Smoking is deleterious to health and dyadic smoking facilitates increased tobacco consumption. In this investigation, a secondary analysis was preformed on a Canadian database of 473 and 128 adoptive families. The purpose of this study was to delineate the role of demographic, personality, family environment, and partner smoking in predicting smoking cessation in a sample of Vancouver couples. Two specific temporal environments were explored: (a) general co-habitation smoking patterns and (b) couples' smoking patterns during pregnancy. The data were extracted from the Vancouver Family Study, and the prevalence and predictors of smoking behavior were investigated through correlational and hierarchical logistical regression techniques. Partner smoking was a significant predictor of smoking behaviors for each gender. Specifically, women's weekly smoking consumption was completely mediated by partner smoking. The results of this study highlight the importance of dyadic smoking in continued tobacco consumption.

Thesis (Ph.D.)--Duquesne University, 2009. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p. 309-335) and index.

Thesis (MVoeding)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Introduction: Heavy alcohol consumption during pregnancy is teratogenic.49-51 A woman’s nutritional requirements increase during pregnancy.4 The dangers of heavy drinking in the presence of malnutrition may put the fetus at a further disadvantage to normal development and life. Objectives: To determine the nutritional status of pregnant women in relation to alcohol consumption during pregnancy, and pregnancy outcome. To relate the combined effect of maternal alcohol consumption and nutritional status to pregnancy outcome. Study design: Prospective, longitudinal and cohort. Study population: Pregnant women attending Hanover Park MOU for pre-natal care. They were classified as subjects (heavy drinkers) or controls (light drinkers or abstainers), and 15 pairs were matched according to race, parity and gestational age at the onset of their participation in the study. Methodology: A skilled FARR worker determined the alcohol consumption of the individuals through a validated questionnaire, whilst the investigator gathered the study data blinded to the participants’ alcohol consumption status. The investigator conducted three interviews with the pregnant individuals. Anthropometrical, clinical and biochemical investigations were done and questionnaires completed to determine dietary intake, sociodemographics, health and eating habits. An experienced FARR paediatrician examined the newborns, assessing their anthropometric status, health and the presence of any alcohol-related signs. Results: The nutritional status of the matched subjects and controls did not differ significantly in terms of dietary intake, anthropometric or clinical assessment. There were significant differences between the 2 groups’ serum vitamin A values (p<0.0097). Significant associations were found between the mother and newborn data; specifically energy intake and gestational age at birth (p<0.0083), MUAC and birth weight (p<0.04), and weight gain and weight for age (p<0.0056). The participants’ energy intake also had a significant correlation with their weight gain during pregnancy (r=0.0389, p<0.01). The prevalence of FAS in the total population was 6.67%; a finding that confirms previously reported data in nearby Wellington, Western Cape.49 Conclusion: Some mothers’ good nutritional status did not protect their offspring against alcohol’s teratogenic effects. Nutritional status did have a few statistical significant effects on pregnancy. However, the investigator is of the opinion that the few significant findings were not enough to accept or reject the hypothesis; therefore, making the results inconclusive. / AFRIKAANSE OPSOMMING: Inleiding: Swaar alkoholgebruik tydens swangerskap is teratogenies.49-51 Vroue se voedingsbehoeftes verhoog met swangerskap.4 Die gevare van swaar alkoholgebruik in die teenwoordigheid van wanvoeding mag die fetus verhoed om normal te ontwikkel en groei. Doelwitte: Om die voedingstatus van swanger vroue te bepaal in verhouding met alkoholgebruik tydens swangerskap, en die swangerskapsuitkoms. Asook om die gekombineerde effek van die moeder se voedingstatus en alkoholgebruik op haar swangerskapsuitkoms te bepaal. Studie-ontwerp: Prospektief, longitudinaal en kohort. Studiepopulasie: Swanger