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Teoretična izhodišča: Pomen besede revščina razumemo vsi in obstaja po vsem/celem svetu, prav tako se pojavlja za vrati slovenskih družin. Nosečnost je naraven pojav in pod besedo nosečnost si predstavljamo žensko, ki bi se morala devet mesecev posvečati zdravemu načinu življenja in se veseliti prihajajočega rojstva otroka, vendar imamo veliko nosečnic, katere so zaradi stiske in revščine primorane razmišljati o tem, kako bodo finančno sposobne skrbeti za svojo družino in otroka. V diplomski nalogi »Nosečnost in revščina« smo najprej opisali revščino in vpliv revščine na nosečnost, prav tako smo z uporabo individualno vodenega intervjuja z nosečnico po funkcionalnih vzorcih zdravega obnašanja Majory Gordon ugotovili, kakšno je duševno, telesno in socialno stanje nosečnice ter zdravstveno vzgojno delovanje patronažne medicinske sestre pri nosečnici. Diplomirana medicinska sestra v patronažnem varstvu je na področju zdravstvene nege nosečnice, otročnice in novorojenčka samostojna ter zagotavlja kontinuirano zdravstveno nego. Naloga diplomirane medicinske sestre je, da deluje zdravstveno vzgojno in vzpodbuja zdrav življenjski slog nosečnice ter celotne družine. Metodologija raziskovanja: Raziskava je temeljila na deskriptivni (opisni) metodi dela in kvalitativni metodologiji, izvedli smo individualno voden intervju z nosečnico, katero je revščina neposredno prizadela. Po enajstih funkcionalnih vzorcih zdravega obnašanja Majory Gordon smo nosečnici postavili štiriinšestdeset vprašanj. Rezultati: Iz rezultatov smo ugotovili, da ima preventivni patronažni obisk pri nosečnici zelo pomembno vlogo ravno pri vzpostavitvi odnosa med nosečnico in družino ter patronažno medicinsko sestro. Revščina na nosečnico, s katero smo izvedli individualno voden intervju, po funkcionalnih vzorcih zdravega obnašanja Majory Gordon ne vpliva v tolikšni meri, da bi škodovala duševnemu, telesnemu ali socialnemu stanju nosečnice. Nosečnica ostaja pozitivna glede prihodnosti sebe in svoje družine. Tako nosečnica kot njen partner vesta, da morata zraven stvari, ki jih bosta rabila za otroka, odmisliti željo po idealnih stvareh in se osredotočiti na funkcionalnost. Sklep: Rezultati raziskave kažejo, kako pomembno vlogo ima socialni suport družine in ostalih bližnjih pri nosečnici, saj ravno zaradi podpore družine ostaja zelo optimistična glede prihodnosti. V patronažni zdravstveni negi je zelo pomembno, da zraven nosečnice obravnavamo tudi družino s katero živi, saj smo tako dobili širši pogled na celotno dogajanje v družini in ugotovili, kako pomembno vlogo ima družina v patronažni zdravstveni negi. Temelj zdravstvene nege v patronažnem varstvu je dobra komunikacija, ki poteka v razgovoru med nosečnico in patronažno medicinsko sestro. Revščina je problem, o katerem noseča žena težko govori. Veselje, ki ga ženska čuti ob pričakovanju rojstva otroka, je čustvo, ki je trenutno zelo močno in dominira ostalim. V obdobju otročnice in novorojenca pa se bodo pojavili že prvi problemi v negi in prehranjevanju (v primeru, če otrok ne bo dojen, potrebe po prehranskih dodatkih, plenicah in oblačilih). Takrat bo patronažna medicinska sestra uporabila vsa sredstva v družini in okolici, da bo otrok dobro napredoval, kljub revščini v družini. Theoretical background: The meaning of the word “poverty” is understood by everyone and it exists all over the world. It also appears within Slovenian families. Pregnancy is a natural phenomenon and under the word pregnancy we imagine a woman who should devote nine months to a healthy lifestyle and anticipate the upcoming birth of a child. However, we have a lot of pregnant women who are due to distress and poverty forced to think about how to be financially able to take care for their family and the child. In the thesis “Pregnancy and poverty” we have first described the poverty and the impact of poverty on pregnancy, we have also used the individually guided interview with the pregnant woman according to functional patterns of healthy behavior Majory Gordon, and found out what is mental, physical and social condition of the pregnant woman and health educational activity of health visitor. A graduated nurse in a health visitor service is independent and provides continuous health care on the area of health care of pregnant woman, neonatal mother and newborn. The job of a graduated nurse is to be health educational and to promote healthy lifestyle of a pregnant woman and her whole family. Research method: Research was based on a descriptive research method and qualitative methodology. We carried out an individually guided interview with a pregnant woman who was directly affected by poverty. Based on the eleven functional patterns of healthy behavior Majory Gordon we have asked the pregnant woman 64 questions. Results: The results had shown that preventive health visitor service at pregnant woman has a very important role at establishment of the relationship between a pregnant woman, family and health visitor. The pregnant woman, who we had guided interview with and that was based on the health behavior patterns Majory Gordon, has not been affected by poverty in a way that could influence her mental, physical or social condition. Pregnant woman is positive about her and her family's future. Pregnant woman and her partner know, that they have to focus on functionality rather than on ideal things that they need for their child. Conclusion: Results of the research show the important role of social support of the family and the others close to the pregnant woman. She stays very optimistic about her future because of her family's support. At health visitors service it is very important to treat pregnant women as well as the family she lives with. Focusing on the family, we have found out how important the role of the family at health visitors service actually is. Foundation of the health care in health visitor’s service is a good communication between the pregnant woman and health visitor. Poverty is a problem about which the pregnant woman rarely speaks. Extreme joy that a woman feels when anticipating the birth of a child is an emotion which is currently very strong and dominates others. During the period of neonatal mother and the newborn, there are going to be first problems in care and feeding (in case that child is not breastfed, the need of nutritional supplements, diapers and clothes). Then the health visitor will use all the resources in a family and around, so the child will be able to make a good progress – despite living in poverty.

