No description available.

To sustain the health and viability of renal transplants, adherence to immunosuppressant therapy (IST) medications is critical. Studies continue to identify decreased adherence rates as time from transplant increases (Chisholm-Burns, Kwong, Mulloy & Spivey, 2008; Chisholm, Lance, Mulloy, 2005; Chisholm, Mulloy, & DiPiro, 2005; Nivens & Thomas, 2009). While previous research has explored the effect of variables known to influence IST adherence in adult renal transplant recipients, limited studies have explored these variables in a population of renal transplant recipients with longer time posttransplant intervals. The purpose of this study was to examine demographic variables, time posttransplant, immunosuppressive agents, health beliefs, social support, and symptom experience and test their relationship to adherence in a population of long-term renal transplant recipients. A cross-sectional correlational design was used to collect data from a convenience sample of 98 adult renal transplant recipients who were three or more years from transplant. Participants completed five instruments: 1) demographic survey, 2) the Beliefs About Medicines Questionnaire (BMQ), 3) the Medical Outcomes Study (MOS) Modified Social Support Survey (MSSS), 4) the Basel Assessment of Adherence with Immunosuppressive Medication Scales (BAASIS), and 5) the Modified Transplant Symptom Occurrence and Symptom Distress Scale- 59R (MTSOSD-59R). A composite adherence score (CAS) consisting of a self-report measure of adherence (BAASIS), nontherapeutic serum drug assay, and collateral report of adherence as provided by two transplant clinic professionals was used to determine final adherence group classification (adherent/nonadherent). Analysis of the relationship between all independent variables and adherence was conducted using Spearman’s rho correlation coefficient. Mean scores for medication complexity, health beliefs, social support, and symptom experience were 4 compared between age, gender, and time posttransplant groups using independent-samples t tests. A logistic regression prediction of probability was conducted to determine which of the variables that demonstrated a significant relationship to adherence were most predictive of adherence. Of the total sample population (N = 98), 39.8% (n = 39) were classified as adherent and 60.2% (n = 59) were nonadherent. Results demonstrated no significant relationship between age (continuous variable), time posttransplant, immunosuppressant medications (measured by a medication complexity index), health beliefs, symptom experience, and adherence. Weak, but significant relationships between age groups (r = -.213, p=.035), tangible social support (r = .215, p =.017), emotional informational social support (r = .274, p = .003), positive social interaction support (r = .199, p = .025), total overall social support (r = .274, p =.003) and composite adherence group classification were found. Older participants ( > 55 yrs) were significantly less adherent than younger ( < 54 yrs) participants. Mean scores for emotional / informational (EMI), positive social interaction (POS), and total social support (MSSS) were significantly lower in nonadherent participants. Regression results indicated the overall model of two predictors (age grouped [ < 54 yrs; > 55 yrs] and EMI social support subscale) was statistically reliable in distinguishing between adherent and nonadherent participants (-2 Log Likelihood 116.244; Goodness-of-Fit x 2 (2) = 13.664, p = .001), correctly classifying 69.1% of the cases. Findings from this study contribute to the body of research exploring predictors of immunosuppressant adherence in long-term renal transplant recipients. Data suggest both younger age (< 55) and categories of social support predict adherence in long-term renal transplant recipients. Healthcare providers caring for renal transplant recipients long-term 5 should consider annually assessing older participants for adherence as well as for changes in social networks.

