nÃo hà / A pesquisa teve como objetivo avaliar o Programa de ErradicaÃÃo do Trabalho Infantil - PETI de MossorÃ-RN em termos de modificaÃÃo das condiÃÃes de vida das famÃlias que tÃm crianÃas e adolescentes assistidos. Foi realizada pesquisa documental e de campo, tendo esta Ãltima ocorrido no perÃodo de marÃo a agosto de 2008. Foi aplicado um formulÃrio em dois momentos distintos e realizadas entrevistas de aprofundamento com os responsÃveis por crianÃas e adolescentes assistidos pelo programa hà quatro anos ou mais. Os dados quantitativos foram submetidos a tratamento descritivo, usando freqÃÃncia absoluta e relativa, tabelas simples, cruzamentos, indicadores de referÃncia e testes especÃficos. Os dados qualitativos foram abordados pelo mÃtodo da anÃlise do discurso e analisados com base nos marcos regulatÃrios vigentes e em autores que discutem e teorizam o trabalho infantil e suas interfaces. Entre as 30 famÃlias que compuseram a primeira amostra, a maioria dos identificados como responsÃveis pelas crianÃas e adolescentes sÃo mulheres relativamente jovens que moram com os filhos e respectivos cÃnjuges e tÃm baixa escolaridade. Da entrada no PETI atà a realizaÃÃo da pesquisa decresceu o nÃvel de emprego nas famÃlias e o percentual de filhos que estudavam, mas em 33,4% das famÃlias havia crianÃas ou adolescentes que ainda trabalhavam. Aumentou a renda mensal e a despesa com alimentaÃÃo, aluguel, gÃs de cozinha, energia elÃtrica e prestaÃÃo da casa prÃpria; mais famÃlias tornaram-se proprietÃrias da casa, diminuiu o nÃmero das que pagavam aluguel ou moravam em casa cedida, aumentou o nÃmero de casas de alvenaria e o nÃmero de cÃmodos; aumentou o nÃmero de eletrodomÃsticos como refrigeradores, liquidificadores, televisores, aparelhos de som, telefones, mÃquina de costura, bicicleta e rÃdios. A maioria dos responsÃveis entrevistados trabalhou quando crianÃa, vÃm de famÃlias numerosas, de origem rural e migrantes e tÃm apreÃo a valores como honestidade e retidÃo. Predominaram lembranÃas agradÃveis sobre as brincadeiras e uniÃo entre irmÃos, mas houve ambivalÃncia em relaÃÃo a terem trabalhado na infÃncia e ao modo autoritÃrio como foram educados. Percebem como mais difÃcil a tarefa de educar filhos hoje comparativamente a quando eram crianÃas e consideram positivo o fato de estarem integrados ao programa avaliado, embora tenham sido constatadas algumas incoerÃncias em relaÃÃo a isto. Os planos para o futuro sÃo modestos e quase se resumem aos filhos estudarem e terem um trabalho quando adultos. O trabalho precoce atravessou o tempo, fazendo-se presente em trÃs geraÃÃes. ConcluÃmos que melhoraram as condiÃÃes de vida, com mudanÃas positivas no perfil das famÃlias apÃs serem integradas ao PETI e que ainda à grave seu estado de pobreza. IncoerÃncias e inconsistÃncias encontradas indicam que os gestores do programa no municÃpio necessitam estar mais atentos e desenvolver medidas concretas para superaÃÃo do trabalho infantil ainda presente nas famÃlias estudadas e para avanÃar no Ãmbito da sociabilidade. AlÃm do mais, em momento posterior, faz-se importante aprofundar a avaliaÃÃo do programa em relaÃÃo a alguns aspectos. / This research aims to evaluate the Elimination of Child Labor Program â PETI in MossorÃ-RN related to life style changes in families that have kids and teenagers trated by the program. Documentary and fields researches were made, the last one happened between march and August 2009. A questionary was given to the people responsible to the children and teenagers, who have been treated by the program for four years or longer, in two different steps. The quantitative information was submitted to a descriptive treatment, using absolut and relative frequency, simple tables, crossings, reference indicators andspecific tests. The quantitavie information was privided by the analisys of speech method and analysed taken into account the rules of the authors who discuss and theorize childlabor and its different sides. From all the 30 families that were interviewed in the first sample, most of the people that are responsible for the children and teenagers are young women, that live with their kids and husband, and have low education. Since tha registration in the PETI program until the date that this research was made, the percentage of employment and kids in school. Also in 33,4% of the families there were kids or teenagers working. The monthly income and expenditure with food, rent, kitchen gas, eletric power and house loan; more families purchased their own houses , less ones had to pay rent or borrowed houses,increased the numbers of masonry houses and their rooms; the number of appliances such as refrigerators, blenders, television sets, stereo systems, telephones, sewing machines,bicycles and radios. Most of the responsible for the children also worked when they were younger,come from large families, from the rural zone and appreciate things like honesty and integrity. They had nice memories about toys and plays between siblings, though there was an ambivalence related to their working during their childhood and about the bossy way that they were raised. They are aware that nowadays is more difficult to raise children comparing to when they were younger and they find positive the fact that they are in the program, even though we found a few misconception about that. Plans for the future are simple and care to having their kids studying and having a good job when they get older. The early employment lasted for three generation.We may conclude that families improved their life styles,with positive changes in the families profiles after applying to the PETI program and also that poverty is still strong. The inconsistencies found indicate the program managers in town need to look carefully and develop projects to help the families that still go through child labor and also to have those families more sociable.Besides all that, later on, it is important to go deeper in the evaluation of the program when related to some aspects.

