Objective: To evaluate the association between shift work and blood pressure, pre-hypertension and hypertension in nursing personnel of a large general hospital. Methods: In a cross-sectional survey, 493 nurses, nurse technicians and assistants, were selected at random in a large general hospital. Hypertension was diagnosed by the mean of four automatic blood pressure readings>= 140/90 mmHg or use of blood pressure lowering agents, and pre-hypertension by systolic blood pressure>= 120-139 or diastolic blood pressure>= 80-89 mmHg. Risk factors for hypertension were evaluated by a standardized questionnaire and anthropometric measurements. The association between turns of work, defined as day or night, and by the combination of turns, and blood pressure, pre-hypertension and hypertension was explored in bivariate and multivariate analyses, controlling for risk factors for hypertension by covariance analysis and modified regression Poisson. Results: The mean age of the participants was 34.3 ± 9.4 years and 88.2% were women. Night shift workers were older, more frequently married or divorced, and less educated. The prevalence of hypertension in the whole sample was 16%, and 28% had pre-hypertension. Blood pressure (after adjustment for confounding) was not different in day and night shift workers. The prevalence of hypertension and pre-hypertension by shift work (day/night and combination of turns) was not different in the bivariate analysis and after adjustment for confounding (all risk ratios = 1.0). Conclusion: Night shift work is not associated with blood pressure, hypertension and pre-hypertension in nurses and nurses assistants working in a large general hospital.

The purpose of this study is to examine how employees in Swedish elderly care, more specific night patrols, describe their care work based on the national value base. A qualitative ap-proach has been used as a method in this study, with semi-structured interviews as a base. To gather empirical material, seven people who are assistant nurses and care assistants, working in Swedish elderly care as night patrols, were interviewed. The theoretical point of departure has been professional ethics, proximity ethics, Martin Buber´s I-and-Thou-theory. The theo-ry has been helpful whilst analysing the empirical material. The national value-based work describes how caregivers perceive when a I-Thou-relationship is achieved. In such relation-ship the caregiver and the elderly are in a subject-subject-relationship. In a opposite relation-ship the caregiver and the elderly are in a subject-object-relationship with a distance between them. In such relationship the caregivers don´t feel they have done a value based work. The results shows that a certain objectification must be done in order for the working process to function. This is also accepted by the employees, as long as there is still a certain balance be-tween the subject-subject relationship and the subject-object relationship. The results also shows that the experience of creating meaningfulness for the elderly seems to be weaker than the creation of security.

Made available in DSpace on 2015-05-07T15:08:32Z (GMT). No. of bitstreams: 1 arquivototal.PDF: 3311790 bytes, checksum: 923aa1a0607808ab7c911d639ef6f5f7 (MD5) Previous issue date: 2010-11-30 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This work focuses on one kind of education was greatly expanded with the creation of school groups and it was extremely important for the consolidation of the republican regime between the years 1916 to 1931: the night courses. In a period when the vote was of paramount importance to establish citizenship, the necessity of educating the majority of the population has become necessary to consolidate and maintain the new political regime in the country. Thus, the night teaching came to meet the requirements imposed so that the Republic. We seek to identify any issues relating to its organization as well as some practice surrounding the daily lives of this teaching approach as in the aforementioned period we found an increasing spread of education for adults and children working. This kind of school activity which gave priority to the teaching of first letters allowed a greater diffusion of the new republican ideals of citizenship and civility, those aspects that supported a possible form of popular education. The analysis developed here, on the history of this teaching, focuses on educational realities in its complexity, from the critical building on the analytical categories developed