Esta tese foi motivada por uma pesquisa anterior (COSTA, G.B. Relevância da obesidade para o incremento do risco cardiovascular global na criança e no adolescente. Aracaju, 2002. 109p. Dissertação (Mestrado) - UFS, na qual se caracterizou o perfil pró-aterosclerótico. Na pesquisa atual realizou-se um ensaio clínico controlado em 52 indivíduos, entre 10 e 18 anos, todos com o percentil do IMC > 85%, divididos em dois grupos: Grupo IR, que recebeu intervenção não-farmacológica multidisciplinar por 16 semanas consecutivas e Grupo IU que recebeu uma única intervenção não-farmacológica. Não houve diferenças estatísticas em relação a: idade, raça e gênero. Na análise multivariada verificou-se interação significativa para grupo x tempo (p<0,05) para as seguintes variáveis: peso (p<0,0001), altura (p=0,0083), índice de massa corpórea (p=0,0053), %GC (p=0,0022), circunferência da cintura (p=0,0359), pressão arterial sistólica (p=0,0021), pressão arterial diastólica (p=0,0004), triglicérides (p=0,029), Apo A-1 (p=0,001), glicemia em jejum (p=0,018), IGFBP-3 (p=0,005), TSH (p=0,045) e testosterona total (p=0,030). Não se verificou interação significativa para grupo x tempo (p<0,05) para as seguintes variáveis: freqüência cardíaca(bpm) (p=0,6809), colesterol total(mg/dL) (p=0,445), HDL-C(mg/dL) (p=0,726), LDL-C(mg/dL) (p=0,926), Apo B(mg/dL) (p=0,069), insulina(uU/mL) (p=0,866), HOMA-ir (p=0,088), IGF-1(nanog/mL) (p=0,424), cortisol sérico(mcg/mL) (p=0,175), PCR-us(mg/mL) (p=0,594) e estradiol(picog/mL) (p=0,507). Observou-se uma baixa incidência das variáveis depressão (23,0%), ansiedade (15,4%) e compulsão alimentar (13,5%) na população estudada. Não se obteve dados estatísticos em relação à nutrição nem ao condicionamento físico, uma vez que os mesmos tiveram papel educativo no presente estudo. / This hypothesis was developed by reason of another research (COSTA G.B. Importance of the obesity increasing cardiovascular risk factors in children and adolescents. Aracaju, 2002. 109p.), in which pro-atherosclerotic profile was determined. At this current survey a controlled clinical trial was performed in fifty-two subjects, aged 10 to 18 years, all of them with IMC percentile > 85% and divided in two groups: Group IR, which received non-pharmacological multidisciplinary interventions for sixteen weeks and Group IU, which received only one intervention. There were no statistical differences in relation to: age, race and gender. There was significant interaction group x time (p<0,05) for: weight(Kg) (p<0,0001), height(m) (p=0,0083), body mass index(Kg/m2) (p=0,0053), percentage of body fat(%) (p=0,0022), waist circumference(cm) (p=0,0359), systolic blood pressure(mm Hg) (p=0,0021), diastolic blood pressure( mm Hg) (p=0,0004), TG(mg/dL) (p=0,029), Apo A-1(mg/dL) (p=0,001), fasting glucose(mg/dL) (p=0,018), IGFBP-3(mcg/mL) (p=0,005), TSH(uUi/mL) (p=0,045) and total testosterone(ng/mL) (p=0,030). However, there was not significant interaction group x time (P<0,05) for: heart rate (bpm) (p=0,6809), total cholesterol(mg/dL) (p=0,445), HDL-C(mg/dL) (p=0,726), LDL-C(mg/dL) (p=0,926), Apo B(mg/dL) (p=0,069), insuline(uU/mL) (p=0,866), HOMA-ir (p=0,088), IGF-1(nanog/mL) (p=0,424), cortisol(mcg/mL) (p=0,175), PCR-us(mg/mL) and estradiol(picog/mL) (p=0,507). There was low incidence of depression (23,0%), anxiety(15,4%) and alimentary compulsion(13,5%) on whole studied population. In regarding to nutrition and exercise, there are no statistic data because the aim was the education.

