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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Perfil epidemiológico, sociodemográfico e psicossocial da doença de Charcot-Marie-Tooth / Epidemiologic profile, sociodemographic and psychosocial of Charcot-Marie-Tooth disease

Santos, Lidiane Carine Lima 26 April 2016 (has links)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Charcot-Marie-Tooth (CMT) disease is the most common genetically determined neurological condition in the world. It is characterized by a slow and progressive degeneration of the peripheral nerves, leading to weakness and atrophy of distal limb muscles. CMT is classified in two main subgroups: CMT type 1 (CMT1), demyelinating form, and CMT type 2 (CMT2), axonal form. The first objective of this study was to conduct a systematic review of the prevalence of CMT disease in the world and the second was to evaluate the epidemiological, socio-demographic and psychosocial profile of families with CMT disease in the State of Sergipe, Brazil. Methods: a systematic survey of the literature was carried out using the following databases: MEDLINE-PubMed, Web of Science, Scopus and CINAHL (January 1990 to May 2015). Apart from this, a descriptive, observational and cross-sectional epidemiological study was carried out by means of interview and clinical evaluation of patients with the disease (CMT Group or CMTG) and non-affected family members called the control group (CG) in the municipalities of Tobias Barreto, Pedrinhas and Itabaianinha - SE. The collection of data included evaluation of socio-demographic characteristics, anthropometric measurements, lifestyle, clinical conditions, co-morbidities, mental health (levels of anxiety and depression), standards of feminine sexual behavior and gynecological and obstetric profiles. Results: in article 1, 12 studies were included in the systematic review, where the prevalence of CMT varied from 9.7/ 100,000 inhabitants in Serbia to 82.3/ 100,000 in Norway. The frequency of the main subtypes in the countries varied from 37.6% to 84% for CMT1 and from 12% to 35.9% for CMT2. In article 2, 90 individuals from 6 families with CMT were interviewed; the prevalence of CMT in Sergipe was of 62/ 100,000 inhabitants; the prevalence of CMT1 was of 37/ 100,000 inhabitants and of CMT2 was of 25/ 100,000. The majority presented the onset of signs and symptoms in childhood. There was a greater incidence of illiteracy among those affected, with a significant difference between the groups CMTG (19.5%) and CG (6%). Elevated levels of anxiety and depression were observed. Changes in sexual activity were observed in 47% of the women. Of these, 88% related to rarely or never use condoms; the most used contraceptive methods were oral and injectable contraceptives; as to fertility, the CG had on average 1.93 children, while the CMTG had on average 2.47 children. Conclusion: the results reveal the gaps, which still exist in the epidemiological knowledge of CMT across the world. The high prevalence of CMT in Sergipe, the elevated index of illiteracy among the individuals presenting signs and symptoms of CMT and the shorter reproductive cycle of women with CMT indicate the impact of the disease in the state. Future research is needed with a focus on the epidemiological characteristics of CMT in different nations and ethnic groups. / A doença de Charcot-Marie-Tooth (CMT) é a afecção neurológica geneticamente determinada mais comum em todo o mundo. Caracteriza-se por provocar degeneração lenta e progressiva dos nervos periféricos, acarretando fraqueza e atrofia dos músculos distais dos membros. CMT é classificada em dois subgrupos principais: CMT tipo 1 (CMT1), forma desmielinizante e CMT tipo 2 (CMT2), forma axonal. O primeiro objetivo deste estudo foi realizar uma revisão sistemática sobre a prevalência da doença de CMT no mundo e o segundo foi avaliar o perfil epidemiológico, sociodemográfico e psicossocial de famílias com a doença de CMT no Estado de Sergipe, Brasil. Métodos: pesquisa sistemática na literatura foi realizada, utilizando como base de dados a MEDLINE-PubMed, Web of Science, Scopus e CINAHL (janeiro de 1990 a maio de 2015). Além disso, foi realizado estudo epidemiológico descritivo, observacional e transversal, por meio de entrevista e avaliação clínica de pacientes, grupo com a doença CMT (GCMT), e familiares não afetados, denominados de grupo controle (GC), nos municípios de Tobias Barreto, Pedrinhas e Itabaianinha- SE. A coleta de dados incluiu avaliação das características sociodemográficas, parâmetros antropométricos, hábitos de vida, condições clínicas, comorbidades, saúde mental (níveis de ansiedade e depressão), padrão de comportamento sexual feminino e perfis ginecológicos e obstétricos. Resultados: no artigo 1, doze estudos foram incluídos na revisão sistemática, cuja prevalência de CMT variou de 9,7/ 100.000 habitantes, na Sérvia, para 82,3/ 100.000, na Noruega. A frequência dos principais subtipos nos países variou de 37,6% a 84% CMT1 é de 12% para 35,9% CMT2. No artigo 2, foram entrevistados 90 indivíduos de seis famílias com CMT; a prevalência de CMT em Sergipe foi de 62/ 100.000 habitantes; a prevalência CMT1 foi de 37/ 100.000 habitantes e CMT2 foi de 25/ 100.000. A maioria apresentou início do surgimento dos sinais e sintomas na infância. Houve maior índice de analfabetismo entre os afetados, com diferença significativa entre os grupos GCMT (19,5%) e GC (6%). Foram observados elevados níveis de ansiedade e depressão. Verificou-se alteração na atividade sexual em 47% das mulheres, das quais 88% relataram o uso de preservativo raramente ou nunca; os métodos contraceptivos mais utilizados foram os anticoncepcionais orais e injetáveis; em relação à fecundidade, o GC apresentou média de 1,93 filho, enquanto o GCMT obteve média de 2,47 filhos. Conclusão: os resultados revelam as lacunas que ainda existem no conhecimento epidemiológico de CMT em todo o mundo. A alta prevalência de CMT em Sergipe, o elevado índice de analfabetismo entre os indivíduos que apresentam os sinais e sintomas de CMT e o ciclo reprodutivo das mulheres CMT mais curto indicam o impacto da doença no Estado. São necessárias pesquisas futuras com foco em características epidemiológicas de CMT em diferentes nações e grupos étnicos.
2

