<p><strong>Abstrakt </strong>Tobak har varit den mest lönsamma konsumentprodukten i världen under mycket lång tid. Nikotinet medför att människor blir beroende både fysiologiskt och psykologiskt. Rökning har relaterats till olika sjukdomstillstånd och är idag den enskilt största orsaken till för tidig död. I Sverige leder rökningen varje år till ett betydande antal för tidiga dödsfall. Rökning är ett stort folkhälsoproblem. De flesta har dock en vilja att sluta röka. Motivation och vilja har visat sig vara nödvändigt för att nå ett rökstopp. <em>Syftet</em> var att beskriva före detta rökares tankar om motivation för att göra rökstopp och att sedan vidmakthålla detta rökstopp<em>. Metoden</em> som användes var en kvalitativ intervjustudie. Tio före detta rökare intervjuades och en ostrukturerad intervjumetod valdes.<strong> </strong>Intervjuerna analyserades med kvalitativ innehållsanalys. <em>Resultatet</em> visade att rökstoppet var en process där motivationen sågs i tre olika faser. De olika faserna var motivation för att förebereda beslut om rökstopp, motivation för att ta beslut om rökstopp samt motivation för att vidmakthålla rökstopp. I de olika faserna identifierades känslor som osäkerhet där exempelvis behovet av stöd framkom. Egenmakt handlade om att bestämma sig och frihetskänslor visade bland annat stolthet och oberoende. <em>Slutsatsen </em>blev att motivationen för att nå ett rökstopp grundades på flera olika faktorer och varierade från individ till individ och över tid.</p><p><strong>         Nyckelord: </strong>folkhälsoproblem, motivation, rökstopp, tobak. <strong></strong></p><p><strong>         </strong></p> / <p><strong>Abstract</strong> Tobacco has been the most profitable consumer product in the world for a very long time. Nicotine makes people addicted, both physiologically and psychologically. Smoking has been related to various diseases and is today the single largest cause of premature death. In Sweden, a significant number of premature deaths are caused each year due to smoking. Smoking is a major public health problem. Most people have a desire to stop smoking. Motivation and willingness have been shown to be necessary to reach a smoking cessation. <em>The aim </em>was to describe the former smokers' views on motivation to quit and then maintain that smoking cessation. <em>The method</em> used was a qualitative interview study. Ten former smokers were interviewed and an unstructured interview method was chosen. The interviews were analyzed with qualitative content analysis. <em>The results</em> showed that smoking cessation was a process in which motivation was seen in three different phases. The different phases were motivation to prepare a decision on quitting smoking, motivation to make decisions about smoking cessation, and motivation for maintaining smoking cessation. The various phases were identified feelings of uncertainty, where for example the need for support was found. Empowering was about how to determine their freedom and how feelings were revealed and among other things, pride and independence. <em>Conclusion </em>was<em> </em>that the motivation to reach a smoking cessation was based on several factors, varying from individual to individual and over time.<strong></strong></p><p><strong>Keywords: </strong>motivation, public health problem, smoking cessation, tobacco.</p>

Abstrakt Tobak har varit den mest lönsamma konsumentprodukten i världen under mycket lång tid. Nikotinet medför att människor blir beroende både fysiologiskt och psykologiskt. Rökning har relaterats till olika sjukdomstillstånd och är idag den enskilt största orsaken till för tidig död. I Sverige leder rökningen varje år till ett betydande antal för tidiga dödsfall. Rökning är ett stort folkhälsoproblem. De flesta har dock en vilja att sluta röka. Motivation och vilja har visat sig vara nödvändigt för att nå ett rökstopp. Syftet var att beskriva före detta rökares tankar om motivation för att göra rökstopp och att sedan vidmakthålla detta rökstopp. Metoden som användes var en kvalitativ intervjustudie. Tio före detta rökare intervjuades och en ostrukturerad intervjumetod valdes. Intervjuerna analyserades med kvalitativ innehållsanalys. Resultatet visade att rökstoppet var en process där motivationen sågs i tre olika faser. De olika faserna var motivation för att förebereda beslut om rökstopp, motivation för att ta beslut om rökstopp samt motivation för att vidmakthålla rökstopp. I de olika faserna identifierades känslor som osäkerhet där exempelvis behovet av stöd framkom. Egenmakt handlade om att bestämma sig och frihetskänslor visade bland annat stolthet och oberoende. Slutsatsen blev att motivationen för att nå ett rökstopp grundades på flera olika faktorer och varierade från individ till individ och över tid.          