Orientador: Leticia de Las Mercedes Marin Leon / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-20T12:33:32Z (GMT). No. of bitstreams: 1 Souza_BrunaFernandadoNascimentoJacintode_M.pdf: 1706725 bytes, checksum: a10d84f881f09fd77059e4e90345d5b2 (MD5) Previous issue date: 2012 / Resumo: As transições demográfica, epidemiológica e nutricional, o envelhecimento populacional, bem como o aumento das doenças crônicas não transmissíveis, dentre elas a obesidade, passaram a ser temáticas importantes nos países em desenvolvimento. Assim, o objetivo deste estudo foi comparar as condições de vida e saúde de idosos usuários do restaurante popular Bom Prato, e seus vizinhos no município de Campinas. Os resultados desta dissertação são apresentados em dois capítulos. No primeiro, Condições de vida e saúde de idosos residentes em Campinas-SP: estudo caso- controle com usuários de restaurante popular, foram analisadas as diferenças nas condições de vida e saúde entre idosos usuários do restaurante popular do município e de seus vizinhos de Condições de vida e saúde de idosos residentes em Campinas-SP: estudo caso- controle com usuários de restaurante popular endereço. Apesar de os idosos usuários do restaurante apresentarem condições socioeconômicas desfavoráveis em relação aos seus vizinhos, mostrando-se como grupo de vulnerabilidade social, suas condições de saúde e autonomia foram melhores que as de seus vizinhos. No segundo capítulo, Condições de vida e saúde associadas ao sobrepeso e obesidade em idosos, avaliaram-se os fatores demográficos, socioeconômicos, de estilo de vida e saúde associados ao sobrepeso e obesidade. Os idosos com sobrepeso ou obesidade foram comparados aos eutróficos. Verificou-se que os idosos com excesso de peso apresentaram piores condições de saúde e autonomia. Estes resultados podem auxiliar na orientação de políticas públicas de saúde, visando à promoção da saúde, por meio da prevenção das doenças crônicas e incentivo de hábitos alimentares e estilo de vida saudável, provendo assim melhor qualidade de vida no envelhecimento / Abstract: The demographic, epidemiological and nutritional transitions led to major changes in population structure and patterns of mortality and morbidity. Thus, aging population and the increases in chronic diseases, among them obesity, have become an important issues also in developing countries. Through these considerations, the objective of this study was to compare the living and health conditions of elderly clients of the social restaurant Bom Prato and its neighbors in the city of Campinas. The results of this work are presented in two chapters. In the first chapter, Living and health conditions of elderly residents in Campinas-SP, Brazil: casecontrol study with social restaurant clients, we analyzed the differences in living and health conditions among elderly clients of the social restaurant in the city and its neighbors address. Although the elderly clients of the restaurant present unfavorable socioeconomic conditions in relation to their neighbors, showing themselves as a group of social vulnerability, their health and autonomy were better than their neighbors. In the second chapter, Living and health conditions associated with overweight and obesity among elderly, we assessed the demographic, socioeconomic, lifestyle and health variables associated with overweight and obesity in the elderly. The elderly with overweight or obese were compared to normal weight. It was found that elderly people with excess of weight had poorer health and autonomy. These findings may help in guiding public health policies aimed the promotion health through the prevention of chronic diseases and encourage eating habits and healthy lifestyle, thus providing better quality of life in aging / Mestrado / Epidemiologia / Mestre em Saude Coletiva

M.Tech. (Radiography) / Cervical cancer is the most frequently diagnosed cancer among women in Zambia. More recently, improved cure rates have been obtained with the concomitant use of radiotherapy and chemotherapy in locally advanced cancer of the cervix. However, the side effects associated with the treatment have a major impact on the quality of life (QoL) of these women. Prior to this study, QoL in Zambian women treated for cervical cancer with chemo-radiation had not been assessed thus creating a gap in the literature and hampering an attempt to improve QoL in this cohort of patients. The aim of this study was therefore to evaluate the impact of chemo-radiation treatment on QoL and to determine what socioeconomic and demographic factors are closely related with QoL decrements in Zambian women treated for cervical cancer at Cancer Diseases Hospital. This would then facilitate the introduction of intervention programmes aimed at improving QoL in these patients. The study was prospective and explored the phenomenon of QoL with the use of the European Organization for Research and Treatment of Cancer (EORTC) questionnaire and a demographics questionnaire answered by 45 women treated for cervical cancer with chemo-radiotherapy at Cancer Diseases Hospital. The use of the EORTC quality of life questionnaire added validity and reliability to the study as it is used extensively to measure health-related quality of life in cancer survivors worldwide. Analysis of the data indicates that patients with advanced cervical cancer treated with chemo-radiotherapy generally experienced a favourable QoL, and treatment was considered worthwhile by the majority of patients. However, women described problems with sexuality and marital relationships. Low education and living without a partner were depicted as risk factors for the development of the reported problems. To improve QoL in survivors, interventions focusing on more social support, education to improve patients’ understanding of their disease and treatment effects as well as physical rehabilitation through exercise interventions are recommended as mandatory.

