The main objective of the thesis is to identify appropriate approach to evaluation of impacts of the first phase of the ecological tax reform in the Czech Republic, its consequent adaption and application for the particular purpose. The input-output analysis has been found as the most convenient solution for such a sort of analysis. The analysis has been used for the evaluation of impacts on final production prices of each NACE sector resulting from introduction of new taxes on electricity, solid fuels, natural gas and some other kinds of gases in the Czech Republic. Because of unavailability of information about the final impact of taxes on particular objects in the economy, the analysis is conducted on the basis of five incidence assumptions about the impact of taxes on distributors and customers. While the aforementioned analysis is the essential chapter of the thesis, the work starts with a theoretical introduction related to optimal tax theories and theories about possible positive effects of environmental tax implementation. Additionally, energy tax implementation in the Czech Republic and in the European Union is mentioned. Furthermore, an important starting point in finding the most convenient model was to summarize various approaches to modelling energy tax impacts on the economy. Therefore, theoretical description of particular models is provided when history of the models, type of equations and dependences in the model are described. Moreover database requirements and possibilities to use the model for another purpose are discussed. The thesis also comprises of the analysis of pros and cons and additional important characteristics of relevant models together with the summary for which purpose was the particular model used in the Czech Republic. The introduction of energy tax in the Czech republic on the final production prices was proved to be unimportant and with only exceptions (namely the sector of production and distribution of electricity, natural gas and water) an increase in final production prices does not exceed 0,2 % and for a half of all the sectors the increase does not exceed 0,1 %.

Introdução: A perda dentária e o edentulismo podem afetar de maneira significativa a saúde bucal e a saúde geral, a qualidade de vida, e a nutrição de idosos. A cárie e a perda dentária têm sido descritas como o resultado de processos que envolvem elementos biológicos, nas superfícies dentárias, e de uma combinação de fatores comportamentais e sociais. Além disso, o contexto histórico no qual os indivíduos estão inseridos influencia seus comportamentos e percepções em relação à saúde bucal. Uma compreensão acerca de comportamentos de saúde demanda a utilização de métodos que permitam explorar a realidade subjetiva destes fatores. Objetivo: Os objetivos deste estudo de métodos quantitativo e qualitativo foram avaliar a associação entre fatores demográficos, socioeconômicos, comportamentais e de saúde e a incidência de Cárie Coronária, Cárie Radicular, e Perda Dentária na amostra estudada, e realizar entrevistas de grupo focal com membros desta amostra para explorar suas percepções acerca da perda dentária. Métodos: Um estudo de coorte foi conduzido com uma amostra aleatória simples de indivíduos com 60 anos ou mais em Carlos Barbosa, RS, entre 2004 e 2008. Entrevistas e exames bucais foram conduzidos com 388 indivíduos dentados na linha de base, e com 273 participantes no seguimento. A incidência de perdas dentárias, cáries coronárias e radiculares e suas associações com variáveis da linha de base foram modeladas com o uso de regressão binomial negativa. Em um segundo momento, informações de natureza qualitativa foram produzidas através de uma séria de oito entrevistas de grupo focal envolvendo 41 idosos, selecionados dos participantes do seguimento do estudo. As discussões de grupo foram moderadas pelo autor, foram gravadas, codificadas e analisadas através do uso da Teoria Fundamentada em Dados. Resultados: Foi observado no modelo multivariável que, ser mais velho; do sexo masculino; viver em área rural; ser casado; ter menor escolaridade; ser fumante; e estar insatisfeito com os serviços de saúde acessados, estiveram associados com a incidência perdas dentárias. Entre as variáveis clínicas, o uso de próteses parciais removíveis e o índice de sangramento gengival foram preditores, enquanto maior taxa de fluxo salivar foi um fator protetor para o desfecho. Com relação às cáries coronárias, no modelo multivariável final foi observado que, ser mais velho; do sexo masculino; viver em área rural; e ser fumante, estiveram associados à sua incidência. Entre as variáveis clínicas, o uso de próteses parciais removíveis foi um preditor, enquanto maior taxa de fluxo salivar foi um fator de proteção para este desfecho. No modelo