vroue wat Hanover Park MOU besoek vir voorgeboorte sorg. Hulle is of as toetslinge (swaar drinkers) of as kontroles (ligte drinkers of geheelonthouers) geklassifiseer, en 15 pare is gepaar na aanleiding van ras, pariteit en gestasionele ouderdom by die aanvang van deelname aan die studie. Metodologie: ‘n Ervare SAVN lid het die individue se alkoholgebruik bepaal deur middel van ‘n gevalideerde vraelys. Die navorser was geblind vir die individue se alkoholgebruik. Die navorser het drie onderhoude gevoer met elke individu. Antropometriese, kliniese en biochemiese ondersoeke is gedoen. Vraelyste is voltooi om dieetinname, gesondheid, sosiodemografiese en eetgewoonte- inligting te versamel. ‘n Ervare SAVN pediater het alle pasgeborenes ondersoek om hulle antropometriese status, gesondheid en die teenwoordigheid van enige alkohol-verwante tekens te bepaal. Resultate: Die voedingstatus van die gepaarde toets-en kontrolegroepe het nie beduidend verskil in terme van dieetinname, antropometriese of kliniese evaluering nie. Daar was ‘n beduidende verskil tussen die 2 groepe se serum vitamien A vlakke (p<0.0097). Beduidende assosiasies is gevind tussen die moeder en pasgebore se data; naamlike tussen energie-inname en gestasionele ouderdom by geboorte (p<0.0083), bo-armomtrek en geboortegewig (p<0.0056), en gewigstoename tydens swangerskap en die baba se gewig vir ouderdom (p<0.0056). Die deelnemers se energie-inname het ook ‘n beduidende positiewe korrelasie met hul gewigstoename tydens swangerskap gehad (r=0.0389, p<0.01). Die prevalensie van FAS in die totale populasie was 6.67%; wat ook gevind is onlangs in die nabygeleë Wellington, Weskaap.49 Gevolgtrekking: Sommige moeders se goeie voedingstatus het nie hul kinders teen alkohol se teratogeniese effekte beskerm nie. Voedingstatus se effek op swangerskapsuitkoms was statisties beduidend in ‘n paar gevalle. Tog is die navorser van mening dat daar nie genoeg beduidende bewyse is om die nulhipotese te aanvaar of verwerp nie; dus is die gevolgtrekking onopgelos.

Made available in DSpace on 2015-04-17T15:02:27Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 637862 bytes, checksum: 29b3c5aa0d67be224d5c710eb1ae17c3 (MD5) Previous issue date: 2010-09-13 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This study wished to analyse the dimension of spirituality as a confrontation strategy used by pregnant women attended in the Maternal and Child Specialized Care Service- SAE/MI in face of seropositive diagnosis for HIV/AIDS, of University Hospital Lauro Wanderley- HULW of Joao Pessoa, in Federal University of Paraíba. This is a descriptive and exploratory research, case study type, with a sample of 08 infected pregnant women who found the diagnosis of HIV/AIDS during prenatal care. It were used as instruments for data collection a script of semi-structured interviews, containing 09 questions that examined the impact of seropositive diagnosis for HIV/AIDS, including biodemographic issues and a questionnaire comprising two scales: Scale of Religiosity and health problem confrontation and scale of satisfaction with life and spirituality. Data analysis of interviews was conducted by Thematic Content Analysis of Bardin (1977) and the questionnaire was treated by the statistical package SPSS (Statistics Package for Social Sciences) version 16.0. The results obtained showed that 87.5% of infected pregnant women come from a stable union and attended incomplete elementary school; 75% presented themselves as Catholic, 37.5% found the diagnosis in late pregnancy (08 months). It was also observed that 75% affirmed private religious practices in their quotidian; where praying, orating and praising were identified as those most frequent by pregnant women, and that 75% of them agree that going to church/Center/Meeting/Temple influenced them to change concepts and practices in their lives. In the analysis of the interviews with pregnant women, seven categories emerged that addressed different issues, they are: 1) Knowledge about HIV/AIDS, 2) Feeling towards the discovery of HIV/AIDS, 3) Current feeling, 4) Relation of family with the pregnant woman diagnosis, 5) Current Concerns, 6) Confrontation of HIV/AIDS and 7) Beliefs about themselves before diagnosis. It is noteworthy that some categories are subdivided further into subcategories. It was observed that the speech of the pregnant women represented on one hand, the knowledge about HIV/AIDS; and, on