• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 357
  • 185
  • 15
  • 12
  • 9
  • 8
  • 7
  • 6
  • 5
  • 4
  • 3
  • 3
  • 3
  • 3
  • 3
  • Tagged with
  • 676
  • 676
  • 226
  • 180
  • 147
  • 128
  • 111
  • 72
  • 71
  • 71
  • 70
  • 63
  • 58
  • 57
  • 57
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
221

Pre-eclampsia and its outcome (maternal and neonatal morbidity and mortality) in two referral hospitals (Windhoek Central and Katutura), Namibia

Woldeselassie, Berhe Hailemariam January 2005 (has links)
Pre-eclampsia is a multi-organ system disorder that occurs after the 20th week of gestation in pregnancy and is characterized by hypertension and proteinuria with or with out oedema. It is a major cause of morbidity and mortality for the woman and her child. Based on surveillance data, pre-eclampsia is one of the leading causes of maternal mortality in Namibia. However, there is no depth study done in Namibia that looks at the extent of confirmed pre-eclampia and its contribution to maternal and perinatal morbidity and mortality. There is also no standard management protocol currently recommended in Namibia. The aim of this study was to evaluate the outcomes and quality of care given to pre-eclamptic patients treated in Windhoek Central and Katutura referral hospitals in Namibia within the period of January 2003 to December 2004.
222

A food multi-mix supplement for pregnant women in the Vaal Region

Twenefor, Charlotte 09 1900 (has links)
M. Tech Food Service Management (Hospitality, Tourism and Public Relations, Faculty of Human Sciences), Vaal University of Technology. / Good maternal nutrition is vital for the health and survival of the developing foetus. Nutritive inadequacy has been associated with pregnant women in developing countries particularly Sub Saharan Africa. Adequate intake of both macro and micronutrients by this vulnerable group must be ensured to avoid maternal and infant morbidity and mortality. In this study, a novel approach was employed to develop a cost effective, culturally acceptable and nutrient-dense food multi-mix (FMM) supplement that would help meet 20-25 percent of the recommended daily allowance (RDA) of pregnant women aged between 20and 30 years in the Vaal region. Twenty FMM supplements were formulated using South African food composition tables to ensure adequate nutritional content. Two out of the twenty, were selected and named FMM C1 and C3 respectively. FMM C I and C3 was selected owing to their better nutrient contents and affordability when compared with the others. Food items used to formulate FMM C 1 included maize meal, pea powder, peanut dry, milk powder and kidney beans. FMM C3 was formulated with sorghum, maize meal, peanut dry and onion powder. Chosen food items were dried, roasted, ground and mixed together proportionately. FMM supplements (C 1 & C3) were analyzed using standard laboratory techniques to determine their nutrient content. Results obtained were from the Agricultural Research Council (ARC). The shelf life of the FMM supplements was microbiologically tested. Shelf life testing proved safety for the time of consumption, as very little microbiological growth was found in 28 days. The FMM supplements were then incorporated in the development of two acceptable recipes (soup and gravy).Simple recipe leaflets were developed for use by the subjects. The process proved that it is possible to formulate a FMM or any other food product according to certain formulation criteria since formulated FMM supplements (C1 and C3) met the criteria of at least 20% RDA of Protein (g). However, the criteria for micronutrients and energy were difficult to meet as folate iron and energy showed lower percentages of 10%, 14% and 18% respectively in the experimental situation. Sensory evaluation was conducted to ascertain the acceptability of the developed recipes (soup and gravy). The sample consisted of pregnant women randomly selected from John Haynes and Sharpeville clinics respectively, it can be concluded it is possible to formulate and develop products that were culturally acceptable to the consumers (pregnant women) as sensory analysis indicated the majority (85%) of the respondents liked the gravy and 65% liked the soup. Further research is needed to address the impact on nutritional status, long-term compliance and development of range of FMM with various ingredients to determine the most nutritional, cost effective and acceptable product for pregnant women.
223

The impact of dietary diversification on the nutritional status of pregnant women in the Vaal Region

