Dispositional optimism, as a stable outcome expectancy, has been shown to predict health outcomes in several contexts. Research has demonstrated that health-impaired subjects with optimistic outlooks fared better than those with a pessimistic outlook. Choice of coping strategies has been theorized as the mediating factor through which optimism operates. However, the construct of dispositional optimism has been challenged as a polar opposite of neuroticism, thus contending that optimism is not an independent notion. The present study was designed to evaluate further the theoretical underpinnings of dispositional optimism theory. Subjects were selected from a population of cardiac patients who received an automatic implantable cardioverter defibrillator (AICD). This device, designed to save the patient from sudden cardiac death, dispenses an electric shock to the heart should it exhibit sustained ventricular tachycardia or fibrillation. This research project examined the relationship of dispositional optimism, coping, and neuroticism to psychological distress, life satisfaction, health perception, and frequency of prior AICD discharges. Intact data from 50 of the 60 participants were examined in multiple regression analyses. The results of the analyses were diverse. Principal findings were (a) general psychological distress was predicted solely by neuroticism but optimism predicted the majority of unique variance in the "style" with which subjects approach the assessment of distress; (b) optimism was subsumed under neuroticism in predicting health perception; (c) avoidance coping interacted with optimism in predicting a significant amount of unique variance over and above neuroticism in the number of AICD discharges experienced by the patients. In this latter finding, pessimistic patients who did not use avoidance coping received a greater number of discharges. Thus, optimism and neuroticism were not parallel constructs in all dependent variables. Also, the optimism/avoidance coping interaction in predicting an actual medical outcome was unprecedented. Limitations and directions for future research were discussed.

INTRODUCTION: population growth of elderly has promoted extensive discussions around social impact and propositions about the epidemiology of aging. Aging causes the reduction of vital functions, health and mobility levels can be an aggravating factor to the quality of life of the elderly. OBJECTIVE: To identify the physical active, perception of health and quality of life in elderly participants of the Lower São Francisco Sergipe living group. METHODS: The study is a descriptive, cross-sectional epidemiological research. The population consisted of elderly participants in social groups linked to CRAS / CREAS. The sample consisted of 184 elderly of 11 municipalities in the Territory Lower São Francisco (SE), aged 69 ± 7.16 years. We used the ABEP questionnaires WHOQOL-BREF and IPAQ to describe the socioeconomic status, the perception of quality of life and satisfaction with health, and physical activity levels. It used the binary logistic regression with robust estimator with 5% significance level organized in univariate and multivariate models. For statistical analysis we used the SPSS version 22. RESULTS: The main results indicate that low levels of education and income do not interfere negatively in the perception of health and quality of life (p = 0.271). The use of medications (p = 0.03) and motor limitations related to disease (p = 0.02) interfere negatively in the perception of health and quality of life. The level of physical activity there was no significant difference, 50.5% had high levels of physical activity. CONCLUSION: social relations in peer groups are factors that favor the improvement of self-esteem and a positive perception of health quality of the elderly and encourages active aging and is therefore a practice to be considered as a public health measure for their systematic planning and intervention in the aging process. / INTRODUÇÃO: o crescimento populacional de idosos tem promovido amplas discussões em torno impacto social e proposições acerca da epidemiologia do envelhecimento. O envelhecimento provoca a redução das funções vitais, dos níveis de saúde e mobilidade podendo ser um fator de agravo à qualidade de vida do idoso. OBJETIVO: identificar o nível de atividade física, a percepção de saúde e qualidade de vida em idosos participantes de grupo de convivência do Baixo São Francisco Sergipano. MÉTODOS: o estudo é uma pesquisa epidemiológica descritiva e transversal. A população foi composta de idosas participantes de grupos de convivência ligados ao CRAS/CREAS. A amostra foi composta por 184 idosas de 11 municípios do Território Baixo São Francisco (SE), com idade de 69±7,16 anos. Utilizou-se os questionários ABEP, WHOQOL-BREF e IPAQ para descrição do nível socioeconômico, a percepção de qualidade de vida e satisfação com a saúde, e níveis de atividade física. Foi utilizada a Regressão logística binária com estimador robusto com nível de significância de 5% organizada em modelos univariados e multivariados. Para tratamento estatístico foi utilizado o SPSS versão 22. RESULTADOS: os principais resultados indicam que os baixos níveis de escolaridade e renda não interferem de forma negativa na percepção de saúde e Qualidade de vida (p=0,271). A utilização de medicamentos (p=0,03) e limitações motoras para doenças relatadas (p=0,02) interferem de forma negativa na percepção de saúde e qualidade de vida. O nível de atividade física não houve diferença significativa, 50,5% apresentaram bons níveis de atividade física. CONCLUSÃO: as relações sociais em grupos de convivência são fatores que favorecem a melhoria da autoestima e a percepção positiva na promoção da saúde e qualidade do idoso, por meio do envelhecimento ativo, sendo, uma prática a ser considerada como medida de saúde pública em relação a sua sistemática, planejamento e intervenção no processo de envelhecimento.