Research exploring the development of the birth control movement in Britain continues to reveal new insights. Local case studies highlight the contentious nature of birth control debates and the significant obstacles that had to be overcome before services could be provided. Moving away from a focus on the activities of birth control campaigners and organisations, such as the Family Planning Association, this paper highlights other local actors in the statutory and voluntary sectors to map why clinics emerged when and where they did. The contrasting examples, provided by Exeter and Halifax, demonstrate the importance of multiple points of contact between local authorities and supporters and opponents of birth control. They also suggest that the attitude of local medical and political elites is not sufficient to explain the success or failure of any clinic.

Bakgrund: Prevalensen av övervikt och fetma hos barn har ökat över hela världen de senaste årtionden. Primroseprojektet är ett forskningsprojekt som studerar möjligheten att förebygga barnfetma genom föräldrasamtal på barnavårdscentralen (BVC). Sjuksköterskans compliance till den interventionsmanual som används förväntas vara viktigt för resultatet. Syfte: Att inom ramen för Primroseprojektet bedöma hur föräldrar och BVC sjuksköterskor, i samband med att barnet genomgår hälsoundersökning vid tolv månaders ålder på barnavårdscentralen, följt Primrosemanualens instruktioner. Metod : Matdagbok och målformuleringsblad granskades utifrån om de var ifyllda enligt manualens instruktioner . Målformuleringsbladet poängsattes också utifrån den detaljnivå målen var formulerade. Resultat: Nästan 75 procent av de inkomna matdagböckerna var ifyllda på ett korrekt sätt. Resultatet av poängbedömningen av målformuleringsbladen visade att sjuksköterskan tillsammans med föräldern inte hade formulerat detaljerade mål i den omfattning som var önskvärd. Slutsats: Instruktionerna för hur matdagböckerna skulle fyllas i var tydliga. Den låga graden av detaljerade mål tror författarna beror på en bristande överensstämmelse mellan hur instruktionerna till sjuksköterskan var formulerade och de kriterier som skulle vara uppfyllda för att få poäng. Background: The prevalence of childhood overweight and obesity has increased worldwide during the last few decades. The Primrose project studies the potential to prevent child obesity by parental consultation at a child health centre. It is critical that the health visitor complies with the instruction manual for any intervention. Aim : Within the framework of the Primrose project, evaluate to what extent health visitors and parents have followed the instructions in the Primrose manual, during a health control at the age of twelve months. Method: The food diary and the goal formulation sheet were studied in order to evaluate whether they had been completed according to the manual. The latter was graded using a recommended point system related to the level of detail the goals were formulated. Result: Nearly 75% of the food diaries were completed in a correct manner. The evaluation of the points derived from the goal formulation sheets indicates that the health visitor, together with the parents, had not been able to formulate the goals in sufficient detail. Conclusion: The instructions for the completion of the food diaries are clear. The authors consider that the unsatisfactory result with the level of detail the goals were formulated is caused by the lack of agreement between the way the instructions were presented and the demands of the criteria that steer the point system.