and used in the field of history of education such as literacy, citizenship Republican and civility. For that we refer to the ideas advocated by Certeau (1996), Viñao Frago (2000) and Souza (1998) regarding both the importance of cultural activities undertaken by the subjects, and by the inner workings of the school. We conduct the collection of primary and secondary sources that were so important to the development of the theme. Among them are The Union Journal, official documents, messages from the presidents of some textbooks state that quite possibly were used in night courses. We also analyze the reforms that normalized the education school at the time, and especially those that were aimed at teaching mode at night. For this, visited the Public Archives of the State of Paraíba, the Cultural Foundation - FUNESC, and some files of school groups that hosted evening schools. We know that we will not achieve the understanding of reality in an entire historical period, but we seek to understand the educational landscape here in force and more specifically the night courses as well as with society Paraiba in the study period. / O presente trabalho tem como objeto uma das modalidades de ensino que muito se expandiu com a criação dos grupos escolares e que foi de extrema importância para a consolidação do regime republicano entre os anos de 1916 a 1931: o ensino noturno. Em um período em que o voto era de fundamental importância para se estabelecer a cidadania, a necessidade de alfabetizar a grande massa da população se tornou necessária para se consolidar e manter o novo regime político do país. Desta forma, o ensino noturno veio a atender as exigências que a República assim impunha. Procuramos aqui identificar algumas questões relativas à sua organização, bem como algumas práticas que circundavam o cotidiano dessa modalidade de ensino visto que no período acima mencionado verificamos uma crescente disseminação deste ensino destinado aos adultos e à infância trabalhadora. Esse tipo de atividade escolar que priorizava o ensino de primeiras letras possibilitou uma maior difusão dos novos ideais de cidadania republicana bem como de civilidade, aspectos estes que fundamentaram uma possível forma de educação popular. A análise que aqui desenvolvemos, sobre a história dessa modalidade de ensino, busca compreender as realidades educativas na sua complexidade, a partir do olhar crítico tomando como base as categorias analíticas desenvolvidas e utilizadas no campo da história da educação, tais como: alfabetização, cidadania republicana e civilidade. Para tanto nos reportamos às ideias propugnadas por Certeau (1996), Viñao Frago (2000) e SOUZA (1998) no que concerne tanto a importância das ações culturais empreendidas pelos os sujeitos, quanto pelo o funcionamento interno da escola. Realizamos coleta de fontes primárias e secundárias que tão importantes foram para o desenvolvimento do tema. Entre elas estão o Jornal A União, documentos oficiais, mensagens dos presidentes de estado alguns livros didáticos que muito possivelmente foram utilizados no ensino noturno. Analisamos ainda as reformas que normatizaram a educação escolar da época, e especialmente, aquelas que foram destinadas a modalidade do ensino noturno. Para isto, foi visitado o Arquivo Público do Estado da Paraíba, da Fundação Espaço Cultural - FUNESC, além de alguns arquivos de grupos escolares que abrigaram escolas noturnas. Bem sabemos que não alcançaremos a apreensão do real na totalidade de um período histórico, mas buscamos aqui compreender o cenário educacional vigente e mais particularmente o ensino noturno, bem como com a sociedade paraibana no período em estudo.

Este trabalho tem por objetivo o estudo e o desenvolvimento de uma solução de engenharia para o mapeamento e caracterização da oclusão dentária, não somente no âmbito de sua distribuição ao longo da arcada, mas também através da mensuração da intensidade de pressão nos pontos de contato oclusal interarco. Neste sentido, empregaram-se esforços no aprofundamento do conhecimento neste campo da Odontologia, assim como, na elaboração de um sistema experimental que, utilizando sensores de pressão/força resistivos (FSR) específicos para uso odontológico, viabilizou a análise do estado da oclusão, atuando como agente facilitador no diagnóstico de desequilíbrios oclusais. Inicialmente, são apresentados e esclarecidos os principais conceitos da esfera odontológica, os quais são tomados como base para todos os projetos deste trabalho, além da abordagem referente às formas