O aumento da proporção de idosos na população e a alta prevalência de condições crônicas torna oportuno o estudo dos aspectos epidemiológicos e sanitários relacionados à saúde bucal dessa população a fim de preservar sua capacidade funcional. Para esse propósito, foram utilizadas publicações da literatura científica e dados do Estudo SABE Saúde Bem-Estar e Envelhecimento, uma ampla pesquisa longitudinal de base populacional, que teve início em 2000 e realizou dois campos em 2006 e 2010 acrescentando em cada um, uma nova coorte de idosos de 60 a 64 anos. O trabalho, estruturado em três seções, deu origem a três manuscritos apresentados na Parte II. O primeiro manuscrito mostrou que idosos com renda insuficiente, que utilizavam somente o Sistema Único de Saúde (SUS), fumantes e que apresentaram 14 ou mais dentes tinham mais chance de necessitar de cuidado odontológico. No segundo manuscrito, concluiu-se que os idosos com maior probabilidade de perda dentária eram homens; utilizavam duas próteses removíveis; avaliavam sua saúde bucal como regular ou ruim/muito ruim; e moravam sozinhos, independentemente da idade e do hábito de fumar. No terceiro manuscrito concluiu-se com base em uma revisão sistemática, que o diabetes mellitus Tipo 2 não controlado está associado à doença periodontal, falha de implantes dentários, maior prevalência de abscessos periapicais, xerostomia, síndrome da ardência bucal, candidíase e prognóstico ruim para carcinoma primário de gengiva. As evidências reunidas reforçaram a tese de que a auto avaliação da saúde bucal, as condições clínicas e os aspectos sociodemográficos, comportamentais, e de acesso a serviços de saúde bucal, estão relacionados com a necessidade de cuidado odontológico e o risco de perda dentária entre idosos dentados. Além disso, o Diabetes Mellitus Tipo 2 quando não controlado, contribui para a deterioração da saúde bucal. Assim, as condições desfavoráveis em que a população brasileira está envelhecendo do ponto de vista socioeconômico, com a permanência de hábitos nocivos à saúde, necessidade de maior acesso aos serviços de saúde bucal, e alta carga de condições crônicas levam a fragilização do estado de saúde dificultando a manutenção da capacidade funcional. O aumento da proporção de idosos na população exigirá abordagens em saúde bucal que levem em conta as especificidades do envelhecimento na perspectiva das multimorbidades. O manejo e o cuidado em saúde dessas pessoas deveria ser transdisciplinar, tendo em vista que em se tratando das pessoas idosas, vários campos disciplinares deveriam ser ativados e a equipe de saúde bucal deveria estar preparada para transitar por esses espaços de maneira a contribuir com seus conhecimentos para a produção de ações que evitem a perda da capacidade funcional e levem em conta os fatores de risco comuns para doenças crônicas, incluindo as doenças bucais. Com isso, impacto positivo na saúde dessa população poderia ser obtido, com menor custo e maior eficiência e efetividade quando comparado ao modelo de atenção às condições agudas e/ou a doenças específicas. / The increasing proportion of elderly in the population and the high prevalence of chronic diseases are desirable to study the epidemiological and health aspects related to oral health of this population in order to preserve their functional capacity. For this purpose, publications were used in the scientific literature and data from the study SABE - Health Wellness and Aging, a large longitudinal population based survey, which began in 2000 and held two fields in 2006 and 2010 adding in each one new cohort aged 60 to 64 years. The work is structured in three sections, has produced three manuscripts presented in Part II. The first manuscript showed that elderly people with insufficient income, which only used the Unified Health System (SUS), and smokers who had 14 or more teeth were more likely to need dental care. In the second manuscript, it was found that individuals with a higher probability of tooth loss were men; used two removable prostheses; assessed their oral health as fair or poor / very poor; and lived alone, regardless of age and smoking. In the third manuscript was concluded based on a systematic review, the diabetes mellitus uncontrolled type 2 is associated with periodontal disease, failure of dental implants, higher prevalence of periapical abscesses, dry mouth, burning mouth syndrome, candidiasis and poor prognosis for primary carcinoma of the gingiva. The evidence gathered reinforced the view that the self-assessment of oral health, clinical conditions and