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Thaduri, Sharanya. "Migratory experiences and perceptions towards pregnancy applications : Comparing insights from natives and immigrants living in Sweden." Thesis, Uppsala universitet, Människa-datorinteraktion, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-447419.
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Increasing number of pregnancy applications (apps) are complementing healthcare systems to educate expectants and improve their maternal well-being. Using similar kind of applications for people from multicultural background might have varied impact on their pregnancy experiences. Especially for immigrants, cultural beliefs first set in their home country, might conflict with practices followed in country of residence and information provided in digital resources. This study aimed to compare the perceptions on pregnancy app usage by first-time expectants living in Sweden from native and migrant perspectives. Data was collected using semi-structured interviews through an online platform, Zoom, and explored the users’ opinions on app’ usage. Twelve first-time expectants were recruited through snowball sampling technique using social media group. Data was then analyzed using thematic qualitative analysis. The findings indicate the importance of understanding healthcare practices and social support in country of residence. Participants expressed that they developed a connection with unborn through pregnancy apps. However, app usage raised conflicts between user expectations from knowledge gained by apps and information provided by healthcare system, also exposed potential problems faced by immigrants due to different approaches followed by Swedish healthcare system. Participants using English apps expressed that they are receiving updates according to American healthcare system, while participants using Swedish apps asserted that they are getting relevant information adapted to Swedish society. The study advocates that the apps are not well-suited for migratory background users and provided possible solutions to improve existing pregnancy apps for maximum number of users to benefit.
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Bissonnette, Laurence. "Biomarqueurs de la réceptivité endométriale humaine : du fondamental aux applications cliniques." Thesis, Montpellier, 2015. http://www.theses.fr/2015MONTT017/document.
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L'acquisition du phénotype de la réceptivité endométriale est une étape clé de l'implantation embryonnaire. Dans ce contexte, ce projet vise à mieux cerner les mécanismes moléculaires de la réceptivité endométriale. Des approches globales (transcriptome et protéome), ont été utilisées pour nos activités de recherche et le développement d'outils diagnostiques en AMP. Nous avons déterminé les fonctions d'un de nos bio-marqueurs de la réceptivité endométriale par shARNs, S100A10. L'extinction de S100A10 dans les cellules primaires endométriales affecte la migration, la décidualisation et l'apoptose des cellules endométriales, des fonctions biologiques majeures impliquées dans le processus d'implantation. D'autre part, nous avons implanté notre test d'appréciation de la réceptivité endométriale dans une clinique de fertilité à Montréal et initié une étude prospective clinique de l'évaluation de la réceptivité endométriale en cycle naturel de patientes en attente d'une procédure de FIV/ICSI. De plus, nous avons démontré un effet délétère d'une progestéronémie élevée le jour du déclenchement de l'ovulation sous traitement de stimulation ovarienne sur la transition des profils transcriptomiques des endomètres pré-réceptif et réceptif, suggérant une accélération de la maturation endométriale pendant la phase péri-ovulatoire, sans pour autant affecter la réceptivité endométriale. Enfin, nous avons montré que la réceptivité endométriale des patientes sous traitements hormonaux substitutifs différait de celles en cycle naturel, caractérisée par une altération des voies de signalisation médiée par les récepteurs aux œstrogènes, des membres de la famille VEGF et des intégrinesThe acquisition of the receptive endometrial phenotype is a key step of the embryo implantation. In this context, this project aims to better understand the molecular mechanisms of the endometrial receptivity. Global technologies (transcriptome and proteome) were used for our research and the development of diagnostics tools in assisted reproductive technologies. We determined the functions of one of our endometrial receptivity biomarkers, S100A10, using shRNAs. S100A10 knockdown in primary endometrial cells affected migration, decidualization and apoptosis of endometrial cells, some major biological functions involved in the implantation process. Moreover, we established our test assessing endometrial receptivity in a fertility clinic in Montreal and initiated a prospective clinical study of the evaluation of endometrial receptivity in natural cycle of patients waiting for an ICSI/IVF attempt. Moreover, we demonstrated an alteration of the gene expression shift from the pre-receptive to the receptive stage of the endometrium of patients with elevated serum progesterone level on the day of ovulation induction, suggesting an accelerated endometrial maturation during the periovulation phase, and thus, without affecting the endometrial receptivity. Finally, we demonstrated that the endometrial receptivity of patients under hormone replacement therapy was different from patients in natural cycle, characterised by alternations in the signaling pathways mediated by the oestrogen receptor, VEGF family members and integrins
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Chen, Min. "Application of ultrasonography in early pregnancy." Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36603314.
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Chen, Min, and 陳敏. "Application of ultrasonography in early pregnancy." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B36603314.
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Lopez, Betsy Diamar Balbin, Jimmy Alexander Armas Aguirre, Diego Antonio Reyes Coronado, and Paola A. Gonzalez. "Wearable technology model to control and monitor hypertension during pregnancy." IEEE Computer Society, 2018. http://hdl.handle.net/10757/624723.
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El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.In this paper, we proposed a wearable technology model to control and monitor hypertension during pregnancy. We enhanced prior models by adding a series of health parameters that could potentially prevent and correct hypertension disorders in pregnancy. Our proposed model also emphasizes the application of real-time data analysis for the healthcare organization. In this process, we also assessed the current technologies and systems applications offered in the market. The model consists of four phases: 1. The health parameters of the patient are collected through a wearable device; 2. The data is received by a mobile application; 3. The data is stored in a cloud database; 4. The data is analyzed on real-time using a data analytics application. The model was validated and piloted in a public hospital in Lima, Peru. The preliminary results showed an increased-on number of controlled patients by 11% and a reduction of maternal deaths by 7%, among other relevant health factors that allowed healthcare providers to take corrective and preventive actions.
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Gordon, Roberta June. "Pregnant women's perception and application of health promotion messages at community health centres." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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Studies have shown that pregnant women do understand and value information of their unborn child. However, those providing health promotion services often focus on medical procedures and health education messages, ignoring the cultural, socio-economic and psychological dimensions that impact on women's health. This research aimed to look at a specific component of health promotion, i.e. health promotion messages shared with pregnant women attending Stellenbosch and Klapmuts Community Health Centre Antenatal Health Promotion Programme and their perceptions of how they apply messages in their daily lives.
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Manjunath, Karan. "PREGNANCY EXPERIENCE DURING COVID-19 : KEY CHALLENGES AND DESIGN IMPLICATIONS." Thesis, Uppsala universitet, Institutionen för informatik och media, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-454021.
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The Covid-19 pandemic has caused problem in a particular sensitive area: pregnancy, a moment with a significant impact on women's life. Prior research in this area has examined how women experience and manage pregnancy. However, it is still unclear how the experience of pregnant women is affected by key challenges arising from COVID-19. This research acts as a prerequisite study which can serve as a base for future design research in HCI (Human Computer Interaction). This study used semi-structured interviews in order to collect data. Participants in this study were recruited from two countries, India and Sweden, using initial purposive sampling followed by snowball sampling method. A qualitative analysis was carried out on the data, which showed that the key challenges faced by pregnant women during COVID-19 were as follows: social life, emotion and online/remote support. The study revealed that participants felt isolated and were deprived of social contact during their pregnancy, and that the feeling of women's partners being separated from the mother and baby during doctor visits and their other pregnancy related activities impacted both partners negatively. Moreover, while pregnancy application were used to compansate for these needs, such applications were typically lacking in accuracy of information on the participants specific needs, and were thus not well-suited for used during the pandemic. Thus, HCI experts need to look at design solutions considering pregnant women needs during pandemic situations.
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Martin, Jilly. "A Practical Application of Implementation Intentions : Changing Pregnancy-Risk Behaviour amongst Teenage Women." Thesis, University of Sheffield, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.515483.
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Gulotta, Charles S. "Predictors of a young woman's pregnancy decision : application of the theory of planned behavior /." Thesis, This resource online, 1994. http://scholar.lib.vt.edu/theses/available/etd-01242009-063202/.
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Lietz, Georg. "Use of red palm oil in vitamin A deficiency : studies on its analysis, stability and field application." Thesis, Oxford Brookes University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.322241.
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Czopek, Alicja. "Effect of maternal iron deficiency during pregnancy on kidney development and blood pressure regulation in the rat offspring." Thesis, Available from the University of Aberdeen Library and Historic Collections Digital Resources, 2009. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?application=DIGITOOL-3&owner=resourcediscovery&custom_att_2=simple_viewer&pid=26459.
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Stephen, Jillian. "Characterisation of effector and regulatory T-cell responses to blood group antigens." Thesis, Available from the University of Aberdeen Library and Historic Collections Digital Resources, 2008. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?application=DIGITOOL-3&owner=resourcediscovery&custom_att_2=simple_viewer&pid=24752.
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Nicaragua, Odila. "Design and application of a nutrition education program based on a test of improved practices for pregnant women and women of childbearing age in La Rinconada and Cuambo." BYU ScholarsArchive, 2003. https://scholarsarchive.byu.edu/etd/5407.