V diplomski nalogi je predstavljena raziskava o problemu oskrbe diabetičnega stopala z vidika patronažne zdravstvene nege. Raziskava je bila izvedena leta 2010, v njej pa so sodelovale patronažne medicinske sestre, ki delujejo v okviru patronažne dejavnosti v Zdravstvenem domu dr. Adolfa Drolca Maribor. Anketiranih je bilo 30 patronažnih medicinskih sester. Za izvedbo ankete sem pridobila soglasje ustanove. Cilji raziskave so bili ugotoviti ali so patronažne medicinske sestre dovolj poučene o pravilni zdravstveni negi diabetičnega stopala. Ugotoviti, ali diabetično stopalo med sladkornimi bolniki narašča, pri katerem spolu in starostni populaciji prevladuje. Predstaviti diabetično stopalo ter vzbuditi kritično razmišljanje o posledicah sladkorne bolezni. V diplomski nalogi je bila uporabljena deskriptivna metoda dela, metoda anketiranja, metoda zbiranja podatkov ter pregled in analiza podatkov. Z raziskavo smo želeli izvedeti, ali patronažne medicinske sestre pacienta zdravstveno—vzgojno informirajo. Zanimalo nas je, ali posvečajo dovolj pozornosti oz. časa za kvalitetno oskrbo diabetičnega stopala. Želeli smo izvedeti, ali se pacienti zavedajo nevarnosti, ki jih prinaša diabetično stopalo. Rezultati raziskave so pokazali, da diabetično stopalo prevladuje predvsem pri moškem spolu, v starostni populaciji med 61 in 70 let. Patronažne medicinske sestre pacienta pri svojem obisku zdravstveno vzgojno informirajo. Za kvalitetno oskrbo diabetičnega stopala pacientu posvečajo dovolj časa, več kot 20 minut. Za delo, ki ga patronažne medicinske sestre opravijo pri pacientu z diabetičnim stopalom, so strokovno dobro podkovane. This diploma work represents problems health visitors have when nursing a patient with diabetic foot ulcer. A survey was performed in 2010 and it involved health visitors working in dr. Adolf Drolc health’s centre in Maribor. Responders were 30 health visitors and the survey was carried out in accordance with the institution. The aim of this diploma work was to ascertain if the health visitors have enough knowledge on nursing patients with diabetic foot ulcer, to ascertain if diabetic foot ulcer is increasing among diabetic patients, to ascertain in which age group and sex it prevails, to describe diabetic foot ulcer and to awaken critical reflection on diabetic foot ulcer consequences. In diploma work we used descriptive method, questionnaire research method, method of data collection, processing and analysis. With the help of questionnaire we wanted to establish if health visitors educate their patients. We wanted to know if they devote enough attention and time to nurse diabetic foot ulcer with quality. We wanted to know if patients are aware of diabetic foot ulcer risks. Results of the research showed us that diabetic foot ulcer prevails among men in population between 61 and 70 years. Health care visitors educate their patients when nursing them. They spent more than 20 minutes nursing a diabetic foot ulcer which is enough to provide quality nursing. Health visitors have enough expertise for the work they practice.

