816 resultados para Hierarchical Age-Period-Cohort Cross-Classified Random Effect Model (HAPC-CCREM)


Relevância:

100.00% 100.00%

Publicador:

Resumo:

O presente trabalho ocupa-se do estudo do Complexo Xisto-Grauváquico ante-ordovícico (Grupo das Beiras) na região do Caramulo-Buçaco (centro de Portugal). Em termos geológicos, a área estudada pertence à Zona Centro Ibérica e encontra-se limitada a N pelo granito do Caramulo, a S pela bacia meso-cenozóica de Arganil, a W pelo sinclinal paleozóico do Buçaco e pela bacia meso-cenozóica ocidental portuguesa e a E pelo sinclinal paleozóico de Arganil e pelo plutonito granítico de Tábua-Santa Comba Dão; no seio da área estudada encontra-se a bacia meso-cenozóica de Mortágua. Com base nas características litológicas e estruturais distinguem-se no Complexo Xisto Grauváquico 4 grandes conjuntos litológicos concordantes entre si, designados de Unidades I, II, III e IV, que se desenvolvem da base para o topo de N para S. A Unidade I situa-se a N da região. O seu limite inferior é desconhecido, e o superior posiciona-se no último conjunto arenoso com potência decamétrica. É constituída por xistos cinzentos e negros com intercalações de arenitos de espessura não superior a 100 metros e de extensão lateral quilométrica. Apresenta uma espessura mínima de 1000 m. A Unidade II apresenta consideravelmente menor proporção de material arenoso intercalado entre os pelitos comparativamente à unidade inferior. É caracterizada por apresentar um predomínio de material silto-argiloso e escassos níveis arenosos com potência não superior à dezena de metros e escassa continuidade lateral. Cartograficamente esta unidade constitui uma franja alargada de orientação próxima a E-W. Apresenta uma espessura aproximada de 1500 m. A Unidade III é caracterizada pela presença de conjuntos arenosos com extensão lateral quilométrica e espessura de várias dezenas de metros, separados por material silto-argiloso. Os limites inferior e superior estão situados respectivamente abaixo e acima dos principais conjuntos arenosos. Esta unidade apresenta uma espessura máxima estimada na ordem dos 2000 m. A Unidade IV, que é a unidade superior, apresenta um predomínio pelítico, com escassas intercalações de conjuntos arenosos. O seu limite inferior encontra-se no topo do último conjunto arenoso da Unidade III. Apresenta uma espessura mínima de 500 m. As características sedimentológicas das 4 unidades indicam uma sedimentação num ambiente de plataforma externa siliciclástica aberta, com a construção de barras e por vezes sujeita à acção de tempestades, com sucessivos períodos de superficialização e profundização numa bacia de sedimentação bastante subsidente. Em termos estruturais, para além duma deformação pré-ordovícica, que é comprovada pelo forte mergulho e dispersão da orientação dos eixos da 1ª fase varisca e da lineação de intersecção L1, a área estudada foi principalmente afectada pela Orogenia Varisca. A 1ª fase de deformação varisca (F1) gerou dobras com superfícies axiais e xistosidade associada (S1) de direcção WNW-ESE, e forte pendor para NNE. Estas dobras D1 apresentam comprimentos de onda que nunca chegam a ser quilométricos, desenvolvendo-se um grande flanco inverso denunciando a presença de uma antiforma para NNE e uma sinforma para SSW. A 2ª fase de deformação varisca (F2) actuou na parte nordeste da área estudada e é caracterizada por ter gerado dobras de comprimento de onda quilométrico, com planos axiais e xistosidade associada S2 de direcção NW-SE, subverticais ou a pender fortemente para NE. Embora com alguma dispersão, as lineações de intersecção L2 e os eixos das dobras D2 apresentam maioritariamente forte pendor para E. A direcção e tipos de estruturas da F2 sugerem uma correlação com a terceira fase definida em vários pontos da Zona Centro Ibérica e estreitamente relacionada com as intrusões graníticas. Do ponto de vista petrológico, distinguem-se várias rochas sedimentares (pelitos e arenitos) todas elas sujeitas a metamorfismo que não ultrapassa a fácies dos xistos verdes. Dentro das rochas sedimentares mais grosseiras, há a destacar a presença de arenitos vulcânicos cuja composição denuncia, não muito afastados da bacia sedimentar, a presença de aparelhos vulcânicos que estariam em actividade durante a sedimentação. Foram analisadas isotopicamente 27 amostras de metapelitos colhidas em 5 locais diferentes de forma a abranger quase toda a área estudada. Os dados isotópicos de quatro destes locais de amostragem forneceram isócronas Rb-Sr, em rocha total, com valores da ordem dos 400-440 Ma. O granito do Caramulo, datado pela isócrona Rb-Sr em amostras de rocha total, forneceu uma idade de 326±12Ma. As idades modelo Sm-Nd (manto empobrecido) de 5 amostras de metapelitos estão compreendidas entre 1.35 e 1.25 Ga. Este período de tempo pode ser considerado como correspondendo à época de diferenciação mantélica da crusta que deu lugar à maioria das áreas fonte dos metapelitos.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