Magister Scientiae Dentium - MSc(Dent) / The aim of the research was to determine oral health status, knowledge, attitude and practicesv regarding oral hygiene among pregnant women attending Omdurman Maternity Hospital in Khartoum, Sudan.

Coronary heart disease takes a large toll of middle-aged males thereby reducing the overall occupational fitness and potential of the workforce. Most of the risk factors for CHD (and other diseases) are self-determined and/or the result of preventable behaviour or alterable environment. The Multiple Risk Factor Hypothesis and the CHD risk factors are reviewed in detail in Chapter 2. It is more the interaction among risk factors within supposedly "normal" limits, rather than abnormally high levels of one or a few factors which results in the development of CHD, a phenomenon which obscures the issue of causation. It is hypothesized that the imbalance between the collective pathogenic effects of risk factors and the ability of the body to resist and/or repair such effects cause CHD. States such as sedentariness and obesity in which most of the risk factors tend to be clustered are important risk indicators. Moreover, since the overall risk profile is improved with reversal of these two states through regular aerobic activity and weight loss, the latter two are key interventions in CHD prevention. Risk factor screening to identify those at risk and subsequent modification of the risk status are useful manoeuvers for the prevention of CHD. As well as being secondary to the ravages of such diseases as CHD, occupational productivity is also reduced by poor levels of employee physical fitness. The recognition by employers of the potential success of CHD prevention programs and the increased productivity of the fit employee has led to the emergence of employer-sponsored occupational fitness programs. Such programs are based on a wholistic health-enhancement approach with regular aerobic physical activity as the core. The operative principles, contents (including the what and how of the all important assessment component) and benefits of such programs are reviewed in Chapter 3. A review of the state of health and fitness in the Canadian Forces and the experimental portion of the thesis make up Chapter 4. In spite of policies, orders and programs to ensure the health and fitness of Canadian Forces' personnel, the CF remains a fairly high-risk population. The cross-sectional study on the health and fitness of 2 83 CF personnel at National Defence Headquarters shows that Other Ranks constitute a higher-risk rank grouping than Officers, as do lower ranks in both of these two major rank groupings. Volunteers appear to be a self-selected sub-population which is healthier and fitter than average. Aerobic fitness (VO₂ max), obesity and resting heart rate emerge as the three key indicators of health and CHD risk status. Chapter 5 summarizes the thesis and contains conclusions and recommendations to the CF for future actions which are also applicable to most occupational settings. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

Orientador: Eliana Martorano Amaral / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-27T18:20:39Z (GMT). No. of bitstreams: 1 Christoforo_Fatima_D.pdf: 2258975 bytes, checksum: 26eb43ac3e7fb395496704555db4a6f1 (MD5) Previous issue date: 2015 / Resumo: Objetivos: Estudar os indicadores de saúde materna e perinatal, e socioeconômicos de 19 municípios e avaliar as rotinas da assistência aos partos da Região Metropolitana de Campinas (RMC). Sujeitos e Métodos: Trata-se de estudo transversal, associado a um estudo de casos de rotinas do cuidado na assistência ao parto em 16 maternidades públicas. Coletaram-se as informações referentes aos indicadores municipais a partir do DATASUS, da Fundação Seade e do censo de 2010. Para conhecer as intervenções realizadas nas 16 maternidades em entrevistas com médicos ou enfermeiros responsáveis, utilizaram-se o "Instrumento de avaliação de implantação das boas práticas na atenção à mulher e ao recém-nascido no parto" (Ministério da Saúde) e um questionário complementar próprio para o estudo. A coleta de dados ocorreu de dezembro de 2013 a outubro/2014. Utilizou-se análise descritiva para as práticas hospitalares e coeficientes de correlação de Pearson e Spearman para avaliar possíveis associações entre características socioeconômicos e demográficas e resultados obstétricos e perinatais. Resultados: As porcentagens de mães adolescentes, de renda ? 