Previsões da Organização Mundial de Saúde (OMS) apontam que entre os anos de 2006 e 2030, o número de pessoas idosas nos países de baixa e média renda está projetado para aumentar em 140% em relação ao aumento nos países de renda alta que será de 51% e, pela primeira vez na história, em 2050 haverá mais idosos do que crianças (0 14 anos), configurando-se um novo panorama demográfico. A assistência à saúde do idoso, em conjunto com a prevenção de doenças crônicas e degenerativas, e o preparo adequado de quem presta cuidado são imprescindíveis para a manutenção da autonomia e qualidade de vida do idoso. O presente estudo foi realizado com 113 cuidadores não familiares de idosos, que prestam cuidado no âmbito domiciliar, residentes na zona urbana do município de Taquaritinga (SP). Teve como objetivo identificar o perfil dos cuidadores na prestação de cuidados domiciliares, bem como suas principais dificuldades, responsabilidades e tarefas assumidas, perante o paciente e a família, no ato de cuidar. Foram aplicados questionários, contendo perguntas abertas e fechadas, a 113 cuidadores, em locais diferentes de onde exerciam a função, após contato prévio, no período de julho a setembro de 2011. Os cuidadores eram predominantemente do sexo feminino (85%), casados ou viviam em união consensual (57.5%), na faixa etária de 19 a 59 anos (90,3%); em menor proporção apareceu a população de cuidadores idosos (9,7%). Entre os cuidadores do sexo masculino, predominaram os na faixa etária de 19 a 59 anos (94,1%). Quanto à escolaridade referida pelos cuidadores, 24,8% possuíam apenas o nível fundamental, 21,2% o nível médio, 31% o nível técnico, 6,2% o nível superior e 16,8% sem escolaridade. Os profissionais de enfermagem constituíram 35% dos cuidadores, e somente um cuidador se auto avaliou como bem preparado. A profissão de cuidador não foi a principal atividade para 77% dos entrevistados, que exerciam outras atividades. Declararam não possuir qualificação para o exercício da função, 87,6% dos entrevistados e 45% referiram pouco preparo. Embora 94,7% dos cuidadores declarem ser capazes de cuidar, todos referiram possuir dificuldades e necessidade de um apoio profissional, independentemente do nível de escolaridade, formação profissional, ou nível de dependência do idoso. A família do idoso não auxilia no trabalho do cuidador em 35% dos casos, e frequentemente (55%) delega serviços domésticos ou externos para serem realizados além do ato de cuidar. A carga horária de trabalho semanal é superior a 30 horas e a grande maioria não possui vínculo empregatício formal; 33% dos cuidadores referiram que raramente são remunerados. Os resultados evidenciam a necessidade de um olhar diferenciado a esses profissionais, principalmente na elaboração de políticas públicas, sociais e de saúde voltadas à formação de recursos humanos para este fim, para manter uma pessoa idosa saudável ou minimizar seu grau de dependência. / World Health Organization (WHO) projections pointed that between 2006 and 2030, the number of old people in low and middle income countries will increase 140% in relation to high income countries where it will increase 51% and , for the first time in the history, in 2050 the number of elderly will exceed the number of children (0-14 years), showing a new demographic profile. Health care for old people, together with the prevention of chronic and degenerative diseases, and the adequate training of carers are necessary for the maintenance of the autonomy and quality of life of the elderly. This study was carried out with 113 nonfamily related home carers of old people, living in urban area of the city of Taquaritinga, SP. The objective was to identify the profile of the home carers, their difficulties, responsibilities and tasks carried out for the patient and family. Interviews with open and closed questions were performed with 113 carers, in different place of their usual work, after previous contact, from July to September, 2011. Female carers predominated (85%), and the majority were married or in a stable union (57,5%) and in the age-group 19-59 years (90,3%); aged home carers appeared in a small proportion (9.7%). Among male carers, the majority was in the age-group 19-39 years. According to school attendance reported by the carers, 24.8% had elementary school, 21.2% high school, 31% technical level, 6.2% university degree and 16.8% never went to school. Nursing professionals were 35% of the carers, and only one carer had self-evaluation as well prepared for their task. The activity of carer was not the main activity for 77% of the interviewers, that have other job. The lack of training to carry their activities was reported by 87.6% of the carers. In spite of 94.7% of the carers mentioned that they were able to give home care, all of them reported that they have difficulties and need professional support, and this was independently of educational level, profession or level of dependence of the elderly. The family of the elderly do not help according to 35% of the interviewers and frequently (55%) delegate domestic or external work to be carried besides the care of the elderly. The weekly working time is more than 30 hours and the great majority do not have formal work contract and 33% of the carers reported that rarely they receive some payment. These results highlighted the need to a different vision to these professionals, mainly in the elaboration of public, social and health policies towards the formation of human resources to this activity, to keep aged persons in healthy conditions or to minimize their dependence.