the other hand, the lack of knowledge of the disease. The pregnant women showed predominantly negative emotions as well as exposed opposition of feelings towards the acceptance of positive diagnosis for HIV/AIDS. Although, otherwise appears pregnant women who complied with the diagnosis for HIV. They showed the involvement and family support to the pregnant woman at the moment of seropositive diagnosis for HIV/AIDS; In many cases the disclosure of diagnosis is feared by the pregnant woman; It were observed apprehensions involving, in the first place, the concern about the baby and anguish about herself and her seropositive status and about the care of the family; Due to the variety of support elements used by seropositive pregnant women, this category was divided into sub-categories "Religious Support," "Family Support", "Support of SAE/MI Health Team" and "Other supports". Regarding beliefs of pregnant women about themselves before diagnosis, they showed positive beliefs sufficiently strong; The negative beliefs about themselves before diagnosis, some pregnant women appeared to present a previous life of hardship. The results allowed to achieve that there was a contribution of the spirituality dimension as a confrontation factor of the impact of diagnosis of HIV/AIDS in these pregnant women. We conclude that the majority of women surveyed cited the importance of spiritual well-being as a contribution to the confrontation of HIV / AIDS diagnosis discovered in their gestation. / Este estudo pretendeu analisar a dimensão da espiritualidade como uma estratégia de enfrentamento utilizada pelas gestantes atendidas no Serviço de Assistência Especializada Materno Infantil - SAE/MI frente ao diagnóstico soropositivo para HIV/AIDS, do Hospital Universitário Lauro Wanderley-HULW de João Pessoa da Universidade Federal da Paraíba. Trata-se de uma pesquisa descritiva e exploratório, do tipo estudo de caso, com amostra de 08 gestantes infectadas que descobriram o diagnóstico de HIV/AIDS no pré-natal. Utilizou-se como instrumentos para coleta de dados um roteiro de entrevistas semi estruturadas, contendo 09 questões que analisou o impacto do diagnóstico soropositivo para o HIV/AIDS, incluindo as questões biodemográficas e um questionário composto por duas escalas: Escala de Religiosidade e enfrentamento a problema de saúde e Escala de satisfação com a vida e de espiritualidade. A análise dos dados das entrevistas foi realizada pela Análise de Conteúdo Temática de Bardin (1977) e o questionário foi tratado através do pacote estatístico SPSS (Statistics Package for Social Sciences) versão 16.0. Os resultados obtidos mostraram que 87,5 % das gestantes infectadas vêm de uma união estável e frequentaram o ensino fundamental incompleto; 75 % apresentou-se como católicas; 37,5 % descobriu o diagnóstico no final da gestação (08 meses). Observou-se também que 75 /% afirmou práticas religiosas privadas em seu cotidiano; onde rezar, orar e louvar foram constatados como as mais frequentes pelas gestantes, e que 75 % delas concorda com que ir à igreja/Centro/Reunião/Templo influenciou-as a mudarem conceitos e práticas em suas vidas. Na análise das entrevistas com gestantes, emergiram sete categorias que abordou temáticas diferentes, são elas:1) Conhecimento sobre HIV/AIDS, 2) Sentimento perante a descoberta do HIV/AIDS, 3) Sentimento atual, 4) Relação da família com o diagnóstico da gestante, 5) Preocupação atual, 6) Enfrentamento ao HIV/AIDS e 7) Crenças sobre si antes do diagnóstico. Ressalta-se que algumas categorias se subdividem ainda em subcategorias. Observou-se que a fala das gestantes representaram, por um lado, o conhecimento sobre o HIV/AIDS; e, por outro lado, a falta de conhecimento da doença. As gestantes apresentaram predominantemente emoções negativas bem como demonstraram oposição de sentimentos com relação à aceitação do diagnóstico positivo para o HIV/AIDS. Embora, por outro lado, apareça gestantes que se conformaram com o diagnóstico pra o HIV. Apresentaram a participação e o apoio da família à grávida no momento do diagnóstico soropositivo para o HIV/AIDS; Em muitos casos a revelação do diagnóstico é temida pela gestante; Observaramse inquietações envolvendo, em primeiro lugar, a preocupação com o bebê e a aflição por si mesma e sua condição soropositiva e pelo cuidado com a família; Devido a variedade de elementos de suporte utilizados pelas gestantes soropositivas, esta categoria