16,834 research outputs found

    Serving to secure "Global Korea": Gender, mobility, and flight attendant labor migrants

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    This dissertation is an ethnography of mobility and modernity in contemporary South Korea (the Republic of Korea) following neoliberal restructuring precipitated by the Asian Financial Crisis (1997). It focuses on how comparative ‚Äúservice,‚ÄĚ ‚Äúsecurity,‚ÄĚ and ‚Äúsafety‚ÄĚ fashioned ‚ÄúGlobal Korea‚ÄĚ: an ongoing state-sponsored project aimed at promoting the economic, political, and cultural maturation of South Korea from a once notoriously inhospitable, ‚Äúbackward‚ÄĚ country (hujin‚Äôguk) to a now welcoming, ‚Äúadvanced country‚ÄĚ (sŇŹnjin‚Äôguk). Through physical embodiments of the culturally-specific idiom of ‚Äúsuperior‚ÄĚ service (sŇŹbisŇ≠), I argue that aspiring, current, and former Korean flight attendants have driven the production and maintenance of this national project. More broadly, as a driver of this national project, this occupation has emerged out of the country‚Äôs own aspirational flights from an earlier history of authoritarian rule, labor violence, and xenophobia. Against the backdrop of the Korean state‚Äôs aggressive neoliberal restructuring, globalization efforts, and current ‚ÄúHell Chosun‚ÄĚ (HelchosŇŹn) economy, a group of largely academically and/or class disadvantaged young women have been able secure individualized modes of pleasure, self-fulfillment, and class advancement via what I deem ‚Äúservice mobilities.‚ÄĚ Service mobilities refers to the participation of mostly women in a traditionally devalued but growing sector of the global labor market, the ‚Äúpink collar‚ÄĚ economy centered around ‚Äúfeminine‚ÄĚ care labor. Korean female flight attendants share labor skills resembling those of other foreign labor migrants (chiefly from the ‚ÄúGlobal South‚ÄĚ), who perform care work deemed less desirable. Yet, Korean female flight attendants elude the stigmatizing, classed, and racialized category of ‚Äúlabor migrant.‚ÄĚ Moreover, within the context of South Korea‚Äôs unique history of rapid modernization, the flight attendant occupation also commands considerable social prestige. Based on ethnographic and archival research on aspiring, current, and former Korean flight attendants, this dissertation asks how these unique care laborers negotiate a metaphorical and literal series of sustained border crossings and inspections between Korean flight attendants‚Äô contingent status as lowly care-laboring migrants, on the one hand, and ostensibly glamorous, globetrotting elites, on the other. This study contends the following: first, the flight attendant occupation in South Korea represents new politics of pleasure and pain in contemporary East Asia. Second, Korean female flight attendants‚Äô enactments of soft, sanitized, and glamorous (hwaryŇŹhada) service help to purify South Korea‚Äôs less savory past. In so doing, Korean flight attendants reconstitute the historical role of female laborers as burden bearers and caretakers of the Korean state.U of I OnlyAuthor submitted a 2-year U of I restriction extension request

    Small newborns in post-conflict Northern Uganda: Burden and interventions for improved outcomes

