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Sökning: Nicaragua > (2005-2009)

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51.
  • Salazar, Mariano, 1976-, et al. (författare)
  • Ending intimate partner violence after pregnancy : findings from a community-based longitudinal study in Nicaragua
  • 2009
  • Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 9, s. 350-
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Although reducing intimate partner violence (IPV) is a pervasive public health problem, few longitudinal studies in developing countries have assessed ways to end such abuse. To this end, this paper aims to analyze individual, family, community and societal factors that facilitate reducing IPV.METHODS: A longitudinal population-based study was conducted in León, Nicaragua at a demographic surveillance site. Women (n = 478) who were pregnant between 2002 and 2003 were interviewed, and 398 were found at follow-up, 2007. Partner abuse was measured using the WHO Multi-country study on women's health and domestic violence questionnaire. Women's socio demographic variables, perceived emotional distress, partner control, social resources, women's norms and attitudes towards IPV and help-seeking behaviours were also assessed. Ending of abuse was defined as having experienced any abuse in a lifetime or during pregnancy but not at follow-up. Crude and adjusted odds ratios were applied.RESULTS: Of the women exposed to lifetime or pregnancy IPV, 59% reported that their abuse ended. This finding took place in a context of a substantial shift in women's normative attitudes towards not tolerating abuse. At the family level, no or diminishing partner control [ORadj 6.7 (95%CI 3.5-13)] was associated with ending of abuse. At the societal level, high or improved social resources [ORadj 2.0 (95%CI 1.1.-3.7)] were also associated with the end of abuse.CONCLUSION: A considerable proportion of women reported end of violence. This might be related to a favourable change in women's norms and attitudes toward gender roles and violence and a more positive attitude towards interventions from people outside their family to end abuse. Maintaining and improving social resources and decreasing partner control and isolation are key interventions to ending abuse. Abuse inquiring may also play an important role in this process and must include health care provider's training and a referral system to be more effective. Interventions at the community level are crucial to reducing partner violence.
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52.
  • Vilchez, Samuel, et al. (författare)
  • Prevalence of diarrhoeagenic Escherichia coli in children from Leon, Nicaragua
  • 2009
  • Ingår i: JOURNAL OF MEDICAL MICROBIOLOGY. - : Microbiology Society. - 0022-2615 .- 1473-5644. ; 58:5, s. 630-637
  • Tidskriftsartikel (refereegranskat)abstract
    • Diarrhoeal disease is a public health problem worldwide, mostly affecting children in developing countries. In Nicaragua, diarrhoea is the second greatest cause of infant mortality. During the period March 2005 to September 2006, a total of 526 faecal samples from children aged 0-60 months (381 with and 145 without diarrhoea) from Leon, Nicaragua, were studied. In order to detect five different diarrhoeagenic Escherichia coli pathotypes simultaneously [enterotoxigenic E. coli (ETEC), enteroaggregative E. coli (EAEC), enteropathogenic E. coli (EPEC), enterohaemorrhagic E. coli (EHEC) and enteroinvasive E. coli (EIEC)], a mixture of eight primer pairs was used in a single PCR. At least one diarrhoeagenic E. coli pathotype was detected in 205 samples (53.8%) of the diarrhoea group and in 77 samples (53.1 %) in the non-diarrhoea group. ETEC was detected significantly more often in children with diarrhoea (20.5 %) than in children without diarrhoea (8.3%) (P=0.001). Atypical EPEC, EIEC and EAEC were detected with slightly lower frequencies in children with (16.0, 0.8 and 27.8%, respectively) than in children without (20.7, 1.4 and 33.1 %,respectively) diarrhoea. EHEC was only detected in children with diarrhoea (2.1%). In conclusion, ETEC continues to be an important agent associated with diarrhoea in children from Leon, Nicaragua. Although not very frequent, the only findings that were 100 % associated with diarrhoea were ETEC estA (4.7%) and EH EC (2.1%). Nevertheless, EAEC and EPEC were also frequent pathotypes in the population under study. In children with severe diarrhoea, more than half had EAEC, ETEC or EPEC, and EAEC was the most prevalent pathotype.
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53.
