Rozprawy doktorskie na temat „Obstetric intervention”
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Creedy, Debra Kay, i D. Creedy@mailbox gu edu au. "Birthing and the development of trauma symptoms: Incidence and contributing factors". Griffith University. School of Applied Psychology, 1999. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030102.101015.
Pełny tekst źródłaCreedy, Debra. "Birthing and the development of trauma symptoms: Incidence and contributing factors". Thesis, Griffith University, 1999. http://hdl.handle.net/10072/367663.
Pełny tekst źródłaThesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Applied Psychology (Health)
Griffith Health
Full Text
Ball, Colleen. "Homebirth in WA: Why women make this choice". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2014. https://ro.ecu.edu.au/theses/1277.
Pełny tekst źródłaMbola, Mbassi Symplice. "Soins obstétricaux d'urgence et mortalité maternelle dans les maternités de troisième niveau du Cameroun : approche évaluative d'une intervention visant à améliorer le transfert obstétrical et la prise en charge des complications maternelles". Thesis, Paris 6, 2014. http://www.theses.fr/2014PA066352/document.
Pełny tekst źródłaDespite numerous initiatives undertaken by health authorities in the past years, maternal mortality remains a major public health issue in Cameroon. Against this background, research was conducted (i) to determine the maternal mortality patterns in 7 tertiary maternity centers in Cameroon, (ii) to document various stages of an intervention for improving referral system and the management of obstetric emergencies and (ii) evaluate the effect of these measures on maternal mortality and propose future actions. The research was conducted in three phases. A retrospective review of the aggregate data for the period 2004-2006 was performed including all births, obstetric complications, caesarean sections and maternal deaths. Then 33 months intervention has been set up in 22 peripheral maternities and in three tertiary maternity centers where maternal mortality was very high. The evaluation of the intervention was made using the quasi-Experimental design. This method combined the pre- and post- intervention study as well as the study of the maternities where there was intervention compared to the control group. Two years after the intervention, maternal deaths recorded in the target tertiary maternity centers decreased by more than half (P = 0.000001). The case fatality rate decreased from 2.2 to 0.7% in the same group (P = 0.000001). Moreover, the number of deaths among referred women decreased significantly and the case fatality rate was less than 1%. The research findings highlight the impact of capacity building providers, improvement of the referral system and quality of care on maternal mortality
August, Furaha. "Effect of Home Based Life Saving Skills education on knowledge of obstetric danger signs, birth preparedness, utilization of skilled care and male involvement : A Community-based intervention study in rural Tanzania". Doctoral thesis, Uppsala universitet, Internationell mödra- och barnhälsovård (IMCH), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-272245.
Pełny tekst źródłaDench, Erin. "Maternal decision making in obstetrical interventions". Honors in the Major Thesis, University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1393.
Pełny tekst źródłaBachelors
Nursing
Nursing
Claesson, Ing-Marie. "Weight gain restriction for obese pregnant women : An Intervention study". Doctoral thesis, Linköpings universitet, Obstetrik och gynekologi, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-56390.
Pełny tekst źródłaEscuriet, Peiró Ramón 1968. "Modelos de organización de los servicios de atención al parto : efecto sobre la provisión de servicios y los resultados". Doctoral thesis, Universitat Pompeu Fabra, 2015. http://hdl.handle.net/10803/319718.
Pełny tekst źródłaThere are different models of maternity care and also other factors related to the organisation of services in which women are attended to. In this thesis the results of delivery of birth care in Catalonia are investigated, and the outcomes of 64 hospitals are compared according to the type of financing and volume of births attended to in each hospital. This thesis also evaluates the impact of the undertaken maternity care policy for the implementation of the normal childbirth model of care and to promote a rational use of the existing health care resources. For the contextualization of this work, some models of care in different industrialized countries are explored, and also it has been identified the most widely used indicators for the assessment of maternity care in Europe. Then specific and appropriate indicators for the Catalan context have been developed. To get information on different models of care and to know what indicators are used in the European context, it has been conducted a critical review of literature, an exploration on several database and also interviews with experts. A number of selected diagnoses and procedures have been obtained from the Minimum Basic Data Set (MBDS) recorded in the Catalan Health Service for the comparison of outcomes. Hospitals have been grouped by type of financing and by the volume of births attended to. All singleton births between 37 to 42 weeks of pregnancy have been included on the analysis. The most relevant conclusions are the type of funding and the volume of births in hospital have a significant effect on the obstetric interventions investigated in Catalonia. Also episiotomy has decreased significantly, and the incidence of severe perineal trauma has remained below 1% in all hospitals in Catalonia.
Pless, Mia. "Developmental co-ordination disorder in pre-school children : Effects of motor skill intervention, parents' descriptions, and short-term follow-up of motor status". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2001. http://publications.uu.se/theses/91-554-4963-8/.
Pełny tekst źródłaLarsson, Margareta. "The Adoption of a New Contraceptive Method – Surveys and Interventions Regarding Emergency Contraception". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4237.
Pełny tekst źródłaEvans, Kerry. "Supporting women with mild to moderate anxiety during pregnancy : the development of an intervention to be facilitated by midwives". Thesis, University of Nottingham, 2018. http://eprints.nottingham.ac.uk/51301/.
Pełny tekst źródłaRai, Vibha. "Development and evaluation of educational intervention to promote informed decision making regarding embryo transfer in IVF patients". Thesis, University of Nottingham, 2012. http://eprints.nottingham.ac.uk/12683/.