OBJETIVO: Verificar o impacto de um programa estruturado de atividade física no local de trabalho, sobre o nível de atividade física e o estágio de prontidão para mudança de comportamento visando a um estilo de vida ativo. MÉTODOS: O programa de atividade física foi estruturado em sessões práticas e palestras de 10 minutos oferecidas no local de trabalho. De junho a dezembro de 2006, foram avaliados 46 funcionários administrativos de uma empresa da cidade de São Paulo, randomizados em 3 grupos, cuja participação sugerida no programa foi 2, 3 ou 5 vezes semanais. Como desfechos: a) o nível de atividade física foi abordado por meio de questionário (International Physical Activity Questionnaire - IPAQ Longo) e pedômetros; b) o estágio de prontidão para a prática de atividade física foi estimado usando um questionário de estágios de comportamento baseado no modelo trans-teórico adaptado para a prática de atividade física. Cada variável de desfecho foi avaliada antes da intervenção, 90 e 180 dias após o início, com comparações feitas por meio de testes não paramétricos de Friedman e Wilcoxon, considerando nível de significância p<0,05. RESULTADOS: Os resultados revelaram aumento estatisticamente significante do tempo referido de atividade física desenvolvida no trabalho, ao final de 180 dias (p< 0,0001) e no tempo total de atividade física de caminhada, ao final de 180 dias (p= 0,020), porém sem impacto nos outros domínios do IPAQ (lazer, transporte, tarefas domésticas) e no tempo de atividade física total dos participantes (caminhada + moderada + vigorosa), incluindo as medidas do pedômetro. Notou-se também uma tendência a uma progressão dos indivíduos para estágios de comportamento mais avançados para a prática de atividade física, porém sem significância estatística. CONCLUSÃO: Conclui-se que a intervenção foi bem sucedida em aumentar o tempo de atividade física dos trabalhadores no local de trabalho, porém não foi capaz de impactar significativamente os estágios comportamentais e o tempo dedicado à atividade física total / OBJECTIVE: To assess the impact of a structured program of physical activities at the workplace in terms of the workers level of physical activity and the readiness to change their behavior in order to adopt an active life style. METHODS: The physical activity program was structured in practical sessions and 10-minute lectures held at the workplace. From June to December 2006, 46 administrative employees of a company in the city of São Paulo were evaluated. These employees were randomly allocated into 3 groups and the suggested participation to each group in the program was 2, 3, or 5 times a week. The measured outcomes were: a) the level of physical activity, assessed by means of pedometers and a questionnaire (International Physical Activity Questionnaire IPAQ Long); b) the readiness to practice physical activities, assessed by means of a questionnaire of behaviour stages based on the trans-theoretical model adapted to the practice of physical activities. Each outcome variable was evaluated at the baseline, 90 days and 180 days after the program start-up. Comparisons were made through the non-parametric tests of Friedman and Wilcoxon, considering a significance level of p<0.05. RESULTS: The results have demonstrated a significant statistical increase in the time dedicated to physical activity at the workplace at the end of 180 days (p< 0.0001) and in the total walking time at the end of 180 days (p= 0.020), but with no impact on other IPAQ domains (leisure, transportation, household tasks) and on the participants total physical activity time (walking + moderate + vigorous), including the pedometer readings. It was also noticed that individuals had a tendency to progress to more advanced behavior stages in the practice of physical activities, but such tendency had no statistical significance. CONCLUSION: The intervention was successful in its purpose to increase the time of physical activity of workers at the workplace, but this change was not able to impact substantially the behavior stages and the total time dedicated to physical activities

Introduktion: Diabetes Mellitus typ 2 är den sjukdomen som ökar med högst fart i världen idag och där grundbehandlingen är livsstilsförändringar. Syfte: Att belysa patientens upplevelse av egenvård i form av livsstilsförändringar vid Diabetes Mellitus typ 2. Metod: En litteraturstudie enligt Polit och Beck (2017) niostegs flödesschema där kvalitetsgransnkning av artiklar gjordes enligt Polit och Beck (2017) mallar för kvalitetgranskning. Resultatet: baserades på 13 vetenskapliga artiklar, varav 12 var av kvalitativ karaktär och en använde mixad metod. Artiklarna analyserades med en induktiv ansats och olika kategorier växte fram som kom att utgöra studiens resultat. Resultat: Baserades på följande fyra kategorier Kunskap har en avgörande betydelse för att införa livsstilsförändringar, Stöttning angående livsstilsförändringar upplevs viktig, men också frustrerande och påträngande, Att införa livsstilsförändringar är utmanade och kräver aktivt engagemang och Förmågan att upprätthålla livsstilsförändringar är en personlig resa. Slutsats: Studien visade att upplevelsen av livsstilsförändringar präglades både av positiva och negativa upplevelser. Genom att som sjuksköterska ha goda kunskaper kring patientens upplevelser rörande livsstilsförändring kan sjuksköterskan bemöta och förstå patienten bättre. En personcentrerad vård krävs för att tillgodose patientens unika behov.

