Le cancer de la cavité orale représente un problème important de santé publique en France où les taux d’incidence sont parmi les plus élevés au monde. Bien qu’une détection précoce soit possible, ces tumeurs sont souvent diagnostiquées à un stade avancé et sont ainsi responsables de plus de 1500 décès par an. L’objectif général est de clarifier le rôle et l’impact des différents facteurs de risque dans la survenue des cancers de la cavité orale en France, notamment d’examiner de façon détaillée le rôle du tabac et de l’alcool par localisation anatomique précise, et d’étudier les associations avec d’autres facteurs de risque potentiels (indice de masse corporelle, antécédents médicaux, antécédents familiaux de cancer, consommations de café et de thé). Ce travail s’appuie sur les données d’une large étude cas-témoins en population générale, l’étude ICARE. Il porte sur un sous-ensemble de ces sujets (772 cas de cancer de la cavité orale et 3555 témoins). Les résultats montrent que le tabac augmente le risque de cancer de la cavité orale même pour des quantités et/ou durées faibles, alors que l’augmentation de risque liée à l’alcool n’est observée que pour de fortes consommations. L’effet conjoint du tabac et de l’alcool est plus que multiplicatif. Les associations avec les consommations d’alcool et de tabac varient selon la sous localisation : les associations les plus fortes sont observées pour le plancher buccal, les plus faibles pour les gencives. L’étude des autres facteurs de risque a mis en évidence : une association inverse entre risque de cancer de la cavité orale et indice de masse corporelle, avec un risque plus faible chez les personnes en surpoids ou obèses ; un risque augmenté lorsqu’un parent du 1er degré a été atteint d’un cancer des voies aéro-digestives supérieures ; un risque élevé chez les personnes présentant des antécédents de candidose buccale ; un risque diminué chez les consommateurs de thé ou de café. A partir de ces premiers résultats, il est envisagé de construire un score prédictif de cancer de la cavité orale permettant d’identifier les sujets à risque élevé sur lesquels cibler préférentiellement les actions de dépistage. / Cancer of the oral cavity is a major public health problem in France. Incidence rates are among the highest in the world. Although early detection is possible and effective, these tumors are often diagnosed at an advanced stage and are thus responsible for over 1,500 deaths per year. The objective of this work was to clarify the role and impact of several risk factors in the development of cancers of the oral cavity in France, particularly to examine the role of tobacco smoking and alcohol drinking by subsite, and to explore associations with other potential risk factors (body mass index, medical history, family history of cancer, tea and coffee consumption). We analyzed detailed data from 772 cases of cancer of the oral cavity and 3555 controls included in a large population-based case-control study, the ICARE study. Tobacco smoking increased the risk of oral cavity cancer even for low quantities and/or durations, while alcohol drinking increased this risk only in heavy drinkers. The combined effect of tobacco and alcohol was greater than multiplicative. Associations with alcohol and tobacco consumption varied depending on subsite: the strongest associations were observed for the floor of the mouth, the lowest for the gums. The analysis of other risk factors showed: an inverse association between oral cancer risk and body mass index with a lowered risk among overweight or obese; an increased risk associated with an history of head and neck cancer in 1st degree relatives; an elevated risk in people with a history of oral candidiasis and a decreased risk among consumers of tea or coffee. From these first results, it is planned to develop an oral cancer risk score to identify high-risk individuals for screening.