Pełny tekst źródłaChaves, Anne Fayma Lopes. "Effects of an educational intervention by telephone on the self-efficacy, duration and exclusivity of breastfeeding: controlled randomized clinical test". Universidade Federal do CearÃ, 2016. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=18490.
Pełny tekst źródłaThis study aimed to evaluate the effects of an educational intervention by telephone to improve maternal self-efficacy in breastfeeding, its duration and exclusivity. This is a Randomized Controlled Clinical Trial that compared two groups: Control Group (CG) (routine care) and Intervention Group (IG) (routine care + educational intervention to promote breastfeeding self-efficacy, following the principles of Motivational Interviewing (MI) by phone, with contacts being held 7, 15 and 30 days after delivery). Study conducted in Fortaleza-CE, Brazil, at the Gonzaga Mota District Hospital in Messejana between May and August 2015. At the end, we obtained a sample of 85 nursing mothers at the second month postpartum, with 41 in the IG and 44 in the CG, and 77 nursing mothers at the fourth month postpartum, 39 in IG and 38 in CG. The study was conducted in three phases: 1. Baseline; 2. Intervention; 3. Evaluation of outcomes at second and fourth month postpartum. For data collection in Phase 1, we used the Form for characterization of nursing mothers and the Breastfeeding Self-Efficacy Scale â Short Form (BSES-SF); in Phase 2, for the intervention, we applied a form containing data about the childâs diet and type of items covered in the session. A form was applied to guide the intervention on the MI approach. Furthermore, to implement the MI technique to inform, it was used an instrument based on the 14 items of the BSES-SF and the Serial Album âI can breastfeed my childâ; in Phase 3, it was applied a form containing the type of breastfeeding, its duration and exclusivity, along with the BSES-SF. Data were analyzed through the Statistical Package for Social Sciences (SPSS) version 20.0 for Windows. Research Ethics Committee approved the study under protocol No. 1,026,156 and it was registered in the Brazilian Clinical Trials Registry (ReBec) platform. As for the characterization, the groups were similar (p>0.05), except for marital status (p=0.018). In the intergroup self-efficacy evaluation, it was identified that the median scores in the breastfeeding self-efficacy scale were the same at the second month in both groups (p=0.773). Nevertheless, at the fourth month, the IG presented higher levels compared with the CG (p=0.011). In the intergroup evaluation of breastfeeding duration, it was evidenced that the educational intervention was able to maintain significantly breastfeeding until the second month (p=0.035) in the IG, while the CG presented a decrease. In the fourth month, it was also possible to identify that the IG maintained breastfeeding for a longer duration than the CG (p=0.109). With regard to the intergroup evaluation of exclusive breastfeeding, it was noted that the IG and CG presented small differences in exclusivity at the second and fourth months (p=0.983/p=0.573). It was found that women with high education and who breastfed immediately after birth were more likely to breastfeed for a longer period. Additionally, women living with a partner are more likely to practice exclusive breastfeeding at the fourth month. Therefore, data showed that the implementation of educational intervention carried out by nurses via telephone focused on breastfeeding self-efficacy and through motivational interviewing increases the self-efficacy of mothers to breastfeed, as well as the duration of breastfeeding, but does not impact its exclusivity.
Objetivou-se avaliar o efeito de uma intervenÃÃo educativa por telefone para a melhoria da autoeficÃcia materna em amamentar, duraÃÃo e exclusividade do aleitamento materno. Trata-se de um Ensaio ClÃnico Randomizado Controlado no qual foram comparados dois grupos: Grupo Controle (GC) (cuidados de rotina) e Grupo IntervenÃÃo (GI) (cuidados de rotina + intervenÃÃo educativa para a promoÃÃo da autoeficÃcia em amamentar, seguindo os princÃpios da Entrevista Motivacional (EM), com o uso do telefone sendo realizado contatos com 7, 15 e 30 dias pÃs-parto). Estudo desenvolvido em Fortaleza-CE, no Hospital Distrital Gonzaga Mota de Messejana entre maio e agosto de 2015. Ao final, obteve-se uma amostra de 85 lactantes aos dois meses pÃs-parto, sendo 41 no GI e 44 no GC e 77 lactantes aos quatro meses pÃs-parto, sendo 39 no GI e 38 no GC. O estudo foi desenvolvido em trÃs fases: 1. Linha de Base; 2. IntervenÃÃo; 3. AvaliaÃÃo dos desfechos aos 2 e 4 meses pÃs-parto. Para a coleta de dados, na Fase 1, utilizou-se o FormulÃrio de caracterizaÃÃo das lactantes e a Breastfeeding Self-Efficacy Scale â Short Form (BSES â SF); na Fase 2, para a intervenÃÃo foi utilizado formulÃrio contendo dados sobre o tipo de dieta da crianÃa e itens abordados na sessÃo. Foi utilizado um formulÃrio para guiar a intervenÃÃo quanto a abordagem da EM. E para utilizar a tÃcnica de informar da EM utilizou-se um instrumento baseado nos 14 itens da BSES-SF e do Ãlbum Seriado âEu posso amamentar meu filhoâ; na Fase 3 foi aplicado um formulÃrio contendo o tipo de aleitamento materno, duraÃÃo e exclusividade da amamentaÃÃo e foi novamente aplicado a BSES-SF. Os dados foram analisados utilizando o Statistical Package for the Social Sciences (SPSS), versÃo 20.0 para Windows. A pesquisa foi aprovada pelo Comità de Ãtica e Pesquisa sob protocolo 1.026.156 e registrado na plataforma de Registro Brasileiro de Ensaios ClÃnicos (ReBEC). Quanto a caracterizaÃÃo, os grupos eram semelhantes (p>0,05), com exceÃÃo do estado civil (p=0,018). Na avaliaÃÃo intergrupo da autoeficacia foi visto que a mediana dos escores da escala de autoeficÃcia em amamentar foi a mesma aos dois meses em ambos os grupos (p=0,773), no entanto, aos quatro meses o GI apresentou nÃveis mais elevados em comparaÃÃo com o GC (p=0,011). Na avaliaÃÃo intergrupo