Kesa, Hema 06 1900 (has links)
D. Tech. (Food Service Management, Dept. of Hospitality, Tourism and PR management), Vaal University of Technology / The main objective of this study was to develop a cost-effective, culturally acceptable, nutrient-dense food multimix (FMM) based on local food staples for pregnant women in the Vaal region. The impact of the consumption of the multimix on the nutritional status of the women, dietary diversity and outcomes of pregnancy was assessed in an intervention study by measuring the same variables as for a pilot study where the nutritional status of pregnant women was determined. Compliance was measured through monitoring of the FMM consumption and sensory evaluation tests. Quantitative food frequency questionnaires (QFFQs) and 24-hour recall questionnaires were completed in interviews. Anthropometric and biochemical measurements were recorded. The pilot study indicated that the mean total iron intake was 9,74 mg/day, below the estimated average requirement (EAR) of 22 mg/day for pregnant women. Therefore, 41,7 per cent of the women were found to be iron deficient and 50 per cent suffered from iron deficiency anaemia. Food consumed supplied little iron. Eighty per cent of the women were overweight before falling pregnant. Based on the pilot study, the FMM was developed and subjected to the following processes: chemical analysis, shelf life tests, recipe development and sensory evaluation. The product was then implemented in an intervention programme. A control group of pregnant women received soup powder. The respondents were relatively healthy and did not suffer from any chronic diseases. According to the nutrient intakes measured by the QFFQ, indicating usual dietary intakes, the iron intake of 87,5 per cent of the experimental group and 94 per cent of the control group fell below the EAR before intervention. After the intervention it improved in that the iron intake of 35,2 per cent of the experimental group and 33,3 per cent of the control group fell below the EAR. The top 10 items consumed by the experimental group during pre- and post-intervention were mainly rich in carbohydrates. Food containing iron absorption inhibitors such as tannin in tea and phytates in maize meal and bread were among the top 10 foods listed. The highest number of individual food items consumed by an individual in seven days was 39 before the intervention and 52 after the intervention, among the experimental group. The individual food variety improved after the intervention. The reason for this could be the inclusion of the FMM in their diets. The majority of the respondents consumed eight to nine of the nutritious food groups before and after the intervention. The mean food variety score (FVS) for the control group was 38,9 (±10,5) before the intervention, which decreased to 35,8 (±8,39) after the intervention. No improvement in FVS was observed after the intervention in the control group and the FVS indicated medium dietary diversity (30-60 food items). The post-intervention results show that there was an improvement in most of the iron variables. The experimental group showed statistically significant differences between pre- and post-intervention measurements in transferrin and haematocrit levels and the control group in haematocrit levels. All the babies born to the mothers of both the experimental and control groups were healthy with measurements in the normal range. The reason for this could be that the inclusion of the FMM and soup powder in the diets of the experimental and control group, respectively, made the women more aware of the importance of pregnancy monitoring. Furthermore, the attention given to the women by the clinic sisters and the researchers could have contributed to all the improvements mentioned.
224

Tensão entre o fumar e o não fumar em gestantes: a dimensão social / Tension between the smoking and non-smoking in pregnant women: the social dimension

Siqueira, Lucíola D'Emery 28 May 2015 (has links)
