Objetivo. Analizar si los principios generales del modelo Atención Primaria de Salud Integral (OMS) propuesto en Alma-Ata se cumple en la práctica asistencial de un EAP de la Región de Murcia con los pacientes que consultan por un problema de rodilla. Hipótesis. La práctica de la atención primaria depende de los profesionales y no está condicionada por el contexto social, político y normativo que ha desarrollado el Sevicio Murciano de Salud, que la calidad de la asistencia sanitaria a los problemas de rodilla es adecuada y que la evidencia científica es utilizada de forma adecuada y los procesos diagnósticos son satisfactorios. Material y método. Tras una revisión histórica de los antecedentes y causas que motivaron el modelo, del marco conceptual del mismo y de sus desarrollos a nivel mundial, nacional y autonómico, se elabora un Chest List para obtener variables operativas. Se emplean variables cualitativas que afectan a todos los usuarios del Centro de Salud y cuantitativas específicas de aquellos que consultaron por primera vez por un problema de rodilla durante el año 2012. Entre las primeras se analizan Universalidad, Accesibilidad y Participación Ciudadana tanto en el proceso de toma de decisiones sobre la salud como en el control de la gestión. Entre las segundas se analiza la Metodología aplicada, la Evidencia Científica y el uso de la Tecnología adecuada. El análisis de las variables cualitativas se ha obtenido a partir de la observación directa, entrevistas con “informadores clave” y búsquedas de datos publicados en Internet. En el estudio cuantitativo, se ha realizado una búsqueda mediante OMI-Est. Una vez aplicados unos criterios de exclusión en función de la calidad del registro, se obtiene una muestra de 313 episodios que corresponden a todos los usuarios con problemas de rodillas atendidos en nueve cupos asistenciales del Equipo de Atención Primaria. Las variables primarias corresponden a metodología y evidencia científica de la Anamnesis (13 variables), Exploración Física (10 variables) y uso de Pruebas de Diagnóstico por Imagen (3 variables). De ellas se han obtenido unas variables secundarias: Evaluación de la Evidencia Científica, Adecuación de la Solitud de las pruebas, Adecuación de la Elección de la prueba y Precisión Diagnóstica tras el proceso asistencial. Los resultados de estas variables han sido recogidos en Excel y, mediante tablas dinámicas se ha analizado la distribución de frecuencias. Posteriormente los datos fueron analizados en SPSS. En las variables que no siguieron una distribución normal los contrates de hipótesis fueron realizados utilizando pruebas no paramétricas (Test Mann-Whitney y Kruskal-Wallis). Resultados: Universalidad amplia pero restringida en ciertos colectivos y complicada en otros. La accesibilidad está afectada por las Listas de Espera en la Atención hospitalaria (159,03 días para una artroscopia y 164,08 días para ua Prótesis Total de Rodilla). Ausencia de Participación Ciudadana. Algún dato psicosocial aparece registrado en el 27.3% de los episodios. Algún registro de anamnesis aparece en el 99,4% (media del nº registros 5,59), de Exploración Física en el 67,3% (media 2,3). Se solicitan pruebas en el 46,3%, con una adecuación del 45,5%, elección correcta del 59,7% y aparece registrado el resultado de la prueba en el 79,5%. Se ha mejorado la precisión diagnóstica a lo largo del proceso asistencial en el 52,7% de los procesos atendidos. El cupo asistencial se relaciona con las características del registro de la Anamnesis, la Exploración Física y el uso de Pruebas. Conclusiones: La APS España ha tenido un desarrollo desigual del marco conceptual. El sistema de registro de la información sanitaria se insuficiente, y en cualquier caso, aunque pudiese cumplir bien con la orientación biomédica, es insuficiente para la biopsicosocial. La variabilidad de la práctica médica es preocupante. / Aim. To analyse whether the general principles of the comprehensive primary healthcare model proposed in the Declaration of Alma-Ata are complied with in practice by an Equipo de Atención Primaria (Primary Healthcare Team) in the Region of Murcia, Spain, in the treatment of patients presenting with knee problems. Hypotheses. That