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    Introduction: A small newborn can be the result of either a low birthweight (LBW), or a preterm birth (PB), or both. LBW can be due to either a preterm appropriate-for gestational-age (preterm-AGA), or a term small-for-gestational age (term-SGA) or intrauterine growth restriction (IUGR). An IUGR is a limited in-utero foetal growth rates or foetal weight < 10th percentile. Small newborns have an increased risk of dying, particularly in low-resource settings. We set out to assess the burden, the modifiable risk factors and health outcomes of small newborns in the post-conflict Northern Ugandan district of Lira. In addition, we studied the use of video-debriefing when training health staff in Helping Babies Breathe. Subjects and methods: In 2018-19, we conducted a community-based cohort study on 1556 mother-infant dyads, nested within a cluster randomized trial. In our cohort study, we estimated the incidence and risk factors for LBW and PB and the association of LBW with severe outcomes. We explored the prevalence of and factors associated with neonatal hypoglycaemia, as well as any association between neonatal death and hypoglycaemia. In addition, we conducted a cluster randomized trial to compare Helping Babies Breathe (HBB) training in combination with video debriefing to the traditional HBB training alone on the attainment and retention of health worker neonatal resuscitation competency. Results: The incidence of LBW and PB in our cohort was lower than the global estimates, 7.3% and 5.0%, respectively. Intermittent preventive treatment for malaria was associated with a reduced risk of LBW. HIV infection was associated with an increased risk of both LBW and PB, while maternal formal education (schooling) of ‚Č•7 years was associated with a reduced risk of LBW and PB. The proportions of neonatal deaths were many-folds higher among LBW infants compared to their non-LBW counterparts. The proportion of neonatal deaths among LBW was 103/1000 live births compared to 5/1000 among the non-LBW. The prevalence of neonatal hypoglycaemia in our cohort was 2.5%. LBW and PB each independently were associated with an increased risk of neonatal hypoglycaemia. Neonatal hypoglycaemia was associated with an increased risk of hospitalisation and severe outcomes. We demonstrated that neonatal resuscitation training with video debriefing, improved competence attainment and retention among health workers, compared to traditional HBB training alone. Conclusion: In northern Uganda, small infants still have a many-fold higher risk of dying compared to normal infants. In addition, small infants are also at more risk of neonatal hypoglycaemia compared to normal infants. Efforts are needed to secure essential newborn care, should we reach the target of Sustainable Development Goal number 3.2 of reducing infant mortality to less than 12/1000 live births by 2030