Introdução: O consumo do tabaco é a principal causa mundial de mortes preveníveis, com estimativa de seis milhões de mortes por ano atribuíveis ao fumo. Configurando-se, então, como uma problemática de proporção mundial que compromete não apenas a qualidade de vida das pessoas, mas influencia índices e perfis de morbimortalidade em diversas regiões do mundo. Da mesma forma que o tabagismo não afeta de maneira homogênea países com desenvolvimento econômico distintos, seus efeitos são mais perceptíveis em países pobres e em desenvolvimento; numa população são as pessoas de classes sociais menos favorecidas que mais consomem o tabaco. Nesse sentido, as mulheres têm um perfil vulnerável para o consumo do tabaco e especificamente a gestação, configura-se como um momento propício para o abandono do tabagismo. Os fatores que levam as gestantes a fumar durante a gestação estão fortemente associados as suas condições socioeconômicas. Objetivo: conhecer a rede social da gestante tabagista acompanhada na Atenção Básica e sua interferência em seu estado de saúde. Método: trata-se de um estudo exploratório-descritivo de abordagem qualitativa, que utilizou a entrevista para construção do genograma e ecomapa das participantes. Participaram do estudo 10 gestantes tabagistas acompanhadas nas Unidades Básicas de Saúde do bairro de Cidade Tiradentes, na região Leste da cidade de São Paulo. Resultados: o estudo evidenciou que as famílias estão estruturadas sob uma rede de cuidado que envolve várias gerações. Apesar de a família nuclear estar presente, a integração da rede de parentesco é fundamental na condução das atividades rotineiras. As características socioeconômicas demonstram baixa escolaridade das gestantes, precária inserção no mercado de trabalho, dependência econômica de outros membros da família e baixa renda familiar. Em relação ao tabagismo, o meio social apresentou-se permeado pelo consumo do tabaco, perpassando gerações e sendo encarado com naturalidade nas normas familiares. As instituições que fazem parte da vida familiar são a creche, a UBS, o trabalho, a vizinhança e a família ampliada. O lazer raramente foi citado e quando presente estava restrito ao ambiente doméstico. Em relação à abordagem do tabagismo no acompanhamento pré-natal, constatou-se a inexistência de uma intervenção coordenada e longitudinal e esta, quando presente, mostrou-se fragmentada e pontual. Diante da análise temática das falas das gestantes, foi possível apreender elementos que podem ser facilitadores ou dificultadores para a cessação do tabagismo. Conclusão: dificuldades de lidar com o estresse e questões relacionadas à dinâmica familiar demonstram que o tabagismo precisa ser encarado como uma escolha individual fortemente influenciada por um contexto social. Compreender a rede social e reciprocidade no apoio é fundamental para abordar a questão do tabagismo numa perspectiva social do cuidado / Due to the magnitud of tobacco problem for public health, and, specifically, due to the damage for the mother and her baby, this study aimed at knowing the social network of smoking pregnant women followed in primary care and its interference in her health. This was an exploratory-descriptive study with a qualitative approach that used interviews to build the genogram and eco-map of the participants. The data were analyzed using thematic analysis and discussed by means of a theoretical framework for health promotion. Ten pregnant smokers, followed in primary care in Cidade Tiradentes neighborhood, in the east of the city of São Paulo participated in the study. The study showed that the families are structured in a transgenerational care network. Although the nuclear family is present, the integration of a kinship network is necessary to conduct routine activities. In terms of socioeconomic characteristics, the participants showed low educational level, poor integration into the labor market, economic dependence on other family members and low income. Regarding smoking, the social environment is permeated by tobacco consumption, which spreads through generations and is seen as common in family rules. The institutions that are part of family life are the day care center, public health center, work place, neighborhood and the extended family. The bonds are poor and based on relationships involving favors and/or cooperation. Leisure was rarely mentioned and when present, it was restricted to the domestic environment. Regarding smoking treatment in prenatal care, there was a lack of coordinated and longitudinal intervention, which was fragmented and occasional. The thematic analysis of the participants discourse revealed elements that can be facilitators or obstacles to smoking cessation. These elements suggest the relevance of smoking to the pregnant women and help direct the intervention to a more effective approach. Difficulties in dealing with stress and issues related to the family dynamics show that smoking must be seen as an individual choice strongly influenced by the social context. Understanding the social network and the importance of reciprocal support is critical to address the issue of smoking in a social perspective of care
225