Previsões da Organização Mundial de Saúde (OMS) apontam que entre os anos de 2006 e 2030, o número de pessoas idosas nos países de baixa e média renda está projetado para aumentar em 140% em relação ao aumento nos países de renda alta que será de 51% e, pela primeira vez na história, em 2050 haverá mais idosos do que crianças (0 14 anos), configurando-se um novo panorama demográfico. A assistência à saúde do idoso, em conjunto com a prevenção de doenças crônicas e degenerativas, e o preparo adequado de quem presta cuidado são imprescindíveis para a manutenção da autonomia e qualidade de vida do idoso. O presente estudo foi realizado com 113 cuidadores não familiares de idosos, que prestam cuidado no âmbito domiciliar, residentes na zona urbana do município de Taquaritinga (SP). Teve como objetivo identificar o perfil dos cuidadores na prestação de cuidados domiciliares, bem como suas principais dificuldades, responsabilidades e tarefas assumidas, perante o paciente e a família, no ato de cuidar. Foram aplicados questionários, contendo perguntas abertas e fechadas, a 113 cuidadores, em locais diferentes de onde exerciam a função, após contato prévio, no período de julho a setembro de 2011. Os cuidadores eram predominantemente do sexo feminino (85%), casados ou viviam em união consensual (57.5%), na faixa etária de 19 a 59 anos (90,3%); em menor proporção apareceu a população de cuidadores idosos (9,7%). Entre os cuidadores do sexo masculino, predominaram os na faixa etária de 19 a 59 anos (94,1%). Quanto à escolaridade referida pelos cuidadores, 24,8% possuíam apenas o nível fundamental, 21,2% o nível médio, 31% o nível técnico, 6,2% o nível superior e 16,8% sem escolaridade. Os profissionais de enfermagem constituíram 35% dos cuidadores, e somente um cuidador se auto avaliou como bem preparado. A profissão de cuidador não foi a principal atividade para 77% dos entrevistados, que exerciam outras atividades. Declararam não possuir qualificação para o exercício da função, 87,6% dos entrevistados e 45% referiram pouco preparo. Embora 94,7% dos cuidadores declarem ser capazes de cuidar, todos referiram possuir dificuldades e necessidade de um apoio profissional, independentemente do nível de escolaridade, formação profissional, ou nível de dependência do idoso. A família do idoso não auxilia no trabalho do cuidador em 35% dos casos, e frequentemente (55%) delega serviços domésticos ou externos para serem realizados além do ato de cuidar. A carga horária de trabalho semanal é superior a 30 horas e a grande maioria não possui vínculo empregatício formal; 33% dos cuidadores referiram que raramente são remunerados. Os resultados evidenciam a necessidade de um olhar diferenciado a esses profissionais, principalmente na elaboração de políticas públicas, sociais e de saúde voltadas à formação de recursos humanos para este fim, para manter uma pessoa idosa saudável ou minimizar seu grau de dependência. / World Health Organization (WHO) projections pointed that between 2006 and 2030, the number of old people in low and middle income countries will increase 140% in relation to high income countries where it will increase 51% and , for the first time in the history, in 2050 the number of elderly will exceed the number of children (0-14 years), showing a new demographic profile. Health care for old people, together with the prevention of chronic and degenerative diseases, and the adequate training of carers are necessary for the maintenance of the autonomy and quality of life of the elderly. This study was carried out with 113 nonfamily related home carers of old people, living in urban area of the city of Taquaritinga, SP. The objective was to identify the profile of the home carers, their difficulties, responsibilities and tasks carried out for the patient and family. Interviews with open and closed questions were performed with 113 carers, in different place of their usual work, after previous contact, from July to September, 2011. Female carers predominated (85%), and the majority were married or in a stable union (57,5%) and in the age-group 19-59 years (90,3%); aged home carers appeared in a small proportion (9.7%). Among male carers, the majority was in the age-group 19-39 years. According to school attendance reported by the carers, 24.8% had elementary school, 21.2% high school, 31% technical level, 6.2% university degree and 16.8% never went to school. Nursing professionals were 35% of the carers, and only one carer had self-evaluation as well prepared for their task. The activity of carer was not the main activity for 77% of the interviewers, that have other job. The lack of training to carry their activities was reported by 87.6% of the carers. In spite of 94.7% of the carers mentioned that they were able to give home care, all of them reported that they have difficulties and need professional support, and this was independently of educational level, profession or level of dependence of the elderly. The family of the elderly do not help according to 35% of the interviewers and frequently (55%) delegate domestic or external work to be carried besides the care of the elderly. The weekly working time is more than 30 hours and the great majority do not have formal work contract and 33% of the carers reported that rarely they receive some payment. These results highlighted the need to a different vision to these professionals, mainly in the elaboration of public, social and health policies towards the formation of human resources to this activity, to keep aged persons in healthy conditions or to minimize their dependence.