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This study was done with the objective of designing and applying a nutrition education program based on a test of improved practices for pregnant women and women of childbearing age in the rural communities of Ibarra canton: La Riconada and Cuambo. For this, information was collected on knowledge, attitudes, and practices (KAP) regarding the eating habits of pregnant women. These results were used to identify content and recommendations to reinforce and/or instruct about eating during pregnancy. Nutrition education was based on the methodology of the improved practices test, which consisted of testing the recommendations in families' homes before recommending them and recording information on their acceptability. The results indicate that pregnant women in the two communities don't eat all the food groups every day. They need to increase the consumption of foods rich in calcium and iron, as well as foods that supply energy, protein, and fats. The pregnant women don't eat additional foods to cover these recommendations during the pregnancy. Despite the knowledge they have and the lessons they received, there are women who don't eat greens, vegetables, and fruits because they don't like them, and those who do eat them don't meet the established nutritional recommendations. The women prefer to eat artificial drinks with unboiled water, and they do not look after personal hygiene. The test of improved practices has been useful for observing if they really put in practice the knowledge about eating during pregnancy, and at the same time it helped design the educational proposal that served as a guide to help improve eating practices of pregnant women in the two rural communities, considering their motivations and recommendations.
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Gradmark, Anna. "Validation and application of objective measures of obesity and physical activity : studies in pregnant and non-pregnant adults and in infants." Doctoral thesis, Umeå universitet, Medicin, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-43770.
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Background Excess adipose tissue and low physical activity are two major determinants for chronic diseases such as type 2 diabetes and cardiovascular disease. Understanding these relationships requires accurate and precise measures of body composition and physical activity, and most existing observational studies lack such measures. Paper I to III in this thesis addresses the validity of measures of physical activity and abdominal adipose mass. In paper IV and V, we explore the relationships between obesity and physical activity on metabolic health in non-pregnant and pregnant women and their offspring. Methods and Results Two hundred men and women representative of the Northern Sweden EPIC cohort were recruited for Paper I. A questionnaire on physical activity (PAQ) was validated against objectively measured physical activity energy expenditure (PAEE). A categorical physical activity index (Cambridge index) calculated from PAQ showed strongest correlation with PAEE (r=0.33 p<0.05). In Paper II, abdominal adiposity were assessed in 29 adult men and women using anthropometric measurements, dual energy x-ray absorptiometry (DXA) and ultrasound and were compared to computed tomography (CT). Waist circumference showed the highest correlation with CT-assessed visceral (r=0.85, p<0.0001) and subcutaneous adipose tissue (r=0.86, p<0.0001). Adipose thickness was best assessed with ultrasound. In Paper III, the validity of a wrist-worn triaxial accelerometer was assessed in 32 pregnant and 74 non-pregnant women using double-labeled water method (DLW) as the criterion measure. The output from the accelerometer explained 24% (p <0.001) of the variation in PAEE in non-pregnant and 11% (p<0.05) in the pregnant women. In Paper IV, 35 pregnant and 73 non-pregnant women underwent a 75g oral glucose tolerance test and habitual energy expenditure and physical activity was assessed objectively. Total physical activity was inversely associated with early insulin response in both pregnant (r=-0.47, p=0.007) and non-pregnant (r=-0.36, p=0.004) women. In, Paper V, 32 women and their offspring (n=33) were studied 4 months post-partum. Body composition was quantified using DXA in the women and air-displacement plethysmography in the infants. Mid-pregnancy weight gain was significantly associated with infant fat mass (r=0.41, p=0.022), whereas late-pregnancy weight gain associated to infant fat-free mass (r=0.37, p=0.04). Conclusion This work describes new methods as well as conventional anthropometric estimates and a questionnaire, that provide relatively strong estimates of body composition and physical activity which could be used in larger studies. Pregnant women were shown to have more sedentary behavior than non-pregnant but physical activity appeared to have equal effect on glucose homeostasis in both groups, which may help guide lifestyle interventions in pregnancy. The impact of weight gain during the different trimesters seems to differentially affect the offspring’s body composition in early infancy, which might give us clues to when different aspects of fetal development and growth occur and how modifiable lifestyle behaviors might be intervened upon to improve long-term health.Embargo
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Wilkinson, Steven. "Semi-automated measurement from X-ray diffraction of connective tissues with an application to the uterine cervix during pregnancy." Thesis, University of Aberdeen, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274847.
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X-ray diffraction from soft tissues can give information about collagen contained within the tissue matrix. Semi-automated analysis software was developed for diffraction pattern analysis. Diffraction patterns are often very different for different tissues and can be relatively indistinct and have more than tow diffractions maxima positions. A marked centre and the first two maxima positions provide distance values. Three different materials containing collagen were used and the variation of distances used to obtain a measure of accuracy. The peaks could be found on the images used to an accuracy of about 4% relating to a precision measured on the originals film of about 4mm. Accuracy of the methods varies according to the diffraction pattern and can vary from 2% to 7% accuracy. A preliminary study was carried out to assess the uterine cervix at various stages during pregnancy using a rat model. Resulting diffraction patterns were scanned to resolution of 105mm per pixel, to create a digital image. Data extracted from the image around a circle passing through the first two peaks located has a Gaussian functional fit applied. There were statistically significant changes towards a more vertical (circumferential to the cervix canal) orientation between pairs of measurements both in separation and in bisector angle measurements. The separation between orientations corresponding to the two diffraction maxima appear to decrease during pregnancy with two pairs of values giving significant changes. Fitted Gaussian curves with the larger sigma value demonstrated a marked increase in width at about the time of parturition. Conclusions from the results on testing the software and using the methods on a real practical study indicate that the software methods developed were easy to use, reasonably accurate and obtain information fairly rapidly from individual images of diffuse peaks.
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Emeis, Cathy L. "An application of the theory of planned behavior on nurse-midwives' intentions to counsel and prescribe emergency contraception /." Connect to full text via ProQuest. Limited to UCD Anschutz Medical Campus, 2007.
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Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2007.Typescript. Includes bibliographical references (leaves 146-157). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;
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Tombor, I. "Development of a smoking cessation smartphone application for pregnant smokers focusing on the role of identity." Thesis, University College London (University of London), 2015. http://discovery.ucl.ac.uk/1471694/.
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This thesis reports two strands of work leading to the creation of a smartphone application harnessing identity change to promote smoking cessation during pregnancy. The first strand studied the role of smoker identity in smoking cessation. Using data from a national prospective study of smokers in England, Study 1 found that most young women do not have a positive smoker identity but that those who do are less likely to try to quit smoking, independent of other smoking-related attitudes. Study 2 used prospective national survey data and showed that adopting a non-smoker identity after a quit attempt predicts medium-term abstinence. Study 3 was a meta-ethnography of smoker identity in young adults and found that multiple smoker identities evolve depending on the context and that these do appear to play a role in cessation. The second strand related to the development of the application itself. Using interviews with pregnant smokers, Study 4 found that, from their perspective, stopping smoking would require strong enough motivation, improved ability and a supportive social and physical environment. Study 5 involved focus groups of health professionals working with pregnant smokers and solicited recommendations regarding the design and delivery of digital cessation aids in pregnancy. Study 6 used data from a pilot randomised controlled trial of the smoking cessation website, MumsQuit, to assess associations between exposure to particular components and four-week continuous abstinence. Six behaviour change techniques were associated with abstinence: promoting problem solving, providing feedback on behaviour, promoting self-monitoring of outcomes of the behaviour, providing feedback on outcomes of the behaviour, providing social reward, and promoting self-reward. The thesis concludes with a description of the development of a smartphone application, SmokeFree Baby, based on preceding work.
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Halili, Lyra. "Characterizing the Factors Associated with Women’s Adherence to Institute of Medicine Gestational Weight Gain Guidelines and Assessing a Possible Role for Mobile Health through the Evaluation of a Pregnancy-Specific Application SmartMoms Canada." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/38463.
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Fetal exposure to an intrauterine environment affected by maternal obesity and excessive gestational weight gain (GWG) pose several adverse short- and long-term health risks to infants. Excessive GWG and maternal obesity are of high priority to public health across many nations. Improving maternal and child health can be achieved by encouraging women to meet Institute of Medicine (IOM) weight gain recommendations, sound clinical guidance, and other forms of support. Another means of helping women adhere to weight gain guidelines is by making use of the near ubiquitous nature of mobile technology and promoting healthy pregnancies through reliable mobile health (mHealth) applications (apps). The objective of the first study of this thesis was to examine the associations between psychosocial factors and achieving IOM-recommended weight gain during pregnancy. Cross-sectional data were collected from pregnant and postpartum women who responded to a validated questionnaire, the Electronic Maternal health survey. Multiple linear logistic regression analyses were used to determine correlates associated with meeting IOM guidelines. The objective of the second study was to conduct a preliminary exploration of women’s attitudes towards an evidence-based, mHealth app, SmartMoms Canada, as a valid source of pregnancy-related information and its ability to offer physical activity, nutrition, and lifestyle support. Focus groups were organized to assess women’s attitudes towards the app and inductive thematic content analysis was utilized to interpret focus group data. It was found that self-efficacy and perceived controllability of behaviours are important factors contributing to whether women meet IOM weight gain recommendations. Further, pregnant women are quite receptive to mHealth technology and positively viewed the future prospective of SmartMoms Canada as a means of promoting overall maternal health. Combined, these findings will contribute to our understanding of how to best improve maternal-fetal health outcomes in the near future.