Influência da posição prona, em maca para gestantes, nos parâmetros hemodinâmicos materno-fetais e no conforto da gestante / Influence of prone position on a stretcher for pregnant women in maternal and fetal hemodynamics parameters and the comfort of the pregnant woman

Oliveira, Claudia de 09 September 2015 (has links)
Introdução: Devido ao aumento do volume abdominal, a posição prona é difícil e desconfortável para a gestante. Por isso, até hoje não foi testado se, nessa posição, a grávida teria seus padrões hemodinâmicos materno-fetais alterados. Objetivos: Analisar a influência da posição prona nos parâmetros hemodinâmicos materno-fetais e no conforto da mulher grávida, em um protótipo de maca especialmente construído para gestantes. Método: Estudo prospectivo, observacional e transversal, com 30 gestantes, em seguimento pré-natal, e 16 não gestantes, como grupo de controle. Os dois grupos foram subdivididos para participar de dois tipos de sequências randomizadas de posições, investigando-se se a mudança na ordem das sequências traria, nas gestantes e seus fetos, alguma variação significativa de valores hemodinâmicos. As posições utilizadas neste estudo foram: prona, supina, semissentada e decúbito lateral esquerdo. Foram avaliados os seguintes parâmetros hemodinâmicos: frequência cardíaca, pressão arterial sistólica, pressão arterial diastólica, saturação de oxigênio e frequência respiratória maternos e linha de base e variabilidade fetais. Para a análise estatística, foi utilizada a análise não paramétrica para medidas repetidas; e, para verificar se a posição anterior à prona teria alguma influência no desempenho dessa última, foram criadas variáveis de variação, que foram comparadas pelo teste de Wilcoxon. Resultados: Comparandose os índices da posição prona aos obtidos nos demais posicionamentos, observou-se que todos os parâmetros mantiveram-se dentro dos valores de normalidade e não houve, nesses valores, interferência das posições anteriores à prona. O grupo de gestantes revelou médias significativamente maiores do que as do grupo de não gestantes em relação às frequências cardíaca (p < 0,004), na sequência 1; e p < 0,001, na 2) e respiratória (na sequência 1, p=0,041; e, na 2, p=0,012). Na análise do grupo de gestantes, observou-se que, em ambas as sequências, as pressões arteriais sistólica e diastólica apresentaram, na posição prona, valores menores que os apresentados nas demais posições. Nesse grupo, observou-se diferença significativa na pressão arterial sistólica, quando se comparou, na sequência 1, a posição prona à semissentada (p < 0,001), à supina (p < 0,01) e ao decúbito lateral esquerdo (p < 0,01); e, na sequência 2, quando se comparou a posição prona às semissentada (p < 0,001) e à supina (p=0,013). Ainda no grupo de grávidas, a pressão arterial diastólica apresentou diferença significativa nas duas sequências: na sequência 1, a posição prona foi comparada às posições semissentada (p < 0,006), supina (p=0,023) e decúbito lateral esquerdo (p=0,017); na sequência 2, foi comparada ao posicionamento semissentado (p < 0,005) e supino (p=0,008). Quanto à saturação do oxigênio, na sequência 2 do grupo de grávidas houve diferença significativa quando se compararam os valores obtidos na posição prona aos obtidos na semissentada (p=0,021) e na supina (p=0,003). Em ambas as sequências, não houve diferença significativa na linha de base fetal, quando se comparou a posição prona com o decúbito lateral esquerdo. Não foram observadas variações significativas na variabilidade fetal nas sequências avaliadas. Todas as pacientes declararam terem se sentido confortáveis durante a permanência em cada uma das posições. Conclusão: No posicionamento prono, os padrões hemodinâmicos materno-fetais mantiveram-se dentro dos valores da normalidade. Na maca especialmente desenvolvida para gestantes, essa posição foi considerada segura e confortável / Introduction: Due to the increase of the abdominal volume, the prone position is a difficult and uncomfortable position for pregnant women. Hence, so far, it has not been tested if, in this position, a pregnant woman would have her maternal fetal hemodynamic parameters altered. Objectives: The objectives of this study were to analyze the influence of prone position in maternal-fetal hemodynamic parameters and the comfort of the pregnant woman on a prototype stretcher specially built for pregnant women. Method: A prospective, observational, crossover study with 30 pregnant women in antenatal segment, and 16 non pregnant women as a control group. The two groups were subdivided to take part in two types of randomized sequences of positions, investigating if the change in the order of the sequences would bring a significant alteration in the maternal fetal hemodynamic values. The positions used in this study were: prone, supine position, fowler position and left lateral. The following hemodynamic parameters were assessed: maternal heart rate, systolic blood pressure, diastolic blood pressure, oxygen saturation and respiratory rate and baseline and fetal variability. To the statistical analysis we used the non-parametric analysis for repeated measures and to verify if the position prior to the prone position would have any influence in it and variables of variation were created and compared to the Wilcoxon test. Results: Comparing the prone positions indexes to the other ones obtained, we observed that all the parameters were within the standards of normality and there was no interference in positions prior to the prone position in these values. The pregnant group showed means significantly higher than the ones of the non-pregnant women regarding the heart rate in sequence 1 (p < 0.004) and in sequence 2 (p < 0.001) and respiratory rate in sequence 1 (p= 0.041) and sequence 2 (p= 0.012). In the analysis of the pregnant group we observed that in prone position the systolic blood pressure and the diastolic blood pressure showed lower values than the other in both sequences. In the systolic blood pressure in the pregnant group sequence 1 the comparison of prone position with the fowler position (p < 0.001), with the supine position (p < 0.001) and with the left lateral (p < 0.001) in the pregnant group sequence 2 the comparison of the prone position with the fowler position (p < 0.001) and with the supine position (p= 0.013) it is observed a significant difference. In the diastolic blood pressure in comparison of the prone position in the pregnant group sequence 1 with the fowler position (p < 0.006), with supine position (p= 0.023) and with the left lateral (p= 0.017) and the pregnant group sequence 2 with the fowler position (p < 0.005) and with the supine position (p= 0.008) it is observed a significant difference. To the oxygen saturation in the pregnant group sequence 2 there was a significant difference when compared to the prone position with the fowler position (p= 0.021) and the prone position with the supine position (p= 0.003). In both sequences there were no significant differences in the fetal baseline between prone position with the left lateral. There were not observed any significant variations in the fetal variability in the sequences assessed. All the patients declared having felt comfortable during their stay in each one of the positions. Conclusion: In the prone positioning the maternal-fetal hemodynamic parameters were within the standards of normality and this position on the stretcher especially designed for pregnant women, considered as a safe and comfortable position
226

Proposta de desenvolvimento de produtos de malha para gestantes utilizando a tecnologia seamless / A proposal for developing seamless knitted clothing for pregnant women

