Dissertations / Theses on the topic 'S health'

Self-reported mental health problems have increased dramatically among young female high school (Swedish: gymnasium) and university students in Sweden since the 1990’s. The reasons for this increase are mostly unknown but self-esteem and body image might be important factors behind this problem. The aim of this study was to test whether self-esteem and body dissatisfaction predict health. All correlation directions were in accordance with previous studies on the subject. There was no age group difference in levels of self-esteem, body dissatisfaction or health among the women. Multiple regression analysis revealed that global self-esteem was the strongest single predictor of health. These results give support for the importance of global self-esteem for subjective health. This should be considered in future studies and in the battle against the development of depression, anxiety and eating disorders among women.

The main aim of this thesis was to study children’s mental health with focus on family arrangements. The thesis was based on four studies (I-IV). Study number I, III and IV were quantitative studies with cross sectional design, using the Swedish version of Health behaviour in School- aged children (HBSC), including children aged 11, 13 and 15 years. The data was analysed with multiple linear regression analysis (I) and multivariate logistic regression analysis (III, IV). Study II was of qualitative descriptive design, based on 28 interviews with parents living in shared physical custody with their children. The qualitative study was analysed with inductive latent content analysis. Study I showed that lower levels of SHC and higher levels of SWB were associated with higher degrees of social capital in the family, school and neighbourhood. Social capital in family, school and neighbourhood had a cumulative influence on children’s SHC and SWB. In study II the participating parents described their own as well as the perceptions of their children and former partners. Parents’ perceptions changed from the beginning of shared physical custody, through the current situation, ending with perception of the future. The fifteen year old boys and girls (III) living in shared physical custody were more at risk of being a smoker or having been drunk compared with children living in two parent families. The results of sex <15 years and conduct problems showed that the risks didn’t differ significantly between these two groups. Study IV showed that children living in shared physical custody with their parents were more likely than children in two parent families to report multiple SHC, and low SWB. The variable of communication did not moderate the SHC and SWB of the children in any of these two groups. This thesis contribute with new and deeper understanding of the relatively new phenomenon: shared physical custody, and its associations to children’s mental health. The parent’s perceptions were an important complement to the children’s self reported health. In order to influence the decreasing mental health among children and adolescents, their opinions contributes to further understanding. Narratives from children, parents and practitioners are required in order to further study the association between children’s health outcomes and different family arrangements. Additional studies are needed to clarify how children’s mental health and different family arrangements are related to school, community economy, and society.
Avhandlingens huvudsyfte var att studera barns mentala hälsa med fokus på familjekonstellationer. Fyra olika studier ligger till grund för avhandlingen (I-IV). Studie I, II och IV var kvantitativa studier med tvärsnittsdesign. Datamaterialet utgjordes av den svenska versionen av Health Behaviour in School- aged Children (HBSC) (Svenska skolbarns hälsovanor). De deltagande barnen var i åldrarna 11, 13 och 15 år. Datamaterialet analyserades med hjälp av multipel linjär regressions analys (I) samt multivariat logistisk regressionsanalys (III, IV). Studie II var av kvalitativ karaktär och baserades på 28 intervjuer med föräldrar som bodde växelvis boende med sina barn. Den kvalitativa studien analyserades med hjälp av induktiv latent innehållsanalys. Studie I visade att lägre nivåer av SHC (subjektiva hälsobesvär) och högre nivåer av SWB (subjektivt välbefinnande) hade ett samband med högre nivåer av socialt kapital i familjen, skolan och närområdet. Socialt kapital i familjen, skolan och närområdet hade en kumulativ effekt på barnens självrapporterade SHC och SWB. I studie två beskrev de deltagande föräldrarna sina egna upplevelser, samt upplevelser relaterat till barnen samt och den före detta partnern. Föräldrarnas upplevelser förändrades från den första tiden av växelvis boende till nuvarande situation och avslutades med tankar om framtiden. De växelvis boende femtonåriga pojkarna och flickorna i studie III rapporterade ökad risk för att vara såväl rökare som att ha varit berusade jämfört med 15- åringarna i traditionella familjer. Resultaten avseende sex <15 år samt beteendeproblem visade inga signifikanta skillnader mellan dessa två grupper. Studie IV visade att barn som bodde i växelvis boende rapporterade fler subjektiva hälsobesvär och lägre välbefinnande jämfört med barn i traditionella familjer. Kommunikationsvariabeln hade ingen modererande effekt på någon av dessa båda grupper. Föreliggande avhandling bidrar med såväl ny som fördjupad kunskap för det relativt nya fenomenet, växelvis boende, och dess relation till barns mentala hälsa. Föräldrarnas upplevelse var ett viktigt bidrag till barnens självrapporterade hälsa. För att kunna påverka barn och ungas rapporter om allt sämre mental hälsa, är deras åsikter ett viktigt inslag för ökade kunskaper inom området. Vi behöver barns, föräldrars och yrkesverksammas åsikter för att vidare kunna studera relationen mellan barns hälsoutfall och olika familjekonstellationer. Vi behöver också veta mer om olika familjekonstellationers relation till skolan, närområdet samt det övriga samhället.

The effect of family structure on household nutrition intake and the effect of wine, beer, and spirits consumption on household nutrition and health are examined. To evaluate nutrition intake, an Eating Healthy Index (EHI) is developed following the Compilation of Food-Based Dietary Guidelines, published by the Chinese Nutrition Society, and the Healthy Eating Index-2010 components and standards for scoring from USDA. Using previously collected household survey data from 11 cities in China, an EHI is developed and calculated for each family to assess their nutrition intake. The score is calculated such that it increases if consumption is in a range representing healthy food intake. The relationship between the score, representing healthy nutrition intake, and household income, wife's education level, demographics, and household composition is explored using regression analysis. The results indicate that changes in family structure have significant effects on household nutrition intake.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
The objective of this research was the perception of the masculinity role model which is predominant in the content from Men s Health Brazil magazine and how it is transmitted through such content. Considering the increasing segmentation of the magazine market and the rising number of vehicles that approach the issue of body and health, this publication is presented in a different way as it escapes from the traditional model for men s magazines once it grasps a series of elements which, after analysis, have been identified as components of a construction script for an ideal masculinity model, cast by a quite clear view of what a healthy and successful man should be like (in his personal and social life). With the slogan Living better is easy , the publication guides the construction of its readers masculinity based on truth-speeches mainly legitimated in the sphere of scientific knowledge (such as researches from different universities and the collaboration of professionals from various areas in the elaboration of articles), instructing its readers in several areas from the male experience, from body care and its figure to their everyday living with women and other men. In shaping this ideal model of being a man, Men s Health also brings a series of values on what it is to be a man, which concern the necessity of being virile, competitive, healthy, good in bed , independent and owner of their world. Notwithstanding all of these aspects hold a close approximation to elements that have already been approached by gender theory as belonging to the patriarchal masculinity model. Through the theoretical productions of Michel Foucault on discipline, norm and body and from the complementing to his theory proposed by Anthony Giddens, which is about the reflexive identity embodiment, I have sought to understand how the magazine elaborates its speech in a way that it shapes the reader into a worldwide accepted standard (once this publication is available in several countries) in relation to a hegemonic masculinity. The latter, on its own, as proposed by Robert/Raewyn Connell, is constructed through processes of socialization of the access to means of communication, which exhibit a masculinity that is stated in the differentiation of other masculinity assortments, in the case of Men s Health, the masculinity of men who do not fit in the physical model advertised by the magazine.
O objetivo desta pesquisa foi a percepção do modelo de masculinidade predominante no conteúdo da revista Men s Health Brasil e como este é transmitido através de seu conteúdo. Diante da crescente segmentação do mercado de revistas e o crescimento do número de veículos que abordam a questão do corpo e da saúde, esta publicação apresenta-se de maneira diferenciada, na medida em que escapa ao modelo tradicional da revista masculina, uma vez que traz em seu conteúdo uma série de elementos que, após análise, identifiquei como componentes de um roteiro de construção de um modelo de masculinidade ideal, formado por uma visão bastante clara do que um homem saudável e bem-sucedido (na vida pessoal e social) deve ser. Sob o slogan Viver melhor é fácil , a publicação orienta, com base em discursos-verdade legitimados principalmente na esfera do conhecimento científico (como pesquisas de universidades diversas e participação de profissionais de diversas áreas na elaboração das matérias), a construção da masculinidade de seus leitores, esclarecendo-os em diversas áreas da experiência masculina, desde o cuidado do corpo e sua formatação até o seu convívio com mulheres e outros homens. Na lapidação deste modelo ideal de ser homem, Men s Health traz também uma série de valores acerca do que é ser homem, os quais concernem à necessidade de ser viril, competitivo, saudável, bom de cama , independente e controlador de seu mundo. Não por coincidência, todos esses aspectos guardam forte aproximação com elementos já abordados pela teoria de gênero como pertencentes ao modelo patriarcal de masculinidade. Através das produções teóricas de Michel Foucault sobre disciplina, norma e corpo e da complementação à sua teoria proposta por Anthony Giddens, que trata da corporificação identitária reflexiva, busquei compreender como a revista em questão elabora seu discurso de forma a moldar seu leitor a uma norma aceita mundialmente (uma vez que a publicação está presente em diversos países) relativa a uma masculinidade hegemônica. Esta, por sua vez, como propõe Robert/Raewyn Connell, é construída através de processos de socialização do acesso aos meios de comunicação, que demonstram uma masculinidade que se afirma na diferenciação de outros arranjos de masculinidade, no caso de Men s Health, de masculinidades dos homens que não se encaixam no modelo físico propagandeado pela revista.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior
Este estudo teve como objetivo analisar e recompor a tessitura da(s) fenomenologia(s) - tomada em sua pluralidade e diversidade - mediada pela noÃÃo de Lebenswelt, apontando potencialidades desse conceito no campo SaÃde Coletiva. Para tanto discutimos a relaÃÃo entre ambos os campos discursivos de saber: o da saÃde coletiva e o da(s) fenomenologia(s). O percurso adotado parte do pensamento de Edmund Husserl, perpassando por Martin Heidegger e sua discussÃo sobre a noÃÃo de mundo - direcionando-se entÃo para a filosofia de Merleau-Ponty, que toma a noÃÃo de Lebenswelt como fio condutor de seu pensamento. Trata-se de um estudo de cunho teÃrico que aborda a(s) fenomenologia(s) e o campo da saÃde coletiva, indicando os aportes fenomenolÃgicos, mais especificamente, os da fenomenologia da ambiguidade para esse campo. à com a noÃÃo de Lebenswelt (mundo vivido) que a(s) fenomenologia(s) evidencia sua proposta de ontologia, possibilitando o reconhecimento do mundo vivido como seu novo objeto. Enfocamos esse conceito sob a Ãtica da fenomenologia da ambiguidade de Merleau-Ponty, pois à com a noÃÃo de Lebenswelt que procuramos apontar a contribuiÃÃo do pensamento fenomenolÃgico para a SaÃde Coletiva. Nossa investigaÃÃo se conduz, portanto, em direÃÃo Ãs contribuiÃÃes da filosofia da ambiguidade, dialogando com o discurso da Reforma SanitÃria, identificando os pilares/diretrizes que norteiam a saÃde coletiva, problematizando-os com a mediaÃÃo do referencial fenomenolÃgico e utilizando a fenomenologia da ambiguidade como inspiraÃÃo para a compreensÃo de um posicionamento dialÃtico em movimento de questÃes como a racionalidade, a noÃÃo de sujeito e clÃnica para a SaÃde Coletiva.