The purpose of this thesis is valuation of the Zentiva, k.s. enterprise. The value of this enterprise will be determined as of 1.1. 2014, using the discounted free cash flows valuation method. This thesis is divided into a theoretical and a practical section. The theoretical section acquaints readers with the key terms and methods used during valuation. The theoretical section includes a chapter about the pharmaceutical industry and will familiarise readers with current factors influencing this sector, such as price regulation in the field of medicaments, demographic development, life style and others, which have significant impact on determining the company's final value. The practical section consists of a description of Zentiva, k.s., a strategic analysis, financial analysis, execution of a financial plan and, finally, actual valuation. The result of this thesis is valuation of the enterprise, taking into account socio- economic factors to determine its final value.

Abstract Low back pain (LBP) is a common condition already in adolescence and seems to predict future symptoms. Most of the previous longitudinal studies on LBP have been conducted in adult populations. Among adolescents, LBP has been linked most convincingly to psychosocial factors and smoking. We are not aware of any previous studies on clustering of potential risk factors in adolescent LBP. The main objective of this study was to analyze the potential associations of mainly modifiable psychosocial and lifestyle factors with LBP in adolescence. The factors evaluated were overweight, smoking, physical workload, family’s socioeconomic status, and the co-occurrence of psychosocial and lifestyle factors. The present study used the database of the 16- to 18-year-old adolescent subcohort, Oulu Back Study (n=1,987), of the Northern Finland Birth Cohort 1986. Moreover, we evaluated whether the associations differ depending on the presence of LBP symptoms at baseline of the two-year follow-up period. LBP was common among cohort adolescents as, on average, every second adolescent reported LBP, girls reporting more symptoms. As a whole, more associations were found among girls than boys. Overweight was associated with new LBP in the follow-up, but the association was not strong. Prolonged habitual smoking was associated with LBP, particularly with symptoms at baseline and follow-up. High exposure to awkward trunk postures and an overall physically demanding job were especially associated with new LBP in the follow-up. Family’s socioeconomic status was not consistently associated with LBP. At 16 years, four latent class clusters of psychosocial and lifestyle factors were found in both genders. Clusters characterized by behavioural problems were associated with LBP among both genders. Especially girls with the combination of emotional and behavioural problems were at the greatest risk of seeking care for new LBP. The results of this study indicate that LBP in adolescence is associated with both psychosocial and lifestyle factors. The information obtained may be utilized for improving preventive measures and individual care for adolescent LBP. / Tiivistelmä Alaselkäkipu on yleistä jo nuorilla, ja varhain koetut oireet ennustavat myöhempiä selkäkipuoireita. Suurin osa alaselkäkivun seurantatutkimuksista on tehty aikuisväestöllä. Nuorten alaselkäkivun on esitetty vakuuttavimmin liittyvän psykososiaalisiin ongelmiin ja tupakointiin. Alaselkäkipuun liittyvien tekijöiden mahdollista kasautumista ei ole nuorilla tutkittu aiemmin. Tämän väitöstutkimuksen tarkoituksena