da duraÃÃo do aleitamento materno evidenciou-se que a intervenÃÃo educativa foi capaz de manter o AM atà dois meses de forma significativa (p=0,035) no GI, enquanto que no GC houve uma queda. Em relaÃÃo ao quarto mÃs, tambÃm foi possÃvel perceber que o GI manteve maior duraÃÃo do AM do que o GC (p=0,109). Em relaÃÃo a avaliaÃÃo intergrupo da exclusividade do aleitamento materno foi visto que o GI e o GC apresentaram pequenas diferenÃas em relaÃÃo a exclusividade aos dois e quatro meses (p=0,983/p=0,573). Foi possÃvel observar que as mulheres com alta escolaridade e as que amamentaram imediatamente apÃs o parto apresentam maiores chances de amamentar por mais tempo. E que as mulheres que vivem com o parceiro tÃm mais chance de praticar aleitamento materno exclusivo aos quatro meses. Dessa forma, os dados evidenciaram que a aplicaÃÃo de intervenÃÃo educativa realizada pela enfermeira via telefone centrada na autoeficÃcia em amamentar e utilizando a entrevista motivacional eleva a autoeficÃcia das mÃes em amamentar, aumenta a duraÃÃo do AM, porÃm nÃo impacta na exclusividade do AM.
Wilson, Amie. "Interventions to reduce maternal mortality in developing countries : a systematic synthesis of evidence". Thesis, University of Birmingham, 2014. http://etheses.bham.ac.uk//id/eprint/5147/.
Pełny tekst źródłaElahi, Maqsood M. "Effects of maternal high fat diet and pharmacological intervention on the developmental origins of metabolic & cardiovascular disease". Thesis, University of Southampton, 2011. https://eprints.soton.ac.uk/372924/.
Pełny tekst źródłaOsterman, Robin Lynn. "Motivational Interviewing Intervention to Decrease Alcohol Use During Pregnancy". University of Cincinnati / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1243021605.
Pełny tekst źródłaMbabazi, Muniirah. "Exploring the efficacy of maternal, child health and nutrition interventions in Uganda". Thesis, University of Nottingham, 2017. http://eprints.nottingham.ac.uk/48215/.
Pełny tekst źródłaIsrafil-Bayli, Fidan. "Cerclage outcome by the type of suture material (COTS) study : randomised pilot/feasibility study comparing monofilament (intervention) sutures versus multifilament (comparison) for cervical cerclage". Thesis, University of Birmingham, 2018. http://etheses.bham.ac.uk//id/eprint/8565/.
Pełny tekst źródłaLundgren, Ingela. "Releasing and relieving encounters : Experiences of pregnancy and childbirth". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2002. http://publications.uu.se/theses/91-554-5292-2/.
Pełny tekst źródłaWipplinger, Petro. "Is an educational intervention effective in improving the diagnosis and management of suspected ectopic pregnancy in a tertiary referral hospital in South Africa". Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5241.
Pełny tekst źródłaENGLISH ABSTRACT: Study objective: To investigate whether an educational intervention in the Gynaecology Department of Tygerberg Hospital (TBH) was effective in improving the accuracy of the diagnosis and appropriateness of treatment options offered to women with suspected Ectopic Pregnancy (EP). Methods: A retrospective cross-sectional before-and-after study was performed, including 335 consecutive patients with suspected EP before (1/3 - 30/6/2008) and after (1/9 - 31/12/2008) “the intervention”. From the gynaecological admissions register all pregnant patients with symptoms potentially compatible with EP were selected and these were cross referenced with beta-hCG requests, entries in the theatre register for surgery for possible EP and methotrexate prescriptions for EP in these time periods. “The intervention” consisted of a formal lecture presented to the registrars and consultants regarding the latest evidence-based guidelines concerning the diagnosis and management of EP. An algorithm based on this information was introduced in the emergency unit and ultrasound unit together with a prescribed ultrasound reporting form containing all the pertinent information required to follow the algorithm. Clinical decisions were left to the registrar and consultant on duty. Primary outcomes: Time from presentation to treatment, number and appropriateness of special investigations, surgical procedures or medical management. Secondary outcomes: Number of in-patient days and visits, adherence to the algorithm. Results: There was a non-significant trend towards improved reporting of the uterine content and significantly less reports of definite signs of an intrauterine pregnancy (IUP) (p<0.001, RR 0.46, 95% CI 0.31-0.70) due to stricter ultrasound criteria being followed. There was a significant change in the spectrum of uterine findings (p=0.001), the spectrum of adnexal findings (p=0.006) and the spectrum of free fluid noted (p=0.05). There was a reduction in the total number of beta-hCG levels requested at presentation (patients with no beta-hCG: 24 vs 34, p=0.05, RR 1.60, 95% CI 0.99-2.59) with a significant reduction in the number of inappropriate beta-hCG requests (77 vs 40, p<0.001, RR 0.60, 95% CI 0.43-0.81). There was a significant difference in the spread of the number of beta-hCG tests per patient with less repeat tests in the study group (p=0.021). Significantly less manual vacuum aspirations (MVAs) were performed (47 vs 21, p=0.003, RR 0.51, 95% CI 0.32-0.81) but there was no change in the other treatment modalities offered nor in the time from presentation to treatment, number of visits or in-patient days. Adherence to the algorithm was poor (59 %). Conclusions: Except for a significant decrease in the MVAs performed, with possibly less interrupted early intrauterine pregnancies, the improvement in the use of special investigations after “the intervention” did not translate into fewer inappropriate diagnoses and management. This could be due to frequent non-adherence to the algorithm, and widespread implementation of the algorithm as well as continuous audits would be necessary before a future study could be attempted to assess the efficacy of the algorithm.