This work aims to investigate the relationship between the entrepreneurship and the incidence of bureaucratic corruption in the states of Brazil and Federal District. The main hypothesis of this study is that the opening of a business in Brazilian states is negatively affected by the incidence of corruption. The theoretical reference is divided into Entrepreneurship and bureaucratic corruption, with an emphasis on materialistic perspective (objectivist) of entrepreneurship and the effects of bureaucratic corruption on entrepreneurial activity. By the regression method with panel data, we estimated the models with pooled data and fixed and random effects. To measure corruption, I used the General Index of Corruption for the Brazilian states (BOLL, 2010), and to represent entrepreneurship, firm entry per capita by state. Tests (Chow, Hausman and Breusch-Pagan) indicate that the random effects model is more appropriate, and the preliminary results indicate a positive impact of bureaucratic corruption on entrepreneurial activity, contradicting the hypothesis expected and found in previous articles to Brazil, and corroborating the proposition of Dreher and Gassebner (2011) that, in countries with high regulation, bureaucratic corruption can be grease in the wheels of entrepreneurship

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Doutoramento em Gestão

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Comunicação apresentada no XVII Encuentro AECA, 22-23 de setembro 2016, Bragança, Portugal

Relevância:

100.00% 100.00%

Publicador:

Resumo:

La industria musical a nivel mundial atraviesa una etapa de transición en varios procesos análogos a digitales y también de formatos físicos, como CD´s por mp3, esto representa para los artistas, nuevos caminos para generar ingresos y facilidades de introducción en la industria. En Ecuador, no se puede hablar de industria musical pues, lo que se ha desarrollado hasta este momento es solo una “escena musical” en donde los artistas intentan salir hacia mercados extranjeros utilizando diferentes herramientas de difusión tanto tradicionales como digitales, siendo pocos quienes consiguen este objetivo y además, rentabilidad en sus carreras musicales. El proyecto de intervención denominado “Construcción de una plataforma digital para la promoción y difusión de artistas musicales del género pop y rock de la ciudad de Cuenca, fundamentado en estrategias digitales creadas bajo el concepto ‘Mezcla de comunicaciones de marketing’, período 2015 -2016”, genera un modelo de negocio experimental basado en soportes digitales y estrategias de marketing y comunicación que benefician la difusión, venta y promoción de los artistas y su material musical. Todo esto con miras a aportar al desarrollo de la escena musical en Ecuador. El modelo de negocio experimental se basa en tres actividades que el Staff 4.32 (nombre de la plataforma digital) brindará como servicios a sus consumidores: 1) generador de contenidos con temáticas referentes a la industria musical, 2) distribución digital de música en tiendas online y 3) sello representante de artistas que forman parte del catálogo de músicos del Staff.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Les biotechnologies, le réchauffement climatique, les ressources naturelles et la gestion des écosystèmes sont tous représentatifs de la “nouvelle politique de la nature” (Hajer 2003), un terme englobant les enjeux marqués par une grande incertitude scientifique et un encadrement réglementaire inadapté aux nouvelles réalités, suscitant de fait un conflit politique hors du commun. Dans l'espoir de diminuer ces tensions et de générer un savoir consensuel, de nombreux gouvernements se tournent vers des institutions scientifiques ad hoc pour documenter l'élaboration des politiques et répondre aux préoccupations des partie-prenantes. Mais ces évaluations scientifiques permettent-elles réellement de créer une compréhension commune partagée par ces acteurs politiques polarisés? Alors que l'on pourrait croire que celles-ci génèrent un climat d'apprentissage collectif rassembleur, un environnement politique conflictuel rend l'apprentissage entre opposant extrêmement improbable. Ainsi, cette recherche documente le potentiel conciliateur des évaluation scientifique en utilisant le cas des gaz de schiste québécois (2010-2014). Ce faisant, elle mobilise la littérature sur les dimensions politiques du savoir et de la