Tesis para optar al grado de Magíster en Gestión y Políticas Públicas / 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.

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Paper one is a systematic review aimed at improving our understanding of the culturally determined risk factors of postnatal depression (PND) within 'Sub-Saharan Africa', by integrating evidence from quantitative and qualitative studies. A mixed-method systematic review approach was employed, nine quantitative and three qualitative studies were quality assessed, synthesised, and integrated. Stressful life events, adhering to cultural values and traditions, the effects of negative cultural perceptions and difficulties within the African extended family system were found to be risk factors for the development and maintenance of PND in Sub-Saharan Africa. The objective of paper two was to explore the lived experience of postnatal depression in West African mothers living in the UK. A qualitative design using semi-structured interviews with six West African mothers (Nigeria = 3; Ghana = 3) who were experiencing low mood in the postnatal period was undertaken. Participants were recruited from mother and baby groups within the National Health Service. Interpretative Phenomenological Analysis was used to explore and analyse the data. Five overarching themes emerged: (1) conceptualiszing PND, (2) isolation, (3) loss of identity, (4) issues of trust and (5) relationships as a protective factor. Each theme consisted of a number of subthemes. Women exhibited symptoms of PND but did not regard it as an illness, with the name 'depression'. They viewed their emotional distress as a result of social stress, and described feelings of isolation, loss of identity and relationship difficulties. Women's cultural background influenced their help-seeking behaviour; participants often avoided talking about their feelings and kept their distress to themselves. The findings have clinical implications in how services should be designed to meet the needs of African communities. Paper three reflects on the process of developing culturally competent research through the development of the current thesis. Suggestions for future research and reflections on the strengths and limitations of the research process are embedded throughout. Clinical implications are discussed with reference to a community psychology model.

Colony-Stimulating Factor (CSF-1) is required for the proliferation, differentiation and survival of cells of the mononuclear phagocyte lineage. Mice with a mutation in their CSF-1 gene demonstrate abnormal development in many organ systems and severe growth retardation. These defects can be corrected by administration of rh- CSF-1, and when similarly administered to wild-type mice, can increase organ and body weight, thus highlighting the importance of CSF-1 in postnatal growth. CSF-1 is known to be elevated in the circulation in the immediate postnatal period of both mice and humans. It remains to be seen whether CSF-1 deficiency underlies important clinical issues such as low birth weight, and whether there are any functionally important variations in expression or biology of CSF-1, or the alternative CSF-1R ligand IL-34 that contributes to variation in somatic growth between individuals. This thesis aimed to use the pig as a model for human innate immunity and disease based upon recent publications that highlighted the similarities in their immune systems. To investigate the effects of CSF-1 on postnatal growth the first aim was to characterise the CSF-1R system in pigs and produce reagents. Biologically active porcine CSF-1 and IL-34 were produced along with expression of full length functional porcine CSF-1R and production of anti-CSF-1R antibodies. A bioassay was developed and optimised to assess the biological activity of these proteins. The cross-species reactivity of a range of species CSF-1 and IL-34 proteins was investigated in-vitro using the bioassay and cell culture systems. Recombinant CSF-1 is known to have a short half-life. Since conjugation of proteins to the Fc region of immunoglobulins has been used extensively to improve circulating half-life; a porcine Fc CSF-1 fusion protein was generated by commercial partners, Pfizer Animal Health. The conjugated and un-conjugated CSF-1 proteins had identical activity in cell line and primary cell assays in-vitro. The in-vivo activity of porcine Fc CSF-1 was tested initially in the Csf1r-EGFP+ mouse reporter line and C57BL/6 mice. The Fc CSF-1 protein was more active than the native protein in promoting increased monocyte and tissue macrophage numbers, increasing body weight and inducing hepatosplenomegaly. Hepatic growth was associated with extensive macrophage infiltration and hepatocyte proliferation, identified by gene expression profiling as well as immunohistochemistry. Fc CSF-1 was then tested in neonatal pigs. They were found to have an immature immune system that develops with age. No postnatal surge of CSF-1 was detected. Fc CSF-1 administration increased blood monocyte and neutrophil numbers confirming that CSF-1 is not saturating at this time. Nevertheless, no influence on postnatal growth rate was identified. This is discussed in terms of the differences in placental architecture in the pig compared to human and mouse. This thesis demonstrates the effectiveness of porcine Fc CSF-1 in both mice and porcine and highlights the important role that CSF-1 and macrophages play in liver homeostasis. Fc CSF-1 is identified as candidate therapeutic agent in humans and companion animals for tissue regeneration, and a tool for the study of the role of macrophages in physiology and pathology.