Made available in DSpace on 2014-07-29T15:29:20Z (GMT). No. of bitstreams: 1 Dissertacao de mestrado barbara miranda ferreira.pdf: 429667 bytes, checksum: d95226fbacb3328ed858bfd9c2fdc8cd (MD5) Previous issue date: 2010-02-12 / The excessive gestational weight gain can cause harmful consequences for both the mother and for the fetus. Nutritional, lifestyle, economic and social factors can affect the weight gain above recommendations. Objectives: To evaluate the nutritional (caloric intake, macro and micronutrients), lifestyle (smoking, physical activity, reproductive behavior) and economic (income) factors associated with the excessive weight gain in eutrophic pregnant women. Methods: This case-control study included 200 low-risk pregnant women in 2 public obstetric hospitals in Goiás, Brazil. The women that agreed to this study were divided in 2 groups: cases with excessive weight gain (> 16Kg) and controls within the recommended weight gain for eutrophic pregnant (11.50 < a < 16Kg), matched on age. The women were inquired about their food intake during the gestational period, by means of a quantitative and qualitative food-frequency questionnaire validated and adapted to the low income regional people. The women were inquired about their economic and lifestyle conditions, too. The software for statistical analyze were the SPSS version 17.0. Were used the folowing tests: Kolmogorov-Smirnov, Fisher, Student´s t, chi-square (x²), odds ratio (CI 95%), Mann-Whitney, Spearman´s correlation coefficient and multivariate linear regression. Results: The median age was 25.00 (22.00-29.00) years-old for cases and 24.00 (22.00-28.00) years-old for controls (p=0.52). The median per capita income was R$ 303.75 (225.60-500.00) for cases and R$ 333.33 (175.00-480.00) for controls (p=0.41). The median education level was 10.50 (9.00-12.00) years for cases and 11.00 (9.00-12.00) years for controls (p=0.77). There was 13.00 (13%) smokers among cases and 8.00 (8%) among controls (p=0.25). The frequency of regular physical activity was 28.00 (28%) pregnant women among cases and 31.00 (31%) among controls (p=0.65). About the reproductive behavior, there were no differences between groups for the parity (p=0.45) and abortion (p=0.90). The birth interval was 27.00 (0.00-60.75) months in cases and 22.50 (0.00-47.75) in controls (p=0.34). The following variables showed in the univariate analysis a significant correlation coefficient (&#961;) to the weight gain: calories = 0.15 (p=0.04), protein = 0.16 (p=0.03), total cholesterol = 0.21 (p<0.01), retinol = 0.21 (p<0.01), iron = 0.18 (p=0.01), zinc = 0.15 (p=0.04), selenium = 0.19 (p<0.01) and phosphorus = 0.16 (p=0.03). The median of the satured fat intake was 36.57 grams (23.37 51.06) in the case group and 28.21 grams (19.92 41.90) in the control group (p=0.04). In the multivariate analysis the protein intake was the only independente variable associated with excessive pregnant weight gain. Conclusion: The factors associated with the excessive weight gain in the group of cases were total caloric intake, proteins, satured fat, cholesterol, retinol, iron, zinc, selenium and phosphorus, and in special, the protein intake. Lifestyle and economic factors didn t affect weight gain. / O ganho ponderal excessivo na gestação pode trazer consequências maléficas tanto para a mãe quanto para o feto. Fatores sociais, econômicos, de estilo de vida e nutricionais podem ser responsáveis por este ganho de peso acima das recomendações. Objetivos: Avaliar os fatores econômicos (renda), de estilo de vida (tabagismo, prática de atividade física, comportamento reprodutivo) e nutricionais (consumo calórico, macro e micronutrientes) que podem estar relacionados ao ganho de peso excessivo em gestantes eutróficas. Metodologia: Este estudo de caso-controle incluiu 200 gestantes de baixo risco obstétrico de 2 maternidades públicas do Estado de Goiás. Todas as gestantes que concordaram em participar do estudo foram divididas em 2 grupos: casos com ganho de peso excessivo (> 16Kg) e controles com ganho de peso dentro do recomendado (11,50 < a < 16Kg), pareados por idade. As mulheres foram entrevistadas com relação ao seu consumo alimentar durante o período gestacional através de um questionário quantitativo e qualitativo de frequência de consumo alimentar validado e adaptado à população regional de baixa renda. Elas também foram questionadas sobre sua condição econômica e de estilo de vida. A análise estatística foi realizada através do programa SPSS, versão 17.0. Foram aplicados os testes de Kolmogorov-Smirnov, Fisher, t de Student, qui-quadrado (x²), odds ratio (IC 95%), Mann-Whitney, coeficiente de correlação de Spearman e regressão linear multivariada. Resultados: A mediana da idade das pacientes foi 25,00 (22,00-29,00) anos para os casos e 24,00 (22,00-28,00) anos para os controles (p=0,52). A renda per capita foi de R$ 303,75 (225,60-500,00) para casos e R$ 333,33 (175,00-480,00) para controles (p=0,41). A mediana de escolaridade foi de 10,50 (9,00-12,00) anos para casos e 11,00 (9,00-12,00) anos para controles (p=0,77). Houve 13,00 (13%) fumantes no grupo de casos e 8,00 (8%) no grupo de controles (p=0,25). A frequência da prática de atividade física regular foi de 28,00 (28%) das gestantes nos casos e 31,00 (31%) nos controles (p=0,65). Em relação ao comportamento reprodutivo, não houve diferenças entre a frequência de paridade (p=0,45) e abortos (p=0,90) entre os grupos. O intervalo intergestacional foi de 27,00 (0,00-60,75) meses entre os casos e de 22,50 (0,00-47,75) meses entre os controles (p=0,34). As seguintes variáveis apresentaram na análise univariada um coeficiente de correlação (&#961;) com o ganho de peso significante: calorias = 0,15 (p=0,04), proteínas = 0,16 (p=0,03), colesterol total = 0,21 (p<0,01), retinol = 0,21 (p<0,01), ferro = 0,18 (p=0,01), zinco = 0,15 (p=0,04), selênio = 0,19 (p<0,01) e fósforo = 0,16 (p=0,03). A mediana do consumo de gordura saturada foi de 36,57 gramas (23,37 - 51,06) no grupo de casos e 28,21 gramas (19,92 - 41,90) no grupo controle (p=0,04). Na análise multivariada o consumo protéico foi a única variável independente relacionada ao ganho de peso excessivo na gestação. Conclusão: O consumo calórico, as proteínas, a gordura saturada, o colesterol, o retinol, ferro, zinco, selênio e fósforo estiveram relacionados ao maior ganho ponderal observado no grupo de casos, em especial o consumo protéico. Os fatores econômicos e de estilo de vida não influenciaram o ganho de peso.

