98 research outputs found
HEALTH SERVICE UTILIZATION OF LATE PRETERM INFANTS
No full textPreterm birth (< 37 weeks gestation) is a major health burden for affected children. Although the risk of health problems increases as the gestational age decreases, research in the last decades has revealed that even late preterm infants born at 34-36 weeks gestational age have higher mortality and morbidity than term infants. Because late preterm infants constitute three fourths of preterm infants, they are important from both public health and health policy perspectives. This doctoral thesis sought to answer important knowledge gaps in health service utilization of late preterm infants via three studies.
Study A, a systematic review and meta-analysis comparing health service utilizations of late preterm infants with those of term infants, found that late preterm infants had increased hospitalization compared with term infants that persisted from the neonatal period through adolescence. Study B is a cohort study evaluating the re-admissions and emergency department visits by late preterm and term singletons and twins for the first 5 years after birth. Study B demonstrated that late preterm infants had higher re-admission rates than term infants although differences in twins were less pronounced than in singletons. Study C is a population-based cohort study with cost analyses assessing the health care costs and resource utilization related to three different discharge timings of late preterm and term singletons: early (< 48 hours), late (48-71 hours), and very-late (72-95 hours) discharge after birth. Study C found that early discharge was not associated with the reduction of health care cost in late preterm infants, and instead was associated with an increase in the cost in term infants over the first year after birth. These findings are useful for parents, care providers, health policy makers, and guideline developers to provide optimal care for late preterm infants.ThesisDoctor of Philosophy (PhD
Attack on Titan and The Hunger Games: Dystopias with an Orwellian Foundation
No full textDystopia as a genre has gained the attention of literary scholars as many dystopian works have been analyzed for the elements, reflections, and sociopolitical critiques they carry. 1984 is a popular dystopia, written by George Orwell, which became the stepping stone for other dystopian works. Among these works are The Hunger Games trilogy, by Suzanne Collins, and Attack on Titan, by Hajime Isayama. In this thesis, I explored both texts in the light of 1984, and it became evident that they follow the patterns and integrate elements from the Orwellian dystopia. Then, I explored the character development in all three works, and it showed how the literary medium, the style of the author, and the purpose of the character affect the method and depth of development
FATAL BLEEDING, CASE-FATALITY RATE OF MAJOR BLEEDING AND ALL-CAUSE MORTALITY IN PATIENTS TAKING TARGET-SPECIFIC ORAL ANTICOAGULANT, A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
No full textSocioeconomic inequity in survival for deliveries at 22–24 weeks of gestation
No full textObjectiveGuidelines recommend individual decision making on resuscitating infants of 22–24 weeks’ gestational age (GA) at birth. When the decision not to resuscitate is made, infants would likely die soon after delivery, and under some circumstances such neonatal deaths may be registered as stillbirths occurring during delivery (intrapartum stillbirth). Thus we assessed whether socioeconomic factors are associated with peridelivery deaths (during or within 1 hour of delivery) of infants delivered at 22–24 weeks’ gestation.MethodsWe analysed 14 726 singletons of 22–24 weeks’ GA using the 2003–2011 Japanese vital statistics, and assessed how maternal characteristics influence risk of peridelivery death as well as intrauterine fetal death (IUFD) and death after 1 hour of age until 40 weeks postmenstrual age.ResultsLiving in a municipality with low-average income (lowest tertile (risk ratio 1.32, 95% CI 1.20 to 1.44), middle tertile (risk ratio 1.08, 95% CI 0.98 to 1.19)), younger maternal age (age <20 (risk ratio 1.43, 95% CI 1.17 to 1.75), age 20–34 (risk ratio 1.14, 95% CI 1.03 to 1.27)) and having previous live births (risk ratio 1.08, 95% CI 1.01 to 1.17) increased risk of peridelivery deaths, but did not increase risk of IUFD or deaths after 1 hour of age. Peridelivery death was twice as likely to occur in births to multiparous teenage mothers in a low-income municipality, compared with those of older primiparous mothers in a wealthier municipality.ConclusionsSocioeconomic factors substantially influence whether births of 22–24 weeks’ GA survive delivery and the first hour of life. Such disparities may reflect the impact of socioeconomic situations on decision making for resuscitation.</jats:sec
Prophylactic effects of cyclooxygenase inhibitor on intraventricular hemorrhage: Effect modification by the risk of intraventricular hemorrhage
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Architectonic epigraphs : connections between typography, architecture and historical context : case study of "Monteiro, Heinsfurter & Rabinovitch"