Bröstmjölk rekommenderas för spädbarn som enda föda upp till sex månaders ålder. Globalt sett syns en nedåtgående trend gällande amning vilket sannolikt kan medföra risker för barn i låginkomstländer. I höginkomstländer är det inte säkert att detta har samma betydelse, debatten pågår. Syftet med litteraturstudien är att beskriva faktorer som kan hindra/främja amning hos kvinnor. För att besvara studiens syfte valdes en litteraturstudie med kvalitativ metod för att identifiera vilka faktorer som är viktiga för att få fler kvinnor att amma. En litteraturstudie enligt Fribergs (2006) modell för litteraturöversikt valdes för att samla in data och ge oss en översikt över varför mammor väljer att amma eller att inte amma. Det analyserade materialet resulterade i två kategorier; faktorer som främjar respektive förhindrar amning. Faktorer som bland annat främjar amning är positiva känslor kring amning, kunskap och erfarenhet, stöd från personal samt stöd från partner. Resultatet visar att stöd är viktigt samt att närståendes förhållningssätt till amning är av stor betydelse. Slutsatsen är att stöd samt utbildning för ammande kvinnor behöver prioriteras i form av mer och bättre utbildning samt emotionellt stöd både under graviditet, men också under den fösta tiden då barnet är fött.

Omega-3 fatty acids are increasingly recognised as playing an important role in human brain development and mental health. The polyunsaturated fatty acids (PUFAs) include omega-3 and omega-6 fats which are essential fatty acids (EFAs), consumed via the diet. Omega-3 fatty acids are particularly abundant in fish oils. The omega-3 fatty acids are being focused on for their role in depression, the main types being docosahexaenoic acid (DHA), which is abundant in neural tissue, and also eicosapentaenoic acid (EPA) which is biologically very active. There is an emerging literature in relation to omega-3 fatty acid blood levels in depression and the effects of treatment with omega-3. Strong epidemiological evidence has also been published indicating an association between a population's fish intake and depression rates. A specific research focus on omega-3 as a treatment for depression in the perinatal period is also starting to emerge. The importance of this particular area is enhanced by the knowledge that omega-3 depletion occurs during the perinatal period due to fetal diversion for neurodevelopment. In view of the lay public promotion of omega-3 and its appeal to women as a 'natural therapy', there is a need to scientifically evaluate its effectiveness to treat depression in the perinatal period. It is also important to investigate omega-3 as an alternative to antidepressants given the ongoing uncertainties regarding their safety in pregnancy. In this thesis a literature review presents current research relating to this field. This is followed by a description of the methodology and results for the two trials conducted. The results of the double-blind randomised placebo controlled trial of omega-3 as a treatment for depression in the perinatal period were essentially negative. However this result is limited by the small sample size in the study and therefore it may be unwise to interpret the result as conclusive. The case-control study confirmed the hypothesis that omega-3 levels were more depleted in depressed women compared to non-depressed women. A discussion of the results and trial limitations then follows in the thesis. It is concluded that further larger studies are warranted in this area.

