La transición nutricional es un proceso que incluye cambios en el perfil nutricional de las poblaciones. Muchos países en desarrollo, incluyendo Perú, se encuentran en transición. Objetivos: Describir la variación del perfil nutricional de los niños, madres en edad fértil y familias peruanas entre 1991 y 2005. Materiales y métodos: Usando la información disponible en las bases de datos de las Encuestas Nacionales Demográficas y de Salud realizadas en el Perú entre 1991 y 2005, se describe la prevalencia de malnutrición en niños menores de cinco años, madres en edad fértil y familias peruanas a nivel nacional, regional, y de acuerdo al nivel socioeconómico y área de residencia (urbano/rural). Resultados: La tasa de retardo de crecimiento infantil se ha mantenido alta y constante desde 1996. El sobrepeso infantil se ha incrementando principalmente en Lima Metropolitana y la Costa. En las madres en edad fértil el problema más importante es la alta prevalencia de sobrepeso y obesidad, que se incrementa principalmente en Lima Metropolitana y la Costa. La coexistencia de retardo de crecimiento infantil y obesidad materna a nivel familiar ha sido baja y sin presentar alguna tendencia temporal en el período estudiado. Conclusiones: El perfil nutricional peruano se encuentra en transición. Sus principales componentes son la alta tasa de retardo de crecimiento infantil y el incremento en sobrepeso y obesidad materna. Estos hallazgos muestran que la población peruana presenta un alto riesgo de desarrollar enfermedades asociadas con ambos extremos de la nutrición. / Nutrition transition is a process including changes in the nutritional profile of populations. Many developing countries, including Peru, are in transition. Objectives: The aim of this study was to describe the variation of the nutritional profile of Peruvian children, mothers in reproductive age and families between 1991 and 2005. Material and methods: using available information from databases from Peruvian Health and Demographic National Surveys, between 1991 and 2005, we described the prevalence of malnutrition in Peruvian children less than 5 years of age, mothers in reproductive age, and families, at the national, regional, and socioeconomic level, and by residence area (urban/rural). Results: Stunting in children has been high and constant since 1996. Overweight in children has increased, mainly in Lima and the Coast. Overweight and obesity are the main nutritional problems of mothers in reproductive age, which have increased in Lima and the Coast. Coexistence of child stunting and maternal obesity at the family level has been low and without specific trend. Conclusions: The Peruvian nutritional profile is in transition. The main components are the high prevalence of stunting in children and the increase of maternal overweight and obesity. This findings show that Peruvian population is posed at a high risk of developing diseases related to both extremes of nutrition.

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第21267号 / 人健博第59号 / 新制||人健||5(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 若村 智子, 教授 十一 元三, 教授 村井 俊哉 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2015-03-05T13:28:52Z No. of bitstreams: 2 Dissertação - Carlos Magno Neves - 2013.pdf: 2235605 bytes, checksum: d06a85ca8f8222f2f6062c3372cbb13b (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-03-05T13:55:53Z (GMT) No. of bitstreams: 2 Dissertação - Carlos Magno Neves - 2013.pdf: 2235605 bytes, checksum: d06a85ca8f8222f2f6062c3372cbb13b (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-03-05T13:55:53Z (GMT). No. of bitstreams: 2 Dissertação - Carlos Magno Neves - 2013.pdf: 2235605 bytes, checksum: d06a85ca8f8222f2f6062c3372cbb13b (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-12-10 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / Several authors have sought to understand the variables that shape health services in the SUS and its management, seeking to support the management with information that may contribute to the defragmentation of the system. In this sense the performance of health systems is of major importance for management of this sector. The evaluation of the performance of the health systems is of major importance