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Brown, Mary Jane. "Application of the ARCS Model for designing and developing a motivational intervention for improving diet, physical activity and weight management in first-time mothers during pregnancy." Thesis, Ulster University, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.627736.
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Maternal overweight and obesity is associated with adverse pregnancy outcomes. Both women and healthcare professionals have expressed a desire for resources to adequately support pregnant women in successful weight management. The primary aim of this research was to identify any motivational deficits for healthy diet and physical activity behaviours in first-time mothers receiving routine antenatal education and in response develop an intervention that solved these deficits, therefore improving optimal weight gain during pregnancy. Application of the ARCS Model of Motivational Instructional Design (Keller, 1987) was undertaken using a mixed method approach with six interrelated phases: Phase one: Goal setting interventions for improving weight management during pregnancy were identified through a systematic literature review. Phase two: A motivational analysis of current antenatal instruction through non-participant observation. Phase three: Maternal motivation to eat a healthy diet and exercise was explored through one-to-one telephone interviews (n=9) and a theoretical measurement tool was developed and validated in a convenience sample (n= 196) of first-time mothers Phase four: Evidence generated in phases 1-3 was collated to create an overall audience motivational profile where lack of confidence-building instruction was identified as the key motivational problem. Phase five: Motivational objectives were established and appropriate ARCS model strategies selected to solve motivational deficits. Phase six: A new resource: "Yummy Tummies" was created and evaluated positively by maternity staff and women (n=11).
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Hurault-Delarue, Caroline. "Approche longitudinale et quantitative de l'exposition aux médicaments dans les études de pharmaco-épidémiologie : développement méthodologique et application aux expositions au cours de la grossesse dans la cohorte EFEMERIS." Thesis, Toulouse 3, 2016. http://www.theses.fr/2016TOU30041.
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Des études de pharmaco-épidémiologie ont montré le rôle de la dose et de la durée d'exposition à un médicament dans la survenue d'effets indésirables. Toutefois, ces différents paramètres sont rarement pris en compte simultanément dans les travaux visant à étudier le risque lié à une exposition médicamenteuse, notamment au cours de la grossesse. Les bases de données administratives de santé permettent d'appréhender ces paramètres et de retracer de façon précise l'historique de l'exposition de chaque patient aux médicaments. L'objectif de ce travail est de développer une nouvelle méthode de mesure d'exposition visant à classifier les individus en tenant compte de l'intensité et de l'évolution de cette exposition au cours du temps. L'application en pharmaco-épidémiologie permet une approche quantitative de l'exposition des patients (à travers la prise en compte des doses de médicaments délivrés) et longitudinale au cours du temps définissant ainsi des trajectoires individuelles d'exposition. La classification des individus en groupes homogènes selon ces trajectoires est mise en oeuvre grâce à l'utilisation d'une méthode de classification non supervisée fondée sur le principe de la méthode des K-means adaptée aux données longitudinales. Cette " Méthode des Trajectoires d'Exposition " a été appliquée à l'exposition aux psychotropes au cours de la grossesse, en utilisant les données de la cohorte EFEMERIS. Elle a mené, lors d'une première phase, à la constitution de clusters aux profils d'exposition homogènes. Lors de la deuxième phase d'application, les clusters issus de la classification des femmes exposées aux anxiolytiques et hypnotiques ont pu être utilisés comme variable explicative dans l'étude des risques pour le nouveauné et l'enfant liés une exposition in utero à ces médicaments. La mise en évidence d'une relation de type dose-effet au sein des 4 clusters identifiés laisse penser qu'un niveau élevé d'exposition à ces médicaments au cours de la grossesse augmenterait notamment le risque de pathologie néonatale. En opposition, les résultats concernant les femmes exposées ponctuellement ou à de faibles doses étaient rassurants. L'application à des données réelles a été l'occasion de valider cette méthode et de montrer l'intérêt de la prise en compte de l'intensité et de l'évolution des expositions médicamenteuses au cours du temps dans les études de pharmaco-épidémiologie. La méthode proposée peut être adaptée à d'autres populations, d'autres classes de médicaments mais également d'autres types d'exposition. Cette approche " trajectorielle " de l'exposition ouvre de nouvelles perspectives pour les futures études épidémiologiquesThe intensity and duration of drug exposure may contribute to the occurrence of drug adverse effects. However, these parameters are rarely simultaneously addressed in studies of risks associated to drug exposure, in particular during pregnancy. Administrative databases give the opportunity to apprehend these parameters and to reconstruct the history of patient drug exposure. The aim of this research is to develop a new method of exposure measurement in order to cluster individuals, taking into account both the intensity and the evolution of exposure. The application to pharmaco-epidemiological studies allow a quantitative approach of drug exposure and longitudinal over time defining individual trajectories of exposure. We used an unsupervised clustering method based on an implementation of K-means adapted to longitudinal data analysis to cluster individuals in homogeneous groups according to their trajectories. This "trajectory method" was applied to psychotropic drug exposure during pregnancy, using EFEMERIS database. The first phase of this application led to the identification of clusters with homogeneous profiles. During the second phase, clusters of women exposed to anxiolytic and hypnotic drugs were used as independent variables to study the effects of in utero exposure to these drugs on newborns and children. The study especially indicates a dose-response relationship between the 4 clusters and an increased risk of neonatal pathologies after an exposure to a heavy drug burden. By contrast, results concerning women punctually exposed or exposed to a light drug burden were reassuring. This application to real-clinical-data has validated this method and demonstrates the interest value of considering intensity and evolution of drug exposure over time in pharmaco-epidemiological studies. The proposed method could be adapted to other populations, classes of drugs and other types of exposure. This "trajectorial" approach of exposure opens up new prospects for future epidemiological studies
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Doyle, Ina-Merle [Verfasser], Jacob [Akademischer Betreuer] Spallek, and Oliver [Akademischer Betreuer] Razum. "Determinants of diet in pregnancy: development of an explanatory model and application to cross-sectional data from a social-epidemiological birth cohort study / Ina-Merle Doyle ; Jacob Spallek, Oliver Razum." Bielefeld : Universitätsbibliothek Bielefeld, 2017. http://d-nb.info/113642217X/34.
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Matheux, Alice. "Implication de PXR, Pregnane X Receptor, dans la résistance aux inhibiteurs de kinases en cancérologie : application au cancer de la prostate et mélanome." Thesis, Montpellier, 2020. http://www.theses.fr/2020MONTT049.