Dans le monde, une naissance sur 10 est prématurée, se produisant avant 37 semaines de gestation, et environ 1% sont très prématurées (<30 semaines de gestation). La prématurité est associée à des altérations de la structure et fonction cardiovasculaire qui persistent à l’âge adulte et sont liées aux maladies cardiovasculaires. Il n’y a cependant pas de recommandations cliniques pour le suivi de la santé cardiovasculaire chez les jeunes adultes nés très prématurément. Cette thèse porte sur la prévention des maladies cardiovasculaires dans cette nouvelle population à risque. Ses objectifs principaux sont de décrire les effets à long terme de la prématurité sur la santé adulte et de présenter les avenues de prévention et d’intervention permettant de mitiger ces effets. Son premier chapitre présente une revue de la littérature pertinente alors que son second détaille les méthodes employées pour obtenir les résultats présentés dans les chapitres suivants. Brièvement, la cohorte HAPI (Health of Adults born Preterm Investigation) est constituée de jeunes adultes nés entre 1986 et 1996 au Québec soit prématurément (<30 semaines de gestation) ou à terme (>37 semaines de gestation). C’est la population étudiée dans les chapitres 3 à 5. Le chapitre 3 présente une diminution de la capacité aérobie à l’effort chez les sujets nés prématurément et explore les facteurs y contribuant, incluant des paramètres hémodynamiques cardiaques. Le chapitre 4 examine la perception de la santé et l’utilisation des services de santé dans cette cohorte et comment ceux-ci sont influencés ou non par les paramètres de santé objectifs identifiés précédemment dans le cadre de l’étude HAPI. Le chapitre 5 présente un plaidoyer en faveur d’un suivi médical à long terme des individus nés très prématurément dont les arguments proviennent de témoignages des participants de l’étude HAPI. Enfin, le chapitre 6 présente les résultats de l’étude HAPI Fit qui avait pour but d’évaluer les effets chez de jeunes adultes nés très prématurément d’une intervention de 14 semaines en activité physique principalement sur la capacité aérobie maximale et secondairement sur les paramètres de santé cardiovasculaire. L’ensemble de ces résultats permet de brosser un portrait des conséquences cardiovasculaires à long terme de la prématurité et des moyens disponibles pour les mitiger. La dissémination de ces résultats à la population ciblée et à ses soignants constitue la base sur laquelle pourront se bâtir de futurs programmes de prévention dans cette population à risque. / Worldwide, one in ten births is preterm, occurring before the 37th week of gestation, and approximately 1% are very preterm (<30 weeks of gestation). Preterm birth is associated with alterations of cardiovascular structure and function that persist into adulthood and are linked to cardiovascular disease. There are, however, no clinical guidelines regarding long term cardiovascular monitoring for adults who are born very preterm. This thesis’s focus is the prevention of cardiovascular disease in this new at-risk population. Its main objectives are to describe the long-term effects of prematurity on adult health and to present prevention and intervention avenues for mitigating those effects. Its first chapter presents a review of the pertinent literature while its second describes the methods that were employed to obtain results that are presented in subsequent chapters. Briefly, the HAPI (Health of Adults born Preterm Investigation) cohort recruited young adults born between 1986 and 1996 in the province of Quebec either prematurely (<30 weeks of gestation) or at term (>37 weeks of gestation). This is the population studied in chapters 3 to 5. Chapter 3 presents a diminished maximal aerobic capacity in subjects born preterm and explores contributing factors, including cardiac hemodynamic parameters. Chapter 4 examines health perception and healthcare use in the cohort and how these are influenced or not by objective health measurements previously performed in the HAPI study. Chapter 5 advocates for long-term medical follow-up in young adults born preterm, using testimonials from participants in the HAPI cohort. Finally, chapter 6 presents results from the HAPI Fit study which aimed to evaluate the effects in young adults born very preterm of a 14-week exercise intervention on their maximal aerobic capacity and cardiovascular health parameters. Overall, these results allow us to paint a global picture of long-term cardiovascular consequences of prematurity and of possible ways to mitigate them. Dissemination of these results to the target population and their healthcare providers constitute the basis of future prevention programs in this new at-risk population.