for the management of the referred sector. With this purpose stands out the population based health surveys, which are being widely used in other countries, and in Brazil they have been gradually used by some government sectors, due to their legitimacy to assess the health status of the population and the health care service provided from the users’ point of view. OBJECTIVE: To analyze the performance of the health services in the municipalities of the northern part of the Integrated Region of Development of the Federal District and surrounding areas from the perspective of the residents. METHODOLOGY: A descriptive epidemiological study using a population-based household survey. An already validated questionnaire was applied, which was submitted to a digital format with the use of an electronic artifact Pocket Hp iPAQ116 The statistical analysis was performed using a SPSS software version 19.0, on which data were crossed and simple frequencies were performed with 95 % confidence interval. RESULTS: From 521 participants, 59.50 % are aged between 18 to 40, 53.93 % are female, being 54.70% of the majority of brown skin color . About the Basic Attention AB1 66.60 % of households were registered in units of the family health, and 33.39 % of residents reported not having health care support, 46.25% residents reported consultation with a physician, 67.63 % of those paid by SUS, also 86.27 % of 51 admissions were provided by SUS, and 82.36 % of the health service users seek predominantly for SUS , and 59.19 % not primarily sought the Primary Care. CONCLUSION: Were recorded a young adult population with a female majority was registered, The provision of health services, are recorded at CNES and enrolls 138 public health services or private contracted by SUS, without however posses or contract a high complexity hospital service, which is presented only in the municipality of Planaltina de Goiás. The gateway service recommended by the federal government to AB, is not perceived as such by the population. / Diversos autores têm buscado compreender as variáveis que configuram os serviços de saúde no SUS e sua gestão buscando subsidiar os gestores com informações que possam contribuir na desfragmentação do sistema. Nesse sentido a avaliação do desempenho dos sistemas de saúde é de reconhecida importância para a gestão desse setor. Com Este proposito destacam-se os inquéritos de saúde de base populacional, que são amplamente utilizados em outros países e no Brasil vem sendo gradativamente utilizados por órgãos oficiais, devido à sua legitimidade para avaliar o estado de saúde da população e a assistência de saúde prestada do ponto de vista do usuário. OBJETIVO: Analisar o desempenho dos serviços de saúde dos municípios do Entorno Norte da Região Integrada de Desenvolvimento do Distrito Federal e Entorno na perspectiva dos residentes. METODOLOGIA: Estudo epidemiológico descritivo, do tipo inquérito domiciliar de base populacional. Foi utilizado questionário já validado, sendo apresentado em formato digital com utilização de artefato eletrônico Pocket Hp iPAQ116, a análise estatística foi realizada por meio do software SPSS versão 19.0, no qual foram realizados cruzamentos e frequências simples com intervalo de confiança 95%. RESULTADOS: Dos 521 participantes, 59.50% estão na faixa etária de 18 e 40 anos, 53.93% são do sexo feminino, sendo a maioria de cor parda 54.70%. Quanto à Atenção Básica (AB), 66.60% dos domicílios estavam cadastrados em unidades de saúde da família e 46.25% residentes relataram consultar com algum médico, 67.63% dessas, pagas pelo SUS. Registram-se também 51 internações, nas quais 86.27% foram realizadas pelo SUS. 82.36% dos usuários buscaram predominantemente o SUS, sendo que 59.19%, não procuraram primeiramente a Atenção Básica. CONCLUSÃO: Registra-se uma população adulta jovem com maioria feminina. A oferta de serviços de saúde encontra-se registrados no CNES 138 serviços de saúde pública e conveniados ao SUS, sem, no entanto, possuir serviço hospitalar ou ambulatorial público ou conveniado de alta complexidade, presente, apenas, no município de Planaltina de Goiás. A porta de entrada do serviço preconizada pelo governo federal à AB, não é entendida como tal pela população.