Orientador: Aarão Mendes Pinto Neto / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-22T22:16:57Z (GMT). No. of bitstreams: 1 Baccaro_LuizFranciscoCintra_D.pdf: 2072530 bytes, checksum: 31649568918c18e7bd2825dac90d7e60 (MD5) Previous issue date: 2013 / Resumo: Objetivos: Conhecer a prevalência e os fatores associados à ocorrência de osteoporose, quedas e fraturas por fragilidade óssea em mulheres brasileiras com 50 anos ou mais. Identificar os fatores associados ao desenvolvimento precoce de osteoporose. Método: inquérito populacional transversal que incluiu mulheres com 50 anos ou mais, conduzido na cidade de Campinas, São Paulo, Brasil de 10/05/2011 a 31/10/2011. As mulheres foram entrevistadas por assistentes de pesquisa treinadas, após o sorteio de 66 setores censitários do município. As mulheres que não responderam ao questionário por problemas pessoais e aquelas com incapacidade cognitiva ou demência foram excluídas do estudo. A variável dependente osteoporose foi classificada como osteoporose autorrelatada, independente da realização de exame de densitometria óssea, ou como osteoporose diagnosticada através de densitometria óssea. As demais variáveis dependentes foram ocorrências de quedas no último ano e de fraturas por fragilidade óssea após os 50 anos de idade. As variáveis independentes foram às características sociodemográficas, hábitos pessoais, problemas de sáude, autopercepção de saúde e avaliação da capacidade funcional. A análise estatística foi realizada através do teste qui-quadrado, regressão de Cox e regressão de Poisson com critério de seleção de variáveis backward. Resultados: Seiscentas e vinte e duas mulheres responderam ao questionário e constituíram a amostra final. A média etária das mulheres foi de 64,1 anos. A prevalência de osteoporose autorrelatada, independente da realização da densitometria óssea foi de 21,3%, e a prevalência de osteoporose diagnosticada através da densitometria óssea foi de 16,7%. A prevalência de quedas no último ano foi de 24,6% e a de fraturas por fragilidade óssea de 10,8%. No modelo estatístico final, os fatores associados à maior prevalência de osteoporose, independente da realização de densitometria óssea, foram ter maior tempo de menopausa (RP 1,04; 95% IC 1,03 - 1,05; p<0,001), autopercepção de saúde regular/ruim/péssima (RP 1,73; 95% IC 1,29 - 2,33; p<0,001), artrose (RP 1,83; 95% IC 1,30 - 2,59; p<0,002) e ter problemas para manter o equilíbrio quando toma banho ou desce escadas (RP 1,52; 95% IC 1,07 - 2,14; p=0,02). Os fatores associados com maior prevalência de osteoporose diagnosticada por densitometria óssea foram possuir maior tempo de menopausa (RP 1,04; 95% IC 1,03 - 1,05; p < 0,001), apresentar artrose (RP 1,80; 95% IC 1,20 - 2,68; p = 0,005), ter problemas para correr / levantar peso / fazer esportes / trabalho pesado (RP 1,82; 95% IC 1,14 - 2,90; p = 0,012) e possuir problemas para manter o equilíbrio quando se está tomando banho ou descendo escadas (RP 1,52; 95% IC 1,04 - 2,23; p = 0,031). As variáveis associadas ao desenvolvimento precoce de osteoporose foram autopercepção de saúde regular/ruim/péssima (coeficiente 0,77; p<0,001), tratamento para menopausa com medicamentos naturais (coeficiente 1,01; p<0,001), fumar atualmente ou no passado mais de vinte cigarros por dia (coeficiente 1,02; p=0,003) e ter problemas para correr / levantar peso / fazer esportes / trabalho pesado (coeficiente 0,60; p=0,029). Os fatores relacionados com maior prevalência de quedas foram ter problemas de equilíbrio quando anda (RP 1,87; 95% IC 1,33 - 2,63; P < 0,001), consumo de álcool (RP 1,69; 95% IC 1,25-2,28; P < 0,002), ter sido internada no último ano (RP 1,46; 95% CI 1,09 - 1,96; P = 0,012), e apresentar catarata (RP 1,40; 95% IC 1,05 - 1,87; P = 0.021). Os fatores relacionados à menor prevalência de quedas foram ter convênio médico (RP 0,67; 95% IC 0,50 - 0,89; P = 0,007) e realizar algum tipo de tratamento para os sintomas da menopausa (RP 0,42; 95% IC 0,19 - 0,92; P = 0,031). Os fatores relacionados à maior prevalência de fraturas foram apresentar maior tempo de menopausa (RP 1,03; 95% IC 1,01-1,05; P=0,003) e apresentar osteoporose (RP 1,97; 95% IC 1,27-3,08; P=0,003). Conclusões: a prevalência de osteoporose e fraturas por fragilidade óssea na população estudada foi semelhante à relatada pelos últimos estudos nacionais. A prevalência de quedas foi discretamente menor do que a relatada pelos últimos estudos nacionais e internacionais. Os fatores associados à osteoporose foram ter maior tempo de menopausa, autopercepção de saúde regular/ruim/péssima, relatar artrose, ter problemas para manter o equilíbrio e apresentar diminuição da capacidade funcional. Os fatores associados ao desenvolvimento precoce da osteoporose foram autopercepção de saúde regular/ruim/péssima, tratamento com medicamentos naturais para a menopausa, fumar mais de vinte cigarros (atualmente ou no passado) e apresentar diminuição da capacidade funcional. Os fatores associados à maior prevalência de quedas foram problemas de equilíbrio, consumir bebidas alcoólicas, ter sido internada nos últimos doze meses e referir catarata. Realizar algum tipo de tratamento para a menopausa e possuir convênio médico se associaram a menor prevalência de quedas. Os fatores clínicos associados à maior prevalência de fraturas por fragilidade óssea foram ter osteoporose e maior tempo de menopausa. Os resultados deste estudo indicam a necessidade da realização de programas de saúde pública que incentivem hábitos saudáveis, como a prática de exercícios físicos regulares, de programas contra o tabagismo e o alcoolismo, além do acompanhamento médico de rotina de mulheres com 50 anos ou mais / Abstract: Objectives: This study was performed to determine the prevalence and factors associated with the occurrence of osteoporosis, falls, and fragility fractures in Brazilian women aged 50 years or older and obtain information on factors related to the early onset of osteoporosis. Methods: A cross-sectional population survey that included women aged 50 years or older was conducted in the city of Campinas, São Paulo, Brazil from 10 May 2011 to 31 October 2011. Women were interviewed by trained research assistants after a draw of 66 census sectors in the city. Women who did not respond to the questionnaire for personal reasons and those with cognitive impairment or dementia were excluded. The dependent variable osteoporosis was classified either as self-reported regardless of bone densitometry, or as osteoporosis diagnosed by bone densitometry. The other dependent variables were the occurrence of falls in the last year and the occurrence of fragility fractures after 50 years of age. The independent variables were sociodemographic data, health-related habits and problems, self-perception of health, and evaluation of functional capacity. Statistical analysis was carried out by the chi-square test, Cox multiple regression model, and Poisson regression analysis using backward selection criteria. Results: A total of 622 women completed the questionnaire and constituted the final sample. The mean age of the women was 64.1 years. The prevalence of self-reported osteoporosis regardless of bone densitometry was 21.3%, and the prevalence of osteoporosis diagnosed by bone densitometry was 16.7%. The prevalence of falls in the last year was 24.6%, and the prevalence of fragility fractures was 10.8%. In the final statistical model, the factors associated with a higher prevalence of osteoporosis regardless of bone densitometry were a longer period of time since menopause (PR, 1.04; 95% CI, 1.03-1.05; p < 0.001), self-perception of health as fair/poor/very poor (PR, 1.73; 95% CI, 1.29-2.33; p < 0.001), arthrosis (PR, 1.83; 95% CI, 1.30-2.59; p < 0.002), and problems maintaining balance when taking a bath or going down stairs (PR, 1.52; 95% CI, 1.07-2.14; p = 0.02). The factors associated with a higher prevalence of osteoporosis diagnosed by bone densitometry were a longer period of time since menopause (PR, 1.04; 95% CI, 1.03-1.05; p < 0.001), arthrosis (PR, 1.80; 95% CI, 1.20-2.68; p = 0.005), problems running/lifting something heavy/practicing sports/doing heavy work (PR, 1.82; 95% CI, 1.14-2.90; p = 0.012), and problems maintaining balance when taking a bath or going down stairs (PR, 1.52; 95% CI, 1.04-2.23; p = 0.031). The variables associated with early onset of the disease were self-perception of health as fair/poor/very poor (coefficient, 0.77; p < 0.001), menopausal treatment with natural remedies (coefficient, 1.01; p < 0.001), smoking or having smoked >20 cigarettes/day (coefficient, 1.02; p = 0.003), and problems running/lifting something heavy/practicing sports/doing heavy work (coefficient, 0.60; p = 0.029). The factors associated with a higher prevalence of falls were trouble maintaining balance when walking (PR, 1.87; 95% CI, 1.33-2.63; p < 0.001), alcohol consumption (PR, 1.69; 95% CI, 1.25-2.28; p < 0.002), admission to a hospital in the last 12 months (PR, 1.46; 95% CI, 1.09-1.96; p = 0.012), and cataracts (PR, 1.40; 95% CI, 1.05-1.87; p = 0.021). Having health insurance (PR, 0.67; 95% CI, 0.50-0.89; p = 0.007) and using some form of medication to treat menopausal symptoms (PR, 0.42; 95% CI, 0.19-0.92; p = 0.031) were associated with a lower prevalence of falls. A longer period of time since menopause (PR, 1.03; 95% CI, 1.01-1.05; p = 0.003) and having osteoporosis (PR, 1.97; 95% CI, 1.27-3.08; p = 0.003) were associated with a higher prevalence of fragility fractures. Conclusions: The prevalence of osteoporosis and fragility fractures in this study population was similar to that reported by recent national studies. The prevalence of falls was slightly lower than that reported by recent national and international studies. The factors