Nyckelord: folkhälsoproblem, motivation, rökstopp, tobak. / Abstract Tobacco has been the most profitable consumer product in the world for a very long time. Nicotine makes people addicted, both physiologically and psychologically. Smoking has been related to various diseases and is today the single largest cause of premature death. In Sweden, a significant number of premature deaths are caused each year due to smoking. Smoking is a major public health problem. Most people have a desire to stop smoking. Motivation and willingness have been shown to be necessary to reach a smoking cessation. The aim was to describe the former smokers' views on motivation to quit and then maintain that smoking cessation. The method used was a qualitative interview study. Ten former smokers were interviewed and an unstructured interview method was chosen. The interviews were analyzed with qualitative content analysis. The results showed that smoking cessation was a process in which motivation was seen in three different phases. The different phases were motivation to prepare a decision on quitting smoking, motivation to make decisions about smoking cessation, and motivation for maintaining smoking cessation. The various phases were identified feelings of uncertainty, where for example the need for support was found. Empowering was about how to determine their freedom and how feelings were revealed and among other things, pride and independence. Conclusion was that the motivation to reach a smoking cessation was based on several factors, varying from individual to individual and over time. Keywords: motivation, public health problem, smoking cessation, tobacco.

Protein Energy Malnutrition (PEM) due to under nutrition is a major public health problem among children in Africa and other developing countries. Sorghum and bread wheat, which are important dietary staples in the semi-arid tropics of Africa, are suitable vehicles for delivering proteins to alleviate PEM. Formulation of foods from these low-lysine staples fortified with legumes is a sustainable approach to improve the protein nutritional quality of foods for young children. Biscuits offer a valuable vehicle for fortification as they are nutrient dense, ready-to-eat, have a long shelf-life and are popular. Therefore, this study investigated the effect of complementing sorghum and bread wheat with defatted soy flour on the nutritional and sensory quality and consumer acceptability of biscuits. Biscuits were formulated and developed by compositing sorghum and bread wheat flours with defatted soy flour at different ratios. To establish the nutritional characteristics of biscuits, proximate composition, lysine and reactive lysine contents and in vitro protein digestibility were determined. Protein Efficiency Ratio (PER), Food Efficiency Ratio (FER) True Digestibility and Biological Value (BV) of sorghum biscuits were determined using Sprague Dowley weanling male rats. The sensory characteristics of biscuits were evaluated using a descriptive panel and instrumental texture analysis. Acceptability was evaluated using eight to nine year old school children. Compared to the 100% cereal biscuits, sorghum-soy and bread wheat-soy composite biscuits in a 1:1 ratio had at least double the protein, mineral and crude fibre contents. The lysine contents of biscuits increased by 500-700%. For the sorghum-soy biscuits, in vitro protein digestibility increased by 170% and Protein Digestibility Corrected Amino Acid Score (PDCAAS) was 8 times higher. Two such biscuits of 28 g each could provide 50% of the recommended daily protein intake for 3 to 10 year olds. In the animal study, PER and FER for sorghum-soy biscuits were equivalent to the reference casein. True Digestibility was high for all diets, 85 to 95% and BV of sorghum biscuits was higher than sorghum-soy diet by 20%. Principal Component Analysis (PCA) revealed that 61% and a further 33% of the variation in sensory properties was due to the type of cereal and concentration of soy in biscuits, respectively. Maximum stress increased by 39% and 34% in sorghum-soy and bread wheat-soy biscuits, respectively at 1:1 ratio. Spread factor of biscuits increased by 7 to 32%. Biscuits were darker in colour (reduced L* value) by 14 to 56% and hardness increased by 84% in sorghum biscuits. Positive hedonic scores by 8 to 9 year old school children for fortified biscuits