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Sökning: Nicaragua > Engelska > (2010-2013)

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1.
  • Laux, Timothy S, et al. (författare)
  • Nicaragua revisited : evidence of lower prevalence of chronic kidney disease in a high-altitude, coffee-growing village
  • 2012
  • Ingår i: JN. Journal of Nephrology (Milano. 1992). - : SAGE Publications. - 1121-8428 .- 1724-6059. ; 25:4, s. 533-540
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Chronic kidney disease (CKD) is found at epidemic levels in certain populations of the Pacific Coast in northwestern Nicaragua especially in younger men. There are knowledge gaps concerning CKD's prevalence in regions at higher altitudes.METHODS: A cross-sectional study of adults between the ages of 20 and 60 years in 1 coffee-growing village in Nicaragua located at 1,000 m above sea level (MASL) altitude was performed. Predictors included participant sex, age, occupation, conventional CKD risk factors and other factors associated with CKD suggested by previous surveys in Central America. Outcomes included serum creatinine (SCr) values >1.2 mg/dL for men and >0.9 mg/dL for women, estimated glomerular filtration rate (GFR) <60 ml/min per 1.73 m2, dipstick proteinuria stratified as microalbuminuria (30-300 mg/dL) and macroalbuminuria (>300 mg/dL), hypertension and body mass index.RESULTS: Of 324 eligible participants, 293 were interviewed (90.4%), and 267 of those received the physical exam (82.4% overall). Of the sample, 45% were men. Prevalence rate of estimated GFR <60 ml/min per 1.73 m2 was 0 for men (0%) and 2 for women (1.4%). The prevalence of at least microalbuminuria was significantly higher among men compared with women (27.5% vs. 21.4%, respectively; p=0.02).CONCLUSIONS: The CKD prevalence in this village is comparable to a previously studied Nicaraguan coffee-farming region and much lower than previously screened portions of northwestern Nicaragua. There is heterogeneity in CKD prevalence across Nicaragua. At this time, screenings should target individuals living in previously identified, higher risk regions. More work is needed to understand determinants of CKD in this resource-poor nation.
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2.
  • Pérez, Wilton, 1979- (författare)
  • Millennium Development Goals in Nicaragua : Analysing progress, social inequalities, and community actions
  • 2012
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The world has made important efforts to meet the Millennium Development Goals (MDG) by 2015. However, it is still insufficient and inequalities prevail in the poorest settings. We tracked selected MDG, barriers for their achievement, and community actions that help to accelerate the pace of their accomplishment in two Nicaraguan communities (León and Cuatro Santos).In the first two studies we track the progress of MDG4 (reduce child mortality) using the under-five mortality rate. Inequalities in mortality were mainly assessed by means of maternal education, but other social stratifications were performed on rural-urban residence and sub-regional comparisons between both communities. The last two studies describe community interventions in Cuatro Santos and their association with progress toward MDG1 (poverty reduction). Participation in interventions and poverty were visualized geographically in this remote rural community between 2004 and 2009. Other selected MDG targets were also tracked.These communities will possibly meet MDG4 even before 2015. In León, MDG progress has been accompanied by a decline in child mortality. Despite social inequalities with regard to mortality persisting in education and places of residence, these have decreased. However, it is crucial to reduce neonatal mortality if MDG4 is to be achieved. For example, in León the percentage of under-five deaths in the neonatal period has doubled from 1970 to 2005. In the remote rural area of Cuatro Santos, progress has been accelerated and no child mortality differences were observed despite the level of a mother’s education.Cuatro Santos has also progressed in the reduction of poverty and extreme poverty. The participation of the population in such community interventions as microcredit, home gardening, technical training, safe drinking water, and latrines has increased. Microcredit was an intervention that was unequally distributed in this rural area, where participation was lower in poor and extremely poor households than in non-poor households. In those households that transitioned from poor to non-poor status, microcredit, home gardening, and technical training were associated with this transition. Furthermore spatial analysis revealed that clusters of low participation in interventions overlapped with clusters of high poverty households.
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3.
