Orientador: Milva Maria Figueiredo De Martino / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-11T22:18:36Z (GMT). No. of bitstreams: 1 Viduedo_AlecssandradeFatimaSilva_M.pdf: 1985853 bytes, checksum: 7f1e28b659a677aa44b25d03387ce7cd (MD5) Previous issue date: 2007 / Resumo: Este estudo teve como propósito Analisar o ciclo vigília-sono de gestantes nos três trimestres de gestação, o cronótipo e a associação com os trimestres gestacionais. Foi no Centro de Saúde Dr. Lourenço Quillici em Bragança Paulista, SP. Tratou-se de um estudo descritivo, exploratório e transversal. A coleta de dados foi realizada durante seis meses e para tal foram utilizados três instrumentos de coleta de dados: Ficha de caracterização da amostra,questionário de identificação de indivíduos matutinos e vespertinos que eram preenchidos imediatamente após a aceitação da gestante em participar da pesquisa, e o diário de sono onde as gestantes que eram orientadas a respondê-los durante quatro semanas e devolvê-los totalmente preenchidos, os dados foram submetidos a testes estatísticos de acordo com a natureza da variável. A amostra foi composta por 62 gestantes que foram dividas em trimestres gestacionais, havia 21 no primeiro trimestre, 31 no segundo e 10 no terceiro, matriculadas no pré-natal de baixo risco, tinham idade de 15 a 39 anos, 46% tinham de 9 a 11 anos de estudo, 67,7% eram brancas, a maioria 53,2% tinham como ocupação o lar, 24 trabalhavam e 5 estudavam e dessas 69% era em período integral, 48,4% da amostra tinha cronótipo indiferente, as gestantes de todos os trimestres iam deitar-se aproximadamente às 22h, a diferença foi o período de latência, as gestantes do primeiro trimestre dormiam em cerca de 13 minutos mais rápido do que as do terceiro, a média de horas de sono das gestantes foi diminuindo de acordo com o aumento da idade gestacional 512,7minutos no primeiro trimestre, até 416 para o último trimestre, a qualidade de sono também vai diminuindo do primeiro para o terceiro trimestre 8,1 ;7,3; 7.4 respectivamente, para sanar a má qualidade de sono, as gestantes de terceiro trimestre tem maior quantidade de minutos que cochila durante o dia em média 109,4 minutos por dia, contra 79 minutos nas de primeiro, as de cronótipo moderadamente vespertinas, as de faixa etária entre 30 a 35 e as que trabalham no período da manhã tem melhor qualidade de sono,.Espera-se que o resultado dessa pesquisa possa nortear novas pesquisas na área a fim de contribuir para saúde de sono das gestantes. / Abstract: The porpouse of this study was to identify the sleep-wakefulness of pregnant in three trimester of pregnancy, the links between chronotype and pregnant trimester. It was performed at the Central of Health Dr. Lourenço Quillici in the city of Bragança Paulista, S.P. It was based on dexcriptive, exploratory anda transversal study. The collection of datas was made during six month through of three questionnarie: individual index, a self-assesment questionnarie to determine morningness-eveningness in human circadian rhythms it was filled after pregnant to agree to participate of the research and the sleep log, the pregnants was orientate to answer through of four weeks and return it all filled. The informations was analyse depends of datas. The sample was composed by 62 pregnants that was slip up between pregnancy trimesters, 21 in the first trimester, 31 in the second and 10 in the third trimester, register in low riscky care labor, that was between 15 and 39 years old, 46% had studied between 9 and 11 years, 67,6% was white, the majority 53,2% that was house keep, 24 of them worked and 5 studied, that 69% all day, 48,4% among of pregnants was chronothype "indiffernt", the hour that pregnats went to the bed was similar, around 22h , the diference was latency of the sleep, in the first trimester them fall sleep 13 min faster than pregnant of the third trimester, descresed total of sleep time according incresed weeks of pregnancy, 512,7 min. To the first trimester until 416 min to the third trimester, quality of sleep descrese from the first trimester to the third trimester 8,1; 7,3; 7,4 respectivty, the pregnanty of third trimester had major minutes of naps 109,4 min each day in middle and 79 min to the first trimester , the chronotype "moderately morning" was frequently among 30 and 35 years old, the pregnants was worked in the morning shift had better quality of sleep. Wish results of this research help to the sleep of pregnants. / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-03-24T18:21:22Z No. of bitstreams: 1 alinedasilvaoliveira.pdf: 2644511 bytes, checksum: 075c9907b7ac1bd99e63265f480197dd (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-03-27T17:55:53Z (GMT) No. of bitstreams: 1 alinedasilvaoliveira.pdf: 2644511 bytes, checksum: 075c9907b7ac1bd99e63265f480197dd (MD5) / Made available in DSpace on 2017-03-27T17:55:53Z (GMT). No. of bitstreams: 1 alinedasilvaoliveira.pdf: 2644511 bytes, checksum: 075c9907b7ac1bd99e63265f480197dd (MD5) Previous issue date: 2009-08-06 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O conhecimento da prevalência de doenças bucais em gestantes pode subsidiar o planejamento de ações e programas específicos para a promoção da saúde da mãe e de seu filho. Este estudo transversal determinou a prevalência de cárie dentária e doença periodontal, necessidades de tratamento, e fatores de risco associados, em gestantes usuárias do serviço público de Juiz de Fora, MG. Foram incluídas 312 gestantes, com idade entre 13 e 43 anos, após cálculo amostral. Condição dentária e periodontal, e necessidades de tratamento foram determinadas por meio do índice de condição dentária e necessidade de tratamento (ICDNT), índice de dentes permanentes cariados, perdidos e obturados (CPO-D), índice periodontal comunitário de necessidade de tratamento (CPITN) e perda de inserção periodontal (PIP). A análise estatística incluiu o teste Qui-quadrado e análise de regressão logística, com nível de significância de 5%. A prevalência de cárie dentária foi 96,5%; 71,5% da amostra apresentaram necessidade de tratamento. O índice CPOD médio foi 10,79. Demonstrou-se associação entre lesões de cárie e etnia (OR=1,7; IC95%: 1,1-2,9), escolaridade (OR=2,4; IC95%: 1,3-4,5), ter mais de um filho (OR=2,0; IC95%: 1,1-3,9) e realizar até duas escovações diárias (OR=3,2; IC95%: 1,5-7,0). A ocorrência de enjoos comportou-se como fator de proteção (OR=0,7; IC95%: 0,5-0,9). A prevalência de doença periodontal foi 87,5%; 82% da amostra apresentaram necessidade de tratamento. A presença de doença periodontal associou-se à baixa escolaridade (OR=2,8; IC95%: 1,1-7,5) e à não utilização de fio dental (OR=1,8; IC95%: 1,1-2,8). A gravidade da doença periodontal associou-se à residência em região mais populosa (OR=3,7; IC95%: 1,9-7,3), baixa escolaridade (OR=3,2; IC95%: 1,6-6,3), ser multigesta (OR=2,7;IC95%: 1,2-6,3) e hipertensa (OR=2,6; IC95%: 1,1-6,2). Os resultados obtidos reforçam a necessidade de implementação de estratégias educativo-preventivas dirigidas às gestantes e de garantia de acompanhamento odontológico como parte do programa de pré-natal do Sistema Único de Saúde. / The knowledge of the prevalence of oral diseases in pregnant women supports action planning and specific programs directed to them in order to promote the health of the mother and child. This cross-secctional study determined the prevalence of dental caries and periodontal disease, needs for treatment and risk factors in pregnant public service users from Juiz de Fora, MG. A total of 312 pregnant women with ages between 13 and 43 was included after sample estimates. Dental and periodontal conditions and treatment needs were determined by the index of dental condition and treatment needs (ICDNT), index of decayed, missing and filled permanent teeth (DMF-T), Community Periodontal Index of Treatment Needs (CPITN), and clinical attachment loss (CAL). The statistical analysis included Chisquare test and logistic regression analysis. The statistical significance level was set at 5%. The prevalence of dental caries was 96.5%; 71.5% of the sample presented the need for treatment. The mean DMF-T was 10.79. The logistic model showed an association between the presence of caries lesions and ethnic groups (OR=1.7; CI95%: 1.1-2.9), education status (OR=2.4; CI95%: 1.3-4.5), having more than one child (OR=2.0; CI95%: 1.1-3.9) and toothbrushing up to least twice a day (OR=3.2; CI95%: 1.5-7.0). The occurrence of nausea acted as a protection factor against the disease (OR= 0.7; CI95%: 0.5-0.9). The prevalence of periodontal disease was 87.5%; 82% of the sample presented the need for treatment. The presence of periodontal disease was associated to low education status (OR=2.8; CI95%: 1.1-7.5) and the non use of dental floss (OR=1.8; CI95%: 1.1-2.8). The severity of periodontal disease was associated to living in more populated regions (OR=3.7; CI95%: 1.9-7.3), low education status (OR=3.2; CI95%: 1.6-6.3), having child (OR=2.7; CI95%: 1.2-6.3) and being hypertensive (OR=2.6; CI95%: 1.1-6.2). The results reinforce the need for educational-preventive strategies for pregnant women and the guarantee of dental follow-up, as part of the pre-natal program of Public Health Service (Sistema Único de Saúde).