multivariável final tendo como desfecho a densidade de incidência de cáries radiculares, ser mais velho; viver em área rural; e escovar os dentes com frequência menor do que diária, foram preditores; ao passo que a única variável clínica associada ao desfecho foi uma maior taxa de fluxo salivar, como fator de proteção. No segmento qualitativo, as respostas dos participantes permitiram concluir que as perdas dentárias estiveram relacionadas com a falta de programas de saúde bucal; normas sociais (incluindo valores relativos ao gênero); nível limitado de informações de saúde; e reduzidas acessibilidade e disponibilidade de serviços odontológicos. Contextos de vulnerabilidade social e programática tiveram um papel fundamental no desenvolvimento de normas e valores sociais e comportamentos individuais que resultaram em extrações dentárias. Conclusão: Estes achados são importantes, porque compreender as relações causais entre práticas individuais como higiene bucal, hábito de fumar, e procura por cuidados odontológicos preventivos, e perdas dentárias, não elucida as razões para as pessoas assumirem tais comportamentos. / Introduction: Tooth loss and edentulism may have a negative impact in the oral and general health, in the quality of life, and nutrition of the elderly. Dental caries and tooth loss have been described as results of processes involving biologic factors, on the surfaces of the teeth, and of a combination of behavioral and social factors. Furthermore, the historical context in which people are placed influences their behaviors and perceptions towards oral health. The understanding of health behaviors requires the use of methods which allow for the exploration of the subjective reality of those factors. Objective: The objectives of this study using quantitative and qualitative methods were to evaluate the association between demographic, socioeconomic, behavioral and health factors and the incidence of tooth loss, coronal and root caries in the studied sample. Also, to carry on focus groups interviews with members from the sample to explore their perceptions about tooth loss. Methods: A cohort study was conducted with a simple random sample of subjects 60 years old or older in Carlos Barbosa city, southern Brazil, between the years of 2004 and 2008. Interviews and oral examinations were conducted with 388 dentate subjects at baseline, and 273 participants at follow-up. The incidence of tooth loss, coronal and root caries and their association with baseline variables were modeled with the use of negative binomial regression. Following the quantitative part of the study, information of qualitative nature was obtained through a series of eight focus groups, involving 41 participants, purposefully selected from those participating in the follow-up. The focus groups discussions’ were moderated by the author, were recorded, coded and analyzed through the use of Grounded Theory. Results: In the multivariate model it was observed that, older age; male gender; living in a rural area; being married; less schooling; being a current smoker; and being dissatisfied with the health services accessed, were associated with the incidence of tooth loss. Among clinical variables, the use of removable partial dentures, and the gingival bleeding index were predictors, whereas higher stimulated saliva flow rate showed a protective effect for the outcome. With regards to the incidence of coronal caries, in the multivariate model it was found that, older age; male gender; living in a rural area; and being a current smoker, were associated with the outcome. Among clinical variables, the use of removable partial dentures was a predictor, whereas a higher stimulated saliva flow was a protective factor for the outcome. In the final model, for the outcome defined as the incidence density of new root caries, it was observed that, older age; living in a rural area; and brushing less than daily were predictors, whereas a higher stimulated saliva flow rate showed a protective effect for the outcome. With regards to the qualitative part of the study, the answers of the participants allowed for the conclusion that tooth extractions had been related, in the past, with the lack of oral health problems; social norms (including social values related to gender); low level of health information; and limited accessibility and availability of dental services. Contexts of social and programmatic vulnerability played a major role in the development of social norms and individual behaviors which resulted in tooth extractions. Conclusion: These findings are important, because understanding the causal relations between individual behaviors such as oral hygiene, smoking, and the pursuing of preventive dental care, do not elucidate why people engage in such behaviors.