AFRIKAANSE OPSOMMING: Studiedoelwit: Die hoofdoel van hierdie studie is om te ondersoek of „n opvoedkundige intervensie in die Ginekologiese afdeling van Tygerberg Hospitaal (TBH) doeltreffend sou wees in die verbetering van die akkuraatheid van diagnose en die gepastheid van behandelingsopsies wat aan vroue gebied word met „n vermoedelike ektopiese swangerskap (ES). Metodes: „n Retrospektiewe, kruisdeursnee voor-en-na studie rakende 335 opeenvolgende pasiënte wat ‟n vermoedelike ES het voor (1/3/2008 – 30/6/2008) en na (1/9/2008 – 31/12/2008) “die intervensie”. Swanger pasiënte is uit die ginekologiese toelatingsregister geselekteer indien hulle simptome gehad het wat moontlik verbind kon word met ES. Hulle is kruisverwys met die beta-hCG‟s aangevra, inskrywings in die teaterregister vir chirurgie vir moontlike ES en ginekologie-pasiënte wat metotrexate vir ES binne hierdie tydperke ontvang het. “Die intervensie” het bestaan uit „n formele lesing aan die kliniese assistente en konsultante ten opsigte van die jongste bewysgebaseerde riglyne rakende die diagnose en hantering van ES. „n Algoritme gegrond op hierdie inligting is in die noodeenheid en ultraklank-afdeling ten toon gestel asook „n voorgeskrewe ultraklank rapporteringsvorm met al die toepaslike inligting wat vereis word om die algoritme te volg. Kliniese besluite is aan die kliniese assistent en konsultant aan diens oorgelaat. Primêre uitkomste: Tydsduur vanaf aanmelding tot behandeling, aantal en gepastheid van spesiale ondersoeke, chirurgiese prosedures en mediese hantering. Sekondêre uitkomste: Die aantal binnepasiëntdae en besoeke, nakoming van die algoritme. Resultate: Daar was „n nie-betekenisvolle neiging tot beter rapportering van die uteriene-inhoud en betekenisvol minder rapportering van definitiewe tekens van „n intra-uteriene swangerskap (IUS) (p<0.001, RR 0.46, 95% CI 0.31-0.70) as gevolg van strenger ultraklankstandaarde gevolg. Daar was „n betekenisvolle verandering in die spektrum van uteriene bevindinge (p=0.001), die spektrum van die adneksale bevindinge (p=0.006) en die spektrum van die vrye vog aangeteken (p=0.05). Daar was „n vermindering in die totale aantal beta-hCG-vlakke aangevra met aanmelding (pasiënte met geen hCG: 24 vs 34, p=0.05, RR 1.60, 95% CI 0.99-2.59) met „n betekenisvolle vermindering in die aantal onvanpaste beta-hCGs aangevra (77 vs 40, p<0.001, RR0.60, 95% CI 0.43-0.81). Daar was „n betekenisvolle verskil in die verspreiding van die aantal beta-hCG-toetse per pasiënt, met minder herhalende toetse in die studiegroep (p=0.021). Betekenisvol minder manuele vakuum aspirasies (MVAs) is uitgevoer (47 vs 21, p=0.003, RR 0.51, 95% CI 0.32-0.81), maar geen verskil in ander behandelingsmodaliteite is aangebied nie, asook geen verskil in die tydsduur vanaf aanmelding, die aantal besoeke of die aantal binnepatiëntdae nie. Nakoming van die algoritme was swak (59%). Gevolgtrekkings: Behalwe vir „n betekenisvolle afname in die MVAs uitgevoer, met moontlik minder onderbroke vroeë IUS, het die verbetering in die gebruik van spesiale ondersoeke ná “die intervensie” nie minder onvanpaste diagnoses en hantering tot gevolg gehad nie. Dit kan die gevolg wees van gereelde nie-nakoming van die algoritme, en uitgebreide implementering van die algoritme asook voortdurende oudits sal nodig wees voor „n verdere studie aangepak kan word om die doeltreffendheid van die algoritme te bepaal.
Van, Niekerk Elizabeth C. "Evaluation of a quality improvement cycle intervention in the provision of PMTCT at a regional hospital". Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/85669.