V diplomski nalogi je predstavljena raziskava, o problemih s katerimi se patronažne medicinske sestre srečujejo v domačem okolju pacientov z golenjo razjedo. Raziskava je bila izvedena leta 2009, v njej pa so sodelovale patronažne medicinske sestre, ki delujejo v urbanem in ruralnem okolju. Anketiranih je bilo 50 patronažnih medicinskih sester. V diplomski nalogi je bila uporabljena deskriptivna metoda dela, metoda anketiranja, metoda zbiranja podatkov ter pregled in analiza podatkov. Skozi diplomsko nalogo smo spoznali dejavnike, ki pripomorejo k nastanku golenje razjede. Seznanili smo se z problemi, s katerimi se srečujejo patronažne medicinske sestre pri pacientih z golenjo razjedo. Spoznali smo razliko med kompresijskimi povoji in kako se nameščajo. S pomočjo anketnega vprašalnika smo ugotovili, da zdravniki redko spremenijo metodo zdravljenja, kadar ne pride do izboljšanja stanja golenje razjede. Rezultati raziskave so pokazali da se patronažne medicinske sestre najpogosteje soočajo s problemi kot so neurejene higienske razmere, bolečina ter odklonilni odnos do kompresijske terapije. Golenja razjeda je kronična rana. Zaradi svojega dolgotrajnega zdravljenja predstavlja velik socialno ekonomski, pa tudi finančni problem. Takšne paciente je potrebno motivirati, jih voditi, jim svetovati, jim prisluhniti ali pa jim samo biti v oporo ko to najbolj potrebujejo. This diploma work presents a survey of the problems, which the health visitors face in the home environment of patients with leg ulcers. The survey was performed in 2009 and involved health visitors in urban and rural areas. Respondents were 50 health visitors. In the diploma work, the descriptive method of work was used, the survey method, method of data collection and review and data analysis. Throughout this diploma we get to know the factors which contribute to the formation of leg ulcers. We were acquainted with the problems faced by health visitors when dealing with patients with leg ulcers. We realized the differences between different types of bandages and how to place them. With the help of a questionnaire survey, we found out that physicians rarely modify the method of treatment, where there is no improvement of the condition of the leg ulcer. The survey results showed that the health visitors are frequently faced with problems such as non-hygienic conditions, pain and the divergent attitudes to compression therapy. Leg ulcer is a chronic wound. Because of its long-term treatment, it represents a large socio-economic, but also a financial problem. Such patients need motivation, instructions, or just support when they need it most.

IZVLEČEK Diplomska naloga predstavlja raziskavo o zadovoljstvu in nezadovoljstvu mater s hišnimi obiski patronažne medicinske sestre ob rojstvu otroka, izvedeno leta 2008/09, v katero je bilo zajetih 30 otročnic, katerih novorojenci so stari do 28 dni. Cilji raziskave so bili: Ugotoviti dejavnike, ki vplivajo na počutje (subjektivno počutje) matere ob hišnih obiskih. Ugotoviti, kako matere sprejemajo obremenitve in neizkušenost v zvezi z oskrbo novorojenca. Ugotoviti kako v Sloveniji poskrbi patronažna služba za matere ob rojstvu otroka. Rezultati raziskave so pokazali, da so anketirane otročnice povprečno stare 29 let, z dvema otrokoma, zadovoljne z obiski patronažne medicinske sestre. Da so empatija in vključevanje družine, predvsem očeta pomembni dejavniki, ki vplivajo na počutje in zadovoljstvo matere. Matere dobro prenašajo obremenitve in neizkušenost pri oskrbi novorojenca. Patronažna služba pa v Sloveniji dobro poskrbi za matere ob rojstvu otroka. Med zastavljenimi hipotezami sta dve potrjeni: Da matere potrebujejo več obiskov in s tem več pozornosti medicinske sestre. Da so matere zadovoljne z delom patronažne medicinske sestre. Hipoteza, da si matere želijo, da bi otroke in njih oskrbela babica pa je ovržena, saj so rezultati raziskave pokazali, da si kar 80% izprašanih otročnic želi na hišnem obisku patronažno medicinsko sestro. Nosečnost, porod in poporodno obdobje ni bolezen, temveč fiziološki procesi, vendar kljub temu prinaša določeno tveganje za zdravje in življenje matere in otroka. Zavedati se moramo, da se je potrebno zelo posvetiti zdravju žensk v obdobju, ko so najbolj ranljive, v času, ko rojevajo nova življenja. The diploma work presents a study of satisfaction and dissatisfaction with health visitor visits at the birth of the child, performed in 2008/09, which included 30 mothers of young babies, whose newborn children aged up to 28 days. The objectives of the survey were: To ascertain the factors that affect the well-being (subjective well-being) of the mother at the home visits. To see how mothers accept the burden and inexperience in connection with the care for newborn child. To ascertain how the health visitor service in Slovenia provides for mothers at childbirth. The survey results showed that the interviewed mothers were on average 29 years old, with two children, and that they were satisfied with the health visitor visits. Empathy and involvement of the family, especially father, are important factors that affect the well-being and satisfaction of mothers. Mothers tolerate the burden and inexperience in the newborn child care very well. Health visitor service in Slovenia well provides for mothers at childbirth. Among the stated hypotheses are first two confirmed: Mothers need more visits and thus more attention to nurses. Mothers are satisfied with the work of health visitor nurses. The hypothesis that mothers would like for themselves and their children to be provided by a midwife is refuted. The results of the survey showed that 80% interviewed mothers want health visitor nurses at the home visits. Pregnancy, childbirth and the postpartum period is not a disease but a physiological process, but nevertheless brings some risk to the health and life of mother and child. We should be aware, that it is very necessary to devote to the health of women during the period when they are most vulnerable, while giving birth to a new life.