oli selvittää, ovatko pääasiassa muunneltavissa olevat psykososiaaliset ja elämäntapatekijät yhteydessä nuoruudessa esiintyvään alaselkäkipuun. Arvioitavina tekijöinä olivat ylipaino, tupakointi, fyysinen työkuormitus, sosioekonomiset tekijät, sekä psykososiaalisten ja elämäntapatekijöiden kasautuminen. Tutkimusaineisto koostui Pohjois-Suomen syntymäkohortti 1986:n osaotoksesta (Oulun selkätutkimus), johon kuului 1987 16–18-vuotiasta nuorta. Mahdollisia yhteyksiä arvioitiin erikseen sen mukaan, raportoivatko nuoret seurannan alussa alaselkäkipuoireita vai ei. Alaselkäkipu oli nuorilla yleistä, ja tytöillä yleisempää kuin pojilla. Keskimäärin joka toinen nuori raportoi oireita. Tutkittujen tekijöiden ja alaselkäkivun välisiä yhteyksiä todettiin selvemmin tytöillä. Ylipaino ennusti seurannassa ilmaantuvaa alaselkäkipua, mutta yhteys ei ollut vahva. Säännöllinen tupakointi oli yhteydessä alaselkäkipuun ja etenkin toistuviin oireisiin. Tutkituista työkuormitustekijöistä etenkin hankalat työasennot ja fyysisesti monella tapaa raskaaksi luokiteltava työ altistivat seurannassa uudelle alaselkäkivulle. Sosioekonomiset tekijät eivät olleet selkeästi yhteydessä alaselkäkipuun. Latenttien luokkien analyysi tunnisti seurannan alkuvaiheessa neljä erilaista ryhmää (klusteria) psykososiaalisten ja elämäntapatekijöiden perusteella molemmilla sukupuolilla. Sekä tytöillä että pojilla alaselkäkipua esiintyi erityisesti niissä ryhmissä, joissa esiintyi runsaasti käyttäytymishäiriöitä. Tunne-elämän ja käyttäytymisen ongelmat ennustivat alaselkäkivun vuoksi hoitoon hakeutumista tytöillä. Tulosten perusteella nuorten alaselkäkipuun liittyy sekä psykososiaalisia että elämäntapatekijöitä. Tuloksia voidaan hyödyntää alaselkäkivun ennaltaehkäisyn ja nuorten yksilöllisen hoidon suunnittelussa.

Please read the abstract in the section, 00front, of this document / Dissertation (MSc)--University of Pretoria, 2008. / Zoology and Entomology / unrestricted

The retail companies have a very conservative approach concerning IT expenses and innovations. Maybe for this reason, it is now the best time for changing an IT infrastructure and a complex retail solution. Most of the companies need to optimize their processes due to the financial crisis to achieve a competitive advantage. There are many differences among the retail companies - these differences may cause that an implementation of a software solution is tricky. It is important to be aware of such aspects when implementing the software solution. The main aim of this work is to design, extend and optimize a methodology of implementation of a complex retail solution. The new methodology is quite general - it might be used for an implementation of any POS solution. The goal of new methodology is to improve top line and margin. Finally, it shall bring a bigger satisfaction to the customer. I divided this work into several main chapters. First chapter is dedicated to the specifics of retail companies - how they work, which processes they use, how much they invest into the IT. The second part contains an analysis of POS solutions available on the Czech market and a brief description of the particular software solutions with their market share. The third part is dedicated to the RIM methodology designed by Microsoft Corporation. The fourth - and the main part of my work - contains an extension of the RIM methodology. In the final part I sum up the main achievements of this work and evaluate the new extended methodology. In the appendix, I compared some examples with the real figures to the new methodology.