Pełny tekst źródłaENGLISH ABSTRACT: The vast majority of new Human Immunodeficiency Virus (HIV) infections in infants and young children occur through mother-to-child-transmission (MTCT), either during pregnancy, labour or delivery or by breastfeeding. Without access to perinatal MTCT (PMTCT) programmes approximately 30% of all babies born annually will be infected with HIV. OBJECTIVES The aim was to implement and audit a quality improvement cycle at the Worcester Obstetric Unit, which comprises of Worcester Hospital, a regional hospital in the Western Cape Province and its level one midwife obstetric Unit (MOU), in order to improve the quality of the PMTCT programme. The intervention included the implementation of easy changes and tools in the Antenatal Clinic, Infectious Diseases Clinic and Labour ward. METHODS The files and antenatal records of all HIV positive patients and patients with an unknown HIV status, who delivered at the Worcester Obstetric Unit during January, February and March of 2010 and 2011, were reviewed. All HIV negative patients and patients that had stillbirths and miscarriages were excluded. The pre-interventional findings of 2010 were compared with the post-interventional findings of 2011. RESULTS At the Worcester Obstetric Unit, for the study time period, there were 907 deliveries in 2010, of which 102 (11.2%) patients were HIV positive and 4 (0.4%) had an unknown HIV status compared to 2011, with 865 deliveries of which 108(12.5%) patients were HIV positive and no patients had an unknown HIV status. Significantly more patients were diagnosed with HIV before they fell pregnant than during pregnancy in the 2011 group, when compared with the 2010 group. A CD4 count was done on 94% of patients who were newly diagnosed with HIV and those with an unknown CD4 count result in the 2010 group, compared to 92% in 2011. There was a significant improvement after the intervention in the time it took from when blood was drawn for a CD4 count until the result was followed up, the median time decreased from 34 to 8 days (p=0.000001). Significantly more patients qualified for highly active antiretroviral therapy (HAART) after the guidelines were changed and the CD4 cut off was increased to 350 cells/l (p=0.001). Prior the intervention 18 patients did not receive the correct management before delivery due to preventable reasons, compared to one at the MOU. After the intervention this decreased significantly to only one patient at Worcester Hospital and none at the MOU (p=0.000001). Before the intervention adherence to the PMTCT protocol at the MOU was significantly better than at the hospital (p=0.0005) and after the intervention there was no significant difference (p=1.0). CONCLUSION Although the audit and quality improvement cycle was performed at a single hospital, with specific changes geared towards their needs, the basic principles can be applied to any Unit in the country providing a PMTCT service. Educating staff, creating awareness and reminding staff of the basic principles of PMTCT, implementing small changes and streamlining processes and setting specific goals or timelines, can lead to significant improvements in care, which ultimately will lead to a decrease in PMTCT of HIV and HIV related maternal and infant morbidity and mortality.
AFRIKAANSE OPSOMMING: Die oorgrote meerderheid (>90%) van nuwe Menslike Immuniteitsgebreksvirus (MIV) infeksies in babas en jong kinders vind plaas deur middel van moeder-na-kind-oordrag, hetsy gedurende swangerskap, die kraamproses of borsvoeding. Sonder toegang tot perinatale voorkomingsprogramme (PMTCT) sal ongeveer 30% van alle babas jaarliks met MIV geïnfekteer word. DOELWITTE Die doel van die studie was om ‘n gehalteverbeteringsiklus by die Worcester Verloskunde Eenheid, wat bestaan uit Worcester Hospitaal, 'n streekshospitaal in die Wes-Kaapprovinsie en sy vlak een vroedvrou verlossingseenheid (VVE), te implementer en daarna te oudit, om sodoende die gehalte van die PMTCT-program te verbeter. Die intervensie het bestaan uit die implementering van eenvoudige veranderinge en prosesse in die voorgeboortekliniek, infeksiesiekte-kliniek en kraamsaal. METODES Die lêers en voorgeboorte rekords van alle MIV-positiewe pasiënte en pasiënte met 'n onbekende MIV-status, wat gedurende Januarie, Februarie en Maart van 2010 en 2011 verlos het by die Worcester Verloskunde Eenheid, is nagegaan. Alle MIV-negatiewe pasiënte en pasiënte met doodgebore babas en miskrame is uitgesluit. Die pre-intervensie bevindings van 2010 is vergelyk met die post-intervensie bevindings van 2011. RESULTATE By die Worcester Verloskunde Eenheid was daar 907 geboortes gedurende die studietydperk in 2010, waarvan 102 (11,2%) pasiënte MIV-positief was en 4 (0,4%) met ‘n onbekende MIV-status. In 2011 was daar 865 geboortes waarvan 108 (12,5%) pasiënte MIV-positief was en geen met 'n onbekende MIV-status. In die 2011-groep is beduidend meer pasiënte gediagnoseer met MIV voor as tydens swangerskap. In die 2010-groep is daar 'n CD4-telling gedoen vir 94% van nuut gediagnoseerde pasiënte en diegene met 'n onbekende CD4-telling, in vergelyking met 92% in 2011. Daar was 'n beduidende verbetering na die intervensie in die tyd wat dit geneem het vandat bloed getrek is vir 'n CD4-telling totdat die resultaat opgevolg is. Die mediane tyd het verminder vanaf 34 na 8 dae (p = 0.000001). Nadat die riglyne vir kwalifisering vir hoogs aktiewe antiretrovirale terapie (HAART) verander is na ‘n CD4 telling 350 selle/l het daar beduidend meer pasiënte gekwalifiseer vir HAART. By Worcester Hospitaal het 18 pasiënte voor die intervensie nie die korrekte behandeling intrapartum ontvang nie weens voorkombare redes, in vergelyking met slegs een pasiënt by die VVE. Na die intervensie was daar ‘n beduidende afname na slegs een pasiënt by Worcester Hospitaal en geen by die MOU (p = 0.000001). Voor die intervensie was die korrekte uitvoering van die PMTCT-protokol by die MOU beduidend beter as by die hospitaal (p = 0,0005) en na die intervensie was daar geen beduidende verskil (p = 1.0). GEVOLGTREKKING Alhoewel die oudit en gehalteverbeteringsiklus uitgevoer is by 'n enkele hospitaal, met spesifieke veranderinge gerig tot hul behoeftes, kan die basiese beginsels toegepas word in enige eenheid in die land wat ‘n PMTCT diens verskaf. Opvoeding van personeel en bewusmaking rakende die basiese beginsels van PMTCT, klein veranderinge en die vaartbelyning van prosesse by die voorgeboorte klinieke en die stel van spesifieke doelwitte of tydlyne, kan lei tot aansienlike verbeteringe in pasiënte sorg. Dit sal uiteindelik lei tot 'n afname in die MIV oordrag van moeder na kind, asook MIV-verwante morbiditeit en mortaliteit in moeders en kinders.