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La résistance clinique aux anticancéreux reste l’une des causes majeures de l’échec des traitements. Cette résistance est multifactorielle et implique un ensemble de mécanismes dont certains ne sont pas encore totalement élucidés. Parmi eux se trouvent des mécanismes impliquant les enzymes du métabolisme et du transport des médicaments dont les gènes sont majoritairement régulés par les récepteurs nucléaires, et notamment PXR (Pregnane X Receptor) ou NR1I2. Son expression et activité via l’expression de ses gènes cibles a souvent été décrite comme étant associée à la chimiorésistance dans des cellules cancéreuses, notamment dans le cancer de la prostate. Le cancer de la prostate résistant à la castration (CPRC) fait partie des cancers pour lequel aucun inhibiteur de kinase (IK) n’a été approuvé malgré un nombre conséquent d’essais cliniques qui se sont soldés par des échecs. Notre travail de Thèse a consisté à étudier l’impact de l’activité de PXR sur l’efficacité des inhibiteurs de kinases dans le contexte du CPRC. Nous avons premièrement confirmé la plus grande fréquence de l’expression de PXR dans les stades avancés de cancer de la prostate sur une cohorte de 512 tissus de patients. Nous avons également démontré que la surexpression stable de PXR dans les cellules de cancer de la prostate 22RV1 conférait une hypersensibilité à l’afatinib, l’erlotinib ou le dabrafénib alors qu’elle conférait une résistance au dasatinib et n’affectait pas la réponse aux autres inhibiteurs testés. L’hypersensibilité à l’afatinib était associée à une augmentation de la concentration intracellulaire de l’inhibiteur et une surexpression significative du transporteur d’influx SLC16A1. De manière intéressante, l’inhibition pharmacologique de SLC16A1 par le dérivé BAY-8002 inhibe l’effet de sensibilisation à l’afatinib par la surexpression de PXR, démontrant pour la première fois le rôle clé de ce transporteur dans la réponse à ce médicament. En parallèle, nous nous sommes intéressés à la possibilité que les inhibiteurs de kinases puissent avoir un effet agoniste de PXR et être à l’origine d’interactions médicamenteuses. Ce volet repose sur des données publiées démontrant une activité agoniste de PXR pour le dabrafénib, pouvant induire l’expression des gènes cibles de PXR tout aussi efficacement que l’agoniste de référence SR12813. Nous avons donc étudié l’effet de la surexpression de PXR sur la réponse aux combinaisons d’inhibiteurs de kinases ciblant BRAF et MEK approuvées dans le mélanome. Nos résultats préliminaires démontrent que dans les cellules de mélanome A375 mutées BRAF V600E, la surexpression de PXR induit une sensibilisation aux combinaisons dabrafenib+tramétinib et vémurafénib+cobimétinib aussi bien qu’aux inhibiteurs utilisés seuls, suggérant que les effets agonistes de PXR ne sont pas responsables de cette sensibilisation mais que d’autres mécanismes, qui sont en cours d’étude, soient mis en jeu. Ils renforcent néanmoins l’intérêt d’utiliser PXR en tant que nouveau marqueur prédictif de l’efficacité des inhibiteurs de kinases en cliniqueClinical resistance to anti-cancer drugs remains one of the major causes of treatment failure. This resistance is pleiotropic and involves various mechanisms, including drug transport and metabolism that implicate key enzymes the expression of which is regulated by nuclear receptors, in particular the Pregnane X Receptor (PXR or NR1I2). The expression of PXR and of its target genes have been associated with chemoresistance in various cancer cell models, including prostate cancer cells. There are currently very few options for the treatment of castration-resistant prostate cancer (CRPC), and despite numerous clinical trials, no kinase inhibitor has been approved in that indication. Our project was intended to study the impact of PXR activity on the efficacy of kinase inhibitors in CRPC. Using a tissue microarray of 512 patients, we first confirmed that the expression of PXR was more frequently detected in late stages of prostate cancers. We also demonstrated that stable expression of human PXR could sensitize 22RV1 prostate cancer cells to afatinib, erlotinib or dabrafenib, whereas it conferred a resistance to dasatinib and had no significant effect on other kinase inhibitors tested. Hypersensitivity to afatinib was associated with an increase in the intracellular concentration of the drug and a significant increase in the expression of the monocarboxylate transporter SLC16A1. Interestingly, pharmacological inhibition of SLC16A1 by the BAY-8002 derivative inhibited PXR-mediated sensitization of 22RV1 cells to afatinib, demonstrating for the first time the critical role of this transporter in the cell response to this kinase inhibitor. In parallel, we also studied whether kinase inhibitors could exert an agonist activity towards PXR and be responsible for potential drug-drug interactions. This relied on published observations demonstrating that dabrafenib is a PXR agonist, able to induce the expression of PXR target genes with the same potency as the reference agonist SR12813. We then studied the effect of PXR expression on the cell response to combinations of kinases inhibitors targeting BRAF and MEK that are approved in the treatment of melanomas. Our preliminary results demonstrate that, in BRAF V600E mutated A375 melanoma cells, stable expression of PXR could induce a sensitization to dabrafenib+trametinib and vemurafenib+cobimetinib combinations and to each inhibitor used alone, suggesting that other mechanisms currently under investigation, but not PXR agonist activity, are involved in this process. Nevertheless, our results further strengthen the fact that PXR could be used as a new predictive biomarker of the efficacy of kinases inhibitors in the clinic
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Codaccioni, Marc. "Évaluation de l’exposition fœtale aux substances chimiques grâce à la modélisation pharmacocinétique basée sur la physiologie (PBPK) et son application aux données d’imprégnation des populations." Thesis, Paris, Institut agronomique, vétérinaire et forestier de France, 2020. http://www.theses.fr/2020IAVF0019.
Full textAbstract:
Des études de biosurveillance ont montré l’exposition des femmes enceintes à des substances de synthèse. Parallèlement, plusieurs études épidémiologiques ont mis en évidence des associations entre des concentrations mesurées dans le sang des femmes enceintes ou dans le sang de cordon et des effets néfastes sur le nouveau-né comme sur sa santé plus tard dans la vie. Néanmoins, ce type de mesures n’offre pas la certitude d’être représentatif des expositions intra-utérines tout au long de la grossesse, et il n’est pas envisageable de mesurer longitudinalement les concentrations fœtales pour des raisons éthiques évidentes. Les modèles pharmacocinétiques basés sur la physiologie pour la femme enceinte et son fœtus (pPBPK) permettent de simuler les expositions internes d’un xénobiotique dans différents organes au cours de la grossesse. Ils fournissent donc l’opportunité de parfaire les estimations de la relation entre dose et risque de survenue d’effets toxiques par une amélioration de la dosimétrie au niveau des tissus. Toutefois, même si les modèles pPBPK peuvent intégrer les changements physiologiques liés à la grossesse, la connaissance de certains processus reste parfois limitée. C’est notamment le cas du passage transplacentaire (PT). L’objectif de la thèse consiste à améliorer la prise en compte du PT dans la modélisation pPBPK en vue de prédire des expositions internes fœtales à partir de données de biosurveillance.Une revue de la littérature sur la modélisation du PT dans les modèles pPBPK a été menée. Ce travail a permis d’identifier 12 structures parmi 50 modèles originaux qui correspondent à 4 types de profils cinétiques liés au nombre de constantes de passage. Les données animales représentaient leur principale source de paramétrisation, même si celles-ci ne sont pas directement extrapolables à l’homme et impliquent le sacrifice de nombreux animaux. A partir de notre revue, nous avons développé un modèle pPBPK intégrant quatre modèles de PT non basés sur des données animales afin d’évaluer leurs performances prédictives de la dosimétrie fœtale sur 10 composés. Nos résultats montrent que ces performances variaient suivant les modèles et les substances, empêchant d’identifier un modèle prédictif de référence. Des simulations Monte-Carlo ont permis de montrer qu’un des modèles différait des trois autres concernant les variations de profils d’exposition fœtale au cours des trimestres de grossesse. Enfin, une analyse de sensibilité globale a souligné l’influence majeure des constantes de passage et dans une moindre mesure de la clairance métabolique comme de la fraction libre sur l’exposition fœtale simulée. La dernière partie de la thèse a consisté à utiliser le modèle pPBPK développé pour estimer les concentrations internes fœtales des enfants de la cohorte française ELFE pour deux PCB et deux PBDE à partir de concentrations plasmatiques maternelles. Pour ce faire, nous avons sélectionné un modèle de PT spécifique à chaque composé sur la base de la qualité de prédiction de ratios de concentrations fœtale sur maternelle à terme. Le classement des substances basé sur des indicateurs d’exposition simulés s’est révélé être variable entre la mère et le fœtus à terme, comme entre le premier et les deux autres trimestres dans le plasma fœtal.En conclusion, ce travail souligne le potentiel de la modélisation pPBPK pour l’évaluation des expositions prénatales. Il démontre la capacité d’un modèle à simuler des indicateurs d’exposition interne adéquats d’un point de vue mécanistique et temporel, notamment à partir de données de biosurveillance. Aussi, dans un contexte de fortes contraintes éthique et réglementaire, ce travail éclaire sur l’apport des méthodes alternatives dans la paramétrisation de processus clé de la dose interne fœtale tel que le passage transplacentaire. L’apport de cette thèse pourra être mis œuvre dans l’étude de l’exposome prénatal comme dans l’évaluation du risque de toxicité développementale d’une substanceNumerous biomonitoring studies have shown the exposure of pregnant women to synthetic substances. In parallel, several epidemiological studies have highlighted associations between maternal blood concentrations measured during pregnancy or cord blood concentrations measured at birth and adverse effects in the offspring at birth or later in life. However, this type of measurements does not guarantee being representative of in utero exposures throughout pregnancy. Furthermore, it is not possible to measure longitudinally fetal concentrations due to obvious ethical reasons. Pregnancy physiologically-based pharmacokinetic (pPBPK) models allow the simulation of xenobiotic internal exposures in different maternal and fetal organs during gestation. Therefore, they offer an opportunity to better estimate the relationship between the dose and the risk of a toxic effect by considering tissue dosimetry. Although pPBPK models often incorporate physiological changes associated with pregnancy, some processes are still poorly known such as placental transfer (PT). The aim of the thesis is to improve the integration of PT in pPBPK modelling in order to predict fetal internal exposures from biomonitoring data.First, a scientific literature review of the published pPBPK models was conducted with a focus on the various model structures used to describe PT. It allowed the identification of 12 structures among 50 original models which corresponded to 4 types of kinetic profiles according to the number of transfer constants. Animal in vivo data were identified as the main source to support their parameterization although they cannot be directly extrapolated to humans and imply the killing of numerous animals. From this basis, we developed a pPBPK model which integrated four transfer models calibrated using non-animal methods so as to assess their performance to predict the fetal dosimetry on a set of ten substances. Our results show that the performance varied among models and substances, preventing the identification of a reference predictive model. Monte-Carlo simulations showed that one of the transfer models differed from the others in terms of fetal exposure variation across trimesters. Finally, a global sensitivity analysis shed light on a great extent of influence of the transfer constants as well as the metabolic clearance and fraction unbound, to a lesser extent, on simulated fetal exposure. The last part of the thesis consisted in applying the developed pPBPK model to estimate the internal fetal concentrations of two PCB and two PBDE substances from observed maternal plasma concentrations taken from the French ELFE cohort. To that end, we selected a specific PT model for each compound based on the prediction of fetal to maternal concentrations ratio at term. The ranking of chemicals based on the simulated exposure indicators varied between mother and fetus at term, as between the first and the other two trimesters in fetal plasma.In conclusion, this work highlights the potential of pPBPK modelling in the prenatal exposures assessment. It demonstrates the ability of a model to simulate adequate internal exposure indicators from a mechanistic and temporal points of view, notably from biomonitoring data. Furthermore, in light of strong ethical and regulatory constraints, this work indicates the role of alternative methods in the parameterization of key processes of the internal fetal dose such as the transplacental passage. This work could be used for the assessment of the prenatal exposome as well as in the developmental toxicity risk assessment of a substance
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Balbin, Lopez Betsy Diamar, and Coronado Diego Antonio Reyes. "Sistema para el control y monitoreo de alteraciones hipertensivas en el embarazo." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2019. http://hdl.handle.net/10757/653510.
