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Human health is multidimensional: apart from physical, mental, and social aspects, it also incorporates subjective perceptions of health, and functional status (FS). Given that elderly persons have very distinctive health and social needs, multidimensional assessment (MA) of health proves particularly useful in this age group.¶ Aboriginal populations suffer poor health, and there are relatively few studies addressing the health problems of older Aboriginal Australians, mainly because of their distinctive demographic structure, and the low proportion of their elderly. Also, there is no prior information available on MA of health in this Australian population group.¶ This thesis offers a MA of health in older Aboriginal persons from two, urban and rural/isolated, locations in the NT, Katherine and Lajamanu (the NT survey).¶ This thesis specifically addresses the following questions: - what is the physical health, FS, subjective perception of health, and social functioning amongst the NT survey participants? - what are the possible similarities and differences in various dimensions of health between the two major survey locations, what age and gender patterns are observed, and what are the reasons for these patterns, similarities and differences? - how do various dimensions of health relate to each other, and why? - how do current findings relate to broader Aboriginal and non-Aboriginal populations, and why? - what can MA add to a better understanding of various aspects of morbidity and health care use? - what are its possible implications for health planning?¶ Findings from this work indicate poor physical health amongst participants in almost all investigated aspects, comparable to information available from other Aboriginal populations. These are accompanied by low levels of ability for physical functioning. Despite this, subjective perception of health is rather optimistic amongst participants, and levels of social functioning high. Use of health services is mainly related to available health infrastructure. Important health differences exist between Katherine and Lajamanu, and they became particularly visible when all dimensions of health are considered together.¶ The Main conclusions from the current work are that 1) poor physical health is not necessarily accompanied by similar level of deterioration in other dimensions of health: even though participants from the isolated community of Lajamanu experience most chronic diseases, their ability for physical functioning is better, self-perceived health (SPH) more optimistic and levels of social functioning highest 2) institutionalised participants from Katherine suffer by far the worst health of all sample segments in this study; at least some of the poor health outcomes are potentially avoidable, and could be improved by more appropriate residential choices for Aboriginal elderly 3) better health infrastructure does not necessarily bring better health in all its dimensions, suggesting that other factors (primarily socio-economic and cultural) should be addressed in conjunction with this in solving complex health problems of Aboriginal Australians, and 4) it provides strong support that MA can become a useful tool in comprehensive health assessment of older Aboriginals.

<p>The objectives of this study concerning Swedish players’ transition from junior to senior football were to examine: (1) transition, perceived health, and athletic identity variables, as well as the relationship between them; (2) how transition, perceived health, and athletic identity variables contribute to: (a) healthy sport participation; (b) unhealthy sport participation; (c) quality of adjustment on the senior level of football; (d) life satisfaction. The theoretical frameworks included: the developmental model on transitions faced by athletes; the career transition model; the perceived health and sport/exercise participation model; the circle of health model. The participants (n = 126) were Swedish adolescent football players at local, national or international competitive levels. Three instruments were used in regard of the quantitative approach: the Transition Monitoring Survey; the Perceived Health and Sport Participation Profile; the Athletic Identity Measurement Scale. The transition variables were examined and several relationships were discovered between transition and perceived health variables, and athletic identity. Four multiple regression analyses showed that satisfaction with different spheres of life and coping strategies are significant positive predictors of healthy sport participation. Athletic identity, personal resources, and environmental pressure are significant positive predictors of unhealthy sport participation. In addition, environmental support was revealed to be a significant negative predictor of unhealthy sport participation. Importance of different aspects of sport and satisfaction with sport participation are significant positive predictors of the quality of adjustment on the senior level of sports, whereas importance of different spheres of life and athletic identity are significant negative predictors. Importance of different spheres of life and healthy sport participation are significant positive predictors of life satisfaction. The results are discussed in relation to theoretical frameworks and previous research.