  • García, Indiana, 1966- (författare)
  • Removal of natural organic matter by enhanced coagulation in Nicaragua
  • 2005
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The existence of trihalomethanes (THMs) in a drinking water plant of Nicaragua has been investigated in order to see whether the concentration exceeded the maximum contaminant level recommended by the environmental protection agency of the United States (USEPA) and the Nicaragua guidelines. The influence of pH, temperature, chlorine dose and contact time on the formation of THMs were studied. The contents of organic matter measured by surrogate parameters such as total organic carbon, dissolved organic carbon, ultraviolet absorbance and specific ultraviolet absorbance were also determined in order to show which type of organic matter is most reactive with chlorine to form THMs. Models developed by other researchers to predict the formation of trihalomethanes were tested to see whether they can be used to estimate the trihalomethane concentration. In addition, empirical models were development to predict the THM concentration of the drinking water plant analysed. The raw water was treated by conventional and enhanced coagulation and these processes were compared with regard to the removal of natural organic matter (NOM). The significance of the results was assessed using statistic procedures. The average concentration of THMs found at the facility is below the USEPA and Nicaragua guideline values. Nevertheless the maximum contaminant level set by USEPA is sometimes exceeded in the rainy season when the raw water is rich in humic substances. Comparison between the water treated by conventional and enhanced coagulation shows that enhanced coagulation considerably diminished the trihalomethane formation and the value after enhanced coagulation never exceeded the guidelines. This is because enhanced coagulation considerably decreases the organic matter due to the high coagulant dose applied. The study of the trihalomethane formation when varying pH, time, temperature and chlorine dose using water treated by conventional and enhanced coagulation showed that higher doses of chlorine, higher pH, higher temperature and a longer time increases the formation of THMs. However, combinations of two and three factors are the opposite. The predicted THM formation equations cannot be used for the water at this facility, since the results shown that the measured THM differs significantly from the THM concentration predicted. Two empirical models were developed from the data for enhanced coagulation, using linear and non-linear regression. These models were tested using the database obtained with conventional coagulation. The non-linear model was shown to be able to predict the formation of THMs in the Boaco drinking water plant.
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56.
  • Tercero, Francisco (författare)
  • Measuring injury magnitude and patterns in a low-income country : experiences from Nicaragua
  • 2007
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • About 16,000 people around the world die every day from injuries. For every person that dies, several thousands more are injured, many suffering with permanent disabilities. However, like many other health problems, the magnitude and pattern of injuries in a certain population are often difficult to assess. While in many high-income countries, regular health registries may provide accurate figures, other approaches are often needed in low-income countries. Therefore, the overall aim of this thesis is to measure the magnitude and pattern of injuries in a defined population (mainly the municipality of Leon, Nicaragua) through the use of different methodologies. The first step in this study was to conduct an exploratory analysis (Paper 1) to compare the existing nationwide data sources on injury surveillance with respect to validity and prevention-relevance. However, these results were discouraging due to low validity and the lack of information for prevention purposes. In part due to the above, it was considered important to collect injury data in the municipality of León in other ways. One of the objectives of this second step was to describe the development of a hospital-based injury surveillance system aimed at prevention and to study the incidence of injuries based on data obtained from this data collection system (Paper 2). About 16% of emergency room visits were due to injuries in this low-income country context. For every death due to injury, 31 inpatients and 253 outpatients were reported. Homes and traffic areas were the main arenas where injuries occurred. The main causes were falls, traffic accidents and violence. The underreporting rate was 6%, and in 20.3% of the cases, no E-code was recorded. This study shows that hospital-based injury surveillance is an effective and potential means available for the prevention and control of injuries. However, its low coverage is a concern due to people s limited access to hospital services. Next, a study was conducted to provide a reliable estimation of traffic-related injuries in the same catchment area by capture-recapture analysis (using hospital and traffic police records) (Paper 3). This study demonstrated that neither police records nor hospital records nor the aggregate database provide acceptable coverage of traffic-related injuries. Limitations of coverage in both these data sources justified the realization of a survey in a representative sample in Leon municipality (Paper 4). Ninety-three percent of injuries were minor and seven percent were moderate or severe. The overall incidence rate was 414.2 per 1,000 inhabitants per year, but decreased to 27.6 per 1,000 when minor injuries were excluded. Most of the injuries were unintentional and only 1.2 percent were intentional. The main places of injury occurrence were homes and streets. Nine percent of all injured persons sought hospital treatment. The main causes of nonfatal cases were falls, traffic, and cuts, whereas fatalities were associated with intentional injuries. For every death due to injury, there was one permanent disability, 25 moderate/severe injuries, and 354 minor injuries. The seeking of hospital treatment depended on the severity of the injury. A complementary study on mortality and disability shows that the leading causes of mortality overall were non-communicable diseases (176/100,000), injuries (55/100,000) and communicable diseases (55/100,000). The incidence of disability-related injuries was 75/100,000, and the main types were skeletal, disfiguring, and blindness. Their causes were falls, traffic, and violence. Around three-quarters of disabilities and half of injury deaths received hospital attention. The leading causes of years of potential life lost (YPLL) and disability-adjusted life year (DALY) were traffic, falls, drowning, and violence (Paper 5). Based on these findings, the ascertainment and validity of data sources and injury indicators must be evaluated carefully when planning injury prevention measures. When results from these studies are compared, the distribution of causes of injury vary by severity and source. The main causes of injury deaths among different data sources were similar; however, these causes differ in non-fatal injuries. A methodological issue in hospital-based surveillance is that it often fails to capture most of the extreme outcomes on the injury spectrum. On the other hand, household surveys can capture most of the injury spectrum, which sometimes is missing in traditional data sources, but they cannot establish temporal variations of injuries, especially in fatal cases. Due to the cost associated with carrying out hospital or population-based studies, capture-recapture methods represent a good option for measuring the magnitude and pattern of injuries, especially in low-income countries where resources are scarce. In conclusion, methodological issues involving the sources of injury data, injury severity, and research methods must be assessed carefully to be able to measure injuries properly as a basis for effective interventions.