This thesis makes an argument for the importance of a high level of commitment from local departments of social services, area businesses, and community organizations to the implementation of the Job Opportunities and Basic Skills (JOBS) program. It contends that such a commitment is a necessary pre-condition for JOBS to ever be successful. It then examines the level of commitment these actors have to JOBS in Roanoke, Virginia in order to explore the process by which local commitment to JOBS is created. A case study was conducted to determine what mechanisms, if any, are currently in place to support such a commitment. Of even greater significance, this analysis suggests the importance of changing our method of evaluating social welfare policy. We need to move beyond analyzing the actions of participants and the impact a program has on participants to illuminating the entire process by which social welfare policy operates if we are to fully understand its impacts. Upon examining the legislative history of the Family Support Act of 1988 (JOBS is the centerpiece of this act) I found no substantial discussion of the importance of encouraging local commitment to JOBS. This suggests that sustaining local commitment was not considered a high priority by federal policy makers. An examination of the actual level of commitment from a local department of social services, area businesses, and community organizations suggests there is a great deal of work yet to be done in establishing an integrated community-based approach to welfare reform. Based on the results of this research, I concluded that community commitment to JOBS can best be established by increasing commitment from all three levels of government. I also developed a hypothesis. Higher levels of commitment from within a locality will be associated with more "successful" JOBS programs. Although the newness of JOBS precludes the immediate testing of this hypothesis, future research can be conducted to determine if we find higher levels of commitment in areas with more successful JOB programs. / Master of Arts

Syfte:                              Syftet med studien är att analysera hur förändringsmottagare upplever att ledningens kommunikation inför organisationella förändringar påverkar dem för att få en beredskap inför förändringen.   Metod:                               Studien är en kvalitativ fallstudie med en abduktiv ansats, där den empiriska datainsamlingen gjorts genom intervjuer med anställda på ett företag i telekombranschen. En analys av insamlad data genomfördes genom en tematisk analys.   Resultat och slutsats:        Kommunikation inverkar på förändringsmottagarnas beredskap från sändarsidan, men effekten av denna dämpas på mottagarsidan av ett filter bestående av två faktorer, avtrubbning och påverkan på förändringsmottagarna.                                                                                      Förändringsmottagarna motsätter sig eller upplever en likgiltighet gentemot organisatoriska förändringar om kommunikationen upplevs som knapphändig eller är otydlig. Likaså påverkar bristen på möjligheter att återkoppla till ledningen för att skapa klargöranden, mottagarna i negativ riktning. Studiens bidrag:               Ge en djupare förståelse och kunskap i             kommunikationens betydelse för att skapa beredskap till förändring, och på så vis öka möjligheterna att genomdriva lyckosamma förändringsarbeten.   Förslag på vidare forskning:                          Att undersöka de faktorer som skapar avtrubbning till förändring hos förändringsmottagaren och hur dessa kan komma att undvikas.

published_or_final_version / Sociology / Master / Master of Philosophy

Thesis presented in partial fulfilment for the degree of Master of Management (in the field of Public and Development Management) to the Faculty of Commerce, Law, and Management, University of the Witwatersrand, 2016 / The research aimed to find out whether one of the unintended outcomes of governments’ top-down implementation of the child support grant was increased fertility among recipients in the rural areas, which generally have higher levels of fertility in the country. South Africa does not have a fertility problem, but development is still much needed in the rural areas. The plight of government, having inherited one of the most unequal society is not minimised. According to Mcnicoll (1998), public transfers among age groups are fertility related. Government directs public expenditures towards social services benefiting the poor. Such expenditures and transfers may significantly modify the economics of fertility as seen by prospective parents. Rural households are more vulnerable because of the economic unviability rooted in the apartheid system. Our study has tried to show how the environment in Lenyenye Township and surrounding villages could make it a possibility for women to see the increment of births as a rational solution for the survival of their family. The theory of bounded rationality was used to demonstrate that rationality is more adaptive to situations based on the environmental constraints. / XL2017