foi subdivida em subcategorias Suporte Religioso , Suporte Familiar , Suporte da Equipe de Saúde do SAE/MI e Outros suportes . No tocante as crenças das gestantes sobre si antes do diagnóstico, apresentaram crenças positivas suficientemente fortes; As crenças negativas sobre si antes do diagnóstico, algumas gestantes pareceram apresentar uma vida pregressa de dificuldades. Os resultados permitiram concluir que houve contribuição da dimensão da espiritualidade como fator de enfrentamento do impacto do diagnóstico do HIV/AIDS nestas gestantes. Conclui-se que a maioria das mulheres pesquisadas citou a importância do bemestar espiritual como contribuição para o enfrentamento do diagnóstico HIV/AIDS descoberto em sua gestação.

Made available in DSpace on 2014-12-17T14:46:37Z (GMT). No. of bitstreams: 1 JammilliCD.pdf: 1430027 bytes, checksum: fdf99e39213187cd63342d6cb1ae9dee (MD5) Previous issue date: 2008-04-17 / The objective of this exploratory descriptive quantitative study was to analyze the behaviors in the detection, treatment and followup of the pregnant woman with syphilis, by health professionals that conduct the pre-natal consultation in the Family Health Strategy, as to the adherence to the recommendations of the Ministry of Health. The study was conducted in nine municipalites of the Trairi region in the state of Rio Grande do Norte. Data were collected during the months of July through September 2007, by means of a questionnaire with a population of 53 health professionals, 30 nurses and 23 physicians. Data were analyzed by descriptive statistics. The results were organized in three major items: knowledge of the health professionals about the symptomatology of syphilis and their actions in the detection of the disease; actions in the treatment of the pregnant woman with syphilis; and the actions of followup of the desease. We identified that 81,2% of the professionals have knowledge about the symptomatology of syphilis in the pregnant woman;79,2% request the VDRL exam in the adequate intervals and approximately 50% conduct the treatment in conformity with the recommendations of the Ministry of Health. For the followup care of the infected woman, 79,2% request a monthly VDRL examination, 69,8% explain the disease to the pregnant woman, and 20,7% affirm that they conduct a proper reception to the woman.We conclude that the majority of the health professionals have knowledge of the detection, treatment and followup of the pregnant woman with syphilis. However, the actions of some professionals diverge from the conduct procedures recommended by the Ministry of Health, as to the requesting of the examinations, medication prescription and notification of the iesease. This indicates the need for improved / Estudo descritivo explorat?rio com abordagem quantitativa, que tem como objetivo de verificar atendimento das recomenda??es do MS para a detec??o, tratamento e acompanhamento da gestante com s?filis nas condutas assistenciais realizadas pelos profissionais que atuam na consulta pr?-natal na ESF nos munic?pios da regi?o Trairi no Estado do Rio Grande do Norte. A pesquisa foi desenvolvida nos nove munic?pios desta regi?o. Os dados foram coletados atrav?s de um question?rio, em uma popula??o de 53 profissionais, sendo 30 enfermeiros e 23 m?dicos. Para a an?lise de dados, utilizamos freq??ncias absolutas e percentuais. Os resultados da an?lise dos dados foram organizados em tr?s grandes itens: conhecimento dos profissionais sobre a intomatologia da s?filis e suas a??es de detec??o, na gestante; a??es dos profissionais no tratamento da s?filis na gestante; a??es dos profissionais no acompanhamento de uma gestante com s?filis. Identificamos, nas afirmativas desses profissionais, que 81,2% t?m conhecimentos sobre a sintomatologia da s?filis na gestante; 79,2% solicitam o VDRL em per?odos adequados e em torno de 50% efetuam o tratamento conforme o orientado pelo Minist?rio da Sa?de; para acompanhamento da gestante infectada,79,2% solicitam o VDRL mensal, 69,8% explicam a doen?a ? gestante e 20,7% garantem a realiza??o do acolhimento a essa mulher. Conclu?mos que as a??es de alguns profissionais divergem do recomendado pelo Minist?rio da Sa?de e que necessitam de um melhor embasamento cient?fico para realizar tais a??es