  • Salazar Torres, Virgilio Mariano, 1976- (författare)
  • Intimate partner violence in Nicaragua : studies on ending abuse, child growth, and contraception
  • 2011
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Intimate partner violence (IPV) is a pervasive, worldwide public health problem and one of the most common violations of human rights. The aim of this thesis were twofold: (i) to study the process and factors related to ending of IPV of Nicaraguan women and (ii) to examine to what extent IPV exposure is associated with the child linear growth and women’s contraceptive use after pregnancy.Methods: Data were collected from a panel study which followed 398 women who were inquired about their IPV exposure during pregnancy and at follow-up a median of 43 months after delivery. Three hundred seventy five of their children were available for anthropometric assessment. Thirteen in-depth interviews were conducted with women exposed to physical/sexual IPV during pregnancy but not at follow-up. For analysis both quantitative and qualitative methodologies were used.Results: Women experienced four patterns of abuse: never abused, ending abuse, continued abuse, and new abuse. Of the women who experienced any IPV before or during pregnancy, 59% (95% CI 52-65%) reported no abuse at follow-up (135/229).  Women exposed to a continued abuse pattern and those exposed to any IPV, emotional or physical IPV at follow-up had higher odds of reversible contraceptive use. Further, exposure to any IPV and controlling behavior by a partner during pregnancy impaired the index child linear growth. Girls whose mothers had low social resources during pregnancy were the most affected. Women felt that being inquired about IPV while pregnant contributed to process of ending the abuse.Ending IPV was experienced as a process with three phases: “I came to a turning point,” “I changed,” and the “Relationship ended or changed.” Successful strategies to ending abuse mainly involved utilizing informal networks. Ending IPV did not always mean ending the relationship. IPV awareness, severity of the abuse, and economic independence were individual factors associated with ending of abuse. At the relationship level, diminishing or no exposure to controlling behavior by their partner was a key element. At the community level, a supportive and less tolerant to IPV environment as well as exposure to IPV inquiry during pregnancy facilitated the process of ending abuse.Conclusion: The study found that IPV exposure is associated with the children’s linear growth and women’s reversible contraceptive use. In addition, it is clear that gender norms regarding IPV are not static and that they play an important role in facilitating the process ending the abuse by increasing abused women’s access to emotional and material support. Our results emphasize the relevance of improving public services response to IPV.
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4.
  • Wedel, Johan, 1962 (författare)
  • Sorcery and Violence in Eastern Nicaragua
  • 2010
  • Ingår i: 35th Caribbean Studies Association Conference, May 24-28, St. Peters, Barbados.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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5.
  • Ugarte Guevara, William J., 1979- (författare)
  • Averting HIV and AIDS epidemic in Nicaragua : Studies of prevalence, knowledge, attitudes, and behavior
  • 2012
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aim of this thesis was to obtain an understanding of the dynamics of the HIV epidemic by estimating prevalence and exploring the relationship between HIV-related knowledge, attitudes, behavior, and HIV status in Nicaragua. Structured questionnaires were administered to adults from a health and demographic surveillance system in León, Nicaragua (Papers I–III). In-depth interviews and a survey were conducted among men who have sex with men (MSM, Paper IV). Blood sampling for HIV was carried out among 2,204 men and women (Paper I). Bivariate and multivariate analyses, including adjusted prevalence ratio (Papers I, II, IV), factor analysis, Cronbach’s alpha, and hierarchical regression analysis (Paper III) were performed. Thematic analysis was used with qualitative data (Paper IV).The prevalence of HIV in the general population was 0.35% (95% CI, 0.17–0.73). Those who have taken a HIV test were more likely to be females, younger, living in an urban setting, have a higher level of education, be married or cohabiting, and have no religious affiliation. HIV-related knowledge was lower among members of the general population than among MSM. Unprotected sex was reported more times with regular partners than with casual partners. Findings suggested that consistency of condom use and emotional attachment (steady relations) were inversely related. Stigma and discrimination were reported high in the general population; they appeared to be negatively associated with HIV-related knowledge, self-perception of HIV risk, HIV testing, and willingness to disclose HIV status in the event of being HIV-positive. Findings demonstrated an increasing tolerance towards same-sex attractions. MSM have a better understanding of HIV transmission than men and women of the general population. Although seven out of ten MSM and six out of ten women were concerned about becoming infected with HIV, inconsistent condom use was common.This study confirmed that Nicaragua has a low prevalence but high risk for HIV infection and transmission. Results underscore that social, behavioral, and cultural factors contribute to retard progress in achieving the Millennium Development Goals on reducing gender inequality and combating HIV/AIDS. Addressing these challenges depends not only on successful behavior change interventions, but requires a culturally gender-appropriate strategy.
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6.
  • Nilsson, Manuela, 1961- (författare)
  • Grassroots Reconciliation Stories from Post-Conflict Nicaragua
  • 2010
  • Ingår i: Social Alternatives. - Australia : University of the Sunshine Coast. - 0155-0306. ; 29:1, s. 49-54
  • Tidskriftsartikel (refereegranskat)abstract
    • How do actors formerly involved in violent conflict reconcile, particularly in the absence of a government-led top down effort? This article analyzing grassroots reconciliation efforts during the fifteen years following the civil war of the 1980s in Nicaragua. As a result of extensive rounds of interviews with actors and opinion leaders from both sides as well as members of the international community in volved in the peace building process, the study concludes that today, after two decades of peace, many Nicaraguans have advanced from negative coexistence to full reconciliation. Faced with the absence of effective ‘trickle down’ policies on the elite level to help this process along, Nicaraguans have found their own ways of reconciliation. Examples for both, the successes as well as the failures to reach reconciliation, are presented.