Mentone, Daniela Antunes Nolasco 02 April 2018 (has links)
Estudos têm sido realizados sobre artigos têxteis de diferentes fibras quanto ao desempenho em relação ao conforto e à funcionalidade. Porém, são raros os que tratam das malhas sintéticas com elastano, utilizando-se da tecnologia denominada seamless com uma proposta de vestuário exterior para gestantes. O objetivo deste trabalho foi desenvolver um protótipo de roupa para gestantes, fabricado a partir de fibras sintéticas de poliamida e poliéster (convencional e microfibra), utilizando a tecnologia seamless, que atendesse às necessidades de conforto e bem-estar deste grupo especial de usuárias. A metodologia utilizada para o desenvolvimento do protótipo foi o Design Thinking, que partiu da busca de conhecimento sobre as necessidades destas usuárias e da obtenção de depoimentos de trinta gestantes. Com o material coletado, identificou-se uma centralidade na necessidade de vestimentas que privilegiassem o conforto das mamas. Em seguida, foi desenvolvido um protótipo de blusa, com malha sintética contendo elastano, utilizando-se da tecnologia denominada seamless e com uma proposta de vestuário exterior para gestantes que dispensasse o uso de sutiã. Para verificar a validade da pesquisa um protótipo foi confeccionado e posteriormente foram fabricadas trinta e duas amostras com as matérias-primas selecionadas. Com os protótipos fabricados, foram realizados os seguintes ensaios físicos: densidade linear (ASTM D3776-96), determinação da espessura (ASTM D 1777 06), tendência à formação de snagging (JIS L 1058), determinação do alongamento e da elasticidade (JIS L 1018 02), gestão da umidade (AATCC Test Method 195 01) e determinação da absorção por capilaridade (JIS 1907 02). Também foi feito um teste de usabilidade com um grupo menor de gestantes, avaliando-se a funcionalidade, o conforto, a adequação das cores e o desejo de compra das peças. A partir da análise dos resultados dos ensaios físicos e do teste de experimentação das amostras, foi possível avaliar a eficiência dos produtos desenvolvidos e a possibilidade de um aprimoramento da solução encontrada. O protótipo se mostrou bem avaliado, sobretudo, no quesito sustentação das mamas. Entre as sugestões de adequações destacaram-se adequação do manequim ao tamanho P e a oferta de cores mais escuras que não evidenciem os mamilos, mais protusos na gestação, além da não retenção de umidade, uma vez que gestantes têm maior produção de suor. A tecnologia seamless agradou as gestantes, por dispensar costuras, causadoras de desconforto e alergias. A presente investigação apresenta o potencial de inspirar o prosseguimento de mais estudos integrando tecnologia têxtil, produção de moda e saúde / There have been a number of studies of textiles made up of different yarns regarding comfort and functionality. However, few have dealt with synthetic fabrics combined with spandex, using seamless technologies to provide outer garments for pregnant women. In order to assess the properties of items of clothing manufactured from different syntetic yarns, the experimental procedure was based on Design Thinking. During the first stage of the investigation, a semi structured interview was conducted with a group of thirty pregnant women. With the collected material, the need of clothes that favor comfort in the breast region was identified as a common issue. A prototype of a blouse with synthetic (polyamide and polyester) knitted fabric containing elastane was developed using the so-called seamless technology. The product was proposed as an outdoor garment for pregnant women, that could also dispense bra use. The prototype was then created and in order to check for validity, thirty-two samples were manufactured from the selected raw materials. The next stage dealt with following physical tests of the manufactured items of clothing: assessment of linear density (ASTM D 3776-96), thickness determination (ASTM D 1777 06), tendency to the formation of snagging (JIS L 1058), stretching determination (JIS L 1018-02), management of liquid moisture (AATCC test Method 195-01) and absorption for capillarity (JIS 1907 02). After that, a smaller group of pregnant women undertook a usability test in order to assess functionality, comfort, color suitability and purchase desirability of the garment. The prototype was well evaluated, above all, in the matter of breast support. Among suggestions highlighted for adjustments are the suitability of size S and the availability of darker colors so that nipples would not show. Seamless technoloty pleased the pregnant women in this study due to dispensing seams that often cause discomfort and allergies. The present research presents the potential to inspire the continuation of further studies integrating textile technoloty, fashion production and health
227

A saúde reprodutiva de mulheres portadoras e ex-portadoras de hanseníase em uma capital do Nordeste - Brasil / The reproductive health of women suffering and former carriers of leprosy in a capital Northeast - Brazil