</p> / <p>Syftena med föreliggande studie angående svenska spelares övergång från junior till seniorfotboll var att undersöka: (1) övergångs-, upplevd hälsa- och idrottsidentitetsvariabler, såväl som förhållandet mellan dem; (2) hur övergångs-, upplevd hälsa- och idrottsidentitetsvariabler bidrar till: (a) ett hälsosamt idrottsdeltagande; (b) ett ohälsosamt idrottsdeltagande; (c) idrottarnas anpassning till seniornivån i fotboll; (d) livstillfredsställelse. De teoretiska referensramarna inkluderade: the developmental model on transitions faced by athletes; the career transition model; the perceived health and sport/exercise participation model; the circle of health model. Deltagarna (n = 126) bestod av svenska ungdomsfotbollsspelare på lokal, nationell och internationell tävlingsnivå. Tre mätinstrument användes med tanke på den kvantitativa utgångspunkten: Enkäten Karriärövergången från Junior till Senioridrott; Upplevd Hälsa & Idrottsdeltagande Profil; Athletic Identity Measurement Scale. Övergångsvariablerna undersöktes och flera samband upptäcktes mellan övergångs- och upplevd hälsavariabler och idrottsidentitet. Fyra multipla regressionsanalyser visade att tillfredsställelse med olika delar av livet och copingstrategier är positivt signifikanta faktorer som bidrar till ett hälsosamt idrottsdeltagande. Idrottsidentitet, personlighetsfaktorer och tidigare erfarenheter, samt press från omgivningen är positivt signifikanta faktorer som bidrar till ett ohälsosamt idrottsdeltagande. Dessutom så upptäcktes support från omgivningen att vara en negativt signifikant faktor som bidrar till ett ohälsosamt idrottsdeltagande. Hur viktiga olika delar av idrotten är och tillfredsställelsen med idrottsdeltagandet är positivt signifikanta faktorer som bidrar till idrottarens anpassning till seniornivån, då däremot hur viktiga olika delar av livet är och idrottsidentiteten är negativt signifikanta faktorer. Hur viktiga olika delar av livet är och ett hälsosamt idrottsdeltagande är positivt signifikanta faktorer som bidrar till livstillfredsställelse. Resultaten diskuteras i förhållande till de teoretiska referensramarna och tidigare forskning.</p>

The objectives of this study concerning Swedish players’ transition from junior to senior football were to examine: (1) transition, perceived health, and athletic identity variables, as well as the relationship between them; (2) how transition, perceived health, and athletic identity variables contribute to: (a) healthy sport participation; (b) unhealthy sport participation; (c) quality of adjustment on the senior level of football; (d) life satisfaction. The theoretical frameworks included: the developmental model on transitions faced by athletes; the career transition model; the perceived health and sport/exercise participation model; the circle of health model. The participants (n = 126) were Swedish adolescent football players at local, national or international competitive levels. Three instruments were used in regard of the quantitative approach: the Transition Monitoring Survey; the Perceived Health and Sport Participation Profile; the Athletic Identity Measurement Scale. The transition variables were examined and several relationships were discovered between transition and perceived health variables, and athletic identity. Four multiple regression analyses showed that satisfaction with different spheres of life and coping strategies are significant positive predictors of healthy sport participation. Athletic identity, personal resources, and environmental pressure are significant positive predictors of unhealthy sport participation. In addition, environmental support was revealed to be a significant negative predictor of unhealthy sport participation. Importance of different aspects of sport and satisfaction with sport participation are significant positive predictors of the quality of adjustment on the senior level of sports, whereas importance of different spheres of life and athletic identity are significant negative predictors. Importance of different spheres of life and healthy sport participation are significant positive predictors of life satisfaction. The results are discussed in relation to theoretical frameworks and previous research. / Syftena med föreliggande studie angående svenska spelares övergång från junior till seniorfotboll var att undersöka: (1) övergångs-, upplevd hälsa- och idrottsidentitetsvariabler, såväl som förhållandet mellan dem; (2) hur övergångs-, upplevd hälsa- och idrottsidentitetsvariabler bidrar till: (a) ett hälsosamt idrottsdeltagande; (b) ett ohälsosamt idrottsdeltagande; (c) idrottarnas anpassning till seniornivån i fotboll; (d) livstillfredsställelse. De teoretiska referensramarna inkluderade: the developmental model on transitions faced by athletes; the career transition model; the perceived health and sport/exercise participation model; the circle of health model. Deltagarna (n = 126) bestod av svenska ungdomsfotbollsspelare på lokal, nationell och internationell tävlingsnivå. Tre mätinstrument användes med tanke på den kvantitativa utgångspunkten: Enkäten Karriärövergången från Junior till Senioridrott; Upplevd Hälsa &amp; Idrottsdeltagande Profil; Athletic Identity Measurement Scale. Övergångsvariablerna undersöktes och flera samband upptäcktes mellan övergångs- och upplevd hälsavariabler och idrottsidentitet. Fyra multipla regressionsanalyser visade att tillfredsställelse med olika delar av livet och copingstrategier är positivt signifikanta faktorer som bidrar till ett hälsosamt idrottsdeltagande. Idrottsidentitet, personlighetsfaktorer och tidigare erfarenheter, samt press från omgivningen är positivt signifikanta faktorer som bidrar till ett ohälsosamt idrottsdeltagande. Dessutom så upptäcktes support från omgivningen att vara en negativt signifikant faktor som bidrar till ett ohälsosamt idrottsdeltagande. Hur viktiga olika delar av idrotten är och tillfredsställelsen med idrottsdeltagandet är positivt signifikanta faktorer som bidrar till idrottarens anpassning till seniornivån, då däremot hur viktiga olika delar av livet är och idrottsidentiteten är negativt signifikanta faktorer. Hur viktiga olika delar av livet är och ett hälsosamt idrottsdeltagande är positivt signifikanta faktorer som bidrar till livstillfredsställelse. Resultaten diskuteras i förhållande till de teoretiska referensramarna och tidigare forskning.