Submitted by Erika Demachki (erikademachki@gmail.com) on 2015-03-20T18:56:10Z No. of bitstreams: 2 Dissertação - Ana Cléia Margarida Tonhá - 2014.pdf: 5081914 bytes, checksum: 6ad4e1a8e4de58f334b18ce7abadbd8a (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Erika Demachki (erikademachki@gmail.com) on 2015-03-20T18:57:46Z (GMT) No. of bitstreams: 2 Dissertação - Ana Cléia Margarida Tonhá - 2014.pdf: 5081914 bytes, checksum: 6ad4e1a8e4de58f334b18ce7abadbd8a (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-03-20T18:57:46Z (GMT). No. of bitstreams: 2 Dissertação - Ana Cléia Margarida Tonhá - 2014.pdf: 5081914 bytes, checksum: 6ad4e1a8e4de58f334b18ce7abadbd8a (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-04-25 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / INTRODUCTION: Since the implementation ofSistemaÚnico de Saúde- SUS (Unified Health System), the access to health care services in Brazil has increased substantially. Despite of this, SUS has been facing large difficulties to establish and about the access to this new model of health care, which can compromise this service. So, it is important that managers be aware of health care services performance and the actions are developed through a participatory and democratic management model according to the characteristics of each region. GOALS: TO analyze the health care services performance in municipalities in EntornoSul da RegiãoIntegrada de Desenvolvimento do Distrito Federal RIDE- DF (Surrounding South Area of Integrated Development Region in Federal District), through habitant’s view.METHODS: An epidemiological, descriptive, transversalstudy based on population with a household survey. Samples of 605 habitants were randomly selected. A questionnaire previously validated was used. Data were typed in a specific database and analyzed using Statistical Package for the Social Science program. Crossings, simple frequencies and a 95 % confidence interval were done.RESULTS: two scientific studies were written. The first article "Access to health services inEntornoSul Do Distrito Federal (SurroundingSouthArea of Federal District)" was developed as a methodological allowance for this job . The second article “Performance of health services inEntornoSul do Distrito Federal(South Surrounding Area of Federal District) through habitant’s view“, a survey of factors that affect health care services performancein these cities was done,according to the habitant’s view.CONCLUSIONS: it can be concluded that health care services performance in thisarea is mainly influenced by social condition of people and place where they live, which enables managers to study andredirecttosuitthe way health care assistance is provided for those people. / INTRODUÇÃO:Desde a implantação do Sistema Único de Saúde – SUS, o acesso aos serviços de saúde no Brasil tem aumentado consideravelmente. Apesar do aumento, o SUS vem enfrentando amplas dificuldades ligadas à estruturação do novo modelo de atenção à saúde e acesso o que pode comprometer o desempenho dos serviços de saúde.Sendo assim, é importante que os gestores tenham conhecimento do desempenho dos serviços de saúde e que as ações sejam realizadas a partir de um modelo gerencial participativo e democráticoem conformidade com as características de cada região.OBJETIVO: Analisar o desempenho dos serviços de saúde dos municípios que compõe o Entorno Sul da Região Integrada de Desenvolvimento do Distrito Federal e Entorno – RIDE-DF, na perspectiva do residente. METODOLOGIA: Estudo epidemiológico, descritivo, transversal do tipo inquérito domiciliar de base populacional. Amostra de 605residentes, selecionadas aleatoriamente. Utilizado questionário previamente validado. Os dados foram digitados em banco específico e analisado pelo programa StatisticalPackage For The Social Science. Foram realizados cruzamentos, frequências simples e intervalo de confiança a 95%%. RESULTADOS:Foram construídos dois artigos científicos. O primeiro artigo "Acesso aos serviços de saúde nos municípios do Entorno Sul do Distrito Federal” foi elaborado como subsídio metodológico para o trabalho. O segundo artigo “Desempenho dos serviços de saúde do Entorno Sul do Distrito Federal, na perspectiva do residente” fez um levantamento dos fatores que interferem no desempenho dos serviços de saúde dos municípios estudados, conforme perspectiva do residente. CONCLUSÃO: Pode-se concluir que o desempenho dos serviços de saúde na região de estudo é influenciado principalmente pela condição social das pessoas e pelo local onde residem, o que permite aos gestores estudar o cenário para reorientar a forma de atendimento e adequar a assistência a saúde àquela população.