Obesity is an increasing problem in the United States with 17% of youth currently classified as obese and an even higher prevalence of obesity among disadvantaged populations. The food environment may be contributing to these high rates as there has been a well documented association among increased away from home food consumption and excess adiposity, as well as evidence to support that children\'s diets are composed of a large portion of restaurant foods. The main purpose of this study is to describe the quality of restaurant food offered to children in a rural health disparate region. Two trained research assistants conducted systematic audits of all food outlets offering a children\'s menu in the Dan River region using the Children\'s Menu Assessment (CMA) tool. A composite score for each outlet for was calculated from the 29 scored items on the CMA. The total sample consisted of 137 outlets with CMA scores ranging from -4 to 9 with a mean score of 1.6+2.7. Scores were lowest in the predominantly Black block groups (0.2+0.4) when compared to the predominately White block groups (1.4+1.6) and Mixed block groups (2.6+2.4) with significantly lower scores in the predominantly Black block group than the Mixed block groups (F=4.3; p<0.05). The results of this study reveal a lack of few healthy food options available for children in this region. These findings have the potential to contribute to public health efforts in developing public policy changes or environmental interventions for the children\'s food environment in the Dan River Region.
Master of Science

Relative Energy Deficiency in Sport (RED-S) is a term expanded from the female athlete triad the is inclusive to males and females and the negative physiological symptoms impacting athlete health and performance from low energy availability. Bone health is one of the ten health consequences of RED-S. Therefore, the purpose of this study is to investigate RED-S in female and male collegiate athletes and determine if there is an association with bone health. Thirteen participants completed an electronic survey containing the LEAF-Q and EAT-26, a three-day food diary and exercise log, and a DXA scan. Energy intake and exercise expenditure was analyzed using an ESHA food analysis processor. Participants at risk for RED-S had higher occurrences of injuries (p<0.022) and lower Z-scores (p<0.063) than those not at risk for RED-S. In conclusion, athletes at risk for RED-S may have higher occurrences of injuries and lower bone mineral density.

The aim of this thesis is to apply multilevel regression model in context of household surveys. Hierarchical structure in this type of data is characterized by many small groups. In last years comparative and multilevel analysis in the field of perceived health have grown in size. The purpose of this thesis is to develop a multilevel analysis with three level of hierarchy for Physical Component Summary outcome to: evaluate magnitude of within and between variance at each level (individual, household and municipality); explore which covariates affect on perceived physical health at each level; compare model-based and design-based approach in order to establish informativeness of sampling design; estimate a quantile regression for hierarchical data. The target population are the Italian residents aged 18 years and older. Our study shows a high degree of homogeneity within level 1 units belonging from the same group, with an intraclass correlation of 27% in a level-2 null model. Almost all variance is explained by level 1 covariates. In fact, in our model the explanatory variables having more impact on the outcome are disability, unable to work, age and chronic diseases (18 pathologies). An additional analysis are performed by using novel procedure of analysis :"Linear Quantile Mixed Model", named "Multilevel Linear Quantile Regression", estimate. This give us the possibility to describe more generally the conditional distribution of the response through the estimation of its quantiles, while accounting for the dependence among the observations. This has represented a great advantage of our models with respect to classic multilevel regression. The median regression with random effects reveals to be more efficient than the mean regression in representation of the outcome central tendency. A more detailed analysis of the conditional distribution of the response on other quantiles highlighted a differential effect of some covariate along the distribution.
Lo scopo di questa tesi è quello di applicare il modello di regressione multilivello nel contesto di indagini sulle famiglie. La struttura gerarchica in questo tipo di dati è caratterizzato da numerosi piccoli gruppi. Negli ultimi anni analisi comparative e multilivello sullo stato di salute percepito sono aumentate molto. L’obiettivo di questa tesi è di applicare un'analisi multilivello a tre livelli per la variabile risposta Physical Component Summary allo scopo di: valutare entità all'interno e tra varianza ad ogni livello (individuale, familiare e comune); indagare quali covariate influiscono sulla percezione dello stato di salute fisica ogni livello; confrontare le analisi model-based e di design-based al fine di stabilire se i pesi campionari siano informativiti per il modello di interesse; stimare una regressione quantile per i dati gerarchici. La popolazione target sono i residenti italiani di età compresa tra 18 anni. Il nostro studio rileva un’elevata omogeneità tra le unità di livello 1 e una correlazione intraclasse del 27% nel modello nullo a 2livelli. Quasi tutta la varianza è spiegata dalle covariate di livello. Nel nostro modello le variabili esplicative hanno un impatto maggiore sulla variabile risposta sono la disabilità, inabilità al lavoro, l’età e le malattie croniche (18 patologie). Un'ulteriore analisi viene eseguita utilizzando una nuova procedura di analisi: "Regressione lineare quantile multilivello”. Questa analisi ci dà la possibilità di descrivere più in generale la distribuzione condizionata della variabile risposta attraverso la stima dei suoi quantili. Questo ha portato un grande vantaggio nei nostri modelli rispetto al classico modello di regressione multilivello. La regressione mediana con effetti casuali si rivela più efficiente del regressione media nella rappresentazione della tendenza centrale. Un'analisi più dettagliata della distribuzione condizionata della variabile risposta in corrispondenza di altri quantili ha evidenziato che certe covariate hanno un effetto diverso lungo la distribuzione.

Thesis (M.S. in Management)--Naval Postgraduate School, March 2008.
Thesis Advisor(s): Shen, Yu-Chu. "March 2008." Description based on title screen as viewed on April 25, 2008. Includes bibliographical references (p. 75-81). Also available in print.

Research on the putative health benefits has indicated that kefir, a traditional fermented milk, might have antimutagenic and antitumor properties. The major objective of the present thesis was to isolate and identify antitumor compounds in cow's milk kefir and investigate the possible mechanisms involved. High speed centrifugation (HSC), molecular weight cut-off filtration (MWCO), size exclusion high performance liquid chromatography (SEC-HPLC) and reverse phase-HPLC (RP-HPLC) were utilized for fractionation of kefir and a cell culture model was developed to screen for the antiproliferative effects of the kefir fractions. The antiproliferative effects of bacteria-free extracts from different fermentation stages of kefir production, as well as bacteria-free extracts from milk and yogurt were compared. The results showed that extracts from an early stage of fermentation (i.e., kefir mother culture) and the final commercial kefir product both exerted dose-dependent inhibition effects on human mammary tumor MCF-7 cells, yogurt extracts showed less potent antiproliferative effects, while pasteurized milk extracts showed no antiproliferative effects. No antiproliferative effects of the kefir extracts were observed on human mammary epithelial cells (HMEC) whereas the yogurt extracts showed antiproliferative action in HMEC cells at a high dose. A fraction of the kefir mother culture isolated by HSC, MWCO and RP-HPLC contained components that inhibited MCF-7 cell growth and had no effect on HMEC cells. Characterization of the bioactive fraction using mass spectrometry (MS) indicated that the main components in the fraction are likely fragments of kefiran and/or ceramide containing compounds such as gangliosides. The growth inhibitory effect may be mainly caused by the induction of TNF-alpha in MCF-7 cells. Whole extracts of kefir depleted glutathione (GSH) in MCF-7 cells, while the SEC-HPLC Fraction 7 and the RP-HPLC Fraction 30 induced GSH produc

The disposal of biosolids poses a major environmental and economic problem. Agricultural use is generally regarded as the best means of disposal. Although the impact on soil ecosystems remains uncertain. Biosolids can improve soil properties by supplying nutrients and increasing organic matter content but there is also a potentially negative impact arising from the introduction of heavy metal contaminants into soils. It is widely acknowledged that the bioavailable fraction, rather than total metal content, is indicative of plant metal uptake and toxicity. The bioavailable metal fraction in turn is dependent on soil properties. Therefore, the overall aim of this work was to determine the bio-geochemical factors that control the dynamics of trace element bioavailability in soils that have been subject to the disposal of sewage sludge for over 100 years. Three main investigations were undertaken. In order to determine the current metal composition of the site and identifying the geochemical factors that control the dynamics of metals bioavailability, thirty -eight fields, from a dedicated sewage sludge disposal site for over 100 years, were sampled for both soil (bulk and rhizosphere) and plant. Special attention was devoted to determining soil properties that govern metal partitioning between different metal pools (i.e. total, isotopically exchangeable, Ca(NO3)2-extractable and free ion activity). In order to identify the best estimate of plant uptake and toxic response, a pot experiment was carried out to compare the effects of Zn on plant growth in soils recently spiked with Zn and soils historically amended with biosolids to identify soil properties that best predict metal uptake and subsequent phytotoxicity. The effect of biosolids on soil microorganisms was assessed. Terminal restriction fragment length polymorphism, a fingerprint molecular technique, in combination with multivariate data analysis were used to relate soil microbial diversity and community structure to metal accumulation and bioavailability. High levels of contamination, exceeding the current limits for the use of biosolids in agriculture, were observed in the studied soils reflecting extensive long-term biosolid application. Enrichment factors in relation to background levels in the area were greater than 5 and followed the trend Cd>Cu>Zn>Pb>Ni. Copper and Cd exhibited extremely high enrichment levels, up to 106 and 151 respectively. Except for Pb, the isotopically exchangeable pool of the studied metals (E-value) was mainly controlled by the total metal content in soil, accounting for more than 90% of the variation in E-values. Lead lability was primarily controlled by the total P, LOI and Fe oxides. Metal labilities expressed as % of total metal content were < 40% for the five studied elements following decreasing order of Cu > Cd > Zn ≈ Ni > Pb. Apart from Pb, all the bioavailability estimates (total, E-values, Ca(NO3)2-extractable and free ion activity) correlated strongly with metal concentration in plant, accounting for more than 70% of the variation in plant concentrations. Ca(NO3)2-extractable provided the best estimate out of the four measures of bioavailability, accounting for 87, 77, 87 and 83% of the variation in plant concentration of Ni, Cu, Zn and Cd respectively. The results of the pot trial showed that 67-90% of the added Zn remained isotopically exchangeable after 3 months of Zn addition, suggesting that rapid adsorption processes take place, followed by a slow aging process that cannot be detected over the period of the experiment (3 months). The speciation of soil solution showed that Zn was present mainly (80% on average) as free ion indicating the low affinity of this metal to complexation by dissolved organic matter. An antagonistic relationship was observed between Zn and Cd suggesting that greater Zn availability suppressed Cd uptake by plant. Although Zn addition increased Cd concentration in the soil solution, Cd transfer factor was simultaneously inversely correlated with Zn concentration in soil solution. The free ion activity model (FIAM), based on the biotic ligand model (BLM), accounted for 94% of the variation Zn concentration in plant. Cadmium appeared to play an important role in competing with Zn for uptake. A simple regression model utilising soil total Zn, soil organic matter and soil pH accounted for 88% of the variation in plant uptake. This indicates the possibility of using soil properties that are measured routinely as input for prediction of plant uptake. The results of the Zn phytotoxicity test indicated that the intensity of the exposure (i.e. free ion activity) was the key quantity in the context of predicting plant toxic response, describing 80% of the variation in the response of barley growth to Zn toxicity. Only labile Zn from the quantity based extraction was able to describe the toxic response explaining only 46% of the variation. The study of the effect of biosolids on soil microorganisms showed that soil total Zn concentration could be adopted as a good indicator of the overall (historical) biosolids loading. A biosolids loading, equivalent to 700 – 1000 mg kg-1 Zn appeared to be optimal for maximum bacterial and fungal diversity. This markedly exceeds the maximum soil Zn concentration of 300 mg kg-1permitted under the current UK Sludge (use in agriculture) Regulations. Redundancy analysis (RDA) suggested that the soil microbial communities had been altered in response to the accumulation of trace metals, especially Zn, Cd, and Cu. Based on the findings of this thesis, it can be concluded that (i) the estimation of metal speciation, both in the solution and solid phase is a key factor in determining the bioavailability and thus, has greater chemical and biological significance than soil total metal content; (ii) the maximum beneficial effect of biosolids on soil microbial diversity occurred at a metal (Zn) concentration well in excess of current regulations governing application of biosolids to agricultural land. This indicates that soil microbial diversity is unlikely to be determining factor for regulatory limits for biosolids disposal to agricultural lands.