de contato entre os dentes, aos diferentes tipos de oclusão e seus problemas. Em relação ao desenvolvimento do sistema, foram projetadas duas placas de circuito impresso para interface com os sensores e elaborados o firmware de acesso ao hardware, assim como o software de gerenciamento global do sistema. Todos os blocos do circuito de condicionamento foram avaliados e as suas funcionalidades validadas. Do mesmo modo, a caracterização da resposta dos sensores e a sua homogeneidade ao longo da extensão sensível foram analisadas, demonstrando que a resistência elétrica varia de forma análoga em todas as áreas do sensor. Através de ensaios realizados com sujeito envolvido no projeto, estabeleceu-se um comparativo entre a utilização do papel carbono e o sistema desenvolvido, mostrando as vantagens na utilização do segundo, principalmente atreladas à capacidade de avaliação da intensidade dos contatos oclusais. Por fim, ainda se valendo do uso paralelo do papel carbono, foram efetuados ensaios de análise da oclusão em sujeito envolvido no projeto utilizando placa miorrelaxante, possibilitando a utilização da capacidade do sistema desenvolvido para executar ajustes precisos na placa, com a finalidade de manter o balanço de pressões oclusais entre ambos os lados da arcada. / This essay has as objective the study and development of an engineer solution for the dental occlusion mapping and characterization, not only related to the interarch occlusal contact distribution, but also through the pressure magnitude measuring in each. In this sense, was employed effort in the Odontological knowledge increasing and also in the system elaboration allowing the occlusion state evaluation and acting as an easier agent in the occlusion disturbs diagnosing using a specific pressure/force sensing resistor (FSR) for dental use. Initially the main concepts of the Odontological sphere are presented, clarified and took as a base for all the projects in this essay. Besides this, different teeth contacts shapes are shown, as well as the occlusion’s types and its problems. In the system development, two printed circuit boards were designed for sensor interfacing. The hardware access through the firmware was elaborated, even as the global system managing software. All the conditioning circuit blocks and functionalities were evaluated and validated. In the same way, the sensor’s output and its homogeneity through all the sensible extension were evaluated, showing that the sensor’s electric resistance changes in the same form in all the sensor’s areas. In addition, it was showed the advantages of the developed system over the articulation paper through trials with a subject that is part of the project, showing the capacity of the system in the occlusion contacts magnitude evaluation. Ultimately, also in an articulation paper versus the developed system comparison, it was made occlusion analysis trials with subject using a night guard for teeth grinding (bruxism), showing the system capacity of precisely adjust the night guards for pressure balance between the both arch sides.

Introdução: Os seres vivos sincronizam suas atividades com os ciclos ambientais influenciados por fatores externos como as condições de luz, horários de alimentação, interações sociais e por fatores endógenos como os genéticos, níveis hormonais e apetite, entre outros. Sensores percebem a variação temporal informando o estado de iluminação ambiental através da rede neural ou sistema endócrino mediado pelos relógios circadianos. Os genes do relógio pertencem a quatro famílias: CLOCK, BMAL1, Cryptochromes e Period onde a formação, expressão e supressão da transcrição destes e de seus heterodímeros resultam na ritmicidade de 24h. O relógio circadiano modula o metabolismo de energia através do controle da atividade de diversas enzimas, dos sistemas de transporte e de receptores nucleares envolvidos no metabolismo dos nutrientes. Alterações nos horários de alimentação podem modificar a relação entre o relógio central e or relógios periféricos podendo causar mudanças no metabolismo e afetar o sistema circadiano. Em algumas desordens alimentares como a Síndrome do Comer Noturno (SCN), reconhecida como um atraso de fase da alimentação, o ritmo de alimentação está alterado. Assim sendo, a SCN pode ser um fator que influencia na obesidade, modificando padrões do sono, padrão alimentar, apetite e regulação neuroendócrina. Objetivos: Estudar os aspectos cronobiológicos na SCN. Métodos: Características, como aspectos emocionais, cronotipo e qualidade do