primary healthcare practice is determined by healthcare professionals and not by the social, political or legislative context developed by the Region of Murcia Health Service; that the quality of healthcare for knee problems is adequate; that scientific evidence is properly implemented; and that diagnostic processes are satisfactory. Materials and methods. After carrying out a historical review of the background and reasons for the development of the model, its concept framework and its development at the global, national and regional levels, we drafted a check list to obtain operational variables. We included qualitative variables that affect every user of the Healthcare Centre and specific quantitative variables for those who visited it for knee problems for the first time in 2012. As qualitative variables, we analysed universality, accessibility and citizen participation in both the health-related decision-making process and in management control. As quantitative variables, we analysed the methodology used, the scientific evidence and the use of appropriate technology. The analysis of qualitative variables was based on direct observation, interviews with key informants and publicly available data found on the Internet. In the quantitative study, we carried out a search using software package OMI-EST. Once we had applied our exclusion criteria related to the quality of each entry, we obtained a sample of 313 episodes of users with knee problems treated in the Primary Healthcare Team’s nine healthcare quota groups. The primary variables are related to methodology and scientific evidence of case history (13 variables), physical examination (10 variables) and the use of diagnostic imaging techniques (3 variables). From those variables, we obtained a number of secondary variables: evaluation of scientific evidence, adequacy of test requests, adequacy of test choice, and accuracy of diagnosis after the care process. The results for these variables were compiled in an Excel spreadsheet. Frequency distribution was analysed using pivot tables. The data were then analysed using software package SPSS. Hypothesis testing for non-normally distributed data was performed using non-parametric tests (Mann-Whitney test and Kruskal-Wallis test). Results. There is broad universality, but it is restricted in certain groups and complex in others. Accessibility has been affected by waiting lists for hospital treatment (159.03 days for an arthroscopy and 164.08 days for a total knee replacement). A lack of citizen participation was found. Some psychosocial data was recorded in 27.3% of episodes. There was some case history in 99.4% of cases (average number of entries 5.59) and a previous physical examination had been carried out in 67.3% of cases (2.3 times on average). Tests were requested in 46.3% of cases, with an adequacy of 45.5%, an appropriate choice 59.7% of the time, and test results recorded in 79.5% of cases. Accuracy of diagnosis throughout the care process has improved in 52.7% of cases. The healthcare quota has been associated with the characteristics of case history recording, physical examination and the use of tests. Conclusions. Primary healthcare in Spain has developed unequally from the concept framework. The healthcare information recording system is insufficient, and in any case, even if it could achieve its biomedical function, it is insufficient for its biopsychosocial function. The variability of medical practice is a cause for concern.

Bibeln är skrivet med ett androcentriskt synsätt. Den är skriven av män, om män och för män. Detta leder till att kvinnorna i biblen är beskrivna utifrån ett manligt perspektiv. I denna uppsats undersöks hur kvinnorna i Lukasevangeliet porträtteras samt hur kvinnobilden som framträder gestaltas i kvinnan som tvättar Jesus fötter i Luk 7:36-50. Detta görs utifrån ett feministiskt synsätt och med en kritiskt granskning av hur detta har uttryckts i tolkningen av perikopen i och med att kvinnan tolkas som prostituerad, trots att detta inte nämns i texten. uppsatsen undersöker frågorna "Hur ser kvinnobilden ut i Lukasevangeliet och hur gestaltas detta i Luk 7:36-50?" samt "Varför har kvinnan i Luk 7:36-50 tolkats som prostituerad?"

