Syftet med studien är att utforska och förstå de resonemang lesbiska par begagnar sig av i beslutsfattandet om reproduktionsmetod. Här ingår även berättelser kring de erfarenheter paren har av möten med professionella inom svensk sjukvård och myndighetsutövning. Studien består av tio intervjuer med lesbiska par, vilka har fått barn inom den offentliga sjukvården sedan detta blev tillgängligt den 1 juli år 2005. Materialet har analyserats med hjälp av kvalitativ metod i det diskursanalytiska fältet. Resultatet visar att parens beslut har föregåtts av en process där alternativ har vägts mot varandra. Här återfinns två typer av tolkningsrepertoarer där svensk sjukvård har fått företräde på grundval av externa omständigheter. Den ena kretsar kring ett samhällsperspektiv där olika juridiska faktorer används retoriskt för att framhäva valet som rimligt. Den andra utgår ifrån ett familjeperspektiv, där det externa synliggörs genom konsekvenserna de får för den egna familjebilden.  Resultatet visar samtidigt på de erfarenheter paren har av att genomföra assisterad befruktning i Sverige. Dels beskrivs upplevelserna utifrån utsatthet, där rollen som vårdtagare och homosexuell framställs som en dubbel sårbarhet. Dels framkommer resonemang om acceptans, genom vilken paren hanterar och föregår bristande bemötande med olika argument som reducerar potentiella stressorer.

Text in Afrikaans / Die doel van die studie was om 'n model te ontwikkel vir openbare bibiioteekdiensiewering in 'n ontwikkelende land met 'n multikulturele samelewing. Die kernprobleem was om die teoretiese fundering van dienslewering en die toepassing daarvan in die praktyk te ondersoek. Die eerste subprobleem was om die eienskappe van 'n professie en professionele dienslewering te ondersoek. Die eienskappe van die professionalis/bibiiotekaris wat leiding aan die gebruiker moet gee, is geidentifiseer. Sleutelelemente is: outonomie (gekoppel aan deskundigheid en opieiding), 'n altruistiese diensorientasie en funksionele diens (volgens professionele riglyne en standaarde) aan alle groepe in die gemeenskap, ongeag sosiale kias. Die tweede subprobleem was om die doelstellings en funksies van die openbare biblioteek en die roi van gebruikersleiding daarin te ontleed. Daar is gevind dat diensleweringsfunksies in die teorie swak gefundeer is. 'n Kategorisering is voorgestel wat onderskei tussen ondersteuningsfunksies, diensleweringsfunksies en bestuursfunksies. Gebruikersleiding is geidentifiseer as oorkoepelende begrip en kernelement van alle diensleweringsfunksies wat gerig is op die optimalisering van die waarde van inligting tot beswil van die samelewing. Die derde subprobleem was om die ontstaan van 'n diensbegrip in die openbare biblioteek te beskryf en paradigmaverskuiwings uit te wys. Professionele riglyne, beginsels en standaarde, is ontleed. Afleidings is gemaak oor 'n heersende diensbegrip en rol van die openbare biblioteek. Daar is bevind dat die riglyne vir die identifisering van gebruikersgroepe en hulle behoeftes asook diensleweringsfunksies ontoereikend is. 'n Kategorisering van potensiele gebruikersgroepe en hul behoeftes is gedoen en 'n model vir openbare biblioteekdiensiewering ontwikkel om die leemte in teoretisering te vul. Die model onderskei 'n diensparadigma van dienslewering aan alie individue en groepe in die gemeenskap en missie van ontwikkeling; die primere doeiltelling opvoeding; beginsels van gemeenskapskontak; behoeftebepaling en toegang lot inligting; diensfunksies en uitreikaktiwiteite; die professionalis-klientverhouding; wetgewing, organisatoriese strukture en omgewingsfaktore. Die model is in 'n vraelysopname in die Suid-Afrikaanse openbare biblioteekpraktyk getoets. Daar is bevind dat die doelsteliings nagestreef en diensfunksies toegepas word. Die grootste probleme word in organisatoriese strukture en finansiering ondervind. Hierdie sake moet dringend aandag kry om die gestelde missie, naamlik om 'n wesenlike rol te speel in die ontwikkeling van die hele Suid-Afrikaanse samelewing, te verwesenlik. / The purpose of the study was to develop a model for public library service rendering in a developing and multicultural society. The core problem was to investigate the theoretical foundation of service rendering and the application thereof in practice. The first subproblem was to examine the characteristics of a profession and professional service rendering. The characteristics of the professional/ librarian who has to provide guidance to the user were identified. Key elements are: autonomy (linked to expertise and training), an altruistic service orientation and functional service (according to professional guidelines and standards) to all groups in the community irrespective of social class. The second subproblem was to analyse the aims and functions of the public library and the role of user guidance in it It was found that service rendering functions are not theoretically well grounded. A categorisation is proposed which distinguishes between supporting, service rendering and management functions. User guidance is identified as an umbrella concept and core element of all service rendering functions which is directed at optima/isirtg the value of information to the benefit of society. The third subproblem was to describe the origins of a service concept in the public library and to expose paradigm shifts. Professional guidelines, principles and standards were analysed. Conclusions were drawn about a predominant service concept and the role of the public library. It was found that