    Long-acting reversible contraception (LARC) after pregnancy and childbirth

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    Background and aims: Unmet need of contraception is a global challenge. The need of additional visits to initiate contraception is found to be a barrier for postpartum and postabortion contraceptive care. The IUDs and the implant are called long-acting reversible contraception (LARC). The LARC-method can be used for years without having to remember a contraceptive during sexual intercourse or, in case of hormonal contraception, every day, week or month. The overall aim of this thesis was to add knowledge to the field of long-acting reversible contraception after pregnancy in Sweden in our effort to improve the quality of contraceptive care after pregnancy and childbirth. Methods and main results: Study 1 was a retrospective cohort study including 11,066 women. Data was extracted from medical records regarding attendance to the postpartum visit and choice of contraception, breastfeeding, and abortion during 12-24 months after delivery. The primary outcome was the proportion of induced abortions during follow-up, with the outcome measure of abortion being a surrogate for unintended pregnancy. Among attendees to the follow up 2.1 % had an abortion compared to 3.6 % among nonattendants. A decision to use LARC was associated with a lower risk of abortion (OR 0.74; 95% CI 0.60-0.91; p = .005), as was exclusive breastfeeding (p < .001). Smoking and having had an earlier abortion were associated with a higher risk of abortion during the follow-up. Study II and III were open-label, prospective, randomised, controlled, multicenter studies. In study II, 101 women were either allocated to early placement (52/101) of a hormonal IUD within 48 hours after vaginal delivery or to standard placement (49/101) at 6-8 weeks postpartum. Follow-up was one year after IUD placement. Inclusion was prematurely stopped after an interim analysis due to high expulsion rate in the early placement group, and instead of 600 women only 101 were included. In the early placement group 23/52 (44.2 %) of devices were expelled within a year and 10 women had the hormonal device replaced. In the standard placement group there were no expulsions. The IUD continuation rate for the early group was 37/52 (71.2%), compared to 41/49 (83.7%, p = .13) for the standard placement group at study closure. In study III, 240 women seeking medical abortion up to 63 days¬ī gestation were randomised to either IUD placement within 48 hours (120/240) after completed abortion or to IUD placement at 2-4 weeks (120/240) after abortion. Follow-up was one year after abortion. The primary outcome was IUD use at 6 months postabortion. In the early placement group (intervention), 91/111 (82%) women used IUD at 6 months compared to 87/112 (77.7%) in the later placement (control) group (p= .51) Pain scores at IUD placement (measured by the visual analogue scale) were lower in the intervention group (p= .002). Women in the intervention group preferred the allocated time significantly more often compared to the control group (p= .03). There was no difference regarding expulsion. In study II and III there were no differences regarding safety profile between groups. Study IV was a qualitative study where 20 women who had undergone elective caesarean section (CS) were interviewed within 6 weeks of CS, to enable deeper understanding of women¬īs preferences and needs regarding contraceptive services at the time of pregnancy. Ten of the interviewees had chosen IUD placement during the latest CS. Three themes were identified; Receptivity to contraceptive counseling during pregnancy; Communication and decision-making of postpartum contraception during pregnancy and Needs to navigate in the Maternal Health Care System to receive contraceptive services before and after caesarean section. Women were generally positive to contraceptive counseling from about 25 gestational weeks and expressed positive attitudes about the concept of antenatal counseling. Feeling involved and informed was important, but few women had been involved in antenatal counseling. Women who had chosen IUD placement during CS were usually satisfied with the decision. Some interviewees expressed a need to navigate in the contraceptive services by themselves. The communication and coordinating units that should integrate around the woman have not sufficiently adapted to new evidence, needs and conditions. Conclusions: The choice of LARC postpartum is associated with lower risk for unintended pregnancy compared to the choice of other contraceptives or no choice at all. Attendance to the postpartum visit is a prerequisite to initiate LARC when provision of early/immediate LARC initiation postpartum is not part of the established contraceptive health care. Placement of a hormonal IUD within 48 hours after vaginal delivery seems safe, accepted by patients but associated with much higher expulsion rates compared to placement 6- 12 weeks postpartum. Early placement of an IUD within 48 hours after completed medical abortion does not lead to higher continuation rates at one year after abortion compared to standard placement 2-4 weeks after abortion when devices are provided free of charge. Early placement seems safe, preferred by patients, and associated with lower pain scores compared to standard IUD placement postabortion. Antenatal counseling for contraceptive method to use postpartum seems acceptable to women from around 25 gestational weeks. To have the opportunity to discuss contraception antenatally and enable placement during planned CS is generally considered valuable

    Complement mediated synapse elimination in schizophrenia

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    Schizophrenia (SCZ) is a devastating psychiatric disorder with a typically age of onset in late adolescence. The heritability is estimated to be in between 60-80% and large-scale genome-wide studies have revealed a prominent polygenic component to SCZ risk and identified more than three-hundred common risk variants. Despite a better understanding of which genetic risk variants that increases SCZ risk, it has been challenging to map out the pathophysiology of the disorder. This has stalled the development of target drugs and current treatment options display moderate efficacy and are prone to produce side-effects. SCZ is generally considered a neurodevelopmental disorder and it was proposed more than forty years ago that physiological removal of less active synapses in adolescence, i.e., synaptic pruning, is increased in SCZ and hereby causes the core symptoms of the disorder. This theory has then been supported by post-mortem brain tissue and imaging studies displaying decreased synapse density in SCZ. More recently, it was then shown that the most strongly associated risk loci can largely be explained by copy numbers of a gene coding for the complement factor 4A (C4A). As microglia prune synapses with the help of complement signalling, we therefore decided to use a recently developed human 2D in vitro assay to assess microglial uptake of synaptic structures in models based on cells from individuals with SCZ and healthy controls (study I). We observed excessive uptake of synaptic structures in SCZ models and by mixing synapses from healthy controls with microglia from SCZ patients, and vice versa, we showed the contribution of microglial and neuronal factors contributing to this excessive uptake of synaptic structures. We then developed an in vitro assay to study neuronal complement deposition dependent on copy numbers of C4A in the neuronal lines. Complement 3 (C3) deposition increased by C4A copy numbers but was independent of C4B copy numbers (also unrelated to SCZ risk). Similar C4A copy numbers correlated with the extent of microglial uptake of synapses. Microglial uptake of synaptic structures could also be inhibited by the tetracycline minocycline that also decreased risk of developing SCZ in an electronic health record cohort. In study II, we cerebrospinal fluid (CSF) from first-episode psychosis patients to measure protein levels of C4A. In two independent cohorts, we observed elevated C4A levels (although not C4B levels) in first-episode patients that later were to develop SCZ and could show correlations with markers of synapse density. However, elevated C4A levels could not fully be explained by more copy numbers of C4A in individuals with SCZ and in vitro experiments revealed that SCZ-associated cytokines can induce C4A mRNA expression while also correlating with C4A in patient-derived CSF. In study III, we set-up a 3D brain organoid models to more fully comprehensively capture processes in the developing human brain and then also included innately developing microglia. We display synaptic pruning within these models and use single cell RNA sequencing to validate them. In conclusion, this thesis uses patient-derived cellular modelling to uncover a disease mechanism in SCZ that link genetic risk variants with bona fide protein changes in living patients