sono foram avaliadas por meio de questionários. Variáveis de ritmicidade da atividade e exposição à luz foram avaliadas por actigrafia e a expressão dos genes do relógio CLOCK, BMAL1, Cry 1 e Per 2 foi medida em leucócitos. Resultados: 28 pacientes (14 com SCN - 10 mulheres e 14 controles - 9 mulheres) participaram deste estudo. A média de idade foi de 40,71 ± 12,37 anos e IMC foi de 26,8 ± 5,7kg/m². Não foi encontrada nenhuma evidência cronobiológica nas análises realizadas relacionada à SCN. Conclusão: Nossos resultados não corroboram a hipótese de que o the time system pode ser ligado à fisiopatologia da SCN, pois a associação de sintomas que definem a SCN como uma síndrome. Os tempos e a qualidade da alimentação devem ser mais profundamente estudados para esclarecer a relação entre a alimentação e o fato de que se os seres humanos alocam a sua principal alimentação no turno da noite pode trazer consequências ao metabolismo e refletir mudanças no comportamento e contribuir no controle da obesidade. Este é o primeiro estudo em humanos para relacionar os genes do relógio e a SCN. / Introduction: Living beings synchronize their activities with environmental cycles influenced by external factors such as light conditions, feeding schedules, social interactions and endogenous factors such as genetics, hormone levels and appetite, among others. Sensors perceive the temporal variation informing the state of ambient lighting through the neural network or endocrine mediated by circadian clocks. The clock genes belong to four families: CLOCK, BMAL1, Cryptochromes and Period where the formation, expression and suppression of these transcriptions and their heterodimers result in 24h rhythmicity. The circadian clock modulates energy metabolism by controlling the activity of several enzymes, transport systems and nuclear receptors involved in the metabolism of nutrients. Changes in feeding schedules may modify the relationship between the central clock and peripheral clocks and cause changes in metabolism and affect the circadian system. Some eating disorders, such as Night Eating Syndrome (NES) recognized as a phase delay in the feed, the feed rthythmicity coul be changed. Thus, NES may be a factor that influences in obesity, changing sleep and eating patterns, appetite and neuroendocrine regulation. Objectives: Cross-sectional study to examine the chronobiological aspects of NES. Methods: Features such as emotional aspects, chronotype and sleep quality were assessed by questionnaires. Variables rhythmicity of activity and light exposure were assessed by actigraphy and expression of clock genes CLOCK, BMAL1, Cry 1 and Per 2 was measured in leukocytes. Results: 28 patients (14 with SCN - 10 women and 14 controls - 9 women) participated in this study. The age average was 40.71 ± 12.37y and BMI was 26.8 ± 5.7kg/m². We found no evidence in chronobiological analyzes related to SCN. Conclusion: Our results do not support the hypothesis that the time system can be conected to the pathophysiology of NES, because the association of symptoms that define the NES as a syndrome mainly by the characteristic temporal power that is possibly involved with the time system. The timing and quality of food should be further studied to clarify the relationship between food and the fact that humans allocate their main food in the night shift may have consequences for metabolism and reflect changes in behavior and contribute to the control of obesity. This is the first study in humans to relate the clock genes and NES.

The purpose of this thesis was to determine which perceptual cues drivers use to identify pedestrians that may constitute a risk in traffic. Methods chosen were recordings of pedestrian behaviour in Linköping by means of a stationary video camera as well as video camera mounted in a car. Interviews on the recordings from the mobile camera were conducted with taxi drivers and driving instructors. Results include that drivers not only react to pedestrians they believe will behave in a dangerous way, but also react to pedestrians that probably not will behave in such a way, but where the possibility still exists. The study concluded that it was not possible to determine how risky a pedestrian is considered to be by only using behavioural factors such as trajectory or position on the sidewalk, and distance. It is necessary also to include environmental factors, mainly where the pedestrian and car are positioned in relation to the side of the road, so that the behaviour of the pedestrian can be interpreted.

