333f. / Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2013-04-22T17:10:30Z No. of bitstreams: 7 Tese Katia Bernardo7.pdf: 6922729 bytes, checksum: 415a54b477c67ae1e0ea2dc40ff9f095 (MD5) Tese Katia Bernardo6.pdf: 7071403 bytes, checksum: 5c20435e72b54770be45263b35cac822 (MD5) Tese Katia Bernardo5.pdf: 6623770 bytes, checksum: a01defc168d6ca8cc0f29661a03540ed (MD5) Tese Katia Bernardo4.pdf: 6444867 bytes, checksum: 8c604618251a966bf55ec1c0e53a670f (MD5) Tese Katia Bernardo3.pdf: 2128356 bytes, checksum: 6032a215ef027999e988395cff274e03 (MD5) Tese Katia Bernardo2.pdf: 6708255 bytes, checksum: 77d68555d85d22482449dbc0cd40b6a8 (MD5) Tese Katia Bernardo1.pdf: 7208484 bytes, checksum: 7161a8792d1a6331aac14f3dfda27ce0 (MD5) / Approved for entry into archive by Rodrigo Meirelles(rodrigomei@ufba.br) on 2013-05-24T11:34:21Z (GMT) No. of bitstreams: 7 Tese Katia Bernardo7.pdf: 6922729 bytes, checksum: 415a54b477c67ae1e0ea2dc40ff9f095 (MD5) Tese Katia Bernardo6.pdf: 7071403 bytes, checksum: 5c20435e72b54770be45263b35cac822 (MD5) Tese Katia Bernardo5.pdf: 6623770 bytes, checksum: a01defc168d6ca8cc0f29661a03540ed (MD5) Tese Katia Bernardo4.pdf: 6444867 bytes, checksum: 8c604618251a966bf55ec1c0e53a670f (MD5) Tese Katia Bernardo3.pdf: 2128356 bytes, checksum: 6032a215ef027999e988395cff274e03 (MD5) Tese Katia Bernardo2.pdf: 6708255 bytes, checksum: 77d68555d85d22482449dbc0cd40b6a8 (MD5) Tese Katia Bernardo1.pdf: 7208484 bytes, checksum: 7161a8792d1a6331aac14f3dfda27ce0 (MD5) / Made available in DSpace on 2013-05-24T11:34:21Z (GMT). No. of bitstreams: 7 Tese Katia Bernardo7.pdf: 6922729 bytes, checksum: 415a54b477c67ae1e0ea2dc40ff9f095 (MD5) Tese Katia Bernardo6.pdf: 7071403 bytes, checksum: 5c20435e72b54770be45263b35cac822 (MD5) Tese Katia Bernardo5.pdf: 6623770 bytes, checksum: a01defc168d6ca8cc0f29661a03540ed (MD5) Tese Katia Bernardo4.pdf: 6444867 bytes, checksum: 8c604618251a966bf55ec1c0e53a670f (MD5) Tese Katia Bernardo3.pdf: 2128356 bytes, checksum: 6032a215ef027999e988395cff274e03 (MD5) Tese Katia Bernardo2.pdf: 6708255 bytes, checksum: 77d68555d85d22482449dbc0cd40b6a8 (MD5) Tese Katia Bernardo1.pdf: 7208484 bytes, checksum: 7161a8792d1a6331aac14f3dfda27ce0 (MD5) Previous issue date: 2010 / O envelhecimento é uma etapa da vida humana que atinge diferentemente os indivíduos de acordo com sua condição social, gênero e cor da pele. Mediante a reconstrução histórica de Salvador na segunda metade do século XIX e dos contextos onde estavam os sujeitos da pesquisa, busca-se identificar o posicionamento das Instituições governamentais e privadas em relação ao tratamento reservado ao segmento da população formado pelos velhos; indicar as práticas e os mecanismos sociais por meio dos quais as posições sociais desses personagens foram estabelecidas e suas diferenças legitimadas; analisar o contexto de institucionalização da velhice, buscando estabelecer relações entre esse evento, a emergência da pobreza como questão social em Salvador e o caráter de caridade e de mendicidade no tratamento dado aos velhos; evidenciar os fundamentos dos modelos asilares, avaliando a qualidade da estrutura desses espaços no referido período; discutir a presença das relações de gênero e raça no tratamento dado à velhice. Acreditando que a observação microscópica revelaria fatores previamente não observados, utilizou-se o referencial teórico e metodológico da Micro-História durante o desenvolvimento da pesquisa. Os resultados permitiram verificar-se que, na segunda metade do século XIX, a velhice não fazia parte das agendas públicas e era objeto de filantropia e piedade ou um problema de família; a população idosa que morava em Salvador formava um grupo heterogêneo e complexo; era composta por pessoas cujo intervalo de idade ultrapassava 30 anos e experimentaram trajetórias de vida diferenciada; e, ao contrário do que se costuma pensar, a longevidade não é um fenômeno recente, mas vem ocorrendo, paulatinamente, desde a segunda