Full textAbstract:
En el Perú, según estudios realizados en el 2010, el 42% de los pacientes hipertensos son tratados, pero solo el 14% de los pacientes logran ser controlados. Esto se debe a que el proceso actual de control de la hipertensión no es completamente eficiente debido a que el paciente no se adhiere completamente al tratamiento y que los controles de la tensión arterial resultan ser muy puntuales tras periodos de tiempo largos de los cuales no se tiene información confiable relacionada con el progreso del paciente.
Se plantea un sistema para el control y monitoreo de alteraciones hipertensivas en el embarazo con el uso de sensores biomédicos no invasivos. De esta manera aseguramos que la medición continua brinde la información precisa y confiable para que las mujeres gestantes puedan detectar a tiempo alguna alteración hipertensiva. Además, en segunda instancia, el sistema alerta a los familiares y al médico encargado sobre los niveles de presión arterial en caso de emergencia.
El aporte del proyecto es reducir el aumento en la prevalencia de las enfermedades crónicas mediante la integración de los servicios de salud con la tecnología, y gestionar la información desde la colección de datos a través del wearable hasta la exposición. En base a las pruebas realizadas con pacientes gestantes, se obtiene que el 38.64% son controladas y monitoreadas el 75% del tiempo. Estos resultados indican que el uso de la tecnología puede influenciar positivamente en la reducción de la hipertensión en general o en enfermedades crónicas similares.In Peru, according to studies conducted in 2010, 42% of hypertensive patients are treated, but only 14% of patients manage to be controlled. This is due to the fact that the current process of hypertension control is not completely efficient because the patient does not completely adhere to the treatment and that blood pressure controls turn out to be very punctual after long periods of time from which there is no reliable information related to the progress of the patient. A system is proposed for the control and monitoring of hypertensive disorders in pregnancy with the use of non-invasive biomedical sensors. In this way we ensure that continuous measurement provides accurate and reliable information so that pregnant women can detect any hypertensive disorder on time. In addition, the system alerts the family members and the doctor in charge about the blood pressure levels in case of emergency. The contribution of the project is to reduce the increase in the prevalence of chronic diseases by integrating health services with technology, and to manage information from data collection through wearable until data exposure. Based on the tests carried out with pregnant patients, 38.64% are controlled and monitored 75% of the time. These results indicate that the use of technology can positively influence the reduction of hypertension in general or in similar chronic diseases.
Tesis
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Chakabuda, Tendai Carol. "Towards an understanding of post-adoption usage behaviours in the context of m-health pregnancy support applications." Thesis, 2017. https://hdl.handle.net/10539/24398.
Full textAbstract:
Research report submitted to the School of Economic and Business Sciences, University of the Witwatersrand in partial fulfilment of the requirements for the degree of Master of Commerce (Information Systems) by coursework and research, 2 November 2017Mobile health applications are fast becoming an influential source of information for pregnant women. Studies have shown that pregnant women download 3 such apps on average on their cellphones. These mobile technologies have been shown to help women monitor their progress during their pregnancy and personalise healthcare to suit their needs. To date, llimited research has been directed towards understanding usage behaviours with these apps. Various authors have argued that there is a need to expand the scope of research from simple usage behaviour to deeper levels as technology becomes more sophisticated and easily available. M-health technologies are increasingly becoming more varied and sophisticated and as such this study aims to explore post-adoption usage specifically of mobile health pregnancy applications in the South African context. This study specifically looked at post adoption usage behaviours and used Hsieh and Zmud’s (2006) framework as a basis of understanding these behaviours. The potential influences on these behaviours were sourced from various studies done on pregnant women usage of ICT in general. These influences were then investigated to see whether they were relevant in the context of m-health pregnancy support applications. The primary method of data collection was open ended semi structured interviews with twelve pregnant women. Data analysis was done using the iterative model for qualitative data analysis proposed by Miles and Huberman (1994). The findings revealed that pregnant women displayed post adoption usage behaviours of routine use and IS continuance. With regards to the infusion stage, the study found that pregnant women engaged in the first set of post adoption usage behaviours i.e. extended usage and deep usage. They did not engage in second stage behaviours namely emergent use, feature extension or intention to explore behaviours. The influences identified in the literature were found to be relevant in the context of m-health applications and additional influences such as cost of seeing gynaecologist, number of features on the app and social structures were found to have an influence on usage of the apps. This study provides unique insights into the views of pregnant women’s experiences with m-health apps. Specifically, by using interpretive research it uncovers the subjective meanings around post adoption usage behaviours, understanding how pregnant women engage in these behaviours and subsequently how these behaviours are sustained during their pregnancy. The study recognises m-health pregnancy support apps as important tools in the pregnancy journey. It highlights how pregnant women value these apps and view them as huge information sources, reassurance and comfort during their pregnancy. It is argued that medical professionals cannot distance themselves away from these apps and need to work in conjunction with them to provide robust maternity care to their patients. 5 Theoretically, this study adds to our understanding of post adoption usage behaviours specifically in the context of m-health pregnancy apps. Limited studies have been done in this field specifically in the South African context and the study provides a foundation for further research. Further research can be done to understand how these apps are changing the relationship between pregnant women and medical professionals and furthermore, whether the information received from these apps is reliable and credible.
GR2018
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Haith-Cooper, Melanie. "Mobile translators for non-English-speaking women accessing maternity services." 2014. http://hdl.handle.net/10454/6729.
Full textAbstract:
noIt is becoming increasingly common for midwives to care for women who do not speak English, and UK interpreting services are often inadequate and underused. Persistent language barriers have been found to contribute to maternal and perinatal mortality thus it is essential that these barriers are overcome to provide safe maternity care. This article reports on a two-stage study undertaken to address this. The study aimed to: • Identify difficulties midwives experience when communicating with non-English-speaking women. Through undertaking a group interview with 11 senior students, four themes emerged: accessing interpreters, working with interpreters, cultural barriers and strategies to address persistent language barriers • Explore the feasibility of using mobile devices with a translation application to communicate in clinical practice. Google Translate was tested in a simulated clinical environment with multi-lingual service users. Google Translate was not adequately developed to be safely used in maternity services. However, a maternity-specific mobile application could be built to help midwives and women communicate in the presence of a persistent language barrier.
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Gibson, Elizabeth Atkeson. "Statistical and Machine Learning Methods for Pattern Identification in Environmental Mixtures." Thesis, 2021. https://doi.org/10.7916/d8-tnfc-et36.
Full textAbstract:
Background: Statistical and machine learning techniques are now being incorporated into high-dimensional mixture research to overcome issues with traditional methods. Though some methods perform well on specific tasks, no method consistently outperforms all others in complex mixture analyses, largely because different methods were developed to answer different research questions. The research presented here concentrates on answering a single mixtures question: Are there exposure patterns within a mixture corresponding with sources or behaviors that give rise to exposure?
Objective: This dissertation details work to design, adapt, and apply pattern recognition methods to environmental mixtures and introduces two methods adapted to specific challenges of environmental health data, (1) Principal Component Pursuit (PCP) and (2) Bayesian non-parametric non-negative matrix factorization (BN²MF). We build on this work to characterize the relationship between identified patterns of in utero endocrine disrupting chemical (EDC) exposure and child neurodevelopment.
Methods: PCP---a dimensionality reduction technique in computer vision---decomposes the exposure mixture into a low-rank matrix of consistent patterns and a sparse matrix of unique or extreme exposure events. We incorporated two existing PCP extensions that suit environmental data, (1) a non-convex rank penalty, and (2) a formulation that removes the need for parameter tuning. We further adapted PCP to accommodate environmental mixtures by including (1) a non-negativity constraint, (2) a modified algorithm to allow for missing values, and (3) a separate penalty for measurements below the limit of detection (PCP-LOD).