No full textOrientador: Anna Paula Silva GouveiaDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de ArtesResumo: O campo das Artes Visuais é bastante extenso e chega a englobar áreas como a arquitetura e a tipografia. O objeto de estudo desta dissertação, que inclui-se neste campo maior das artes visuais e em áreas correlatas, são as epígrafes arquitetônicas, que tratam-se de inscrições tipográficas presentes em edifícios cujo conteúdo textual identifica o autor do projeto (seja um engenheiro, um arquiteto ou uma construtora). Esta dissertação tem como objetivo analisar três destes artefatos que constam no "Acervo Epigráfico Paulistano" (http://www.iar.unicamp.br/lis/pat), referentes à empresa de construção e engenharia "Monteiro, Heinsfurter & Rabinovitch" (que a partir de 1942 passa a ser somente Monteiro & Heinsfurter). A análise consiste em traçar a base histórico-cutural em que estes artefatos se inserem, bem como compreender a forma tipográfica destes objetos e a arquitetura dos seus prédios, buscando, desta forma, traçar relações entre estilo tipográfico, arquitetônico e o contexto histórico. Como resultado, foi possível perceber que, nos exemplares escolhidos para o estudo de caso, existe coerência entre estes três elementos (contexto histórico, tipografia e arquitetura). Nota-se que a epígrafe mais antiga da firma possui traços inspirados nas inscrições clássicas romanas, o que condiz com a arquitetura do prédio, que é de estilo eclético; assim como ocorre com as outras duas, que portam traços que as incluem no padrão geométrico, o que mostra adesão à tendência geometrizante presente no pensamento arquitetônico e tipográfico da época, que se reflete na arquitetura Art Déco dos dois prédios. A partir disso, conclui-se que as epígrafes podem auxiliar na compreensão do gosto estilístico de uma época, e também portam e expõem em local público informações relevantes, como os nomes dos responsáveis pelo projeto de um prédio, que muito raro são divulgadas pública e extensamente. Entretanto, este objeto deixou de ser usado e com ele se foram informações diretas e indiretas e indícios de época que portava. Também aponta-se para uma possível mudança neste cenário devido à lei municipal do Rio de Janeiro, que exige que novos edifícios tenham o nome de seus autores exibidos na fachadaAbstract: The Visual Arts field is quite extensive, and it includes areas such as architecture and typography. The study object of this Master thesis, which is included in the broader field of the Visual Arts as well as in correlative areas, are the architetonic epigraphs, which are typographic inscriptions present in buildings whose textual content indentifies the project's author (be it an engineer, an architect or a construction company). The objective of this Master Thesis is to analyze three of those artifacts, contained in the "Acervo Epigráfico Paulistano" (http://www.iar.unicamp.br/lis/pat), which belong to the construction and engineer company "Monteiro, Heinsfurter & Rabinovitch" (which, from 1942 forwards, starts being called "Monteiro & Heinsfurter" only). This analisys consists in tracing the historical and cultural base in which those objects appear, as well as understand the typographical form of those objects and the architecture of the building in which it is inserted aiming to establish, in that way, connections between typographic and architectonical style and the historical context. As a result, it was possible to notice that, in the selected examples for this case study, there is coherence between those three elements (historical context, typography, and architecture). It is noticeable that the eldest epigraph has a design inspired by the classical Roman inscriptions, which fits the building's eclectic style of architecture; similarly to what happens to the other two cases, which carry a design that includes them in the geometric pattern, what shows support to the geometrizing tendency present in the architectonic and typographic paradigm of the time, which is also reflected in the Art Déco architecture of the two buildings. All of it considered, it is possible to conclude that the epigraphs can help understand the stylistic taste of a period, and also that they carry and expose in public view some relevant information, such as the names of the people responsible for the project of a building, an information that is seldom disclosed publicly and extensively. However, this object ceased to be used and with it all those direct and indirect informations and indexes of a time that it carried were also gone. It is also pointed that there is a possibility for a change of scenery thanks to a city law in Rio de Janeiro, which obliges all new buildings to carry their author's name in the frontageMestradoArtes VisuaisMestra em Artes Visuai
Health Services Use by Late Preterm and Term Infants From Infancy to Adulthood: A Meta-analysis
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CONTEXT:
Late-preterm infants born at 34 to 36 weeks’ gestation have increased risks of various health problems. Health service utilization (HSU) of late-preterm infants has not been systematically summarized before.
OBJECTIVES:
To summarize the published literature on short- and long-term HSU by late-preterm infants versus term infants from infancy to adulthood after initial discharge from the hospital.
DATA SOURCES:
We searched Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature, and PsycINFO.
STUDY SELECTION:
Cohort and case-control studies that compared HSU (admissions, emergency department visits, etc) between late-preterm infants and term infants were included.
DATA EXTRACTION:
Data extracted included study design, setting, population, HSU, covariates, and effect estimates.
RESULTS:
Fifty-two articles were included (50 cohort and 2 case-control studies). Meta-analyses with random effect models that used the inverse-variance method found that late-preterm infants had higher chances of all-cause admissions than term infants during all the time periods. The magnitude of the differences decreased with age from the neonatal period through adolescence, with adjusted odds ratios from 2.34 (95% confidence intervals 1.19–4.61) to 1.09 (1.05–1.13) and adjusted incidence rate ratios from 2.62 (2.52–2.72) to 1.14 (1.11–1.18). Late-preterm infants had higher rates of various cause-specific HSU than term infants for jaundice, infection, respiratory problems, asthma, and neurologic and/or mental health problems during certain periods, including adulthood.
LIMITATIONS:
Considerable heterogeneity existed and was partially explained by the variations in the adjustment for multiple births and gestational age ranges of the term infants.
CONCLUSIONS:
Late-preterm infants had higher risks for all-cause admissions as well as for various cause-specific HSU during the neonatal period through adolescence.
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