The purpose of the project, which led to this thesis, was to investigate the possible effects different horizontal Fields of View (FoV) have on driving performance when driving at night with a Vision Enhancement System (VES). The FoV chosen to be examined were 12 degree and 24 degree FoV, both displayed on a screen with the horizontal size of 12 degree FoV. This meant that the different conditions of FoV also had different display ratios 1:1 and 1:2. No effort was made to separate these parameters. A simulator study was performed at the simulator at IKP, Linköping University. Sixteen participants in a within-group design participated in the study. The participants drove two road sections; one with a 12 degree FoV and the other with a 24 degree FoV. During each section four scenarios were presented in which the participants passed one of three types of objects; a moose, a deer or a man. In each section, two of the objects stood right next to the road and two were standing seventeen meters to the right of the road. As the drivers approached the objects standing seventeen meters to the right of the road, the objects moved out of the VES when the vehicle was 200 meters in front of the object with a 12 degree FoV. The objects could be seen with the naked eye when the vehicle was 100 meters in front of the object. When the drivers approached the objects with a 24degree FoV the objects moved out of the VES display when it was possible to see them unaided. Results show that a 24 degree FoV displayed with a 1:2 ratio gives the drivers improved anticipatory control, compared to a 12 degree FoV displayed with a 1:1 ratio. The participants with a broader FoV were able to make informed decisions whereas with a narrow FoV some participants started to reaccelerate when they could not see an object. Results also show that any difference in recognition distance that may exist between a 12 degree and a 24 degree camera angle displayed in a 12 degree FoV display do not seem to have any adverse effect on the quality of driving.

At night, the visibility is reduced and the demands on the driver increase. A safety system that enables the driver to discover warmer objects in the surroundings when the visibility are reduced, such as the Vision Enhancement System (VES) contributes to safer night-time driving. Since the benefits of this system are established, it is of interest to investigate different design aspects. The VES display has in earlier studies been positioned in front of the driver but different display positions such as peripheral placement should be evaluated. The present simulator study is an investigation of the effects of different display positions inside the car. Two different display positions were investigated, in front of the driver and to the right of the driver. When driving with a display positioned to the right, the driver will have to divide his attention between the road scene and the display by turning his head or he might be able to use peripheral vision. It was hypothesised that there would be significant differences in driving performance between the two display positions in favour of the display position above the steering wheel. The results were measured in driving performance as well as opinions from the participants. Results show that there were some significant differences and several tendencies of better driving performance when driving with the display in front of the driver. The participants also rated this display as being better positioned and effecting the driving in a more positive way than the display to the right. It was therefore concluded that that the most preferred display position is in front of the driver.

Objective: To evaluate the association between shift work and blood pressure, pre-hypertension and hypertension in nursing personnel of a large general hospital. Methods: In a cross-sectional survey, 493 nurses, nurse technicians and assistants, were selected at random in a large general hospital. Hypertension was diagnosed by the mean of four automatic blood pressure readings>= 140/90 mmHg or use of blood pressure lowering agents, and pre-hypertension by systolic blood pressure>= 120-139 or diastolic blood pressure>= 80-89 mmHg. Risk factors for hypertension were evaluated by a standardized questionnaire and anthropometric measurements. The association between turns of work, defined as day or night, and by the combination of turns, and blood pressure, pre-hypertension and hypertension was explored in bivariate and multivariate analyses, controlling for risk factors for hypertension by covariance analysis and modified regression Poisson. Results: The mean age of the participants was 34.3 ± 9.4 years and 88.2% were women. Night shift workers were older, more frequently married or divorced, and less educated. The prevalence of hypertension in the whole sample was 16%, and 28% had pre-hypertension. Blood pressure (after adjustment for confounding) was not different in day and night shift workers. The prevalence of hypertension and pre-hypertension by shift work (day/night and combination of turns) was not different in the bivariate analysis and after adjustment for confounding (all risk ratios = 1.0). Conclusion: Night shift work is not associated with blood pressure, hypertension and pre-hypertension in nurses and nurses assistants working in a large general hospital.