La consolidation des sols argileux est un enjeu majeur dans le domaine de la géotechnique pour la conception des ouvrages. Ceci est notamment le cas lorsque les sols argileux peuvent être exposés à des cycles thermiques, comme dans le cas des géostructures géothermiques, dépôts de stockage des déchets nucléaires, stockage de chaleur dans les remblais, etc. Ces changements de température pourraient avoir une incidence sur le comportement de consolidation des sols, tant du point de vue de la consolidation primaire que du fluage. Dans ce contexte, cette étude a examiné l'impact de la température sur le comportement de consolidation et du fluage d’argiles compactées saturées. L’impact de la nature du sol et de son histoire mécanique a été considéré. Une cellule œdométrique à température contrôlée a été utilisée pour effectuer des essais à vitesse de déformation constante (CRS) pour différentes vitesses de déformation (0,002% / min à 0,02% / min) dans une gamme de température comprise entre 5 ° C et 70 ° C. Deux argiles compactées, avec différentes histoires de chargement mécanique, ont été utilisés. Les résultats indiquent que les indices de compression et de gonflement pour les deux matériaux ne sont que légèrement modifiés par une augmentation de la température allant de 5 à 70°C. En revanche, la pression de préconsolidation des deux argiles diminue à mesure que la température augmente, cet effet étant cependant fonction de la nature du sol considéré. Le coefficient de consolidation augmente lorsque la température augmente pour les deux matériaux, ainsi que la conductivité hydraulique. La perméabilité intrinsèque reste stable en fonction de la température. L'indice de fluage augmente lorsque la température augmente pour les deux argiles. En outre, l'histoire des chargementsmodifie l’impact de la température sur le comportement mécanique. Ainsi, les résultats montrent une dilatation thermique pour les sols fortement surconsolidées et une contraction thermique des échantillons faibles et normalement consolidés. Cette étude a ainsi permis de mettre en évidence l’impact relatif d’un certain nombre de paramètres sur l’évolution du comportement des argiles compactées avec la température / Consolidation of clay soils is one of the main challenges in engineering design and construction. Clayey soils could be exposed to thermal cycles in some engineering applications such as geothermal piles, nuclear waste storages, heat storage in embankments, etc. These temperature changes could affect the primary consolidation as well as the creep behaviour of the soils. In this context, this study investigated the impact of temperature on consolidation behaviour and creep behaviour of saturated compacted clays. In addition, the impact of stress history and clay nature on the temperature dependent mechanical and hydraulic behaviours was also considered. Temperature controlled oedometric cells were employed to perform constant rate of strain (CRS) consolidation tests for different strain rates (0.002%/min to 0.02%/min) within a temperature range of 5° C to 70o C. Two different compacted saturated clays with different stress histories were used in these CRS tests (clay A: PI=31%, clay B: PI=23.8%). The results showed that the compression and swelling indices for both materials changed slightly with temperature and strain rate alteration. The preconsolidation pressure of both clays decreased as the temperature increased, but less in the case of clay B, while it decreased as the strain rate decreased for both materials. The hydraulic conductivity increased with temperature while the intrinsic permeability remained unchanged in the investigated range of temperature. The creep index increased as the temperature increased for both clays. In addition, the stress history has an impact on the temperature dependent mechanical and hydraulic behaviour of clay soils. Results showed a thermal dilation for highly overconsolidated soils and a thermal contraction for low and normally consolidated samples. The relative impact of several parameters on the modification of the behaviour of compacted clays with temperature was also assessed.