were sustained above 80% through 8 consumption occasions. This data shows that fortifying with defatted soy flour imparts positive sensory characteristics associated with biscuits to sorghum and bread wheat biscuits and the acceptance of such biscuits may be sustained over an extended period of time. This study indicates that soy fortified sorghum and bread wheat biscuits have high nutrient density, protein quality, positive sensory properties and high acceptability if consumed over an extended period. Hence, the biscuits have great potential as protein-rich supplementary foods to alleviate PEM among children and to provide an income to small holder farmers in rural African communities through purchase of grain for the Home Grown School Feeding Programme. / Thesis (PhD)--University of Pretoria, 2010. / Food Science / unrestricted

Introduction Violence against women is one of the major social problems of our time and a violation of women's human rights. Globally, it is estimated that one out of three women are exposed to some type of violence. Extensive, consequential health problems lead women subjected to violence to seek medical treatment more frequently than women who are not subjected to violence.   Aim The aim was to describe abused women's experiences of the healthcare providers’ encounter in contact with the health and medical services. Method General literature study with an inductive approach and descriptive design. Result The women were reluctant to start conversations about violence on their own initiative, why healthcare providers became a crucial actor in violence disclosure and could, in some cases, be the only chance in identifying violence. Several women had never been asked about violence, instead they described negative experiences of medical services where healthcare providers had acted in a manner which left them feeling humiliated and insulted. A minority of the women experienced that the disclosure of violence had led to better medical care and that the healthcare providers subsequently were also able to support the women through following vulnerable medical procedures. Healthcare providers who showed understanding and empathy could contribute to a comfortable and trusting experience. The women preferred to speak to healthcare providers of their own sex, particularly nurses and midwives. Healthcare providers’ validation and terminological explanations of abuse and violence were also important to help women disclose violence. Conclusion This literature study demonstrates substantial challenges in healthcare services’ response to the patient group of women subjected to violence, in a person-centered manner.The healthcare provider plays an important role in the response of these women. More knowledge and competence is required to develop the healthcare’s response to women subjected to violence. / Introduktion Våld mot kvinnor är ett av vår tids stora samhällsproblem samt en kränkning av kvinnors mänskliga rättigheter. Globalt estimeras att en av tre kvinnor utsatts för någon typ av våld. Hälsoproblemen är omfattande vilket gör att våldsutsatta kvinnor söker vård mer frekvent än icke våldsutsatta. Syfte Syftet var att beskriva våldsutsatta kvinnors erfarenheter av vårdpersonalens bemötande i kontakt med hälso- och sjukvården. Metod  Litteraturöversikt med induktiv ansats samt deskriptiv design. Resultat Kvinnorna ville sällan själva ta initiativ till samtal om våld. Sjukvården blev därför en viktig resurs vid avslöjandet om våld och kunde i vissa fall vara den enda chansen att identifiera våld. Flertalet kvinnorna hade inte blivit tillfrågade om våld, utan beskrev istället negativa vårderfarenheter där sjukvårdspersonal agerat på ett sådant sätt att de känt sig förnedrade och kränkta. En minoritet av kvinnor tyckte att avslöjandet lett till bättre vård samt att vårdpersonal därefter kunnat hjälpa kvinnorna igenom svåra vårdsituationer. Vårdpersonal som försökt förstå och visat empati kunde skapa en bekväm och tillitsfull situation. Kvinnorna föredrog att prata med sjukvårdspersonal av samma kön, företrädelsevis sjuksköterskor samt barnmorskor. Sjukvårdspersonalens validering samt begreppsförklaring av övergrepp och våld var likaså viktiga för att hjälpa kvinnornas avslöjande. Slutsats  Av litteraturöversikten framgår att hälso- och sjukvården haft framstående svårigheter med att bemöta gruppen våldsutsatta kvinnor på ett personcentrerat sätt.Vårdpersonalen har en betydelsefull roll vid bemötande av dessa kvinnor. Ökad kunskap och kompetens behövs för att utveckla vårdpersonalens bemötande av våldsutsatta kvinnor.