metade do século XIX, quando um contingente significativo de pessoas tornou-se longevo. Constatamos que, apesar de todo o avanço da capital da Província, ela era perigosa para os velhos que nela transitavam, seja pelos riscos de atropelos provocados pelos novos meios de transporte, pela pouca iluminação das ruas ou pela sujeira decorrente da falta de saneamento básico, que tornava as ruas esgotos a céu aberto, infestadas por repetidas epidemias de febre amarela e de cólera. Verificou-se que a sociedade baiana oitocentista via a velhice como uma fase de decadência e decrepitude. O contexto do surgimento dos asilos explica, de alguma forma, a representação social negativa da velhice: pessoas idosas misturadas aos diversos tipos sociais. As relações de gênero e raça expunham diferenças de tratamento em ambos os casos; havia diferença de tratamento para homens e mulheres brancos idosos. Um aspecto que mereceu destaque foi o número de idosos que morreram trabalhando, independente de classe social, gênero ou raça, a despeito da manutenção, no imaginário social, da velhice como uma fase improdutiva, devido à incapacidade para o trabalho e do surgimento de limitações físicas e mentais. Concluiu-se que a velhice, longe de ser uma categoria natural, é um fenômeno construído socialmente, já que o grupo constituído pelos idosos não é homogêneo, mas fortemente marcado pelas relações de gênero, classe social e etnia/raça. Acima de tudo, ao se pensar o envelhecimento, não se pode esquecer que o contexto influi de maneira significativa nas diversas formas de velhice. / Salvador

Yes / Older people have an increased risk of falling during locomotion, with falls on stairs being particularly common and dangerous. Step going (i.e., the horizontal distance between two consecutive step edges) defines the base of support available for foot placement on stairs, as with smaller going, the user's ability to balance on the steps may become problematic. Here we quantified how stair negotiation in older participants changes between four goings (175, 225, 275, and 325 mm) and compared stair negotiation with and without a walking approach. Twenty-one younger (29 ± 6 years) and 20 older (74 ± 4 years) participants negotiated a 7-step experimental stair. Motion capture and step-embedded force platform data were collected. Handrail use was also monitored. From the motion capture data, body velocity, trunk orientation, foot clearance and foot overhang were quantified. For all participants, as stair going decreased, gait velocity (ascent pA = 0.033, descent pD = 0.003) and horizontal step clearance decreased (pA = 0.001), while trunk rotation (pD = 0.002) and foot overhang increased (pA,D < 0.001). Compared to the younger group, older participants used the handrail more, were slower across all conditions (pA < 0.001, pD = 0.001) and their foot clearance tended to be smaller. With a walking approach, the older group (Group x Start interaction) showed a larger trunk rotation (pA = 0.011, pD = 0.015), and smaller lead foot horizontal (pA = 0.046) and vertical clearances (pD = 0.039) compared to the younger group. A regression analysis to determine the predictors of foot clearance and amount of overhang showed that physical activity was a common predictor for both age groups. In addition, for the older group, medications and fear of falling were found to predict stair performance for most goings, while sway during single-legged standing was the most common predictor for the younger group. Older participants adapted to smaller goings by using the handrails and reducing gait velocity. The predictors of performance suggest that motor and fall risk assessment is complex and multifactorial. The results shown here are consistent with the recommendation that larger going and pausing before negotiating stairs may improve stair safety, especially for older users. / This study was supported by the New Dynamics of Aging (RES-356-25-0037).