La littérature fait suspecter mais n’indique pas clairement un lien entre la contamination du réseau d’eau et les infections nosocomiales à Pseudomonas aeruginosa. Les recommandations de prélèvements d’eau sont différentes selon les pays. Notre travail s’appuie sur les données des résultats des prélèvements d’eau et des prélèvements positifs à P. aeruginosa chez les patients (colonisation ou infections nosocomiales), réalisés au CHU de Dijon entre 2005 et 2013. Les contaminations des points d’eau étaient fréquentes (17%, IC95% 15,5-18,2). Des modèles mixtes n’ont pas montré de diminution d’incidence des cas de P. aeruginosa dans le nouveau bâtiment, moins souvent contaminé, pour les unités qui ont déménagé d’un bâtiment à un autre. La méthode de Kulldorff a permis de détecter peu d’agrégats temporels de cas. Des modèles GEE (Generalized Estimated Equations) ont montré une association positive entre la proportion de prélèvements d’eau positifs dans le trimestre dans le bâtiment et l’incidence des cas nosocomiaux. Cette association était retrouvée dans les analyses en sous-groupe des données de réanimation mais ne l’était plus lorsque les unités de réanimation et d’hématologie étaient exclues.Peu d’arguments en faveur d’un rôle du réseau d’eau dans la survenue de cas de P. aeruginosa sont apportés, en dehors des services de réanimation ou d’hématologie. En raison du coût associé aux prélèvements et aux mesures correctrices, il pourrait être proposé de limiter les prélèvements à ces unités à risque. Des études prospectives génotypiques devraient être conduites afin de mieux explorer l’association entre qualité microbiologique de l’eau à l’hôpital et infections nosocomiales. / Scientific literature allows suspecting but does not clearly indicate a link between water network contamination and Pseudomonas aeruginosa healthcare-associated infections. Guidelines for water samples vary across countries.Our work is based on water samples and P. aeruginosa patients’ samples (healthcare-associated colonizations or infections) in Dijon University hospital between 2005 and 2013.Water outlets contaminations were frequent (17%, CI95% 15.5-18.2). Mixed models on units that moved from a building to another did not show a lower incidence of P. aeruginosa cases in the new building than in the others, although it was less contaminated. Kulldorff’s method allowed detecting few temporal clusters of cases. GEE (Generalized Estimated Equations) models showed a positive association between the proportions of positive water samples in the building in the quarter and the incidence of healthcare-associated cases. This association was still observed in subgroup analyses of intensive care units but was no more observed in the database excluding hematology and intensive care units. Few arguments for an association between water network contamination and P. aeruginosa healthcare-associated colonizations or infections are provided, except in hematology and intensive care units. Given the costs associated with the samples and correctives measures, it could be proposed to limit the samples to these units at risk. Prospective studies with molecular typing methods should be conducted in order to better understand the association between hospital water network microbiologic quality and healthcare-associated infections.

La spondylolyse et le spondylolisthésis sont une déformité bien connue dans le domaine de l’orthopédie. Par contre, il persiste des confusions et des débats sur différents aspects de cette pathologie incluant l’étiologie, l’histoire naturelle et le traitement. Récemment, deux études ont démontré l’influence significative de la morphologie du sacrum dans le spondylolisthésis par Inoue et al. et Whitesides et al.4,5 Ces trouvailles ont renouvelé l’intérêt dans l’évaluation radiologique de la balance sagittale de cette condition. L’objectif principal de ce travail est d’évaluer l’influence de la forme et l’orientation du sacrum chez les patients atteints de spondylolisthésis. Pour ce faire, nous avons construit une base de données de patients présentant un spondylolisthésis et d’un groupe contrôle. Par la suite les radiographies de ces sujets ont été analysées par un programme d’ordinateur afin de calculer tous les paramètres pertinents. Ce travail nous a tout d’abord permis de déterminer à partir des radiographies de 120 volontaires pédiatriques et plus de 130 patients pédiatriques atteints de la spondylolisthésis, les valeurs moyennes et la variation des paramètres angulaires qui influencent l’équilibre sagittal du rachis. Cette base de données est la première existante dans la population pédiatrique. Ces données seront d’une grande utilité pour le futur lors d’études concernant diverses conditions spinales. Nous avons remarqué une différence significative de la morphologie sacrée chez les sujets présentant le spondylolisthésis. Par ailleurs, l’étude de corrélation nous a également permis d’établir une forte relation entre le sacrum, le bassin et la colonne dans le profil sagittal. Finalement, ce travail a permis une meilleure compréhension globale de la posture sagittale chez les sujets normaux et chez les sujets atteints du spondylolisthésis qui pourra servir pour mieux analyser cette condition et pour ajuster les traitements selon l’analyse. / Developmental spondylolysis and spondylolisthesis is a well known and described sagittal spinal deformity in the literature. However, there is still an ongoing debate on different aspects about this pathology including its etiology, pathophysiology, natural evolution and preferred treatment. Numerous parameters and radiologic measures have been described in order to precisely quantify the abnormal relationship between L5 and S1. So far none of these parameters have been proven reliable to predict the evolution in the spinal deformity. Recently, two interesting studies showed that sacral morphology has a significant influence on spondylolisthesis.4,5 These findings have a direct implication to the evaluation and treatment of spondylolisthesis. This also renews our scientific interest in the sagittal morphology in this condition. The principal objective of this work is to evaluate the influence of the sacral form and orientation in patients with spondylolisthesis. First of all, we constructed a large database of all patients with spondylolisthesis with a comparable control group. After the radiographs are analyzed by computer to calculate all possible sagittal parameters described in the current literature. This project has first of all allowed us to establish an ongoing database of all patients with spondylolysis and spondylolisthesis. So far this database is the largest in the literature and consists of more than 120 subjects. This database allows us to analyze retrospectively and prospectively on the influence of sacropelvic sagittal morphology in subjects with spondylolisthesis.