Made available in DSpace on 2018-06-04T19:14:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-05-09 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Objetivo: Descrever os caminhos percorridos pelo portador da Síndrome do Olho Seco em busca da atenção integral do cuidado na saúde pelo Sistema Único de Saúde. O objeto de estudo foi construído a partir da contextualização do agravo no cenário mundial, inclusive no Brasil, do entendimento da doença como problema de saúde pública, bem como sob o ponto de vista da integralidade sistêmica, passando pelas políticas públicas, e da atenção integral do cuidado individual na saúde, incluindo os aspectos psicossociais. Método: Trata-se de uma pesquisa com abordagem qualitativa e de caráter exploratório que envolveu duas etapas: a teórico-conceitual e a empírica. Na primeira, foram utilizados trabalhos que abordam a temática deste estudo, incluindo uma pesquisa bibliográfica correspondente ao período de 2011-2015. Na segunda etapa, as ferramentas utilizadas foram: a realização de grupos focais e entrevistas semiestruturadas, e como suporte, o diário de campo. Os grupos focais, com a participação de usuários do Ambulatório de Doenças Externas e Córnea, portadores da Síndrome do Olho Seco, no intuito de conhecer os caminhos percorridos na busca por um cuidado integral. A “amostra” final para a análise constituiu-se de 14 participantes. As entrevistas semiestruturadas com gestores do Departamento de Oftalmologia para conhecer a dinâmica de funcionamento dos serviços, incluindo a da assistência psicossocial, e o médico oftalmologista, no que tange a assistência ao portador da Síndrome do Olho Seco pelo serviço estudado. O diário de campo foi o instrumento utilizado para o registro sobre o reconhecimento do cenário da pesquisa, bem como outros acontecimentos no decorrer do estudo, inclusive durante os grupos focais e entrevistas semiestruturadas. Este estudo foi realizado num serviço universitário ligado ao Departamento de Oftalmologia de uma Escola Médica vinculada a uma Universidade Federal. Resultados: quanto à análise da empiria, pode-se afirmar que o cuidado em saúde ao portador da Síndrome do Olho Seco está aquém do princípio da integralidade. Tanto na gestão, quanto no cuidado, o Sistema Único de Saúde apresenta lacunas que incidem sobre a qualidade de vida do portador do agravo. Considerações: Por fim, este estudo propõe algumas ações que visam tornar o SUS mais acessível ao portador da Síndrome do Olho Seco, inclusive sugerindo a aproximação do Departamento de Oftalmologia com a rede básica, a integração entre os serviços de psicologia/psicoterapia, de assistência social e de oftalmologia clínico-cirúrgica, e, no serviço estudado, o incentivo para a formação de grupo de apoio com portadores do agravo em parceria com a Associação dos Portadores de Olho Seco, entidade tida como porta-voz dos portadores desse agravo para a população brasileira, por meio de ações que realiza. / Objective: Describing the paths covered by the Dry Eye Syndrome patient in search of the integral attention of health care by the Unified Health System (SUS). The object of study was constructed from the contextualization of the disease in the world scenario, including in Brazil, the understanding of the disease as a public health problem, as well as from the point of view of systemic integrality, through public policies, and the integral attention of individual health care, including psychosocial aspects. Method: This is a research with a qualitative and exploratory approach that involved two stages: the theoretical-conceptual and the empirical. In the first one, papers which approach the theme of this study were used, including a bibliographical research corresponding to the period of 2011-2015. In the second stage, the tools used were the observance