guidelines for the identification of user groups and their needs as well as service rendering functions are inadequate. A categorisation of potential user groups and their needs was compiled and a model for public library service rendering was developed to bridge the gap in XXtheorisation. The model distinguishes a paradigm of service to all Individuals and groups in the community and a developmental mission; the primary aim of education; service principles of community networking, needs assessment and information access; service functions and outreach activities; the professionalclient- relationship; legislation, organisational structures and environmental factors. The model was tested in South African public library practice by means of a questionnaire survey. It was found that aims are pursued and service functions are applied. The greatest problems are experienced In organisational structures and financing. These issues must be urgently addressed to realise the public library's declared mission, namely to play a substantial role in the development of the South African society as a whole. / Information Science / D. Litt. et Phil. (Information Science)

This study investigates the history of the phenomenon illiteracy and the response of the public library in selected countries for about one hundred and fifty years with particular focus on the Republic of south Africa. The influence that this manifestation has on the individual Black urban adult, the society in which the illiterate adult lives and the economy of the country are sharply focused. The principal argument is that public libraries have historically adapted their services to meet new social challenges, and in South Africa illiteracy among Black urban adults constitutes such a challenge. As an extension of its traditional educational function, the public library is beginning to meet this challenge in the role of literacy support. The reasons for the high illiteracy rate among the Black adult urban population are discussed in their historical context. As far as the methodology is concerned, extensive literature studies were undertaken on international as well as local data bases. Correspondence was entered into with overseas research institutes, academics and consultants. Interviews were conducted to ascertain the most recent developments relating to the literacy problem in a well-defined geographical region. Conclusions are made to the effect that there is a historical imperative for the South African public library system to fully discharge its responsibility to Black South Africans. In order to achieve this the public library in South Africa should re-examine, re-interpret and extend its educational function to include the challenge of the role of literacy support. It is further reconunended that the Provincial Library services in south Africa should coordinate disparate efforts and activities in this regard. The marketing of the public library has become more important in the prevailing economic climate. If the public library wishes to remain an indispensable social institution in the lives of the citizens of South Africa and specifically if it takes the role of literacy support seriously, it will of necessity have to market its services. Other organizational implications for public libraries of this new challenge of literacy support are spelled out clearly and areas requiring further research are indicated. / Information Studies / D. Litt. et Phil.

Text in Afrikaans / Die doel van die studie was om 'n model te ontwikkel vir openbare bibiioteekdiensiewering in 'n ontwikkelende land met 'n multikulturele samelewing. Die kernprobleem was om die teoretiese fundering van dienslewering en die toepassing daarvan in die praktyk te ondersoek. Die eerste subprobleem was om die eienskappe van 'n professie en professionele dienslewering te ondersoek. Die eienskappe van die professionalis/bibiiotekaris wat leiding aan die gebruiker moet gee, is geidentifiseer. Sleutelelemente is: outonomie (gekoppel aan deskundigheid en opieiding), 'n altruistiese diensorientasie en funksionele diens (volgens professionele riglyne en standaarde) aan alle groepe in die gemeenskap, ongeag sosiale kias. Die tweede subprobleem was om die doelstellings en funksies van die openbare biblioteek en die roi van gebruikersleiding daarin te ontleed. Daar is gevind dat diensleweringsfunksies in die teorie swak gefundeer is. 'n Kategorisering is voorgestel wat onderskei tussen ondersteuningsfunksies, diensleweringsfunksies en bestuursfunksies. Gebruikersleiding is geidentifiseer as oorkoepelende begrip en kernelement van alle diensleweringsfunksies wat gerig is op die optimalisering van die waarde van inligting tot beswil van die samelewing. Die derde subprobleem was om die ontstaan van 'n diensbegrip in die openbare biblioteek te beskryf en paradigmaverskuiwings uit te wys. Professionele riglyne, beginsels en standaarde, is ontleed. Afleidings is gemaak oor 'n heersende diensbegrip en rol van die openbare biblioteek. Daar is bevind dat die riglyne vir die identifisering van gebruikersgroepe en hulle behoeftes asook diensleweringsfunksies ontoereikend is. 