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-05-12T18:14:24Z No. of bitstreams: 1 leandrohermisdorffbernardo.pdf: 2471442 bytes, checksum: d3adf8f386800446bd62310452998a26 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-06-27T19:54:28Z (GMT) No. of bitstreams: 1 leandrohermisdorffbernardo.pdf: 2471442 bytes, checksum: d3adf8f386800446bd62310452998a26 (MD5) / Made available in DSpace on 2016-06-27T19:54:28Z (GMT). No. of bitstreams: 1 leandrohermisdorffbernardo.pdf: 2471442 bytes, checksum: d3adf8f386800446bd62310452998a26 (MD5) Previous issue date: 2013-03-25 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O foco específico na relação homem e saúde vêm ocorrendo, nos últimos anos, tanto nos meios acadêmicos quanto no âmbito dos serviços de saúde. Incluir a participação do homem nas ações de saúde é, no mínimo, um desafio, por diferentes razões. Apesar de avanços no campo da saúde do homem, muitas questões ainda precisam ser consideradas no cuidado destes com a própria saúde. Uma questão importante seria como esta população avalia seu próprio estado de saúde, bem como os fatores que estão associados a esta avaliação pois permite identificar o perfil desta população ainda pouco estudada, o que pode, assim, auxiliar no planejamento de medidas de prevenção e promoção de saúde, bem como subsidiar estratégias necessárias para o maior alcance destes homens em termos de saúde. O objetivo do presente estudo foi avaliar condições de saúde auto-referidas, e os possíveis fatores relacionados, da população masculina na cidade de Belo Horizonte (MG), nos anos de 2006 e 2011. Trata-se de um estudo epidemiológico longitudinal, que se propõe fazer a análise desta população em 2006 e 2011, através de inquérito telefônico (VIGITEL 2006 e 2011). As amostras foram compostas por 782 indivíduos em 2006 e 836 em 2011, com idades superiores a 18 anos. Os dados foram processados em um banco de dados criado por meio do software Statistical Package forthe Social Sciences (SPSS), versão 20.0, que permitiu verificar a associação entre cada uma das variáveis independentes com a variável dependente, através da utilização do teste Qui-quadrado (χ²). Houve uma significativa mudança na idade dos indivíduos entrevistados, onde a média passou de 41,9 em 2006 para 44,2 anos em 2011; diminuição significativa, de 59,2% para 51,7% (2006 e 2011, respectivamente), do consumo alcoólico;melhora nas condições de saúde auto-referidas, aumentando de 21,1% (0,18 – 0,23) para 28,1% (0,24 – 0,31) a proporção de indivíduos que referiram a saúde como excelente. Esses dados chamam a atenção para a necessidade de políticas públicas e ações de saúde voltadas para essa população, com ênfase em ações educativas, preventivas, e de promoção à saúde. Apesar de o VIGITEL constituir um importante instrumento de coleta de dados que favoreçam o entendimento acerca das doenças crônicas não transmissíveis, a inclusão de questões referentes às condições econômicas dos participantes seria importante para se traçar com maior clareza os fatores associados às morbidades nas populações estudadas. / The specific focus in the relationship between man and health has been occurring, in the last years, both in academic terms and in scope of health services. For many reasons, it's a challenge to include man's participation in care health. Although there are advances in the field of human health, many questions have to be considered in the care of man with own health. An important point would be how this population evaluates its own state of health, as well as the factors that are associated to this evaluation because it allows us to identify this population profile, which is still not very studied, which may, thus, help in the planning of prevention methods and health promoting, as well as support strategies, which are necessary to a higher reach of these men in terms of health. The objective of this study was to evaluate conditions of self-reported health and the possible factors related of the male population in Belo Horizonte (MG) in 2006 and 2011. This is a longitudinal epidemiological study which proposes to do an analysis of this population in 2006 and 2011 through telephonic survey (VIGITEL 2006 and 2011). The samples were composed of 782 people in 2006 and 836 in 2011 with more than 18 years. The data were processed on a database created through the software Statistical Package for Social Sciences (SPSS), version 20.0, which allowed to verify the association between each one of the independent variables with the dependent variable, through the use of qui-square test. There was a meaningful change in the interviewed individuals age, in which the average changed from 41.9 in 2006 to 44.2 years old in 2011; meaningful decrease, from 59.2% to 51.7% (2006 and 2011, respectively), in the alcoholical consume; self reported health condition improvement, increasing from 21.1% (0.18-0.23) to 28.1% (0.24-0.31) the individuals proportion that referred to the health as excellent. These data call our attention to the need for policies and health public actions focused on this population, with emphasis on educational actions, preventive and promotion to the health. Although VIGITEL be an important tool for data collection to encourage the understanding of chronic diseases, including questions relating to economic conditions of the participants would be important to more clearly delineate the factors associated with morbidity in the populations studied.