La présente recherche traite des constructions participiales en –ing de l’anglais contemporain. Elle s’appuie sur un corpus de plus de 1700 occurrences de participiales issues de romans et d’articles de journaux, ainsi que sur le British National Corpus et le Corpus of Contemporary American English. Les participiales ont pour caractéristique majeure ne pas expliciter les liens syntaxiques et sémantiques qui les unissent à la proposition dont elles dépendent. Pour expliquer les fondements linguistiques de cette propriété, la recherche établit une typologie détaillée des participiales, étudie les relations qu’elles entretiennent avec leur sujet, ainsi que la nature de l’incidence et de la prédication qui les caractérisent, et détaille les interprétations sémantiques qu’elles peuvent recevoir. Elle montre que la valeur sémantique basique des participiales est la circonstance concomitante, soit un simple lien établi entre deux procès qui forment une unité dans l’esprit de l’énonciateur. Ce sont les traits spécifiques du co- et du contexte qui peuvent modifier cette valeur basique pour déboucher sur l’interprétation finale, adverbiale ou adjectivale, de la participiale. La recherche propose, dans le cadre de la psychosystématique de Gustave Guillaume, des hypothèses susceptibles d’expliquer le comportement syntaxique et sémantique des participiales ; elle montre qu’il est directement lié au sens du participe présent, dont il est postulé que l’incidence est interne et qu’il code la simultanéité et l’imperfectif dans tous ses emplois. / This research deals with –ing participle clauses in contemporary English. It is based on a corpus totalling over 1,700 participle clauses collected from novels and newspaper articles, and it also relies on data from electronic corpora – the British National Corpus and the Corpus of Contemporary American English. The main characteristic of –ing participle clauses is that they lack an explicit syntactic and semantic link to their superordinate clause: to shed light on the linguistic phenomena accounting for this specificity, the research establishes a detailed typology of –ing clauses, studies their relationship to their subjects, investigates the specific nature of their incidence and predication, and provides a detailed analysis of their semantic indeterminacy. It shows that their basic semantic value is one of attendant circumstance – a mere link between two events or states that form a unit in the speaker’s mind. The characteristics of the co- and context may alter this basic value to give the clause its final (adjectival or adverbial) meaning. The research puts forward hypotheses to account for the syntactic and semantic characteristics of –ing participle clauses within the framework of Gustave Guillaume’s psychosystematic theory: it shows the syntactic and semantic behaviour of –ing clauses can be directly traced back to the meaning of the –ing participle, which, it is hypothesised, has an internal incidence and expresses simultaneity and imperfectivity in all of its uses.