In this paper, we examine the relationships between health care visits to general practitioners, public sector specialists and private sector specialists using data from Italy, which has a mixed public-private health care system. We develop a simultaneous equations model that allows for the discreteness of measures of utilization and estimate this model using maximum simulated likelihood. Once common unobserved heterogeneity is properly accounted for, general practitioners, public specialists and private specialists are found to be substitute sources of medical care. In contrast, a naive model finds they are complements.

Periconceptional folic acid use considerably reduces the risk of neural tube defects. The aim of this study was to measure the effect of the national and the local 'Folic Acid Campaign' on periconceptional folic acid use. Before (1995 survey) and 1 year after the campaign (1996 survey), the awareness and use of folic acid was measured among pregnant women in four regions of the Netherlands. To this end, pregnant women who visited the midwife, general practitioner or obstetrician for the first or second prenatal visit were asked to complete a questionnaire. The results showed that use of folic acid for any period around conception increased from 25.1% in 1995 to 53.5% in 1996. Appropriate use (4 weeks before until 8 weeks after conception) increased from 4.8% in 1995 to 21.0% in 1996. No additional effect of the local Folic Acid Campaign was found (adjusted odds ratio = 1.0; 95% confidence interval = 0.7, 1.4). It was possible to conclude that folic acid use at the recommended time increased considerably as a result of the national and the local Folic Acid Campaign, but the target (use in 46% of women wishing to conceive) was not achieved. New health education programmes are needed to increase further its use at the appropriate times.

Periconceptional folic acid use considerably reduces the risk of neural tube defects. The aim of this study was to measure the effect of the national and the local 'Folic Acid Campaign' on periconceptional folic acid use. Before (1995 survey) and 1 year after the campaign (1996 survey), the awareness and use of folic acid was measured among pregnant women in four regions of the Netherlands. To this end, pregnant women who visited the midwife, general practitioner or obstetrician for the first or second prenatal visit were asked to complete a questionnaire. The results showed that use of folic acid for any period around conception increased from 25.1% in 1995 to 53.5% in 1996. Appropriate use (4 weeks before until 8 weeks after conception) increased from 4.8% in 1995 to 21.0% in 1996. No additional effect of the local Folic Acid Campaign was found (adjusted odds ratio = 1.0; 95% confidence interval = 0.7, 1.4). It was possible to conclude that folic acid use at the recommended time increased considerably as a result of the national and the local Folic Acid Campaign, but the target (use in 46% of women wishing to conceive) was not achieved. New health education programmes are needed to increase further its use at the appropriate times.

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited., Background Lactational mastitis is a painful, debilitating condition that if inappropriately managed, may lead women to discontinue breastfeeding prematurely. The aim of this paper is to report the incidence of mastitis in the first six months postpartum in a Scottish population, its impact on breastfeeding duration and to describe the type and appropriateness of the support and management received by affected women from health professionals. Methods A longitudinal study of 420 breastfeeding women was undertaken in Glasgow in 2004/05. Participants were recruited and completed a baseline questionnaire before discharge from hospital. Cases of mastitis were reported either directly to the researchers or were detected during regular follow-up telephone interviews at weeks 3, 8, 18 and 26. Women experiencing mastitis provided further information of their symptoms and the management and advice they received from health professionals. Results In total, 74 women (18%) experienced at least one episode of mastitis. More than one half of initial episodes (53%) occurred within the first four weeks postpartum. One in ten women (6/57) were inappropriately advised to either stop breastfeeding from the affected breast or to discontinue breastfeeding altogether. Conclusion Approximately one in six women is likely to experience one or more episodes of mastitis whilst breastfeeding. A small but clinically important proportion of women continue to receive inappropriate management advice from health professionals which, if followed, could lead them to unnecessarily deprive their infants prematurely of the known nutritional and immunological benefits of breast milk.