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57.
  • Reyes Castro, Guillermo, et al. (författare)
  • Sequence characterization of Dasheen mosaic virus isolates from cocoyam in Nicaragua
  • 2009
  • Ingår i: Archives of Virology. - : Springer Science and Business Media LLC. - 0304-8608 .- 1432-8798. ; 154, s. 159-162
  • Tidskriftsartikel (refereegranskat)abstract
    • Dasheen mosaic virus (DsMV) is an important constraint to production of cocoyam (Xanthosoma spp.) in Nicaragua. Reverse transcription polymerase chain reaction was used to amplify the coat protein (CP) region from ten Nicaraguan DsMV isolates. These isolates showed high nucleotide identity to DsMV isolates from the USA, eastern Asia and Australasia. All Nicaraguan isolates except one shared a tandem repeat in the N-terminus of the CP. Phylogenetic analyses showed that the Nicaraguan isolates formed two distinct subgroups correlated with geographic origin. This can be explained by different origins of the cocoyam genotypes grown in these regions.
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58.
  • Alänge, Sverker, 1951, et al. (författare)
  • Innovation Systems in Latin America: Examples from Honduras, Nicaragua and Bolivia
  • 2005
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • The main purpose of the study was to identify and analyze the current status of local innovation and cluster activities in three Latin American countries, Bolivia, Honduras and Nicaragua. This included the goals to identify key stakeholders active in innovation and to analyze the relationships between the various stakeholder and cluster groups. More specifically we were also interested in analyzing the university’s role in innovation activities. Finally, our aim was to identify supports and hinders to innovation activities and the emergence of innovation clusters. The cluster model (based on Sölvell et al. 2003) that was used for analysis was a good starting point – but not sufficient. We needed to adjust and adapt it during our research process and had to add 4 key stakeholders which were missing: Unions; Aid community; Development banks; and Indigenous communities. Using our interview data from Bolivia, Honduras and Nicaragua for the analysis, it was found that there were many similarities across the three countries. There is limited sharing of research results and lack of diffusion of competence, learning and know-how. There is a lack of research culture (incentives, funding) and research and science is not on the national agenda or connected to industry. Limited resources, risk avoidance and low esteem in locally grown inhibit local innovation and entrepreneurship. Intellectual property rights (IPR) are poorly developed and lack links to business development.Public universities have most of the state research money as well as money from donors but have very limited contact with industry and there is a lack of trust. Some great examples of research being conducted were identified where financing for research and advanced degrees had been provided by international donor organisations. However, the researchers act as islands so research is not visible even internally at the universities. There is a lack of research culture where teachers have no time for research, and promotion/prestige does not value research. The research that exists is not linked to the market and there is no commercialization of research. Private universities are a recent phenomenon, during the last 10 years, primarily focused on education and typically with excellent contacts with industry, but with a few exceptions, without any research tradition. A few examples of well-functioning and market driven research institutes were identified. Industry is in general not making innovation and do not budget for innovation and R & D activities, although we found good examples of innovative activities in all three countries - primarily in organisation innovation and product innovation. Government policies and institutions for Innovation, Science and Technology are either non-existent or weak. Some innovative approaches were identified, e.g. in bidding system to link suppliers and producers in agro business (Bolivia), financing innovation in SMEs and support to cluster development (Nicaragua) and financing of micro businesses (Bolivia, Nicaragua). In the financial sector, traditional banks do not support SMEs and do not give loans for innovation. Instead, international donor agencies are important actors when it comes to financing, but they have their own agendas, which do not necessarily coincide with National goals. Various types of organizations, including NGOs, perform the role of linking organizations and the services provided can include financing which make them a stronger player. Laws and regulations are sometimes creating disincentives for local entrepreneurs, for example tax incentives for foreign investment, Tax free zones create islands of industry, without interaction with the local business or society. The Intellectual Property systems are weak with limited capacity to evaluate intellectual assets, mainly foreigners (90%) apply for patents and universities offer no courses or information to students or teachers on IP and IP processes. The above study provided input for an action learning project with the main goal of introducing and developing a process that will increase awareness, cooperation and debate on the role and opportunity that ‘innovation clusters’ may have in the development of innovations. A sub-goal was to increase the connectivity between the key stakeholders active in innovation activities both locally in within the wider region. As part of this action learning project various stakeholders were invited to meet and discuss the preliminary findings in a workshop at the end of our visit to each of the Latin American countries. Finally, a group of stakeholders from each country were invited to participate in the 7th Global Innovation Cluster Conference in Ottawa, Canada.