A transferência de embriões (TE) é uma biotecnologia amplamente utilizada na produção de equinos no Brasil, e a égua receptora exerce um papel fundamental nos resultados finais nos programas de reprodução. Alguns tratamentos têm sido preconizados com objetivo de exercer ação luteotrófica, melhorando a função luteal, e com isto aumentando os níveis sistêmicos de progesterona, como também o uso de drogas anti-inflamatórias, que evitam a perda da função luteal causada pela liberação de prostaglandina em processos inflamatórios prévios ou por manipulação na passagem transcervical do embrião no momento da TE. O objetivo deste estudo foi investigar os efeitos do anti-inflamatório inibidor seletivo COX 2 (meloxicam) associado ao uso luteotrófico da hCG na gestação, características de corpo lúteo, fertilidade e desenvolvimento embrionário em éguas receptoras. Para isto, 60 éguas receptoras alojadas em central de reprodução foram aleatoriamente divididas em 4 grupos de 15 animais, de acordo com os seguintes tratamentos: aplicação de 5ml solução fisiológica no dia da ovulação (controle); aplicação de 2500 UI hCG no dia da ovulação; aplicação de 2500 UI hCG no dia da ovulação associado a 0,6 mg/kg de meloxicam; aplicação de 2500 UI hCG no momento da transferência do embrião associado a 0,6 mg/kg meloxicam. No dia da TE, 7 dias após a TE e 21 dias após a TE para as éguas que ficaram gestantes, foi avaliada a irrigação do corpo lúteo por ultrassonografia modo doppler colorido por meio de score do percentual de irrigação (0-100%), e a irrigação do útero avaliado por score (1-4). Por meio da ultrassonografia no modo B, a área do CL em mm2 foi avaliada nos mesmos momentos, a área da vesícula em mm2 aos 15 e 21 dias da gestação e o tamanho do embrião em cm aos 29 dias de gestação. Além disso, foi realizada dosagem plasmática de progesterona no dia da TE, 7 dias após a TE e 21 dias para as éguas gestantes. As comparações entre os grupos foram analisadas para efeitos principais de tratamento e tempo, assim como para efeito de interação tratamento x tempo. Não foi observado influencia da aplicação de hCG e/ou meloxicam nos animais tratados comparados ao controle (P&gt;0,05). No entanto, foi observado um aumento numérico na taxa de gestação para os dois grupos de receptoras que receberam anti-inflamatório meloxicam, correspondendo a um índice superior em 13,3 % de gestação para éguas tratadas. Em conclusão, não há influencia da aplicação de hCG associado ou não meloxicam sobre a perfusão sanguínea uterina, do corpo lúteo, no desenvolvimento embrionário e nas concentrações plasmáticas de progesterona em receptoras de embriões. No entanto, existe, pela aplicação de meloxicam, evidência de melhora nos índices de gestação, podendo estar associado ao efeito anti-inflamatório seletivo COX-2, que pode melhorar resultados em programas comerciais de transferência de embriões em equinos. / Embryo transfer (ET) is a biotechnology widely used in equine production in Brazil, and the recipient mare plays a key role in the final results of breeding programs. Several treatments have been advocated both for the purpose of exerting luteotrophic action, improving luteal function, and thereby increasing systemic levels of progesterone, such as the use of anti-inflammatory drugs, which prevent the loss of luteal function caused by the release of prostaglandin in previous inflammatory processes or by manipulation in the transcervical passage of the embryo at the time of ET. The objective of this study was to investigate the effects of the anti-inflammatory COX 2 inhibitor (meloxicam) associated with luteotrophic use of hCG in gestation, corpus luteum characteristics, fertility and embryonic development in recipient mares. For this, 60 receiving mares housed in a reproduction center were randomly divided into 4 groups of 15 animals, according to the following treatments: application of 5ml physiological solution on the day of ovulation (control group); application of 2500 IU hCG on ovulation day; application of 2500 IU hCG on the day of ovulation associated with 0.6 mg/kg of meloxicam; application of 2500 IU hCG at the time of embryo transfer associated with 0.6 mg/kg meloxicam. On the day of ET, 7 days after ET and 21 days after ET for pregnant mares, corpus luteum irrigation was evaluated by color Doppler ultrasonography using a score of the percentage of irrigation (0-100%), and irrigation of the uterus evaluated by score (1-4). Using B-mode ultrasonography, corpus luteum area in mm2 was assessed at the same time points, the area of the embryonic vesicle in mm2 at 15 and 29 days of gestation, and the size of the embryo in cm at 29 days of gestation. In addition, plasma progesterone dosage was performed on ET day 7 days after ET in all groups and 21 days after ET for pregnant mares. The comparisons between the groups were analyzed for main effects of treatment and time, as well as for interaction effect treatment x time. No influence of application of hCG and / or meloxican was observed on treated animals compared to control (P&gt;0.05). However, a numerical increase in gestation rate was observed for the two groups of recipients who received anti-inflammatory meloxicam, corresponding to an index higher than 13.3% of gestation for treated mares. In conclusion, there is no influence of the application of hCG associated or not to meloxicam on uterine irrigation, corpus luteum, embryo development and plasma concentrations of progesterone in embryo recipients. However, there is evidence of improvement in gestation rates due to the application of meloxicam, which may be associated with the COX-2 selective anti-inflammatory effect of this drug, improving results in commercial embryo transfer programs in horses.