INTRODUÇÃO: Estudos epidemiológicos demonstram que as doenças cardiovasculares e suas complicações estão associadas ao estilo de vida das pessoas. Há evidências de que o processo aterosclerótico se inicia na infância, e que sua prevenção pode ser mais efetiva se iniciada precocemente, com ações de educação em saúde que visem a promover a prática regular de atividade física e a mudança de hábitos alimentares. OBJETIVOS: Observação das representações dos adolescentes sobre hábitos alimentares e práticas de atividade física no contexto da promoção da saúde cardiovascular. Verificação d a exeqüibilidade das técnicas de ensino-aprendizagem baseadas em Paulo Freire, Pichon-Rivière, Prochaska e Di Clemente na reflexão com os adolescentes sobre a prevenção primária dos fatores de risco relacionados com essas representações. Testar a hipótese de que a presença da doença cardiovascular nos familiares têm influência nas representações observadas. MÉTODOS: Alunos da sétima série de uma escola pública de São Paulo foram levantados por meio de questionário epidemiológico para avaliar os riscos associados ao estilo de vida. Dois grupos diferentes de alunos, selecionados de acordo com a presença de doença cardiovascular nos pais, receberam a intervenção educativa em dinâmicas aplicadas no decorrer de 10 reuniões de grupo. RESULTADOS: A matriz de Prochaska e Di Clemente permitiu avaliar que a representação dos temas de alimentação e atividade física foi modificada nos dois grupos, que passaram do estágio de pré-contemplação para contemplação; no entanto, dez reuniões não foram suficientes para os grupos se manterem no estágio de preparação para mudança, oscilando com o estágio de contemplação. A análise feita pela matriz de Pichon- Rivière demonstra que o aprendizado do grupo sem história familiar aparece de forma clara como conhecimento construído sobre os temas propostos, enquanto o grupo com história familiar possui conhecimento pré-existente, e adquire novos conceitos de maneira mais lenta. Justificando as diferentes formas de abordagem aplicadas às atividades dos grupos no presente trabalho. CONCLUSÃO: A intervenção por meio de grupos educativos baseados em Paulo Freire, Pichon-Rivière e Prochaska e Di Clemente se mostrou útil para observar as representações dos adolescentes sobre hábitos alimentares e práticas de atividade física no contexto da promoção da saúde cardiovascular. Durante as atividades dos grupos educativos foi possível avaliar a informação pré-existente, como também, estabelecer com eles um diálogo construtivo para a prevenção primária dos fatores de risco relacionados com essas representações. / INTRODUCTION: Epidemiologic studies demonstrated that the cardiovascular disease and its complications are associated with people\'s life style. There are evidences that the atherosclerotic process begins in infancy and that its prevention can be more effective if it is precociously started by taking educative actions concerning health, which aim at promoting regular physical activity practice and the change of eating habits. OBJECTIVE: Observe the adolescents\' representations on eating habits and physical activities practices to promote cardiovascular health. Verify the techniques applied in the teaching - learning process, based on Paulo Freire, Pichon- Rivière, Prochaska and Di Clemente and together with the adolescents reflect on the primary prevention of the risks related to these representations. Test the hypothesis that the presence of the cardiovascular disease in the family influences in the representations observed. METHODS: Students of the 7th. grade of a public elementary school of São Paulo were surveyed by means of an epidemiologic questionnaire to evaluate the risks associated with their life style. Two different groups of students, chosen according to the presence of cardiovascular disease in their parents were followed during ten sections, when educative dynamics were applied. RESULTS: Prochaska and Di Clemente\'s matrix enabled the evaluation of the representations related to eating and physical activity. The representations were modified in both groups, which changed from pre- contemplation stage to contemplation stage. However, the ten group meetings were not enough for the groups to keep in the stage of preparation for the change, oscillating to the stage of contemplation. The analyses made by Pichon-Rivière?s matrix demonstrates that the learning process in the group which belongs to a family with no risk of cardiovascular disease presents a clear constructed knowledge on the proposed themes, whereas the group belonging to families under such risks has a pre- existing knowledge and acquires new concepts more slowly, justifying the different approaches applied to the activities of the groups in this study. CONCLUSION: The intervention by means of educative groups based on Paulo Freire, Pichon-Rivière, Prochaska and Di Clemente was useful to observe the representations of the adolescents on eating habits and physical activities practices to promote cardiovascular health. During the activities of the educative groups it was possible to evaluate the adolescents pre-existing information as well as establish a constructive dialogue for a primary prevention of the risk factors related to these representations.

