden och fann det bästa stödet i partnern. Få beskrev dock att partnern involverades i amningsstödet. Olika råd gavs av personalen vilket skapade en känsla av otrygghet och tvivel till personalens kompetens. Många beskrev att hands-on metod användes i samband med amningsstöd. Upprättande av amningsplan saknades för majoriteten och bristfällig information om amningssignaler gavs. Slutsatser: Många mammor var missnöjda med amningsstödet och kände en otrygghetmed amningen vid hemgång. Det önskades mer stöd och bekräftelse i samband med amning. Möjligtvis kan det initiala bristande stödet ha påverkat mammornas fortsatta amning och lett till ett tidigare amningsavslut. / Purpose: To map mothers' experiences of breastfeeding support at BB.Method and Material: Web-based cross-sectional study with quantitative approach. Inclusion criteria: mothers that had children and been cared for in a specific BB ward in Central Sweden during the years 2019–2021 and have chosen to breastfeed. The questionnaire consisted of 60 closed questions and 5 free text questions. Reported with descriptive statistics and quantification of the free text answers.Results: Based on n=146 mothers. Both positive and negative experiences were described by the mothers. Most of the participants wanted a higher presence of the midwife and more support with breastfeeding. Experiences of being left alone with the child for most of the care period were reported and found the best support in the partner. Few described that the partner was involved in breastfeeding. Various advice was given by the staff, which created a feeling of insecurity and doubt about the staff's competence. Many described that the hands-on method was used in connection with breastfeeding support. Establishment of a breastfeeding plan was lacking for the majority and inadequate information on breastfeeding signals was provided.Conclusions: Many mothers were dissatisfied with breastfeeding support and felt insecure about breastfeeding at home. More support and confirmation in connection with breastfeeding was desirable. Possibly, the initial lack of support may have affected the mothers' continued breastfeeding and led to an earlier termination of breastfeeding.

No description available.

No description available.