science afin de conceptualiser le rôle des évaluations scientifiques au sein d'une théorie de la médiation scientifique (scientific brokerage). Une analyse de réseau (SNA) des 5751 références contenues dans les documents déposés par 268 organisations participant aux consultations publiques de 2010 et 2014 constitue le corps de la démonstration empirique. Précisément, il y est démontré comment un médiateur scientifique peut rediriger le flux d'information afin de contrer l'incompatibilité entre apprentissage collectif et conflit politique. L'argument mobilise les mécanismes cognitifs traditionnellement présents dans la théorie des médiateurs de politique (policy broker), mais introduit aussi les jeux de pouvoir fondamentaux à la circulation de la connaissance entre acteurs politiques.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Les biotechnologies, le réchauffement climatique, les ressources naturelles et la gestion des écosystèmes sont tous représentatifs de la “nouvelle politique de la nature” (Hajer 2003), un terme englobant les enjeux marqués par une grande incertitude scientifique et un encadrement réglementaire inadapté aux nouvelles réalités, suscitant de fait un conflit politique hors du commun. Dans l'espoir de diminuer ces tensions et de générer un savoir consensuel, de nombreux gouvernements se tournent vers des institutions scientifiques ad hoc pour documenter l'élaboration des politiques et répondre aux préoccupations des partie-prenantes. Mais ces évaluations scientifiques permettent-elles réellement de créer une compréhension commune partagée par ces acteurs politiques polarisés? Alors que l'on pourrait croire que celles-ci génèrent un climat d'apprentissage collectif rassembleur, un environnement politique conflictuel rend l'apprentissage entre opposant extrêmement improbable. Ainsi, cette recherche documente le potentiel conciliateur des évaluation scientifique en utilisant le cas des gaz de schiste québécois (2010-2014). Ce faisant, elle mobilise la littérature sur les dimensions politiques du savoir et de la science afin de conceptualiser le rôle des évaluations scientifiques au sein d'une théorie de la médiation scientifique (scientific brokerage). Une analyse de réseau (SNA) des 5751 références contenues dans les documents déposés par 268 organisations participant aux consultations publiques de 2010 et 2014 constitue le corps de la démonstration empirique. Précisément, il y est démontré comment un médiateur scientifique peut rediriger le flux d'information afin de contrer l'incompatibilité entre apprentissage collectif et conflit politique. L'argument mobilise les mécanismes cognitifs traditionnellement présents dans la théorie des médiateurs de politique (policy broker), mais introduit aussi les jeux de pouvoir fondamentaux à la circulation de la connaissance entre acteurs politiques.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Introdução: A perda transitória da consciência e tónus postural seguido de rápida recuperação é definida como síncope. Tem sido dada atenção a uma síncope de origem central com descida da pressão sistémica conhecida por síncope vasovagal (SVV). Objetivos: A análise da variabilidade da frequência cardíaca (HRV) é uma das principais estratégias para estudar a SVV através de protocolos padrão (por exemplo tilt test). O principal objetivo deste trabalho é compreender a importância relativa de diversas variáveis, tais como pressão arterial diastólica e sistólica, (dBP) e (sBP), volume sistólico (SV) e resistência periférica total (TPR) na HRV. Métodos: Foram usados modelos estatísticos mistos para modelar o comportamento das variáveis acima descritas na HRV. Analisaram-se mais de mil e quinhentas observações de quatro pacientes com SVV, previamente testados com análise espectral clássica para a fase basal (LF/HF=3.01) e fases de tilt (LF/HF=0.64), indicando uma predominância vagal no período tilt. Resultados: O modelo 1 revelou o papel importante da dBP e uma baixa influência de SV, na fase de tilt, relativos à HRV. No modelo 2 a TPR revelou uma baixa influência na HRV na fase de tilt entre os pacientes. Conclusões: Verificou-se que a HRV é influenciada por um conjunto de variáveis fisiológicas, cuja contribuição individual pode ser usada para compreender as flutuações cardíacas. O uso de modelos estatísticos salientou a importância de estudar o papel da dBP e SV na SVV.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