A doença hepática terminal reduz de forma significativa a qualidade de vida de pacientes e com o transplante do órgão é possível melhorar as condições de saúde. A sexualidade é aspecto central do ser humano durante todo o ciclo vital. É área complexa do comportamento humano, assim a sexualidade de candidatos e receptores de transplante de fígado não deve ser menosprezada. O presente estudo teve como objetivo analisar as evidências disponíveis na literatura sobre as alterações na sexualidade de candidatos e receptores de transplante de fígado. Trata-se de revisão integrativa da literatura: as bases de dados selecionadas para a busca dos estudos primários foram PubMed, CINAHL e LILACS. Os 16 estudos primários incluídos na revisão foram agrupados em três categorias: (1) sexualidade feminina (n=5); (2) sexualidade masculina (n=5) e; (3) sexualidade masculina e feminina (n=6). Na categoria 1, os principais temas de investigação foram contracepção, gravidez, disfunção sexual, presença de sintomas ginecológicos e doença sexualmente transmissível. Na categoria 2, o foco principal dos estudos primários agrupados foi a disfunção erétil e investigou-se também desejo/satisfação sexual e as consequências de homens que tiveram filhos, em regime imunossupressor com ácido mycofenólico. Na categoria 3, a avaliação da função sexual foi o principal tema abordado nas pesquisas analisadas. A sexualidade é problemática desafiadora, revestida por tabus e preconceitos, vivenciada de forma diferente pelos indivíduos. Assim, os pacientes podem apresentar dificuldades em relatar para os profissionais da saúde seus problemas, acarretando atraso do diagnóstico e tratamento, prolongando a sensação de desconforto e sentimento de angústia. A dificuldade em abordar sobre sexualidade também ocorre por parte dos profissionais de saúde que não recebem capacitação adequada. O conhecimento sobre as dúvidas e problemas vivenciados pelos candidatos e receptores de transplante de fígado pode proporcionar a implementação de intervenções direcionadas para prevenção, redução ou controle das complicações no período pré e pós-transplante. O presente estudo forneceu subsídios para encorajar os profissionais de saúde a incorporar a sexualidade na rotina de atendimento destes pacientes, bem como indicou lacunas no conhecimento para a condução de novas pesquisas com o propósito de implementar intervenções na pratica clínica para prevenir, minimizar e/ou controlar as alterações relacionadas à sexualidade do paciente, contribuindo para a melhoria da assistência de enfermagem e, consequentemente, para o sucesso do tratamento / The end-stage liver disease significantly reduces the quality of life of patients. However, with organ transplantation it is possible to improve health conditions. Sexuality is a central aspect of the human being throughout the life cycle. It is a complex area of the human behavior and therefore the sexuality of liver transplant candidates and recipients should not be overlooked. The present study aimed to analyze the evidence available in the literature on the changes in the sexuality of candidates and recipients of liver transplant. This is an integrative literature review, and the databases selected for the search of the primary studies were PubMed, CINAHL and LILACS. The 16 primary studies included in the review were grouped into three categories: (1) female sexuality (n = 5), (2) male sexuality (n = 5) and (3) male and female sexuality (n = 6). In category 1, the main research topics were contraception, pregnancy, sexual dysfunction, presence of gynecological symptoms and sexually transmitted disease. In category 2, the focus of the primary studies grouped was erectile dysfunction, it was also investigated the sexual desire/satisfaction, and the consequences of men who had children under immunosuppressive regimen with mycophenolic acid. In category 3, the evaluation of sexual function was the main topic addressed in the studies analyzed. Sexuality is a challenging problem, enrobed with taboos and prejudices, and experienced differently by