Aquesta tesi està centrada en l'estudi dels períodes de regressió i transició. A partir dels treballs de van de Rijt-Plooij & Plooij (1992) sobre els períodes de regressió, l'autor analitza les característiques comportamentals d'aquests períodes i la relació que tenen amb els períodes de transició. Els períodes de regressió s'entenen com uns moments del desenvolupament durant els quals els nens perden la homeostasi del seu organisme i manifesten una sèrie de conductes pertorbadores per a la mare. El matrimoni Plooij manté que els períodes de regressió són la manifestació de les reorganitzacions cerebrals que tenen lloc durant el període postnatal, i constitueixen la base de les noves habilitats que el nen va adquirint. Així, doncs, l'augment de l'atenció que la mare dispensa al nen durant els períodes de regressió esdevé una font estimular imprescindible en els processos d'educació i culturalització de l'infant. Per tant, els períodes de regressió estan íntimament relacionats amb els períodes durant els quals apareixen nous comportaments qualitativament diferents dels anteriors, que es manifesten de forma ràpida i sobtada, permetent una certa sistematització del procés evolutiu, per la qual cosa s'han denominat transicions. Van de Rijt-Plooij & Plooij, i també nosaltres, considerem que els períodes de regressió són índexs dels períodes de transició. Per aquesta raó també s'han denominar reprogressions.Tanmateix, els períodes de regressió es poden convertir en una font de conflictes que, en situació de risc, poden degenerar en maltractament infantil i, fins i tot, esdevenir el germen de possibles patogènies. Com veiem, els conceptes de període de regressió i transició es troben a l'encreuament entre la fisiologia, la psicologia i la psicopatologia del desenvolupament i, el seu estudi establiria un pont interdisciplinar que contribuiria a la construcció d'un model biopsicosocial del desenvolupament.Els objectius del nostre estudi varen ser comprovar si els períodes descrits per van de Rijt-Plooij i Plooij (1992) també els podem observar en un grup de nens de la població catalana sense problemes socio-econòmics o sanitaris aparents. Per altra banda, vàrem voler comprovar si els períodes de regressió tenen relació amb els períodes de transició. El disseny d'investigació correspon a un model longitudinal i transversal. Es varen seguir -mitjançant entrevistes, qüestionaris i observacions- vint diades mare-nen durant catorze mesos, repartides en quatre cohorts de cinc diades cada una d'elles.Partint d'uns criteris establerts a priori per a la categorització dels períodes de regressió i transició, vàrem estudiar la temporalitat d'ambdós tipus de períodes. També s'ha aprofundit sobre les característiques comportamentals i dinàmiques dels períodes de regressió.Respecte les dades, els percentatges màxims dels períodes de regressió del nostre grup d'estudi han aparegut a les setmanes: 5, 8, 12-13, 18, 26-27, 35, 43 i 52. La mitjana setmanal de cada període ha sigut de dues setmanes. Les nostres dades confirmen les obtingudes en la investigació de van de Rijt-Plooij & Plooij. Tanmateix, també hem trobat diferències (els períodes de regressió de l'estudi holandès són més llargs i coincideixen més) que ens suggereixen que la cultura podrien estar actuant en la forma de presentació del períodes de regressió.Pel que fa a la relació entre els períodes de regressió i l'emergència de nous comportaments (períodes de transició), els resultats mostren que les freqüències màximes dels períodes de regressió sempre es troben poques setmanes abans de les freqüències màximes dels períodes de transició. Per tant, és possible que els períodes de regressió siguin indicadors dels períodes de transició. / This thesis focuses on the study of the transitions and regression periods in the infancy. Starting from van de Rijt-Plooij & Plooij's research works about emergence of regression periods in the first years of life, the authors analyse the presence of such periods and your relation with the transition periods.The regression periods can be understood as behavioural signs of brain reorganisations, which the infant experiences in his process of development. This maturing experience would cause a loss of control and of homeostatic regulation in the infants that guarantee the necessary attention and care to the infant's organism during a phase of instability and change. As the author quoted above admits, during regression periods the infant's mind is very sensitive and open to external stimuli, mainly to the socioaffective stimuli proceeding from their mother. But the mother and adults who interact with the infant are not only an important source of affective stimuli. At the same time, they make up the dialogical matrix through which children acquire and share the individual's internal structure to be modified and the psyche development to be oriented towards superior ways of functioning (transitional periods).The basic purpose of our study has been to check whether the regression periods described by van de Rijt-Plooij & Plooij (1992, 1993) appeared in a sample of babies in our country. In addition, whether the ages at which they emerged and their characteristics were likewise comparable to the one found by the author quoted. On the other hand, our intention is to analyse the qualitative changes, which supposedly precede regression periods.The research design corresponds to a transversal and longitudinal model. For this reason, twenty pairs mother-infant were divided into cohorts of five months each in the follow way: 1 cohort (3-20 weeks), 2 cohort (12-33 weeks), 3 cohort (24-44 weeks) and 4 cohort (36-56 weeks).The instruments used to collect information have been the following: a questionnaire completed by the very own mothers and which we weekly collected. A semi-structured weekly tape-record interview. Finally, we carried out a three-hour observation every fortnight during the firs months and once a month from that age.The criterion we have followed to rate a period as a regression period has been the coexistence of three of the behavioural categories which typify the episodes according to the previously quoted work: a) an increase of the bodily contact between mother and child, b) an increase in crying and irritability behaviours, c) the presence of a third disruptive element like alteration in the sleep-wakefulness rhythm, decrease of ingestion, very altered activity, drowsiness, etc...In relation to data, the maximum percentages of the regression periods found in our research appear distributed along the following weeks: 5, 8, 12-13, 18, 26-27, 35, 43 and 52. The mean of lasting of a regression period was of 2 weeks in a range of 1-4 weeks.Our data confirm the ones obtained in van de Rijt-Plooij & Plooij's research. Still we can appreciate some differences what suggested that the culture could be also operating in the presentation shape of regression periods.About relationship between regression periods and new behaviours emergence (transition periods), the results prove that the maxim peaks of regression appear placed some week before the peak of transition periods. The hypotheses that assist that the regression periods are index of transition periods is confirmed by the results.