Orientador: Cristina Maria Garcia de Lima Parada / Banca: Ana teresa de Abreu Ramos Cerqueira / Banca: Jamile Claro de Castro Bussadori / Resumo: Objetivou-se identificar fatores sociodemográficos, características e intercorrências gestacionais associadas à realização de cesárea eletiva e avaliar os efeitos dos tipos de parto sobre recém-nascidos cujos partos foram realizados no primeiro semestre de 2012, no município de Botucatu/SP. Estudo de abordagem epidemiológica, observacional e analítico, do qual participaram puérperas e seus recém-nascidos internados nas duas maternidades existentes no município. Os dados foram coletados nos prontuários dos binômios nas unidades de internação, nas anotações de sala de parto e cartão de pré-natal e por entrevista com as puérperas. Buscou-se identificar associação entre as variáveis independentes (idade, escolaridade, trabalho, vive com companheiro, gestação planejada, uso de drogas na gestação, pré-natal no SUS, parto no SUS, número de consultas pré-natal, hemorragia, síndrome hipertensiva, diabetes, infecção na gestação, anemia e problema emocional) e tipo de parto. A análise univariada foi realizada pelo Teste Exato de Fisher ou Qui-quadrado. Variáveis com p< 0,20 foram agrupadas em três níveis e, mediante modelo de regressão logística múltiplo, hierarquizado, identificaram-se fatores associados à cesárea eletiva, considerando-se p < 0,05. A relação entre o tipo de parto e os desfechos perinatais (necessidade de reanimação, índice de Apgar de quinto minuto inferior a sete pontos, tempo de internação e peso ao nascer) foi analisada por Modelo de Regressão Logística Múltipla ou por Regressão com Resposta Gama. Os resultados indicam que das 1.289 mulheres que participaram do estudo, 18,0% foram submetidas à cesárea eletiva, 34,5% tiveram parto vaginal e 47,5% cesárea com indicação. No modelo final hierarquizado houve associação entre cesárea eletiva e o fato da puérpera ter trabalho remunerado e ter realizado pré-natal e parto fora do Sistema Único de Saúde, indicando melhores... / Abstract: The objective was to identify sociodemographic factors, characteristics and pregnancy complications associated with elective cesarean section and evaluate the effects of mode of delivery on newborns whose birth were performed in the first half of 2012 in Botucatu/SP. Study epidemiological, observational and analytical approach, attended pregnant women and their newborn infants in the only two county hospitals. Data were collected from medical records of binomials in inpatient units, delivery room notes, prenatal card and interview with the mothers. We tried to identify associations between the independent variables (age, education, work, living with partner, planned pregnancy, drug use during pregnancy, prenatal care in the SUS, SUS delivery, number of prenatal visits, hemorrhage, hypertensive syndrome, diabetes, infection during pregnancy, anemia and emotional problem) and type of delivery. Univariate analysis was performed using Fisher's exact test or chi-square. Variables with p <0.20 were grouped into three levels and by the multiple logistic regression model, hierarchical, were identified factors associated with elective cesarean section, considering p <0.05. The relationship between mode of delivery and perinatal outcomes (need for resuscitation, Apgar score at five minutes less than seven points, length of stay and birth weight) was analyzed by multiple logistic regression model or regression with Answer Range. The results indicate that of the 1,289 women who participated in the study, 18.0% were submitted to elective cesarean section, 34.5% had vaginal delivery and 47.5% cesarean section with details. In the final model hierarchical was no association between elective caesarean section and the fact that postpartum women have paid work and have received prenatal care and childbirth outside the Health System, indicating the best conditions. The chance of resuscitation was lower among newborns whose mothers underwent previously ... / Mestre