BN²MF decomposes the exposure mixture into three parts, (1) a matrix of chemical loadings on identified patterns, (2) a matrix of individual scores on identified patterns, and (3) and diagonal matrix of pattern weights. It places non-negative continuous priors on pattern loadings, weights, and individual scores and uses a non-parametric sparse prior on the pattern weights to estimate the optimal number. We extended BN²MF to explicitly account for uncertainty in identified patterns by estimating the full distribution of scores and loadings.
To test both methods, we simulated data to represent environmental mixtures with various structures, altering the level of complexity in the patterns, the noise level, the number of patterns, the size of the mixture, and the sample size. We evaluated PCP-LOD's performance against principal component analysis (PCA), and we evaluated BN²MF's performance against PCA, factor analysis, and frequentist nonnegative matrix factorization (NMF). For all methods, we compared their solutions with true simulated values to measure performance. We further assessed BN²MF's coverage of true simulated scores.
We applied PCP-LOD to an exposure mixture of 21 persistent organic pollutants (POPs) measured in 1,000 U.S. adults from the 2001--2002 National Health and Nutrition Examination Survey (NHANES). We applied BN²MF to an exposure mixture of 17 EDCs measured in 343 pregnant women in the Columbia Center for Children’s Environmental Health's Mothers and Newborns Cohort.
Finally, we designed a two-stage Bayesian hierarchical model to estimate health effects of environmental exposure patterns while incorporating the uncertainty of pattern identification. In the first stage, we identified EDC exposure patterns using BN²MF. In the second stage, we included individual pattern scores and their distributions as exposures of interest in a hierarchical regression model, with child IQ as the outcome, adjusting for potential confounders. We present sex-specific results.
Results: PCP-LOD recovered the true number of patterns through cross-validation for all simulations; based on an a priori specified criterion, PCA recovered the true number of patterns in 32% of simulations. PCP-LOD achieved lower relative predictive error than PCA for all simulated datasets with up to 50% of the data < LOD. When 75% of values were < LOD, PCP-LOD outperformed PCA only when noise was low.
In the POP mixture, PCP-LOD identified a rank three underlying structure. One pattern represented comprehensive exposure to all POPs. The other two patterns grouped chemicals based on known properties such as structure and toxicity. PCP-LOD also separated 6% of values as extreme events. Most participants had no extreme exposures (44%) or only extremely low exposures (18%).
BN²MF estimated the true number of patterns for 99% of simulated datasets. BN²MF's variational confidence intervals achieved 95% coverage across all levels of structural complexity with up to 40% added noise. BN²MF performed comparably with frequentist methods in terms of overall prediction and estimation of underlying loadings and scores.
We identified two patterns of EDC exposure in pregnant women, corresponding with diet and personal care product use as potentially separate sources or behaviors leading to exposure. The diet pattern expressed exposure to phthalates and BPA. One standard deviation increase in this pattern was associated with a decrease of 3.5 IQ points (95% credible interval: -6.7, -0.3), on average, in female children but not in males. The personal care product pattern represented exposure to phenols, including parabens, and diethyl phthalate. We found no associations between this pattern and child cognition.
Conclusion: PCP-LOD and BN^2MF address limitations of existing pattern recognition methods employed in this field such as user-specified pattern number, lack of interpretability of patterns in terms of human understanding, influence of outlying values, and lack of uncertainty quantification.
Both methods identified patterns that grouped chemicals based on known sources (e.g., diet), behaviors (e.g., personal care product use), or properties (e.g., structure and toxicity). Phthalates and BPA found in food packaging and can linings formed a BN²MF-identified pattern of EDC exposure negatively associated with female child intelligence in the Mothers and Newborns cohort. Results may be used to inform interventions designed to target modifiable behavior or regulations to act on dietary exposure sources.
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Weng, Yuan-Cheng, and 翁源成. "Application of Methotrexate and Bromocriptine in Termination of Pregnancy in Bitches." Thesis, 1997. http://ndltd.ncl.edu.tw/handle/29220415332380651915.
Full textAbstract:
碩士國立中興大學
獸醫學系
85
Methotrexate (MTX) and bromocriptine (BrC) were used in this study for terminating pregnancy in bitches. MTX can block DNA synthesis. BrC can inhibit prolactin secreetion and decrease serum pregesterone conxentration. Blood count, serum biochemistry, and serum pregesterone concentrations were analyzed in five normal pregnant bitches, five MTX (5 mg/M2) treated bitches,and eight MTX (5 mg/M2) treated bitches in 5, 15, 25, 38 days of pregnancy.Strong side effects were found in MTX treated bitches, especially in bitches with 25 or 38 day of pregnancy. None of the eight pregnant bitches terminated their pregnancy after MTX treatment. Four ultrasound confirmed pregnant bitcheswere treated with BrC (0.1 mg/Kg). Serum progesterone concentrations weredecreased immediately after the first day of BrC treatment. Three bitches (40to 50 day of pregnancy) were aborted within 2 or 3 days after BrC Treatment. The fetus ultrasound image of a 30-day-pregnant bitch was undertectable aftera 6 day BrC treatment. BrC is proved useful in terminating mid or late pregnancy in bitches..
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"Application of Low Frequency Focused Ultrasound Waves Ripen the Rat Cervix During Pregnancy." Master's thesis, 2012. http://hdl.handle.net/2286/R.I.15938.
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abstract: The object of this study is to charac terize the effect of focused ultrasound stimulation (FUS) on the rat ce rvix which has been observed to speed its ripening during pregnancy. Ce rvical ripening is required for successful fetal delivery. Timed-pregnant Sprague-Dawley rats (n=36) were used. On day 14 of gestation, the FUS system was placed on the body surface of the rat over the cervix and ultrasound energy was applied to cervix for variable times up to 1 hour in the control group, the FUS system was placed on rats but no energy was applied. Daily measurement of cervix light-induced florescence (LIF, photon counts of collagen x-bridge fluorescence) were made on days 16 of gestation and daily until spont-aneous delivery (day22) to estimate changes in cervical ripening. We found that pulses of 680 KHz ultrasound at 25 Hertz, 1 millisecond pulse duration at 1W/cm^2 applied for as little as 30 minutes would immediately afterwards show the cervix to hav e ripened to the degree seen just before delivery on day 22. Delivery times, fetal weights and viability were unaffected in the FUS-treated animals.Dissertation/Thesis
M.S. Bioengineering 2012
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Chao, Kuo-Min, and 趙國閔. "An application of case based reasoning to predict pregnancy rates of artificial reproductive technology." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/pr8z86.
Full textAbstract:
碩士國立臺北科技大學
工業工程與管理研究所
99
With the era of declining birthrate, coupled with the rising average age of marriage, to accept the number of assisted reproductive technology increases every year, the success rate of artificial insemination has become a frequently discussed topic in recent years. Currently there are many medical institutions Jie help patients IVF embryo implantation, in order to maintain its accuracy, application of artificial intelligence and data mining technology to solve medical problems is a very important issue. In this study, case-based reasoning construct an artificial reproductive case-based reasoning mechanism, the case of all assessments by the old data, indicators for new cases of similarity comparison of the re-calculated with the AHP weights of individual indicators to effectively calculate a new case closest to the current state of the old cases in order to assist physicians in the usual human reproductive surgery to follow precedent, the diagnosis and treatment, encounter new situations can also accumulate new case, to establish a more complete case-base .
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Hess, Leona E. "Intersectionality: A Systematic Review and Application to Explore the Complexity of Teen Pregnancy Involvement." Thesis, 2012. https://doi.org/10.7916/D8CV4FTQ.
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This three-paper dissertation investigates current applications of intersectionality in social work research and explores the utility of intersectionality in uncovering the complexity of teen pregnancy involvement. To illustrate the current methodological and theoretical applications of intersectionality in social work research, the first paper presents a systematic review of the literature. As shown in this paper, while intersectionality is underutilized as a theoretical concept in social work research, the potentialities of intersectionality to examine the complexity of social locations and identities is manifest. The second and third papers employ intersectional approaches to uncover the complexity of teen pregnancy involvement in New York City. The second paper examines quantitatively the interaction of gender, race/ethnicity, and sexual orientation on teen pregnancy involvement among a representative sample (N=176,289) of New York City public high school students. Findings from this paper reveal new patterns of disparities in teen pregnancy involvement based on the interactive effects of gender, race/ethnicity, and sexual orientation. The third paper captures qualitatively the interactions of social locations that contribute to perceptions about teen pregnancy among 24 sexual-minority female youth of color who participated in focus groups at a community-based organization in New York City. This paper examines the heteronormative assumptions underpinning teen pregnancy involvement and provides a different story about teen pregnancy "risk."
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Theriault, Lynne Anne. "Toward cultural competence when caring for Muslim women and their families : application to pregnancy loss." 2005. http://hdl.handle.net/1993/22354.
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Chiou, Jyh-Shin, and 裘志信. "Cost Containment Through Weight Control During Pregnancy -Practical Application of Preventive Medicine and Capitation Implication Prospectively." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/19514145989761903609.