sociodemographic, behavioral, and access to oral health services are related to the need for dental care and the risk of tooth loss among dentate . In addition, Type 2 diabetes mellitus when not controlled, contributes to the deterioration of oral health. Thus, the unfavorable conditions in which the Brazilian population is aging the socioeconomic point of view, with the permanence of harmful health habits, need for greater access to oral health services, and high burden of non-communicable chronic diseases lead to weakening of state health hindering the maintenance of functional capacity. The increasing proportion of elderly in the population will require approaches in oral health that take into account the specificities of aging from the perspective of multimorbidities. The management and the health care of these people should be interdisciplinary, considering that in the case of older people, several disciplinary fields should be activated and the oral health team should be prepared to move through these spaces in order to contribute their knowledge for the production of actions to prevent loss of functional capacity and take into account the common risk factors for chronic diseases, including oral diseases. Thus, positive impact on the health of this population could be obtained at a lower cost and greater efficiency and effectiveness when compared to the model of care to acute and / or specific disease conditions.

O Brasil tem experimentado transformações na composição etária e no perfil epidemiológico da população, com alterações relevantes no quadro de morbi-mortalidade. Diante deste contexto, aumenta o interesse dos estudiosos sobre as conseqüências sociais e econômicas das doenças crônicas não transmissíveis e a busca por novos métodos para analisar o perfil dessas doenças e formas de alocar, com eficiência, os recursos em saúde visando à promoção da saúde da população. Os objetivos deste estudo, de delineamento metodológico, foram traduzir, adaptar culturalmente para o Brasil o instrumento Health and Work Performance Questionnaire (HPQ) e avaliar as propriedades psicométricas da versão brasileira em enfermeiros. O HPQ é um instrumento adotado pela Organização Mundial da Saúde que permite a coleta de informações sobre condições crônicas de saúde e avaliar o impacto destas condições no desempenho do trabalho, pela análise do absenteísmo, presenteísmo e a ocorrência de acidentes de trabalho. O processo de adaptação seguiu o Protocolo de Tradução da Organização Mundial da Saúde. Os dados para a avaliação das propriedades psicométricas foram coletados no período de julho a agosto de 2011, em um hospital público e de ensino do interior do Estado de São Paulo, por meio da aplicação da versão adaptada do HPQ, denominada \"Questionário Saúde e Desempenho no Trabalho\" (HPQ Brasil), em 100 enfermeiros.. As propriedades psicométricas analisadas foram: a validade de face e conteúdo (grupo de especialistas), a confiabilidade pelo Alfa de Cronbach e a estabilidade por teste-reteste. O nível de significância adotado foi de 0,05. Os resultados demonstraram que a amostra estudada foi composta por enfermeiros que possuíam as seguintes características; 89% sujeitos do sexo feminino, com média de idade de 33,9 anos, 51% solteiros e 67% com formação de pós graduação. Na avaliação das propriedades psicométricas, a consistência interna da versão adaptada do HPQ, alfa de cronbach foi de 0,94 para a seção A e 0,86 para a seção B do instrumento. Na análise das concordâncias da estabilidade teste-reteste, as concordâncias foram positivas e estastisticamente significantes. Desta forma, a versão adaptada do HPQ mostrou-se valida e confiável na amostra estudada. O HPQ - Brasil poderá ser usado para acompanhar a prevalência de problemas de saúde entre trabalhadores, as taxas de tratamento destes problemas e os seus efeitos no desempenho no trabalho, além de oferecer as instituições de saúde informações fundamentais para o planejamento de programas de melhoria da saúde e da produtividade dos trabalhadores e de redução dos custos com as Doenças Crônicas Não-Trasmissíveis aspectos que denotam a relevância do estudo ora apresentado. / Brazil has undergone a process of transition with changes in age composition and epidemiological profile of its population which has caused a significant impact on morbidity and mortality. In light of that there is a growing interest among experts in social and economic consequences of chronic noncommunicable diseases (NCDs) and new approaches to assess the profile of these diseases and to effectively allocate resources for health