La presente investigación tiene como objetivo principal, analizar las dinámicas de desarrollo local del distrito minero Litoral Pacífico durante el periodo 2008-2012 a partir del modelo extractivista, con el fin de demostrar que, a pesar del auge minero durante estos gobiernos, el crecimiento de la actividad y la entrada de capital a estos municipios, el desarrollo local es escaso ante las dinámicas del conflicto armado interno y el abandono estatal que ha existido por excelencia en esta zona. Por lo tanto, a partir de la utilización del método cualitativo, se utilizarán estudios e informes de las fuentes primarias y secundarias, que permitan un análisis explicativo de este fenómeno económico y social.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Comumente dados de precipitação pluvial apresentam variação e a obtenção da estimativa de sua distribuição espacial é primordial no planejamento agrícola e ambiental. O objetivo neste trabalho foi comparar o método de estimação dos mínimos quadrados ponderados para ajuste de modelos ao semivariograma com o método de tentativa e erro, através da técnica de auto-validação "jack-knifing", para dados de precipitação pluvial média anual do Estado de São Paulo. Observações de precipitação correspondentes ao período de 1957 a 1997 foram usadas para trezentos e setenta e nove (379) estações pluviométricas abrangendo todo o Estado de São Paulo, representando uma área de aproximadamente 248.808,8 km². A periodicidade exibida pelos semivariogramas foi ajustada pelo modelo "hole effect", em que os parâmetros foram estimados com maior precisão pelo método de mínimos quadrados ponderados quando comparado com o método de tentativa e erro. O método de auto-validação "jack-knifing" mostrou-se adequado para a definição de métodos e modelos a serem usados para semivariâncias, cujo procedimento permitiu definir dezesseis vizinhos como o número ideal para a estimativa por krigagem de valores de precipitação pluvial para locais não amostrados no Estado de São Paulo.

Relevância:

80.00% 80.00%

Publicador:

Resumo:

OBJECTIVE: To investigate adaptive changes in bone and muscle parameters in the paralysed limbs after detraining or reduced functional electrical stimulation (FES) induced cycling following high-volume FES-cycling in chronic spinal cord injury. SUBJECTS: Five subjects with motor-sensory complete spinal cord injury (age 38.6 years, lesion duration 11.4 years) were included. Four subjects stopped FES-cycling completely after the training phase whereas one continued reduced FES-cycling (2-3 times/week, for 30 min). METHODS: Bone and muscle parameters were assessed in the legs using peripheral quantitative computed tomography at 6 and 12 months after cessation of high-volume FES-cycling. RESULTS: Gains achieved in the distal femur by high-volume FES-cycling were partly maintained at one year of detraining: 73.0% in trabecular bone mineral density, 63.8% in total bone mineral density, 59.4% in bone mineral content and 22.1% in muscle cross-sectional area in the thigh. The subject who continued reduced FES-cycling maintained 96.2% and 95.0% of the previous gain in total and trabecular bone mineral density, and 98.5% in muscle cross-sectional area. CONCLUSION: Bone and muscle benefits achieved by one year of high-volume FES-cycling are partly preserved after 12 months of detraining, whereas reduced cycling maintains bone and muscle mass gained. This suggests that high-volume FES-cycling has clinical relevance for at least one year after detraining.