Tavares, Clodis Maria 10 March 2014 (has links)
A detecção de casos novos de hanseníase permanece elevada no mundo, no Brasil e em Alagoas. Trata-se de uma importante morbidade que leva a incapacidades físicas, preconceito e estigma. A ênfase dada à saúde reprodutiva de mulheres portadoras e ex-portadoras de hanseníase deve-se ao fato de a gestação induzir recidivas, exacerbar lesões pré-existentes e aumentar a evolução da forma indeterminada para outras formas clínicas, o que exige um acompanhamento para uma prática anticonceptiva segura. O objetivo geral foi conhecer a situação da saúde reprodutiva das mulheres portadoras e ex-portadoras de hanseníase na rede de atenção básica do município de Maceió. Trata-se de um estudo descritivo de corte transversal com abordagem quantitativa. O estudo foi realizado em 14 Unidades Básicas de Saúde (UBS) dos 07 Distritos Sanitários do município de Maceió/Alagoas. A população foi constituída por 60 mulheres. Os dados nos revelam que a maioria das mulheres se encontrava na faixa etária de 30 a 49 anos (75%), tinham companheiro (70%), eram analfabetas ou com o ensino fundamental incompleto (53,3%). Em relação à ocupação, 45% eram do lar e 55% desempenhavam outras ocupações remuneradas. Essas mulheres coabitavam com uma a três pessoas (36,7%) ou com seis a quatorze pessoas (28,3%). Quanto à religião, 61,7% eram católicas. A maioria buscou detecção por demanda espontânea (30,0%). Quanto à forma clínica, 30,0% era Dimorfa, 20% Tuberculóide, 15% Indeterminada, 10% Virchowiana e 25,0% formas clínicas não classificadas. Eram multibacilares 56,7%. Quanto às reações hansênicas, 16,7% informaram tê-las antes do diagnóstico, 28,3% durante o tratamento e 21,7% no pós-tratamento; 8,3% das reações eram do tipo I e 66,7%, do tipo II. Das mulheres, 5% estavam grávidas no diagnóstico, 1,7% no período puerperal e 1,7% amamentando. Em relação à história reprodutiva, 63,3% engravidou de uma a três vezes e 26,6% de quatro a dez vezes e 75% tiveram de um a três partos. Três mulheres estavam grávidas no momento do diagnóstico. Conheciam métodos contraceptivos, como condom masculino (98,3%), pílula (88,3%), laqueadura tubária (86,7%) e outros; os utilizavam, em maior índice, pílula (73,3%), condom masculino (70,0%), laqueadura tubária (53,3%) e outros. Quanto ao conhecimento dos métodos anticoncepcionais e características sociodemográficas, os maiores percentuais foram: condom masculino (100%), pílula (87,8%), laqueadura tubária (85,7%), injeção (75,6%), tabela (71,4%), DIU (64,3%). Realizando uma análise inferencial os dados denotam relação significativa com associação entre temperatura e ocupação, aleitamento materno e número de pessoas na família, pílula e número de pessoas, injeção e escolaridade, injeção e ocupação, diafragma e número de pessoas, espermicida e número de pessoas, vasectomia e se estudava, com p>0,05. Médicos e enfermeiros contribuíram mais na oferta de informações sobre contraceptivos, meios midiáticos exerceram grande influência. O principal local de recebimento dos contraceptivos foi a UBS. Concluímos que as mulheres em idade fértil portadoras e ex-portadoras de hanseníase estão sendo pouco aconselhadas para a anticoncepção, tornando-se susceptíveis ao risco de uma gravidez indesejável, levando-as a apresentar reações imunológicas graves / The detection of new leprosy cases in the world remains high in Brazil and Alagoas. This is an important morbidity that leads to physical disability, prejudice and stigma. The emphasis on reproductive health of women suffering and former carriers of leprosy is due to the fact pregnancy induce relapses, exacerbate pre-existing injuries and increase the evolution of indeterminate form for other clinical forms, which requires monitoring for a safe contraceptive practice. The overall objective was to know the situation of reproductive health of women suffering and former carriers of leprosy in primary health care in the city of Maceió network. This is a descriptive cross-sectional study with a quantitative approach. The study was conducted in 14 Basic Health Units (BHU) of the 07 health districts of the city of Maceió / Alagoas. The study population consisted of 60 women. The data reveal that a majority of women in the age group 30-49 years (75%) had a partner (70%) were illiterate or with incomplete primary education (53.3%). In terms of occupation, 45% were housewives and 55% played other paid occupations. These women lived with one to three people (36.7%) or six to fourteen people (28.3%). As for religion, 61.7% were Catholic. Most searched detection by spontaneous demand (30.0%). Clinical forms, 30.0% were borderline, 20% Tuberculoid, Indefinite 15%, 10% and 25.0% Lepromatous clinical forms not classified. 56.7% were multibacillary. As for leprosy reactions, 16.7% reported having them before diagnosis, during treatment 28.3% and 21.7% after treatment; 8.3% of the reactions were of type I and 66.7% type II. Among women, 5% were pregnant at diagnosis, 1.7% in the postpartum period and 1.7% breastfeeding. Regarding reproductive history, 63.3% of pregnant once to three times, and 26.6% for four to ten times, and 75% had one to three deliveries. Three women were pregnant at the time of diagnosis. Knew contraception, and male condom (98.3%), pill (88.3%), female sterilization (86.7%) and others; used them in highest pill (73.3%), male condom (70.0%), female sterilization (53.3%) and others. Regarding knowledge of contraceptive methods and sociodemographic characteristics, the highest percentages were male condom (100%), pill (87.8%), female sterilization (85.7%), injection (75.6%), table (71 , 4%), IUD (64.3%). Performing an inferential data analysis showed a significant relationship with association between temperature and occupation, breastfeeding and number of family members, and number of people pill, injection and education, and occupation injection, diaphragm and number of people, number of people and spermicide, vasectomy and studied with p> 0.05. Doctors and nurses have contributed more to offer information about contraceptives, exerted great influence from the media. The principal place of receipt of contraceptives was BHU. We conclude that women of childbearing age bearers and former carriers of leprosy are being advised to little contraception, making it susceptible to the risk of an unwanted pregnancy, leading them to develop severe immune reactions
228

Influência da vacinação com dTpa em gestantes no perfil da resposta imunológica contra a Bordetella pertussis na criança / Influence of pregnant women\'s Tdap vaccination in the child\'s immunological response profile against Bordetella pertussis