individuals. Thus, patients may present difficulties in reporting their problems to health professionals, leading to delays in diagnosis and treatment, prolonging feelings of discomfort and distress. The difficulty in addressing sexuality also occurs on the part of health professionals who do not receive adequate training. Knowledge about the doubts and problems experienced by candidates and recipients of liver transplant can facilitate the implementation of interventions aimed at prevention, reduction or control of complications in the pre- and post-transplantation period. The present study provided subsidies to encourage health professionals to incorporate sexuality in the care routine of these patients, it also indicated gaps in knowledge for the conduct of new research with the purpose of implementing interventions in clinical practice to prevent, minimize and/or to control the changes related to the patient\'s sexuality, contributing to the improvement of nursing care and, consequently, to the success of the treatment

A transferência de embriões (TE) é uma biotecnologia amplamente utilizada na produção de equinos no Brasil, e a égua receptora exerce um papel fundamental nos resultados finais nos programas de reprodução. Alguns tratamentos têm sido preconizados com objetivo de exercer ação luteotrófica, melhorando a função luteal, e com isto aumentando os níveis sistêmicos de progesterona, como também o uso de drogas anti-inflamatórias, que evitam a perda da função luteal causada pela liberação de prostaglandina em processos inflamatórios prévios ou por manipulação na passagem transcervical do embrião no momento da TE. O objetivo deste estudo foi investigar os efeitos do anti-inflamatório inibidor seletivo COX 2 (meloxicam) associado ao uso luteotrófico da hCG na gestação, características de corpo lúteo, fertilidade e desenvolvimento embrionário em éguas receptoras. Para isto, 60 éguas receptoras alojadas em central de reprodução foram aleatoriamente divididas em 4 grupos de 15 animais, de acordo com os seguintes tratamentos: aplicação de 5ml solução fisiológica no dia da ovulação (controle); aplicação de 2500 UI hCG no dia da ovulação; aplicação de 2500 UI hCG no dia da ovulação associado a 0,6 mg/kg de meloxicam; aplicação de 2500 UI hCG no momento da transferência do embrião associado a 0,6 mg/kg meloxicam. No dia da TE, 7 dias após a TE e 21 dias após a TE para as éguas que ficaram gestantes, foi avaliada a irrigação do corpo lúteo por ultrassonografia modo doppler colorido por meio de score do percentual de irrigação (0-100%), e a irrigação do útero avaliado por score (1-4). Por meio da ultrassonografia no modo B, a área do CL em mm2 foi avaliada nos mesmos momentos, a área da vesícula em mm2 aos 15 e 21 dias da gestação e o tamanho do embrião em cm aos 29 dias de gestação. Além disso, foi realizada dosagem plasmática de progesterona no dia da TE, 7 dias após a TE e 21 dias para as éguas gestantes. As comparações entre os grupos foram analisadas para efeitos principais de tratamento e tempo, assim como para efeito de interação tratamento x tempo. Não foi observado influencia da aplicação de hCG e/ou meloxicam nos animais tratados comparados ao controle (P&gt;0,05). No entanto, foi observado um aumento numérico na taxa de gestação para os dois grupos de receptoras que receberam anti-inflamatório meloxicam, correspondendo a um índice superior em 13,3 % de gestação para éguas tratadas. Em conclusão, não há influencia da aplicação de hCG associado ou não meloxicam sobre a perfusão sanguínea uterina, do corpo lúteo, no desenvolvimento embrionário e nas concentrações plasmáticas de progesterona em receptoras de embriões. No entanto, existe, pela aplicação de meloxicam, evidência de melhora nos índices de gestação, podendo estar associado ao efeito anti-inflamatório seletivo COX-2, que pode melhorar resultados em programas comerciais de transferência de embriões em equinos. / Embryo transfer (ET) is a biotechnology widely used in equine production in Brazil, and the recipient mare plays a key role in the final results of