Abstract General anaesthesia (GA) is a widely used sedation method in dentistry. It is usually used for patients with an extensive dental treatment need, most often related to dental caries, and limited coping skills to consider conventional dental care. These patients are often small children or persons with dental fear. Using dental general anaesthesia (DGA) is expensive, special equipment and trained staff are needed, and it is not without risks for patients. The aim of this study was to investigate factors associated with children’s DGA. In addition to dental caries and dental fear, general health status, oral health behaviours, family-related factors, as well as dental attendance after DGA were in focus. The thesis is composed of five independent studies. There were three different study populations ‒ one in specialised and two in primary health care. There was also an age- and gender-matched comparison group for one of the study populations. Questionnaires were used in three of the studies, and two of the studies were based on patient files. According to the results, DGA is more common among medically compromised children than among healthy children. Medically compromised children have more often a history of DGA treatments compared with their healthy peers. Dental caries and dental fear were the main reasons for DGA in all of the studies. Dietary and drinking habits, as well as oral hygiene behaviours were distinctly poorer among children undergoing DGA than among those treated in a normal dental setting. A history of DGA in the family, a large number of siblings and male gender were important background factors associated with DGA. Patients treated under DGA were prone to miss or cancel their upcoming appointments. In conclusion, DGA is necessary in some cases, but it could be avoided if factors associated with DGA were taken into account in treatment plans. DGA in itself does not have an enhancing effect on oral health over the long term. / Tiivistelmä Yleisanestesia on hammashoidossa yleisesti käytetty sedaatiomenetelmä vaikeahoitoisille potilaille. He ovat usein pieniä lapsia, hammashoitopelkoisia tai sellaisia potilaita, joiden hoidontarve on liian laaja ja haastava tavanomaiseen hammashoitoon. Tämän tutkimuksen tavoitteena oli selvittää lasten nukutushammashoitoon liittyviä tekijöitä. Karieksen ja hammashoitopelon lisäksi tutkimuksen kohteena oli yleisterveydellisiä seikkoja, suunterveystottumuksia, perheeseen liittyviä tekijöitä sekä hammashoitopalvelujen käyttö nukutushammashoidon jälkeen. Tämä väitöskirja koostuu viidestä erillisestä osajulkaisusta. Tutkimusjoukkoja oli kolme: yksi erikoissairaanhoidosta ja kaksi perusterveydenhuollosta. Yhdelle tutkimusjoukolle oli ikä- ja sukupuolivakioitu vertailuryhmä. Kyselylomakkeita käytettiin kolmessa osajulkaisussa ja kaksi osajulkaisua perustui potilaspapereihin. Nukutushammashoito oli yleisempää yleissairailla kuin terveillä lapsilla. Yleissairailla lapsilla oli myös useammin nukutushammashoitohistoriaa kuin terveillä lapsilla. Karies ja hammashoitopelko olivat pääsyyt nukutushammashoitoon kaikissa tutkimuksissa. Juoma- ja ruokatottumukset, kuten myös suuterveystottumukset, olivat selkeästi huonommat nukutushammashoidossa hoidetuilla lapsilla kuin niillä lapsilla, jotka hoidettiin normaalisti hereillä. Perheen nukutushammashoitohistoria, suuri määrä sisaruksia ja miessukupuoli olivat merkittäviä nukutushammashoitoon yhteydessä olevia tekijöitä. Nukutushammashoidossa hoidetut potilaat jättivät usein tulematta nukutushammashoidon jälkeisille hammashoitokäynneilleen tai peruivat aikansa. Nukutushammashoito on välttämätön tietyissä tilanteissa, mutta se voitaisiin välttää, jos siihen liittyviä tekijöitä huomioitaisiin paremmin hoitosuunnitelmissa. Nukutushammashoidolla sinänsä ei ole suunterveyttä parantavaa pitkäaikaisvaikutusta.

