Mothers’ perception of recovery and satisfaction with patent medicine dealers’ treatment of childhood febrile conditions in rural communities

Background Infant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine ‘mothers’ perception of recovery’ and ‘mothers’ satisfaction’ after PMD treatment of childhood febrile conditions, as likely drivers of mothers’ health-seeking behaviour, which must be targeted to reverse the trend. Methods Ugwuogo-Nike, in Enugu, Nigeria, has many PMDs/PHCs, and was selected based on high prevalence of childhood febrile conditions. In total, 385 consenting mothers (aged 15–45 years) were consecutively recruited at PMD shops, after purchasing drugs for childhood febrile conditions, in a cross-sectional observational study using a pre-tested instrument; 33 of them (aged 21–47 years) participated in focus group discussions (FGDs). Qualitative data were thematically analysed while a quantitative study was analysed with Z score and Chi square statistics, at p < 0.05. Results Most participants in FGDs perceived that their child had delayed recovery, but were satisfied with PMDs’ treatment of childhood febrile conditions, for reasons that included politeness, caring attitude, drug availability, easy accessibility, flexibility in pricing, shorter waiting time, their God-fearing nature, and disposition as good listeners. Mothers’ satisfaction with PMDs’ treatment is significantly (p < 0.05) associated with mothers’ perception of recovery of their child (χ2 = 192.94, df = 4; p < 0.0001; Cramer’s V = 0.7079). However, predicting mothers’ satisfaction with PMDs’ treatment from a knowledge of mothers’ perception of recovery shows a high accord (lambda[A from B] = 0.8727), unlike when predicting mothers’ perception of recovery based on knowledge of mothers’ satisfaction with PMDs’ treatment (lambda[A from B] = 0.4727). Conclusions Mothers’ satisfaction could be the key ‘driver’ of mothers’ health-seeking behaviour and is less likely to be influenced by mothers’ perception of recovery of their child. Therefore, mothers’ negative perception of their child’s recovery may not induce proportionate decline in mothers’ health-seeking behaviour (patronage of PMDs), which might be influenced mainly by mothers’ satisfaction with the positive attributes of PMDs’ personality/practice and sets an important agenda for PHC reforms.

Fatores determinantes do comportamento infantil na consulta de Medicina Dentária da Unidade de Saúde da Ilha Terceira