Magister Public Health - MPH / Background: The advent of antiretroviral therapy (ART) has significantly redefined the course of the HIV pandemic making HIV, a chronic illness rather than a death sentence. To maximize the efficacy of ART in improving survival rates of HIV/AIDS patients, lowering the incidence of opportunistic infections, reducing HIV transmission and minimizing the possibilities of developing drug resistance, long-term retention in care is critical. In South Africa, poor retention in care of 32% has been noted in women who were initiated on ART during pregnancy as compared to 13% in non-pregnant women initiated on ART. However, little is known in Swaziland about the retention in care in women who were initiated on ART during pregnancy and the factors that influence retention in care among this category of women. Aim: To determine the factors associated with poor retention in care among women initiated on ART during pregnancy at King Sobhuza II Public Health Unit (PHU) in Swaziland. Methodology: A quantitative, retrospective cohort review of 316 medical records of women who were initiated on ART during pregnancy from January 2012 to December 2013 was conducted. A data extraction sheet was used to collect data from the files of patients who were initiated on ART during pregnancy. The dataset was imported into IBM SPSS Statistic 20 Software for analysis. Bi-variate analysis was done to determine risk factors associated with retention in ART care at ART initiation and on the last ART refill visit. Kaplan-Meier analysis was used to determine retention in care at 6, 12, 24 and 36 months. Cox proportional hazards models were then used to determine factors associated with poor retention. Results: The overall retention rate of women who were initiated on ART during pregnancy at the PHU after a median duration on ART of 25.80 months [interquartile range (IQR): 16.70 – 30.98] of follow up was 74.1% (n=316). Most women initiated on ART during pregnancy (52.4%) became lost to follow up after giving birth as compared to 47.6% who became lost to follow up before giving birth. After 6 months on ART, the lost to follow up rate was 16.5% (n=316); but increased to 20.9% (n=316), 23.5% (n=243) and 26.9% (n=52) after 12, 24 and 36 months respectively. On the ART initiation visit, the factors associated with retention in care for pregnant women included being married, having the partner on ART, disclosing one’s HIV status to the partner, not drinking alcohol, being a non-smoker and reporting no financial challenges. In addition, on the last ART refill visit, the risk factors for retention in care for women initiated on ART during pregnancy were having the ART regimen changed, having regular CD4 cell count done, rise in CD4 cell count, good adherence on ART and use of contraceptive other than the condom for family planning after delivery. Conclusion: The retention in care for women who were initiated on ART during pregnancy was found to be lower than in the general adult population. However, the study findings on retention in care are similar to what has been found in other settings. The factors influencing poor retention also mirror those found in the other parts of sub-Saharan Africa. Whilst decentralisation of ART services improves ART coverage it should be coupled with strategies aimed at improving patient retention.