Twenty-nine entrepreneurial teams from central Ontario were examined in three aspects: the mechanisms by which they were formed and modified, their social structure and the complementarity of team members were identified: Husband-Wife, Family-related, Partnerings, and Short-term partnerings, each type showing distinctive characteristics in terms of venture creation and team formation. _________ Vingt-neuf équipes d'entrepreneurs du centre de l 'Ontario ont fait l'objet d'une étude sur trois aspects soit, les mécanismes qui ont contribué à leur formation et à leur évolution, leur structure sociale et la complémentarité des membres de l'équipe : mari-femme, membres d'une même famille. sociétés de personnes et participations à court terme, chaque type présentant des caractéristiques distinctes en termes de création d'entreprise et de formation d'équipe

Les études longitudinales en milieu scolaire débutant en maternelle permettent une analyse des facteurs propres à l'enfant et à son environnement impliqués dans le développement de la lecture et de la réussite scolaire. Cependant, les études visant à analyser l'influence longitudinale de ces facteurs dès l'école maternelle restent exceptionnelles en France. Une étude épidémiologique initiée en 2001 dans la Communauté Urbaine de Creusot Montceau (Saône-et-Loire, France) avait comme objectif l'examen des contributions des facteurs propres à l'enfant et des variables environnementales dans l'acquisition de la lecture et la réussite scolaire dès la maternelle (3-6 ans) jusqu'au milieu de l'école élémentaire (CE2, 8-9 ans). Le travail de thèse présenté a permis le prolongement de la période de recueil de donnés jusqu'à la fin du collège (3ème, 14-15 ans) représentant une période de suivi de 10 ans dans la population générale. L'objectif principal de ce travail est d'identifier les facteurs propres à l'enfant (cognitifs, académiques et comportementaux) et des variables environnementales (facteurs sociodémographiques et caractéristiques familiales) dans le développement de la lecture à la fin de l'école primaire (CM2) et la réussite scolaire à la fin du collège (3ème). Les échantillons comprenaient 829 enfant inscrits en Grande Section de Maternelle pendant l'année scolaire 2001-2001 (Cohorte 1, 90% de l'échantillon initial) suivis jusqu'à la fin du collège (année scolaire 2010-2011) et 812 enfants de Grande Section de Maternelle durant l'année 2003-2004 (Cohorte 3) suivis jusqu'à la fin de l'école élémentaire (Cours Moyen 2, année scolaire 2008-2009). En Grande Section de Maternelle, le recueil de données a compris l'évaluation des compétences cognitives, académiques et comportementales des enfants, ainsi que le recueil des informations concernant le contexte familial. Les mesures de réussite scolaire ont compris les résultats des enfants dans les évaluations nationales réalisées à la fin du collège pour la Cohorte 1, (Diplôme National du Brevet) et les performances des enfants dans une mesure standardisée de lecture de mots à la fin de l'école élémentaire pour la Cohorte 3 (ODEDYS, Jacquier-Roux, Valdois & Zorman, 2002). Les compétences de traitement phonologique, la connaissance de lettres et le comportement attentif étaient les prédicteurs le plus significatifs de la lecture de mots au Cours Moyen 2. Le signalement par les parents d'antécédents familiaux de difficultés de lecture était associé simultanément avec des difficultés de lecture et le comportement inattentif à la fin de l'école élémentaire. En 3ème année du collège, les compétences de langage oral, la connaissance de lettres, la mémoire verbal à court terme, le raisonnement perceptif (facteur non-verbal) et le comportement attentif des enfants en maternelle, ainsi que le niveau d'éducation des parents et le type de famille, ont prédit significativement la mesure de réussite scolaire générale à la fin du collège. En outre, les résultats ont montré l'influence de plusieurs caractéristiques familiales dont la nationalité du père, le mode de garde avant la scolarisation, les rituels d'endormissement et les antécédents familiaux de difficultés de lecture. Ces caractéristiques renvoient à des facteurs qui mettent un enfant en risque d'échec scolaire à la fin du collège. Ce travail contribue à la littérature scientifique existante concernant les facteurs propres à l'enfant et à son environnent familial liés à l'acquisition de la lecture et à la réussite scolaire. Les résultats permettent l'identification des facteurs familiaux mettant un enfant à risque d'échec scolaire. Il ont des importantes implications pour repérer le plus précocement possible les enfants à risque de développer des difficultés de lecture et d'échec scolaire et pour mettre en place des programmes d'intervention adéquats à ses difficultés dès le début des trajectoires académiques de l'enfant. / Longitudinal