Background: The question on how to account for goodwill has long been a subject that causes big debates among actors within financial accounting. In 2004, the IASB released a new standard, IFRS 3 – Business Combinations, that changed the accounting for goodwill. The interpretation for goodwill impairments according to IAS 36 has led to findings in studies that show patterns of earnings management and that a possible gap exists between the standard setter’s basic aim of IAS 36 and what actually is done by the practitioners. Purpose: Examine what determines the amount of reported goodwill impairment for firms listed on the Nasdaq OMX Stockholm (OMXS). Method: To fulfil the purpose of the thesis, the authors takes a quantitative research approach by a using a multiple linear regression model. The regression model is based on proxies for economic impairment, earnings management and corporate governance mechanisms from previous literature (Stenheim & Madsen, 2016; AbuGhazaleh, Al-Hares, & Roberts, 2011; Riedl, 2004). The data used for the regression model has been collected from published annual reports of 69 firms listed on the Nasdaq Stockholm OMX (OMXS), between the years 20072016. Conclusion: The findings of the thesis show that the accounting behaviour of “Big Bath” is exercised for firms listed on the Nasdaq Stockholm OMX (OMXS). The proxies for economic impairment have, to some extent, an impact on the amount of reported goodwill impairment, but the majority of the proxies for corporate governance mechanisms does not affect the amount of reported goodwill impairment. These findings might suggest that the standard IAS 36, which regulates the accounting for goodwill, may not entirely fulfil its purpose of creating a more transparent financial reporting.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-04-25T23:51:26Z No. of bitstreams: 1 RenatoFerreiraDeAlmeidaJunior_DISSERT.pdf: 1495100 bytes, checksum: f007a8b773603ddf1cf491e66172e839 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-28T20:17:55Z (GMT) No. of bitstreams: 1 RenatoFerreiraDeAlmeidaJunior_DISSERT.pdf: 1495100 bytes, checksum: f007a8b773603ddf1cf491e66172e839 (MD5) / Made available in DSpace on 2016-04-28T20:17:55Z (GMT). No. of bitstreams: 1 RenatoFerreiraDeAlmeidaJunior_DISSERT.pdf: 1495100 bytes, checksum: f007a8b773603ddf1cf491e66172e839 (MD5) Previous issue date: 2015-03-16 / Os v?rus dengue pertence ? fam?lia Flaviviridae e ao g?nero Flavivirus, sendo composto por 4 sorotipos antigenicamente distintos, s?o considerados os arbov?rus mais importantes no mundo por causar altas taxas de morbidade e mortalidade em regi?es tropicais e subtropicais do planeta, colocando em risco at? 3,6 bilh?es de pessoas em mais de 100 pa?ses. Por ser uma doen?a com amplo espectro cl?nico e por n?o possuir vacina ou tratamento eficaz, o estudo de poss?veis antivirais que visam diminuir a viremia do paciente ? de suma import?ncia, j? que este ? um dos fatores que pode levar a febre hemorr?gica da dengue e a s?ndrome do choque da dengue que s?o as formas grave da doen?a. No presente estudo foi avaliado o potencial antiviral do extrato da folhada planta Caesalpinia echinata contra o v?rus dengue-2 (DENV-2) em cultura de c?lulas C6/36 e Vero e a a??o antiviral da Rifampicina em c?lulas Vero. A escolha da Caesalpinia echinata se deve ao fato de que j? foi observada sua a??o antiinflamat?ria e antimal?rica, al?m de n?o ter sido encontrado nenhum trabalho que tenha avaliado seu potencial de a??o frente a v?rus. A Rifampicina foi escolhida por demonstrado a??o antiviral, principalmente contra os poxvirus, por?m poucos s?os os relatos da utiliza??o deste f?rmaco contra v?rus de RNA. O resultado foi obtido atrav?s da quantifica??o da carga viral pela t?cnica da qRT-PCR em Tempo Real. As c?lulas infectadas por DENV-2 foram submetidas ao tratamento pelo per?odo de 7 dias em diferentes concentra??es do extrato da planta Caesalpinia echinataque variou entre 0,68 a 0,0068mg/mL. N?o foi poss?vel observar neste estudo, evid?ncias de inibi??o significativa da replica??o do v?rus DENV-2 em ambas as culturas celulares. ARifampicina foi utilizada em diferentes condi??es de tratamento, no qual foi avaliado ao longo de 72 horas a carga viral produzida nas c?lulas Vero.Nas condi??es de tratamento p?s-infec??o e no ensaio virucida o f?rmaco apresentou atividade antiviral, reduzindo a taxa de replica??o em 100 vezes em rela??o ao controle. De acordo com os nossos resultados conclui-se que a Rifampicina mostrou-se eficaz