Mobility is central to living an independent life, to participating in society, and to maintaining well-being in later life. The point of departure in this thesis is that retirement implies changes in time-space use and interruption in routines, which influence demands and preconditions for mobility in different ways.  The aim of this thesis is to explore mobility strategies and changes in mobility upon retirement and how mobility develops during the first years of retirement. A further aim is to provide knowledge of the extent to which newly retired people maintain a desired mobility based on their needs and preconditions. The thesis is empirically based on travel diaries kept by newly retired people, and qualitative interviews with the same persons, and follow-up interviews three and a half years later. The results show that mobility is a way of forming a structure in the new everyday life as retirees by getting out of the house, either just for a walk or to do errands. Many patterns of everyday life remain the same upon retirement, but the informants also merge new responsibilities and seek new social arenas and activities. As a result, the importance of the car have not changed, but it is used for other reasons than before. After leaving paid work, new space-time constraints are created which influences demands for mobility. The study further shows that “third places” become important, especially among those who live alone, as they give an opportunity to being part of a social context and a reason for getting out of the house. The follow-up interviews revealed that declining health changes the preconditions for mobility. Daily walks had to be made shorter, and the car had to be used for most errands to where they previously could walk or cycle. However, mobility can also be maintained despite a serious illness and a long period of rehabilitation. / Mobilitet är en förutsättning för oberoende, delaktighet och välbefinnande när man åldras. Utgångspunkten i avhandlingen är att pensioneringen innebär tidsrumsliga förändringar och brott i rutiner som på olika sätt påverkar människors behov av att resa och deras förutsättningar för mobilitet. Syftet med avhandlingen är att utforska mobilitetsstrategier och förändringar i mobilitet i samband med pensioneringen samt hur mobiliteten utvecklas under de första åren som pensionär. Ambitionen är att öka kunskapen om i vilken utsträckning nya pensionärer upprätthåller en önskad mobilitet utifrån deras egna behov och förutsättningar. Avhandlingen baseras empiriskt på resedagböcker som nyblivna pensionärer har fört och kvalitativa intervjuer med samma personer, samt uppföljningsintervjuer tre och ett halvt år senare. Resultaten visar att mobiliteten är en strategi för att skapa en struktur i vardagen som pensionär genom att komma hemifrån, t.ex. för att ta en promenad eller för att uträtta ärenden. Många vardagsmönster behålls vid pensioneringen men informanterna finner också nya åtaganden och söker nya sociala arenor och aktiviteter. Betydelsen av bilen har inte förändrats men den används av andra anledningar än tidigare. Vid pensioneringen skapas andra tidsrumsliga begränsningar vilka inverkar på efterfrågan på mobilitet. Resultaten visa också att "tredje platser" blir viktiga, särskilt bland dem som lever ensamma, eftersom de ger en möjlighet att vara en del av ett socialt sammanhang och en anledning att komma hemifrån. Uppföljningsintervjuerna visade att förutsättningarna för mobilitet förändras när hälsan försämras. Promenaderna blir kortare och bilen används i högre utsträckning för de ärenden dit de tidigare kunde gå eller cykla. Men trots allvarliga sjukdomar och långa perioder av rehabilitering kan mobiliteten upprätthållas. / ERA-NET 2007 "Keep moving: improving the mobility of older persons" / Sentrip - Senior life transition points

Participation of people in all ages is one of the main goals in Swedish disability policy. Despite this, ageing and becoming old with intellectual disability has been given very little attention in policy documents and guidelines regarding support and service provided for this group. This thesis aims to explore ageing and participation among older people with intellectual disabilities who live in a group homes in accordance to the Swedish Disability Act. The focus has been on the group of people who were born before or around 1960. This group belongs to a generation that share unique experiences. They have lived a long life with disability, and they have experienced first-hand the development of the Swedish disability policy that started in the 1960s and resulted in today’s disability policy. These experiences carried through life course are likely to influence this group’s opportunities to participate as they age and reach later life. The thesis has a multiple methodological approach. Participant observations were executed and combined with individual semi-structured interviews with older people with intellectual disabilities as well as group home staff. The results of this thesis show that there is a discrepancy between how older people with intellectual disabilities experience ageing and later life and how these in turn are described by the staff. The thesis also reveals how aging and becoming old is not given particular attention to in everyday discussions in the group home, and that aging is understood mainly as a physical phenomenon. The results show that the formal organizational culture of the group home is weak in relation to ageing and becoming old with intellectual disability. This is because the staff perceives a lack of preparation, discussion and working methods on how to support participation among older residents. The results also show, however, that the residents’ age does play an important role for the staff’s perceptions and attitudes regarding participation of the older residents. The concept of participation is described and  operationalized as a social contextual doing, and as an aspiration to create a sense of coherence or experience of meaning and security at home. Finally, this thesis underlines that the life course unique to persons growing old with intellectual disabilities may influence the opportunities for and the experience of participation in the group home. / Delaktighet i alla åldrar är ett av funktionshinderspolitikens centrala mål. Trots detta har att åldras och vara äldre med intellektuell funktionsnedsättning inte uppmärksammats i politiska dokument och riktlinjer kring hur stöd och service ska ges till denna grupp. Denna avhandling syftar till att belysa och problematisera åldrande och delaktighet bland äldre personer med intellektuell funktionsnedsättning som bor i gruppbostad enligt Lagen om stöd och service till vissa funktionshindrade. I fokus står personer som är födda före eller omkring 1960. De tillhör en generation som delar unika erfarenheter. Dels har de levt ett långt liv med funktionsnedsättning, dels har de varit en del av den funktionshinderspolitiska resa som startade i Sverige under 1960-talet och som har lett fram till dagens funktionshinderspolitik. Detta är erfarenheter som de har burit med sig genom livsloppet och som kan antas påverka möjligheten till delaktighet när de åldras och blir äldre. Denna avhandling har ett multipelt metodologiskt angreppssätt i form av deltagande observation kombinerat med individuella semistrukturerade intervjuer med äldre personer med intellektuell funktionsnedsättning och deras personal. Avhandlingen visar att det finns skillnader mellan hur äldre personer med intellektuell funktionsnedsättning själva erfar att vara och bli äldre och hur detta fenomen beskrivs av gruppbostadens personal. Avhandlingen visar också att åldrande och att vara äldre inte ges utrymme i gruppbostadens vardagliga diskussioner där åldrandet främst betraktas som ett fysiskt fenomen. Avhandlingens studier belyser även att gruppbostadens formella organisationskultur är svag i förhållande till att åldras och vara äldre med intellektuell funktionsnedsättning. Detta då personalen upplever att det saknas förberedelse, diskussion och arbetsmetoder kring hur stöd för delaktighet ska erbjudas äldre boende. Resultatet visar emellertid att de boendes ålder har betydelse för personalens föreställningar och förhållningssätt gällande delaktighet bland äldre boende. Denna delaktighet beskrivs och operationaliseras dels som ett socialt kontextuellt görande, dels som en strävan efter att skapa en känsla av sammanhang och trygghet i hemmet. I tillägg till detta framkommer att den studerade generationens unika erfarenheter av att ha levt ett långt liv med intellektuell funktionsnedsättning, är betydelsefulla för hur delaktigheten ser ut i gruppbostaden och hur den beskrivs av både boende och personal.