The thesis concentrates on characteristics os Slovenian balneology and its comparison with spa tourism in the Czech Republic. It comes out of a hypothesis that balneology of both states has a similar tradition. The European spa tourism is identified as a health tourism on our continent. The thesis includes definition of basic ideas of balneology, health tourism and approaching Slovenia as a tourist destination. The second part concentrates on characteristics of Slovenian balneology, conditions of offering spa treatment and statistics of Slovenian balneology. It shortely depicts 15 Slovenian health resorts which are certified by the state. The comparison with Czech republic is based on table system. Firstly, the compared data are put for the Czech Republik, secondly there is the comparison with Slovenia.

In this article we take a critical stance toward the rational progressive narrative surrounding the integration of domestic violence within health care. Whilst changes in recent UK policy and practice have resulted in several tangible benefits, it is argued that there may be hidden dilemmas and challenges. We suggest that the medical model of care and its discursive practices position women as individually accountable for domestic violence-related symptoms and injuries. This may not only be ineffective in terms of service provision but could also have the potential to reduce the political significance of domestic violence as an issue of concern for all women. Furthermore, it is argued that the use of specific metaphors enables practitioners to distance themselves from interactions that may prove to be less comfortable and provide less than certain outcomes. Our analysis explores the possibilities for change that might currently be available. This would appear to involve a consideration of alternative discourses and the reformulation of power relations and subject positions in health care.

This thesis provides a description of reflux disease, especially its nature, diagnosis and treatment, followed by the analysis of the costs of this disease and the procedure for the patient as an example.

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES
This thesis is composed of three articles on Health Economics. The first document seeks to analyze the possible spatial integration of the network of public hospitals in Colombia, with the aim of analyzing whether there is efficiency when remitting patients according to the type of care demanded in the hospital. Based on the estimation of a spatial panel model, we analyzed the total of hospitals that make up the public offer system, concluding that although there may be a certain degree of transfer in patient care, it is very low for the case of general medicine, given that the spatial coefficient of the SDM model, rho is less than one. Once the analysis for the static model was estimated, the dynamic SAR and SDM model was estimated, a dynamic model was estimated that decomposed the effects in direct and indirect, where it was evidenced that there is a long-term spatial distribution effect for the attention of appointments of general medicine determined by the number of health care personnel of the 4 closest hospitals, however the presence of transshipments was not found in the short term in general medical care among the hospitals of the public network, since these are the ones that behave as institutions providing basic services, without having a trained staff that allows better care from the development of better medical practices. The same article calculates the SDM, SAR, SAC models for highly complex hospitals, having as dependent variable the number of surgeries performed with a normalized distance matrix of 8 neighbors, concluding that the number of emergencies attended by the hospital affects negative in the total of surgeries practiced, that is to say, the hospitals of high level of complexity carry out in their majority programmed surgeries, nevertheless a change in the total of emergencies. In order to control the existence of random spatial effects in the error, the model is estimated. GSPRE shows that there is a spillover effect that varies little in the time given by the coefficient lambda = 0,10, which is statistically significant but small , and that if there are shocks over time that significantly modify the behavior between hospitals. This type of variation is related as it is expressed cite baltagi2013generalized with technological shocks, changes in the facilities of hospitals that allow to significantly change the capacity to perform surgeries. The second article analyzes decentralization in the health system, studying one of the main objectives in public policy: the prevention of diseases, analyzing the effectiveness of the program in performing preventive cytopathological exams in women, given the availability of resources in the basic care teams located in all the municipalities of Brazil. Based on the analysis of the National Melhoria do Acceso e da Qualidade de Aten??o B?sica -AMPprogram, a factorial analysis is performed that calculates the covariances between the personnel, medical and physical supplies available in the equipment, as well as features such as race, income, literacy level, among others, the decision of women to undergo the cytopathological examination, a model is realized that includes a system of structural equations. It concludes that decentralization is due more than to a system formed in a correct way according to national and international parameters, to a management of the bureaucrats, as it was shown, in the states where there is a deficit or an adequate number of health posts , the estimate had positive coefficients, but this beyond the flow of resources, depends on the political will of each one of the government spheres to increase the number of health establishments or health programs. In this way, and in family health programs such as the performance of cytopathological tests, it is taking place in the basic care network in Brazil, in compliance with the Health Pact established for Brazil. Finally, the analysis of the demand for private health plans is made from different variables of individual, family, social, economic and geographical characterization of individuals and units of family consumption or Brazilian households, based on a logit model. It allows determining that individuals of the amarela race have the highest probability of choosing to demand a private health plan in Brazil, specifically in the North, South and Southeast regions of the country. Thus, in the Southeastern region of Brazil, at a level of significance of 1% the probability of demanding private health insurance is greater for people of that skin color or race, an additional control is created: division by range of monthly per capita income level; In this way, it is observed how the possibility of demanding private health plans varies according to the race declared by the individuals associated with the level of income received in per capita terms by the Brazilian family consumption units, which reflects that with a per capita income monthly of 200 reais, regardless of the declared race, all individuals have the same probability of demanding a private health plan in Brazil.
Esta tesis esta compuesta por tres art?culos sobre Econom?a de la Salud. El primero documento busca analizar la posible integraci?n espacial de la red de hospitales p?blicos en Colombia, con el objetivo de analizar si existe eficiencia la momento de remitir los pacientes de acuerdo a el tipo de asistencia demandada en el hospital. A partir de la estimaci?n de un modelo de panel espacial, se analiz? la el total de hospitales que componen el sistema de oferta p?blica, concluyendo que a pesar de que puede existir cierto grado de transferencia en la atenci?n de pacientes es muy baja para el caso de medicina general, dado que el coeficiente espacial del modelo SDM, ? es inferior a uno. a vez realizado el an?lisis para el modelo est?tico se estimo el modelo din?mico SAR y SDM, se estimo un modelo din?mico que descompusiera los efectos en directos e indirectos, donde se evidencio que existe un efecto de distribuci?n espacial a largo plazo para la atenci?n de citas de medicina general determinado por el n?mero de personal asistencial de los 4 hospitales m?s cercanos sin embargo no se encontr? la presencia de transbordamientos en el corto plazo en la atenci?n de medicina general entre los hospitales de la red p?blica, dado que estas que estos se comportan como instituciones de prestaci?n de servicios b?sicos, sin disponer de un personal capacitado que permita una mejor atenci?n a partir del desarrollo de mejores practicas medicas. El mismo articulo calcula los modelos SDM,SAR,SAC para los hospitales de alta complejidad, teniendo como variable dependiente el n?mero de cirug?as practicadas con una matriz de distancia normalizada de 8 vecinos, concluyendo que el n?mero de urgencias atendidas por el hospital incide de manera negativa en el total de cirug?as practicadas, es decir, los hospitales de nivel alto de complejidad realizan en su mayor?a cirug?as programada, no obstante un cambio en el total de emergencias. con el prop?sito de controlar la existencia de efectos espaciales aleatorios en el errores se estimo el modelo GSPRE muestra que existe un efecto spillover que varia poco en el tiempo dado por el coeficiente ? = 0, 10 , que es estad?sticamente significativo pero peque?o, y que si existen shocks en el tiempo que modifican de manera significativa el comportamiento entre los hospitales. Este tipo de variaciones esta relacionado tal como lo manifiesta [21] con shocks tecnol?gicos, cambios en las instalaciones de los hospitales que permitan var?en de manera significativa la capacidad de realizar cirug?as. El segundo articulo analiza la descentralizaci?n en el sistema de salud, estudiando uno de los principales objetivos en la pol?tica p?blica: la prevenci?n de enfermedades, analizando la efectividad del programa en la realizaci?n de examenes citopatologicos preventivos en las mujeres, dada la disponibilidad de recursos en los equipos de atenci?n b?sica situados en todos los municipios de Brasil. A partir del an?lisis del programa Nacional de Melhoria do Acceso e da Qualidade de Aten??o B?sica ?PMAQ-, se hace un an?lisis factorial que calcula las covarianzas entre los insumos de personal, m?dicos y fisicos disponibles en los equipos, as? junto con caracter?sticas como la raza, ingresos, nivel de alfabetizaci?n, entre otras, la decisi?n de las mujeres de realizarse el examen citopatol?gico, se realiza un modelo que comprenda un sistema de ecuaciones estructurales. Se concluye as? que la descentralizaci?n se debe m?s all? que a un sistema conformado de manera correcta seg?n par?metros nacionales e internacionales, a una gesti?n de los bur?cratas, tal como se mostr?, en los estados donde hay d?ficit o un adecuado numero de puestos de salud, la estimaci?n tuvo coeficientes positivos, pero esto m?s all? del flujo de recursos, depende de la voluntad pol?tica de cada una de las esferas del gobierno para aumentar el numero de establecimientos de salud o de programas de salud. De est? manera, y en programas de salud familiar como la realizaci?n de examenes citopatologicos, se esta dando en la red de atenci?n b?sica en Brasil, dando cumplimiento al Pacto por la salud establecido para Brasil. Por ultimo se realiza el an?lisis de la demanda de planes de salud privados a partir de diferentes variables de caracterizaci?n individual, familiar, social, econ?mica y geogr?fica de los individuos y unidades de consumo familiar u hogares brasileros, a partir de un modelo logit. La permite determinar que los individuos de raza amarela, poseen la probabilidad m?s alta de elegir demandar un plan de salud privado en Brasil, espec?ficamente en las regiones Norte, Sur y Sureste del pa?s. De modo tal que en la regi?n sureste de Brasil, a un nivel de significancia del 1% la probabilidad de demandar un aseguramiento privado en salud es mayor para las personas de dicho color de piel o raza, se crea un control adicional: divisi?n por rango de nivel de renta per c?pita mensual; de esta manera se observa c?mo var?a la posibilidad de demandar planes de salud privados de acuerdo a la raza declarada por los individuos asociada al nivel de ingresos percibidos en t?rminos per c?pita por las unidades de consumo familiar brasileras lo cual refleja que con una renta per c?pita mensual de 200 reales, independientemente de la raza declarada, todos los individuos tienen la misma probabilidad de demandar un plan de salud privado en Brasil.