Contexte : Le cancer est la seconde cause de mortalité chez la femme en France, et la première chez les femmes âgées de 35 à 84 ans. Le cancer du sein est le cancer le plus fréquemment diagnostiqué, représentant 35 % des cas chez les femmes en France en 2012. De multiples facteurs, comportementaux et non-Comportementaux, augmentant le risque de cancer, tant en incidence qu’en mortalité, ont été identifiés dans la littérature, tandis que leur influence conjointe est très peu évaluée. Dans le cas du cancer du sein, certains facteurs diffèrent selon le statut ménopausique des femmes, suggérant une étiologie différente entre les cancers du sein diagnostiqués avant et après la ménopause. Objectif : Les données de la cohorte prospective française E3N ont été utilisées pour évaluer l’influence des facteurs comportementaux et non-Comportementaux sur le risque de cancer et de mortalité chez les femmes avant et après la ménopause. Nous avons également cherché à estimer leur impact relatif sur la population et à identifier les facteurs à forts pouvoirs prédictifs.Résultats : Nos résultats suggèrent que le mode de vie a une influence modeste sur le risque de cancer et de mortalité lors de l’adhésion à une seule recommandation de santé publique. En revanche, elle est conséquente lors d’une adhésion conjointe à plusieurs recommandations. Les facteurs comportementaux jouent ainsi un rôle non négligeable dans la survenue de cancer et sur le risque de décès prématuré. Dans le cas du cancer du sein, ces facteurs influencent particulièrement le risque après la ménopause, tandis qu’avant la ménopause leur impact est plus faible que les facteurs qui ne relèvent pas du mode de vie ou de choix personnels. Ces observations sont retrouvées lorsque l’on cherche à prédire le risque de cancer du sein avant et après la ménopause. En effet, la prédiction du risque de cancer du sein en préménopause s’établit principalement à partir de facteurs non-Comportementaux, alors que la prédiction du risque en postménopause est également déterminée par des facteurs comportementaux.Conclusion : Nous avons montré que l’étiologie du cancer du sein diffère selon la nature de la tumeur, et en particulier selon le statut ménopausique des femmes. À tout âge, le mode de vie a une influence sur le risque de cancer et de mortalité prématurée, particulièrement après la ménopause lorsque leur impact est supérieur à celui des facteurs non-Comportementaux. Ces résultats demandent, cependant, à être reproduits dans des études prospectives portant sur des femmes plus jeunes. / Background: Cancer is the second leading cause of mortality among women in France, and the leading cause of mortality among women aged between 35 and 84. Breast cancer is the most frequently diagnosed cancer, with 35% of cases among women in France in 2012. Multiple behavioural and non-Behavioural factors have been associated with increases in cancer incidence and mortality. However, the literature about their combined impact is scarce. Regarding breast cancer, some risk factors differed according to the menopausal status, suggesting a different etiology between premenopausal and postmenopausal breast cancers.Objectives: Data from the E3N prospective cohort of French women were used to evaluate the influence of behavioural and non-Behavioural factors on cancer risk before and after the menopause and on mortality. In addition, we aimed at estimating their relative impact on the population and identifying factors with the highest predictive power.Results: Our results suggest a modest influence of the lifestyle on cancer risk and mortality when adhering to only one public health recommendation. However, the influence is substantial with a combined adherence to several recommendations. Behavioural factors play a key role in the occurrence of cancer and mortality risk. Regarding breast cancer, these factors influence particularly the risk after the menopause, while before, their impact is lower than non-Behavioural factors. These observations were retrieved when aiming at predicting breast cancer risk according to menopausal status. Prediction was established by non-Behavioural factors in premenopause, while the prediction in postmenopause was driven by behavioural factors.Conclusion: We have shown that the etiology of breast cancer differs according to the nature of the tumour, and particularly according to the menopausal status of women. Whatever the age, lifestyle influence the risk of cancer and mortality, especially after the menopause when their impact is higher than the non-Behavioural factors’ one. New results from prospective study on younger women are warranted to confirm the results.

Embedded In These Walls uses photographic imagery, archival ephemera, and written text to examine a specific history of generational trauma through the lens of a singular family of a southern tradition to point to a larger systemic breakdown of accountability and truthfulness regarding abuse