'n Kategorisering van potensiele gebruikersgroepe en hul behoeftes is gedoen en 'n model vir openbare biblioteekdiensiewering ontwikkel om die leemte in teoretisering te vul. Die model onderskei 'n diensparadigma van dienslewering aan alie individue en groepe in die gemeenskap en missie van ontwikkeling; die primere doeiltelling opvoeding; beginsels van gemeenskapskontak; behoeftebepaling en toegang lot inligting; diensfunksies en uitreikaktiwiteite; die professionalis-klientverhouding; wetgewing, organisatoriese strukture en omgewingsfaktore. Die model is in 'n vraelysopname in die Suid-Afrikaanse openbare biblioteekpraktyk getoets. Daar is bevind dat die doelsteliings nagestreef en diensfunksies toegepas word. Die grootste probleme word in organisatoriese strukture en finansiering ondervind. Hierdie sake moet dringend aandag kry om die gestelde missie, naamlik om 'n wesenlike rol te speel in die ontwikkeling van die hele Suid-Afrikaanse samelewing, te verwesenlik. / The purpose of the study was to develop a model for public library service rendering in a developing and multicultural society. The core problem was to investigate the theoretical foundation of service rendering and the application thereof in practice. The first subproblem was to examine the characteristics of a profession and professional service rendering. The characteristics of the professional/ librarian who has to provide guidance to the user were identified. Key elements are: autonomy (linked to expertise and training), an altruistic service orientation and functional service (according to professional guidelines and standards) to all groups in the community irrespective of social class. The second subproblem was to analyse the aims and functions of the public library and the role of user guidance in it It was found that service rendering functions are not theoretically well grounded. A categorisation is proposed which distinguishes between supporting, service rendering and management functions. User guidance is identified as an umbrella concept and core element of all service rendering functions which is directed at optima/isirtg the value of information to the benefit of society. The third subproblem was to describe the origins of a service concept in the public library and to expose paradigm shifts. Professional guidelines, principles and standards were analysed. Conclusions were drawn about a predominant service concept and the role of the public library. It was found that guidelines for the identification of user groups and their needs as well as service rendering functions are inadequate. A categorisation of potential user groups and their needs was compiled and a model for public library service rendering was developed to bridge the gap in XXtheorisation. The model distinguishes a paradigm of service to all Individuals and groups in the community and a developmental mission; the primary aim of education; service principles of community networking, needs assessment and information access; service functions and outreach activities; the professionalclient- relationship; legislation, organisational structures and environmental factors. The model was tested in South African public library practice by means of a questionnaire survey. It was found that aims are pursued and service functions are applied. The greatest problems are experienced In organisational structures and financing. These issues must be urgently addressed to realise the public library's declared mission, namely to play a substantial role in the development of the South African society as a whole. / Information Science / D. Litt. et Phil. (Information Science)

This study investigates the history of the phenomenon illiteracy and the response of the public library in selected countries for about one hundred and fifty years with particular focus on the Republic of south Africa. The influence that this manifestation has on the individual Black urban adult, the society in which the illiterate adult lives and the economy of the country are sharply focused. The principal argument is that public libraries have historically adapted their services to meet new social challenges, and in South Africa illiteracy among Black urban adults constitutes such a challenge. As an extension of its traditional educational function, the public library is beginning to meet this challenge in the role of literacy support. The reasons for the high illiteracy rate among the Black adult urban population are discussed in their historical context. As far as the methodology is concerned, extensive literature studies were undertaken on international as well as local data bases. Correspondence was entered into with overseas research institutes, academics and consultants. Interviews were conducted to ascertain the most recent developments relating to the literacy problem in a well-defined geographical region. Conclusions are made to the effect that there is a historical imperative for the South African public library system to fully discharge its responsibility to Black South Africans. In order to achieve this the public library in South Africa should re-examine, re-interpret and extend its educational function to include the challenge of the role of literacy support. It is further reconunended that the Provincial Library services in south Africa should coordinate disparate efforts and activities in this regard. The marketing of the public library has become more important in the prevailing economic climate. If the public library wishes to remain an indispensable social institution in the lives of the citizens of South Africa and specifically if it takes the role of literacy support seriously, it will of necessity have to market its services. Other organizational implications for public libraries of this new challenge of literacy support are spelled out clearly and areas requiring further research are indicated. / Information Studies / D. Litt. et Phil.