Background: College settings are likely environments for Black women to contract STIs (including HIV) or experience unintentional/unwanted pregnancies. Effective prevention strategies for this population include dialogue and activities that focus on gender, maturity, cultural barriers, personal strength, and information needs. However, technological advancements (including virtual reality) and innovation are limited in prevention efforts. Methods: Four 90-minute focus group sessions were conducted in a convenience sample of Black college females (ages 18 years or older) and a research-intensive public institution in the southeast. A series of surveys were distributed during each audio-recorded focus group session. A mixed-method approach to data analysis was based on applications of the Health Belief Model constructs to three principal research questions: (1) Q1: How do Black college females perceive the importance of sexual risk topics? (2) What are the experiences and attitudes of Black college females regarding the use of VR for education and training versus video game entertainment (i.e. “gaming)? and (3) Among Black college females, what sexual risk topics are considered most relevant to a VR education and training platform? Results: Each of four study cohorts enrolled between 2-6 participants each (n=15). Participant ages ranged from 18-48 (x̅=28.6, σ=9.2) years within age groups of 18-24 years (60%, n=9), 25-34 years (26.7%, n=4), and 35 years or above (13.3%, n=2). The majority of participants (86.7%, n=13) were enrolled as full-time students, and resided in various off-campus locations (73.3%; n=11). Assessments of sexual risk topic importance were reported based on aggregated Survey 1 Lickert scale values. The majority of participants equally viewed the topics of HIV and STI status as important, mostly important, or very important. Other notable concerns include sex with drug/alcohol use, risk of intimate partner violence, and sexual communication (e.g. partners and peers. Despite the lack of formal virtual reality knowledge, the majority of participants reported experience with VF technology via “gaming” (e.g. SIMS). They also concluded that a virtual reality platform for sexual health education and training should involve comprehensive approaches to HIV/STI and unintentional pregnancy via use of barrier methods, including birth control, as well as facilitation of sexual communication. Discussion: This research represents a unique approach to the identification of sexual health risk importance for HIV/STI transmission, as well as unintentional pregnancy, in Black college females. Although a successful demonstration of feasibility, this research is formative in nature – results should be interpreted as preliminary. However, methods and concepts presented in this thesis hold the potential for scientific contribution in prevention research, clinical practice, and other fields of study.

The overall aim was to describe and compare functional ability and health complaints of older people receiving municipal care in relation to housing and informal care, and factors associated with medical health care, municipal care and informal care. Further, the aim was to investigate agreement in needs assessments between personnel and older people and to investigate care satisfaction and health-related quality of life among older people receiving municipal care and services. Study I and II included 1958 persons aged 65 years and above, who were assessed for functional ability, health complaints, and level of informal and municipal care and service. Study II in addition included data from a register including medical health care. In study III (n=152), standardised needs assessments were performed by the staff. Later, the older person’s view was collected in a personal interview concerning functional ability, health complaints, public and informal care. In addition (Study IV, n=166), SF-12 was used for measuring health-related quality of life and for measuring care satisfaction. Cohabitation was a predictor of a combination of municipal and informal care at home (OR: 5.935), while assistance with Instrumental Activities of Daily Living (IADL) provided by municipal home care and services predicted municipal care only (OR: 0.344). Care in special accommodation was predicted by advanced age (OR: 1.051), dependency in IADL (OR: 19.883), Personal Activities of Daily Living (PADL) (OR: 02.695), and impaired cognitive ability (OR: 3.849) with receiving municipal care only as a reference. Living alone (OR: 0.106), dependency in IADL (OR: 11.348) and PADL (OR: 2.506), impaired cognitive ability (OR: 3.448), impaired vision or blindness (OR: 1.812) and the absence of slowly healing wounds (OR: 0.407) were predictors of special accommodation with a combination of informal and municipal care at home as a reference. 35% of those with public care at home were admitted to hospital and 76% had contact with outpatient care by physician compared to 26% and 87% respectively of those in special accommodation. Living in special accommodation was associated with more contacts with primary health care (B=0.643) and fewer contacts with specialist care (B=-0.722). Informal care was associated with more contacts with primary health care (B=0.413), specialist care (B=0.787), admissions to (B=0.265) and days in hospital (B=1.573). Agreement for dependency in IADL and PADL varied between good (κ=0.78) and moderate (κ=0.43). Poor agreement was found for dizziness (κw=0.17) and fair agreement for impaired hearing, urinary incontinence, pain, anxiety and depressed mood (κw between 0.21 and 0.37). Older persons reported more health complaints than were found in the personnel’s assessments, although significantly lower estimation was found only for incontinence and vision. Agreement for provided public care at home was poor, while for informal care it varied between very good and moderate. Low care satisfaction was associated with dependency in IADL (B=-1.338 and B=-1.630), impaired mobility (B=-12.579), blindness (B=-26.143), faeces incontinence (B=-11.898 and B=-17.529) and anxiety (B=-6.105 and B=-27.197), while high care satisfaction was associated with dependency in PADL (B=2.109) and receiving informal care with IADL from spouse (B=8.738). In special accommodation, low care satisfaction had to do with continuity, timing, the staff’s personal characteristics and with their ability to give service. At home, the older people were the least satisfied with the staff’s ability to do housework and to give medical care, with the staff’s amount of time and with their own influence over their care.

Härtill 1 appendix och 4 uppsatser

Children's speech sound errors may reflect deficits in acoustic-phonetic, articulatory-phonetic, or phonological knowledge of those sounds. The purpose of the current study was to explore the factors believed to contribute to accurate articulation of /s/ in children with typically developing speech. Forty-eight children in their pre-kindergarten or kindergarten year participated. Acousticphonetic knowledge was assessed using a computer game targeting identification of correct and incorrect productions of /s/. Articulatory-phonetic skill was evaluated using maximum repetition tasks and by assessing stimulability for /s/. Phonological knowledge was assessed by examining the acoustic cues used by children to distinguish their productions of /s/ and /theta/. Acoustic-phonetic knowledge and phonological knowledge were each found to explain a small but significant amount of the variance in articulation accuracy. Three different perspectives regarding the relative importance of perceptual and articulatory skills in the development of phonological knowledge are discussed. Clinical implications of the results are considered.

Orientador: Ricardo Afonso Teixeira
Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Estudos da Linguagem
Made available in DSpace on 2018-08-24T09:14:02Z (GMT). No. of bitstreams: 1 Carlini_Marcela_M.pdf: 986349 bytes, checksum: 9d5d894a9176a2161976a4f8cdde685e (MD5) Previous issue date: 2013
Resumo: OBJETIVO: A divulgação de notícias relacionadas com a saúde por meio de jornais pode influenciar o comportamento dos pacientes e de profissionais da saúde. O objetivo desse trabalho foi analisar as características das pesquisas em saúde publicadas por dois dos principais jornais brasileiros. MÉTODO: Foram avaliadas retrospectivamente notícias relacionadas com a saúde publicadas nas versões eletrônicas dos jornais Folha de São Paulo e O Estado de São Paulo ao longo de um período de três meses ( de julho a setembro de 2009) . apenas artigos que citam pesquisas médicas foram incluídos. Os artigos foram categorizados de acordo com o tema , a fonte , a localização do estudo e natureza do título . Analisamos também a presença de informações básicas sobre o tema, citações de periódicos médicos , contextualização e referências a produtos ou empresas nacionais. RESULTADOS : artigos científicos correspondeu a 57 % e 20 % dos artigos relacionados com a saúde publicados pela Folha de São Paulo e O Estado de São Paulo, respectivamente. A Folha de São Paulo publicou significativamente mais artigos sobre estudos nacionais , e a maioria dos artigos foram escritos por seu próprio pessoal. Em contraste , a maioria dos artigos do jornal O Estado de São Paulo vieram de agências de notícias . A Folha também teve seus textos melhor contextualizados para a sociedade brasileira . O Estado tendeu a citar o nome do periódico em que o estudo foi publicado com mais frequência , mas faltou contextualização nacional em seus artigosl. CONCLUSÃO : Os resultados mostram uma diferença significativa na maneira em que os jornais estudados relataram as pesquisas em saúde. A Folha de São Paulo tendeu a escrever seus próprios artigos e mais frequentemente publicou os resultados da pesquisa nacional , enquanto O Estado de São Paulo publicou artigos originados em agências de notícias , a maioria sem contextualização nacional
Abstract: OBJECTIVES: The dissemination of health-related news through newspapers can influence the behavior of patients and of health care providers. We conducted a study to analyze the characteristics of health-related research published by two leading Brazilian newspapers. METHOD: We retrospectively evaluated health-related news published in the electronic versions of the newspapers Folha de São Paulo and O Estado de São Paulo over a period of three months (July through September, 2009). Only articles mentioning medical research were included. The articles were categorized according to topic, source, study location and the nature of the headline. We also analyzed the presence of background information on the topic, citations of medical periodicals, national contextualization and references to products or companies. RESULTS: Scientific research articles corresponded to 57% and 20% of health-related articles published by Folha de São Paulo and O Estado de São Paulo, respectively. Folha de São Paulo published significantly more articles about national studies, and most articles were written by its own staff. In contrast, most articles in O Estado de São Paulo came from news agencies. Folha de São Paulo also better contextualized its reports for Brazilian society. O Estado de São Paulo tended to cite the name of the periodical in which the study was published more frequently, but their articles lacked national contextualization. CONCLUSION: The results showed a significant difference in the way in which the studied newspapers report on health-related research. Folha de São Paulo tends to write its own articles and more frequently publishes the results of national research, whereas O Estado de São Paulo publishes articles that originate in news agencies, most of which have little national contextualization
Mestrado
Divulgação Científica e Cultural
Mestra em Divulgação Científica e Cultural

In this study, C. S. Lewis's books, essays, stories, and poems, in addition to biographies and essays written about Lewis, were read in an attempt to understand the relationship between Lewis's spiritual quest and his total health. The spiritual quest is defined as the search for the ultimate truth and meaning of life. For Lewis, who was a Christian, the quest for the Spirit is a journey toward God-Jesus-the Holy Spirit. Health is defined as total experience; the interrelationship of the body, mind, and spirit with all there is, has been, and will be. Health is considered a changing perception, not a fixed state. The dimensions of Lewis's health—physical, psychological, social, and spiritual—are studied. Lewis's physical states, literary works, literary themes, friendships, ethics, marriage, and views on religion are considered as each relates to his determination to know and to love God. For Lewis, anything without God is nothing. God is the creator of all living things and all matter. He is the inventor of all loves and is Love. In Lewis's opinion, one's health is in direct proportion to one's love for God. When man loves God he is healthy, the more he loves Him the healthier, the less he loves Him the less healthy.