promotion. This study aimed to translate into Brazilian Portuguese and culturally adapt the World Health Organization (WHO) Health and Work Performance Questionnaire (HPQ) and evaluate its psychometric properties among Brazilian nurses. The HPQ was developed by the WHO and can measure the impact of chronic illnesses on work performance through the analysis of absenteeism, presenteeism and work-related injuries. The adaptation process followed the WHO Translation Protocol. The psychometric properties of the Brazilian version of the questionnaire (Health and Work Performance Questionnaire, HPQ-Brazil) were evaluated in a sample of 100 nurses from a public teaching hospital in the state of São Paulo, southeastern Brazil, between July and August 2011. The psychometric properties analyzed included face validity and content validity (expert group), reliability by Cronbach\'s alpha, and test-retest stability. A 5% level of significance was set. The study sample comprised nurses with the following characteristics: 89% were female, mean age 33.9 years; 51% were single and 67% had graduate training. The internal consistency of the adapted version of HPQ using Cronbach\'s alpha was 0.94 for the instrument\'s section A and 0.86 for section B. There were statistically significant positive concordances in the analysis of test-retest stability. Thus, the adapted version of the HPQ proved valid and reliable in the sample studied. The HPQ-Brazil can be used to assess the prevalence of health conditions and treatment rates and their impact on work performance among workers. In addition it can provide input for planning strategies to improve worker\'s health and productivity and reduce NCD-related costs.

Orientador: Sílvia Justina Papini / Resumo: Introdução: A esquizofrenia é uma doença crônica e o tratamento acontece com utilização de fármacos antipsicóticos de modo prolongado. As medicações controlam os sintomas da doença, melhoram o bem-estar do indivíduo e elevam a chance de adaptação ao meio social, em contrapartida, acarretam vários efeitos adversos, sendo a alteração dos componentes da síndrome metabólica a mais comum. Objetivo: Avaliar o efeito da suplementação de farelo de aveia sobre o peso corporal, circunferência abdominal e componentes da síndrome metabólica de pacientes psicóticos institucionalizados em um hospital psiquiátrico. Método: Trata-se de um estudo quantitativo com intervenção em indivíduos psicóticos crônicos. A partir da medida de peso e estatura calculou-se o índice de massa corporal (IMC) para classificação do estado nutricional nos 4 momentos do estudo, início, 90 e180 dias de suplementação e 180 dias após o término da suplementação. Foram avaliados os componentes da síndrome metabólica: circunferência abdominal, glicemia de jejum, HDL-colesterol, triglicerídeos, antes e ao final da suplementação e após 180 dias sem suplementação. Resultados: Foram estudados todos os 45 moradores do local, destes, 62% eram do sexo masculino, com a média de idade de 55,5± 13,2 anos, todos há mais de cinco anos internados. Na sua totalidade faziam uso de medicação antipsicótica, 75% deles apresentaram risco cardiovascular, 46,7% eram obesos, 33,3% apresentaram colesterol total elevado, 50% hipertrigliceridem... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Schizophrenia is a chronic disease and treatment occurs with prolonged use of antipsychotic drugs. The medications control the symptoms of the disease, improve the well-being of the individual and increase the chance of adaptation to the social environment. On the other hand, medications have several adverse effects, and the alteration of the components of the metabolic syndrome is the most common. Objective: To evaluate the effect of supplementation of oat bran on body weight, abdominal circumference and components of the metabolic syndrome of institutionalized psychotic patients in a psychiatric hospital. Method: This is a quantitative study with intervention in chronic psychotic individuals. Body mass index (BMI) was calculated from the body mass index (BMI) for the classification of the nutritional status in the 4 study moments, beginning, 90 and 180 days of supplementation and 180 days after the end of the supplementation. The components of the metabolic syndrome: abdominal circumference, fasting glucose, HDL-cholesterol, triglycerides, before and at the end of the supplementation, and after 180 days without supplementation, were evaluated. Results: All 45 residents were studied. Of these, 62% were male, with a mean age of 55.5 ± 13.2 years, all of whom had been hospitalized for more than five years. 75% of them had a cardiovascular risk, 46.7% were obese, 33.3% had high total cholesterol, 50% had hypertriglyceridemia, 28.9% had arterial hypertension and 88... (Complete abstract click electronic access below) / Mestre