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59.
  • Aragón, Aurora (författare)
  • Dermal exposure to pesticides in Nicaragua : a qualitative and quantitative approach
  • 2005
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Pesticide use continues to be a serious public health problem in developing countries, despite decades of safe pesticide use strategies. In Nicaragua, organophosphate insecticides, in particular chlorpyrifos and methamidophos are responsible for about half of the acute pesticide poisonings. Contamination of the skin occurs frequently in the occupational setting. There is extensive research to improve methods to assess dermal exposure. The applicability and feasibility of such methods in developing countries is uncertain. Aim: This thesis aims at increasing the understanding of risk factors underlying exposure, evaluating dermal exposure among Nicaraguan subsistence farmers, and proposing more suitable methods for developing country conditions. Methods: A group of 29 subsistence farmers were interviewed in four focus groups and their responses were analyzed using grounded theory. Field data for semi-quantitative and quantitative exposure measurements of 31 farmers were collected during 33 pesticide applications, using observation, supplementary video recording, a fluorescent tracer, and skin wiping. A visual scoring system developed in the US was modified into a Nicaraguan Visual Scoring System suitable for developing country conditions. Pesticides were traced during application. Skin fluorescence was videotaped in a foldaway darkened room which was later measured through Body Segment Scores (BSS), Contaminated Body Area (CBA) and Total Visual Score (TVS). TVS was used as a criterion indicator for the identification of main exposure determinants by observation. Univariate and multivariate analyses were performed. Hundred and ten potential exposure determinants were reduced to 27 variables grouped as worksite, spray equipment, work practices, clothing, and hygiene practices. Reliability of the visual score was tested with intraclass correlation coefficients, in a sub-sample of five farmers evaluated by five raters. Observations of hand exposure events (direct and indirect contacts) were summarized into a Concentrate Contamination Index (CCI) and a Solution Contamination Index (SCI). Chemical residues were quantified for the hands and selected body parts according to fluorescent intensities. Spearman rank correlation coefficients were computed to compare the observational indices (CCI+SCI), fluorescent visual scores and quantitative residues. Results: Reasons for unsafe practices were connected with poverty, inadequacy of personal protective equipment, climatic factors, and limited knowledge influenced by beliefs and traditions. Farmers felt affection towards their traditional crops and this relationship seemed to have strong meanings for pest removal and pesticide use, contributing to dangerous work practices. The observed fluorescent images on the skin of farmers reflected work practices and contamination mechanisms and pathways. Novel determinants included spraying on a muddy terrain, dew on plants, sealing of tank lids with a cloth, and wiping sweat from the face. The Visual Scoring System was highly consistent (Cronbach alpha = 0.96) and reasonably reliable (0.75; 95% CI: 0.62-0.83), with scoring of extent being more reliable than scoring of intensity. The highest CBA was 66% and the farmer with the highest TVS scored 60% of the maximum possible. Hands were most frequently contaminated and the back had the highest BSS. Hand contact was most frequently indirect, by touching contaminated surfaces. All farmers had quantifiable pesticide residues on their hands. Spearman correlation coefficients between the observational contamination scores, fluorescent visual scores and residues in relation to the hands ranged from 0.65 to 0.74 for chlorpyrifos and 0.62 to 0.87 for methamidophos. Differences in scores could be explained by limitations of the different methods. Conclusions: Poverty and cultural factors contribute to pesticide use and unsafe use conditions. Education programs should be culturally appropriate to achieve pesticide exposure reduction. Each method studied in this thesis can be used independently. However, they can also complement each other, providing a better understanding of the mechanisms of skin exposure. With further improvements, a combination of observation and fluorescent visual scoring techniques, both lowcost and practical, would become highly accessible methods for surveillance and for epidemiological studies in developing countries.
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60.
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