Introdução: A perda dentária e o edentulismo podem afetar de maneira significativa a saúde bucal e a saúde geral, a qualidade de vida, e a nutrição de idosos. A cárie e a perda dentária têm sido descritas como o resultado de processos que envolvem elementos biológicos, nas superfícies dentárias, e de uma combinação de fatores comportamentais e sociais. Além disso, o contexto histórico no qual os indivíduos estão inseridos influencia seus comportamentos e percepções em relação à saúde bucal. Uma compreensão acerca de comportamentos de saúde demanda a utilização de métodos que permitam explorar a realidade subjetiva destes fatores. Objetivo: Os objetivos deste estudo de métodos quantitativo e qualitativo foram avaliar a associação entre fatores demográficos, socioeconômicos, comportamentais e de saúde e a incidência de Cárie Coronária, Cárie Radicular, e Perda Dentária na amostra estudada, e realizar entrevistas de grupo focal com membros desta amostra para explorar suas percepções acerca da perda dentária. Métodos: Um estudo de coorte foi conduzido com uma amostra aleatória simples de indivíduos com 60 anos ou mais em Carlos Barbosa, RS, entre 2004 e 2008. Entrevistas e exames bucais foram conduzidos com 388 indivíduos dentados na linha de base, e com 273 participantes no seguimento. A incidência de perdas dentárias, cáries coronárias e radiculares e suas associações com variáveis da linha de base foram modeladas com o uso de regressão binomial negativa. Em um segundo momento, informações de natureza qualitativa foram produzidas através de uma séria de oito entrevistas de grupo focal envolvendo 41 idosos, selecionados dos participantes do seguimento do estudo. As discussões de grupo foram moderadas pelo autor, foram gravadas, codificadas e analisadas através do uso da Teoria Fundamentada em Dados. Resultados: Foi observado no modelo multivariável que, ser mais velho; do sexo masculino; viver em área rural; ser casado; ter menor escolaridade; ser fumante; e estar insatisfeito com os serviços de saúde acessados, estiveram associados com a incidência perdas dentárias. Entre as variáveis clínicas, o uso de próteses parciais removíveis e o índice de sangramento gengival foram preditores, enquanto maior taxa de fluxo salivar foi um fator protetor para o desfecho. Com relação às cáries coronárias, no modelo multivariável final foi observado que, ser mais velho; do sexo masculino; viver em área rural; e ser fumante, estiveram associados à sua incidência. Entre as variáveis clínicas, o uso de próteses parciais removíveis foi um preditor, enquanto maior taxa de fluxo salivar foi um fator de proteção para este desfecho. No modelo multivariável final tendo como desfecho a densidade de incidência de cáries radiculares, ser mais velho; viver em área rural; e escovar os dentes com frequência menor do que diária, foram preditores; ao passo que a única variável clínica associada ao desfecho foi uma maior taxa de fluxo salivar, como fator de proteção. No segmento qualitativo, as respostas dos participantes permitiram concluir que as perdas dentárias estiveram relacionadas com a falta de programas de saúde bucal; normas sociais (incluindo valores relativos ao gênero); nível limitado de informações de saúde; e reduzidas acessibilidade e disponibilidade de serviços odontológicos. Contextos de vulnerabilidade social e programática tiveram um papel fundamental no desenvolvimento de normas e valores sociais e comportamentos individuais que resultaram em extrações dentárias. Conclusão: Estes achados são importantes, porque compreender as relações causais entre práticas individuais como higiene bucal, hábito de fumar, e procura por cuidados odontológicos preventivos, e perdas dentárias, não elucida as razões para as pessoas assumirem tais comportamentos. / Introduction: Tooth loss and edentulism may have a negative impact in the oral and general health, in the quality of life, and nutrition of the elderly. Dental caries and tooth loss have been described as results of processes involving biologic factors, on the surfaces of the teeth, and of a combination of behavioral and social factors. Furthermore, the historical context in which people are placed influences their behaviors and perceptions towards oral health. The understanding of health behaviors requires the use of methods which allow for the exploration of the subjective reality of those factors. Objective: The objectives of this study using quantitative and qualitative methods were to evaluate the association between demographic, socioeconomic, behavioral and health factors and the incidence of tooth loss, coronal and root caries in the studied sample. Also, to carry on focus groups interviews with members from the sample to explore their perceptions about tooth loss. Methods: A cohort study was conducted with a simple random sample of subjects 60 years old or older in Carlos Barbosa city, southern Brazil, between the years of 2004 and 2008. Interviews and oral examinations were conducted with 388 dentate subjects at baseline, and 273 participants at follow-up. The incidence of tooth loss, coronal and root caries and their association with baseline variables were modeled with the use of negative binomial regression. Following the quantitative part of the study, information of qualitative nature was obtained through a series of eight focus groups, involving 41 participants, purposefully selected from those participating in the follow-up. The focus groups discussions’ were moderated by the author, were recorded, coded and analyzed through the use of Grounded Theory. Results: In the multivariate model it was observed that, older age; male gender; living in a rural area; being married; less schooling; being a current smoker; and being dissatisfied with the health services accessed, were associated with the incidence of tooth loss. Among clinical variables, the use of removable partial dentures, and the gingival bleeding index were predictors, whereas higher stimulated saliva flow rate showed a protective effect for the outcome. With regards to the incidence of coronal caries, in the multivariate model it was found that, older age; male gender; living in a rural area; and being a current smoker, were associated with the outcome. Among clinical variables, the use of removable partial dentures was a predictor, whereas a higher stimulated saliva flow was a protective factor for the outcome. In the final model, for the outcome defined as the incidence density of new root caries, it was observed that, older age; living in a rural area; and brushing less than daily were predictors, whereas a higher stimulated saliva flow rate showed a protective effect for the outcome. With regards to the qualitative part of the study, the answers of the participants allowed for the conclusion that tooth extractions had been related, in the past, with the lack of oral health problems; social norms (including social values related to gender); low level of health information; and limited accessibility and availability of dental services. Contexts of social and programmatic vulnerability played a major role in the development of social norms and individual behaviors which resulted in tooth extractions. Conclusion: These findings are important, because understanding the causal relations between individual behaviors such as oral hygiene, smoking, and the pursuing of preventive dental care, do not elucidate why people engage in such behaviors.