no combate a infec??o do DENV-2 em cultura de c?lulas Vero. / The dengue virus belongs to the Flaviviridae family and the Flavivirus genus, consisting of four serotypes antigenically distinct, are considered the most important arbovirus in the world to cause high rates of morbidity and mortality in tropical and subtropical regions of the world, threatening to 3, 6 billion people in over 100 countries. Because it is a disease with a wide clinical spectrum and has no vaccine or effective treatment, the study of possible antiviral drugs aimed at reducing viremia of patients is of paramount importance, since this is one of the factors which can lead to dengue hemorrhagic fever and dengue shock syndrome that are severe forms of the disease. In the present study we evaluated the antiviral potential of the leaf extract of the plant Caesalpinia echinata against dengue-2 virus (DENV-2) in cultured C6/36 and Vero cells and the antiviral action of Rifampicin on Vero cells. The choice of Caesalpinia echinata is due to the fact that has been observed its action anti-inflammatory and antimalarial , and not have been found no study evaluated its antiviral effect. Rifampin was chosen was chosen for demonstrated antiviral action, especially against poxviruses, but few sane reports usage of this drug against RNA viruses. The result was obtained by quantifying the viral load bythe technique of Real-time qRT-PCR. Cells infected with DENV-2 were subjected to treatment for 7 days in different concentrations of plant extract Caesalpinia echinata (0.68 - 0,0068mg / ml). As a result, we could not observe a inhibition significant of virus replication in both cell cultures. The Rifampicin was used for different treatment condition,which were evaluated over 72 hours the amount of viral load produced in Vero cells, In the conditions treatment and the test virucidal theantiviral activity, which is capable of reducing the rate of 100X replication as compared to control. According to our results we can conclude that Rifampicin was effective in action against to infection DENV-2 in Vero cell culture.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-04-25T23:51:26Z No. of bitstreams: 1 TabataLoiseCunhaLima_DISSERT.pdf: 1403767 bytes, checksum: 7424c70f286f04743b45ac7531e6829b (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-28T20:23:59Z (GMT) No. of bitstreams: 1 TabataLoiseCunhaLima_DISSERT.pdf: 1403767 bytes, checksum: 7424c70f286f04743b45ac7531e6829b (MD5) / Made available in DSpace on 2016-04-28T20:23:59Z (GMT). No. of bitstreams: 1 TabataLoiseCunhaLima_DISSERT.pdf: 1403767 bytes, checksum: 7424c70f286f04743b45ac7531e6829b (MD5) Previous issue date: 2015-03-13 / A dengue ? uma doen?a de notifica??o compuls?ria e cerca de 50 a 100 milh?es de casos s?o registrados anualmente. Possui amplo espectro cl?nico e ? transmitida ao homem atrav?s da picada dos mosquitos do g?nero Aedes, tendo como principal vetor a esp?cie Aedes aegypti. O agente etiol?gico da doen?a ? o v?rus dengue (DENV) pertencente ao g?nero Flavivirus, fam?lia Flaviviridae e s?o conhecidos quatro sorotipos antigenicamente distintos (DENV-1, DENV-2, DENV-3 e DENV-4). Atualmente o tratamento da dengue ? apenas de suporte, feito atrav?s de intensa hidrata??o. Ainda n?o existe uma vacina comprovadamente eficaz ou tratamento espec?fico, o estudo de poss?veis antivirais que possam diminuir a viremia no paciente ? de alt?ssima relev?ncia, uma vez que a carga viral ? um dos fatores associado ao aparecimento das formas graves da doen?a (febre hemorr?gica da dengue e s?ndrome do choque da dengue). No presente estudo n?s avaliamos o potencial antiviral de extratos brutos obtidos a partir das folhas das plantas do Nordeste brasileiro Annona muricata (graviola) e Spondias mombin (caj?) contra o DENV-2 em cultura de c?lulas C6/36 e Vero. A avalia??o da a??o dos extratos brutos foi feita por meio da quantifica??o da carga viral atrav?s da PCR em Tempo Real (qRT-PCR) e pela t?cnica de contagem de unidades formadoras de placa (PFU). As concentra??es dos extratos de ambas as plantas utilizadas foram: 0,01, 0,1 e 1mg/mL. As culturas de c?lulas infectadas foram submetidas ao tratamento com os extratos durante os per?odos de 24-168h horas (7 dias). C?lulas Vero tratadas com o extrato da S. mombin n?o apresentaram redu??o na carga viral. Em contrapartida, quando estas c?lulas foram tratadas com o extrato da A. muricata, uma hora ap?s infec??o, observou-se uma redu??o significativa na carga viral nas primeiras horas (24h), quando