O medo e a ansiedade dentária são importantes fatores condicionantes do tratamento dentário. Ao interferirem na condição psicológica do paciente, condicionam o seu comportamento na consulta e a atitude que apresentam em relação aos cuidados de saúde oral. Os pacientes ansiosos, medrosos ou fóbicos adiam a consulta de medicina dentária, evitam os tratamentos e só recorrem ao médico dentista quando surgem os sintomas dolorosos. Este adiar dos procedimentos dentários resultará num agravamento dos problemas de saúde oral, e em maiores necessidades de tratamento, tratamento esse que será mais intensivo, mais invasivo e potencialmente mais traumático, levando a um reforço do medo e da ansiedade dentária já existente. As crianças, pela menor maturidade psico-emocional têm menor capacidade de lidar com as suas emoções perante diversos acontecimentos, nomeadamente, em contexto médico-dentário. Tornam-se assim mais suscetíveis ao desenvolvimento de medo e ansiedade dentária, e exibindo, com alguma frequência, comportamentos negativos na consulta, que dificultam a adequada prestação de cuidados de saúde oral. Existem ainda outros fatores etiológicos predisponentes e desencadeantes de ansiedade dentária na criança e que condicionam o seu comportamento na consulta (idade, género, faixa etária, número de consultas anteriores, entre outros). Objetivo: Neste trabalho pretendeu-se avaliar os fatores determinantes do comportamento infantil na consulta de medicina dentária da Unidade de Saúde da Ilha Terceira, em crianças com idades entre os 4 e os 16 anos. Métodos: Foi realizado um estudo descritivo observacional transversal onde se pretendeu avaliar a ansiedade dentária da criança antes da consulta dentária através da Facial Image Scale (FIS); avaliar a ansiedade dentária dos acompanhantes através da. Corah Dental Anxiety Scale, Revised (DAS-R). e o comportamento das crianças durante o tratamento dentário usando a Escala de Frankl. O estudo decorreu de 30 de Abril a 8 de Maio na Unidade de Saúde da Ilha Terceira, Região Autónoma dos Açores, tendo sido observadas 53 crianças de idades compreendidas entre os 4 e os 16 anos. Resultados: Numa amostra de 53 crianças, verificou-se que 11,3% das crianças apresentavam ansiedade dentária antes da consulta dentária, que os pais eram mais ansiosos que as crianças, 49,1% apresentavam ansiedade dentária e que a percentagem de crianças com um comportamento negativo durante a consulta médico-dentária foi muito baixa, correspondendo a 1,9%. Verificou-se que a ansiedade dentária parental não interfere com a ansiedade dentária da criança, quando comparadas, ao contrário do que alguns estudos sugerem. Não houve relação entre a ansiedade dentária da criança e o género, idade, número de vezes que veio ao médico dentista ou estatuto social. Conclusão: Neste estudo pôde-se concluir que as crianças que frequentaram a consulta de medicina dentária da Unidade de Saúde da Ilha Terceira entre 30 de Abril a 8 de Maio apresentaram baixa prevalência de ansiedade dentária e elevada prevalência de comportamento positivo na consulta. Já os seus pais ou acompanhantes apresentaram uma prevalência de ansiedade dentária parental elevada. Conhecer os fatores que condicionam o comportamento infantil na consulta dentária como a ansiedade dentária da criança e a ansiedade dentária parental e medi-los antes da consulta poderá ajudar a equipa dentária na abordagem comportamental da criança durante os tratamentos dentários. Envolver a comunidade escolar e a população infantil em ações de promoção da saúde oral, promovendo rastreios dos problemas orais nas escolas, e consultas dentárias de acompanhamento logo desde muito jovens, poderá ter um efeito benéfico na diminuição da ansiedade dentária nas crianças e no desenvolvimento de comportamentos positivos nas consultas.

Researching a segmented market: reflections on telephone interviewing

Purpose The purpose of this paper was to review the effectiveness of telephone interviewing for capturing data and to consider in particular the challenges faced by telephone interviewers when capturing information about market segments. Design/methodology/approach The platform for this methodological critique was a market segment analysis commissioned by Sport Wales which involved a series of 85 telephone interviews completed during 2010. Two focus groups involving the six interviewers involved in the study were convened to reflect on the researchers’ experiences and the implications for business and management research. Findings There are three principal sets of findings. First, although telephone interviewing is generally a cost-effective data collection method, it is important to consider both the actual costs (i.e. time spent planning and conducting interviews) as well as the opportunity costs (i.e. missed appointments, “chasing participants”). Second, researchers need to be sensitised to and sensitive to the demographic characteristics of telephone interviewees (insofar as these are knowable) because responses are influenced by them. Third, the anonymity of telephone interviews may be more conducive for discussing sensitive issues than face-to-face interactions. Originality/value The present study adds to this modest body of literature on the implementation of telephone interviewing as a research technique of business and management. It provides valuable methodological background detail about the intricate, personal experiences of researchers undertaking this method “at a distance” and without visual cues, and makes explicit the challenges of telephone interviewing for the purposes of data capture.

Incidência de cárie dentária em adolescentes em município do Nordeste brasileiro, 2006

NORO, Luiz Roberto Augusto et al. Incidência de cárie dentária em adolescentes em município do Nordeste brasileiro, 2006, Cadernos de Saúde Pública, Rio de Janeiro, v. 25, n. 4, p. 783-790, abr. 2009.