In my graduation theses I focus on charge of consumption taxes of consumer sector´s spending. Indirect taxes are imposed onto selected economic goods and increase their costs. Herewith they cause decrease of consumers´ available pension. Howsoever the available pension of different income groups is reduced depends at indirect taxes only on the level of consumption and which economic goods are used by these groups. Indirect taxes are on the contrary to direct taxes less conspicuous, because they are included in the prices of the wares and services. The consumer pays the tax by paying each purchase without any administrative acts and in doing so they do not know how much they paid in taxes to the government. The tax paid by an entity (natural or legal person) can be basically relocated in two ways. Onward to the buyer on the product market by increase of economic goods´ price or of a factor; backward to the seller. This relocation can be partial, i.e. the tax in new price will be partial; hundred-per-cent and in case of certain conditions it can be even higher than the height of tax is. The relocation doesn´t need to occur at all. For assesment of consumer sector tax charege level from consumption I chose a method which uses accessible agregate dates about consumption of social income group. In calculations I arised from dates from year 2006 published by Czech Statistical Office. From the analysys results of consumer sector´s consumption spending charge of consumer tax in 2006 result that the tax burden, which the consumer sector has, represents 13,15 {--} 14,90 % of their total average consumption spending. 11% of tax burden constitutes a value added tax and 3% constitutes a consumer tax. This means that if their consumption spending is 100 000 Kč, then the tax burdern would be 13 150 {--} 14 900 Kč. Consumer sector of employees and self-employers have a bigger tax burden than consumer sector of unemloyed and retirees. The reason is a bigger part of economic goods usage charged by 19% VAT rate.

This diploma thesis deals with value added tax on development of consumer prices on partial market. Term of tax incidence and factors are explained in the theoretical part of thesis. These factors are affected on partial market. The aim of diploma thesis is an analysis of added value tax reduce rate variance (from 1. 1. 2008) in consumer prices and evaluate effect of value added tax on chosen products. This analysis was made in the terms of factors, which are acting on partial market. In diploma thesis were monitoring milk products prices in chosen food shops Company in interval of one year. Then assessment was made in the influence of VAT increase rate on consumer The assessment of influencing factors in milk market was made in the terms of VAT.