    Anu√°rio cient√≠fico da Escola Superior de Tecnologia da Sa√ļde de Lisboa - 2021

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    √Č com grande prazer que apresentamos a mais recente edi√ß√£o (a 11.¬™) do Anu√°rio Cient√≠fico da Escola Superior de Tecnologia da Sa√ļde de Lisboa. Como institui√ß√£o de ensino superior, temos o compromisso de promover e incentivar a pesquisa cient√≠fica em todas as √°reas do conhecimento que contemplam a nossa miss√£o. Esta publica√ß√£o tem como objetivo divulgar toda a produ√ß√£o cient√≠fica desenvolvida pelos Professores, Investigadores, Estudantes e Pessoal n√£o Docente da ESTeSL durante 2021. Este Anu√°rio √©, assim, o reflexo do trabalho √°rduo e dedicado da nossa comunidade, que se empenhou na produ√ß√£o de conte√ļdo cient√≠fico de elevada qualidade e partilhada com a Sociedade na forma de livros, cap√≠tulos de livros, artigos publicados em revistas nacionais e internacionais, resumos de comunica√ß√Ķes orais e p√≥steres, bem como resultado dos trabalhos de 1¬ļ e 2¬ļ ciclo. Com isto, o conte√ļdo desta publica√ß√£o abrange uma ampla variedade de t√≥picos, desde temas mais fundamentais at√© estudos de aplica√ß√£o pr√°tica em contextos espec√≠ficos de Sa√ļde, refletindo desta forma a pluralidade e diversidade de √°reas que definem, e tornam √ļnica, a ESTeSL. Acreditamos que a investiga√ß√£o e pesquisa cient√≠fica √© um eixo fundamental para o desenvolvimento da sociedade e √© por isso que incentivamos os nossos estudantes a envolverem-se em atividades de pesquisa e pr√°tica baseada na evid√™ncia desde o in√≠cio dos seus estudos na ESTeSL. Esta publica√ß√£o √© um exemplo do sucesso desses esfor√ßos, sendo a maior de sempre, o que faz com que estejamos muito orgulhosos em partilhar os resultados e descobertas dos nossos investigadores com a comunidade cient√≠fica e o p√ļblico em geral. Esperamos que este Anu√°rio inspire e motive outros estudantes, profissionais de sa√ļde, professores e outros colaboradores a continuarem a explorar novas ideias e contribuir para o avan√ßo da ci√™ncia e da tecnologia no corpo de conhecimento pr√≥prio das √°reas que comp√Ķe a ESTeSL. Agradecemos a todos os envolvidos na produ√ß√£o deste anu√°rio e desejamos uma leitura inspiradora e agrad√°vel.info:eu-repo/semantics/publishedVersio

    The role of community health nurses in promoting school learners’ reproductive health in North West province