comparadas com as c?lulas n?o tratadas utilizadas como controle positivo. Ao serem tratadas em intervalos de 24 horas apresentaram uma redu??o na carga viral nos dias subsequentes (at? o s?timo dia). N?o foi observada redu??o na carga viral em c?lulas C6/36 tratadas com ambos os extratos. De acordo com os nossos resultados, o extrato da planta A. muricata possui potencial antiviral promissor contra a infec??o pelo DENV-2 em cultura de c?lulas Vero. / Dengue is a reportable disease and about 50 to 100 million cases are reported annually. It has a wide clinical spectrum and is transmitted to humans through the bite of Aedes mosquitos, the main vector the Aedes aegypti species. The causative agent of disease is dengue virus (DENV) belonging to the genus Flavivirus, family Flaviviridae and are known four antigenically distinct serotypes (DENV-1, DENV-2, DENV-3 and DENV-4). Currently the treatment of dengue is supportive, made by intense hydration. Although there is no proven effective vaccine or specific treatment, the study of potential antiviral drugs that can reduce viremia in patients is very high importance, since the viral load is one of the factors associated with the development of severe forms of the disease (hemorrhagic fever dengue and dengue shock syndrome). In the present study we evaluated the antiviral potential of crude extracts obtained from the leaves of plants in Northeastern Brazil Annona muricata (soursop) and Spondias mombin (caja) against DENV-2 in cultured C6/36 and Vero. The evaluation of the activity of the crude extracts was performed by the quantification of viral load by RT-PCR (qRT-PCR) and counting technique of plaque forming units (PFU). The concentrations of extracts of both plants used were 0.01, 0.1 and 1 mg/mL. The infected cell cultures were subjected to treatment with the extracts during periods of 24-168h hours (7 days). Vero cells treated with the S. mombin extract showed no reduction in viral load. In contrast, when these cells were treated with the extract of A. muricata, one hour after infection, significant reductions in viral load in the first hour was observed (24 h) when compared to untreated cells used as positive control. When they are treated at 24 hour intervals showed a reduction in viral load in subsequent days (until day). There was no reduction in viral load in C6/36 cells treated with both extracts. According to our results, the plant extract has antiviral A. muricata promising potential against infection by DENV-2 in Vero cell culture.

Hip fractures occur frequently in the aged and have a considerable impact on health-related quality of life (HRQOL) of the elderly affected. This study aimed to assess the psychometric properties of the Brazilian version of the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) in elderly with hip fractures and the HRQOL of this population over 4 months following fracture. Forty five elderly (60% female) aged between 62 and 92 years (mean= 74.4; SD=8.81) answered the SF-36. Patient scores at baseline, 1 and 4 months after surgery (ou hospital discharge), were compared to 135 controls (mean age=72.3;SD=6.92), and according to fracture type (femoral neck or trochanteric). Psychometric qualities assessed were: on floor and ceiling effect, item internal consistency, internal consistency reliability, reprodutibility, discriminant validity, item discriminant validity, convergent validity, divergent validity, criterion validity, concurrent validity, construct validity and minimallyl important difference. All psychometric properties assessed were deemed adequate as a whole. Patients scores at baseline were lower (p<0.05) than the controls for vitality, mental health and social aspects domains. Similarly, patients scored lower at 4 months after surgery (p<0.05) than controls, except for the general state of health domain, and also lower at baseline, except for pain, general state of health, social aspects, mental health and vitality domains. No significant difference was observed amongst scores according to type of fracture. Brazilian version of the SF-36 demonstrated good reliability, validity and responsiveness as applied to patients with hip fracture. Independent of type of hip fracture, elderly patients presented significant compromise in their quality of life, at one and four months after hip fracture, both in physical and psychosocial aspects, while experiencing partial recovery only within the fourth month. / As fraturas de quadril ocorrem freqüentemente na