<p>The aim of this thesis is to shed light upon the Swedish nineteenth century poor relief system, how it operated in a local rural context, how it changed over time, and not least, who was supported and why. It raises questions about how the poor laws were interpreted on the parish level, how the welfare systems interacted with local society and about who was considered to be poor and entitled to support. The geographical setting of the thesis is Skellefteå, a rural parish in northern Sweden, and it concentrates upon the period 1830–1875.</p><p>Swedish poor relief was governed by the fundamental principle that each parish had a duty to support their own poor and each parish was allowed a large amount of freedom to adjust their welfare arrangements according to local conditions. In Skellefteå, the main incentive for modification of the poor relief system was not new regulations from the national level, but social and economic transformations on the local level. This implies that local requirements were put before national legislation and suggests the existence of several regional, and perhaps also local, poor relief systems in nineteenth-century Sweden.</p><p>On the local level, the results indicate the existence of a parochial social citizenship based upon a common understanding of social rights and duties in the community, and grounded in a strong sense of affiliation with the local society. Generally there was a larger distance between the poor and their providers in the wealthier and more socially stratified villages, hence a more egalitarian context seem to have facilitated identification and empathy with the poor. The local provision for the poor created and maintained bonds within a community, as well as it helped to build and reinforce boundaries towards those who did not belong. A sometimes suspicious and negative attitude towards outsiders was to some extent caused by a fear of increased poor relief expenses, but it also bears witness to a rural culture with a strong sense of belonging to one’s own village or hamlet.</p><p>The majority of men and women supported by poor relief in Skellefteå belonged to the lower strata of society long before they became welfare recipients. They were landless rural people with weak kinship networks, that in most cases were unable to mobilize any significant support in times of need. Childhood, early middle age, and old age were identified as phases in the life cycle that seem to have entailed an increased risk of poverty and dependence. A substantial proportion of the poor were breadwinners, middle aged men with large households to support, while the widowed and unmarried paupers usually were women. For many of these households the life cycles’ vulnerable periods were further reinforced by other factors: a breadwinner’s illness or disability, the death of a spouse, a major subsistence crisis, or a larger marginalization caused by a deviation from society’s moral standards. In most cases there seems to have been a delicate interplay between several social risks that determined if and when a person or a household was to end up being supported by poor relief.</p>

The aim of this thesis is to shed light upon the Swedish nineteenth century poor relief system, how it operated in a local rural context, how it changed over time, and not least, who was supported and why. It raises questions about how the poor laws were interpreted on the parish level, how the welfare systems interacted with local society and about who was considered to be poor and entitled to support. The geographical setting of the thesis is Skellefteå, a rural parish in northern Sweden, and it concentrates upon the period 1830–1875. Swedish poor relief was governed by the fundamental principle that each parish had a duty to support their own poor and each parish was allowed a large amount of freedom to adjust their welfare arrangements according to local conditions. In Skellefteå, the main incentive for modification of the poor relief system was not new regulations from the national level, but social and economic transformations on the local level. This implies that local requirements were put before national legislation and suggests the existence of several regional, and perhaps also local, poor relief systems in nineteenth-century Sweden. On the local level, the results indicate the existence of a parochial social citizenship based upon a common understanding of social rights and duties in the community, and grounded in a strong sense of affiliation with the local society. Generally there was a larger distance between the poor and their providers in the wealthier and more socially stratified villages, hence a more egalitarian context seem to have facilitated identification and empathy with the poor. The local provision for the poor created and maintained bonds within a community, as well as it helped to build and reinforce boundaries towards those who did not belong. A sometimes suspicious and negative attitude towards outsiders was to some extent caused by a fear of increased poor relief expenses, but it also bears witness to a rural culture with a strong sense of belonging to one’s own village or hamlet. The majority of men and women supported by poor relief in Skellefteå belonged to the lower strata of society long before they became welfare recipients. They were landless rural people with weak kinship networks, that in most cases were unable to mobilize any significant support in times of need. Childhood, early middle age, and old age were identified as phases in the life cycle that seem to have entailed an increased risk of poverty and dependence. A substantial proportion of the poor were breadwinners, middle aged men with large households to support, while the widowed and unmarried paupers usually were women. For many of these households the life cycles’ vulnerable periods were further reinforced by other factors: a breadwinner’s illness or disability, the death of a spouse, a major subsistence crisis, or a larger marginalization caused by a deviation from society’s moral standards. In most cases there seems to have been a delicate interplay between several social risks that determined if and when a person or a household was to end up being supported by poor relief.