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    Background: Reproductive health education is a major component in schools, which is delivered through Life Orientation and Life Science subjects. Providing sexual and reproductive health education and services remains a challenge in schools of many countries, as well as South Africa. Community health nurses have the responsibility to initiate and participate in reproductive health promotion initiatives in schools. Aim: To explore the roles of community health nurses in the promotion of school learners’ reproductive health in schools. Setting: This study was conducted in the clinics of Madibeng municipality in North West province, South Africa. Methods: An exploratory qualitative research study was conducted using in-depth interviews for data collection. The population included community health nurses who were sampled purposively. Results: Community health nurses revealed that their primary role was to provide health education to learners, particularly in clinics. Furthermore, they revealed that they did not visit schools and had no communication with teachers regarding learners’ reproductive health issues. Conclusion: The Department of Education has opened a platform for the provision of reproductive health education in schools through various teacher-led initiatives. However, this has posed a significant challenge to teachers as they may not be willing to deliver sensitive and sexually themed information to learners. To ensure effective delivery of reproductive health education in schools, community health nurses, teachers and other relevant stakeholders must collaborate in schools. Contribution: This article highlights the importance of community health nurses visiting schools to promote the reproductive health of school learners

    Maternal risk factors associated with term low birth weight in India: A review

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    Low birth weight is one of the leading factors for infant morbidity and mortality. To a large extent affect, various maternal risk factors are associated with pregnancy outcomes by increasing odds of delivering an infant with low birth weight. Despite this association, understanding the maternal risk factors affecting term low birth weight has been a challenging task. To date, limited studies have been conducted in India that exert independent magnitude of these effects on term low birth weight. The aim of this review is to examine the current knowledge of maternal risk factors that contribute to term low birth weight in the Indian population. In order to identify the potentially relevant articles, an extensive literature search was conducted using PubMed, Goggle Scholar and IndMed databases (1993 ‚Äď Dec 2020). Our results indicate that maternal age, educational status, socio-economic status, ethnicity, parity, pre-pregnancy weight, maternal stature, maternal body mass index, obstetric history, maternal anaemia, gestational weight gain, short pregnancy outcome, hypertension during pregnancy, infection, antepartum haemorrhage, tobacco consumption, maternal occupation, maternal psychological stress, alcohol consumption, antenatal care and mid-upper arm circumference have all independent effects on term low birth weight in the Indian population. Further, we argue that exploration for various other dimensions of maternal factors and underlying pathways can be useful for a better understanding of how it exerts independent association on term low birth weight in the Indian sub-continent

    The effects of dairy foods intakes on weight change and fracture risk during critical life stages in women