associated with osteoporosis were a longer period of time since menopause, self-perception of health as fair/poor/very poor, arthrosis, trouble maintaining balance, and reduced functional capacity. Factors associated with early onset of the disease were self-perception of health as fair/poor/very poor, treatment with natural remedies for menopause, smoking >20 cigarettes/day (currently or in the past), and reduced functional capacity. The factors associated with a higher prevalence of falls were trouble maintaining balance when walking, alcohol consumption, admission to a hospital in the last 12 months, and cataracts. Administration of some type of treatment for menopause and having health insurance were associated with a lower prevalence of falls. The clinical factors associated with a higher prevalence of fragility fractures were osteoporosis and a longer period of time since menopause. The results of this study indicate the need to carry out public health programs that encourage healthy habits such as regular physical exercise, programs that discourage smoking and alcoholism, and the performance of routine medical monitoring of women aged 50 years or older / Doutorado / Fisiopatologia Ginecológica / Doutor em Ciências da Saúde

Orientador: Maria Inês Monteiro / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T16:11:23Z (GMT). No. of bitstreams: 1 Masson_ValeriaAparecida_D.pdf: 5748783 bytes, checksum: 4014442b8b82661fef81701faf7dccc8 (MD5) Previous issue date: 2012 / Resumo: Este estudo sobre condições de trabalho, aspectos de saúde e capacidade para o trabalho de jovens trabalhadores de um Entreposto Hortifrutigranjeiro de Campinas visa à promoção da saúde no local de trabalho. Trata-se de estudo de intervenção de delineamento quase-experimental. Foram realizadas entrevistas com 42 jovens na faixa etária de 15 a 29 anos, selecionados no local de trabalho, de maneira intencional, com o objetivo de avaliar a capacidade para o trabalho e os fatores de estilo de vida, condições de trabalho, fadiga e sonolência, para realização de promoção da saúde entre os sujeitos. Após as entrevistas foram realizadas atividades de promoção da saúde como grupos educativos, entrega de folders, exposição de pôster no mercado tomando por base a educação em saúde e a conscientização da população pela adoção de hábitos de vida saudáveis. Após a intervenção, o mesmo grupo de jovens, com perda de 11 sujeitos, foi novamente entrevistado. Foram utilizados os seguintes instrumentos: questionário com dados sociodemográficos, estilo de vida e aspectos de saúde e trabalho; Índice de Capacidade para o Trabalho, Questionário de fadiga e a Escala de Sonolência de Epworth, Escala de Karolinska e Analise Ergonômica do Trabalho. A análise dos dados foi realizada por meio de estatística descritiva, testes estatísticos e análise de conteúdo por meio dos programas estatísticos SPSS e SAS. As atividades de intervenção não tiveram efetividade sobre a saúde, capacidade para o trabalho e percepção de fadiga dos jovens. A prática de atividade física caiu de 54,8% para 42,9%, com aumento do Índice de Massa Corpórea médio (IMC) de 24,3 kg/m² (DP 6,8) para 25,5 kg/m². Após a intervenção, houve diminuição do uso de bebidas alcoólicas entre os sujeitos, de 42,8% para 19,1%, também houve redução do número de fumantes a zero. A maior parte dos sujeitos estudados apresentou capacidade para o trabalho adequada tanto no pré-intervenção quanto no pós-intervenção. Não ocorreu alteração da capacidade para o trabalho e fatores como escolaridade, estresse, dor e uso de medicamentos foram associados à menor capacidade para o trabalho. Fatores como estresse, sonolência, dor e escolaridade foram associados com a fadiga. Os jovens apresentaram riscos ocupacionais em suas atividades de trabalho, como movimentos repetitivos, posições inadequadas, cargas de peso, que devem ser considerados em futuros estudos de intervenção sobre as condições e organização do trabalho. Os resultados analisados mostraram a necessidade de se dar continuidade às intervenções no local de trabalho visando manter a capacidade para o trabalho e reduzir a fadiga da população estudada / Abstract: This study on working conditions, health issues and work ability of young workers from the supply center of Campinas aims to promote health in the workplace, since the working conditions and health are major determinants of inappropriate situations that these workers are exposed to. This is a quasi-experimental design intervention study. The interviews were conducted with a group of 42 young people aged 15 to 29 years, intentionally selected at work with the purpose of evaluating the work ability and lifestyle factors, working conditions, fatigue and drowsiness, in order to conduct health promotion among the individuals. After conducting the interviews, activities to promote health like education groups, delivering