PhDRDV / Institute for Rural Development / Providing access to knowledge and connecting it to the needs of individuals as well as grassroots community have always been at the centre of the mission and purpose of public libraries. Numerous studies conducted in various parts of the world have shown that public libraries are the anchor of the lives of communities where they are established. These studies have revealed that information needs may not be the same for different age groups and for different genders. For that reason many countries have been investing in the establishment of community libraries. In South Africa, a community libraries conditional grant was introduced in 2007 to build capacity for public libraries through building additional libraries and renovating existing ones so that they provide information that will satisfy information needs of all community members. However, there are still concerns about the functionality of public libraries and need to strengthening their capacity so that they adequately address community information. This study was conducted on rural community libraries in Mutale located in the Vhembe District of Limpopo Province, South Africa. The main objective was to develop a model for enhanced functionality of public libraries for rural community development. The study was conceptualized around the ecological framework (Asselin and Doiron, 2014). The specific objectives were: to identify challenges faced by the library in providing services to adults, youth and children: to establish if information needs of adults, youth and children varied due to age, and to assess the level of satisfaction of adults, youth and children with the services of the local public library. The study used an exploratory sequential mixed method design with the qualitative phase preceding the quantitative phase. The qualitative phase had two phases. In the first, phase fourteen key informants were purposefully selected and engaged in face-to-face interviews as well as one focus group. Qualitative data from this phase were analysed using atlas.ti version 8. Results distilled showed that the library was hampered by centralized library services which were run from the district level, insufficient funding, inadequate library operating hours and lack of ICT support. In the second phase, a total of 150 adults, youth and children were purposefully selected and engaged in face-to-face interviews as well as focus group discussions. An interview guide complimented by camera, and voice recorder were used to collect data from the respondents. Atlas ti version 8 was used to analyse the data. The results showed that information needs of the community were not fully met by provisions in the library. A variety of information resources expected to satisfy the needs of adults, youth and children respectively include increased number of computers with internet connection, extended library opening hours including Saturdays , stakeholder engagement to be recognized, the extensive marketing of the library for it to be used by the community and the need to improve the amenities and library infrastructure. Results obtained in the qualitative phase of the study informed the second quantitative phase . During this phase, an evaluative survey was conducted with adults, youth and children. Convenience and snowballing techniques were used to sample 176 respondents. A questionnaire with a Likert-type ranking scale was used to collect data. The International Business Machines, Statistical Product and Service Solutions (IBM SPSS) version 24 was used to analyse the data. Chi Square and Crammer’s V tests were performed on the data. It was established that more female (59%) than male (41%) respondents used the library. Of the respondents engaged 26% o were children; 30% were youth and 55% were adults. In terms of travelling to access the library services 32% of the respondents travels less than two kilometers while 68% travel more than two kilometers. This indicates that the majority of the users have a challenge of accessing the library due to distance. The majority of the respondents (70%) did not use the library frequently, with only 30% being active library users. Significant differences in accessing library services were observed according to age in terms of “Current books on all subjects”, “Major reference works such as Encyclopaedias and dictionaries”, “Books on arts and crafts”, “Audio-visual materials” and “Electronic databases”. No significant differences according to gender were observed on all aspects on availability of materials except for “Children’s materials”. Only the perception on availability of “Current books on all subjects” showed a moderate relationship across age (based on the Cramer’s V value >.3). However, on all the aspects where the results showed an association by age and gender the relationship was deemed weak as demonstrated by Cramer’ V values (<.3). Generally, all the respondents (adults, youth and children) were not satisfied with the ICTs, availability of information and available services and amenities. Chi-square tests showed no significant associations between age and perceptions on ICT resources of an ideal library, available services, available amenities, marketing of library services, availability of materials in the library and type of information needed to make informed decisions. These results imply that for the library to provide unhindered services, there must be an enabling environment for