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7.
  • Flores, Johnny, et al. (författare)
  • Analyzing IT service delivery in an ISP from Nicaragua
  • 2010
  • Ingår i: Organizational, Business, and Technological Aspects of the Knowledge Society. - Berlin, Heidelberg : Springer Berlin/Heidelberg. - 3642163238 - 9783642163234 ; , s. 155-165
  • Konferensbidrag (refereegranskat)abstract
    • This paper presents a method for analyzing IT service delivery and its application in an Internet Service Provider (ISP). The method proposed is based on ITIL-processes and case study technique; it includes questionnaires for gathering information, semi-structured interviews, focus groups and documents as sources of information for recognition of factual information. The method application allows to the ISP determines its practices and limitations of the IT Service Delivery.
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8.
  • Ugarte, William J., 1979-, et al. (författare)
  • Measuring HIV- and AIDS-related stigma and discrimination in Nicaragua : Results from a community-based study
  • 2013
  • Ingår i: AIDS Education and Prevention. - : Guilford Publications. - 0899-9546 .- 1943-2755. ; 25:2, s. 164-178
  • Tidskriftsartikel (refereegranskat)abstract
    • Psychometric properties of external HIV-related stigma and discrimination scales and their predictors were investigated. A cross-sectional community-based study was carried out among 520 participants using an ongoing health and demographic surveillance system in León, Nicaragua. Participants completed an 18-item HIV stigma scale and 19 HIV and AIDS discrimination-related statements. A factor analysis found that 15 of the 18 items in the stigma scale and 18 of the 19 items in the discrimination scale loaded clearly into five- and four-factor structures, respectively. Overall Cronbach’s alpha of .81 for the HIV stigma scale and .91 for the HIV discrimination scale provided evidence of internal consistency. Hierarchical multiple linear regression analysis identified that females, rural residents, people with insufficient HIV-related transmission knowledge, those not tested for HIV, those reporting an elevated self-perception of HIV risk, and those unwilling to disclose their HIV status were associated with higher stigmatizing attitudes and higher discriminatory actions towards HIV-positive people. This is the first community-based study in Nicaragua that demonstrates that overall HIV stigma and discrimination scales were reliable and valid in a community-based sample comprised of men and women of reproductive age. Stigma and discrimination were reported high in the general population, especially among sub-groups. The findings in the current study suggest Community-based strategies, including the monitoring of stigma and discrimination, and designing and implementing stigma reduction interventions, are greatly needed to reduce inequities and increase acceptance of persons with HIV.
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9.
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10.
  • Ugarte, William J., et al. (författare)
  • Assessing knowledge, attitudes, and behaviors related to HIV and AIDS in Nicaragua : A community-level perspective
  • 2013
  • Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 4:1, s. 37-44
  • Tidskriftsartikel (refereegranskat)abstract
    • Background:Nicaragua's HIV epidemic is concentrated among men who have sex with men.Nevertheless, the increasing number of HIV cases among heterosexuals, high levels of poverty andmigration rates, and incomplete epidemiological data suggest the need to improve the understanding of the epidemic.Objective:To examine the prevalence of HIV-related knowledge, attitudes, and sexual rsik-taking behaviors, and their predictors among the adult population.Methods: A community-based cross-sectional survey was conducted in 2009 among 520 participants ages 15 to 49 from an ongoing Health and Demographic Surveillance System in Nicaragua. Bivariate analysis and adjusted prevalence ratios were use to examine factors associated with HIV-related knowledge, attitudes, and sexual behavior.Results: Contributing factors for risk-taking behaviors included cognitive, psychosocial, and emotional elements. Insufficient knowledge affecting the accurate assessment of HIV risk were low educational level, poverty, and rural origin, especially among females. Recognizing risk was not sufficient to promote safer sex: 90% of the females and 70% of the males who reported being sexually active in the past year did not use condoms during their last sexual encounter. Inconsistent condom use among men was associated with older age, long-term relationships, and lack of awareness about acquiring HIV infection.Conclusions:Interventions to reduce social-structural contextual factors in Nicaragua are needed so that individuals may adopt and maintain HIV risk reduction strategies. Increased gender-specific HIV education and skills-building programs need to be implemented. Sensitive mass media messages may also increase the knowledge of HIV and AIDS, and serve to encourage protective attitudes and behaviors.
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