BIMBATO, A. M. J. A representação de velhice entre os profissionais que atuam nos Núcleos de Saúde da Família. 2008. 91 f. Dissertação (Mestrado) Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 2008. Diversas mudanças têm ocorrido no perfil demográfico do Brasil, passando o envelhecimento populacional a ser uma realidade e não mais uma expectativa. Muitos são os mitos, conceitos e concepções sobre idoso, velhice e envelhecimento existentes em nossa sociedade, assim como meios legais que regem sobre os direitos e deveres da pessoa idosa (Programa Nacional de Saúde do Idoso, Estatuto do Idoso e Pacto pela Vida 2006). Objetivando analisar as representações de velhice presentes entre os profissionais que atuam nos Núcleos de Saúde da Família I, III, IV e V do Centro de Saúde Escola da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo (CSE FMRP/USP) e as possíveis implicações para o serviço de saúde, realizamos este estudo, utilizando-se da abordagem qualitativa por meio de entrevistas semi-estruturadas, com dezenove profissionais que atuam nesses Núcleos (agentes comunitários de saúde, auxiliares de enfermagem, enfermeiras, médicos e dentistas). As concepções de velhice variaram em função da formação, idade e experiência de vida dos entrevistados, sendo apresentadas como: fase de sabedoria e experiência de vida; evolução natural do corpo humano; estado de espírito; fase que se assemelha ao mundo infantil; fase de decadência ou solidão; e melhor idade. Há a compreensão por parte dos profissionais entrevistados, de que a velhice é um conjunto bio-psico-social-espiritual, sendo manifestadas pelos mesmos as dificuldades encontradas em prestar uma assistência de qualidade neste cenário tão complexo. Demonstraram também, os seus sentimentos, medo e ansiedade frente ao próprio processo de envelhecimento, como conseqüência da cultura e da sociedade em que vivem, onde ser idoso é visto de forma negativa. As concepções sobre idoso, velhice e envelhecimento, apresentadas pelos entrevistados, indicam a dimensão do quanto esses profissionais encontram-se despreparados para enfrentar o grande desafio de melhorar o atendimento oferecido pelo serviço de saúde, principalmente, em se levando em consideração o aumento acentuado do número de idosos neste país. / BIMBATO, A. M. J. The representation of old among the professionals who actuate in the Nucleus of Health of Family. 2008. 91 f. Dissertação (Mestrado) Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto SP, 2008. Several alterations (changes) have accured in the demographic profile (side view) of Brazil, passing the populational aging to be a reality (a fact) and not else an expectation. There are a lot of myths (fables), concepts and conceptions about old people, old age and aging in our society, in the same way that legal ways that rule about the rights and obligations of old person (National Programe of Health of old people, Statute of old people and Pact for life 2006). Objectifying analyze the representations of old age present among the professionals who actuate in the Nucleus of Health of Family I, III, IV, and V in the Center of School Health of the Medical Scholl of Ribeirão Preto SP and University of São Paulo (CSE FMRP/USP) and the possible implications for the health service, we have realized this study, through the qualitative contacts by semi organized interviews with nineteen professionals who actuate in these Nucleus (communitarian of health agents, auxiliary of nursing, nurses, doctors and dentists). The conceptions of the old age have changed in function of the formation, age and experience of life of the interviewers, being showed as phase of knowledge (wisdom) and experience of life; natural evolution of the human body; condition of the spirit; phase like to the infantile world; phase of decadence and loneliness (desolation) and better age. There is the understanding (the comprehension) in part of the interviewed professionals that the old age is a biko-psycho-social-spiritual body (assemblage), being manifested (declared) by these; the difficulties found in giving a good care in this so complex decor (setting). They have also demonstrated their feelings (fear and anxiety) before their own process of aging as consequence of the education of the society they live, where who is old is seen in a negative form. The conceptions about old people, old age and aging expressed by the interviewed show a good dimension of how these professionals are unprepared to face (to confront) the great challenge to improve the work offered by the health service, mainly, when we take into consideration the accentuated growth of the number of the old people in this country.