the smooth running of the library. There is a need for government to review the policy of running the libraries from districts, as this negatively impacts on opening hours, acquisitions of materials and ICTs support. The library needs to do a periodic survey of the information needs of the community so that it responds by providing relevant and current resources. The study proposed a conceptual model that will enhance the functionality of libraries and to enhance their capacity to offer better services to their users. The proposed model is anchored on nine broad areas which are strengthening human resources, funding, access and accessibility, partnerships, infrastructure, ICTs, management, stakeholder consultation and periodic users’ surveys. Thus, if these interventions are heeded to, there is a higher possibility that the library will be more functional and better positioned to close the information gap. The study contributes to the body of knowledge through provision of a conceptual model which highlights factors that hamper smooth provision of library services, and offers pillars (components of the model) that can enhance the functionality of public libraries in rural areas. It further contributes by highlighting those services regard by users to be important for maximal usage of libraries. This study was unique in that as at the time of completion according to the investigator’s knowledge no other study on rural public libraries has looked into the functionality of libraries funded by the conditional grant using a variety of methods, different perspectives through engaging key informants, factoring in the different age groups and bringing in the gender perspective in a single study. Use of different computer assisted software packages (Atlas version 8 and SPSS version 24) over and above the thematic content analysis to analyse the data was also unique as most other known studies only used thematic content analysis for their qualitative data. Based on the findings it was concluded that decentralized services to local municipal level could reduce many of the challenges that hinder libraries from providing smooth and quality services to their communities. Improved materials collections to satisfy individual and communal information needs, user friendly opening hours as well as engaging the community in library decisions could go a long way in ensuring the library is recognized as a community development hub that fulfills its mission of keeping the community informed. It was therefore recommended that the policy on the running of public libraries should be reviewed with the view to decentralize the running of public libraries to local municipalities,. More still, policy on library funding should be reviewed, library opening hours should be extended, better trained ICT technicians should be placed in local libraries, librarians should be appointed on a permanent basis, and a comparative study of all libraries in Vhembe should be conducted to gauge if the community is deriving any benefits from the provision of computers and access to the internet through “Mzansi Online” project. / Staff Capacity Development

Thesis (MBA)--Stellenbosch University, 2013. / The South African Northern Cape Department of Health has many challenges to overcome in order to provide the province with quality public health care. One of these challenges is the recruitment and retention of foreign doctors in order to maintain and improve on the population’s access to physicians. Due to the lack of locally trained physicians willing to work and settle in the Northern Cape Province, the Department of Health in the province have been employing foreign-trained physicians to fill the gap in providing adequate medical care to its population. This study examined how well foreign doctors have integrated into the Northern Cape public health care system. It further identified, described and explored the factors that might influence the integration of these foreign physicians. This was done in order to make recommendations to improve the existing retention strategies of the Northern Cape Department of Health. This research utilised the mixed-method of research by obtaining secondary qualitative as well as primary quantitative data. The qualitative data were obtained through a literature review. Questionnaires informed by the literature review were utilised in order to obtain the primary quantitative data. The data obtained were subjected to a statistical analysis.The results indicated that the needs of the foreign doctors were generally met and the factors pertaining to work, community and family aspects of integration did not have an overtly negative or positive influence on integration. The results pertaining to rurality were not as prominent as expected. The main factors identified related to relational (professional as well as personal) factors. The researcher concluded that relational factors contributed the most as they had an influence on all the categories of possible factors that might influence integration. This finding stressed that the social phenomena that influence integration should not be overlooked. The implementation of interventions to improve integration and retention should be accompanied by a detailed examination of the factors that affect the recruitment, integration and retention of the workforce in a country/region. This research could be an important step towards achieving this goal for the Northern Cape Department of Health.