of leaflets, and poster exhibition at the market building, all based on health education and the public awareness for adopting healthy life habits. After the intervention, the same group of young people with loss of 11 subjects was interviewed again. We used the following instruments: a questionnaire about socio-demographic, lifestyle and aspects of heath and work; Work Ability Index, Fatigue Questionnaire and the Epworth Sleepiness Scale, Karolinska Sleepiness Scale and Ergonomic Work Analysis. The data was analyzed using descriptive statistics, statistical tests and content analysis by means of statistical programs SPSS and SAS. Intervention activities were not effective on health, work ability and perception of fatigue. Subjects who practiced physical activities before the intervention were 54.8% and after the intervention that number dropped to 42.9%. The average Body Mass Index (BMI) increased from 24.3 kg/m² (SD 6.8) to 25.5 kg/m². After the intervention, there was a decrease in alcohol consumption among the subjects, 42.8% to 19.1%, with respect to smoking, two subjects stopped smoking after the intervention, therefore no subject smoked in the post-intervention. Most of the subjects studied had adequate capacity to work both in the pre-test and post-test. Factors such as education, stress, pain and medication use was associated with reduced capacity for work. Factors associated with increased perception of fatigue, were stress, somnolence, pain and schooling. The youth had occupational risks in their work activities, such as repetitive motions, awkward positions, load weight, which should be considered in future intervention studies on the conditions and work organization. The analyzed results show the need to continue the interventions in the workplace to maintain the ability to work and reduce fatigue of the population studied / Doutorado / Enfermagem / Doutora em Enfermagem

Esta dissertação de mestrado tem por objetivo principal estabelecer os perfis de ocorrência de estresse e mortalidade de dois diferentes grupos pré-históricos de São Paulo - os construtores do sambaqui fluvial Moraes e do sambaqui litorâneo Piaçaguera - relacionando-os com o estilo de vida e subsistência de cada um desses grupos. O período foco de interesse foi o infantil mesmo que os indivíduos adultos estivessem sendo analisados. Foram considerados para tanto 88 indivíduos de Piaçaguera e 55 de Moraes, todos eles analisados para o estabelecimento do perfil de mortalidade. Já para a análise de hipoplasias foram considerados, respectivamente 28 e 21 indivíduos, que cumpriram os critérios de inclusão definidos para a análise. Como resultado observou-se uma alta mortalidade na infância em ambas as séries, no entanto com diferenças entre os períodos mais afetados. A série de Piaçaguera apresentou maior risco de morrer em períodos mais tardios da infância enquanto que Moraes apresentou maior risco ainda no período neonatal. Já ao se considerar as hipoplasias lineares de esmalte, há uma sinalização no sentido da ocorrência de estresse relativamente contínuo durante toda a fase intermediária da infância em Moraes, que não apresentou picos de ocorrência de defeitos hipoplásicos. Já para Piaçaguera, os dados sugerem a ocorrência de um período de maior ocorrência/susceptibilidade ao estresse, o qual corresponde a um pico de prevalência de defeitos hipoplásicos entre 3 e 4 anos. / This dissertation has as main objective to establish the profiles of occurrence of stress and mortality on two different prehistoric groups from São Paulo State, Brazil - the builders of the riverine shellmound Moraes and the builders of the coastal shellmound Piaçaguera - relating them to the lifestyle and subsistency of each of these groups. The period focus of interest was the childhood, even if the adults were being analyzed. In order to establish the mortality profile were analized 88 individuals from Piaçaguera and 55 individuals from Moraes. For the analysis of hypoplasias were considered, respectively, 28 and 21 individuals which met the inclusion criteria defined for the analysis. There is possible to stabilish that if the child mortality is very high in both series, there are strong differences between the ages periods more affecteds. The Piaçaguera\'s skeletal serie showed a higher risk of dying in later periods of childhood while Moraes had a higher risk in the neonatal period. Considering the data obteined for linear enamel hypoplasia, there is a signal towards the occurrence of stress relatively continuous throughout the intermediate phase of childhood in Moraes. For this sample there are no peaks of occurrence of hypoplastic defects. In contrast, the data produced for Piaçaguera\'s sample suggest the occurrence of a period of higher incidence / susceptibility to stress, which corresponds to a peak prevalence of hypoplastic defects between 3 and 4 years old .