população idosa e provocam impacto considerável na qualidade de vida relacionada à saúde (QVRS) dos idosos comprometidos. O estudo teve como objetivo avaliar as propriedades psicométricas da versão brasileira do Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) para idosos com fratura de quadril e a QVRS dessa população por um período de quatro meses após fratura. Quarenta e cinco idosos (60% do sexo feminino) com idade entre 62 a 92 anos (média= 74,4; DP=8,81) responderam o SF-36. Os escores obtidos pelos pacientes foram comparados entre eles nas fases recordatória, de um e quatro meses após a cirurgia reparadora da fratura, com os do grupo controle constituído por 135 idosos (média de idade= 72,3; DP= 6,92), e segundo o tipo de fratura (colo de fêmur e transtrocanteriana). As propriedades psicométricas foram avaliadas por meio dos efeitos piso e teto, consistência interna do item, confiabilidade da consistência interna, reprodutibilidade, validade discriminante do item, validade discriminante, validade convergente, validade divergente, validade concorrente, validade de construto e diferença mínima importante. As propriedades psicométricas avaliadas foram consideradas adequadas como um todo. Os escores do grupo de pacientes na fase recordatória foram menores (p<0,05) que os do grupo controle nos domínios vitalidade, saúde mental e aspectos sociais. As médias dos escores obtidos pelos pacientes na fase de quatro meses foram menores (p<0,05) que as do grupo controle, exceto no domínio estado geral da saúde e em relação à fase recordatória desses pacientes, exceto nos domínios dor, estado geral da saúde, aspectos sociais, saúde mental e vitalidade. Não ocorreram diferenças significativas entre os escores obtidos segundo os tipos de fratura. Os resultados confirmam que a versão brasileira do SF-36 apresenta propriedades psicométricas adequadas para a sua utilização em idosos com fratura de quadril. Independentemente do tipo de fratura de quadril, idosos apresentam prejuízo significativo na sua qualidade de vida um mês e quatro meses após a fratura de quadril, tanto no aspecto físico quanto no psicossocial, com recuperação parcial ao final do quarto mês. / Mestre em Ciências da Saúde

Multiple sclerosis (MS) is a chronic disease which may exert significant effects on the lives of patients. The Kurtzke Expanded Disability Status Scale (EDSS) remains the most widely used outcome measure in MS, despite its limitations. The use of healthrelated quality of life (HRQoL) as outcome measure has been increasing in the last years, with development and utilization of several instruments. One of most utilized is the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36), a generic measure utilized for general population and for many diseases, including MS. The goals of this study are to assess psychometric properties of SF-36 (Brazilian version) in MS patients, and measure HRQoL in MS patients in the city of Uberlândia, state of Minas Gerais, Brazil. HRQoL was measured in 23 MS patients and in 40 subjects of general population (blood donors) in Uberlândia, using the Brazilian version of the SF-36. EDSS score was assigned by neurologic examination at the time of interview. Reliability and validity of SF-36 were assessed. Mean scores of SF-36 domains in general and MS patient groups, general and MS patient subgroup with EDSS < 3.5, and MS patients with EDSS < 3.5 e > 4.0 were compared. Correlations among clinical aspects of disease and SF-36 scores were assessed. The Brazilian version of SF-36 is reliable and valid for use in MS patients. MS patients show lower scores in all SF-36 scales than do the general population, principally in physical function domains (p<0.05). Patients with EDSS scores < 3.5 also show lower scores in all SF-36 scales than control group. The patients with EDSS scores < 3.5 have higher mean scores in physical functioning, bodily pain, general health and energy/vitality domains than do the patients with EDSS scores > 4.0 (p<0.05). There is no correlation among time of disease and time since diagnosis with SF-36 scores. Depressive symptoms and heat intolerance show correlation with SF-36 domains and components. In conclusion, the Brasilian version of SF-36 is valid to measure HRQoL in MS patients. MS patients have a significant negative impact on all HRQoL domains measured by SF-36, including mental and social domains, compared with general population, even in the stages with less disability. Physical SF-36 scales, but not mental and social