SOUSA, Kássia Mota de. Por onde andou nossa família: veredas e narrativas da história de famílias. 2015. 173f. – Tese (Doutorado) – Universidade Federal do Ceará, Programa de Pós-graduação em Educação Brasileira, Fortaleza (CE), 2015. / Submitted by Márcia Araújo (marcia_m_bezerra@yahoo.com.br) on 2015-08-25T14:47:18Z No. of bitstreams: 1 2015_tese_kmsousa.pdf: 8263629 bytes, checksum: 5c6172980a72b4292387853d890a0737 (MD5) / Approved for entry into archive by Márcia Araújo(marcia_m_bezerra@yahoo.com.br) on 2015-08-28T13:29:57Z (GMT) No. of bitstreams: 1 2015_tese_kmsousa.pdf: 8263629 bytes, checksum: 5c6172980a72b4292387853d890a0737 (MD5) / Made available in DSpace on 2015-08-28T13:29:57Z (GMT). No. of bitstreams: 1 2015_tese_kmsousa.pdf: 8263629 bytes, checksum: 5c6172980a72b4292387853d890a0737 (MD5) Previous issue date: 2015 / A tese parte da história da família Sousa, durante meados do século XX e XXI, em Juazeiro do Norte, para reconstruir a história da cidade, demarcando a presença afrodescendente e sua importância no desenvolvimento cultural, urbano de Juazeiro do Norte. Tem como objetivo contribuir para o desenvolvimento e a sistematização do campo teórico da Afrodescendência, um campo de pesquisa que parte da particularidade, do local, em busca de construir uma história da população afrodescendente produzida por ela mesma, e onde os protagonistas sejam esta população e seus ancestrais que construíram e constroem a riqueza deste país. A tese tem como objetivo principal ser mais um instrumento de luta e teórico para a implementação da lei 10.639/2003, que estabelece a obrigatoriedade do ensino de história e cultura afro-brasileira e africana na educação básica, na medida em que esta tese subsidia a produção de material didático. Metodologicamente traçamos um caminho particular que entrelaça as metodologias advindas da revolução historiográfica da escola dos Annales: autobiografia, histórias de vida, narrativas, oralidade, memórias de velhos, fotografias... ao uso das redes sociais virtuais para construir a história do tempo presente, numa perspectiva fundamentada na importância do desenvolvimento da Afrodescendência como campo de saber. E neste sentido, rever a história da população afrodescendente no Ceará, inscrevendo-a num período em que a produção historiográfica existente a invizibilizou.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / As doenças cardiovasculares estão entre as principais causas de mortalidade em muitos países. O sistema nervoso autônomo e a função endotelial constituem mecanismos centrais no desenvolvimento e progressão de doenças cardiovasculares. A função autonômica e a reatividade vascular podem estar alteradas em indivíduos com maior risco para doença cardiovascular, como indivíduos com história familiar de primeiro grau de diabetes tipo 2 (HFDM2) e indivíduos com polimorfismo 894G>T da enzima óxido nítrico sintase endotelial (eNOS). Os objetivos dos três artigos apresentados na tese foram: artigo I. Investigar a influência da HFDM2 na modulação autonômica cardíaca em ausência de desordens metabólicas concomitantes; artigo II. Investigar a influência da HFDM2 na reatividade vascular em ausência de desordens metabólicas concomitantes e, artigo III. Investigar a influência do polimorfismo 894G>T no efeito de uma sessão de exercício dinâmico máximo na reatividade vascular. Foram recrutados indivíduos saudáveis com e sem HFDM2 para os artigos I e II. A variabilidade da frequência cardíaca (VFC) foi determinada através da análise espectral de um registro de intervalos RR durante 10 minutos na posição supina (artigo I) e a reatividade vascular durante a hiperemia reativa através da pletismografia de oclusão venosa (artigo II). Para a realização do artigo III, foram recrutados indivíduos saudáveis com e sem o polimorfismo 894G>T da eNOS. O protocolo consistiu na determinação da reatividade vascular basal e durante a hiperemia reativa, o qual eram realizados pré, 10, 60 e 120 minutos após um teste de esforço cardiopulmonar máximo. Os indivíduos com HFDM2 apresentaram maiores valores para variáveis antropométricas e metabólicas e uma menor VFC (artigo I) e reatividade vascular (artigo II) quando comparados com o grupo-controle (p<0,05). Em seguida, os grupos foram emparelhados para essas variáveis consideradas capazes de alterar a VFC e a reatividade vascular e nenhuma diferença significativa foi encontrada entre os grupos nos artigos I e II (p>0,05). Foi realizada análise de correlação simples, sendo que as variáveis que apresentaram significância estatística foram submetidas à análise de regressão múltipla. Esta identificou colesterol (P=0,014) e triglicerídeos (P=0,014) como preditores independentes da VFC (modelo r2=0,16; P<0,001) e insulina (P<0,05) e razão cintura-quadril (P<0,05) como preditores independentes da reatividade vascular (modelo r2=0,22; P=0,006). No artigo III, não foram observadas diferenças entre os indivíduos com e sem o polimorfismo 894G>T em