Amalgam has been used as a dental restorative material for centuries, but its potential health effects and biopersistance has lead to a decreased use especially in the Nordic countries. New materials have been introduced, partly to replace the mercury containing amalgam and partly because of esthetical reasons. The possible health effects of amalgam have been studied extensively and the material has been replaced with other less well-examined materials during the last few decades. The prevalence of side effects of dental materials is considered to be low in relation to the vast number of dental treatments undertaken. With the introduction of new and more complex materials, side effects related to dental treatment may increase. Epidemiological data suggest that the side effects of dental resins that have almost completely replaced amalgam fillings in Scandinavia, possess a risk for adverse reactions; however, the causal relation has not been fully established. Therefore, the type and extent of side effects caused by resin-based materials are of great interest. The aims of the study were: - to describe the change in health over time for patients with problems related to their dental materials. The hypothesis was that the patients could be divided into subgroups based on their symptoms and that the ability to recover differs between these groups [Paper I]. Furthermore, to determine whether factors such as the replacement of dental restorative materials and follow-up time had any impact on the perceived health. - to assess the long-term development of symptoms and their social consequences among patients referred for diagnosis and treatment of symptoms related to dental materials [Paper II] - to investigate the possible risks with dental restorative materials other than amalgam [Paper III]. - to describe side effects assessed to be caused by resin-based materials that occurred in a group of patients as well as treatment and long-term consequences of the reactions [Paper IV]. A questionnaire was sent to 614 patients [Paper I and II] that had been referred to the School of Dentistry, Umeå, Sweden, with symptoms allegedly caused by dental materials. The questionnaire contained questions on, among others; civil status, present health, medical and dental treatment and other measures and precautions taken because of psychosocial problems related to current employment situation, feelings, self-image and coping behavior. Moreover, information was collected [Paper III] from the Swedish Dental Materials Register 2003 (DentMr), a compilation of MSDS for 487 materials, and information from the user guide of the materials. The Material Safety Data Sheets (MSDS) included in the DentMR were examined regarding the given composition of the products, the occurrence of CAS-numbers and the risk- and safety phrases of the substances. Information was collected [Paper IV] on 36 patients with reactions to resin-based restorative materials from the Swedish National Register of Side-Effects of Dental Materials. Patients with complex symptoms had a more unfavorable long-term prognosis concerning persistent complaints than those with local symptoms only. Furthermore, the results indicate that the patients might experience health improvements after removal of their dental restorative materials. However, the reason for this improvement was unclear. Replacement of dental restorative materials had no significant impact on the ability to recover completely. Our results also indicate a relationship between patients’ self-related health and social consequences in daily life. Those with remaining complex symptoms had more often stopped working or had decreased their work hours because of their symptoms The information about hazards with dental materials seems insufficiently described in MSDS and there might be materials with side effects unknown to both patients and dental professionals. A literature search indicated that some of the listed substances had possible hazards, e.g. substances with embryotoxic and neurotoxic potential. The patients were very heterogeneous; a few with only local symptom free reactions while other had more complex symptoms. The latter group would gain from a multidisciplinary approach, i.e. dental, medical, as well as social and psychological factors have to be considered when developing care management programs for this group of patients. Furthermore, there is a need for stronger regulations of dental materials, such as those applied to pharmaceutical drugs. Finally, it was found that the majority of symptoms suspected to be caused by resin-based materials were local or a combination of local and extra-oral symptoms that appeared within the first 24 hours after treatment. The most frequent adverse effect reported was skin problems/dermatitis. It appears as though immediate reactions to resin based materials are not uncommon and more prevalent than allergic reactions. Still, we have had, difficulties in verifying associations between the dental restorative materials and adverse reactions and also to identify the offending component.