scales, decrease with EDSS progression. / A esclerose múltipla (EM) é uma doença crônica que pode ter efeitos profundos na vida dos pacientes. O Expanded Disability Status Scale (EDSS) ainda é o instrumento mais utilizado como medida de evolução de incapacidade na EM, mas não é capaz de determinar outros efeitos da doença na qualidade de vida relacionada à saúde (QVRS). Um dos instrumentos mais usados para medir conceitos gerais de saúde é o Medical Outcome Study 36-Item Short-Form Health Survey (SF-36). Sua versão brasileira ainda não foi utilizada em portadores de EM. Este estudo tem como objetivos verificar as propriedades psicométricas da versão brasileira do SF-36 e avaliar a QVRS em portadores de EM da cidade de Uberlândia por meio deste instrumento. O SF-36 foi aplicado em 23 portadores de EM e em 69 doadores de sangue na cidade de Uberlândia. O EDSS foi aplicado no grupo de portadores durante exame neurológico à entrevista. Confiabilidade e validade do SF-36 foram determinadas. Foram comparados os escores médios dos domínios do SF-36 entre os grupos de portadores e controle, entre os portadores com EDSS < 3,5 e os controles, e os portadores com EDSS < 3,5 e > 4,0. Correlações entre aspectos clínicos da doença e escores do SF-36 foram medidas. O SF- 36 se mostrou confiável e válido para a avaliação da QVRS em EM. Os portadores de EM apresentaram escores mais baixos em todos os domínios do SF-36 que a população geral, principalmente nos domínios de função física (p<0,05). Portadores com EDSS < 3,5 também pontuaram menos em todos os domínios que o grupo controle (p<0,05). Pacientes com escores de EDSS &#8804; 3,5 apresentaram maiores escores nos domínios capacidade física, dor, estado geral da saúde e vitalidade que os pacientes com EDSS &#8805; 4,0 (p<0,05). Não houve correlação da duração da doença e do tempo de diagnóstico com os domínios e componentes do SF-36. Sintomas depressivos e intolerância ao calor mostraram correlação com domínios e componentes do SF-36. Concluindo, a versão brasileira do SF-36 é válida para avaliar a QVRS em portadores de EM. A doença provoca um impacto negativo significante em todos os domínios do SF-36, comparados à população geral, mesmo nas fases de menor incapacidade. Escores físicos diminuem com a progressão do EDSS, mas os escores mentais e sociais são baixos nos estágios iniciais, refletindo o impacto psicológico do diagnóstico de EM, e se mantém relativamente estáveis com a progressão da doença. / Mestre em Ciências da Saúde

4 Abstract The prevalence of obesity and its related cardiometabolic complications in children remains high across the world. Obesity is a multifactorial disease caused by interaction between genes and environmental factors. Genome-wide association studies have discovered several single nucleotide polymorphisms associated with obesity. A causal role of infection in the pathogenesis of obesity has also been considered, particularly the role of adenovirus 36 (Adv36). The aim of the Ph.D. thesis was to investigate the associations of obesity susceptibility loci (TMEM18, SH2B1, KCTD15, PCSK1, BDNF, SEC16B, MC4R, FTO) and Adv36 infection with obesity-related characteristics and complications in the Czech adolescent population. The results are described in eight publications, of which six are original papers and two are reviews. Studies were performed on a cohort of Czech adolescents recruited either from the general population (1,533 individuals from the epidemiological study) and from in-patient or outpatient weight management clinics (562 overweight/obese individuals underwent an intervention). The results demonstrated an association of TMEM18, SEC16B and FTO gene variants with obesity. Some variants of the genes involved in hypothalamic regulation of energy homeostasis − MC4R, BDNF, PCSK1 − were related to...

This diploma thesis deals with the reporting of non-current tangible assets in accordance with International Financial Reporting Standards and according to Czech accounting regulations. In the part devoted to IFRS is a detailed description of the approach the reporting of non-current tangible assets according to the standards: IAS 16, IAS 41, IFRS 5 and IAS 36. In the section devoted to Czech accounting regulations is the most valuable part comparison of the reporting in accordance Czech regulation and the reporting of non-current tangible assets in IFRS. The last part of this diploma thesis is the practical part, which deals with the analysis of selected company financial statements.