breeding programs. Several treatments have been advocated both for the purpose of exerting luteotrophic action, improving luteal function, and thereby increasing systemic levels of progesterone, such as the use of anti-inflammatory drugs, which prevent the loss of luteal function caused by the release of prostaglandin in previous inflammatory processes or by manipulation in the transcervical passage of the embryo at the time of ET. The objective of this study was to investigate the effects of the anti-inflammatory COX 2 inhibitor (meloxicam) associated with luteotrophic use of hCG in gestation, corpus luteum characteristics, fertility and embryonic development in recipient mares. For this, 60 receiving mares housed in a reproduction center were randomly divided into 4 groups of 15 animals, according to the following treatments: application of 5ml physiological solution on the day of ovulation (control group); application of 2500 IU hCG on ovulation day; application of 2500 IU hCG on the day of ovulation associated with 0.6 mg/kg of meloxicam; application of 2500 IU hCG at the time of embryo transfer associated with 0.6 mg/kg meloxicam. On the day of ET, 7 days after ET and 21 days after ET for pregnant mares, corpus luteum irrigation was evaluated by color Doppler ultrasonography using a score of the percentage of irrigation (0-100%), and irrigation of the uterus evaluated by score (1-4). Using B-mode ultrasonography, corpus luteum area in mm2 was assessed at the same time points, the area of the embryonic vesicle in mm2 at 15 and 29 days of gestation, and the size of the embryo in cm at 29 days of gestation. In addition, plasma progesterone dosage was performed on ET day 7 days after ET in all groups and 21 days after ET for pregnant mares. The comparisons between the groups were analyzed for main effects of treatment and time, as well as for interaction effect treatment x time. No influence of application of hCG and / or meloxican was observed on treated animals compared to control (P&gt;0.05). However, a numerical increase in gestation rate was observed for the two groups of recipients who received anti-inflammatory meloxicam, corresponding to an index higher than 13.3% of gestation for treated mares. In conclusion, there is no influence of the application of hCG associated or not to meloxicam on uterine irrigation, corpus luteum, embryo development and plasma concentrations of progesterone in embryo recipients. However, there is evidence of improvement in gestation rates due to the application of meloxicam, which may be associated with the COX-2 selective anti-inflammatory effect of this drug, improving results in commercial embryo transfer programs in horses.

The value of an organization’s availability and transparency towards the public whenever and wherever it is necessary has increased. Internet and the social networks have become essential to most of the citizens of Sweden but for organizations social networking still is an area that is relatively unexplored. As the Internet and social media progresses it becomes a greater part of people’s lives, which leads to more demands but also a great amount of possibilities for the organizations that participate in this technical revolution. The purpose of this quantitative study is to examine if and how the people receiving the information published on the Växjö and Alvesta police department’s Facebook-page are considering Facebook as a channel of communication. The study is based on survey responses from users Liking the Facebook page Polisen i Växjö/Alvesta. By analyzing our findings we discovered that although people where interested in taking part of the information they were not too eager to participate in the conversation by for example making comments, however the average reliance for the police had increased since the respondents started Liking the Facebook page. Facebook is a good place for citizens to connect with authorities such as the police, getting the information that they want faster and easier and making the organization more transparent to the audience.