Princesses et duchesses bibliophiles à la cour de René d'Anjou

De nombreuses dames de la cour d'Anjou ont exercé un mécénat littéraire et bibliophilique important à la cour d'Anjou. Parmi elles se trouvent Marie de Blois (v. 1340-1404), Yolande d'Aragon (1381-1442), Isabelle de Lorraine (v. 1400-1453), Jeanne de Laval (1433-1498) et Marie de Clèves (1426-1487). Le mécénat de ces femmes, parentes, épouses ou amies de René d'Anjou, est ici abordé à travers les documents d'archives et les manuscrits conservés qui attestent d'un intérêtréel et constant pour l'art du livre et de l'enluminure et pour la littérature en vogue à la cour. Une attention toute particulière est réservée au Pèlerinage de Vie humaine de Guillaume de Digulleville dont la version rimée, et plus tard la version en prose commandée par Jeanne de Laval, n'a cessé de captiver le lectorat féminin et notamment Marguerite d'Anjou, Blanche d'Anjou et Guyonne de Beauvau

Avaliação da sensibilidade médica para o risco de gravidez não planeada

Prémio em Contraceção 2012 da Sociedade Portuguesa de Contraceção

King of the Renaissance: Art and Politics at the Neapolitan Court of Ferrante I, 1458-1494

In the second half of the fifteenth century, King Ferrante I of Naples (r. 1458-1494) dominated the political and cultural life of the Mediterranean world. His court was home to artists, writers, musicians, and ambassadors from England to Egypt and everywhere in between. Yet, despite its historical importance, Ferrante’s court has been neglected in the scholarship. This dissertation provides a long-overdue analysis of Ferrante’s artistic patronage and attempts to explicate the king’s specific role in the process of art production at the Neapolitan court, as well as the experiences of artists employed therein. By situating Ferrante and the material culture of his court within the broader discourse of Early Modern art history for the first time, my project broadens our understanding of the function of art in Early Modern Europe. I demonstrate that, contrary to traditional assumptions, King Ferrante was a sophisticated patron of the visual arts whose political circumstances and shifting alliances were the most influential factors contributing to his artistic patronage. Unlike his father, Alfonso the Magnanimous, whose court was dominated by artists and courtiers from Spain, France, and elsewhere, Ferrante differentiated himself as a truly Neapolitan king. Yet Ferrante’s court was by no means provincial. His residence, the Castel Nuovo in Naples, became the physical embodiment of his commercial and political network, revealing the accretion of local and foreign visual vocabularies that characterizes Neapolitan visual culture.

Politics and protestant Lordship in North East Scotland during the reign of James VI: The life of George Keith, fourth Earl Marischal, 1554-1623