<p>Aim: The aim of this study was to investigate the prevalence and determinants of obesity amongst NAMDEB employees working at Pocket Beaches diamond mine.</p>

<p>Physical inactivity has become a global health concern and is among the 10 leading causes of death and disability. This has led to increased concern for chronic diseases of lifestyle (CDL).&nbsp / Studies have revealed that regular physical activity is effective in combating several CDL such as cardiovascular disease, diabetes, cancer, hypertension and obesity. Physiotherapists are in a&nbsp / position to combat inactivity and effectively promote physical activity to their clients. Studies however have shown that participation in physical activity among physiotherapists could have an&nbsp / impact on the promotion of physical activity and their health practices. This study therefore sought to establish the relationship between physical activity levels of physiotherapists and their&nbsp / physical&nbsp / activity promotion strategies and barriers to promoting physical activity. Sequential Mixed Method Design was used in this study. Data was collected by means of a self administered&nbsp / questionnaire and a total of 92 physiotherapists voluntarily answered the questionnaire. A focus group discussion comprising of 10 purposively selected physiotherapists was conducted. The&nbsp / questionnaire assessed physical activity levels&nbsp / and physical activity promoting strategies of the participants while the focus groupdiscussion looked at the barriers to promoting physical&nbsp / activity. The Statistical Packages for Social Sciences (SPSS) version 18 was used for data capturing and analysis. Descriptive statistics were employed to summarize demographic information&nbsp / as means, standard deviation, frequencies and percentages. Inferential statistics (chi-square) was used to test the associations between different categorical variables (p&lt / 0.05). For the qualitative data, focus group discussions were used to collect data. Tape recorded interviews were transcribed verbatim, field notes typed, sorting and arranging data was done and themes&nbsp / &nbsp / were generated. Thematic analysis was then done under the generated themes. Ethical issues pertaining to informed consent, anonymity, confidentiality and the right to withdraw from the&nbsp / study were respected in this current study. The findings in the current study revealed that a big number of the participants were physical active both at work and recreation domains. However,&nbsp / there was no statistically significant association between physical activity and the demographicvariables. The results in this study revealed that the majority of participants were good&nbsp / physical activity promoting practices, although there was no significant association between physical activity levels and the physical activity promoting practices. The finding in this study revealed that discussing physical&nbsp / activity and giving out information regarding physical activity to their clients were the most common methods used in promoting physical activity. However, participants also highlighted barriers they&nbsp / ace in promotion of physical activity such as policies on physical activity, cultural influence, nature of work, time management as well as environmental barriers. The study demonstrates the&nbsp / need for all stakeholders to come up with solutions to break the barriers to promotion of physical activity. In return it will bring about enormous health&nbsp / benefits to the general population.</p>

<p>Across the world, physical inactivity was found to be associated with cardiovascular and chronic diseases of lifestyle which often leads to an increased rate of various physical disabilities andpremature death. To combat these high incidences of chronic diseases of lifestyle, WHO strongly encourages people to become physically active on a daily basis to reduce the risk of&nbsp / premature death. Running has thus become the preferred choice of physical activity by thousands of people to help improve their overall health and wellbeing. Apart from the health benefits&nbsp / that running provides, it can also predispose the runner to potential injury especially when runners follow an inappropriate training programme and have inadequate knowledge about factors causing