1 salário-mínimo (SM) e a taxa de analfabetismo se correlacionaram positivamente com a número de consultas pré-natais e com a taxa de mortalidade perinatal, porém inversamente com partos cesáreos. A renda média domiciliar per capita e o Índice de Desenvolvimento Humano Municipal foram correlacionados diretamente com partos cesáreos e inversamente com número de consultas pré-natais e com a taxa de mortalidade perinatal. A porcentagem de mães adolescentes e de escolaridade ? 8 anos e a taxa de analfabetismo se correlacionaram positivamente com a taxa de mortalidade neonatal precoce, taxa de prematuridade e baixo peso ao nascer. Em relação às rotinas das 16 maternidades públicas da RMC, treze hospitais utilizavam partograma, 10 utilizavam frequentemente a ocitocina para a condução do trabalho de parto, nove executavam a episiotomia frequentemente e 14 realizavam o manejo ativo do terceiro período do parto. A presença de acompanhante durante o trabalho de parto e parto foi rotineira para 9 e 14 hospitais, respectivamente. Todos os hospitais forneceram rastreamento para HIV e sífilis. Doze hospitais realizavam indução em gestação prolongada e 13 em ruptura prematura de membranas, enquanto 15 tinham protocolos de conduta para hipertensão arterial severa e profilaxia de sepse neonatal precoce por Streptococcus do grupo B. Cinco hospitais não utilizavam antibióticos para cesarianas. Produtos derivados de sangue não estavam disponíveis em quatro hospitais e oito não poderiam cuidar de gestantes em situação clínica grave. Quinze hospitais relataram ter profissional treinado para atendimento neonatal. Conclusão: A taxa de mortalidade perinatal foi o indicador que melhor refletiu os indicadores socioeconômicos na região. A adolescência foi um indicador social de grande risco perinatal, frequentemente associada com ausência de parceiro. A taxa de cesárea retratou os municípios com maior poder aquisitivo na região. As práticas qualificadas de assistência ao parto estavam disponíveis em quase todos os hospitais. No entanto, algumas delas parecem excessivas, como condução de parto e episiotomia, enquanto outras precisam ser melhoradas, como uso de antibióticos para todos os partos cesáreos e disponibilidade de sangue e cuidado de emergência. Os resultados destacam a inequidade da assistência e a importância de rever as rotinas hospitalares, mesmo em uma região com amplo acesso a recursos materiais e humanos e oportunidades de educação continuada / Abstract: Objectives: To study maternal and perinatal health, and socioeconomic indicators of 19 municipalities, and assess the routines of care during childbirth in the metropolitan region of Campinas (RMC). Subjects and Methods: Cross-sectional study, coupled with a case study of 16 public hospitals on clinical routines applied for labour and delivery. The information on health and socioeconomic indicators derived from the DATASUS, the Seade Foundation and 2010 census. Routines were assessed by through the "Assessment Tool of Good Practice Caring for Women and Newborns during Childbirth" (Ministry of Health) and a complementary questionnaire, for interviews with responsible doctors or nurses in 16 hospitals. Data collection occurred from December / 2013 to October / 2014. Descriptive analysis was applied to report routine practices in hospitals, and Pearson and Spearman correlation coefficients were used to evaluate possible associations between socioeconomic, obstetric, and perinatal outcomes. Results: The proportion of teenage mothers and income ? 1SM, and the illiteracy rate were positively correlated with number of prenatal visits and perinatal mortality rate, and inversely with caesarean deliveries. The average household income per capita and the Municipal Human Development Index (MHDI) correlated directly with caesarean deliveries and inversely with number of prenatal consultations and perinatal mortality rate. The percentages of teenage mothers and education ? 8 years, and the illiteracy rate correlated positively with the early neonatal mortality rate, prematurity and low birth weight. Regarding routine practices during deliveries into 16 public maternities, thirteen hospitals used partograph, 10 frequently used oxytocin for labour augmentation, nine frequently performed episiotomy and 14 informed active management of the third stage of labour. The presence of a companion during labour and delivery was a routine for nine and 14 hospitals, respectively. All hospitals provided screening for HIV and syphilis. Twelve hospitals performed induction in prolonged gestation and 13 in premature rupture of membranes. Fifteen had clinical protocol for severe hypertension and for group B Streptococcus early neonatal sepsis prophylaxis. Five hospitals did not use antibiotics for caesarean sections. Blood products were not available in four hospitals and eight could not take emergency care for severe