George Keith, fourth Earl Marischal is a case study of long-term, quietly successful and stable lordship through the reign of James VI. Marischal’s life provides a wholly underrepresented perspective on this era, where the study of rebellious and notorious characters has dominated. He is also a counter-example to the notion of a general crisis among the European nobility, at least in the Scottish context, as well as to the notion of a ‘conservative’ or ‘Catholic’ north east. In 1580 George inherited the richest earldom in Scotland, with a geographical extent stretching along the east coast from Caithness to East Lothian. His family came to be this wealthy as a long term consequence of the Battle of Flodden (1513) where a branch of the family, the Inverugie Keiths had been killed. The heiress of this branch was married to the third earl and this had concentrated a large number of lands, and consequently wealth, in the hands of the earls. This had, however, also significantly decreased the number of members and hence power of the Keith kindred. The third earl’s conversion to Protestantism in 1544 and later his adherence to the King’s Party during the Marian Civil War forced the Keiths into direct confrontation with their neighbours in the north east, the Gordons (led by the Earls of Huntly), a Catholic family and supporters of the Queen’s Party. Although this feud was settled for a time at the end of the war, the political turmoil caused by a succession of short-lived factional regimes in the early part of the personal reign of James VI (c.1578-1585) led the new (fourth) Earl Marischal into direct confrontation with the new (sixth) Earl of Huntly. Marischal was outclassed, outmanoeuvred and outgunned at both court and in the locality in this feud, suffering considerably. However, Huntly’s over-ambition in wider court politics meant that Marischal was able to join various coalitions against his rival, until Huntly was exiled in 1595. Marischal also came into conflict briefly with Chancellor John Maitland of Thirlestane as a consequence of Marischal’s diplomatic mission to Denmark in 1589-1590, but was again outmatched politically and briefly imprisoned. Both of these feuds reveal Marischal to be relatively cautious and reactionary, and both reveal the limitations of his power. Elsewhere, the study of Marischal’s activities in the centre of Scottish politics reveal him to be unambitious. He was ready to serve King James, the two men having a healthy working relationship, but Marischal showed no ambition as a courtier, to woo the king’s favour or patronage, instead delegating interaction with the monarch to his kinsmen. Likewise, in government, Marischal rarely attended any of the committees he was entitled to attend, such as the Privy Council, although he did keep a keen eye on the land market and the business conducted under the Great Seal. Although personally devout and a committed Protestant, the study of Marischal’s interaction with the national Kirk and the parishes of which he was patron reveal that he was at times a negligent patron and exercised his right of ministerial presentation as lordly, not godly patronage. The notion of a ‘conservative North East’ is, however, rejected. Where Marischal was politically weak at court and weak in terms of force in the locality, we see him pursuing sideways approaches to dealing with this. Thus he was keen to build up his general influence in the north and in particular with the burgh of Aberdeen (one result of this being the creation of Marischal College in 1593), pursued disputes through increasing use of legal methods rather than bloodfeud (thus exploiting his wealth and compensating for his relative lack of force) and developed a sophisticated system of maritime infrastructure, ultimately expressed through the creating of the burghs of Peterhead and Stonehaven. Although his close family caused him a number of problems over his lifetime, he was able to pass on a stable and enlarged lordship to his son in 1623.

Mestres estrangeiros; operariado nacional : resistências e derrotas no cotidiano da maior fábrica têxtil do rio de janeiro (1890 - 1920)

Dissertação (mestrado)—Universidade de Brasília, Departamento de História, Programa de Pós-Graduação em História, 2015.

Parasitoses internas e frequência de desparasitação em cães do concelho de Vila Franca de Xira, Portugal

Dissertação de Mestrado Integrado em Medicina Veterinária

Impact of a fall prevention program in the Internal Medicine wards of a tertiary care university hospital

Objective: To determine whether a falls prevention program reduces the incidence of falls within a hospital. Materials and methods: Each patient admitted to the Internal Medicine ward was classiied into a risk category (high, medium, low) according to the scale of J.H. Downton, and then various general and speciic measures were applied by risk group. Interventions included appointments, teaching materials, and training of medical staff and family. Furthermore, a registration system was developed that allowed adverse event fe edback to the program and identiicat ion of the causes of the fall. The SPSS version 20.0 was used for the data analysis. Descriptive analysis was used for quantitative variables, and qualitative variables were expressed as proportions. To compare the rate of pre- and post-program implementation falls, x 2 was used, with a  = 0.05 determining a signiicant statistical value. Results: Since the implementation of the program, the rate of falls per 1000 days/patient decreased from 1.9 in 2007 to 0.67 in the period 2008-2013, representing a decrease of the rate of falls of up to 70%, with a statistically signiicant difference (P=.02). Conclusions: The implementation of a falls prevention program is an effective tool and reduces the rate and complications associated with them.