relação as características antropométricas, metabólicas e hemodinâmicas e medidas de fluxo sanguíneo antes do exercício dinâmico máximo (P>0,05). Os indivíduos polimórficos apresentaram menor reatividade vascular independente do tempo (efeito do grupo P=0,019) e a análise de post-hoc revelou que os indivíduos polimórficos apresentavam valor menor apenas no momento 120 minutos (P=0,022) quando comparados com indivíduos sem o polimorfismo. Estes achados sugerem que indivíduos com HFDM2, em ausência de desordens metabólicas concomitantes, não apresentam alteração da modulação autonômica cardíaca e de reatividade vascular. Em adendo, indivíduos com polimorfismo 894G>T, têm menor reatividade vascular após um sessão de exercício, denotando a presença de disfunção vascular. / Cardiovascular diseases are among the leading causes of mortality in many countries. The autonomic nervous system and the endothelial function are central mechanisms in the development and progression of cardiovascular diseases. The autonomic function and vascular reactivity may be altered in subjects with higher risk for cardiovascular disease, as subjects with family history of first-degree relatives of type 2 diabetes (FDRs), and subjects with the 894G>T polymorphism of the endothelial nitric oxide synthase (eNOS). The aims of these three papers presented at this thesis were: paper I. To investigate the influence of FDR on cardiac autonomic modulation in the absence of concomitant metabolic disorders; paper II. To investigate the influence of FDR on vascular reactivity in the absence of concomitant metabolic disorders; paper III. To investigate the influence of the 894G>T polymorphism on the effect of a single bout of maximal dynamic exercise on vascular reactivity. Healthy subjects with and without FDRs were recruited for the paper I and II. The heart rate variability (HRV) was determined by spectral analysis of inter-beat intervals recorded during 10 min in the supine position (paper I) and vascular reactivity during the reactive hyperemia by venous occlusion plethysmography (paper II). For the paper III, healthy subjects with and without the 894G>T polymorphism of the eNOS were recruited. The protocol consisted of vascular reactivity assessment at baseline and during reactive hyperemia, which were performed pre, 10, 60 and 120 min after a maximal cardiopulmonary exercise test. The FDRs exhibited higher values for anthropometric and metabolic variables and lower values for HRV (paper I), and vascular reactivity (paper II) when compared to the control subjects (p<0.05). After matching the groups for variables, that are known to alter HRV and vascular reactivity, no significant difference was observed between groups in the paper I and II (p>0.05). Following single correlation analysis, only the variables with statistical significance were submitted to multiple regression analysis. This identified cholesterol (P=0.014) and triglycerides (P=0.014) as significant predictors of HRV (model r2=0.16; p<0.001), and insulin (P<0.05) and waist-to-hip ratio (P<0.05) as independent predictors (model r2=0.22; P=0.006). There were no differences between the subjects with and without the 894G>T polymorphism concerning anthropometric, metabolic, and hemodynamic characteristics, and blood flow measurements before maximal dynamic exercise (P>0.05), in the paper III. The polymorphic subjects presented lower vascular reactivity regardless of time (P=0.019 for group main effect), and post-hoc analysis revealed that polymorphic subjects had lower values only at the 120 min measurement (P=0.022) when compared with subjects without the polymorphism. These findings suggest that FDRs, in the absence of concomitant metabolic disorders, does not impair cardiac autonomic modulation and vascular reactivity. Furthermore, subjects with the 894G>T polymorphism had lower vascular reactivity after a single bout of exercise, denoting the presence of vascular dysfunction.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / As doenças cardiovasculares estão entre as principais causas de mortalidade em muitos países. O sistema nervoso autônomo e a função endotelial constituem mecanismos centrais no desenvolvimento e progressão de doenças cardiovasculares. A função autonômica e a reatividade vascular podem estar alteradas em indivíduos com maior risco para doença cardiovascular, como indivíduos com história familiar de primeiro grau de diabetes tipo 2 (HFDM2) e indivíduos com polimorfismo 894G>T da enzima óxido nítrico sintase endotelial (eNOS). Os objetivos dos três artigos apresentados na tese foram: artigo I. Investigar a influência da HFDM2 na modulação autonômica cardíaca em ausência de desordens metabólicas concomitantes; artigo II. Investigar a influência da HFDM2 na reatividade vascular em ausência de desordens metabólicas concomitantes e, artigo III. Investigar a influência do polimorfismo 894G>T no efeito de uma sessão de exercício dinâmico máximo na reatividade