injury. Therefore, baseline data about the prevalence, incidence of injury and the identification of the aetiological factors associated with running injuries are needed to develop and&nbsp / implement preventative programmes to allow runners to optimally perform in training and races without injury. In South Africa, there is limited research available on the incidence of injury in runners yet there is an annual increase in participation in races such as Two Oceans and Comrades marathon which could lead to an increase in the number of running injuries.Thus, the purpose of this study was to determine the incidence of injuries and identify the various risk factors that are associated with injuries in road runners at a local athletic club. Methods: A prospective cohort study design over a 16 week period using quantitative research methods was used. A sample of 50 runners had consented to participate in the study. The participants had to complete a self-administered questionnaire and clinical measurements of BMI, Q-angle, leglength, muscle strength of lower leg and ROM of hip and knee were recorded. The participants had&nbsp / to complete an injury report form to record any new injuries sustained over the 16 week period of the study. Statistical Package for Social Sciences (SPSS) version 18 and software SAS v9 (SAS Institute Inc., Cary, NC, USA) was used for data capturing and analysis. Descriptive and inferential statistics were done to summarize the data and was expressed as frequencies, percentages, means and standard deviations. Injury prevalence and cumulative incidence was calculated as a proportion rate along with 95% confidence interval. The Poisson regression model was used to analyse the association between running injury and the independent variables of interest such as demographics, anthropometric measurements, training methods, running experience and&nbsp / previous injury. The alpha level was set as p&lt / 0.05. Results: The study found that the majority (92%) of the participants (n=46) sustained running injuries in the past prior to the study. A total of 16 participants sustained a number of 50 new injuries over the 16 week study period. Thus the prevalence rate of injuries was 32%. The incidence rate of injuries for this study was 0.67 per&nbsp / 1000km run at a 95% confidence interval of 0.41, 1.08. Furthermore, the most common location of new injuries reported were the calf (20%) and the second most common location was the&nbsp / knee (18%). PFPS was the most common type of knee injury diagnosed, followed by lumbar joint sprain. The results showed that none of the identified factors (running distance, stretching, age, Q-angle, BMI, running experience, leg-length discrepancy and previous running injuries) were directly associated with running injuries. However, a marginal significance was found for&nbsp / running distance (p = 0.08) and leg length discrepancy (p = 0.06). Conclusions: The study found a high prevalence and incidence rate of injury thus the need for preventative programmes have been highlighted. There was no statistical significance found between the identified factors and risk of injury however, there was clinical relevance found between factors identified. One major&nbsp / limitation was the small sample of participants and the short duration of study period. Thus, future research is needed to further determine possible factors associated with running injuries over a longer period and including a larger sample. The results of the study will be made available to all the stakeholders (runners, coaches and medical team) to implement in athletic club. </p>

Chronic disease is rising globally, but LMICs may require novel approaches to management suited to a low-resource setting. Private health care providers in LMICs have experimented and developed new models for organizing, financing, and delivering care. This thesis examines some of the innovations that have emerged in LMICs to manage chronic disease. Using a common performance measurement framework and drawing from a database of over 1200 innovative health programs, I identify and evaluate 46 programs addressing chronic disease in LMICs. I then go on to identify, innovative practices used by the subset of 19 diabetes focussed programs and catalogue them according to the Chronic Care Model (CCM). Delivery system design is the most commonly used domain of the CCM, which even earlier has shown to have great potential to impact health outcomes. Few of the identified innovations may also have the potential for ‘Reverse innovation’ in high income countries.