The efficiencies of extraction with the [S,S]-stereoisomer of ethylenediaminedisuccinic acid ([S,S]-EDDS) on selected toxicants were investigated. A soil washing procedure to solubilize mixed contaminants, polycyclic aromatic hydrocarbon (PAH) compounds and heavy metals from soil, into an aqueous mobilizing solution containing 0.1 M EDDS-6% (V/V) Brij98 was optimized and evaluated. The optimized procedure with EDDS had mobilized a total of 101% of B[a]P burden from the soil after nine successive equilibrations with the same charge of mobilization aids (complexing reagent plus surfactant), which was 21% higher than analogous extractions with the equivalent quantity of EDTA and 28% higher than extractions in the absence of complexing reagent (surfactant Brij98 alone). In contrast to B[a]P, chrysene recovery was not affected appreciably by the presence of the EDDS reagent. Modelling of the extraction process for PAH compounds remaining within the soil revealed that B[a]P was extracted more efficiently in the presence of EDDS, i.e. the number of washes needed to reduce the initial concentration of B[a]P by half was less than the predicted number of washes in the presence of EDTA or Brij98, and the differences were significant at the 95% level of confidence. EDDS also had an appreciable influence on heavy metal exraction efficiency. Most analyte metals, (Al, As, Cd, Cr, Cu, Fe, Ni, Pb and Zn,) were extracted more efficiently in the presence of EDDS than in the presence of an equivalent quantity of EDTA or in the absence of complexing reagent. By contrast, the mobilization of Ca, Mg, and Mn by EDDS was decreased when compared with EDTA and/or surfactant alone.
Les efficacités d'extraction choisis avec le stéréoisomère [S,S] – de l'acide éthylènediaminedisuccinique ([S,S] - EDDS) sur des produits toxiques sélectionnées ont été étudiées. Un procédé de lavage a été optimisé et évalué pour solubiliser simultanément les composés aromatiques polycycliques de l'hydrocarbure (APH) et les métaux lourds du sol, dans une solution de mobilisation aqueuse contenant 0.1 M EDDS-6% (V/V) Brij98. Le procédé optimisé avec l'agent chélateur EDDS a mobilisé du sol un total de 101% de B [a] P après neuf extractions successifs. Comparativement, quand les expériences ont été réalisée avec EDTA ou sans l'adition d'agent complexant (seulement agent tensio-actif Brij 98), l'EDDS augment la efficacité un 21% par rapport à EDTA et 28% à la solution traitante en absence de agente complexant. Cependant, l'extraction de chrysène n'a pas été sensiblement affectée par la présence du réactif chélateur EDDS. La modélisation du processus d'extraction pour des composés organiques, APH, qui restent dans le sol a indiqué que B [a] P a été extraite plus efficacement en présence d'EDDS, c.-à-d. le nombre de lavages requis pour réduire la concentration initiale de B [a] P à la moitié était moins que le nombre prévu de lavages en présence d'EDTA ou de Brij98 seulement, et les différences étaient significatives au niveau de 95% de la confiance. L'EDDS a également eu une influence appréciable sur l'efficacité d'extraction de métaux lourds. La plupart des métaux analysés, (Al, As, Cd, Cr, Cu, Fe, Ni, Pb et Zn,) ont été extraits plus efficacement en présence d'EDDS qu'en présence d'une quantité équivalente d'EDTA ou en l'absence du réactif complexant. Néanmoins, l'extraction du Ca, du magnésium, et du manganèse par EDDS ont été diminués en comparaison avec seuls l'EDTA et/ou l'agent tensio-actif. fr

The ophthalmopathy associated with Graves' hyperthyroidism (GH) and Hashimoto's thyroiditis is an autoimmune-mediated inflammation of extraocular muscle and orbital connective tissue. The association of thyroid-associated ophthalmopathy (TAO) with autoimmune thyroid disease (ATD) can be explained by the expression on thyroid and eye muscle of shared or cross-reactive Ag(s) targeted by autoimmunity. The best candidate for such Ag(s), at present, are 64 kDa membrane molecules. When incubated with cultured human eye muscle, thyroid, and skeletal muscle cells in vitro, autoAbs in TAO patient sera immunoprecipitated a 64 kDa Ag from the first two tissues, but not from skeletal muscle. In dot blot experiments using D1 fusion protein, a fragment of a cloned 64 kDa protein, autoAbs were detected in the sera of 47% of patients with TAO and 57% of those with GH without ophthalmopathy but in only 5% of normal subjects. Short random fragments (100 to 200 bp) of 1D cDNA, a cloned 64 kDa protein, were cloned an expressed in E. coli as fusion proteins using the pUEX1 vector. Four antigenic peptides recognized by TAO sera were cloned and sequenced. When a panel of sera was screened for recognition of each peptides, sera from TAO patients reacted to one or more peptides significantly more frequently than sera from normal controls. A quantitative reverse transcriptase polymerase chain reaction (RT-PCR) methodology was used to investigate the tissue distribution of 1D mRNA and quantitate the levels of expression of transcripts of this specificity from a variety of human tissues. Expression of 1D was highest in thyroid and eye muscle, consistent with a high level of expression of this protein in these tissues. These studies indicate that 64 kDa proteins are expressed in eye muscle and thyroid, and that autoAbs reactive with the Ag(s) are present in the early stages of thyroid eye disease.

Human Leukotriene C$ sb4$ synthase is a membrane-bound glutathione S-transferase that catalyzes the first committed step leading to the biosynthesis of the pro-inflammatory mediators, the cysteinyl leukotrienes (LTC$ sb4,$ LTD$ sb4$ and LTE$ sb4$). Using chromatographic separation and photoaffinity labelling techniques, LTC$ sb4$ synthase was found to be a unique enzyme distinct from all other known glutathione S-transferases. An 18 kDa membrane polypeptide was specifically labelled in the microsomal membranes of myelocytic cell lines containing LTC$ sb4$ synthase activity (U937 and THP-1), with a photoaffinity derivative of LTC$ sb4$ (azido (I$ sp{125}$) -LTC$ sb4$) and was identified as a candidate for being LTC$ sb4$ synthase or a subunit thereof. LTC$ sb4$ synthase was subsequently purified to homogeneity from THP-1 cells and the purified preparation contained only one polypeptide which had a molecular mass of 18 kDa. By gel filtration chromatography, the native molecular mass of LTC$ sb4$ synthase was determined to be approximately $39 pm3$ kDa. It was therefore concluded that LTC$ sb4$ synthase is enzymatically active as a homodimer. The sequence of the N-terminal 35 amino acids of purified human LTC$ sb4$ synthase was determined and was found to be unique, composed primarily of hydrophobic amino acids and containing a protein kinase C (PKC) consensus sequence. Further analysis of the potential phosphoregulation of LTC$ sb4$ synthase in neutrophilic and eosinophilic HL-60 cells demonstrated that cysteinyl leukotriene biosynthesis, but not non-cysteinyl leukotriene biosynthesis, was specifically attenuated by phorbol ester-mediated activation of PKC. In eosinophilic HL-60 and THP-1 cells this decrease in cysteinyl leukotriene production was demonstrated to be due to non-competitive inhibition of LTC$ sb4$ synthase activity. Concomitant with the PKC-mediated decrease in cysteinyl leukotriene biosynthesis, an increase in prostanoid biosynthesis occurred. Based

Dairy calves in the U.K. are currently reared on ‘least cost’ principles, with minimal milk feeding and early weaning to solid foods. This has been described as maintaining the calf in ‘a state of chronic hunger’. As well as repercussions on calf health, growth and welfare, human studies suggest that underfeeding the newborn is a major risk factor for metabolic disease in the adult. The aims of this study were to determine current dairy calf rearing practices across the U.K., to investigate the performance of Holstein heifer calves fed increased milk replacer (MR) compared to restricted volumes, and to determine the impact of this on key performance indicators (KPIs) of these animals as calves and growing heifers. A postal questionnaire was offered to one thousand U.K. dairy farmers to determine current calf rearing practices. The response rate was 72% and revealed that housing and feeding practices were variable between farms. The majority of farmers (93%) fed restricted volumes of milk or milk replacer to their pre-weaned calves. The body weight, withers and loin height, heart and belly girth, crown to rump length, hock-fetlock length and body condition score (BCS) were recorded weekly from birth to 12 weeks and monthly from 12 weeks until conception in two groups of Holstein heifer calves on one commercial dairy farm in the north-west of England, U.K. Calves were assigned to a restricted, Group R (n = 50) or ad libitum, Group A (n = 50) MR feeding strategy from birth until weaning. Growth rates were greater for Group A (0.72kg/day) from birth until 3 weeks than Group R (0.17kg/day). Body condition score increased for Group A during this period (0.1 points) while it decreased for Group R (0.3 points). Thereafter, growth rates were similar between dietary groups although no catch-up growth was observed for Group R animals. Changes in morphometric measures were greater for Group A calves than Group R from birth to 12 weeks. From 12 weeks of age onwards, dietary group differences in morphometric measures disappeared but body weight differences remained until conception. The glucose metabolism and insulin sensitivity of a subset of heifer calves (n = 6 Group A, n = 6 Group R) was investigated at 3, 12 and 39 weeks of age and was shown not to be affected by dietary group. The carcass composition of Holstein bull calves assigned to one of the two dietary groups was assessed. Calves were studied at birth (n = 3), 3 weeks, 9 weeks or 12 weeks (n = 3 per dietary group at each age). Carcass composition was assessed using spiral CT technologies. Group A calves had greater internal adipose deposition at all ages but there was no difference in carcass associated adipose tissue. The age at puberty, first service and conception was between 2 and 3 weeks lower for Group A animals than for Group R. Increased MR feeding of Holstein heifers allows for greater growth rates and earlier entry into the milking herd.