BIMBATO, A. M. J. A representação de velhice entre os profissionais que atuam nos Núcleos de Saúde da Família. 2008. 91 f. Dissertação (Mestrado) Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 2008. Diversas mudanças têm ocorrido no perfil demográfico do Brasil, passando o envelhecimento populacional a ser uma realidade e não mais uma expectativa. Muitos são os mitos, conceitos e concepções sobre idoso, velhice e envelhecimento existentes em nossa sociedade, assim como meios legais que regem sobre os direitos e deveres da pessoa idosa (Programa Nacional de Saúde do Idoso, Estatuto do Idoso e Pacto pela Vida 2006). Objetivando analisar as representações de velhice presentes entre os profissionais que atuam nos Núcleos de Saúde da Família I, III, IV e V do Centro de Saúde Escola da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo (CSE FMRP/USP) e as possíveis implicações para o serviço de saúde, realizamos este estudo, utilizando-se da abordagem qualitativa por meio de entrevistas semi-estruturadas, com dezenove profissionais que atuam nesses Núcleos (agentes comunitários de saúde, auxiliares de enfermagem, enfermeiras, médicos e dentistas). As concepções de velhice variaram em função da formação, idade e experiência de vida dos entrevistados, sendo apresentadas como: fase de sabedoria e experiência de vida; evolução natural do corpo humano; estado de espírito; fase que se assemelha ao mundo infantil; fase de decadência ou solidão; e melhor idade. Há a compreensão por parte dos profissionais entrevistados, de que a velhice é um conjunto bio-psico-social-espiritual, sendo manifestadas pelos mesmos as dificuldades encontradas em prestar uma assistência de qualidade neste cenário tão complexo. Demonstraram também, os seus sentimentos, medo e ansiedade frente ao próprio processo de envelhecimento, como conseqüência da cultura e da sociedade em que vivem, onde ser idoso é visto de forma negativa. As concepções sobre idoso, velhice e envelhecimento, apresentadas pelos entrevistados, indicam a dimensão do quanto esses profissionais encontram-se despreparados para enfrentar o grande desafio de melhorar o atendimento oferecido pelo serviço de saúde, principalmente, em se levando em consideração o aumento acentuado do número de idosos neste país. / BIMBATO, A. M. J. The representation of old among the professionals who actuate in the Nucleus of Health of Family. 2008. 91 f. Dissertação (Mestrado) Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto SP, 2008. Several alterations (changes) have accured in the demographic profile (side view) of Brazil, passing the populational aging to be a reality (a fact) and not else an expectation. There are a lot of myths (fables), concepts and conceptions about old people, old age and aging in our society, in the same way that legal ways that rule about the rights and obligations of old person (National Programe of Health of old people, Statute of old people and Pact for life 2006). Objectifying analyze the representations of old age present among the professionals who actuate in the Nucleus of Health of Family I, III, IV, and V in the Center of School Health of the Medical Scholl of Ribeirão Preto SP and University of São Paulo (CSE FMRP/USP) and the possible implications for the health service, we have realized this study, through the qualitative contacts by semi organized interviews with nineteen professionals who actuate in these Nucleus (communitarian of health agents, auxiliary of nursing, nurses, doctors and dentists). The conceptions of the old age have changed in function of the formation, age and experience of life of the interviewers, being showed as phase of knowledge (wisdom) and experience of life; natural evolution of the human body; condition of the spirit; phase like to the infantile world; phase of decadence and loneliness (desolation) and better age. There is the understanding (the comprehension) in part of the interviewed professionals that the old age is a biko-psycho-social-spiritual body (assemblage), being manifested (declared) by these; the difficulties found in giving a good care in this so complex decor (setting). They have also demonstrated their feelings (fear and anxiety) before their own process of aging as consequence of the education of the society they live, where who is old is seen in a negative form. The conceptions about old people, old age and aging expressed by the interviewed show a good dimension of how these professionals are unprepared to face (to confront) the great challenge to improve the work offered by the health service, mainly, when we take into consideration the accentuated growth of the number of the old people in this country.