Orientador: José Eduardo Corrente / Resumo: O objetivo geral deste estudo foi avaliar o nível de atividade física, capacidade funcional e qualidade vida de idosos cadastrados nos Centros de Atenção Integral a Melhor Idade (CAIMI) da cidade de Manaus. Além disso, foi traçado um perfil socioeconômico e demográfico, avaliado os sintomas depressivos e presença de deficit cognitivo. Trata-se de um estudo transversal com 741 idosos cadastrados nos três CAIMI da cidade, no período de novembro de 2015 a março de 2017. As coletas eram realizadas por estudantes do curso de fisioterapia da Universidade Federal do Amazonas, previamente treinados. Para avaliação dos idosos, foram utilizados os questionários: Internacional Physical Activity Questionnaire (IPAQ), Escala de Qualidade de Vida de Flanagan (EQVF), Escala de Lawton e Brody, Índice de Katz, Escala de Depressão Geriátrica (EDG) e Mini Exame do Estado Mental (MEEM). Esta pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Federal do Amazonas, pelo parecer número 786. 685. Os idosos apresentaram média de idade de 69 anos, sendo que a maioria (521) era do sexo feminino, 44,94% casados e 60,05% não completaram o primeiro grau. Em relação à renda, 40,60% ganhavam até um salário mínimo e 53,51% diziam ser o principal provedor da casa. A maior frequência (72,74%) era de aposentados e 79,76% relataram ainda trabalhar. Referente ao nível de atividade física ,70,18% dos idosos foram classificados como ativos pelo IPAQ, 98,38% eram independentes, segundo índice de K... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The main objective of this study was to evaluate the level of physical activity, functional capacity and quality of life in elderly enrolled in specialized centers for elderly care in Manaus. In addition, a socioeconomic and demographic profile was drawn, in which depressive symptoms and cognitive deficit presence was accessed. A cross-sectional study was conducted with 741 elderly people enrolled in the three of thaose centers in the city, from November 2015 to March 2017. Interviews were carried out by previously trained physiotherapy students of Federal University of Amazonas. Questionnaires used were: International Physical Activity Questionnaire (IPAQ), Flanagan Life Quality Scale (QOLS), Lawton and Brody Scale, Katz Index, Geriatric Depression Scale (GDS), Mini-Mental State (MMSE). This research was approved by Research Ethics Committee at Federal University of Amazonas for under number 786,685. The elderly mean age was 69 years, and the majority (521) were female, 44.94% married and 60.05% did not complete the first degree. In relation to income, 40.60% earned up to a minimum wage and 53.51% said to be the main provider of the family. The highest frequency (72.74%) was retired subjects and 79.76% reported that they were still working. Regarding the level of physical activity, 70.18% of the elderly were classified as active by IPAQ, 98.38% were independent by Katz Index and, in the EQVF, they presented a mean of 80.07, indicating a positive satisfaction with their quali... (Complete abstract click electronic access below) / Doutor

The AIM of the study from which the empirical data were obtained for this thesis, was the collection of basic demographic information and selected health related data from a group of adolescents at high-school in Cape Town. 1.2 The OBJECTIVES were Description of the demographic features of the pupils in Standards 8, 9 and 10 at a specific co-educational high school in Cape Town; Determination of the prevalence of smoking, and the attitudes to, and knowledge of the health risks of smoking; Determination of the prevalence of alcohol use, and the attitudes to, and knowledge of the health risks of consuming alcohol; Determination of the prevalence of habit-forming drug use, and the attitudes to, and knowledge of the health risks of using drugs; Determination of the sexual experience of the pupils, attitudes to and knowledge of the health risks of sexual activity, and knowledge of contraception and venereal disease; Examination of whether the above habits correlated within individuals i.e. whether those who smoked were more likely to use drugs or be sexually active, and vice versa.