Orientador: Iracema de Mattos Paranhos Calceron / Resumo: Justificativa: A despeito da ação, comprovada ou não, é comum a constatação de que gestantes diabéticas fazem uso de plantas popularmente conhecidas como antidiabéticas. Uma das mais citadas é a Bauhinia forficata (Pata-de-vaca). O risco está em não se conhecer seus efeitos e possíveis repercussões maternofetais. Nesse aspecto, justifica-se o interesse em verificar se o extrato aquoso de folhas de B. forficata, administrado a ratas prenhes, não-diabéticas e diabéticas, interfere na glicemia materna, na performance reprodutiva e, em especial, na freqüência de malformações fetais. Objetivo Geral: Avaliar os efeitos do extrato aquoso de folhas de Bauhinia forficata (Pata-de-vaca) sobre o metabolismo materno, a performance reprodutiva, o desenvolvimento fetal e a teratogênese na prenhez de ratas diabéticas e nãodiabéticas. Objetivos Específicos: -Comparar os níveis glicêmicos e o ganho de peso em ratas prenhes, diabéticas e não-diabéticas, tratadas ou não com o extrato aquoso de folhas de Bauhinia forficata. - Comparar as taxas de prenhez a termo e de perda pré e pós-implantação em ratas prenhes, diabéticas e não-diabéticas, tratadas ou não com o extrato aquoso de folhas de Bauhinia forficata. -Comparar o peso médio dos recém-nascidos e das placentas, o índice placentário e o percentual de recém-nascidos pequenos (PIP), adequados (AIP) e grandes (GIP) para a idade de prenhez em ninhadas de ratas prenhes, diabéticas e não-diabéticas, tratadas ou não com o extrato... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Justificative: It is well known that diabetic pregnant women often use plants that are popularly used as hypoglycemic, regardless its action is not established yet. In this set, Bauhinia forficate ("Pata-de-vaca") is one of the most mentioned. The risk using this plant lies in the fact that maternal and fetal effects, as well as its side effects, are not known. Thus, it is plausible to access whether the aqueous extract of B. forficata, administered to diabetic and non-diabetic pregnant rats, can interfere in maternal glycemia, especially in reproductive performance and fetal malformations. General goal: To investigate the effects of aqueous extract of leaves of Bauhinia forficata ("Pata-de-vaca") on maternal metabolism, reproductive performance, fetal development and teratogenicity in pregnant diabetic and non-diabetic female rats. Specific goals: • To compare glycemia levels and body weight gain in diabetic and nondiabetic pregnant female rats, treated or not with aqueous extract of... (Complete abstract, click electronic access below) / Mestre

Orientador: Marilza Vieira da Cunha Rudge / Resumo: Introdução: A nova ênfase no diagnóstico e tratamento da Diabetes Mellitus Gestacional (DMG) não é apenas para prevenir a morbidade e mortalidade perinatal, mas também representa a lacuna única de oportunidades para prover cuidados a longo prazo da mãe e do feto. Os efeitos de toda essa informação dada às mães sobre DMG no meio da gravidez e sua responsabilidade de gerenciar os fatores metabólicos intrauterinos por controle hiperglicêmico rigoroso enfrentam um estado de ansiedade e incerteza sobre problemas futuros atuais ou potenciais. Todos esses ajustes podem afetar a emoção, a mentalidade e a sexualidade aprovada pela declaração da Organização Mundial de Saúde como o direito fundamental para todas as pessoas. As dificuldades sexuais mais frequentes durante a gestação estão associadas a fatores psicológicos, físicos, relacionais, socioculturais e religiosos, bem como medos e mitos sobre a sexualidade feminina durante a gravidez. Objetivos: Este estudo foi projetado para investigar a função sexual usando índices de composição e pontuação específica do Inventário de Resposta Sexual de Gravidez (PSRI) em uma população bem categorizada de pacientes recentemente diagnosticados e sob tratamento de mulheres com Diabetes Mellitus Gestacional (GDM). Método: O presente estudo de coorte transversal foi composto por dois grupos, sendo um com 168 participantes no grupo de normoglicêmicas e outro com 108 participantes no grupo de hiperglicêmicas. Foi aplicado o questionário Pregnancy Se... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The new emphasis on the diagnosis and treatment of Gestational Diabetes Mellitus (GDM) is not only to prevent perinatal morbidity and mortality but also represents the unique gap in opportunities to provide long-term care for the mother and fetus. The effects of all this information given to mothers about GDM in the midst of pregnancy and their responsibility for managing the intrauterine metabolic factors for rigorous hyperglycemic control face a state of anxiety and uncertainty about current or potential future problems. All of these adjustments can affect the emotion, mentality and sexuality endorsed by the World Health Organization statement as the fundamental right for all people. The most frequent sexual difficulties during gestation are associated