ill women. Fifteen hospitals reported trained professional providing neonatal care. Conclusion: The perinatal mortality rate proved to best indicator reflecting socioeconomic indicators in the region. The caesarean rate pictured the municipalities with higher income. Qualified health practices were available in most hospitals. However, augmentation with oxytocin and episiotomy sounded excessive, while others need improvement, as antibiotics for all C-sections and availability of blood and emergency care. The results highlight the health care inequity and the importance of reviewing hospital care routines, even in a region with ample access to material and human resources, and continuing education opportunities / Doutorado / Saúde Materna e Perinatal / Doutora em Ciências da Saúde

Orientador: Letícia de Las Mercedes Marín-León / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-27T21:41:12Z (GMT). No. of bitstreams: 1 White_HarrietJane_D.pdf: 2077224 bytes, checksum: 00cc57ec7743150ef044b91043e24621 (MD5) Previous issue date: 2015 / Resumo: O objetivo do estudo foi investigar as variáveis socioeconômicas, condições de saúde, hábitos alimentares, estado nutricional, aconselhamento nutricional e qualidade de vida em idosos portadores de diabetes mellitus e hipertensão arterial, em relação aos idosos sem estas doenças. A amostra foi de conveniência e composta por idosos de ambos os sexos, de 60 anos e mais e residentes em Campinas. Os idosos portadores de diabetes e hipertensão foram recrutados em um Hospital Universitário e o grupo dos idosos, sem estas doenças foram selecionados em centros esportivos, onde são realizadas atividades físicas direcionadas à população idosa. Os dados obtidos foram avaliados por meio de um questionário estruturado, e aferido peso, altura e circunferência da cintura. Nos artigos 1 e 2, o delineamento do estudo epidemiológico foi caso-controle e no artigo 3, desenho transversal. No primeiro artigo, deste trabalho "Condições de saúde de idosos diabéticos e hipertensos: estudo caso-controle", o objetivo foi comparar idosos portadores de diabetes e hipertensão (casos; n=150), com idosos sem essas doenças (controles; n=300), quanto às características sociodemográficas, comportamentos de saúde, estado nutricional e capacidade funcional. Idosos portadores de hipertensão e diabetes apresentaram maior percepção de limitações econômicas e físicas, piores condições de saúde e obesidade, quando comparados aos idosos sem essas doenças. No segundo artigo, "A importância da Síndrome Metabólica em idosos", o objetivo foi comparar idosos portadores de Síndrome Metabólica (casos; n=103), com idosos sem Síndrome Metabólica (controles; n=206), quanto às características sociodemográficas, estilo de vida, e hábitos alimentares. Para a seleção dos casos, foi utilizado o critério proposto pela NCEP-ATPIII (2001), e para o grupo dos controles foram selecionados os idosos que não apresentaram o conjunto de fatores de risco para Síndrome Metabólica. Reforça-se a importância das modificações no estilo de vida, incluindo perda de peso e abstenção do tabagismo, e intervenções dietéticas que possam contribuir para a redução da circunferência da cintura, além da prática de atividade física regular e cuidados com a alimentação na prevenção e no controle da Síndrome Metabólica. No terceiro artigo "Orientações nutricionais em serviços de saúde - a percepção de idosos portadores de hipertensão e diabetes", o objetivo foi descrever os aspectos do atendimento nutricional e das práticas alimentares entre idosos, em face das orientações nutricionais recebidas. Realizado estudo transversal com idosos portadores de diabetes e hipertensão, de ambos os sexos. Participaram 150 idosos e disseram ter recebido material educativo contendo orientações nutricionais, 80% dos homens e 64% das mulheres, porém, estas não eram seguidas por uma parcela dos entrevistados, e 50% das mulheres e 62% dos homens relataram dúvidas sobre as orientações recebidas. O expressivo número de idosos com sobrepeso e obesidade, e aumento da circunferência da cintura, reflete a baixa adoção das recomendações nutricionais, e aponta para a necessidade de aprimorar a capacitação dos profissionais de saúde quanto às orientações de alimentação e atividade física / Abstract: The objective of the study was to investigate socioeconomic, health, eating habits, nutritional status, nutrition counseling, and quality of life among elderly patients with diabetes mellitus and hypertension and elderly without these diseases. A convenience sample composed of elderly men and women, 60 years and more, and living in Campinas-SP. Elderly diabetic and hypertensive patients, were recruited at