Relevância:

70.00% 70.00%

Publicador:

Resumo:

OBJECTIVE To assess objectively patient compliance with removable orthodontic appliances and the effect of possible influential factors. MATERIALS AND METHODS Wearing times of 45 White patients were recorded with the aid of the TheraMon microsensor. Patient compliance was assessed relative to wear prescription and other parameters, such as age and sex. RESULTS There was high individual variation in most measured variables and in all groups/subgroups. During a median observation period of 186 days (range, 55-318 days) the actual wear time was 9.0 h/d (range, 0.0-16.0 h/d) and did not differ between distinct prescriptions (P = .49). Eight patients wore their appliances less than 2 h/d, and six of them did not wear their appliances at all. Overall, the median wear per day relative to prescription was 62.5% (range, 0.0-89.3%) for the 14 h/d and 112.5% (range, 0.0-200.0%) for the 8 h/d prescription wear (P = .01) groups. There was a strong negative correlation of age (median: 12.5 years) with the daily percentage of actual wear time per day relative to wear prescription (14 h/d prescription: n = 21, rho = -0.61, P = .00; 8 h/d prescription: n = 24, rho = -0.73, P = .00), while sex did not exert a significant influence on compliance (P = .58). CONCLUSIONS Despite the fact that patients and parents were informed about wear time recording, compliance was insufficient with regard to functional treatment (14 h/d prescription), while it was sufficient for retention purposes (8 h/d prescription). Objective measures are necessary to assess compliance with removable orthodontic appliances since patient compliance is a highly variable issue.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