with psychological, physical, relational, sociocultural and religious factors, as well as fears and myths about female sexuality during pregnancy. Objectives: This study was designed to investigate sexual function using composite indexes and specific Pregnancy Sexual Response Inventory (PSRI) scores in a well-categorized population of newly diagnosed and under-treated women with GDM (Gestational Diabetes Mellitus). Method: The present cross-sectional cohort study consisted of two groups, one with 168 participants in the normoglycemic group and another with 108 participants in the hyperglycemic group. The Pregnancy Sexual Response Inventory (PSRI) questionnaire was applied to evaluate the sexual quality of pregnant women in th... (Complete abstract click electronic access below) / Mestre

Objectives: The purpose of this study was to examine rural women s access to maternal health information and its impact on levels of skilled healthcare utilization. Method: A qualitative study involving twenty five (25) pregnant women,five (5) Skilled healthcare providers and five (5) Traditional Birth Attendants (TBAs) was conducted in Chamwino District in Dodoma Region, Tanzania for a period of six months. Due to time and resource limitation the researcher selected two (2) of the 32 wards in the district where the problem of maternal mortality and non-utilization of skilled healthcare was most prominent. The two selected wards were Msanga and Buigiri wards. The researcher used The Health Belief Model and Theory of Planned Behaviour to develop interview questions and focus group guides as well as the interpretation of the findings. The researcher examined how variable factors e.g. maternal health literacy, individual perceptions, local knowledge and care provider-related factors affect pregnant women s health behaviours and utilization of skilled maternal services. The Data was analysed thematically using the 6-stage guide to thematic data analysis with the help of NVIvo Software. Results: The inadequate conditions of the health facilities and the poor working conditions of the care providers affected the provision of quality of maternal services and health information to pregnant women in the study area. The limited access to skilled maternal health information from skilled healthcare providers and lack of alternative sources of reliable health information led pregnant women to seek health information from their Mothers-in-laws, TBAs and other women in the society. However, there was a shortcoming of information inaccuracy as their health advice was not based on previous expert advice but rather on the personal opinion and attitude towards skilled maternal services. The limited access to maternal health information caused majority of pregnant women to underestimate the risks of pregnancy related complications and how they responded to pregnancy danger signs and other ill-health conditions that raised during pregnancy. The majority of pregnant women reported not to seek and kind of care when experienced a health problem. It was also found that during labour some would go to the TBA for childbirth and later go to the dispensary when the TBA failed while others would just go for TBAs opinion and confirmation that it was real labour then go to the health facility. This delayed women s timely access to obstetric care which is essential for positive outcome when a pregnant woman experiences a pregnancy or childbirth complications. Conclusion: The improvement of the quality of skilled healthcare services in rural areas is a prerequisite for achieving desired outcomes in maternal mortality reduction efforts in Tanzania. However, improvement of quality itself is not a panacea if pregnant women are not aware of the services, hence the healthcare providers should also focus in increasing provision of maternal health information to pregnant women. The findings show that the limited access to skilled maternal health information from healthcare providers and lack of alternative sources for reliable health information has constrained majority of these women from becoming maternal health literate hence affecting their levels of utilization of skilled maternal services. The healthcare providers and policy makers should focus on meeting the health information needs of general rural populations and enable them to become well-informed and knowledgeable to make better and well-informed maternal health decisions.