Este estudo toma como objeto a autonomia nas práticas de enfermeiros que atuam na atenção básica em um município do interior de Minas Gerais. O referencial teórico metodológico é o processo de trabalho em saúde e tomamos autonomia como um dos elementos desse processo, uma tecnologia leve produzida nos encontros entre trabalhadores e usuários, trabalhadores e trabalhadores e, trabalhadores e gestores. Nosso objetivo foi o de identificar e analisar no processo de trabalho do enfermeiro de atenção básica, a produção de autonomia dos sujeitos envolvidos nas relações de produção em saúde. Com a abordagem qualitativa, realizamos observação participante do cotidiano de trabalho de dois enfermeiros, um de unidade básica de saúde e outro de unidade de saúde da família. Também realizamos doze entrevistas individuais com os enfermeiros de distintas equipes. Os dados foram submetidos a analise de conteúdo, vertente temática, sendo dispostos em dois temas: 1. Concepções de autonomia e 2. Limites e possibilidades para a produção de autonomia no trabalho em saúde. Como concepção predominante está a autonomia como algo centrado em si próprio, relacionada ao poder de fazer e decidir e como objeto que pode ser dado e recebido. Outra concepção é a da autonomia relacional na qual se entende a possibilidade do exercício da autonomia em um processo relacional com a equipe, usuários e gestores, mas de uma forma hierárquica em que a presença da autonomia de um anula ou enfraquece a do outro. Embora tenham sido observadas situações de exercício de autonomia, os sujeitos não as nomina como tal. Construímos a perspectiva da autonomia como exercício a ser considerado no plural; autonomias, que é sempre relacional, podendo conformar-se como autonomia horizontalizada. Nesse sentido a segunda categoria, dos limites e potencialidades, indica a tutela como um primeiro momento desse processo que deve ser superado. A falta de condições de trabalho, a sobrecarga e a relação com a gestão são consideradas como fatores limitantes da autonomia pelos sujeitos. Dialeticamente, são potencialidades para uma outra organização do trabalho e conformam tomadas de decisão e menor controle do trabalho do outro. Destacamos ainda um elemento importante do processo de trabalho que é a finalidade do mesmo. Essa parece não ser clara para os trabalhadores e relaciona-se com a resolução de problemas cotidianos e atendimento de necessidades de saúde segundo uma lógica biomédica. As possibilidades discutidas voltam-se para a cogestão e educação permanente em saúde. Concluímos que sem o vislumbre de um projeto de atenção que supere a lógica que está dada, fica a autonomia como ideal, sendo naturalizada a heteronomia.
This study takes as an object the Autonomy in the practices of nurses that act in primary health care in a municipality of the state of Minas Gerais. The theoretical methodological frame of reference is the work process in health and and we take autonomy as one of the elements of this process, a light technology produced between workers and users, workers and workers, and workers and managers. Our goal was to identify and analyze the work process of the primary health care nurse, producing autonomy of individuals involved in the relations of production in health care. With the qualitative approach, we conducted participant observation of daily work of two nurses, one from a basic health care unit and another from a family health care unit. We also conducted interviews with twelve nurses from different teams. The data were subjected to content analysis, thematic field, being arranged on two themes: 1. Conceptions of autonomy and 2. Limits and possibilities for the production of autonomy in health work. As prevalent conception is the one of autonomy as something self-centered, related to power to do and decide and as an object that can be given and received. Another conception is the one of relational autonomy in which the possibility of the exercise of autonomy in a relational process with staff, users and managers is understood, but in a hierarchical manner in which the presence of an autonomy weakens or cancels the other. Although there have been observed cases of exercise of autonomy, the subjects don\'t name them as such. We have built the prospect of autonomy as an exercise to be considered in the plural; autonomies, which is always relational, and may conform itself as horizontal autonomy. In this sense the second category, of limits and potentials, indicate the tutelage as a first step on this process that must be overcome. The lack of working conditions, overload and relationship with the management team are considered as limiting factors of the autonomy by the subjects. Dialectically, they are potential for another labor organization and shape decision-making and less control of the work of another. We also highlight an important element of the work process that is the purpose of it. This seems to be unclear for employees and relates to the resolution of everyday problems and health care needs according to biomedicine logics. The possibilities discussed turn to co-management and continuing health education. We conclude that without the glimpse of a care project that surpasses given logics, autonomy keeps an ideal, and heteronomy becomes natural.

The aim was to psychometrically test the S-HSOPSC and HSOPSC, investigate health care staff’s perceptions of patient safety culture and their suggestions for improvement. Methods: A three-time cross-sectional study with data from health care staff (N= 3721) in a Swedish county council was conducted in 2009 (N = 1,023), 2011 (N = 1,228) and 2013 (N =1,470) using the S-HSOPSC (I, II, III). Health care staff’s suggestions for improvement were analyzed in a qualitative content analysis study (IV). Results: The S-HSOPSC (14 dimensions, 51 items) is acceptable for measuring patient safety culture (I). Health care staff held a positive attitude towards their own unit’s teamwork, and a less favorable attitude towards hospital managers’ support for patient safety work (I). Managers held a more positive attitude towards patient safety than others and enrolled nurses held a more positive attitude than registered nurses and physicians (II, III). Positive attitudes towards learning, nonpunitive response and staffing was associated with positive attitudes towards overall safety (II). Health care staff’s attitudes towards patient safety decreased between 2009- 2013 for 12 dimensions (III). A diversity of approaches, nuanced in relation to the informant’s profession was suggested to improve patient safety, for example ‘Increased staffing’ ‘Teamwork and collaboration’ and ‘Committed management' (IV). Conclusions: The S-HSOPSC is suitable for measuring patient safety culture. Supporting and committed managers, teamwork and collaboration are important for patient safety improvement. RNs have an important coordinating position in patient safety work, since they work in close proximity to the patients, and strategically in teams, where decisions of importance for patient safety are made. Health care staff attitudes towards communication, nonpunitive approach, feedback and learning from mistakes have deteriorated. To prevent from organizational fatigue, actions are needed.
Baksidestext: In health care, many patients are being harmed, with leads to suffering and financial costs. Health care staff’s patient safety culture reflects their attitudes towards safety for patients. The overall aim was to psychometrically test the questionnaires S-HSOPSC and HSOPSC for measuring patient safety culture, investigate health care staff’s perceptions of patient safety culture and their suggestions for improvement. In this thesis, respondents in the most common health care staff groups participated. Health care staff held a positive attitude towards patient safety culture within their own unit’s work. The perception of patient safety culture differed between professions and managers had a more positive attitude towards patient safety culture than others. Health care staff’s attitudes towards patient safety decreased during the measurement period for almost all aspects and they suggested many approaches to improve patient safety. Patient safety needs to be a responsibility for everyone. Supporting, committed managers, teamwork and collaboration are important for patient safety improvement. RNs have an important coordinating position in patient safety work.
Syftet var att psykometriskt testa frågeformulären S-HSOPSC och HSOPSC och undersöka sjukvårdspersonals attityder till patientsäkerhet samt förslag till förbättringar. Metod: Tre tvärsnittsundersökningar genomfördes. Sjukhuspersonal (N = 3 721) i ett landsting besvarade enkäten Hospital Survey on Patient Safety Culture om patientsäkerhetskultur år 2009 (n = 1 023), 2011 (n = 1 228) och 2013 (n = 1 470) (I, II, III). Sjukvårdspersonalens förslag på förbättring av patientsäkerhet studerades med kvalitativ innehållsanalys (IV). Resultatet visade att den svenska versionen S-HSOPSC (14 dimensioner, 51 frågor) är acceptabel för att mäta patientsäkerhetskultur (I). Sjukvårdspersonalen hade en positiv attityd till aspekter av patientsäkerhet som handlade om arbete på den egna vårdenheten, men en mindre positiv attityd till högsta ledningens stöd för patientsäkerhetsarbetet (I). Chefer hade en mer positiv attityd till patientsäkerhet än andra och undersköterskor hade en mer positiv attityd än sjuksköterskor och läkare (II, III). Förmågan att dra lärdom av misstag, en icke-skuldbeläggande attityd vid misstag samt bemanning var positivt associerad till en positiv attityd till generell patientsäkerhet (II). Sjukvårdspersonalens attityder till patientsäkerheten försämrades under mätperioden för 12 av 14 dimensioner. (III). Sjukvårdspersonalen föreslog en mängd förbättringar av patientsäkerheten. Förslagen var nyanserade i relation till informanternas egen profession (IV). Konklusioner: Engagerade chefer är viktigt för patientsäkerheten. Teamwork och förståelse för varandras arbete är gynnsamt för patientsäkerheten. Sjuksköterskor är viktiga i patientsäkerhetsarbetet, då de både arbetar nära patienterna och i team där beslut fattas som rör patientsäkerheten. Personalens attityd till kommunikation, icke- bestraffande synsätt, återkoppling och lärande i samband med misstag har försämrats. Detta kan indikera en organisatorisk utmattning och kräver åtgärder.

Work context has many consequences for the psychological outcomes of employees. These outcomes also have consequences for the employer through possible loss of productivity, impaired health of employees which may be associated with absenteeism and turnover intention, among others. The literature also shows that these outcomes are not always the same even under similar working conditions. Theorising in cognitive psychology indicates that the way in which an individual appraises a situation may be more important to psychological outcomes than the actual presence of a stressor. Recently, personal resources have been hypothesised to influence these individual differences. Few if any studies have explored such personal resources as moderators in the relationship between work context and psychological outcomes, especially in the South African public service context. Thus, the general aim of this study was to determine whether personal resources (emotional intelligence, self-efficacy and explanatory styles) are moderators in the relationship between work context Gob demands and job resources) and psychological outcomes (psychological well-being and work engagement) in a sample of government employees. A cross-sectional survey research design was implemented. Data were collected from 459 participants with the following measuring instruments, the Job-Demands Resources (JD-R) Scale, the Satisfaction with Life Scale (SWLS), the Affectomemter-2 Short-form (AFM.), the Utrecht Work Engagement Scale (UWES) , the Emotional Intelligence Scale (ElS), the General Self-efficacy (GSE) scale, and the Explanatory Style (ES) Questionnaire. A demographic questionnaire was developed by the first author to capture diverse information from the participants relating to gender, turnover intention, post level and so forth. Analyses were conducted mainly in 2 steps. Firstly, multiple regression analyses were used to test the main effects of work context variables on psychological outcomes. Secondly, two-step hierarchical regression analyses were used to test whether personal resources (emotional intelligence, self-efficacy, and explanatory styles) moderated the relationship between work context variables and psychological outcomes. Before testing the moderation, all independent variables and moderator variables (dimensions of personal resources) were centred so as to exclude the possibility of any multicollinearity in the regression equation. The results of the study, reported in three articles/manuscripts, showed significant main effects for work context and the personal resources as predictors of psychological outcomes. In the second place, the results also showed that the personal resources used in this study moderate the relationship between work context and psychological outcomes. In the first article, it was concluded that emotional intelligence is of potential value, especially in the public sector that is focussed on optimal service delivery, and where emotional encounters are stock-in-trade. Emotional intelligence is a valuable personal resource to cultivate for establishing, developing, and maintaining positive outcomes in psychological well-being in the workplace. In the second article, it was concluded that as self-efficacy beliefs facilitate actions and behaviour taken by individuals, it is important that feedback and modelling could play an important role especially in service-oriented work contexts that may need self-regulation of emotions. In the third article, it was concluded that as attributional feedback can induce change in how individuals perceive their success or failure in a task, the role of explanatory styles in psychological outcomes could be cultivated through active feedback given to employees on their performance and possibilities of future growth in the organisation. Overall it was concluded that a lack of job resources in the presence of high job demands will undermine psychological outcomes even in the presence of personal resources. Therefore, the consequences for health impairment and negative outcomes cannot be over-emphasised in a situation where job demands outstrip job resources. Employees in the public service require skills such as social and emotional competency, self-efficacy and optimism as these are important tools in dealing with the public. Employees must have initiative, flexibility, motivation to achieve, empathy, self-esteem and confidence, self-control, and group management among fellow employees and the public that is served by them. Although the limitations for this study are related to the fact that it was a cross-sectional research design and data was collected using self-reports, insights were gained about the role of personal resources in the relationship between work context and psychological outcomes. Based on all three articles, it was recommended that cross lagged panel studies may be useful in further clarifying the role of personal resources in longitudinal studies about the relationship between job resources and psychological outcomes and possible upward spirals arising from facilitating these relationships. Aspects of such studies may also include a qualitative assessment of what participants perceive as job resources and personal resources and these help them to achieve their goals.
Thesis (Ph.D. (Psychology))--North-West University, Potchefstroom Campus, 2010.