vascular. Foram recrutados indivíduos saudáveis com e sem HFDM2 para os artigos I e II. A variabilidade da frequência cardíaca (VFC) foi determinada através da análise espectral de um registro de intervalos RR durante 10 minutos na posição supina (artigo I) e a reatividade vascular durante a hiperemia reativa através da pletismografia de oclusão venosa (artigo II). Para a realização do artigo III, foram recrutados indivíduos saudáveis com e sem o polimorfismo 894G>T da eNOS. O protocolo consistiu na determinação da reatividade vascular basal e durante a hiperemia reativa, o qual eram realizados pré, 10, 60 e 120 minutos após um teste de esforço cardiopulmonar máximo. Os indivíduos com HFDM2 apresentaram maiores valores para variáveis antropométricas e metabólicas e uma menor VFC (artigo I) e reatividade vascular (artigo II) quando comparados com o grupo-controle (p<0,05). Em seguida, os grupos foram emparelhados para essas variáveis consideradas capazes de alterar a VFC e a reatividade vascular e nenhuma diferença significativa foi encontrada entre os grupos nos artigos I e II (p>0,05). Foi realizada análise de correlação simples, sendo que as variáveis que apresentaram significância estatística foram submetidas à análise de regressão múltipla. Esta identificou colesterol (P=0,014) e triglicerídeos (P=0,014) como preditores independentes da VFC (modelo r2=0,16; P<0,001) e insulina (P<0,05) e razão cintura-quadril (P<0,05) como preditores independentes da reatividade vascular (modelo r2=0,22; P=0,006). No artigo III, não foram observadas diferenças entre os indivíduos com e sem o polimorfismo 894G>T em relação as características antropométricas, metabólicas e hemodinâmicas e medidas de fluxo sanguíneo antes do exercício dinâmico máximo (P>0,05). Os indivíduos polimórficos apresentaram menor reatividade vascular independente do tempo (efeito do grupo P=0,019) e a análise de post-hoc revelou que os indivíduos polimórficos apresentavam valor menor apenas no momento 120 minutos (P=0,022) quando comparados com indivíduos sem o polimorfismo. Estes achados sugerem que indivíduos com HFDM2, em ausência de desordens metabólicas concomitantes, não apresentam alteração da modulação autonômica cardíaca e de reatividade vascular. Em adendo, indivíduos com polimorfismo 894G>T, têm menor reatividade vascular após um sessão de exercício, denotando a presença de disfunção vascular. / Cardiovascular diseases are among the leading causes of mortality in many countries. The autonomic nervous system and the endothelial function are central mechanisms in the development and progression of cardiovascular diseases. The autonomic function and vascular reactivity may be altered in subjects with higher risk for cardiovascular disease, as subjects with family history of first-degree relatives of type 2 diabetes (FDRs), and subjects with the 894G>T polymorphism of the endothelial nitric oxide synthase (eNOS). The aims of these three papers presented at this thesis were: paper I. To investigate the influence of FDR on cardiac autonomic modulation in the absence of concomitant metabolic disorders; paper II. To investigate the influence of FDR on vascular reactivity in the absence of concomitant metabolic disorders; paper III. To investigate the influence of the 894G>T polymorphism on the effect of a single bout of maximal dynamic exercise on vascular reactivity. Healthy subjects with and without FDRs were recruited for the paper I and II. The heart rate variability (HRV) was determined by spectral analysis of inter-beat intervals recorded during 10 min in the supine position (paper I) and vascular reactivity during the reactive hyperemia by venous occlusion plethysmography (paper II). For the paper III, healthy subjects with and without the 894G>T polymorphism of the eNOS were recruited. The protocol consisted of vascular reactivity assessment at baseline and during reactive hyperemia, which were performed pre, 10, 60 and 120 min after a maximal cardiopulmonary exercise test. The FDRs exhibited higher values for anthropometric and metabolic variables and lower values for HRV (paper I), and vascular reactivity (paper II) when compared to the control subjects (p<0.05). After matching the groups for variables, that are known to alter HRV and vascular reactivity, no significant difference was observed between groups in the paper I and II (p>0.05). Following single correlation analysis, only the variables with statistical significance were submitted to multiple regression analysis. This identified cholesterol (P=0.014) and triglycerides (P=0.014) as significant predictors of HRV (model r2=0.16; p<0.001), and insulin (P<0.05) and waist-to-hip ratio (P<0.05) as independent predictors (model r2=0.22; P=0.006). There were no differences between the subjects with and without the 894G>T polymorphism concerning anthropometric, metabolic, and hemodynamic characteristics, and blood flow measurements before maximal dynamic exercise (P>0.05), in the paper III. The polymorphic subjects presented lower vascular reactivity regardless of time (P=0.019 for group main effect), and post-hoc analysis revealed that polymorphic subjects had lower values only at the 120 min measurement (P=0.022) when compared with subjects without the polymorphism. These findings suggest that FDRs, in the absence of concomitant metabolic disorders, does not impair cardiac autonomic modulation and vascular reactivity. Furthermore, subjects with the 894G>T polymorphism had lower vascular reactivity after a single bout of exercise, denoting the presence of vascular dysfunction.