Orientadores: Sílvia Maria Santiago, Celene Aparecida Ferrari Audi / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T13:54:25Z (GMT). No. of bitstreams: 1 Silva_HeloisaMarisMartins_M.pdf: 1807448 bytes, checksum: 276d2c0b7484cf3d6c14ed87727b8c72 (MD5) Previous issue date: 2014 / Resumo: O presente trabalho tem como principal objetivo descrever o perfil dos trabalhadores de uma penitenciária feminina do estado de São Paulo de forma a conhecer suas necessidades e desenvolver ações de promoção à saúde e prevenção de doenças. Para atingir este objetivo serão abordadas características sociodemográficas, estilo de vida, condições de saúde e transtorno mental comum. Trata-se de um estudo descritivo transversal que faz parte do Projeto Atenção Integral à Saúde da Mulher no Cárcere e dos Servidores da Penitenciária Feminina de Campinas ¿ SP, desenvolvido por pesquisadores do Departamento de Saúde Coletiva (DSC) da Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP). Os dados foram obtidos através de questionário. O hábito de fumar, o consumo de bebidas alcoólicas e o transtorno mental comum foram avaliados a partir da aplicação de instrumentos validados que são respectivamente, Teste de Fagerström, AUDIT e SQR 20. Foram entrevistados 127 servidores envolvidos tanto na área administrativa quanto na área de segurança. A maioria dos trabalhadores é do sexo feminino (57,9%), a média de idade foi 41,3 anos (DP 10,2). Vivem em união conjugal 63,5% dos entrevistados e 75,4% tem filhos. Quanto à escolaridade, 50% dos servidores já cursou ou está cursando o curso superior. Foi encontrado que 63,5% trabalham na área de segurança, carga horária média de 38,6 horas por semana (DP=5,1), tempo de trabalho nesta unidade prisional de 10 anos ou mais em 48,7% dos casos, sendo que 68,2% tem renda de até 4 salários mínimos.Não foi encontrada prevalência de doenças crônicas estatisticamente diferente da população geral e de outros estudos. O transtorno mental comum foi encontrado em 15.2% da amostra / Abstract: This research was designed to describe the profile of the staff of a female prison in São Paulo State to subsidize actions of health promotion and disease prevention. Designed as a cross-sectional study, it is part of the project "Atenção Integral á Saúde da Mulher no Cárcere e dos Servidores da Penitenciária Feminina de Campinas-SP" and it investigates sociodemographic characteristics, lifestyle, health conditions and commom mental disorder. Data was collected through a questionnaire. Smoking cigarettes, alcohol use and common mental disorder were investigated using validated questionnaires: Fagesrström Test, AUDIT and SRQ20, respectively. There were interviewed 127 workers involved in administrative or security areas. The majority of the staff is female (57.9%), the mean age is 41.3 years (SD= 10,2). 63,5% of the interviewed workers live with a partner and 75.4% have children. Coming to education, 50% have reached or are enrolled in a graduate course. We found that 63,5% of the workers are in the security area, the mean weekly workload is 38.6 hours (SD=5.1), presenting a mean time of work in this prison of 10 or more years in 48.3% of the cases and 68.2% of the workers have a salary under 4 times the minimum wage valid in the country. There were no significantly statistical differences neither between the population in study and the general population nor between the population in study and other studies in this field. Mental common disorder was found in 15.2% of the sample / Mestrado / Política, Planejamento e Gestão em Saúde / Mestra em Saúde Coletiva