COORDENAÇÃO DE APERFEIÇOAMENTO DO PESSOAL DE ENSINO SUPERIOR
FUNDAÇÃO NACIONAL DE SAÚDE
O design do livro é uma arte invisível? Depende do leitor. Mas como este leitor é considerado pelos designers de livros? Esta questão é o ponto de partida deste estudo, que busca investigar como o designer pode participar do processo de formação de escritores e leitores, compreendendo a inserção do Design, enquanto campo de vocação interdisciplinar, em projetos em que há a predominância do hibridismo, da mescla de vozes e da mescla de identidades.Sabendo que os designers de livro servem a três clientes: autor, leitor e editor, é verificado que apenas autor e editor interferem diretamente no trabalho do designer, enquanto este profissional considera o leitor apenas por uma noção pré-concebida. Desta forma, questiona-se a ausência do leitor nos projetos de design do livro,ao mesmo tempo em que se propõe a noção de Design da Leitura.O estudo considera as teorias que tratam da recepção e mediação da leitura, como em Chartier, e utiliza-se de um exercício etnográfico sobre os encontros presenciais do Projeto de Escolarização dos Agentes de Saúde voltado para o agentes Guarani das aldeias de Itaxi, Araponga, Sapukai e Rio Pequeno, na região de Angra dos Reis e Paraty. A partir da observação das práticas da leitura do grupo Guarani são levantadas questões para pensar uma abordagem que contemple as características destes leitores. Portanto, ao reconhecer a importância do leitor e das mediações, o Design da Leitura contempla também o letramento, ao tentar contribuir tanto para a alfabetização como para a formação das práticas sociais de leitura e escrita.
Is Book Design an invisible Art? How is the reader considered by book designers? These questions are the starting point for this study, which aims at investigating how can a designer contribute to the process of forming new writers and readers. Design is here approached as an interdisciplinary vocational area where hybrid projects occur; encompassing different voices and identities. We work on the assumption that book designers consider three kinds of clients - the author, reader and publisher - and that only author and publisher have traditionally interfered in the designer´s work more directly, while the reader exists more as a pre-conceived notion. By and large, the reader has been disregarded by book designers. We, then, try to propose what we call a Design for Reading or Reading Design. We consider theories that deal with reception and mediation in the reading process. We use theoretians like Roger Chartier and apply them to an Ethnographic exercise carried out at the Schooling Project with Guarani Health Agents in the Native Brazilian Villages of Itaxi, Araponga, Sapukai and Rio Pequeno in the Angra dos Reis and Paraty Regions. By observing the reading process by the Guarani Agents, we raise questions on how to encompass the specific profile of such a reader in the visual project, thereby recognizing the importance of the reader and mediation in the Reading Design. We also consider some aspects of literacy in order to contribute to new reading and writing. social processes.

碩士
國立臺灣大學
衛生政策與管理研究所
95
BACKGROUND: In spite of the impressive growth of cross-border marriages and the increased number of children born in these families, few studies have examined the health of these children in Taiwan. Existing studies suggest children of foreign-born women have worse health status than those of Taiwan-born. OBJECTIVES: To examine whether there exhibits significant health differentials between children of foreign-born and Taiwan-born women, and the relationship between family socioeconomic position and the health disparity of children in Taiwan. METHODS: A national representative sample of 1617 infants completed two pilots of Taiwan Birth Cohort Study was used in this study. Information was collected from April to June in 2004 and May to July in 2005, at the age of 6 and 18 months old. Health variables are birth outcome (prevalence of preterm birth, low birth weight and birth defect), early child development (attainment of developmental milestones at 6 and 18 month of age), and health conditions (having injury and fever, infectious or gastrointestinal diseases). RESULTS: (1) No significant differences were found between nativity groups for prevalence in preterm birth, low birth weight and birth defect. (2) Comparing with children of Taiwan-born, children of foreign-born mothers exhibit significantly poor motor developmental attainment (OR=1.69, 1.10-2.61). However after controlling for family socioeconomic characteristics, the risk of adverse motor development for children of foreign-born mothers became not significant (OR=1.56, 0.99-2.46). (3) Children of foreign-born mothers have significantly lower risk of having fever, infectious or gastrointestinal diseases (OR=0.44, 0.27-0.73) than that of Taiwan-born mothers regardless of their disadvantaged family socioeconomic position. CONCLUSIONS: Children of foreign-born and China-born mothers do not experience worse health status in Taiwan. Family socioeconomic position plays an important role in differentiating early child development between children of foreign-born mothers and Taiwan-born.

碩士
國立中正大學
行銷管理研究所
96
The utility rate of the Pap smear and the rate of cervical cancer have been an index to examine the medical treatment standard of a country. However, the frequency of Pap smears for Taiwan women is still below standard. The purpose of this research is to find out why they decide to either take the Pap smear or not, and to analyze the satisfaction of those who have been tested. We hope this research resuls could offer the government and health care authority an approach to encourage Taiwan women to have the Pap smear check-up regularly. This research provides a conceptual theory construction after referring to Andersen’s 4th Health Service Utilization Model. The data of this research comes from the secondary data taken from a National Health Interview Survey (NHIS) in Taiwan that was done in 2002. This survey incorporated a multi-stage stratified systematic sampling scheme and 12,998 samples were valid in this research. The data analysis was based on Logistic Regression and Stepwise Regression. The results are: 1. Predisposing component (except educational level), Enabling component, Need component (except healthy condition), and Enhancement component have a relationship with the women’s decision of “taking the Pap smear or not”. 2. Tertiary education level, health belief, health behaviors and reminding function have a relationship with the satisfaction of the Pap smear. This research provides a correlative proposal to the government, hospitals and health center. Hopefully our quality of health care could meet the world high standard, and also accomplish the purpose of promoting the health of people in Taiwan.

Mental Health is a matter of utmost importance. Nonetheless, it is still intertwined with a culture of taboo and stigma. Many individuals with mental health conditions are sub-jected to unfair treatment as a result of stigmatized perceptions embedded in society. These stereotyped social constructs can impact their individuality coupled with undermining their ca-pabilities, namely in the realm of employment. Thus, the present research aimed to deconstruct these cultural structures in order to understand if stigma was present in the workplace, how it was being perpetuated and whether this environment could serve as a platform to challenge it. Therefore, through the dissemination and analysis of a questionnaire, insights were gathered regarding the matter. Findings suggested that, although stigma is indeed present in the work-place, it was less manifested than anticipated. Furthermore, these stigmatized views were mainly supported by perceptions of unaccountability and incapability, thus culminating in a culture of pity and sympathy. Contrarily, physical conditions were perceived with higher ac-countability which prompted negative reactions such as anger. Results also underlined an in-teraction between the culture of the organization and the personal level of stigma. Thus, when workplaces foster stigma-free practices, participants demonstrated decreased stigma towards individuals with mental health conditions. Therefore, as the present environment revealed to be a powerful platform to challenge stigma, it is recommended to all organizations to engage in such initiatives with the aim of fostering a society exempted from stigma.
Saúde Mental é uma temática de extrema relevância. Não obstante, esta está entrela-çada com uma cultura de tabo e estigma. Muitos indivíduos que padecem de psicopatologias estão sujeitos a um trato indevido como resultado de perceções estigmatizadas presentes na sociedade. Estas construções sociais impactam a sua individualidade assim como subestimam as suas capacidades, nomeadamente num contexto laboral. Consequentemente, este estudo pre-tendeu desconstruir estas estruturas sociais com o intuito de perceber se o estigma está presente num contexto laboral, como se perpetua e se este meio pode servir como uma plataforma para o desafiar. Por conseguinte, um questionário foi disseminado e analisado com o propósito de compreender a temática. Os resultados sugeriram que, embora o estigma esteja presente num contexto laboral, a sua manifestação é mais reduzida do que o que foi antecipado. Ademais, estas posições estigmatizadas são maioritariamente sustentadas por perceções de desresponsa-bilização e incapacidade, fomentando uma cultura de pena e compaixão. Contrariamente, con-dições físicas foram percecionadas com um maior nível de responsabilização, induzindo rea-ções negativas como revolta. Adicionalmente, uma interação entre a cultura da organização e o nível pessoal de estigma foi também observado. Quando é fomentada uma cultura de anti-sti-gma num contexto laboral, as participantes manifestaram níveis de estigma mais reduzidos. Assim, uma vez que este meio revelou ser uma plataforma fulcral para desafiar o estigma, é recomendado às organizações que adotem estas medidas de modo a fomentar uma sociedade isenta de estigma.