Made available in DSpace on 2015-12-10T14:23:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-02-23. Added 1 bitstream(s) on 2015-12-10T14:29:19Z : No. of bitstreams: 1 000848608.pdf: 1183884 bytes, checksum: e3b0afce67478565441233adb4ec5a37 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Objetivou-se identificar fatores sociodemográficos, características e intercorrências gestacionais associadas à realização de cesárea eletiva e avaliar os efeitos dos tipos de parto sobre recém-nascidos cujos partos foram realizados no primeiro semestre de 2012, no município de Botucatu/SP. Estudo de abordagem epidemiológica, observacional e analítico, do qual participaram puérperas e seus recém-nascidos internados nas duas maternidades existentes no município. Os dados foram coletados nos prontuários dos binômios nas unidades de internação, nas anotações de sala de parto e cartão de pré-natal e por entrevista com as puérperas. Buscou-se identificar associação entre as variáveis independentes (idade, escolaridade, trabalho, vive com companheiro, gestação planejada, uso de drogas na gestação, pré-natal no SUS, parto no SUS, número de consultas pré-natal, hemorragia, síndrome hipertensiva, diabetes, infecção na gestação, anemia e problema emocional) e tipo de parto. A análise univariada foi realizada pelo Teste Exato de Fisher ou Qui-quadrado. Variáveis com p< 0,20 foram agrupadas em três níveis e, mediante modelo de regressão logística múltiplo, hierarquizado, identificaram-se fatores associados à cesárea eletiva, considerando-se p < 0,05. A relação entre o tipo de parto e os desfechos perinatais (necessidade de reanimação, índice de Apgar de quinto minuto inferior a sete pontos, tempo de internação e peso ao nascer) foi analisada por Modelo de Regressão Logística Múltipla ou por Regressão com Resposta Gama. Os resultados indicam que das 1.289 mulheres que participaram do estudo, 18,0% foram submetidas à cesárea eletiva, 34,5% tiveram parto vaginal e 47,5% cesárea com indicação. No modelo final hierarquizado houve associação entre cesárea eletiva e o fato da puérpera ter trabalho remunerado e ter realizado pré-natal e parto fora do Sistema Único de Saúde, indicando melhores... / The objective was to identify sociodemographic factors, characteristics and pregnancy complications associated with elective cesarean section and evaluate the effects of mode of delivery on newborns whose birth were performed in the first half of 2012 in Botucatu/SP. Study epidemiological, observational and analytical approach, attended pregnant women and their newborn infants in the only two county hospitals. Data were collected from medical records of binomials in inpatient units, delivery room notes, prenatal card and interview with the mothers. We tried to identify associations between the independent variables (age, education, work, living with partner, planned pregnancy, drug use during pregnancy, prenatal care in the SUS, SUS delivery, number of prenatal visits, hemorrhage, hypertensive syndrome, diabetes, infection during pregnancy, anemia and emotional problem) and type of delivery. Univariate analysis was performed using Fisher's exact test or chi-square. Variables with p <0.20 were grouped into three levels and by the multiple logistic regression model, hierarchical, were identified factors associated with elective cesarean section, considering p <0.05. The relationship between mode of delivery and perinatal outcomes (need for resuscitation, Apgar score at five minutes less than seven points, length of stay and birth weight) was analyzed by multiple logistic regression model or regression with Answer Range. The results indicate that of the 1,289 women who participated in the study, 18.0% were submitted to elective cesarean section, 34.5% had vaginal delivery and 47.5% cesarean section with details. In the final model hierarchical was no association between elective caesarean section and the fact that postpartum women have paid work and have received prenatal care and childbirth outside the Health System, indicating the best conditions. The chance of resuscitation was lower among newborns whose mothers underwent previously ... / FAPESP: 2013/02747-6