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    Menopause and pregnancy are crucial events in women‚Äôs lives because women experience a series of physical and psychological changes at these stages. One of the most critical challenges is excessive weight gain during both of these stages, which could contribute to various adverse health events in their later lives. In addition to weight gain, another critical health concern that women face is fragility-related factures. The rate of fragility fractures begins rising in women during their 40s and increases to the end of life. Fractures result in impaired mobility and hospitalization, which can decrease the life quality of women significantly. Identification of modifiable dietary risk factors for excessive weight gain and fracture risk is crucial. The objectives of this dissertation are to estimate the independent effects of total dairy and individual dairy foods (e.g., yogurt, milk, and cheese), alone and in combination with overall diet patterns, physical activity, and other lifestyle factors, on three outcomes among women: weight change during the menopausal transition, weight retention after pregnancy, and risk of fragility-related fractures throughout mid-life and older adult years. Data from two prospective studies of nurses were used: Nurses‚Äô Health Study I (NHS I) and Nurses‚Äô Health Study II (NHS II). NHS II was used for both weight change analyses, while NHS was used for the fracture analyses. The first specific aim for the analysis of weight change during the menopausal transition was to investigate the effects of total dairy, yogurt, milk, and cheese intakes on menopausal weight change (N = 35,177) and risk of obesity (N = 38,892) among women in NHS II. Weights were self-reported in biennial questionnaires. Diet was assessed with food frequency questionnaires (FFQ) every 4 years. Generalized estimating equations were used to assess the adjusted mean weight change using repeated measures of weight change. Cox proportional hazards models were used to estimate risk of obesity, controlling for confounding. The second specific aim relates to the postpartum weight change analyses and were to investigate the effects of total dairy, yogurt, milk, and cheese intakes on postpartum weight retention (N = 18,366) and risk of postpartum obesity (N = 17,126) among women in the NHS II. Generalized linear models were used to assess postpartum weight change as continuous outcomes and multivariable models with a Poisson distribution were used to estimate risk of postpartum obesity. The third specific aim was for the fragility fracture analyses and included investigating the effects of total dairy, yogurt, milk, and cheese on fragility fractures of the hip, wrist, and vertebrae in women ages 40 years and older in NHS I. In total, there are 99,072 women included. Fractures at the wrist and hip were self-reported. For vertebral fractures, we relied on medical record confirmed cases. Proportional hazards models were used to estimate risk of first fracture (including wrist, hip, or vertebral fractures). Results associated with the first aims suggested that more than 2 servings per week (s/w) of yogurt led to consistently less weight gain than that observed in women consuming less than 1 serving per month (s/m) throughout the menopausal transition. Further, this same yogurt intake was associated with a 31% reduced obesity risk (95% CI: 0.64 - 0.74) after adjusting for potential confounders and baseline body mass index (BMI). Higher total dairy intake was also associated with less obesity risk, but the effect was somewhat weaker than that for yogurt. There was a U-shaped relation between milk consumption and obesity risk during perimenopause. Moderate (0.5 s/d -< 1 s/d vs. < 0.5 s/d) milk consumption reduced obesity risk by 17% (95% CI: 0.78 - 0.89), while higher milk (‚Č•1 s/d vs. < 0.5 s/d) consumption led to a marginally statistically significant 6% higher obesity risk. Cheese intake was not associated with obesity risk in perimenopausal women. In the postpartum weight retention analyses, women who consumed moderate amounts of yogurt (1 s/m -< 2 s/w) and higher amounts of yogurt (‚Č• 2 s/w) had a 0.38 lb and 0.63 lb reduction in postpartum weight retention, respectively, than those who rarely consumed yogurt (< 1 s/m). Moderate and higher cheese intakes were associated with 0.30 lb and 0.64 lb less postpartum weight retention, respectively, than lower cheese intake (< 2 s/w). In the obesity analysis, moderate (1 s/m -< 2 s/w) and higher yogurt (‚Č• 2 s/w) intakes were associated with 20% (95%: 0.69 - 0.93) and 16% (95%: 0.69 - 1.02) reduced risks of postpartum obesity, but the association was weakened by adjusting for pre-pregnancy BMI. Women with higher levels of activity and higher yogurt intakes had a 39% (95%: 0.50 - 0.74) lower risk of obesity. Higher Alternative Healthy Eating Index 2010 (AHEI) scores alone were associated with a statistically significantly lower obesity risk. Results from our fracture analyses found that women who consumed more than 2 s/d of total dairy had a 19% (95% CI: 0.67 - 0.98) lower fracture risk than those who consumed less than 1 s/w. In terms of individual dairy products, 2 s/d of milk were associated with a 14% (95% CI: 0.77 - 0.95) reduction in fracture risk compared with lower milk consumption (<1 s/w). Higher cheese (‚Č• 1 s/d vs. < 1 s/w) intake was associated with a non-statistically significant 9% (95% CI: 0.81 - 1.02) reduction in fracture risk. No association was found between yogurt consumption and fracture. In stratified analysis, the intakes of calcium, vitamin D, and protein from non-dietary sources did not modify the inverse association between total dairy or milk intake and fracture risk. In summary, the findings of this dissertation suggested that greater yogurt consumption was inversely associated with weight change during menopausal transition and after pregnancy while intakes of total dairy and milk had beneficial effects on the risk of fragility fractures among women ages 40 years and older
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