<p>There are several traditions of conceptualizing and measuring harm from drinking. Two main approaches are considered in the introduction – the psychiatric epidemiology and the social survey research traditions. The present thesis adopts the latter, although, as discussed, on the empirical level there is no sharp borderline between the two perspectives, as there is not between personal (i.e. physical and psychological) and social harm from drinking as such. But while methods for studying personal harm are fairly well developed, social harm, i.e. adverse consequences of alcohol that involve social interaction, has received less attention. One of the aims of the thesis has been to explore different dimensions of harm from drinking, identify different harm areas and develop and apply area-specific measures using general population survey data.</p><p>Two papers examine psychometric properties of a widely used screening instrument, the AUDIT (Alcohol Use Disorder Identification Test). While the first paper is concerned with the validity of the AUDIT, testing it against different criteria, the second paper focuses on the test-retest reliability of the instrument. In the third paper, a number of summary measures of different areas of alcohol-related harm are constructed using factor analysis. These measures are then, in the last paper, applied to estimate prevalence and risk of alcohol-related harm in the Swedish general population. The analyses are based on data from a national survey on drinking problems in Sweden collected in 2001-2002.</p><p>It is concluded that the AUDIT screens well for both impaired self-control and social harm from drinking (as well as for high volume drinking), but performs less well when screening for health problems. The test-retest reliability of the AUDIT is relatively high. In the other two papers, constructing new summary measures and applying them to estimate prevalence of harm, it is concluded that, except for being young, no particular sociodemographic risk groups can be identified for different areas of harm from the same level and pattern of drinking. To what extent this reflects reality or is an effect of the methods we use and kind of population we reach in surveys is discussed.</p>

There are several traditions of conceptualizing and measuring harm from drinking. Two main approaches are considered in the introduction – the psychiatric epidemiology and the social survey research traditions. The present thesis adopts the latter, although, as discussed, on the empirical level there is no sharp borderline between the two perspectives, as there is not between personal (i.e. physical and psychological) and social harm from drinking as such. But while methods for studying personal harm are fairly well developed, social harm, i.e. adverse consequences of alcohol that involve social interaction, has received less attention. One of the aims of the thesis has been to explore different dimensions of harm from drinking, identify different harm areas and develop and apply area-specific measures using general population survey data. Two papers examine psychometric properties of a widely used screening instrument, the AUDIT (Alcohol Use Disorder Identification Test). While the first paper is concerned with the validity of the AUDIT, testing it against different criteria, the second paper focuses on the test-retest reliability of the instrument. In the third paper, a number of summary measures of different areas of alcohol-related harm are constructed using factor analysis. These measures are then, in the last paper, applied to estimate prevalence and risk of alcohol-related harm in the Swedish general population. The analyses are based on data from a national survey on drinking problems in Sweden collected in 2001-2002. It is concluded that the AUDIT screens well for both impaired self-control and social harm from drinking (as well as for high volume drinking), but performs less well when screening for health problems. The test-retest reliability of the AUDIT is relatively high. In the other two papers, constructing new summary measures and applying them to estimate prevalence of harm, it is concluded that, except for being young, no particular sociodemographic risk groups can be identified for different areas of harm from the same level and pattern of drinking. To what extent this reflects reality or is an effect of the methods we use and kind of population we reach in surveys is discussed.