studies starting during kindergarten provide an appropriate method to investigate the child- and environmental-level factors that account for children's reading and academic achievement later in their educational trajectories. In France, studies designed to follow-up children longitudinally from kindergarten onwards remain scarce. An epidemiological study started in 2001 in the Urban Community of Creusot Montceau (Saône-et-Loire, France) sought initially to identify the factors associated with children's reading acquisition and academic achievement from preschool (3-6 years) to the middle of elementary school (Grade 3, 8-9 years). The PhD project reported here aimed to extend the original design of data collection to the end of middle school (Grade 9, 14-15 years) spanning a 10-year follow-up period in the general population. This work aimed to investigate the specific contributions of child-level factors (cognitive-academic skills, behavior problems) and environment-level factors (sociodemographic and family characteristics) for children's subsequent reading acquisition at the end of elementary school (Grade 5), as well as academic achievement at the end of middle school (Grade 9). The samples of analysis comprised 829 kindergarteners in the 2001-2002 school year (Cohort 1, 90% of the initial sample) followed through the end of middle school (Cohort 1, 2010-2011 school year) and 812 kindergarteners in the 2003-2004 school year (Cohort 3), from which a sub-sample of 154 participants was followed through the end of elementary school (2008-2009 school year). At kindergarten, assessment included measures of children's cognitive-academic and behavioral skills, as well as family background characteristics. Outcome measures were composed of children's results in the national evaluations performed at the end of middle school for Cohort 1 ("Diplôme National du Brevet") and of children's scores in standardized measures of word reading achievement at the end of elementary school for Cohort 3 (ODEDYS, Jacquier-Roux, Valdois & Zorman, 2002). The results indicated that children's phonological processing skills, letter knowledge and attentive behavior were the most robust predictors of word reading achievement at Grade 5. In addition, parental reports of familial antecedents of reading difficulties also contributed to predict word reading at Grade 5 and were specifically associated with both reading difficulties and inattention behavior at this grade level. At Grade 9, children's oral language skills, letter knowledge, short-term verbal memory, perceptual reasoning (non-verbal cognitive ability) and attentive behavior at kindergarten predicted significantly the outcome measure of general academic achievement at Grade 9, together with parental educational level and family structure. Moreover, results indicated the influence of several family characteristics referring to father's nationality, type of early childcare, language-based bedtime routines and familial antecedents of reading difficulties as risk factors for children's subsequent academic underachievement. The present work contributes to the extant literature regarding the child- and family-level factors associated with subsequent reading acquisition and academic achievement from kindergarten to elementary and middle school. Importantly, these results allowed the identification of novel familial risk factors that influence negatively children's subsequent academic trajectories. These findings have important implications regarding the child and family factors that should be targeted during kindergarten in order to prevent children's subsequent reading and academic difficulties and to promote adequate intervention strategies early in children's educational trajectories.

The purpose of the study was to explore the factors that contribute to poor academic achievement in TVET Colleges in the North West Province. A qualitative method of one-on-one interviews was utilised to collect data from participants. The study revealed that poor funding or late payment of NSFAS constitutes the demotivation of students, which results to poor performance. On the other hand, the lecturers also blame the poor results on students’ lack of motivation. The quality of students that register for NC(V) programmes do not match the curriculum as the mainstream schools do not adequately prepare them for the college curriculum. Based on the findings of the study, it is recommended that the top achieving students be awarded with incentives to motivate them. The NSFAS Bursaries ought to pay-out early in the year so that students may have enough funds for their transport and other college related needs. The students’ support services ought to be made available for the low performing students. / Educational Management and Leadership / M. Ed. (Education Management)