碩士
高雄醫學大學
公共衛生學研究所碩士在職專班
92
Background and objectives：People’s demand for health and hygiene has been continuously increased to a higher level in recent years, and hence the masses avidly expect to acquire medical service in better quality and quantity. Government also implements hygienic measures of all sorts due to this kind of demand in hopes of the promotion of people’s health and their knowledge and capability for disease prevention. But those advocated – by – government measures offering to community people, which in clude maternal &child health, family plan, vaccination, infection control, disease survey, cancer referral, and so forth, should be enforced by public health staff of basic health departments. Therefore, pressure faced by the staff is bound to exist. Problems such as excessive laboring hours, pressure of work, and lack of leisure time can affect the staff’s emotion , attitude, quality of service, and efficiency of work. Being under pressure in the long term will make people strained. So wo wonder how their pressures are and how to deal with .Still how are their states of health in both mind and should？ We hope that by this research report we can offer some advice of management to public health administrators and staff. Methods：This research adopts cross-section survey, with 242 members of Tainan County Health Bureau and Departments as the subjects and OSI-2 as the tool, to discuss public health staff’s pressure of work and state of health, and solution to their problems. The result obtained in processed by using soft ware, SPSS for windows 10.2, using frequeney, percentage, mean, standard deviation (SD),t-test,One-Way ANOVA,pearsons correlation coefficient for data analysis. Results：Result（－）Female make up 79.2﹪of public health staff, whose average age is 42.39 years old. College graduates rank the first （70.3﹪）in terms of education. 87.6﹪of them are married.7.6﹪are administrators. 36.6﹪bring home their unfinished work more than twice a week. I lein average of working experiemce is 14.46 years . 40.2﹪exercise from time to time, which make up the most part. 5.5﹪smoke. 9.8﹪are in the habit of drinking. And 47.7﹪consider to leave their positions sometimes. Result（＝） The staff’s feelings toward pressure of work are placed according to the result of scores from high to low. They are as follows 1st interpersonal relationship, 2nd burden of work, 3rd the balance between work ＆ family , 4th personal responsibility, 5th atmosphere of the organization. As for gague distribution; effect resulted from your fault 1st, clash between job and demand from high –ranked 2nd, thinking about work while being at home 3rd, having to pick up adventure 4th, improper leadership and support from officials 5th。 Conclusion： (1) The female personnel''s health conditions are worse than the male personnel''s and the pressure on the former is significantly higher than the latter. (2) The higher an employee''s educational background is, the higher the tendency of his/her behavior type A is. (3) The health conditions of the executives are better than those of professional Suggestion： 一.Maneuver the proper finesse for dealing with stresses and strains. 二.The intrumal management of facilities： Ameliorate the interactive methods and boost the organizational rapport.

碩士
國立體育大學
休閒產業經營學系
105
The purpose of this study is to explore the effect of athletes' gratitude on life satisfaction. A single-subject research designed with A-B-A reversal included baseline phase, intervention phase and tracking phase was used in this study. Each phase will last for one week and experiment takes totally three weeks. Questionnaires and letters in dairy way will be written three times a week. Life satisfaction and individual emotional state as criterion to make a comprehensive assessment. The result shows negative trends in three aspects (positive emotions, negative emotions, life satisfaction).

碩士
中國醫藥學院
醫務管理研究所
90
The purpose of this research is to understand the self-evaluation of clinic physicians and its related factors, and also to study the views of clinic physicians for primary care services related to National Health Insurance (NHI). The sample of this research is 7560 clinic physicians in the file of NHI contracted medical care organizations, which contained all clinic physicians participating in the NHI in late Dec., 1999. Sixty percent of clinic physicians were randomly selected. A total of 4536 questionnaires was sent, and 16.75% of questionnaires was received. Multiple regression analysis and importance/performance analysis were used to examine the variables that influenced clinic physicians’ self-valuations. The study results showed that clinic physicians have a higher self-evaluation on their overall medical services who also have higher self-evaluations on ”Convenience on Seeking Medical Advice and Consultation”, ”Doctor’s Reputation and Skills”, “Service Attitudes”, “Prescription Explanation”, “Clinic’s Environment Hygiene”. Female clinic physicians have a higher self-evaluation than male clinic physicians, while pediatricians have a lower self-evaluation than internists. Clinic physicians think the reasons that many patients like to visit hospitals are the incompleteness of the referral system, hospital’s care having more insurance coverage, and hospital’s services having higher payments for prescriptions. Clinic physicians think that a complete referral system, higher co-payments for patients visiting hospitals without clinic physician’s referral, lower co-payments for patients visiting clinic physicians, and NHI only covering severe illnesses will attract more patients to visit clinics. The results of the importance/performance analysis indicated that clinic physicians think all of their medical services belong to the sector — “Keeping of the Work”. It means clinic physicians realize all patients’ choices of clinics are important and evaluate themselves doing well. However, the parking inconvenience is the most urgent thing, which needs to be improved for clinics. Based on the study results, clinic physicians will mainly attract patients by continuously improving their medical care quality, and reforming current NHI policies such as increasing clinic prescription payment and lowering co-payment for visiting clinics. Only do clinic physicians attract more patients to visit their clinics that will reduce the waste of medical care resources.

碩士
銘傳大學
管理研究所碩士在職專班
94
Along with the increase of global humanity health consciousness, the demand of health food market continues to grow. Based on a report from the Nutrition Business Journal, the function food market of the global health care in 2005 reached 77 billion US dollars, a 2.6-fold increase as compared to that in 1995. In addition, according to the statistical yearbook of investigation of the consumption of Taiwan food, consumers have focused noticeably on the food health care function during 1999-2005. This fully reflects that the demand on the nutrition and self-heath care is high. Therefore, the aim of this research is to investigate the expense behavior of consumers to the health foods. This research is in part motivated to understand the relationship between the actual life demand and the behavior of the consumers and to investigate whether or not this difference would affect the attitude of buying the health foods. The questions remain to be answered in this study are the followings: (a) Will the consumers’ demographic parameter influence their buying behavior? (b) Will the marketing factor have an apparent impact on consumer’s purchase behavior? (c) Will the purchase-situation of focus influence the buying behavior? In order to answer the questions above, this research will be carried out based on the questionnaires obtained from the Taipei’s inhabitants. The data will be analyzed using SPSS statistical method to evaluate the demographic parameter, health promoting lifestyle parameter, marketing factor and purchase-situation involvement parameters of buying the health food behavior. The hypotheses of this study are summarized below: 1.Different sex has a revealing difference to the health promoting lifestyle parameter and marketing factor parameter. 2.Different age has a revealing difference to the health promoting lifestyle parameter and marketing factor parameter. 3.Different education level has a revealing difference to the health promoting lifestyle parameter and marketing factor parameter. 4.Different occupation has a revealing difference to marketing factor parameter and purchase-situation involvement parameter. 5.Women have a higher positive degree of purchase in the health food than men. 6.Different age has a revealing correlation between the purchase frequency of use and purchase manner. 7.Different occupation is related to different purchase manner. 8.The factor of nutrition leisure has a revealing difference to purchase frequency of use. 9.The factor of quality guidance has a revealing difference to purchase behavior.

碩士
國立臺灣大學
衛生政策與管理研究所
91
The purposes of this study were to understand the typology of school-aged children’s health behavior and to explore the factors related to different health behavior clusters. Data of Children and Adolescent Behaviors in Long-term Evolution (CABLE)─2001 was used for secondary data analysis. The subjects were 2075 forth grade children as well as their fathers and mothers. The children’s health behaviors can be categorized into five factors, which were named “positive health behavior”, ”deviant health behavior”, “substance use behavior”, “violent inclination behavior”, and “health indulgent behavior”. Based on the factor scores, the subjects were clustered into four groups, and they were named as “healthy type”(48%), “indulgent type”(32.9%), “violent type”(17.8%), and “ deviant type”(1.3%). In sum, the factors related to different typologies of school-aged children’s health behavior include gender, inter-locus control, internalizing problem, living-area, father education level, father health behaviors, parent violent, and social support. According to our findings, the priority of health education program should be focused on male, high-level internalizing problem and low-level social support children. Besides, health behavior changing programs based on children’s health behavior patterns and background features can also refer to the findings.

碩士
國立中山大學
生物科學系研究所
99
Bird’s nest is the saliva from the Colloclia that have a lot of mucin and sialic acid. However the sialic acid is an important intermediate of influenza virus infection. In 2006, Guo et al was confirmed the Inhibitory effect of bird’s nest extract on influenza virus infection. But the anti-virus component has not been isolated and purified. First, the bird''s nest used in this study was proved to be a pure bird’s nest by SDS-PAGE, sialic acid content and protein content. Qualification analysis by SDS-PAGE showed sample possessed three bands at about 50 kDa, 100 kDa and 150 kDa, by Warren assay showed sample possessed a sialic acid content about 10% of dry weight, by Kjeldahl method showed sample possessed a protein content about 50% of dry weight, and by fluorescence analysis in 365 nm showed sample emitted a blue-white light. According to the criteria on previous studies, the sample was considered to be a real and pure bird’s nest. Subsequently, the sample was applied to pronase digestion and then separated by Bio-gel P2 for size exclusion chromatography. All fractions were performed carbohydrate analysis including sialic acid. In lectin blotting, Maackia amurensis agglutinin (MAA) lectin can interact with the fraction that suggest the structure of sialic acid is sialic acid-2,3 galactose in bird’s nest. And carbohydrate membrane array to demonstrate the influenza virus of H5N1 and H1N1 can bind the fractions that suggest the antivirus effect of bird’s nest. These fractions will be further analyzed by neutralization assay to study their antivirus effects in vitro.

碩士
國立雲林科技大學
工業工程與管理研究所碩士班
94
In recent years, due to the fast development of the science, the medical technologies improve rapidly. Thus, the average life of compatriots increases. Nevertheless, the main death factors of compatriots change from infective diseases into chronic diseases. Chronic diseases can be treated through finding the causes of diseases early, and then use proper treatment to prevent the deterioration of diseases. Health examination represents the concept that ”prevention is better than cure”. On the other aspect, because the increasing finance deficit of National Health Insurance, the Bureau of National Health Insurance reduced the subsidy for hospitals in order to maintain balanced account. Therefore, in order to keep the hospitals running, many hospitals use health examinations to increase their profits. This research utilized questionnaire to investigate health examination centers of four hospitals in central Taiwan. The study concentrated on the factor of persons’ choices for health examination center. Total 400 questionnaires were surveyed and 310 questionnaires were received. Based on the statistical analysis, the top ten factors of choosing health examination centers included ”progressive facilities”, “doctors’ specialty”, “nurses’ specialty”, “hygienic environment”, “independent equipment and space”, “solve the customers’ complains immediately”, “doctor’s explain all details before examination”, “the examination report in plain language” and “courtesy of nursing”.

碩士
國立中山大學
傳播管理研究所
96
Health communication has become a popular way for health promotion. Public service advertisements of disease prevention construct the understanding of disease and actions toward caution and healing. However, the health messages provided by mass media are not neutral and value-free information; instead, they imply with domestic cultural values, moral regulation, and social order by framing people who affect a disease as lack of self-control, self-surveillance, and negligent behavior. A series of cervical cancer preventing advertisements long-term sponsored by P&G is selected for studying samples. The aims of this research are to discover the power, ideology and dominant discourse about women''s health in advertisements. Semiotic theory is adopt as analyzing methodology in exploring mainstream discourse about women''s health and body regulation in Taiwan, through voice-over, story, and images in advertising. This research finds that information for preventing cervical cancer appeared through media is full of patriarchy ideology. The perception of "healthy" women body is shaped to fit social expectations in female characters, as well-controlled, fragile and protection needed, as well as capability for giving birth of a child. The advertising represents social construction of illness, and defines women''s health problems as individual and private responsibility. The importance of national health policy and the force of social control are absent and ignore. Thus, to disclose how patriarchy, dominant ideologies which undermines women''s health are implemented in health communication is the main purpose of this paper.