Abstract The study is part of a project titled Self-motivated control of hypertension. The project is multidisciplinary, and the participants were from the Department of Nursing and Health Administration, University of Oulu, the Department of Internal Medicine, Oulu University Hospital, the health centers of the Liminka and Rantsila municipalities, Polar Electro Oy and The National Technology Agency (TEKES). The main purpose of the study was to evaluate the compliance and the blood pressure control of the intervention patients and the positive effect of the intervention on the compliance and the control of blood pressure. A further purpose was to develop a scale for measuring hypertensive patients' compliance and to test the reliability and validity of the scale. The intervention included the use of a multimedia-based computer program and a heart rate monitor, home measurements of blood pressure and two walking tests as a support of hypertension care. The study consisted of four phases. In the first phase, the patients in the intervention group (n = 21) were interviewed. The topics were: the patients' compliance and attitude towards hypertension and its care and the patients' attitude towards information technology and its use as a support of hypertension care. The material was analysed using the method of content analysis. In the second phase, the Compliance of Hypertensive Patients' Scale (= CHPS) was developed and its reliability and validity were assessed. Data were collected from five health centers (n = 103). Dimensionality was explored using principal component analysis and internal consistency was estimated according to a standard item analysis approach and Theta coefficient. Validity was assessed using face validity, content validity and criterion-related validity (through the use of concurrent validity). In the third phase, by using the CHPS, the compliance of the intervention (n = 14) and control patients (n = 21) was evaluated and the groups were compared. Data were analysed using Mann Whitney's U-test. The control of blood pressure of intervention (n = 16) and control (n = 18) groups was also evaluated and compared. Data were analysed using T-test. In the fourth phase, the patients were interviewed for an evaluation of how the intervention had improved their (n = 16) compliance. The material was analyzed using content analysis. The patients' attitude towards information technology as a support of hypertension care and their attitude towards hypertension and its care were more positive at the end than at the beginning of the intervention. The intervention improved the patients' compliance. They used less sodium (p = .014), exercised more effectively (p = .017) and needed fewer follow-up appointments with nurses than the patients in the control group. The most important part of the intervention consisted of the measurement of blood pressure at home, sending the readings to the health center and the use of a heart rate monitor to improve the effectiveness of exercise. The program illustrated and made more concrete the things connected with lifestyle. The patients who felt that hypertension was caused by stress did not find the setting of the goals and the use of the program meaningful. The variation of diastolic blood pressure at home was statistically almost significant (p = .057) at the end of the project and the blood pressure values were lower in the intervention group than in the control group. The blood pressure readings recorded at home were lower than the measurements recorded by the physician at the health center (SBP p = .000, DBP p = .003). / Tiivistelmä Tutkimus oli osa Omatoiminen verenpaineen hallinta -projektia (OVH-projekti). Projekti on monitieteinen, ja siihen ovat osallistuneet Oulun yliopiston hoitotieteen ja terveyshallinnon laitos, Oulun yliopistollisen sairaalan sisätautien klinikka, Limingan ja Rantsilan terveyskeskukset, Polar Electro Oy ja Tekes. Tutkimuksen päätarkoituksena oli arvioida interventioryhmän potilaiden hoitoon sitoutumista ja hoitotasapainoa sekä sitä, miten kyseinen interventio edisti hoitoon sitoutumista. Lisäksi tarkoituksena oli kehittää hoitoon sitoutumista arvioiva mittari ja testata sen luotettavuutta. Projektissa toteutettuun interventioon kuului kohonneen verenpaineen hoidon tueksi suunnitellun multimediapohjaisen tietokoneohjelman (OVH-ohjelma) ja sykemittarin käyttö, verenpaineen kotimittaukset sekä kaksi kävelytestiä. Tutkimus sisälsi neljä vaihetta. Ensimmäisessä vaiheessa interventioryhmän (n = 21) potilaat haastateltiin. Aiheina olivat potilaiden hoitoon sitoutuminen ja suhtautuminen kohonneeseen verenpaineeseen sekä suhtautuminen tietotekniikkaan ja sen käyttöön kohonneen verenpaineen hoidon tukena. Aineisto analysoitiin sisällönanalyysillä. Toisessa vaiheessa kehitettiin hoitoon sitoutumista arvioiva mittari, jonka luotettavuutta testattiin viiden eri terveyskeskuksen verenpainepotilailla (n = 103). Luotettavuuden arvioinnissa käytettiin osioiden välisiä korrelaatiokertoimia, face-validiteettia, faktorianalyysiä, osioiden välisiä korjattuja korrelaatiokertoimia, theeta-arvoa ja Pearsonin tulomomenttikorrelaatiokerrointa. Kolmannessa vaiheessa arvioitiin ja verrattiin interventio- ja vertailuryhmän potilaiden hoitoon sitoutumista (n = 14, n = 21) kehitetyn mittarin avulla sekä hoitotasapainoa (n = 16, n = 18). Aineiston analyysissä käytettiin kuvailevia arvoja, Mann Whitneyn U-testiä ja T-testiä. Neljännessä vaiheessa arvioitiin haastattelujen avulla sitä, miten interventio edisti potilaiden (n = 16) hoitoon sitoutumista. Aineisto analysoitiin sisällönanalyysillä. Potilaiden suhtautuminen tietotekniikkaan ja sen käyttöön kohonneen verenpaineen hoidon tukena sekä suhtautuminen kohonneeseen verenpaineeseen ja sen hoitoon oli intervention lopussa myönteisempää kuin sen alussa. Interventio edisti tutkittavien hoitoon sitoutumista. He käyttivät suolaa vähemmän (p = .014), liikkuivat tehokkaammin (p = .017) ja kävivät hoitajan vastaanotolla harvemmin (p = .000) kuin vertailuryhmän potilaat. Tärkeimmät intervention osa-alueet olivat verenpaineen mittaus kotona ja arvojen lähettäminen terveyskeskukseen sekä sykemittarin käyttö. Sykemittarin käyttö lisäsi liikunnan tehokkuutta. OVH-ohjelman käyttö havainnollisti ja konkretisoi elintapoihin liittyviä asioita. Potilaat, jotka pitivät stressiä kohonneen verenpaineen syynä, eivät kokeneet tavoitteiden asettamista eivätkä myöskään ohjelman käyttöä mielekkääksi. Interventioryhmän diastolisen verenpaineen muutos kotimittauksissa oli intervention lopussa tilastollisesti melkein merkitsevä (p = .057) ja verenpainearvot olivat matalammat kotimittauksissa kuin vertailuryhmän potilaiden arvot. Tutkittavien verenpainearvot olivat kotimittauksissa matalammat kuin lääkärin mittauksissa terveysasemalla (SVP p = .000, DVP p = .003).