Boson, Maria, i Sofia Sundlöf. "Skiljer sig interventioner och förlossningsutfall mellan äldre och yngre förstföderskor med spontan värkstart? : en kvantitativ retrospektiv tvärsnittsstudie". Thesis, Högskolan Dalarna, Institutionen för hälsa och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:du-38412.
Pełny tekst źródłaBackground: The age of first-time mothers increases in high-income countries and with increasing age, the risk of pregnancy related complications gets more common. The proportion of interventions that are needed to initiate, strengthen and monitor the psychological birth process is also increasing. Aim: The aim of this study was to investigate if interventions and delivery outcomes differ between older nulliparous women (≥35 years) and younger nulliparous women (20–24 years) with spontaneous onset of labor. Method: We conducted a quantitative retrospective cross-sectional study where data were collected from a hospital in Sweden. The material, which consisted of 232 nulliparous women, was processed with descriptive and comparative statistical analyzes. Results: In our study, we found that older nulliparous women more often received extended fetal monitoring and gave birth to babies weighing 4,500 grams or more compared to younger nulliparous women. Regardless of age, nulliparous gave birth vaginally and interventions such as administration of oxytocin and fetal scalp electrodes were used in around half of the births. Conclusion and clinical implications: There were few significant differences between the compared age groups. Our study didn’t show large differences between the age groups, however, research shows that age is a risk factor. As a midwife, you must consider that age is only one factor in assessing the woman giving birth.
Massawe, Siriel Nanzia. "Anaemia in women of reproductive age in Tanzania : A study in Dar es Salaam". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2002. http://publications.uu.se/theses/91-554-5308-2/.
Pełny tekst źródłaUmscheid, Dana Marie. "A comparison of two modes of delivery of an educational intervention to encourage compliance with American College of Obstetrics and Gynecology recommendations regarding the gynecological exam among sorority women". [Bloomington, Ind.] : Indiana University, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3324541.
Pełny tekst źródłaTitle from PDF t.p. (viewed on May 14, 2009). Source: Dissertation Abstracts International, Volume: 69-08, Section: B, page: 4707. Adviser: Nancy T. Ellis.
Machado, Angélica Pontes. "Fatores que influenciam a produção de colostro em porcas". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/94614.
Pełny tekst źródłaColostrum provides newborn piglets with energy and with passive immunity. An adequate colostrum intake, in order to fulfill the needs of piglets and then ensure their survival and weight gain, depends on sow’s ability to produce enough colostrum for the whole litter. The aim of this study was to evaluate factors involved on colostrum yield variability related to the sow, the litter and farrowing process. The experiment was conducted with 96 Camborough 25® sows of parities one to seven whose farrowing was spontaneous. Sows and their litters were followed until 24 h after farrowing onset. Colostrum production was estimated by summing up colostrum intake of each piglet of the litter. Colostrum ingestion by individual piglets was estimated using piglet weight gain during the first 24 h of life. The multiple regression model explained 28% of variation in colostrum yield, with 24% and 4% of variation being explained by the litter weight at birth and the width of first mammary glands, respectively. Litter weight at birth was positively correlated with the number of total born (r = 0.73) and liveborn piglets (r = 0.83).When separated into two classes of colostrum yield (HIGHPROD; >3.4 kg; n= 50 vs LOWPROD; ≤3.4 kg; n= 46), LOWPROD sows had lighter litters and fewer total born and liveborn piglets (P < 0.05). The logistic regression analysis showed that sows from parities 1, 2 and >3 had greater odds (P ≤ 0.05) to be in the LOWPROD group than parity 3. Sows with two or more obstetrical interventions had higher odds (P < 0.05) of belonging to the LOWPROD group than sows without interventions at farrowing. This study showed that litter weight at birth is the most important factor involved in colostrum yield variability, indirectly representing the number of piglets nursed by the sow.
Stanley, Leisa J. "Association among neonatal mortality, weekend or nighttime admissions and staffing in a Neonatal Intensive Care Unit". [Tampa, Fla.] : University of South Florida, 2008. http://purl.fcla.edu/usf/dc/et/SFE0002421.
Pełny tekst źródłaFerriols, Pérez Elena. "Efecto de una intervención educativa sobre la frecuencia y adecuación de la asistencia a urgencias de las embarazadas de nuestra área". Doctoral thesis, Universitat Autònoma de Barcelona, 2015. http://hdl.handle.net/10803/325158.