of focal groups and semi-structured interviews, and as support, the field diary. The focal groups, with the participation of users of the Outpatient Clinic of External Diseases and Cornea, with Dry Eye Syndrome, in order to know the paths covered in the search for integral care. The final sample for the analysis consisted of 14 participants. The semi-structured interviews with managers of the Department of Ophthalmology to know the dynamics of the functioning of the services, including psychosocial assistance, and the ophthalmologist, regarding the assistance to the bearer of Dry Eye Syndrome by the service studied. The field diary was the instrument used to register the recognition of the research scenario, as well as other events during the study, including during focus groups and semi-structured interviews. This study was carried out in a university service linked to the Department of Ophthalmology of a Medical School linked to a Federal University. Results: Regarding the empirical analysis, it can be affirmed that health care for patients with Dry Eye Syndrome falls short of the principle of integrality. In both management and care, the Unified Health System has gaps that affect the quality of life of people suffering from the disease. Considerations: Finally, this study proposes some actions aiming at making the SUS more accessible to the bearer of Dry Eye Syndrome, including suggesting the approach of the Department of Ophthalmology with the basic network, the integration between psychology / psychotherapy services, social care and clinical-surgical ophthalmology, and, in the service studied, the stimulus for the formation of a support group with patients with the disease in partnership with the Association of Carriers of Dry Eye, an entity considered as the spokesperson for those who suffer from this disease to the Brazilian population, through its actions. / BV UNIFESP: Teses e dissertações

nÃo hà / O dengue permanece como problema de saÃde pÃblica no Brasil. No nordeste brasileiro, os grandes depÃsitos domiciliares utilizados para acumular Ãgua sÃo importantes criadouros para reproduÃÃo do Aedes aegypti, o principal transmissor do dengue. O uso de alternativas ao controle quÃmico desse vetor vem sendo incentivado. Os objetivos desse trabalho foram avaliar se a presenÃa de peixes larvÃfagos altera o padrÃo de postura do A. aegypti, identificar a sobrevivÃncia de peixes larvÃfagos ao cloro e descrever a eficÃcia do peixe Betta splendens em condiÃÃes de campo. O padrÃo de postura foi avaliado em uma gaiola com 6 m3. Os peixes avaliados foram Poecilia reticulata e B. splendens. Na gaiola foram inseridos oito depÃsitos, sendo quatro com peixes, quatro sem peixes (controle) e 100 mosquitos. Em cada depÃsito tinha Ãgua e uma palheta de eucatex para postura dos ovos. Ao final de cada semana os ovos postos nessas palhetas foram contados. Os ensaios foram replicados por sete semanas consecutivas para cada espÃcie. A sobrevivÃncia do B. splendens e P. reticulata, ao cloro, foi avaliada para trÃs concentraÃÃes (1,0; 1,5 e 2,0 mg/L) utilizando tambores com 35 litros de Ãgua. Foram utilizados 105, 140 e 175 peixes para cada concentraÃÃo testada, na proporÃÃo de 6 depÃsitos com cloro para cada controle (sem cloro). A eficÃcia foi avaliada a partir de dados gerados pelo Programa Municipal de Controle do Dengue, na cidade de Fortaleza. Foi avaliada a permanÃncia dos peixes em depÃsitos domiciliares e a infestaÃÃo nesses depÃsitos com B. splendens e o larvicida Bacillus thuringiensis israelensis. A presenÃa do B. splendens inibiu a postura de ovos pelas fÃmeas de Aedes aegypti com um Ãndice de Atividade de OviposiÃÃo (IAO) de -0,627. O nÃmero mÃdio de ovos postos em depÃsitos com B. splendens (32,5/semana) foi menor que nos depÃsitos com o P. reticulata (200,5/semana) e os controles (186,5/semana; p < 0,0001). Todos os B. splendens sobreviveram a concentraÃÃo de cloro de 1,0 mg/L; 72,5 e 39,3% sobreviveram as concentraÃÃes de 1,5 e 2,0 mg/L. Por outro lado, apenas 4,4% do P. reticulata sobreviveram a concentraÃÃo mÃnima de 1,0 mg/L. Em campo foram encontrados trÃs depÃsitos com a presenÃa do B. splendens e larvas de mosquitos (1,6%), infestaÃÃo significativamente menor que nos depÃsitos com o Bti, onde essa infestaÃÃo foi de 10,9% (p < 0,001). Nos depÃsitos onde o peixe nÃo permaneceu a infestaÃÃo foi de 27,8%, maior que nos depÃsitos com Bti (p < 0,010). Nos depÃsitos onde o peixe permaneceu ele foi 85% mais eficaz que o larvicida. A permanÃncia dos peixes foi maior nos tanques de alvenaria (48,5%), localizados no peridomicÃlio (47,5%) e ao nÃvel do solo (53,3%). ConcluÃmos que o B. splendens pode ser apropriado para controle biolÃgico de larvas de Ae. aegypti em grandes reservatÃrios domiciliares, desde que possa ser atestada sua permanÃncia nesses depÃsitos. / Dengue fever remains an important public health problem in northeast Brazil. Large domestic containers used to store water are important breeding sites of Aedes aegypti, the main vector. The use of alternatives to chemical vector control has increased in the last years. The objectives of this study were: to evaluate the inhibition of oviposition by female Ae. aegypti in domestic containers with larvivorous fish; to describe the survival of larvivorous fish to different chlorine concentrations; and to describe the efficacy of Betta splendens fish under field conditions. Oviposition was assessed in a cage of 6 m3 of size. The fish species Poecilia reticulata and B. splendens were used in the laboratory assays. In the cage, eight water containers were placed - four with fish, four without fish (control), and 100 mosquitoes. In each container with 15 l water eucatex strips were placed to facilitate oviposition. At the end of each week, eggs laid on these strips were counted. For each species, the assays were repeated for seven consecutive weeks. Survival of B. splendens and P. reticulata to different concentrations of chlorine (1.0, 1.5 and 2.0 mg / L) was assessed in drums with 35 liters of water. We used 105, 140 and 175 fish for each concentration: six test containers with chlorine for each control without chlorine. Secondary data of the Municipal Dengue Control Program of the city of Fortaleza were analyzed to assess the efficacy of B. splendens under field conditions. The presence of fish in household containers was verified after several weeks. Infestation of containers with mosquito larvae was compared to containers with the larvicide Bacillus thuringiensis israelensis. The presence of B. splendens inhibited oviposition by Ae. aegypti with an activity oviposition index of -0.627. The mean number of eggs laid in deposits with B. splendens (32.5 / week) was lower than in deposits with P. reticulata (200.5 / week) and controls (186.5 / week, p <0.0001). All B. splendens specimens survived a chlorine concentration of 1.0 mg / L, and 72.5% and 39.3% survived concentrations of 1.5 and 2.0 mg / L, respectively. On the other hand, only 4.4% of P. reticulata survived a concentration of 1.0 mg / L. Under field conditions, three containers were encountered with B. splendens and mosquito larvae (1.6%), significantly less than infested deposits with Bti (10.9%; p <0.001). In containers where the fish died or disappeared, infestation was 27.8% higher than in deposits with Bti (p <0.010). In deposits where the fish remained, efficacy was 85% better than Bti. The permanence of fish was higher in concrete tanks (48.5%), located outside the house (47.5%) and at ground level (53.3%). We conclude that B. splendens may be suitable for biological control of Ae. aegypti larvae in large domestic water containers.