A busca por um estilo de vida saudável é crescente sendo desafiante para a indústria alimentícia atender às demandas atuais de mercado. A idade do consumidor é variável importante frente às expectativas dos indivíduos. Pois os jovens em geral são saudáveis, estão em fase de descobertas, mudanças e em formação de opinião, enquanto os idosos possuem preferências consolidadas e geralmente apresentam restrições alimentares. Neste contexto, para produtos cárneos, o reduzido teor de gordura e a mastigabilidade são características atrativas. Para o desenvolvimento de produtos cárneos diferenciados são práticas usuais as combinações de ingredientes não cárneos passíveis de substituir a gordura, ou ainda a redução de ácidos graxos saturados por meio da utilização de óleos vegetais para substituir a gordura suína. Contudo, raros são os estudos que abordam simultaneamente a redução e a substituição de gordura avaliando a influência destas modificações na percepção sensorial de consumidores com diferentes idades. Assim, o presente estudo tem por objetivo principal viabilizar a obtenção de emulsionados com alta redução de gordura animal e aceitabilidade sensorial, utilizando ingredientes não cárneos (alginato, guar e soro de leite) associados à gordura vegetal; além de comparar os perfis sensoriais obtidos por jovens, adultos e idosos treinados. Nas formulações a gordura foi reduzida em 66% e o máximo de substituição foi de 100% do toucinho. Sendo as formulações: CA e CV os tratamentos controles contendo respectivamente 24% de gordura animal (A) e gordura vegetal (V) na massa; RGA (reduzida gordura animal) e RGV (reduzida gordura vegetal) com teor reduzido para 12% de gordura na massa; enquanto RGAH (reduzida gordura animal com hidrocolóides) e RGVH (reduzida gordura vegetal com hidrocolóides) possuem 12% de gordura e foram adicionados de soro de leite (1,2%), alginato (0,25%) e goma guar (0,05%). A substituição da gordura animal por vegetal modificou a qualidade do produto principalmente quanto à textura (elasticidade e mastigabilidade). A redução de gordura diminuiu o potencial oxidativo e o teor de ácidos graxos saturados, minimizou as perdas na cocção e apresentou a maior aceitação sensorial. Os resultados dos consumidores demonstrou que nenhum dos tratamentos foi estatisticamente (p>0,05) preferido, entretanto 64% dos consumidores preferiram os produtos com teor reduzido de gordura. Os consumidores com mais idade não conseguiram diferenciar as amostras. Entre os grupos treinados, os perfis sensoriais obtidos foram diferentes, porém os grupos treinados destacaram que a redução da gordura animal proporcionou a obtenção de produtos com características mais similares aos tradicionais quando comparados aos substituídos por gordura vegetal. Conclui-se que o novo produto deve possuir apelo à saudabilidade, ressaltando seu teor de gordura e suas características diferenciadas quanto à maciez e mastigação. Esta pesquisa aponta um caminho promissor para pesquisas envolvendo a utilização de fontes lipídicas diferenciadas associadas aos hidrocolóides em produtos cárneos. Além disso, ele estudo reforça a importância da seleção de grupos de provadores para testes sensoriais dependendo do público alvo do produto a ser desenvolvido. Destaca-se ainda a necessidade de aprimoramento das análises sensoriais descritivas, sendo os mapas de referências, utilizados neste trabalho, uma ferramenta simples que auxilia os provadores na obtenção de resultados. / The search for a healthy lifestyle, it have been a challenge for the food industry meet the demands of current market. The consumer age is an important variable to obtain the expectations of individuals. Young people in general are healthy, and they are in opinion formation, while the elderly have consolidated preferences and often should have dietary restrictions. In this context, for the low-fat meat products and chewiness are attractive features. For the development of meat products differentiated, are common to combine nonmeat ingredients that can substitute the fat, or the reduction of composition saturated by the use of vegetable oils to replace pork fat. However, few are the studies that consider both requirements: the reduction and replacement of fat assessing the influence of these changes in sensory perception of consumers of different ages. Thus, the present has the main objective to facilitate obtaining emulsified with high fat reduction and sensory acceptability, using nonmeat ingredients, associated with vegetable fat, in addition to compare the sensory profiles obtained by youth, adults and seniors trained. Three processes were performed at different time periods from the standardization of the raw material. In the formulations fat was reduced by 66% and the maximum was 100% replacement of fat. Being formulations: CA and CV treatments controls containing respectively 24% animal fat (A) and vegetable fat (V) the mass; RGA (reduced animal fat) and RGV (reduced vegetable fat) with content reduced to 12% fat mass, while RGAH (reduced animal fat with hydrocolloids), and RGVH (reduced fat with vegetable hydrocolloids) have 12% fat and added whey (1.2%), sodium alginate (0.25%) and guar gum (0.05%). The replacement of animal fat to vegetable modified product quality especially in regard to texture (elasticity and chewiness). The reduction of fat decreased the oxidative potential and of saturated fatty acids, downplayed cooking loss and had the highest sensory acceptance. The results demonstrate the consumer 110 that no treatment was considered preferred, though 64% of consumers prefer products with reduced fat content. Older consumers could not differentiate the samples. Among the groups trained sensory profiles obtained were different, the trained groups emphasized that the reduction in animal fat afforded to obtain products with characteristics similar to those when compared to traditional replaced by vegetable fat (RGV and RGVH). We conclude that the new product should have appeal to healthiness, highlighting its fat content and its distinctive characteristics as the softness and chewing. This result shows promising areas for future research involving the use of different lipid sources associated with hydrocolloids in meat products associated with different lipid sources. This study reinforces the importance of the selection of groups of assessors depending on the target audience of the product to be developed. Another important point is the need for improvement of sensory descriptive analysis, with the maps of references used in this work a simple tool that helps testers in getting results.