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-19T19:15:24Z No. of bitstreams: 1 Mário César Nascimento.pdf: 1745805 bytes, checksum: ad4c8a4e2dc9ca8de775e2bd0ca30068 (MD5) / Made available in DSpace on 2018-07-19T19:15:24Z (GMT). No. of bitstreams: 1 Mário César Nascimento.pdf: 1745805 bytes, checksum: ad4c8a4e2dc9ca8de775e2bd0ca30068 (MD5) Previous issue date: 2017-12-15 / The objective of the present study was to evaluate the impact of the level of physical activity and overweight in offspring of normotensives or hypertensives, as well as to validate a scale of prediction of adherence to physical activity. This thesis was divided into two studies. In Study I, we observed that among the twenty items on the adherence scale, ten presented good reproducibility (Kappa> 0.70, Pearson's correlation> 0.81), good internal consistency (Cronbach's Alpha 0.84), good clarity and discriminant validity (p = 0.0006 vs sedentary, t = 4.12), correlation between the sum of the scale and the Mets (metabolic equivalent) evaluated by IPAQ with r = 0.073 and p = 0.048. In Study II, 114 males, young, physically active and insufficiently active adults, offspring of normotensives or hypertensives, overweight or eutrophic were selected. The IPAQ was used for the level of physical activity, the PSS-10 for perceived stress, the WHOQOL for quality of life analysis. Anthropometric, hematological and biochemical analyzes and systemic oxidative stress evaluations were performed. In addition, blood pressure (BP) recording beat-to-beat using the Finometer® was used for evaluation of hemodynamic parameters and of heart rate (HRV) and BP variability (BPV). The results showed a higher BMI and % of fat, both by folds and Bioelectrical impedance analysis, in the overweight groups compared to the eutrophic groups, as well as higher weekly caloric expenditure among the active groups in relation to the sedentary groups, independently of the familial history of hypertension (FHH). In the hematological and biochemical profile all groups presented values within the normal range. The BP values were similar between the studied groups, but a lower heart rate was observed in the active groups with a negative FHH. There was no difference in perceived stress levels, but the quality of life was better in the active groups, with lower benefits in the group with a positive FHH. In relation to HRV, the active eutrophic groups, both with a positive and negative FHH, had higher values of RMSSD (cardiac parasympathetic modulation) and lower sympatho/vagal balance in relation to their respective eutrophic sedentary groups, which was not observed in overweight groups. The groups with a positive FHH presented higher values of both simpato/vagal balance (eutrophic and overweight), SAP variance (just overweight) and vascular sympathetic modulation (LF) (eutrophic and overweight) compared to the group with negative FHH, and these differences were attenuated in the physically active group with FHH and overweight. The active eutrophic group with a negative FHH presented better baroreflex sensitivity in relation to their respective sedentary group, which was not observed in the group with a FHH. With regard to oxidative stress, active groups with a negative FHH had lower levels of hydrogen peroxide and nitrites and greater activity of the antioxidant enzyme glutathione peroxidase (just eutrophic) when compared to their respective sedentary groups, which was not observed for the offspring of hypertensives (sedentary vs actives). In addition, these two parameters and the oxidation of proteins (carbonyls) were increased in the overweight and non-overweight groups with a FHH in relation to the eutrophic group with a negative FHH, being attenuated in the active group with FHH and overweight. In conclusion, the scale of adherence to the physical active developed in this study showed good reproducibility, good internal consistency, clarity and discriminating validity. In addition, our results showed that even under normal clinical conditions, a positive FHH, regardless of the presence of overweight, induced autonomic dysfunction and increases in oxidative stress markers that may be precursors of cardiometabolic diseases in this genetically predisposed population. On the other hand, a physically active lifestyle improves HRV, baroreflex and parameters related