Introdução - A anemia ferropriva constitui um problema de saúde pública da maior relevância dadas a elevada frequência com que ocorre e as consequências dela decorrentes. Programas de intervenção foram implantados para seu controle: a fortificação universal de farinhas de trigo e milho com ferro e a suplementação profilática com sulfato ferroso (PNSF), especialmente para lactentes. Ao mesmo tempo, houve a aproximação dos serviços públicos de saúde da população com a transformação de Unidades Básicas de Saúde em Estratégia da Saúde da Família em todo o território nacional. Objetivos - Estimar as prevalências de anemia na criança no primeiro ano de vida e na mãe biológica e a relação entre elas; identificar a prática alimentar familiar e da criança. Metodologia - Estudo transversal desenvolvido em UBS no universo de crianças no primeiro ano de vida e suas mães (122 pares), que compareceram às oito UBSs que mantêm uma rotina de puericultura. Os dados antropométricos, socioeconômicos, de consumo alimentar foram obtidos através de entrevista e informações de prontuários. O sangue para diagnóstico de anemia foi colhido por punção digital e leitura em hemoglobinômetro portátil. Resultados - A prevalência de anemia entre as mulheres ([Hb]<12,0g/dL) foi de 61,5 por cento e entre as crianças encontrou-se 77,0 por cento delas com [Hb]<11,0g/dL, sendo que 30 das 34 crianças com até quatro meses de idade estavam nessa condição. Entre as mais velhas, a prevalência de [Hb]<11,0g/dL foi de 72,7 por cento . Foi verificado através do teste de Mc Nemar e do coeficiente de correlação de Yule que a prevalência de anemia em mães e seus filhos são significativamente diferentes e não existe correlação entre elas. Das oito unidades de serviços de saúde, seis são Estratégia de Saúde da Família; no entanto, apenas 10 por cento das mulheres referiram ter participado de alguma atividade de educação alimentar. Durante a gestação, 106 mulheres referiram a ingestão de sulfato ferroso e 44 delas referiram seu uso no puerpério. Entre as 54 crianças com 6 a 11 meses de idade, 21 estavam ingerindo o suplemento. A alimentação familiar tem por base o arroz/feijão e carnes diariamente nas refeições. Dentre os alimentos fortificados com ferro, o pão foi referido como alimento diário e o macarrão como alimento de consumo semanal. Frutas, verduras e legumes apareceram com frequência abaixo do recomendado. Dentre as 34 crianças menores de quatro meses, apenas 38 por cento mantinham-se em regime de aleitamento materno exclusivo. Entre as 88 mais velhas, 55 por cento ainda ingerem o produto junto com a alimentação complementar. Alimentos fontes de ferro não são frequentes na alimentação dos lactentes cuja restrição à diversidade alimentar é nítida. Legumes, frutas e verduras foram referidos com pouca frequência, estando ausentes na maioria dos questionários. Conclusões - Verificou-se alta prevalência de anemia na população estudada e que não existe correlação entre as prevalências de anemia nas mães e respectivas crianças. Constatou-se também que, embora alimentos fontes de ferro estejam presentes na alimentação habitual da família e suplementos profiláticos de ferro estejam disponíveis para a população atendida pelos serviços públicos de saúde de Santa Isabel, a deficiência marcial ocorre em grande proporção, sugerindo a necessidade de que os profissionais das UBSs sensibilizem a população através de orientação nutricional destinada à família como um todo / Introduction - Deficiency anemia is a public health problem of great importance given the high frequency with which it occurs and the consequences resulting there from. Intervention programs were implemented for its control: universal fortification of wheat flour and corn prophylactic supplementation with iron and ferrous sulfate (PNSF), especially for infants. At the same time, there was the approach of public health services of the population with the transformation of Basic Health Units in the Family Health Strategy across the country. Objectives - To estimate the prevalence of anemia in children in the first year of life and the biological mother and the relationship between them; identify feeding practices family and child. Methodology - Sectional study developed in UBS in the universe of children in the first year of life and their mothers (122 pairs), who attended 8 UBS maintains a routine childcare. Anthropometric, socioeconomic, dietary intakes were obtained through interviews and information from medical records. Blood samples for diagnosis of anemia were collected by fingerstick reading and portable hemoglobin. Results - The prevalence of anemia among women ([Hb] <12.0 g / dL) was 61.5 per cent among children and found them to be 77.0 per cent ([Hb] <11.0 g/dL) with 30 of the 34 children up to four months of age were in this condition. Among older women, the prevalence of [Hb] <11.0 g / dL was 72.7 per cent . It was determined using the McNemar test and the correlation coefficient of Yule that the prevalence of anemia in mothers and their children are significantly different and there is no correlation between them. 8 units of health services are 6 Family Health Strategy however, only 10 per cent of women reported having participated in some educational activity feed. During pregnancy 106 women referred to the ingestion of ferrous sulfate and 44 of them reported their use postpartum. Among the 54 infants 6-11 months of age, 21 were ingesting the supplement. The family diet is based on rice/beans and meats, in daily meals. Among the iron-fortified foods such as bread was the daily food and noodles as food consumption weekly. Fruits and