En torno a la imagen literaria de Alfonso V de Aragón: Fortún García de Ercilla y su traducción castellana del De dictis de Antonio Beccadelli. Edición y estudio

Alfonso V of Aragon (1396-1458), who won from his contemporaries the title “the Magnanimous”, became one of the most brilliant fifteenth century monarchs, not only because of being a shrewd politician and king of one of the main kingdoms in the Iberian Peninsula, but also due to his cultural activity. Thanks to him the Aragonese territories were extended throughout the Mediterranean up to Naples, where he established a magnificent court that turned into maybe the most remarkable centre of intellectual vitality and development of Humanism. His patronage attracted a considerable number of leading poets of the period, as well as the most important Italian humanists. The presence of so many writers and outstanding scholars, together with the academic environment that the monarch encouraged, promoted an enormous literary production in four languages: Latin, Spanish, Catalan and Italian. Additionally, the valuable library gathered by the king and the Academy founded in order to spread knowledge illustrate part of his intellectual concerns. This way, through his love to literature and generosity to men of letters, Alfonso the Magnanimous boosted the culture of that time. The principal protagonist in the cultural activities of the circle of erudites formed around the sovereign was Antonio Beccadelli, called Panormita (1394-1471). He, one of the most prominent personalities of Italian Humanism, assumed the role of main royal advisor. His work De dictis et factis Alphonsi regis (The sayings and deeds of king Alfonso), which will be studied in our dissertation, became a very popular text about Alfonso’s personality, as a kind of biography based on anecdotes of the Magnanimous’ life by way of exempla to be imitated. The success of these episodes lasted for a long time and they are appreciated even nowadays. The work was valued as specula principum and had great impact in sixteenth century, when De dictis was republished several times and translated from Latin into Spanish. One of these translations, the one by Fortún García de Ercilla, caught our interest since it is in a manuscript signed by Ercilla himself and this version is still unpublished...

Parents' concerns about future pregnancy after stillbirth: a qualitative study

Objectives: As stillbirth has a devastating impact, it is imperative to understand the importance of clinical and emotional care after stillbirth and how it influences subsequent pregnancies. The aim of the study was to gain insight into the consideration and planning of a subsequent pregnancy by parents in the weeks following stillbirth. Design: A qualitative semi-structured interview format was utilized. Interpretative phenomenological analysis was employed as the analytic strategy. Participants and setting: The recruitment strategy focused on couples whereby the parents of ten stillborn babies were contacted; however, five men declined to participate in the study. The final sample of 15 parents were all Irish: ten of whom were female and five of whom were male. Results: Findings revealed two superordinate themes relating to a subsequent pregnancy after stillbirth: aspirations for future pregnancy and expectations of future care. Parents disclosed how the prospect of a subsequent pregnancy was daunting with fears about the potential loss of another child. Despite these fears, parentsâ aspirations differed in the days following stillbirth; mothers wished to plan a future pregnancy while fathers were reluctant to consider any pregnancies. Parents were unsure of what to expect in terms of the level of care that would be provided to them in a subsequent pregnancy. Additional appointments at the maternity hospital were considered crucial to provide reassurance during a subsequent pregnancy. Conclusions: These findings underscore the far-reaching and contrasting effects of stillbirth on parents. These complex needs highlight the importance of the multidisciplinary team approach.Objectives: As stillbirth has a devastating impact, it is imperative to understand the importance of clinical and emotional care after stillbirth and how it influences subsequent pregnancies. The aim of the study was to gain insight into the consideration and planning of a subsequent pregnancy by parents in the weeks following stillbirth. Design: A qualitative semi-structured interview format was utilized. Interpretative phenomenological analysis was employed as the analytic strategy. Participants and setting: The recruitment strategy focused on couples whereby the parents of ten stillborn babies were contacted; however, five men declined to participate in the study. The final sample of 15 parents were all Irish: ten of whom were female and five of whom were male. Results: Findings revealed two superordinate themes relating to a subsequent pregnancy after stillbirth: aspirations for future pregnancy and expectations of future care. Parents disclosed how the prospect of a subsequent pregnancy was daunting with fears about the potential loss of another child. Despite these fears, parentsâ aspirations differed in the days following stillbirth; mothers wished to plan a future pregnancy while fathers were reluctant to consider any pregnancies. Parents were unsure of what to expect in terms of the level of care that would be provided to them in a subsequent pregnancy. Additional appointments at the maternity hospital were considered crucial to provide reassurance during a subsequent pregnancy. Conclusions: These findings underscore the far-reaching and contrasting effects of stillbirth on parents. These complex needs highlight the importance of the multidisciplinary team approach.