Introdução: A perda dentária e o edentulismo podem afetar de maneira significativa a saúde bucal e a saúde geral, a qualidade de vida, e a nutrição de idosos. A cárie e a perda dentária têm sido descritas como o resultado de processos que envolvem elementos biológicos, nas superfícies dentárias, e de uma combinação de fatores comportamentais e sociais. Além disso, o contexto histórico no qual os indivíduos estão inseridos influencia seus comportamentos e percepções em relação à saúde bucal. Uma compreensão acerca de comportamentos de saúde demanda a utilização de métodos que permitam explorar a realidade subjetiva destes fatores. Objetivo: Os objetivos deste estudo de métodos quantitativo e qualitativo foram avaliar a associação entre fatores demográficos, socioeconômicos, comportamentais e de saúde e a incidência de Cárie Coronária, Cárie Radicular, e Perda Dentária na amostra estudada, e realizar entrevistas de grupo focal com membros desta amostra para explorar suas percepções acerca da perda dentária. Métodos: Um estudo de coorte foi conduzido com uma amostra aleatória simples de indivíduos com 60 anos ou mais em Carlos Barbosa, RS, entre 2004 e 2008. Entrevistas e exames bucais foram conduzidos com 388 indivíduos dentados na linha de base, e com 273 participantes no seguimento. A incidência de perdas dentárias, cáries coronárias e radiculares e suas associações com variáveis da linha de base foram modeladas com o uso de regressão binomial negativa. Em um segundo momento, informações de natureza qualitativa foram produzidas através de uma séria de oito entrevistas de grupo focal envolvendo 41 idosos, selecionados dos participantes do seguimento do estudo. As discussões de grupo foram moderadas pelo autor, foram gravadas, codificadas e analisadas através do uso da Teoria Fundamentada em Dados. Resultados: Foi observado no modelo multivariável que, ser mais velho; do sexo masculino; viver em área rural; ser casado; ter menor escolaridade; ser fumante; e estar insatisfeito com os serviços de saúde acessados, estiveram associados com a incidência perdas dentárias. Entre as variáveis clínicas, o uso de próteses parciais removíveis e o índice de sangramento gengival foram preditores, enquanto maior taxa de fluxo salivar foi um fator protetor para o desfecho. Com relação às cáries coronárias, no modelo multivariável final foi observado que, ser mais velho; do sexo masculino; viver em área rural; e ser fumante, estiveram associados à sua incidência. Entre as variáveis clínicas, o uso de próteses parciais removíveis foi um preditor, enquanto maior taxa de fluxo salivar foi um fator de proteção para este desfecho. No modelo multivariável final tendo como desfecho a densidade de incidência de cáries radiculares, ser mais velho; viver em área rural; e escovar os dentes com frequência menor do que diária, foram preditores; ao passo que a única variável clínica associada ao desfecho foi uma maior taxa de fluxo salivar, como fator de proteção. No segmento qualitativo, as respostas dos participantes permitiram concluir que as perdas dentárias estiveram relacionadas com a falta de programas de saúde bucal; normas sociais (incluindo valores relativos ao gênero); nível limitado de informações de saúde; e reduzidas acessibilidade e disponibilidade de serviços odontológicos. Contextos de vulnerabilidade social e programática tiveram um papel fundamental no desenvolvimento de normas e valores sociais e comportamentos individuais que resultaram em extrações dentárias. Conclusão: Estes achados são importantes, porque compreender as relações causais entre práticas individuais como higiene bucal, hábito de fumar, e procura por cuidados odontológicos preventivos, e perdas dentárias, não elucida as razões para as pessoas assumirem tais comportamentos. / Introduction: Tooth loss and edentulism may have a negative impact in the oral and general health, in the quality of life, and nutrition of the elderly. Dental caries and tooth loss have been described as results of processes involving biologic factors, on the surfaces of the teeth, and of a combination of behavioral and social factors. Furthermore, the historical context in which people are placed influences their behaviors and perceptions towards oral health. The understanding of health behaviors requires the use of methods which allow for the exploration of the subjective reality of those factors. Objective: The objectives of this study using quantitative and qualitative methods were to evaluate the association between demographic, socioeconomic, behavioral and health factors and the incidence of tooth loss, coronal and root caries in the studied sample. Also, to carry on focus groups interviews with members from the sample to explore their perceptions about tooth loss. Methods: A cohort study was conducted with a simple random sample of subjects 60 years old or older in Carlos Barbosa city, southern Brazil, between the years of 2004 and 2008. Interviews and oral examinations were conducted with 388 dentate subjects at baseline, and 273 participants at follow-up. The incidence of tooth loss, coronal and root caries and their association with baseline variables were modeled with the use of negative binomial regression. Following the quantitative part of the study, information of qualitative nature was obtained through a series of eight focus groups, involving 41 participants, purposefully selected from those participating in the follow-up. The focus groups discussions’ were moderated by the author, were recorded, coded and analyzed through the use of Grounded Theory. Results: In the multivariate model it was observed that, older age; male gender; living in a rural area; being married; less schooling; being a current smoker; and being dissatisfied with the health services accessed, were associated with the incidence of tooth loss. Among clinical variables, the use of removable partial dentures, and the gingival bleeding index were predictors, whereas higher stimulated saliva flow rate showed a protective effect for the outcome. With regards to the incidence of coronal caries, in the multivariate model it was found that, older age; male gender; living in a rural area; and being a current smoker, were associated with the outcome. Among clinical variables, the use of removable partial dentures was a predictor, whereas a higher stimulated saliva flow was a protective factor for the outcome. In the final model, for the outcome defined as the incidence density of new root caries, it was observed that, older age; living in a rural area; and brushing less than daily were predictors, whereas a higher stimulated saliva flow rate showed a protective effect for the outcome. With regards to the qualitative part of the study, the answers of the participants allowed for the conclusion that tooth extractions had been related, in the past, with the lack of oral health problems; social norms (including social values related to gender); low level of health information; and limited accessibility and availability of dental services. Contexts of social and programmatic vulnerability played a major role in the development of social norms and individual behaviors which resulted in tooth extractions. Conclusion: These findings are important, because understanding the causal relations between individual behaviors such as oral hygiene, smoking, and the pursuing of preventive dental care, do not elucidate why people engage in such behaviors.