vegetables appeared frequently below recommended. Among the 34 children under 4 months only 38 per cent had remained regime of exclusive breastfeeding. Among the 88 older, 55 per cent still ingest the product along with complementary feeding. Food sources of iron are not frequent in the feeding of infants whose restriction on food diversity is clear. Vegetables, fruits and vegetables have been reported infrequently are absent in most questionnaires. Conclusions - There was a high prevalence of anemia in this population and that there is no correlation between the prevalence of anemia in mothers and their children. It was also found that although food sources of iron are present in normal feed the family, and prophylactic iron supplements are available to the population served by the public health services of Santa Isabel, martial deficiency occurs in large proportion suggesting the need for professionals of UBS sensitize the population through nutritional guidance designed the family as a whole

Made available in DSpace on 2016-04-26T20:26:12Z (GMT). No. of bitstreams: 1 TESE - CESAR AUGUSTO GUIMARAES PEREIRA.pdf: 3312958 bytes, checksum: 11ed29eece76f5772f1b5c564754f54a (MD5) Previous issue date: 2005-11-30 / This work is based on a certain conception of users of public services, defined here as participants in a specific legal relationship binding them to the service provider. This idea stems from the Celso Antonio Bandeira de Mello's proposition of 2002 that public utility services are only those apt to be used individually by specific users. Chapter 2 examines the legal system and deepens the theoretical consequences of this proposition. It compares the user to similar individual positions. Chapter 3 is dedicated to the legal situation of the user vis-a-vis the service provider. They are linked by a predominately statutory bound that allows however certain spaces of freedom to be filled by consensus. This is an important condition for Chapter 4, which analyzes the relationship between consumer law - under the Consumer Protection Code - and the public utility services. It intends to clear certain mistakes by identifying boundaries and grounds for the limited application of consumer law. These three chapters form the part of the work dedicated to the legal position of the user. The following chapters deal with certain economic aspects of the service and their implications. Chapter 5 examines the creation of utility services as linked to the coming-of-life of constitutional fundamental rights and values. It examines the economic constraints to the provision of services. It establishes the rights of (hypothetical or potential) users with regard to the creation and organization of utility services. This is a supply-based analysis. Chapter 6 proposes a demand-oriented approach: it examines the position of the users and the remuneration of utility services (by taxes or user fees). The work reviews deeply entrenched opinions and proposes pragmatic and flexible criteria for the creation of user fees unlike those applicable under tax regulations. By proposing that the user should be placed in the center of any analysis of public utility services, this dissertation aims at abandoning a view of mere protection of the user and enhances the idea of individual responsibility. The first step towards that goal is to acknowledge that the service is provided always to a certain specific user. This person is entitled to individual rights and can claim his satisfaction. It proposes that the user be seen as a citizen, not a subject. He should not be guarded, but entitled and encouraged to exercise individually or collectively his rights with regard to public utility services / O estudo baseia-se na caracterização do usuário do serviço público como participante de uma relação jurídica concreta que o liga ao prestador. A idéia deriva da restrição do conceito de serviço público às utilidades fruíveis singularmente pelos usuários, proposta por Celso Antônio Bandeira de Mello em 2002. O Capítulo 2 examina o direito positivo e aprofunda as conseqüências teóricas dessa redução, comparando o usuário com figuras próximas. O Capítulo 3 é dedicado ao exame da situação jurídica do usuário em face do prestador do serviço. Conclui-se pela existência de um vínculo predominantemente estatutário, embora com espaços de liberdade para preenchimento consensual. Essa constatação é importante como pressuposto para o Capítulo 4, no qual se analisam os termos em que o direito do consumidor tal como veiculado pelo CDC pode ser aplicado ao serviço público. Pretende-se desfazer equívocos, identificando os limites e fundamentos dessa aplicação. Esses três capítulos compõem a parte do estudo dedicada à posição jurídica do usuário. Os capítulos seguintes relacionam-se com os aspectos econômicos do serviço e suas relações com essa posição jurídica. O Capítulo 5 examina as condições para a criação dos serviços públicos, a partir de sua vinculação à realização dos direitos fundamentais e demais valores constitucionais. Analisa-se a chamada reserva econômica do possível e se estabelecem os direitos dos usuários (hipotéticos ou potenciais) em face da criação e organização do serviço. Faz-se aí a análise de aspectos econômicos do serviço sob o prisma da oferta. O Capítulo 6 tem um enfoque de demanda: examina-se a posição do usuário frente à remuneração do serviço (taxa ou tarifa). São revistas posições consolidadas sobre o tema, propondo-se critérios pragmáticos e flexíveis para a instituição de tarifas, apartados dos critérios próprios do regime tributário. Ao defender-se que o usuário deve ser posto no centro da análise do serviço público, busca-se abandonar uma visão de tutela do usuário e reforçar a idéia de sua responsabilidade individual. O primeiro passo para esse objetivo é reconhecer que o serviço é prestado sempre em favor de um usuário determinado, que detém direitos subjetivos e pode reclamar sua satisfação. Pretende-se que o usuário seja cidadão, não súdito; que não seja tutelado, mas que tenha condições formais e materiais para exercer individual ou coletivamente seus direitos subjetivos em relação ao serviço público