Magister Curationis - MCur / The use of health education during antenatal care of pregnant women has been a commonly used strategy in improving maternal health worldwide. However the health education strategy sometimes does not prove to be effective in promoting maternal health, especially in Sub-Sahara Africa.

D.Cur. (Psychiatric Nursing Science) / The overall goal of this research study was to explore and describe strategies in order to promote the mental health of married couples throughout the ante- and postnatal period. The majority of research on the transition to parenthood has found that as couples become parents, there is a dramatic decrease in positive marital interchanges, a dramatic increase in marital conflict and a precipitous decline in marital satisfaction (Belsky & Kelly, 1994; Belsky & Pensky, 1988: 133-156; Belsky, Spanier & Rovine, 1983: 567-577). The transition to parenthood is viewed as instigating a shift in the marriage whereby most couples are expected to experience a qualitative change in their relationship that is relatively abrupt (Pancer, Pratt, Hunsberger & Gallant, 2000: 253-280). Becoming a new parent poses challenges for nearly every married couple (Curran, Hazen, Jacobvitz & Feldman, 2005: 189). Becoming a parent is a major developmental transition of adulthood (Harwood, McLean & Durkin, 2007: 1). Individuals often have optimistic expectations about parenthood, yet this transition also presents a number of challenges (Harwood et al, 2007: 1). The questions that arose was what are the stories of married couples throughout the ante- and postnatal period of their first child, and what can be done by an advanced psychiatric nursing practitioner to promote the mental health of married couples based on their story. The researcher utilised a qualitative, explorative, descriptive and contextual study design as described in Babbie (2010: 92). This research study was carried out in four phases. During the first phase of this research study, the researcher explored and described the stories of married couples throughout the ante- and postnatal period of their first child according to the quest narrative method described by Frank (1997: 115). The results were discussed within relevant literature. iv In the second phase of this research study the researcher developed a conceptual framework on the basis of the empirical data. The conceptual framework was developed according to the concepts as proposed by Dickoff, James and Wiedenbach (1968: 435). The researcher described strategies, to promote the mental health of married couples throughout the ante- and postnatal period of their first child, in the third phase of this research study. These strategies were described according to a relationship phase, a working phase and a termination phase as part of the facilitation process. These three phases were discussed as part of a proposed facilitation process that forms part of the developed conceptual framework. In the fourth phase of this research study, the developed strategies were subjected to expert assessment according to the criteria stated by Chinn and Kramer (2011: 196-205). The findings of the research study are applicable to psychiatric nursing practice, research and psychiatric nursing education.