This small exploratory study considers the use of the narrative approach in eliciting and understanding illness stories. The four participants, (two male and two female) range in age from 29 years to 74 years. They live with a variety of chronic illnesses (heart disease, Multiple Sclerosis, and Pick's disease). Narrative analysis of the four semi-structured transcribed interviews revealed four dominant themes: the emotional reaction to diagnosis; the role of stress in aggravating and coping with chronic illness; a view of death; the meaning attributed to illness. / A postmodern perspective is employed to explicate the social construction of the notion of chronic illness. A critique of the medical discourse regarding chronic health challenges is offered. / This study invites social workers to consider their position of power and privilege as they learn new ways of listening to illness narratives.

<p>Aim: The aim of this study was to investigate the prevalence and determinants of obesity amongst NAMDEB employees working at Pocket Beaches diamond mine.</p>

<p>Across the world, physical inactivity was found to be associated with cardiovascular and chronic diseases of lifestyle which often leads to an increased rate of various physical disabilities andpremature death. To combat these high incidences of chronic diseases of lifestyle, WHO strongly encourages people to become physically active on a daily basis to reduce the risk of&nbsp / premature death. Running has thus become the preferred choice of physical activity by thousands of people to help improve their overall health and wellbeing. Apart from the health benefits&nbsp / that running provides, it can also predispose the runner to potential injury especially when runners follow an inappropriate training programme and have inadequate knowledge about factors causing injury. Therefore, baseline data about the prevalence, incidence of injury and the identification of the aetiological factors associated with running injuries are needed to develop and&nbsp / implement preventative programmes to allow runners to optimally perform in training and races without injury. In South Africa, there is limited research available on the incidence of injury in runners yet there is an annual increase in participation in races such as Two Oceans and Comrades marathon which could lead to an increase in the number of running injuries.Thus, the purpose of this study was to determine the incidence of injuries and identify the various risk factors that are associated with injuries in road runners at a local athletic club. Methods: A prospective cohort study design over a 16 week period using quantitative research methods was used. A sample of 50 runners had consented to participate in the study. The participants had to complete a self-administered questionnaire and clinical measurements of BMI, Q-angle, leglength, muscle strength of lower leg and ROM of hip and knee were recorded. The participants had&nbsp / to complete an injury report form to record any new injuries sustained over the 16 week period of the study. Statistical Package for Social Sciences (SPSS) version 18 and software SAS v9 (SAS Institute Inc., Cary, NC, USA) was used for data capturing and analysis. Descriptive and inferential statistics were done to summarize the data and was expressed as frequencies, percentages, means and standard deviations. Injury prevalence and cumulative incidence was calculated as a proportion rate along with 95% confidence interval. The Poisson regression model was used to analyse the association between running injury and the independent variables of interest such as demographics, anthropometric measurements, training methods, running experience and&nbsp / previous injury. The alpha level was set as p&lt / 0.05. Results: The study found that the majority (92%) of the participants (n=46) sustained running injuries in the past prior to the study. A total of 16 participants sustained a number of 50 new injuries over the 16 week study period. Thus the prevalence rate of injuries was 32%. The incidence rate of injuries for this study was 0.67 per&nbsp / 1000km run at a 95% confidence interval of 0.41, 1.08. Furthermore, the most common location of new injuries reported were the calf (20%) and the second most common location was the&nbsp / knee (18%). PFPS was the most common type of knee injury diagnosed, followed by lumbar joint sprain. The results showed that none of the identified factors (running distance, stretching, age, Q-angle, BMI, running experience, leg-length discrepancy and previous running injuries) were directly associated with running injuries. However, a marginal significance was found for&nbsp / running distance (p = 0.08) and leg length discrepancy (p = 0.06). Conclusions: The study found a high prevalence and incidence rate of injury thus the need for preventative programmes have been highlighted. There was no statistical significance found between the identified factors and risk of injury however, there was clinical relevance found between factors identified. One major&nbsp / limitation was the small sample of participants and the short duration of study period. Thus, future research is needed to further determine possible factors associated with running injuries over a longer period and including a larger sample. The results of the study will be made available to all the stakeholders (runners, coaches and medical team) to implement in athletic club. </p>