Made available in DSpace on 2016-04-27T18:47:21Z (GMT). No. of bitstreams: 1 GER - Lucia Teixeira Lopes Ferraz.pdf: 467462 bytes, checksum: 9ddea662708bc1faaa404dcdd0a6ffbc (MD5) Previous issue date: 2006-10-02 / The early detection and prevention of breast cancer in middle age and elderly age women, through the analysis of their bodily symptoms, is the main purpose of this article. The world is undergoing a transformation both in its demography and in its epidemiology. Demographically, the aging of our population is a direct consequence of the increase of the life expectancy. Thought observed in both sexes, this increase is greater for women. Epidemiologically, these changes in demographics have caused a change in the cause of death profile of the population. One of the representations of these changes is the fall in the death-rate of infect-contagious diseases, characteristic of younger populations, and a rise in the death-rate of chronicle diseases, which are characteristic of populations with a predominance of older people. In Brazil, cancer is one of the main causes of death among the elderly, being breast cancer one of the main female causes of death. The public health policy is geared mainly towards the early detection of this disease, being the clinical mammography and ultra-sound exams the main methods used. However, these diseases are usually diagnosed too late, frequently leading to deaths. For the purposes of this research, a qualitative approach was adopted. The chosen subjects were middle age and elderly women who were frequent patients at Jardim Colorado s basic health unit, in Suzano, São Paulo. The chosen procedure was an interview with each subject in separate. The main focus of the interview was to get to know which signs these women looked for in their bodies and which procedures they adopted to diagnosis breast cancer on themselves. Through this series of interviews, it was discovered that the mere transmission of information regarding the prevention of breast cancer is not enough to ensure that the recommended procedures are followed. This implies that health campaigns by themselves are not as effective if not accompanied by procedures that ensure both that these women incorporate and use the knowledge acquired as well as that they routinely visit health units in order to undergo the necessary exams. It was thus concluded that, in the specific subject of early cancer detection in middle age and elderly women, it s mandatory that public policies focus in creating in younger women a culture in which it s common for people to frequently visit public health systems to be examined / A investigação das representações do corpo em mulheres envelhescentes e idosas, através dos procedimentos adotados para a prevenção e detecção precoce do câncer de mama, é o objetivo central dessa dissertação. O mundo está passando por uma dupla transição - demográfica e epidemiológica. Demograficamente, o envelhecimento populacional resulta do aumento da esperança de vida ao nascer; apesar de observado em ambos os sexos, este aumento é mais acentuada nas mulheres ( feminização da velhice). Epidemiologicamente, a transição demográfica levou à alteração do perfil de morbimortalidade da população, diminuindo a prevalência das doenças infectocontagiosas, que afetam principalmente os jovens, e aumentando a prevalência das doenças crônicas, típicas de pessoas mais idosas. No Brasil, o câncer situa - se entre as doenças crônicas que mais acometem a população encontra-se; nas mulheres o de mama constitui uma das principais causas de morte. As ações de saúde pública para o diagnóstico do câncer de mama são direcionadas para sua detecção precoce; esta ocorre, principalmente, através do rastreamento de mulheres pelo exame clínico da mama, pela mamografia e pela ultrassonografia da mama. No entanto, os diagnósticos são feitos tardiamente, levando muitas vezes ao óbito. Em termos metodológicos, optou-se pela abordagem qualitativa; os sujeitos foram mulheres envelhescentes ou idosas que freqüentavam a Unidade Básica de Saúde do Jardim Colorado, em Suzano, São Paulo. O procedimento adotado para a coleta de dados foi a entrevista individual em profundidade. Com ela procuramos conhecer as representações de corpo a partir da investigação dos procedimentos adotados para a prevenção do câncer de mama. Na análise das entrevistas compreendemos que não basta a transmissão de informações sobre a prevenção para que sua prática seja efetiva, ou seja, que é necessário que as campanhas sejam acompanhadas de mecanismos que garantam a freqüência das mulheres aos serviços de saúde e a incorporação dos conhecimentos sobre corpo, saúde, envelhecimento. Concluímos que no caso específico da detecção precoce do câncer de mama em mulheres envelhescentes e idosas deve-se iniciar a formação de um conhecimento específico que objetiva a criação de um vínculo com os serviços de saúde, através do diálogo e da reflexão, desde a adolescência, para que seja disseminado em todas as etapas seguintes da vida da mulher. Para isto, as políticas públicas devem prever e contemplar essas ações de saúde