Bakgrund: Sjukdomen diabetes typ 2 är en kronisk sjukdom som ständigt ökar runt om i världen. Sjukdomen medför ett lidande för patienten, vilket leder till att livskvaliteten försämras. Därför är egenvård viktigt för att patienterna inte ska besväras av komplikationerna. Syftet: Beskriva patientens upplevelser att leva med diabetes typ 2. Metod: En litteraturöversikt baserad på 12 kvalitativa artiklar. Resultat: Består av tre teman; påfrestningar att leva med diabetes, ansvar för sin livsstilsförändring och stöd från omgivningen. Dessa tre teman bilda sex subteman; livskvaliteten försämras, det skapar oro, en ständig kamp att förändra kosten, viljan att kunna röra sig, stöd från närstående och stöd från vården. Resultatet visar på en ständig kamp för patienten att hantera diabetes typ 2, då det skapar oro och rädsla över komplikationerna som diabetes kan leda till. Det visar också hur påfrestande det är med nya livsstilsförändringar när det gäller kost och fysisk aktivitet. Närstående och vården har en betydande roll när det gäller stöd till patienterna. Slutsats: Visar hur viktigt det är att patienter får stöd både från vården och närstående för att öka motivationen till att ändra sina livsstilsförändringar och minska riskerna för komplikationer. / Background: The type 2 diabetes is a chronic disease that is increasing around the world. The disease causes a suffering, which leads to deterioration in health. Self-care is important so that patients are not bothered by the complications. Aim: Patient's experiences of living with type 2 diabetes. Method: A literature review was used, in which 12 qualitative articles were selected. Results: Consists of three themes; stress of living with diabetes, responsibility for lifestyle changes and support from the surrounding area. These three themes form six subthemes; the quality of life deteriorates, it creates concern, a struggle to change the diet, the will to exercise, support from relatives and health care. The results show that they create a constant struggle for the patient to manage diabetes, as it creates anxiety over the complications that diabetes can cause. It also shows how stressful it is with new lifestyle changes in terms of diet and physical activity. Relatives and care have a significant role to play in supporting patients. Conclusion: Shows how important it is for patients to receive support from both health care and their relatives in order to motivate them to change their lifestyle changes and reduce the risk of complications.

Introduction: The long-term success of non-surgical weight loss treatment in adults with obesity is limite by substantial relapse, and only a few evidence-based weight loss maintenance treatments exist. This clinical trial investigates the feasibility and efficacy of a social facilitation maintenance programme for weight loss maintenance, tailored to meet the needs of obese adults who have undergone a lifestyle weight loss intervention. Methods and analysis: In a single-centre, open feasibility trial, 72 adults currently or previously obese or overweight who have undergone a lifestyle weight loss intervention are centrally randomised to 4 months of social facilitation maintenance treatment or treatment as a usual control condition. In 16 outpatient group sessions, the social facilitation maintenance treatment, based on a socioecological model and on evidence supporting social facilitation as a key process in maintaining weight loss, focuses on promoting interpersonal relationships to build up a healthy lifestyle for long-term weight loss maintenance. Primary outcome is the amount of weight regain at 6-month follow-up, compared with pre-treatment weight, derived from measured body weight. Secondary outcomes address feasibility, including recruitment, attrition, assessment non-completion, compliance and patients’ programme evaluation; and in comparison with pre-weight loss maintenance, social and interpersonal functioning, eating behaviour and physical activity, psychological and physical symptoms, body composition and risk of comorbidity, and quality of life at post-treatment and follow-up assessments. Ethics and dissemination: The study was approved by the Ethical Committee at the University of Leipzig (165-13-15072013). The study results will be disseminated through peer-reviewed publications. Trial registration number: DRKS00005182

This diploma thesis focuses of czech population's description from the perspective of chronotype and its relationship to sociodemographic characteristics and to variables affecting lifestyle. The aim of this thesis is to describe the sample examined in terms of social jetlag. The thesis is based mainly on quantitative methods, specifically I was using individual forms of regression analyzes, which allow to capture the influence of independent variables on the dependent variable. The analytical part data from Qualitas 2016 survey within the AV21 Strategy project are processed. The analysis revealed the existence of an association between chronotype and gender, respectively between chronotype and age. It also turned out that extreme owls consume addictive substances to a greater extent than extreme larks. Owls also generally have higher BMI, lower psychological well-being and more often suffer from social jetlag than those with early circadian preference. However, the social jetlag does not only concern respondents with late circadian preference, but the whole sample analyzed. The average length of social jetlag in the sample is 66 minutes. The analysis also revealed the link between social jetlag and addictive substance abuse.

IN ENGLISH The diploma thesis presents physical activity and quality of life. Thesis characterizes these two areas, discusses the influences that affect these two areas and then compares the influence of themselves - or the influence of one of them on the other, the impact of physical activity on the quality of life. The theoretical part presents physical activity as a tool of benefit, a determinant of health, part of an active lifestyle. The quality of life is discussed in a similar way. The practical part examines the influence of physical activity on the quality of life in individual age categories. In addition to the influence of physical activity on the quality of life in general, practical part is also testing the influence of this activity on individual dimensions of quality of life. Two questionnaires - WHO QOL-BREF and GPAQ - are used to determine the values needed for the research.