Pełny tekst źródłaInadequate emergency visits which could be resolved in primary care are frequent. Moreover, they are an unnecessary healthcare service outlay, which could be reduced. There are several aims of this study. First, we would like to describe the adequacy of the emergency visits by pregnant women in our Hospital and to identify the risk factors for an inappropriate visit. Secondly, we intend to develop and validate a leaflet about the symptoms that may occur during pregnancy and instructions for treatment should they appear. Finally, we will analyze the effectiveness of the leaflet to reduce inappropriate visits and attendance to the emergency room by a randomized intervention study. Specifically, out of a sample of 1,743 visits to the Gynecology and Obstetrics emergency, we classified the reasons for consultation according to the three levels of adequacy: adequate, moderately adequate and inadequate. Our findings show consultation motivations were adequate in 38.9% of the cases, moderately adequate in 46.7% and inadequate in 14.4 %. Several factors shaped variations in results. Patients with a history of stillbirth, death child or higher gestational risk tended to distribute their reasons of consultation in groups of moderately adequate and inadequate (marginally significant). We found a trend towards more appropriate reasons for consultation in more developed pregnancies while it was less adequate in the earlier gestations. The number of children at term or preterm and miscarriages are variables that didn´t change the level of adequacy in a statistically significant number. This shows that the amount of inadequate and moderately adequate visits to the emergency department could be reduced by 61 % by implementing different interventions. Therefore, unnecessary expense could be reduced. The leaflet was validated by four obstetricians’ experts and a group of 19 pregnant and puerperal women. The leaflet was committed in a group of 209 pregnant women, during their first ultrasound, and they were compared to a control group of 216 pregnant women. Adequacy level was not different between the case and the control group. No significant differences were found in the primary endpoint: "level of adequacy", between the case group and control group. Every pregnant woman went to emergency room 1.83 times in each group. We found significant differences in ultrasound requirement (the case group required more sonography) but not in hospitalization requirement, urine sediment requirement, "fetal non-stress test" requirement or blood test requirement. No significant differences were found in the short-term analysis; the tool neither proves to be effective in the short term. The inadequacy visits were more frequent during morning and nights. The higher gestational age was, the more appropriate were the visits. In conclusion we validated a leaflet about the symptoms that may occur during pregnancy and used it to make a simple and economic educational intervention in the pregnant woman population. Although we have demonstrated their high level of inappropriate visits to the emergency department, we could not demonstrate efficacy of the educational intervention under these conditions.
Lushiku, Lunganga Toms. "Profile of obstetric cardiac patients delivered with an anaesthetic intervention at an academic hospital". Thesis, 2018. https://hdl.handle.net/10539/26674.
Pełny tekst źródłaBackground Pregnant women with cardiac disease present some of the greatest challenges to the anaesthesiologist. Data from South Africa as to the incidence, the type of anaesthetic technique used as well as maternal cardiac and obstetric outcomes of these patients is scanty. Therefore, the aim of this study is to describe the profile of obstetric cardiac patients who delivered with an anaesthetic intervention at Chris Hani Baragwanath Academic Hospital. Methods A retrospective audit using consecutive convenience sampling was done by reviewing the labour ward admission books, the cardiac obstetric anaesthetic assessment forms, the intraoperative anaesthetic forms and the labour epidural forms from January 2014 to December 2015. Results Two hundred and three (0.49%) patients were identified with underlying cardiac disease and 83 met the criteria for inclusion. Acquired cardiac disease was most prevalent (65%) and rheumatic valvular cardiac disease being the most dominant (41%) lesion. Pulmonary hypertension was present in 19% of patients. Eighteen percent of patients were included in mWHO class 4 where pregnancy is not advised. Neuraxial anaesthesia was used in 57% of deliveries. Intraoperative complications were present in 8 (10%) patients. Two (2%) patients had cardiac complications. There was no maternal death recorded in the first 24 hours post-delivery. iv Conclusions This audit demonstrated that acquired cardiac diseases were more prevalent than congenital and rheumatic valvular disease is still the most common cause of acquired cardiac disease in pregnancy. Neuraxial anaesthesia was the most used anaesthetic technique for delivery in these patients
XL2019
"The effect of a theory-based intervention on promoting self-efficacy for childbirth among pregnant women in Hong Kong". Thesis, 2005. http://library.cuhk.edu.hk/record=b6074077.
Pełny tekst źródłaThe aim of this study was to test the effectiveness of an educational intervention, based on Self-efficacy theory (Bandura, 1989); to promote women's self-efficacy for childbirth and their coping ability for reducing anxiety and pain during labour. The study consisted of two phases: the 1st phase was to establish the validity and reliability of the primary outcome measure of the phase 2 study: a short form of the Chinese version of the Childbirth Self-efficacy Inventory (CBSEI-C32). The confirmatory factor analysis (CFA) was used to establish the construct validity of the CBSEI-C32. In the 2nd phase, the focus was to test the effectiveness of educational intervention to promote women's self-efficacy for childbirth and their coping behaviour during labour. The researcher used an experimental design with random assignment of eligible participants into experimental (n = 54) or control (n = 62) group that completed one pre-test (baseline at 32--34 weeks of gestation) and three posttest surveys (post-intervention at 37 weeks of gestation and within 48 hours and 6 weeks after delivery). The experimental group received two 90-minute sessions of an educational program offered at 33--35 weeks of gestation based on Bandura's (1986) self-efficacy theory. The primary outcome measures were the two subscales of the CBSEI-C32: outcome expectancy (OE-16) and efficacy expectancy (EE-16). The secondary measures included psychological morbidity (GHQ12), pain and anxiety during labour (VAS) and performance of coping behaviour during labour (CCB). Physiological labour outcomes in terms of mode of delivery, length of labour, types of analgesia used, Apgar scores of newborn and neonatal admission were also extracted from the participants' medical record.
Ip Wan Yim.
"June 2005."