Purpose: The purpose of this study was to improve the retention of primary healthcare (PHC) nurses through exploring and assessing their quality of work life (QWL) and turnover intention. Design and methods: A cross-sectional survey design was used in this study. Data were collected using a questionnaire comprising four sections (Brooks’ survey of Quality of Nursing Work Life [QNWL], Anticipated Turnover Intention, open-ended questions and demographic characteristics). A convenience sample was recruited from 143 PHC centres in Jazan, Saudi Arabia. A response rate of 87% (n = 508/585) was achieved. The SPSS v17 for Windows and NVivo 8 were used for analysis purposes. Procedures and tests used in this study to analyse the quantitative data were descriptive statistics, t-test, ANOVA, General Linear Model (GLM) univariate analysis, standard multiple regression, and hierarchical multiple regression. Qualitative data obtained from responses to the open-ended questions were analysed using the NVivo 8. Findings: Quantitative findings suggested that PHC nurses were dissatisfied with their work life. Respondents’ scores ranged between 45 and 218 (mean = 139.45), which is lower than the average total score on Brooks’ Survey (147). Major influencing factors were classified under four dimensions. First, work life/home life factors: unsuitable working hours, lack of facilities for nurses, inability to balance work with family needs and inadequacy of vacations’ policy. Second, work design factors: high workload, insufficient workforce numbers, lack of autonomy and undertaking many non-nursing tasks. Third, work context factors: management practices, lack of development opportunities, and inappropriate working environment in terms of the level of security, patient care supplies and unavailability of recreation room. Finally, work world factors: negative public image of nursing, and inadequate payment. More positively, nurses were notably satisfied with their co-workers. Conversely, 40.4% (n = 205) of the respondents indicated that they intended to leave their current employment. The relationships between QWL and demographic variables of gender, age, marital status, dependent children, dependent adults, nationality, ethnicity, nursing tenure, organisational tenure, positional tenure, and payment per month were significant (p < .05). The eta squared test for these demographics indicates a small to medium effect size of the variation in QWL scores. Using the GLM univariate analysis, education level was also significantly related to the QWL (p < .05). The relationships between turnover intention and demographic variables including gender, age, marital status, dependent children, education level, nursing tenure, organisational tenure, positional tenure, and payment per month were significant (p < .05). The eta squared test for these demographics indicates a small to moderate effect size of the variation in the turnover intention scores. Using the GLM univariate analysis, the dependent adults’ variable was also significantly related to turnover intention (p < .05). Turnover intention was significantly related to QWL. Using standard multiple regression, 26% of the variance in turnover intention was explained by the QWL F (4,491), 43.71, p < .001, with R² = .263. Further analysis using hierarchical multiple regression found that the total variance explained by the model as a whole (demographics and QWL) was 32.1%, F (17.433) = 12.04, p < .001. QWL explained an additional 19% of the variance in turnover intention, after controlling for demographic variables, R squared change =.19, F change (4, 433) = 30.190, p < .001. The work context variable makes the strongest unique contribution (-.387) to explain the turnover intention, followed by the work design dimension (-.112). The qualitative findings reaffirmed the quantitative findings in terms of QWL and turnover intention. However, the home life/work life and work world dimensions were of great important to both QWL and turnover intention. The qualitative findings revealed a number of new factors that were not included in the survey questionnaire. These included being away from family, lack of family support, social and cultural aspects, accommodation facilities, transportation, building and infrastructure of PHC, nature of work, job instability, privacy at work, patients and community, and distance between home and workplace. Conclusion: Creating and maintaining a healthy work life for PHC nurses is very important to improve their work satisfaction, reduce turnover, enhance productivity and improve nursing care outcomes. Improving these factors could lead to a higher QWL and increase retention rates and therefore reinforcing the stabilisation of the nursing workforce. Significance of the research: Many countries are examining strategies to attract and retain the health care workforce, particularly nurses. This study identified factors that influence the QWL of PHC nurses as well as their turnover intention. It also determined the significant relationship between QWL and turnover intention. In addition, the present study tested Brooks’ survey of QNWL on PHC nurses for the first time. The qualitative findings of this study revealed a number of new variables regarding QWL and turnover intention of PHC nurses. These variables could be used to improve current survey instruments or to develop new research surveys. The study findings could be also used to develop and appropriately implement plans to improve QWL. This may help to enhance the home and work environments of PHC nurses, improve individual and organisational performance, and increase nurses’ commitment. This study contributes to the existing body of research knowledge by presenting new data and findings from a different country and healthcare system. It is the first of its kind in Saudi Arabia, especially in the field of PHC. It has examined the relationship between QWL and turnover intention of PHC nurses for the first time using nursing instruments. The study also offers a fresh explanation (new framework) of the relationship between QWL and turnover intention among PHC nurses, which could be used or tested by researchers in other settings. Implications for further research: Review of the extant literature reveals little in-depth research on the PHC workforce, especially in terms of QWL and organisational turnover in developing countries. Further research is required to develop a QWL tool for PHC nurses, taking into consideration the findings of the current study along with the local culture. Moreover, the revised theoretical framework of the current study could be tested in further research in other regions, countries or healthcare systems in order to identify its ability to predict the level of PHC nurses’ QWL and their intention to leave. There is a need to conduct longitudinal research on PHC organisations to gain an in-depth understanding of the determents of and changes in QWL and turnover intention of PHC nurses at various points of time. An intervention study is required to improve QWL and retention among PHC nurses using the findings of the current study. This would help to assess the impact of such strategies on reducing turnover of PHC nurses. Focusing on the location of the current study, it would be valuable to conduct another study in five years’ time to examine the percentage of actual turnover among PHC nurses compared with the reported turnover intention in the current study. Further in-depth research would also be useful to assess the impact of the local culture on the perception of expatriate nurses towards their QWL and their turnover intention. A comparative study is required between PHC centres and hospitals as well as the public and private health sector agencies in terms of QWL and turnover intention of nursing personnel. Findings may differ from sector to sector according to variations in health systems, working environments and the case mix of patients.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