Correia, Carolina Argondizo 11 April 2018 (has links)
A Bordetella pertussis é a bactéria causadora da coqueluche, doença infectocontagiosa que tem reemergido em diversos países apesar das altas coberturas vacinais. Como os indivíduos mais afetados são crianças menores de seis meses de idade, a vacinação de gestantes com uma dose de vacina adsorvida contra tétano, difteria e coqueluche (B. pertussis acelular - dTpa) foi proposta. O objetivo é promover a transferência de altos títulos de anticorpos maternos ao feto e recémnascido, resultando na sua proteção até que o seu esquema vacinal esteja concluído. Esta estratégia é empregada em diversos países e no final de 2014 foi introduzida no Brasil. Entretanto, pouco se sabe sobre sua eficácia, efetividade e interação com a posterior vacinação da criança, que é realizada com a formulação de células inteiras (DTP), enquanto outros países substituíram-na pela formulação acelular (DTPa). Sabe-se que a vacinação materna induz anticorpos que ajudam a proteger recém-nascidos da infecção, mas podem, também, neutralizar a vacinação da criança, diminuindo a eficiência vacinal, além de promover a transferência de antígenos para o feto, induzindo desvio do perfil de resposta. Esses aspectos são particularmente importantes e devem ser investigados quando novos programas de vacinação materna são implantados. Sendo assim, o objetivo do presente estudo foi avaliar a resposta celular contra B. pertussis em parturientes e neonatos no dia do parto, e em lactentes após vacinação completa contra a coqueluche com DTP no primeiro ano de vida, comparando-se o grupo proveniente de mães que foram vacinadas durante a gestação com as que não receberam a dose de reforço. As células mononucleares do sangue periférico e de cordão umbilical dos participantes foram isoladas e estimuladas com antígeno bacteriano ou antígeno policlonal em cultura. Após o tempo estipulado, verificou-se o perfil de expressão gênica por qPCR nas células e a concentração de citocinas de interesse em sobrenadante, por meio de citometria de fluxo. Os dados obtidos mostram que a vacina na gestação induz resposta celular favorável à proteção contra infecção em gestantes, com produção de citocinas de perfil Th1 após estímulo antigênico, enquanto que nos neonatos poucas citocinas estavam acima dos limites de detecção. Quando se comparou a resposta de lactentes nascidos de mães vacinadas ou não durante a gestação, não foi encontrada diferença significativa nos níveis de citocinas produzidos, sugerindo que os anticorpos maternos presentes durante o desenvolvimento fetal e os primeiros meses de vida das crianças não interferiu no processo de reconhecimento e geração de resposta específica. Apesar do número amostral limitado, este trabalho mostra um panorama da interação da vacinação materna com a resposta celular à vacinação da criança no seu primeiro ano de vida, mostrando que a princípio a dose de reforço com dTpa durante a gestação é capaz de gerar resposta celular protetora nas gestantes, prevenindo-as de transmitir a doença a seus filhos, e a resposta humoral produzida não interfere na geração de resposta celular de seus filhos após o seu próprio esquema de imunização. / Bordetella pertussis is the bacterial agent of whooping cough, an infectious and contagious re-emerging disease despite high vaccine coverage. As the most affected are children younger than six months of age, a dose of tetanus/diphtheria/pertussis vaccine (acellular pertussis - Tdap) in pregnancy was proposed. It is aimed to promote the transfer of high maternal antibodies\' titres to the foetus and newborns, resulting in their protection until their own vaccination scheme is completed. This strategy is present in several countries, and it was implemented in Brazil by the end of 2014. However, little is known about its efficacy, effectiveness and interaction with the subsequent child\'s vaccination, which comprehends the whole-cell formulation (DTP), while other countries replaced it for the acellular version (DTaP). Maternal vaccination induces antibodies that would protect newborns from infection, but they can also neutralize the effect of the child vaccination, reducing the vaccine efficiency. Besides, it can promote the transfer of antigens to the foetus, which can induce deviation in the response pattern. These aspects are particularly important and should be investigated when new maternal vaccination programs are implemented. Therefore, the aim of this project was to evaluate the cellular response against B. pertussis in women at labour and their neonates, as in young children after complete pertussis vaccination by the first year of life, comparing groups from vaccinated and non-vaccinated women during pregnancy. Peripheral blood and cord blood mononuclear cells were isolated and stimulated with bacterial or polyclonal antigen in culture. After the stipulated time the gene expression profile and cytokine concentration were evaluated by qPCR and flow cytometry. Data from the present study show that pregnancy vaccination inducing favourable cellular response for protection against infection in pregnant women, with Th1 cytokines\' production upon antigenic stimulus, while in newborns few cytokines were detected above the detection limit. When comparing children\'s response, born either from vaccinated or unvaccinated mothers, cytokine levels were not significantly different, suggesting that maternal antibodies present during foetal development and first months of life do not interfere with recognition and cellular response generation to vaccination. Despite limited sample size, this work shows a broader view of interaction between maternal and child vaccination, showing that the Tdap boost dose during pregnancy may be able to generate protective response in women, preventing them to transmit the disease to children, and the induced humoral response may not interfere in generating cellular response in children after their own vaccination.
229

Validação de um questionário de frequência alimentar para estimativa da ingestão de vitamina A em gestantes / Validation of a food frequency questionnaire for estimating vitamin A intake in pregnant women.