to redox status in individuals with a negative FHH. Such benefits seem to be attenuated by the positive FHH, but a physically active lifestyle seems to prevent/attenuate the dysfunctions observed in this condition. / O objetivo do presente estudo foi avaliar o impacto do nível de atividade física e do sobrepeso em filhos de pais normotensos ou hipertensos, bem como validar uma escala de predição da aderência a atividade física. Esta tese foi dividida em dois estudos. No Estudo I, nossos resultados demonstram que entre os vinte itens da escala de aderência, dez apresentaram boa reprodutibilidade (Kappa > 0,70, correlação de Pearson >0,81), boa consistência interna (Alfa de Cronbach 0,84), boa clareza e validade discriminante (ativos p=<0,0006 vs. Sedentários; t= 4,12), Correlação entre o somatório da escala e o Mets (equivalente metabólico) avaliado pelo IPAQ com r=0,073 e p=0,048. No Estudo II, foram selecionados 114 sujeitos do sexo masculino, adultos jovens, fisicamente ativos e insuficientemente ativos, filhos biológicos de pais normotensos ou hipertensos, com sobrepeso ou eutróficos. Foram utilizados o IPAQ para o nível de atividade física, o PSS-10 para estresse percebido, e o WHOQOL para qualidade de vida. Foram realizadas análises antropométrica, hematológicas e bioquímicas sanguínea e de estresse oxidativo sistêmica, além de registro da pressão arterial (PA) batimento-a-batimento utilizando o Finometer® para avaliação de parâmetros hemodinâmicos e avaliação da variabilidade da frequência cardíaca (VFC) e da PA (VPA). Os resultados evidenciaram conforme esperado maior IMC e %G tanto por dobras quanto por bioimpedância, nos grupos com sobrepeso em relação aos eutróficos, bem como maior gasto calórico semanal entre os grupos ativos em relação aos grupos sedentários, independentemente do histórico familiar de hipertensão (HFH). No perfil hematológico e bioquímico sanguíneo todos os grupos apresentaram valores dentro da faixa de normalidade. Os valores de PA foram semelhantes entre os grupos estudados, porém foi observada menor frequência cardíaca nos grupos ativos com histórico negativo de hipertensão. Não houve diferença para níveis de estresse percebido, mas a qualidade de vida foi melhor nos grupos ativos, com menores benefícios no grupo com HFH positivo. Em relação a VFC, os grupos eutróficos ativos, tantos com HFH positivo quanto negativo, apresentaram valores maiores de RMSSD (modulação parassimpática cardíaca) e menores de balanço simpato/vagal em relação aos seus respectivos grupos sedentários eutróficos, o que não foi observado nos grupos com sobrepeso. Os grupos com HFH apresentaram maior balanço simpato/vagal que os eutróficos com HFH negativo. Quanto a VPA, os grupos com HFH positivo, eutrófico e com sobrepeso, apresentaram valores maiores tanto de variância de PAS quanto modulação simpática vascular (LF) em comparação ao grupo sem HFH, e essas diferenças foram atenuadas no grupo fisicamente ativo. O grupo de eutrófico ativo com HFH negativo apresentou melhor sensibilidade barorreflexa em relação ao seu respectivo grupo sedentário, o que não foi observado no grupo entre os sujeitos com HFH positivo. Com relação ao estresse oxidativo, os grupos ativos com HFH negativo apresentaram menores níveis de peróxido de hidrogênio e nitritos e maior atividade da enzima antioxidante glutationa peroxidase quando comparados aos seus respectivos grupos sedentários, o que não foi observado para os filhos de pais hipertensos. Além disto, estes dois parâmetros e a oxidação de proteínas (carbonilas) estavam aumentados nos grupos com e sem sobrepeso com HFH positivo em relação ao grupo eutrófico com HFH negativo, sendo atenuadas no grupo ativo com HFH positivo e sobrepeso. Em conclusão, a escala de aderência ao exercício desenvolvida neste estudo apresentou boa reprodutibilidade, boa consistência interna, clareza e validade descriminante. Além disto, os resultados evidenciam que mesmo sob condições clínicas de normalidade, o HFH positivo, independentemente da presença de sobrepeso, induz disfunção autonômica e aumento de marcadores de estresse oxidativo que podem ser precursores de doenças cardiometabólicas nesta população geneticamente predisposta. Por outro lado, um estilo de vida fisicamente ativo melhora a VFC, o baroreflexo e parâmetros relacionados ao estado redox em indivíduos com HFH negativo. Tais benefícios parecem atenuados pelo HFH positivo, mas um estilo de vida fisicamente ativo parece prevenir/atenuar as disfunções observadas nesta condição.

A written thesis to accompany the M.F.A. Exhibition Heritage Sites, in which vignettes of the artist’s personal and familial narratives become a backdrop for examining themes such as global tourism, the notion of universal heritage, and questioning Puerto Rico as a postcolonial place. A two channel short video layers archival imagery with original material to examine the ways Puerto Rico has been represented and misrepresented personally and globally.