Caracterización nutricional mediante antropometría de los niños sanos menores de 5 años asistentes a una institución de salud en Puerto Inírida 2014

Introducción: Siendo la desnutrición infantil, un indicador trazador en el perfil de salud de una población y prioridad establecida por los objetivos de desarrollo del milenio y el plan decenal de salud pública en Colombia - PDSP en su dimensión de seguridad alimentaria y nutricional, mantiene gran prevalencia a nivel nacional a pesar de presentar subregistro en la información reportada, por ende, es prioridad la medición, notificación y tratamiento de la misma. La OMS estandarizó los parámetros de medición y el gobierno nacional los adoptó mediante la resolución 2121 de 2010. Sin embargo, para disminuir el indicador de desnutrición que al año 2015 debería estar reducido en un 50% según el PDSP, es necesario identificar el sub registro que hay en el diagnóstico de la misma. Metodología: Se realizó un estudio poblacional, descriptivo y transversal, en el cual se analizó la base de datos de los niños menores de 5 años asistentes a consulta de crecimiento y desarrollo en una institución de salud del municipio de Puerto Inírida, con el fin de realizar una caracterización nutricional basados en mediciones antropométricas y contrastándolas realizadas por los profesionales de salud con las encontradas utilizando los patrones establecidos por la OMS. La información se analizó con el Software WHO Anthro propiedad de la OMS. Resultados: Se encontró que el 33,6% de los menores de 5 años registrados presentan desnutrición crónica, el 7,6% desnutrición aguda, el 13,2% de desnutrición global y el 13,9% tiene obesidad. Al discriminarlo por edad se encontró mayor prevalencia de desnutrición crónica en ambos sexos, siendo mayor en población de sexo masculino (40,1% masculino – 27,6% femenino); al igual que al realizar la comparación por pertenencia puesto que se encuentra la misma prevalencia en desnutrición crónica (29,1% en población indígena y 29% en población no indígena). Según los estándares de la OMS, en la población estudiada 12 se identificaron 243 casos de malnutrición, mientras que en la consulta de crecimiento y desarrollo fueron diagnosticados como casos de malnutrición por los profesionales de salud solo 99. Discusión: La malnutrición es un problema estructural, por ende, se deben tener en cuenta factores tanto intrínsecos como extrínsecos de la persona. Las medidas antropométricas son sólo una manera de medir, que se debe contextualizar con el entorno y las condiciones socioeconómicas, patológicas y culturales en las que se encuentre la población. El estado nutricional de los menores asistentes a los controles de crecimiento y desarrollo de la población estudiada, se encuentra mal registrado, de la misma manera se encontró una gran prevalencia de desnutrición crónica que es un determinante en la calidad de vida. Es imperante la implementación de políticas públicas adecuadas que permitan profundizar en las causas de este flagelo y así mismo en su tratamiento.

El rol de la Unión Africana (UA) en el Cuerno de África a partir del caso de Somalia - AMISOM (2007-2013)

El propósito de esta monografía es comprender cuál ha sido el rol de la Unión Africana (UA), dentro de la misión de paz AMISOM en el periodo de 2007- 2013. Por ello, el trabajo abarca aspectos geopolíticos e históricos, que han influido en la configuración del conflicto armado de Somalía y que han llevado progresivamente a la creación, evolución e implementación de mecanismos como las misiones de paz. Además, se abarcan los planteamientos del neo-funcionalismo y el neo-regionalismo para comprender las estructuras y las dinámicas propias de la UA y así, comprender la naturaleza tanto de sus acciones, como de sus propósitos; propósitos que aclaman el fomento del panafricanismo. Desde aquí se puede entender como su rol ha contribuido con el crecimiento del mercado de la industria militar en la región, a costa de la responsabilidad de proteger. Por último, se concluye que dichas dinámicas han llevado a la creación de comunidades de inseguridad.