De allra äldsta i samhället är människor med lång livserfarenhet och med nästan ett helt liv bakom sig. Hur resten av deras liv kommer att gestalta sig beror mycket på dem själva, deras anhöriga och på samhällets insatser. Det är av största vikt att samhället ger de insatser som gör att de allra äldsta känner sig ansvariga, självständiga och trygga. Syftet är att ta reda på vad de allra äldsta själva uppfattar är betydelsefullt för dem, när det gäller att bo kvar i sitt eget hem. Tio personer deltog i en kvalitativ intervjustudie. De allra flesta i vår studie vill fortsätta bo kvar i sitt hem och de känner sig trygga, fria och tillfreds där. De beskriver på olika sätt hur de tar ansvar för sina liv och att de gör det de kan själva, med hjälp av teknik och hjälpmedel. De får hjälp med resten av hemtjänst eller anhöriga. För våra informanter är det viktigt att vara aktiva utifrån sina egna förutsättningar. Intressanta områden att undersöka vidare kan vara hur bemötandet i vård och omsorg påverkar de allra äldstas liv och hur stöd och handledning från arbetsterapeut till omvårdnadspersonal gör skillnad. / The oldest old in our society have a long life experience. How well they can live the remaining part of their lives depends not only on themselves, but also on their relatives and societal contributions. Our society must provide a setting in which the elderly are given a sense of responsibility, independence and safety. The aim of this study was to identify the self-reported factors that are of importance for the oldest old to continue to live in their own home. Ten individuals participated in qualitative interviews. The majority of the respondents wanted to remain in their homes where they felt safe, free and peaceful. They described how they took responsibility for their lives and did what they could by themselves or with technical aid. They received help from home-help services and relatives in areas they could not manage by themselves. That they continued to be active on their own conditions was of great importance to the respondents. Interesting fields for future research would be how the interaction with health care has an influence on the lives of the oldest old, and whether support and guidance from an occupational therapist to health care personnel makes a difference.

En viktig del av den svenska välfärden är kommunens äldreomsorg för personer över 65 år, där Socialtjänstlagen ger rättighet till vårdboende och andra servicetjänster när det behövs. Kommunernas kommunaltjänst ska enligt Socialtjänstlagen vara av god kvalitet. Rapportering av avvikande händelser är en av hörnpelarna i arbetet med att förbättra kvalitet och säkerhet i vården. Avvikelserapportering bidrar till att undvika att negativa händelser upprepas, samt att rutiner förbättras för att höja kvalitet. Genom att ta tillvara möjligheterna med avvikelserapporter kan kvaliteten på vårdboenden förbättras och utvecklas. Denna studie visar på behovet av ytterligare fokus på arbetet med avvikelsehantering gällande omsorg.

Background Inner strength has been described as an important phenomenon in association with disease management, health, and ageing. To increase the knowledge of the phenomenon of inner strength, a meta-theoretical analysis was performed which resulted in a model of Inner Strength where inner strength comprises four interrelated and interacting dimensions; connectedness, creativity, flexibility, and firmness. The model was used in this thesis as a theoretical framework. Aim The overall purpose of this thesis was to develop and validate an inner strength scale, describe inner strength among an older population, and elucidate its significance for experience of health, despite disease and adversities. Methods The studies had quantitative approaches with cross-sectional designs (I-III) and a qualitative approach with narrative interviews (IV). Studies I-IV was part of the GErontological Regional DAtabase (GERDA) Botnia project. In study I, the participants (n = 391, 19-90 years old) were mostly from northern Sweden. In studies II and III, the participants (n = 6119, 65, 70, 75 and 80 years old) were from Sweden and Finland, and in study IV the participants (n = 12, 67-82 years old) were from Västerbotten County. Data was analysed using principal component analysis and confirmatory factor analysis (CFA), various statistics, structural equation modelling, and qualitative content analysis. Results In study I, the Inner Strength Scale (ISS) was developed and psychometrically tested. An initial 63-item ISS was reduced to a final 20-item ISS. A four-factor solution based on the four dimensions of inner strength was supported, explaining 51% of the variance, and the CFA showed satisfactory goodness-of-fit. In study II, ISS scores in relation to age, gender and culture showed the highest mean ISS score among the 65-year-olds, with a decrease in mean score for every subsequent age (70, 75, and 80 years). Women had slightly higher mean ISS scores than men, and there were minor differences between the regions in Sweden and Finland. In study III, a