Introdução: Os seres vivos sincronizam suas atividades com os ciclos ambientais influenciados por fatores externos como as condições de luz, horários de alimentação, interações sociais e por fatores endógenos como os genéticos, níveis hormonais e apetite, entre outros. Sensores percebem a variação temporal informando o estado de iluminação ambiental através da rede neural ou sistema endócrino mediado pelos relógios circadianos. Os genes do relógio pertencem a quatro famílias: CLOCK, BMAL1, Cryptochromes e Period onde a formação, expressão e supressão da transcrição destes e de seus heterodímeros resultam na ritmicidade de 24h. O relógio circadiano modula o metabolismo de energia através do controle da atividade de diversas enzimas, dos sistemas de transporte e de receptores nucleares envolvidos no metabolismo dos nutrientes. Alterações nos horários de alimentação podem modificar a relação entre o relógio central e or relógios periféricos podendo causar mudanças no metabolismo e afetar o sistema circadiano. Em algumas desordens alimentares como a Síndrome do Comer Noturno (SCN), reconhecida como um atraso de fase da alimentação, o ritmo de alimentação está alterado. Assim sendo, a SCN pode ser um fator que influencia na obesidade, modificando padrões do sono, padrão alimentar, apetite e regulação neuroendócrina. Objetivos: Estudar os aspectos cronobiológicos na SCN. Métodos: Características, como aspectos emocionais, cronotipo e qualidade do sono foram avaliadas por meio de questionários. Variáveis de ritmicidade da atividade e exposição à luz foram avaliadas por actigrafia e a expressão dos genes do relógio CLOCK, BMAL1, Cry 1 e Per 2 foi medida em leucócitos. Resultados: 28 pacientes (14 com SCN - 10 mulheres e 14 controles - 9 mulheres) participaram deste estudo. A média de idade foi de 40,71 ± 12,37 anos e IMC foi de 26,8 ± 5,7kg/m². Não foi encontrada nenhuma evidência cronobiológica nas análises realizadas relacionada à SCN. Conclusão: Nossos resultados não corroboram a hipótese de que o the time system pode ser ligado à fisiopatologia da SCN, pois a associação de sintomas que definem a SCN como uma síndrome. Os tempos e a qualidade da alimentação devem ser mais profundamente estudados para esclarecer a relação entre a alimentação e o fato de que se os seres humanos alocam a sua principal alimentação no turno da noite pode trazer consequências ao metabolismo e refletir mudanças no comportamento e contribuir no controle da obesidade. Este é o primeiro estudo em humanos para relacionar os genes do relógio e a SCN. / Introduction: Living beings synchronize their activities with environmental cycles influenced by external factors such as light conditions, feeding schedules, social interactions and endogenous factors such as genetics, hormone levels and appetite, among others. Sensors perceive the temporal variation informing the state of ambient lighting through the neural network or endocrine mediated by circadian clocks. The clock genes belong to four families: CLOCK, BMAL1, Cryptochromes and Period where the formation, expression and suppression of these transcriptions and their heterodimers result in 24h rhythmicity. The circadian clock modulates energy metabolism by controlling the activity of several enzymes, transport systems and nuclear receptors involved in the metabolism of nutrients. Changes in feeding schedules may modify the relationship between the central clock and peripheral clocks and cause changes in metabolism and affect the circadian system. Some eating disorders, such as Night Eating Syndrome (NES) recognized as a phase delay in the feed, the feed rthythmicity coul be changed. Thus, NES may be a factor that influences in obesity, changing sleep and eating patterns, appetite and neuroendocrine regulation. Objectives: Cross-sectional study to examine the chronobiological aspects of NES. Methods: Features such as emotional aspects, chronotype and sleep quality were assessed by questionnaires. Variables rhythmicity of activity and light exposure were assessed by actigraphy and expression of clock genes CLOCK, BMAL1, Cry 1 and Per 2 was measured in leukocytes. Results: 28 patients (14 with SCN - 10 women and 14 controls - 9 women) participated in this study. The age average was 40.71 ± 12.37y and BMI was 26.8 ± 5.7kg/m². We found no evidence in chronobiological analyzes related to SCN. Conclusion: Our results do not support the hypothesis that the time system can be conected to the pathophysiology of NES, because the association of symptoms that define the NES as a syndrome mainly by the characteristic temporal power that is possibly involved with the time system. The timing and quality of food should be further studied to clarify the relationship between food and the fact that humans allocate their main food in the night shift may have consequences for metabolism and reflect changes in behavior and contribute to the control of obesity. This is the first study in humans to relate the clock genes and NES.