Objective The aim of this study was to examine the prevalence of overweight and obesity and the association with demographic, reproductive work variables in a representative cohort of working nurses and midwives. Design A cross sectional study of self reported survey data. Settings Australia, New Zealand and the United Kingdom. Methods Measurement outcomes included BMI categories, demographic (age, gender, marital status, ethnicity), reproductive (parity, number of births, mother's age at first birth, birth type and menopausal status) and workforce (registration council, employment type and principal specialty) variables. Participants 4996 respondents to the Nurses and Midwives e-Cohort study who were currently registered and working in nursing or midwifery in Australia (n=3144), New Zealand (n=778) or the United Kingdom (n=1074). Results Amongst the sample 61.87% were outside the healthy weight range and across all three jurisdictions the prevalence of obesity in nurses and midwives exceeded rates in the source populations by 1.73% up to 3.74%. Being overweight or obese was significantly associated with increasing age (35–44 yrs aOR 1.71, 95% CI 1.41–2.08; 45–55 yrs aOR 1.90, 95%CI 1.56–2.31; 55–64 aOR 2.22, 95% CI 1.71–2.88), and male gender (aOR 1.46, 95% CI 1.15–1.87). Primiparous nurses and midwives were more likely to be overweight or obese (aOR 1.37, 95% CI 1.06–1.76) as were those who had reached menopause (aOR 1.37, 95% CI 1.11–1.69). Nurses and midwives in part-time or casual employment had significantly reduced risk of being overweight or obese, (aOR 0.81, 95% CI 0.70–0.94 and aOR 0.75, 95% CI 0.59–0.96 respectively), whilst working in aged carried increased risk (aOR 1.37, 95% CI 1.04–1.80). Conclusion Nurses and midwives in this study have higher prevalence of obesity and overweight than the general population and those who are older, male, or female primiparous and menopausal have significantly higher risk of overweight or obesity as do those working fulltime, or in aged care. The consequences of overweight and obesity in this occupational group may impact on their workforce participation, their management of overweight and obese patients in their care as well as influencing their individual health behaviours and risks of occupational injury and chronic disease.

Relevância:

60.00% 60.00%

Publicador:

Resumo:

Maternal depression is a known risk factor for poor outcomes for children. Pathways to these poor outcomes relate to reduced maternal responsiveness or sensitivity to the child. Impaired responsiveness potentially impacts the feeding relationship and thus may be a risk factor for inappropriate feeding practices. The aim of this study was to examine the longitudinal relationships between self-reported maternal post-natal depressive symptoms at child age 4 months and feeding practices at child age 2 years in a community sample. Participants were Australian first-time mothers allocated to the control group of the NOURISH randomized controlled trial when infants were 4 months old. Complete data from 211 mothers (of 346 allocated) followed up when their children were 2 years of age (51% girls) were available for analysis. The relationship between Edinburgh Postnatal Depression Scale (EPDS) score (child age 4 months) and child feeding practices (child age 2 years) was tested using hierarchical linear regression analysis adjusted for maternal and child characteristics. Higher EPDS score was associated with less responsive feeding practices at child age 2 years: greater pressure [β = 0.18, 95% confidence interval (CI): 0.04–0.32, P = 0.01], restriction (β = 0.14, 95% CI: 0.001–0.28, P = 0.05), instrumental (β = 0.14, 95% CI: 0.005–0.27, P = 0.04) and emotional (β = 0.15, 95% CI: 0.01–0.29, P = 0.03) feeding practices (ΔR2 values: 0.02–0.03, P < 0.05). This study provides evidence for the proposed link between maternal post-natal depressive symptoms and lower responsiveness in child feeding. These findings suggest that the provision of support to mothers experiencing some levels of depressive symptomatology in the early post-natal period may improve responsiveness in the child feeding relationship.