Text in English, with Annexures in English and Amharic / Annexure 5 and Annexure 7 "Questionnaire for qualitative study" in English and Amharic / The Ministry of Health (MOH) and its partners are determined to prevent and manage preventable causes of morbidity and mortality in mothers, neonates and children. In the last decade, special emphasis has been given to increasing the number of health facilities that provide maternal and child health services (MNCH), huge production of skilled birth attendants (SBAs), and equipping the health facilities to improve the utilisation of quality services. This study investigated the community perspectives of health service utilisation and proposes a framework for improving the utilisation of the available SBA and postnatal care (PNC). PURPOSE The purpose of this study was to develop a framework for the utilisation of skilled care for delivery and postnatal care by women of childbearing age (15-45). METHODOLOGY The study used a Sequential explanatory Mixed Methods Approach to investigate the utilisation of SBA and PNC in a district in Ethiopia. The Delphi Technique helped to solicit input from maternal health care experts on the development of a Framework for utilisation of SBA and PNC. This study utilised the Anderson Health Utilisation Model. RESULTS In the study, 79.8% of the women who delivered within 12 months prior to this study received ANC from SBA. Baby care and PNC for the mother and baby received from SBA were at 248 (71.5%), 55 (15.8%), and 131 (38%) respectively. The study further found that women who can read and write and were educated are more likely to utilise SBA and receive quality health care services. The study showed that certain factors such as disrespecting service users, abusing service users’ lack of trust on the SBA by service users, religion and superstition contribute negatively to the use of SBAs. None of the predisposing, enabling and need factors predicted the use of SBA for PNC by the mothers. Nevertheless, through the focus group discussions (FGDs) and individual interviews (IDI), it was revealed that there was a widespread knowledge and perception gaps in the community related to the importance of postnatal period and PNC. Religious sanctification also have imperative role in hampering PNC service use by the mothers. The Health care workers (HCWs) also lacked the keenness and orientation to provide the service. Babies born from families with monthly income equal to 500 or above USD were more likely to use PNC within 45 days. There was a widespread misconception in the community that Babies do not need PNC before 45 days of birth except for vaccination purpose. CONCLUSION To examine their role in health service utilisation for SBA and PNC, researches can integrate social support and social network to the Andersen’s health-service utilisation model. A framework for utilisation of SBA and PNC is proposed. The researcher recommends developing an utilisation tool kit that specifies the detail operationalisation of the framework. / Health Studies / D. Litt. et Phil. (Health Studies)

Postnatal care provides the opportunity for protecting the health of women and their babies by optimising human immunodeficiency virus (HIV) treatment and management. This study intended to explore the implementation of postnatal care to HIV positive women by explicating nurses’ views regarding their practices with the aim of improving the programme. The study was conducted at three clinics in Mangaung. An evaluative case study design was used to provide a detailed account on implementation of postnatal care to HIV positive clients. The purposive non-probability sampling was used. Semi-structured methods using focus group interviews were used to collect data. Data were reviewed through thematic analysis. The study found that nurses understood guidelines, used them to direct their practice and challenges were highlighted. It was concluded that the system limitations needed to be addressed, skills of health care providers improved and linkages with community based services strengthened to improve effectiveness of care. / Health Studies / M.PH.

Submitted in fulfilment of the requirements of the Degree of Master of Technology: Biomedical Technology, Durban University of Technology, 2013. / The purpose of the study was to evaluate knowledge and effects of Haemolytic Disease of the Newborn (HDN) in postnatal women from the Umgungundlovu District. Although the prevalence of HDN has declined because of prophylaxis from 45 cases per 10,000 births to 10.2 cases per 10,000 births but it is still a cause of infant and neonatal morbidity and mortality. The effects of the disease range from jaundice, kernicterus and in severe cases death. Methodology : An interviewer-administered questionnaire was used to obtain information about the knowledge and effects of HDN amongst postnatal women. The incidence rate was calculated using the number of cases that were found divided by the total number of deliveries during the study period. A total of 300 women were interviewed. SPSS version 19.0 was used to analyse data. Findings : Fifteen (15) of the 300 women had babies with confirmed HDN and only four of the 15 (26%) women had knowledge of HDN. Two hundred and eighty five women had babies with jaundice but were not affected by HDN and, of these women, 12 (4.2%) of them knew what HDN was. Overall, only 16 (5.3%) knew what HDN was. All 15 women who had babies with HDN indicated financial and emotional effects because of HDN. The total incidence was 0.09% for the first 12 months of the study period. Conclusion : Postnatal women with jaundiced babies lack knowledge of HDN and HDN has financial and emotional effects on these women. Although the incidence rate of HDN was found to be even smaller than previously reported, it still exists and threatens the lives of infants and neonates.