Master of Public Health - MPH / 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. / South Africa

Master of Public Health - MPH / Studies have shown that pregnant women do understand and value information of their unborn child. However, those providing health promotion services often focus on medical procedures and health education messages, ignoring the cultural, socio-economic and psychological dimensions that impact on women's health. This research aimed to look at a specific component of health promotion, i.e. health promotion messages shared with pregnant women attending Stellenbosch and Klapmuts Community Health Centre Antenatal Health Promotion Programme and their perceptions of how they apply messages in their daily lives. / South Africa

Magister Scientiae (Medical Bioscience) - MSc(MBS) / Tobacco smoking remains one of the leading causes of death worldwide. Despite all the efforts made by governments, researchers and communities to educate women about the dangerous effects of tobacco smoke and nicotine, smoking during pregnancy continues to be a common habit and accounts for a significant percentage of fetal morbidity and mortality. The offspring is, as a result, exposed to nicotine through the blood and the milk of the mother. Nicotine is therefore expected to interact with the developing fetus and the offspring of mothers who smoke or use Nicotine Replacement therapy for smoking cessation, resulting in the interference with normal fetal lung development. Maternal cigarette smoke or nicotine exposure produces adverse effects in the lungs of offspring, these include; intrauterine growth retardation, low birth weight, premature birth, reduced pulmonary function at birth, and a high occurrence of respiratory illnesses after birth. The main objectives of this study were to determine: 1) the effects of maternal nicotine exposure during gestation and lactation on lung development in the offspring, 2) if there is evidence of premature aging of the lungs of the lungs of the nicotine exposed offspring, and 3) whether tomato juice can have protective effects on the fetal lung development and function in the offspring. From the study, it was established that maternal nicotine exposure had no significant effect on the growth parameters of the offspring. However, it results in the late onset of gradual parenchymal damage which resembles premature aging. The study also found that the consumption of tomato juice may have protective effects on the premature aging of the lungs of the offspring. / South Africa

Magister Scientiae Dentium - MSc(Dent) / The aim of the research was to determine oral health status, knowledge, attitude and practicesv regarding oral hygiene among pregnant women attending Omdurman Maternity Hospital in Khartoum, Sudan.

Previously, our workplaces were characterised by serious hardships emanating from labour laws which did not always cater for all areas of the employment relationship. South African female employees were without a clear legitimate remedial right precluding any severe violation and infringement to their fundamental rights resulting from their pregnancy; a task they did not opt for in the first place, but was instead, naturally imposed on them as a result of their gender category. Undoubtedly, many female employees were victims of unfair discrimination. The legislature therefore saw it fit to democratise the workplace by making rapid statutory interventions. As a result, a number of significant changes in various spheres of our labour laws were brought in. Amongst the greatly notable valuable changes was the introduction of the Employment Equity Act 55 of 1998. This piece of legislation has generally reformed our industrial society by bringing in the elimination of unfair discrimination and thereby enhancing the principle of equity in the workplace. The act has further touched a place within hearts of female employees for fear of discrimination as a result of their pregnancy status or any reasons related to their pregnancy. The act further codified Industrial Court decisions that were already established under the discrimination law jurisprudence from the Labour Relations Act 28 of 1956. The application of the provisions of the Act has made the employment relationship no longer to be a comfort zone for employers. These general changes to the law also impact on the dismissal law regime. The purpose of this treatise is to give an overview of the applicable legislation and contributions made by the Labour Courts in developing pregnancy dismissal and discrimination law. The Labour Courts have handed down few judgements that have helped in clarifying the provisions of both the current Labour Relations Act and the Employment Equity Act around the topic. One should hasten to say that this has never been a smooth process by the courts. It is further shown in this treatise that some of the court decisions were not well accepted in the light of other important considerations, such as the equality provisions of the Constitution. For the purpose of effectively dealing with this topic, this treatise contains a discussion of the historical context of discrimination law in the form of common-law position, and the discrimination law before the Bill of Rights and the Constitution. It then endeavours to identify the legislative provision of the Act when it comes to discrimination law provisions. At the same time the important court decisions that were made are identified and examined.