Isobe, Michela Teixeira 29 May 2015 (has links)
Objetivo: Verificar a validade relativa de um questionário de frequência alimentar (QFA) para estimativa da ingestão de vitamina A em gestantes empregandose biomarcadores como referência. Métodos: Os dados do presente estudo foram obtidos de um estudo anterior, que aplicou o QFA em gestantes/puérperas da maior maternidade pública de Ribeirão Preto, SP e coletou amostras de sangue materno e do cordão umbilical e de leite materno para dosagem de retinol Para avaliar a acurácia do QFA, foram realizados testes de correlação de Pearson parcial, análise de concordância por kappa quadrático, classificação cruzada em quartis e método das tríades com dois biomarcadores. Resultados: Foram obtidos dados de 161 questionários e um número variado de amostras biológicas. A estimativa média de ingestão de vitamina A obtida pelo QFA foi de 875 g/dia e houve uma frequência de inadequação do consumo de 52,8%. Baixos coeficientes de correlação e de concordância foram observados. Na classificação cruzada, os resultados foram considerados bons para mesmo quartil ou quartil adjacente e também para quartil oposto. O QFA apresentou melhor desempenho quando considerados apenas os alimentos fontes de vitamina A pré-formada; mas seu desempenho foi satisfatório ( = 0,554) mesmo considerando os alimentos provitamina A, fontes importantes e também mais acessíveis para a população, apesar da menor biodisponibilidade. O melhor biomarcador foi o retinol sérico materno, cujo coeficiente de validade variou de 0,567 a 0,777. Conclusão: O desempenho do QFA foi considerado satisfatório e o retinol sérico materno foi o biomarcador que melhor indicou a estimativa de vitamina A. O QFA permite uma estimativa moderada da ingestão de vitamina A em gestantes, sendo adequado para utilização na avaliação do consumo desse nutriente nessa população específica. / Objective: To assess the relative validity of a food-frequency questionnaire (FFQ) estimates of vitamin A against biomarkers in pregnant women. Methods: Data were obtained from a previous study that has applied the FFQ for pregnant/postpartum women at the largest public maternity hospital in Ribeirão Preto, SP, and collected samples of maternal and umbilical cord blood and breast milk retinol. To evaluate the accuracy of the FFQ were performed partial Pearson correlation test, concordance by kappa quadratic statistics, cross-classification into quartiles and method of triads with two biomarkers. Results: 161 questionnaires and data from a varied number of biological samples were obtained. The mean FFQ intake of vitamin A was 875 g/day and the frequency of inadequate intake was 52.8%. Low coefficients of correlation and concordance were observed. In cross-classification, results were considered good into the same or adjacent quartiles and also into opposing quartiles. The FFQ performed better when considering only food sources of preformed vitamin A, regardless of adjustment for energy; but its performance was satisfactory ( = 0.554) even considering provitamin A food items, which are an important source and which are more affordable, despite lower bioavailability. The best biomarker was the maternal serum retinol, which validity coefficient ranged from 0.567 to 0.777. Conclusion: FFQ performance was considered satisfactory and maternal serum retinol was the best biomarker for vitamin A status. The FFQ provides a conservative estimate of vitamin A intake in pregnant women and it is suitable for evaluating this nutrient in this specific population.
230

Malaria perception among pregnant women in Chhattisgarh, India

Bondzie, Philip A. 21 February 2019 (has links)
BACKGROUND: Malaria in pregnant women continues to be a public health problem in India. The prevalence of malaria in pregnancy is particularly high in the tribal conflict areas of India such as Chhattisgarh. Pregnant women have less acquired immunity protecting them against malaria than non-pregnant women of child bearing age. The decreased immunity results in a much more severe presentation of malaria symptoms, and potential death of both mother and fetus during malaria in pregnancy. Recognizing the need for effective malaria interventions in pregnant women, global and national malaria prevention and treatment guidelines have been established. Practice of these guidelines has been found to be inadequate in the Asian Pacific Region. LITERATURE REVIEW FINDINGS: Qualitative studies on the knowledge, attitudes and practices of malaria interventions have demonstrated that meeting communities at their level of understanding is essential in circumventing malaria spread. In an effort to create a synergy between health care workers, national and global malaria control strategies and pregnant women, there is the need to identify pregnant women’s knowledge, attitudes and practices of malaria interventions. Currently, there is no data on the knowledge, attitudes and practices of pregnant women in the conflict districts of Chhattisgarh, India, where malaria prevalence and related symptoms have been identified to be significantly high. PROPOSED PROJECT: This study seeks to assess the knowledge, attitudes and practices of malaria prevention and treatment in pregnant women in the conflict areas of Chhattisgarh, India, using a cross-sectional qualitative research design. This study will highlight the understanding of malaria transmission, perceptions of cause, recognition of signs and symptoms, treatment-seeking behaviors, preventive measures and practices of pregnant women who visit the antenatal clinic and those who do not. CONCLUSION: If this study demonstrates knowledge and attitudes that favor customary or unproven methods of malaria interventions as shown in previous studies, then this may explain the present rate of MIP in these districts and hence the need for specific mediations for controlling and preventing malaria in this populace. SIGNIFICANCE: Findings from this study will help inform malaria education programs, health policies and practices that are tailored or targeted towards pregnant women in Chhattisgarh, India.

Page generated in 0.0819 seconds