El propósito de la tesis es estudiar las características socioeconómicas y el estatus social subjetivo de las mujeres inmigrantes y analizar su relación con la salud. Así como, explorar los determinantes del estatus social subjetivo y como las mujeres explican la influencia de los mismos en sus trayectorias de salud. El estudio utilizó metodología cuantitativa y cualitativa. Se observó una asociación débil entre las medidas del estatus socioeconómico y la salud percibida. El estatus social subjetivo fue significativamente asociado con la salud percibida, lo que sugiere que puede ser un indicador relevante para el estudio de las desigualdades en salud Las entrevistas muestran las trayectorias de salud y las desigualdades en los determinantes sociales de salud de las inmigrantes en relación a la población Cántabra. Los determinantes del estatus social subjetivo y de la salud de las mujeres se encuentran, principalmente, en el contexto socioeconómico y político de España.

Syfte: Arbetet är en experimentell studie i samarbete med Lidköpings kommun där syftet är att undersöka om konditionshöjande motion och ökad VO2-max kan sänka blodtrycket och öka upplevd hälsa, och minska den upplevda arbetsbelastningen. Metod: En grupp kvinnor anställda inom hemvården har under en period genomfört en intervention med ett aktivitetsprogram. Innan och efter interventionsperioden har de, och en kontrollgrupp, genomgått tester för att mäta blodtryck och VO2-max. De har också i samband med testerna, via ett frågeformulär, svarat på frågor om sin hälsa, fysiska aktivitetsnivå samt sin upplevda hälsa och arbetsbelastning. Resultat: Det finns inga signifikanta skillnader mellan grupperna varken innan eller efter interventionsperioden. Det finns inte heller några signifikanta skillnader av interventionsgruppens resultat innan och efter interventionsperioden. Slutsats: Studien kan inte svara på om konditionshöjande motion och en ökad syreupptagningsförmåga kan sänka blodtrycket och öka den upplevda hälsan och minska den upplevda arbetsbelastningen. Stickprovet har varit för litet. På grund av detta, och pga. av att ett frivilligt deltagande i studien omöjliggör ett slumpvis urval, kan undersökningen inte sägas vara representativt för gruppen av människor som det avser att studera. / Aims: To examine if an increased oxygen uptake and moderate to vigorus physical exercise, could lower blood pressure and increase the level of perceived health and lower the level of perceived workstrain, in women working with elderly care. The work is an experimental study in cooperation with Lidköpings kommun. Methods: An experimental group have participated in a period of exercise in a given program. Before, and after the period of exercise the participants and a controlgroup have undergone tests to measure their bloodpressure and VO2-max. In connection with the tests a survey with questions abouth their physical activitylevel and ther perceived health and workstrain were answered. Results: No significant differences could be seen between the experimental group and the controlgroup in any parameter, neither before or after the experimental period. No significant differences could be seen in the results of the experimental group, before or after the experimental period. Conclusion: The study could not answer the questions whether an increased oxygen uptake and moderate to vigorus exercise, could lower bloodpressure and increase the level of perceived health and lower the level of perceived workstrain. The sampel of individuals who participated is too small. In relation to that, and that voluntary participation makes a random selection of individuals an impossibility, makes this study not representative to those people it aims to study.