the University Hospital and the group without these diseases, was selected in sports centers, which offer physical activities for the elderly. Elderly were evaluated through a questionnaire, and mesured weight, height and waist circumference. Article 1 and 2, are case-control study, and article 3, cross-sectional study. In the first article of this thesis "Health conditions of diabetic and hypertensive elderly: Case-control study", the objective was to compare elderly patients with diabetes and hypertension (cases, n=150), with older people without these diseases (controls, n=300), regarding sociodemographic characteristics, health behaviors, nutritional status and functional capacity. Elderly patients with hypertension and diabetes had more physical and economic limitations, worse health status, and obesity, when compared to subjects without hypertension and diabetes. In the second article, "The importance of metabolic syndrome in the elderly", the objective was to compare elderly patients with metabolic syndrome (cases, n=103), or without metabolic syndrome (controls, n=206), regarding sociodemographic characteristics, lifestyle, eating habits and eating disorders. To select the cases, we used the criteria proposed by the NCEP-ATPIII (2001), and the control group, were selected who did not have the set of risk factors for metabolic syndrome. Reinforces the importance of changes in lifestyle, including loss of weight and smoking abstention, and dietary interventions that can contribute to the reduction of waist circumference, in addition to regular physical activity and nutritional care, in the prevention and control of Metabolic Syndrome. The third article "nutritional guidelines in health services - the perception of elderly patients with hypertension and diabetes", aims to describe aspects of nutritional care and feeding practices among the elderly in face of nutritional guidelines received. A cross-sectional study of elderly patients with diabetes and hypertension of both sexes was carried out with 150 elderly, and 80% of men and 64% of women, informed they had received educational materials containing nutritional guidelines, but these were not followed by part of them and 50% of women and 62% of men reported having doubts about the guidelines received. The significant number of overweight or obese elderly, and the increased waist circumference reflects the limited use of nutritional recommendations and indicates the need to improve the training of health professionals as to food guidelines and physical activity / Doutorado / Epidemiologia / Doutora em Saúde Coletiva

京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第21962号 / 社医博第93号 / 新制||社医||10(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 古川 壽亮, 教授 中山 健夫, 教授 川上 浩司 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

Background: To explore the effectiveness of a multi-layered health promotion approach in rural China. Methods: A two-year intervention was applied to the 18 intervention rural villages while the 18 controls received standard health communication materials. Data were collected at baseline and post-intervention respectively to evaluate the effectiveness. Results: All intervention villages had developed healthy policies addressing prioritized health issues such as livestock captivity, garbage disposal, etc.; however, no healthy policies had been developed in the controls. The two-week morbidity rate and incidence of diarrhea of the intervention villages decreased to 13.4% from 18.5% (p = 0.009), and to 9.5% from 13.0% (p = 0.038), respectively, whereas no statistically significant change was found in the controls. The knowledge about hepatitis B and rabies transmission had increased significantly among the intervention villagers (hepatitis B from 27.5% to 34.4%, p = 0.005; rabies from 12.0% to 24.6%, p < 0.001) but not in the control for rabies (p > 0.05). Among both intervention and control groups, the proportion of proper hand-washing and chopping board use increased significantly (all p < 0.01). Greater changes had been found in physical inactivity and alcohol drinking among the intervention group than the control. No change was found in smoking rate among both groups. Score values (mean ± SD) for environmental quality, livestock captivity, and vector density (e.g., mosquitoes, flies, rats, and cockroaches) increased significantly from 2.8 ± 0.9 to 3.4 ± 0.7, from 1.9 ± 0.9 to 2.5 ± 0.9, and from 0.6 ± 0.9 to 1.8 ± 0.4, respectively (p < 0.05) in the intervention villages. Conclusions: The two-year multi-layered health promotion approach shows real promise in empowering the rural communities to take control over, and protect their own health.