Full textAbstract:
碩士國立陽明大學
醫務管理研究所
99
Medical expenditure inflamed has been a major concern for almost every industrialized country. Moral hazard and cost sharing are the dilemma in every health care insurance system. Payment system with fee-for-service are the major cause of higher medical care utilization. The Taiwan’s National Health Insurance (NHI) implemented in March, 1995. 92 percent of population had enrolled in the NHI by the end of 1995. The payment system with fee-for-service from the beginning, it may induced demand for the new medical technology. But, the health care system spending was escalating rapidly despite of copayment for each outpatient visit and coinsurance for inpatient service. Sample and design: Study intake was conducted over 3-year period from Jan. 2007 through Dec. 2009 among pregnant women in our hospital. All pregnant women who began prenatal care at our hospital were screened for study eligibility. All cases participated in an individual 20-minutes intake education program conducted by physician and nurse staff. This mandatory procedure marked the formal beginning of prenatal care in our hospital. Health education on various prenatal topic and body weight gained monitoring were employed during the whole course of pregnancy sequentially. Despite the large number of surverys on pregnancy complications in obesity women, few data are available on medical cost in this high-risk group. In this retrospective study, we found that the cost of prenatal care in obesity women exceeded that in normal weight gain group during pregnancy. Efforts to reduce the prevalence of obesity through preventive medicine could result in significant medical cost savings. It maybe could be the strategy to capitation in near future.
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LI, SHI-LONG, and 李世隆. "Circulating concentrations of trace elements in pregnant women and its gynecological applications." Thesis, 1986. http://ndltd.ncl.edu.tw/handle/11145780714123717430.
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Yi-ChienTsai and 蔡伊茜. "Effectiveness of Prenatal Breathing Skills Application on Labor Pain, Self-efficacy and Childbirth Satisfaction among Pregnancy Women." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/27ya3a.
Full textAbstract:
碩士國立成功大學
護理學系
104
The study aimed to examine the effectiveness of a Lamaze breathing skills application (LB-APP) on labor pain, childbirth self-efficacy and childbirth satisfaction. This study applied a randomized controlled trial (RCT) design, including an experimental group (EG) and a control group (CG). At trimester pregnancy, the pregnant women in the EG received an intervention, the LB-APP; whereas the women in CG received a breasting leaflet. A total of 51 pregnant women participated in study (experimental group = 23; control group = 28). The women in EG were more likely to practice breathing during labor than those women in CG. After controlling for pretest scores of childbirth self-efficacy, women in experimental group had significantly higher score of childbirth self-efficacy than that in control group (F = 14.82，p 〈 .001). There were no group differences in labor pain and childbirth satisfaction. This study reveals the Lamaze breathing skills APP can enhance childbirth self-efficacy among perinatal women.
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WU, PO-WEI, and 吳柏緯. "Application of rule-based analysis and sequence analysis in neural network classifier for wearable pregnancy monitoring device." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/qq4xyb.
Full textAbstract:
碩士南臺科技大學
電機工程系
106
Fetal distress is a symbol of fetal hypoxia in the uterus, which might affect the fetal nervous system function, leading to an increased risk of cerebral palsy during fetal growth, and could be serious enough to cause fetal death. At present, bedside fetal monitors which are used clinically to display fetal heart rate (FHR) and uterine contraction (UC) signals on sheets of ordinary paper or monitor screen are recognized as a reference in the assessment of fetal hypoxia. The bedside fetal monitors are pretty heavy, quite difficult to move, and expensive, therefore, most pregnant women must process the monitors only in hospitals or in maternity clinics. The bedside fetal monitors are pretty heavy, quite difficult to move, and expensive, therefore, most pregnant women need to go to the hospitals or maternity clinics examination. Additionally, most doctors mainly rely on visual observation for the interpretation of long-term data during the prenatal examination. In addition to the fact that it was not easy to find subtle signal differences, and was rather prone to make an assessment with their own subjective thinking. This study used a self-developed positive force UC and Doppler ultrasound sensing technology, and combined with wireless transmission and intelligent classification methods to design a wearable maternal fetal heart rate (FHR) and UC detection device. The proposed device could immediately carry out signals classification and warning signs, the results were transmitted and displayed on the phone. The intelligent classification method was based on the clinical three-tier classification and used the method of sequence analysis and artificial neural network (ANN) method to further classified into IIa and IIb based on the unknown clinical signals (type II). The more precise reference would be provided to improve the detection accuracy of fetal distress in clinical trials. The positive force UC and Doppler ultrasonic sensing technology developed by the institute, it had the same high-degree of correlation in comparison with commercially available equipment. In the classification experiment of 68 pregnant women in clinical trial, the average Kappa score of the rule classification system and the doctor's interpretation was 0.72. In combination with sequence analysis and artificial neural network method, it could distinguish the unknown clinical signals (type II) into IIa and IIb which their probability of fetal distress were 25% and 75%, respectively. Hence, it could be seen that the clinical application potential of this system could be expected. The study could further to add other clinical physiological parameters to improve the accuracy of system prediction. It was expected that the results of the present study could improve the quality of clinical care and reduce the requirements for Nurse Staffing, and serve as an optimal medical treatment for pregnant women in the future.
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Tonn, George Roger. "Application of stable isotope labeled diphenhydramine to study the pharmacokinetics and metabolism of diphenhydramine in pregnant, non-pregnant, and fetal sheep." Thesis, 1995. http://hdl.handle.net/2429/8809.
Full textAbstract:
Diphenhydramine (DPHM), an antihistamine, has been used in pregnant women;
however, information regarding its disposition in human pregnancy is lacking. Recently, detailed
pharmacokinetic studies in pregnant sheep have demonstrated that DPHM readily crosses the
ovine placenta, and is eliminated from the fetus by placental and non-placental pathways. The
purpose of this study is to investigate the components of the fetal non-placental elimination (i.e.,
fetal renal and hepatic), and to compare these to the estimates obtained from adult sheep. Since
stable isotope techniques were to be employed, synthesis of stable isotope labeled DPHM (i.e.,
[²H10]DPH0M) and its major metabolite diphenylmethoxyacetic acid (i.e., [²H10]DPM0A) was
required. Next, gas chromatographic - mass spectrometric methods were developed to
simultaneously measure either DPHM and [²H10]DPH0M, or DPMA and [²H10]DPM0A. The
current study demonstrates that the measured fetal renal clearance of DPHM contributes only
~2% to the observed fetal non-placental clearance. Overall, the total non-placental clearance of
DPHM measured by direct methods (i.e., pulmonary [Yoo, 1989] and renal) can account for
~10% of the non-placental clearance. Unlike adult sheep, where hepatic extraction of DPHM
was ~93%, no significant extraction of DPHM by the fetal liver following umbilical venous
administration was observed. Therefore, fetal hepatic elimination is not likely to account for the
remainder of the fetal non-placental clearance. However, fetal hepatic in vitro metabolism of
DPHM (to form N-demethyl DPHM and DPMA) suggests that the fetal liver is capable of
DPHM biotransformation. Thus, the liver and possibly other organs may contribute at least a
portion of the fetal non-placental clearance via DPHM biotransformation. It appears that only a
small fraction of the fetal non-placental clearance of DPHM can be accounted for by fetal renal and pulmonary clearances. While the low renal clearance of intact DPHM is similar both in fetus
and mother, large differences in the hepatic uptake and/or metabolism of DPHM were observed
between mother and fetus. This suggests that the pathways for the non-placental elimination of
DPHM differ in mother and fetus. Despite the advances made in this study, the components of
the fetal non-placental clearance remains largely unknown, and requires further study.
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Hung, Szu-Jung, and 洪示容. "A Study of Pregnant Women's Information Needs and Usage Behavior of Mobile Health Applications." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/84996733053141380073.