ABSTRACT Naturalistic Inquiry was used to explore, describe and discover the experiences and perceptions of men whose partners have been admitted to an Intensive Care Unit (ICU) immediately after childbirth. The sixteen men's experiences were explored using semi-structured open-ended questions. Data were analysed using thematic content analysis. The research questions driving this study were: • What are men's experiences and perceptions of the incidence and impact of their partners being admitted to ICU following the complications of childbirth? • What is the nature of the relationships and interactions that men have with healthcare professionals before, during and after their partner's ICU admission following the complications of childbirth? • What impact did the experience of their partners being admitted to ICU, following the complications of childbirth, have on the men's relationships with their partners, newborn child, and other children? • What impact did the experiences of their partners being admitted to ICU following the complications of childbirth have on their future life plans? During the time of their partners' obstetric crisis the men, in this study, were left isolated, alone and struggling. The current healthcare policy and practice for men with their partners in life-threatening situations intrapartum and immediately postpartum failed 16 families.

La cellule cardiaque requiert un apport énergétique conséquent qui exige une production et un transfert énergétiques efficaces. Si la production de l'énergie dépend essentiellement des propriétés intrinsèques des mitochondries, il semblerait que l'efficacité du transfert d'énergie du site de production vers les sites consommateurs (ATPases) pourrait être liée à l'architecture spécifique du cardiomyocyte qui conduit à une organisation spatiale singulière des structures internes (mitochondries, réticulum sarcoplasmique, myofilaments). Pour comprendre ce qui lie la cytoarchitecture, la compartimentation cellulaire et la fonction contractile, il a été entrepris d'étudier l'architecture cellulaire et la signalisation énergétique de cardiomyocytes au cours du processus de maturation de la cytoarchitecture et dans un modèle présentant une désorganisation des structures intracellulaires. La première partie de ce travail, réalisée durant le développement postnatal de la souris, a permis de démontré qu'il existe une synchronisation parfaite entre la mise en place de la cytoarchitecture et la maturation fonctionnelle du transfert d'énergie par canalisation directe des nucléotides adényliques entre les mitochondries et les ATPases. Si cette étude apporte un élément qui tendrait à démontrer l'implication de l'architecture cellulaire dans l'efficacité des transferts d'énergie, elle a également mis en avant la maturation très précoce de l'énergétique cellulaire. La mitochondrie faisant partie intégrante de cette architecture et étant modelée par des mécanismes de fusion et de fission, la deuxième étape de ce travail de thèse a consisté à étudier l'implication de la morphologie mitochondriale dans l'énergétique du cardiomyocyte. Il a ainsi été montré que, chez la souris, la diminution d'expression de la protéine OPA1, impliquée dans la fusion mitochondriale, conduit à des perturbations de la morphologie mitochondriale qui n'affectent pas la fonction intrinsèque mitochondriale mais qui altèrent le système de canalisation directe entre les mitochondries et les ATPases des myofilaments. De manière générale, ces résultats démontrent clairement une dépendance des transferts d'énergie à l'architecture cellulaire spécifique de la cellule musculaire cardiaque.

<p>Early life stress is something that animals used in production often have to experience. What we do not know is if there are any consequences of this treatment later on in life. Zebra finches postnatal treated with the stress hormone corticosterone showed an exaggerated and prolonged stress response later on. To examine the effects of early life stress 77 White Leghorn chicks were used, half of them was stressed from postnatal day 1-14 and then tested between 47-63 days of age. The tonic immobility (TI) test is a commonly used test to evaluate the fearfulness and stress reaction in fowl. The chicks were placed on their back in a V-shaped wooden cradle and TI was induced by applying light pressure on the breast and neck. The number of inductions required to induce TI was recorded as well as the time until the first alert head movement and the total duration of the TI. The birds were tested in a calm environment but also after a stressful situation. There were no differences in the total duration of the TI reactions. However, stressed animals tended to need more induction attempts than the control animals. While looking at the time elapsed until the first head movement stressed chicks had a significantly lower duration. This indicates a dullness or shift in the stress response of the treated birds and there seem to be a more exaggerated response in the males.</p>