hypothesis was proposed and subsequently supported in the results where inner strength was found to partially mediate in the relationship between disease and self-rated health. The bias-corrected bootstrap, estimating the mediating indirect effect was significant and the test of goodness-of-fit was satisfactory. In study IV, from the narratives of inner strength it was found that inner strength comprised feelings of being connected and finding life worth living. Having faith in oneself and one’s possibilities and facing and taking an active part in the situation were also expressed. Finally, coming back and finding ways to go forward in life were found to be essential aspects of inner strength. Conclusions The newly developed ISS is a reliable and valid instrument that captures a broad perspective of inner strength. Basic data about inner strength in a large population of old people in Sweden and Finland is provided, showing the highest mean ISS score among the 65-year-olds. Inner strength among old people is a resource for experience of health, despite disease and adversities. This thesis contributes to increase knowledge of the phenomenon of inner strength and provide evidence for the importance of inner strength for old people’s wellbeing. Increased knowledge of the four dimensions of inner strength; connectedness, creativity, flexibility and firmness, is proposed to serve as an aid for health care professionals in their efforts to identify where the need of support is greatest and to find interventions that promotes and strengthen inner strength. / Bakgrund Inre styrka har beskrivits som ett viktigt fenomen associerat till att hantera sjukdom, till hälsa och åldrande. För att öka kunskapen om fenomenet inre styrka genomfördes en metateoretisk analys som resulterade i en Inre Styrka modell där inre styrka omfattar fyra samverkande dimensioner; samhörighet, kreativitet, flexibilitet och fasthet. Modellen har använts i denna avhandling som ett teoretiskt ramverk. Syfte Det övergripande syftet med denna avhandling var att utveckla och testa en skala som mäter inre styrka, beskriva inre styrka i en population av äldre, och att belysa dess betydelse för upplevelsen av hälsa, trots sjukdom 0ch motgångar. Metod Studierna som genomfördes hade kvantitativ ansats med tvärsnittsdesign (I-III) och kvalitativ ansats med narrativa intervjuer (IV).  Alla studier var en del av GErontologiska Regionala DAtabas (GERDA) Botnia projektet. Deltagarna i studie I (n= 391, 19-90 år) var mestadels från norra delarna av Sverige. I studierna II och III var deltagarna (n=6119, 65, 70, 75 och 80 år) från Sverige och Finland. I studie IV var deltagarna (n=12, 67-82 år) från Västerbotten. Data analyserades med hjälp av principalkomponentanalys och konfirmatorisk faktor analys (CFA), varierande statistik, strukturell ekvationsmodellering, och kvalitativ innehållsanalys. Resultat I studie I utvecklades och testades Inre Styrka Skalan (ISS). En inledande 63 frågors ISS reducerades till en slutlig 20 frågors ISS. Baserad på de fyra dimensionerna av inre styrka bekräftades en fyrafaktors lösning med 51 % förklaringsgrad och CFA visade ett tillfredställande goodness-of-fit. I studie II beskrevs inre styrka i relation till ålder, kön och kultur. Det högsta totala ISS medelvärdet skattades bland 65-åringarna med lägre medelvärden för varje efterföljande ålder (70, 75 och 80 år). Kvinnor skattade ett något högre totalt ISS medelvärde än män och det var inte några större skillnader mellan regionerna i Sverige och Finland. I studie III bekräftades den hypotes som lagts fram, att inre styrka kan mediera i relationen mellan sjukdom och upplevelsen av hälsa. Bias-corrected bootstrap visade en signifikant indirekt effekt i relationen mellan sjukdom och upplevelsen av hälsa, medierad av inre styrka, och test av modellens goodness-of-fit var tillfredsställande. I studie IV, utifrån berättelserna om inre styrka visade det sig att inre styrka omfattar känslor av samhörighet och att finna livet värt att leva. Att ha tillit till sig själv och sina möjligheter, och att kunna möta och ta aktiv del i situationen beskrevs också. Slutligen, att komma igen och hitta vägar att gå vidare i livet var viktiga aspekter av inre styrka.  Slutsatser Den nyutvecklade Inre Styrka Skalan är ett reliabelt och valitt instrument som fångar ett brett perspektiv av inre styrka. Basdata om inre styrka i en stor population äldre i Sverige och Finland har presenterats, och visar det högsta ISS medelvärdet bland 65-åringarna. Inre styrka bland äldre är en resurs för upplevelsen av hälsa, trots sjukdom och motgångar. Denna avhandling bidrar till att öka kunskapen om fenomenet inre styrka och ger evidens för att inre styrka har en viktig betydelse för äldres välbefinnande. Ökad kunskap om de fyra dimensionerna av inre styrka; samhörighet, kreativitet, flexibilitet, och fasthet, föreslås kunna vara en hjälp för vårdpersonal i deras arbete att identifiera var behovet av stöd är störst och att sätta in insatser som främjar och stärker inre styrka. / GErontologiska Regionala DAtabas (GERDA) Botnia projektet