La sclérose Latérale Amyotrophique (SLA) est une maladie neuro-dégénérative rare. Il n’existe aucune donnée d’incidence française en population générale. Le profil phénotypique des patients français atteints de SLA, n’a pas été étudié. En outre, aucun facteur de risque confirmé n’existe pour cette pathologie bien que l’activité physique (AP) soit souvent rapportée comme possible facteur étiologique. Dans
 ce
 contexte, 
 pour améliorer les connaissances dans ces domaines, nos
 travaux
 ont
 consisté
 en trois études : (1) une étude sur l’incidence de la SLA dans la région du Limousin sur la base de données issues du premier registre français de SLA, (2) une étude des phénotypes des patients issus de 11 centres SLA français et (3) une revue de littérature des études épidémiologiques originales sur le lien entre PA et SLA. Nos travaux ont mis en évidence une incidence brute et standardisée sur la population européenne de 2010, élevée : 3,19/100 000 personnes-année (P-A) et 2,58/100 000 P-A respectivement. Concernant les aspects phénotypiques, nos travaux ont identifié huit phénotypes de SLA : (1) bulbaire, (2) spinal cervical, (3) spinal lombaire (4) flail leg, (5) flail arm, (6) respiratoire, (7) SLA-DFT et (8) Tête tombante (« Dropped head »). Nous avons conclu notre revue de littérature que l’AP en elle-même n’est probablement pas un facteur de risque de SLA. Comme perspective, (i) nous espérons étendre le registre de la SLA à d’autres régions françaises. En outre (ii) il serait très important de confirmer nos travaux sur les phénotypes sur un échantillon plus représentative Enfin, (iii) concernant le lien entre AP et SLA, d’autres travaux de niveau de preuve élevé sont souhaitables pour asseoir le résultat synthétique que nous avons apporté. / Amyotrophic Lateral Sclerosis (ALS) is a rare neurodegenerative disease. Currently in France, there is no population-based incidence data. The phenotypic profile of French patients with ALS, has not been studied. Lastly, no risk factors are confirmed for this pathology. In this context, to improve knowledge in these fields, our work consisted of three studies: (1) a study on the incidence of ALS in the Limousin region based on the database from the first French ALS register (2) a study of the phenotypes of patients from 11 French ALS centers and (3) a literature review of original epidemiological studies focusing on physical activity (PA) and ALS risk. Our work has highlighted a high crude and standardized incidence (on Europe population): 3.19 / 100 000 person-years (PY) and 2.58 / 100,000 PY respectively. Regarding phenotypic aspects, our work identified eight ALS phenotypes: (1) bulbar, (2) cervical spinal (3) lumbar spinal (4) flail leg, (5) flail arm, (6) respiratory, (7) ALS-FTD and (8) dropped head. We demonstrated that the PA itself is probably not a risk factor for ALS. As a first perspective we hope to expand the ALS Register to other French regions. In a second perspective, it would be very important to confirm our work on phenotypes on a larger and representative sample of ALS patients. Finally, regarding the relationship between PA and ALS, other work of high level of evidence are desirable to confirm the synthetic result we brought in this thesis work.