La prise en compte de la notion de la qualité de vie (QDV) du patient est révélatrice d'un changement profond dans la pratique médicale, notamment en néphrologie, pour les patients atteints d'insuffisance rénale chronique terminale (IRCT). Compte tenu de la prévalence, de l'incidence et de la mortalité de cette maladie en France, il paraissait important de pouvoir mesurer de façon pertinente et cohérente la QDV des patients atteints d'IRCT. La QDV liée à la santé constitue un indicateur pour apprécier les conséquences de cette maladie. En 2007, après une étude de revue de la littérature concernant les outils de mesure de la QDV des IRCT, il a été mis en évidence un manque de questionnaires spécifiques validés en langue française. Il existait donc un besoin réel d'évaluer la QDV de ces patients, et plus particulièrement celle des patients porteurs d'un greffon rénal fonctionnel.En 2008, une échelle spécifique a donc été développée et validée pour mesurer la QDV des patients greffés rénaux : le ReTransQol (ou RTQ). Après 5 années d'utilisation du RTQ dans diverses études nationales, cet outil a été amélioré et une nouvelle version a vu le jour: le RTQ V2. Après de nombreuses analyses, cette échelle présente actuellement de bonnes propriétés psychométriques et est validée auprès de diverses populations d'études. Le RTQ V2 sera d'ailleurs utilisé dans des études internationales (Brésil, Allemagne, Canada...), et une validation transculturelle est prévue. Le RTQ V2 est donc un outil de mesure spécifique de la QDV adapté pour une utilisation en routine auprès des patients porteurs d'un greffon rénal fonctionnel. / The inclusion of the concept of quality of life (QOL) is indicative of a profound change in the way of practicing medicine, particularly in the field of nephrology for patients with end stage renal disease (ESRD). Given the prevalence, incidence and mortality of this disease in France, it seemed important, even essential, to measure properly, appropriately and consistently, the QOL of patients with ESRD. Health related quality of life (HRQOL) is therefore an important indicator of results to evaluate the consequences of this disease, the effect of medical procedures, treatment effects, or the impact of health policies.In 2007, after a study of literature concerning the assessment of QOL's scales of patients with ESRD, it was revealed a certain lack, quantitative or qualitative, of specific questionnaires for measuring QOL for ESRD patients validated in French, especially for patients with a functioning kidney transplant.In 2008, a specific scale has been developed and validated to measure the QOL of renal transplant recipients: the ReTransQol (Renal Transplant Quality of life questionnaire). After 5 years of use and application of ReTransQol in different national studies, this tool has been improved and a new version was created: the ReTransQol V2 (or RTQ V2). After lots of analysis, this scale has currently good psychometric properties and has been validated in various populations. The RTQ V2 is also used in international studies (Brazil, Germany, Canada ...), and a cross-cultural validation of the scale is planned.The ReTransQol V2 is a specific tool to assess the HRQOL and is suitable for a routine use among renal transplant recipients.

Britain's Asians are a young population and their socio-economic status is low, with racial disadvantage in housing, employment, education and health. Research on their health has usually not been conducted in its socio-economic and demographic context and there is little on their use of primary care. Three studies were conducted to investigate their relationship with primary care in Bradford. A study of general practice attenders of white/British, Pakistani and Indian origin confirmed the demographic and socio-economic differences between the groups. The former had higher rates of alcohol and cigarette consumption. For Pakistanis and Indians, fluency and literacy in English was poor. Ethnic and linguistic match between doctor and patient was more important in patients' choice of doctor than the doctor's sex. Differential employment status of Asian and white/British accounted for some of the differences in health. A study of general practice attendance showed similar rates of surgery consultations between Asians and Non-Asians; the latter made greater use of domiciliary services. Both these studies were conducted in an inner Bradford health centre with an Asian male, a white male and a white female doctor. Bradford GPs were found to perceive that Asian patients made greater use of surgery and domiciliary consultations; attended more often for trivial complaints; and had lower compliance rates than Non-Asians. These perceptions were not supported by objective data. Better qualified GPs had a smaller, and Asian doctors had a greater proportion of Asian patients on their lists. Research, and action on Asians' health, needs to take account of their poorer socio-economic status. / Yorkshire Regional and Bradford District Health Authority.

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