Indiana University-Purdue University Indianapolis (IUPUI) / The emergence of the global SARS-CoV-2 pandemic created tremendous impact on humanity beginning in late 2019. Public health researchers at Indiana University Richard M. Fairbanks School of Public Health responded by conducting research into the etiological profile of the virus, including a large Indiana state-wide population-based prevalence study in early 2020. Methods Data on demographics, tobacco use, health status, and reasons for participating in the population prevalence study were used to conduct three retrospective cross-sectional studies. The first study assessed the association of self-reported health and tobacco behaviors with COVID-19 infection (n=8,241). The second study used successive wave analysis to assess nonresponse bias (n=3,658). Finally, participants demographics were characterized by who responded to text, email, phone calls, or postcards and by the number of prompts needed to elicit participation (n= 3,658). Results The first study found self-identified health status of those reporting “poor, “fair” or good” had a higher risk of past or current infections compared to “very good” or “excellent” health status (P <0.02). Positive smoking status was inversely associated with SARS-CoV-2 infection (p <0.001). When assessing the sample for non-response bias (n=3,658), 40.9% responded in wave 1 of recruitment, 34.1% in wave 2 and 25.0% in wave 3 for an overall participation rate of 23.6%. There were no significant differences in response by waves and demographics, being recently exposed or reasons for participating. In the final study, compared to males, females made up 54.6% of the sample and responded at a higher rate to postcards (8.2% vs. 7.5%) and text/emails (28.1 vs. 24.6%, 2= 7.43, p 0.025); and responded at a higher percentage after 1 contact (21.4 vs. 17.9%, 2 = 7.6, p 0.023). Conclusion This research contributed to the scientific understanding of the etiological picture of SARS-CoV-2. Additionally, the current study used a novel method that public health practitioners can easily implement to detect non-response bias in primary data collection without advanced statistical methods. Finally, the current study allows researchers to focus not only on the modality of inviting participants, but the frequency of invitations needed to secure specific populations, reducing time and resources.

Over an 18-year period, beginning in 1955, a group of subjects has been studied six times to determine if any relationship exists among serum cholesterol levels, body weight, health status, diet quality and stress or anxiety. For the first four test periods, extending through ages 7 to 16 years, there were 321 subjects. Later, in 1968, 86 of the original 321 subjects, now aged 19-22 years, were able to participate in a follow-up study. The 1974 study was able to involve 30 of the original 321 subjects now aged 26-29 years. Findings show that from approximately the fifteenth year onward serum cholesterol levels in males continue to rise in an almost linear fashion, whereas females experienced a drop in serum cholesterol levels at ages 19-22 years which was followed by a rise when they reached 26-29 years. Persons who were classified as overweight in the sixth test period had higher serum cholesterol levels than persons classified as either desirable weight or under-weight for both sexes. Anxiety levels as determined by the IPAT anxiety scale questionnaire in the sixth test period showed that for males there was a positive relationship between serum cholesterol and anxiety but for women a negative relationship was shown. Subjects with serum cholesterol levels above 250 mg/100 ml consumed diets higher in saturated fats than the subjects with serum cholesterol levels below 250 mg/100 ml. In males a significant positive correlation was shown between serum cholesterol levels and smoking.