Full textAbstract:
碩士國立臺灣師範大學
圖書資訊學研究所
104
Pregnant women are eager for plenty of information due to the change of physical and psychological status during pregnancy. So women would retrieve health information frequently during antepartum and postpartum period. Since the rise of mobile health (mHealth) in recent years, there are many practices proved that pregnant women give fully positive feedback for mHealth in obstetrics. With the popularity of mobile devices and mobile networks, mHealth applications (mHealth apps) also developed rapidly. Currently, the amount of mHealth app has over one hundred thousand on both iTunes App Store and Google Play. There are more and more pregnant women using mHealth app to meet their information needs and personal health management. There are many case studies about mHealth and pregnant women, but few are related to mHealth app and pregnant women even in Taiwan. In order to figure out the pregnant health information seeking experiences of pregnant women and behaviors of using pregnancy applications (pregnancy apps), the specificpurpose of this study, includesdiscussionsof health information needs of pregnant women, channels of pregnancy information, opinions and behaviors of using pregnancy apps. For realizing existing pregnancy apps, we also progress content analysis on 30 pregnancy apps with two dimensions: “information topics” and “functions”. This study used interview method to collect 12 pregnant women who was using at least one pregnancy app. According to the research and we found that there are many information channels for pregnant women, includes interpersonal relationship, paper materials, digital resources and physical activities. Choosing information channels based on different purposes and contexts, and different channelsare complementary.Pregnant women's information needs can be divided into four categories, including antenatal knowledge, postnatal knowledge, medical information and life information. Also, information needs various from pregnancy stage and parity. Besides, pregnant women have some problems on information seeking, such as reliableness of information issue, reliability of information and interpersonal relationship obstacles. There three categories that pregnant women access from pregnancy apps, include pregnancy knowledge, medical information and life information; and three functions they used are note taking, counting & measuring and others. Pregnant women have good feedback on using pregnancy apps, because of practicality and convenience of. However, there's some system stability problems, such as appcrush. And almost near 60% pregnant women indicated that pregnancy apps can't meet her demand because some lack of information. Almost near 70% pregnant women think pregnancy apps should provide extracted information and the amount of information should be adequate, that allow users grasp information fast. Besides, pregnant women also suspect suitability of information and accuracy of information in apps, moreover, the information on apps is stationary, lacking of novelty. And the information presentation and visual design also influence usage Intention of pregnancy apps. Based on the research result, we suggested that government shouldattach importance to promote mHealth, and draw up regulations of mHealth apps. We also suggested medical institutes could take advantages of the completeness of electronic medical record (EMR), and develop their mobile application to connect with EMR, and provide some practical functions such as making appointments, check clinic progress, could access simple prenatal care record; suggested pregnancy app developers realize pregnant women’s actual needs and preference on using pregnancy apps, and provide faultless pregnancy apps to pregnant women.
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Sun, Wei-Ya, and 孫湋亞. "Pregnant Women’s Attitude Towards Carrier Testing forFragile X Syndrome: An Application of Health Belief Model." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/90008615980749508913.
Full textAbstract:
碩士國立臺灣大學
分子醫學研究所
96
Fragile X syndrome (FXS) is the most common inherited mental retardation disorder. The patient''s mother is always the carrier of this disease. Through prenatal diagnosis on carrier woman, this disease is preventable. Based on health belief model, the purpose of this study was to (1) document the acceptance of fragile X carrier screening among pregnant women, (2) explore the factors that influence pregnant women’s attitude for carrier screening. The study setting was in the obstetric OPD of a regional general hospital at Taipei County. 205 participants with gestational age less than 14 weeks filled out a self-administered questionnaire. The instrument included demographic data, personality traits, the knowledge on FXS, perceived susceptibility and severity, perceived benefits and barriers of taking action, cues in action and the acceptance of carrier screening. These data were analyzed using descriptive and inferential statistic. From inferential statistics, we found that 1. Compared with senior high school education, participants with tertiary education had higher perceived susceptibility. Participants with higher education, higher family income, married and atheists had higher perceived severity. Women who had experience of pregnancy loss had higher perceived benefits. Participants with higher family income had lower perceived barriers. Women with advanced maternal age (≥34 years of age) or multipara had more cues in action than age less than 34 years or primigravidae. 2. The knowledge of FXS were positively correlated with perceived susceptibility, severity and benefits and negatively correlated with perceived barriers. 3. Logistic regression analysis revealed that perceived barriers and susceptibility were the two major predictors for acceptance of fragile X carrier screening. From study results, we also discovered that the lack of knowledge on FXS was the most obstacle to the acceptance of fragile X carrier screening. Hospital needs to provide the FXS handout to these pregnant women to facilitate their decision on fragile X carrier screening. Moreover, the genetic counseling should be carried out by certified genetic counselor or clinical geneticist before and after the carrier screening.
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Mehari, Tesfai T. "The application and use of the partogram in evaluating the Saving Mothers programme in South Africa in 2002." Thesis, 2004. http://hdl.handle.net/10413/7586.
Full textAbstract:
The SA National Department of Health made maternal deaths notifiable in 1997. It also commissioned a National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD) to confidentially investigate all maternal deaths, to write the "Saving Mothers Report" and to make recommendations based on the findings of the study. The Department of Health in 2003 commissioned an evaluation of the extent to which the 10 recommendations contained in the first "Saving Mother's Report" had been implemented. This rapid appraisal was carried out by Centre for Health and Social Studies (CHESS), University of Natal. A report 'The Progress with the Implementation of the Key
Recommendations of the 1998 "Saving Mothers Report" on the Confidential Enquiry into Maternal Deaths in South Africa - A Rapid Appraisal," was published in 2003. The data collected on Recommendation 5 on the use of the obstetric partogram in 46 selected provincial hospitals in all the 9 provinces was only partially analysed in this report. This study reports on a secondary analysis of the 942 questionnaires that were completed on the use and application of the partogram in hospitals in South Africa. In the rapid appraisal experienced field workers evaluated the use of the partogram using a 36-point
checklist. Provincial and national averages for each of these variables were calculated and hospitals were evaluated into how they performed according to these averages using Lot Quality Assurance Sampling methodologies. Using national and provincial averages, the hospitals in each province are compared with one another provincially and nationally. In addition, the application and use of partograms in areas and levels of hospitals are described. An attempt is made to show if there is relation between the number of deliveries and the recording of the partogram. The main findings were that, of all the provinces KwaZulu-Natal had the lowest number variables below the national average from the 36 variables used as a checklist. Eastern Cape and Limpopo had the highest number of variables below the national average. The hospital with the highest number below the national average is in the Eastern Cape. In the
recording of the chart rural and level one hospitals are low in comparison with urban and level three hospitals. There was no relation in the recording of the chart and the number of deliveries.Thesis (M.PH.)-University of KwaZulu-Natal, 2004.
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Simon, Jaqueline Louisa. "How to launch a mobile application in the german market : the case of BECONVIDA." Master's thesis, 2020. http://hdl.handle.net/10400.14/31296.
Full textAbstract:
During pregnancy, foodborne illnesses can cause serious health problems, premature delivery,
stillbirth, or even death of expectant women. BECONVIDA is a mobile application designed to
prevent expectant women from becoming diseased and thereby harming the embryo by informing
expectant parents about products that contain potential health risks.
This dissertation presents a practical example of how to launch a mobile application in the German
market by using the case of BECONVIDA. The dissertation aimed to investigate BECONVIDA’s
market potential, its potential consumers, and developed a suitable monetization strategy to ensure
financial success. To that end, an online survey, expert interviews, and extensive market research
was conducted.
First, the dissertation found that BECONVIDA can penetrate a gap in a market that experiences
continuous growth. Further, the COVID-19 pandemic has led to a massive disruption of access to
information, pushing for digitalization. This change combined with the prospected market trends
offers an attractive market environment for BECONVIDA. Second, the analysis of the survey
revealed an attractive consumer segment that BECONVIDA will target by positioning itself as a
high-end mobile application. Third, further analysis showed that the mobile application should be
priced as a monthly subscription model, leveraging multi-person pricing. Taken together,
BECONVIDA should take advantage of current market developments in a timely manner.Durante a gravidez, as doenças de origem alimentar podem causar graves problemas de saúde, parto prematuro, nado-morto ou mesmo a morte de mulheres grávidas. O BECONVIDA é uma aplicação móvel concebida para evitar que as mulheres grávidas fiquem doentes, prejudicando assim o embrião, ao informar os futuros pais sobre produtos que contêm potenciais riscos para a saúde. Esta dissertação apresenta um exemplo prático de como lançar uma aplicação móvel no mercado alemão, utilizando o caso do BECONVIDA. A dissertação visava investigar o potencial de mercado da BECONVIDA, os seus potenciais consumidores, e desenvolveu uma estratégia de monetização adequada para garantir o sucesso financeiro. Para o efeito, foi realizada uma pesquisa online, entrevistas com peritos e uma extensa pesquisa de mercado. Em primeiro lugar, a dissertação descobriu que a BECONVIDA pode penetrar numa lacuna num mercado que experimenta um crescimento contínuo. Além disso, a pandemia de COVID-19 levou a uma enorme perturbação no acesso à informação, conduzindo à digitalização. Esta mudança, combinada com as tendências de mercado previstas, oferece um ambiente de mercado atrativo para a BECONVIDA. Em segundo lugar, a análise do inquérito revelou um segmento de clientes atrativo que a BECONVIDA irá visar, posicionando-se como uma aplicação móvel de topo de gama. Em terceiro lugar, uma análise mais aprofundada mostrou que a aplicação móvel deve ser tarifada como um modelo de assinatura mensal, alavancando diferentes preços para pessoas diferentes. Tomando tudo em em consideração, a BECONVIDA deverá tirar partido dos atuais desenvolvimentos do mercado de forma atempada.
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Marat, Ronald Kirk. "The application of modern NMR techniques to problems of structure, stereochemistry and conformation in steroids : C-20 stereochemistry and C-17 side-chain conformation in C-20 substituted pregnanes ; structure and conformation in ring A and ring B cyclosteroids and cyclopropanosteroids." 1996. http://hdl.handle.net/1993/19206.
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