Source: Dissertation Abstracts International, Volume: 67-07, Section: B, page: 3717.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2005.
Includes bibliographical references (p. 159-191).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
School code: 1307.
Kyei-Nimakoh, Minerva. "Management and Referral of Obstetric Complications: a Study in the Upper East Region of Ghana". Thesis, 2017. https://vuir.vu.edu.au/35051/.
Pełny tekst źródłaDerbie, Engida Yisma. "Obstetrical interventions during labour and birth: an examination of effects on breastfeeding, neonatal mortality and children’s educational outcomes". Thesis, 2020. https://hdl.handle.net/2440/135370.
Pełny tekst źródłaThesis (Ph.D.) -- University of Adelaide, School of Public Health, 2020
Bressler, Kaylee. "Etiology and treatment of postpartum hemorrhage in low- and middle-income countries". Thesis, 2020. https://hdl.handle.net/2144/41180.
Pełny tekst źródłaVan, Busum Kelly M. ""Nobody asked if I was ok:" C-section experiences of mothers who wanted a birth with limited medical intervention". Thesis, 2014. http://hdl.handle.net/1805/5585.
Pełny tekst źródłaThis thesis project aims to address the following question: How do women who were planning a vaginal birth with limited medical intervention experience an unplanned c-section? Specifically, this research project involved: completing in-depth interviews with 15 women who planned a vaginal birth with limited medical intervention but instead experienced an unplanned c-section between six months and two years ago; discovering and describing the nature of the birth the mothers originally envisioned for their child; exploring the women’s experiences with, and feelings about, the birth itself and how it might differ from what they envisioned; developing a better understanding of how these experiences and feelings affected the women during the first two years following the birth; describing any challenges they faced and how, if at all, they managed such challenges; and identifying strategies that could be used to improve the experience of women recovering from an unplanned c-section who envisioned a vaginal birth with limited medical intervention.
"A comparison of two modes of delivery of an educational intervention to encourage compliance with American College of Obstetrics and Gynecology recommendations regarding the gynecological exam among sorority women". INDIANA UNIVERSITY, 2009. http://pqdtopen.proquest.com/#viewpdf?dispub=3324541.
Pełny tekst źródłaBieda, Janine. "Certified nurse-midwives and physicians a study of their clients' origins of locus of control and preferences for medical interventions throughout pregnancy and during labor : a research report submitted in partial fulfilllment ... Master of Science (Nurse-Midwifery) ... /". 1992. http://catalog.hathitrust.org/api/volumes/oclc/68796080.html.
Pełny tekst źródłaJean-Baptiste, Elisa. "Estimation de la macrosomie fœtale chez les populations Cris de l’Est de la Baie-James". Thèse, 2016. http://hdl.handle.net/1866/19155.
Pełny tekst źródłaObjective: Assess the impact of fetal macrosomia based on definitions (birth weight> 4000 g,> 4500g, ≥90ième percentile Kramer) currently used in Quebec and compare the prevalence of maternal and perinatal morbidity associated with macrosomia between the Cree populations of Eastern James Bay and the general population of Quebec. Specific postnatal curves for the Cree will be constructed. Design: Comparison of two prospective cohort Cree and Quebec. Cohort of Cree populations of eastern James Bay, has recruited 2546 women from 2000 to 2010, during the study of fetal macrosomia in the Cree of eastern James Bay. Quebec cohort consisted of 97,475 women and comes from the multicenter randomized clinical trial QUARISMA 2008-2010, this study promulgates the reduction of caesarean delivery rate. Methods: The risk of fetal macrosomia, maternal and perinatal morbidity, by ethnicity, Cree and Quebec, are evaluated by generalized estimating equations models (GEE). GEE models were adjusted to control for potentially confounding factors. The reference group is Quebec women. The specific growth curves of the Cree are built by quantile regression. Results: More than a third, 36.8%, of Cree populations of Eastern James Bay and 9.3% of newborns in Quebec have a birth weight> 4000g. For a birth weight> 4500g, the results show that 10.9% of the Cree, have a birth weight of more than 4500g, the rate is 1.2% in Quebec. The definition of fetal macrosomia by neonatal birth weight≥90th percentile of Kramer identifies 40.02% Cree’s for 8.8% of infants of Quebec as macrosomic. The Cree population are more at risk of fetal macrosomia, compared to the general population of Quebec, these associations were statistically significant: OR = 5.2; 95% CI (4.6 to 6.0) for birth weight> 4000g, OR = 8.1; 95% CI (6.2 to 10.7) for birth weight> 4500g and OR = 6.2; 95% CI (5.7 to 6.7) for birth weight percentile ≥90th Kramer. The risk of major perinatal morbidity associated with fetal macrosomia, is generally less important for the Cree than for the general population of Quebec: 0.76; 95% CI 0.62-0.94. Fetal macrosomia should be described by birth weight ≥95th percentile of Kramer, for the Cree, but preferably at the 90th percentile of the specific postnatal curves of Cree populations of Eastern James Bay. The specific Cree birth weight thresholds for diagnosing fetal macrosomia, at the 90th percentile of the 40th week of gestation, are 4 417g for the girls and 4 488g for the boys. Conclusion: Kramer’s curves diagnose systematically too much macrosomic Cree babies compare to the general population of Quebec. Futhermore, the risk of major maternal and perinatal morbidity is lower for these indigenous communities, at the different definitions of fetal macrosomia, suggesting the use of specific curves for the Cree, to reduce obstetrics interventions not required in large, but non macrosomic, Cree babies.