Gojaznost i fizička neaktivnost kao javnozdravstveni problemi odraslog stanovništva Vojvodine / Obesity and physical inactivity as public health problems among the adult population of Vojvodina

Radić Ivana 28 October 2016 (has links)
<p>Gojaznost i fizička neaktivnost su među najznačajnijim faktorima rizika za hronične nezarazne bolesti, koje su vodeći javnozdravstveni problemi u svetu i kod nas. Cilj istraživanja je procena prevalencija gojaznosti, predgojaznosti i fizičke neaktivnosti u slobodno vreme kod odraslog stanovni&scaron;tva Vojvodine, kao i procena povezanosti demografskih, socio-ekonomskih i bihevioralnih faktora sa gojazno&scaron;ću i fizičkom neaktivno&scaron;ću u slobodno vreme. Istraživanje predstavlja deo Istraživanja zdravlja stanovni&scaron;tva Srbije iz 2013. godine koje je sprovedeno od strane Ministarstva zdravlja Republike Srbije, kao studija preseka na reprezentativnom stratifikovanom dvoetapnom uzorku. Istraživanjem je obuhvaćeno 3337 osoba uzrasta 20 i vi&scaron;e godina sa prebivali&scaron;tem u Vojvodini. Instrument istraživanja su bili upitnici konstruisani u skladu sa upitnikom Evropskog istraživanja zdravlja, a podaci o telesnoj masi i telesnoj visini su dobijeni merenjem. Rezultati istraživanja su pokazali da je u 2013. godini svaka četvrta odrasla osoba u Vojvodini bila gojazna, a svaka treća osoba predgojazna. U odnosu na 2000. godinu nije do&scaron;lo do značajnog povećanja prevalencija gojaznosti i predgojaznosti, mada su se prevalencije održale na visokom nivou. &Scaron;anse za gojaznost su rasle do 75-te godine života, a nakon toga opadaju. Najveću &scaron;ansu za gojaznost su imale osobe u braku ili vanbračnoj zajednici. Gojaznost je povezana sa socio-ekonomskim karakteristikama samo kod žena. Značajni prediktori gojaznosti kod žena su bili najniži nivo obrazovanja, lo&scaron; materijalni status i nezaposlenost/ekonomska neaktivnost. Biv&scaron;i pu&scaron;ači su imali oko dva puta veću &scaron;ansu za gojaznost u odnosu na pu&scaron;ače, dok je &scaron;ansa za gojaznost bila manja kod osoba koje su u poslednjih 12 meseci konzumirale alkohol. Fizička neaktivnost u slobodno vreme, kao i fizička neaktivnost u domenu transporta povećavaju verovatnoću za pojavu gojaznosti. Prevalencija fizičke neaktivnosti u slobodno vreme je bila veoma visoka (89%). &Scaron;anse za fizičku neaktivnost u slobodno vreme su se značajno povećavale sa staro&scaron;ću. Prediktori fizičke neaktivnosti su bili ženski pol, život u braku/vanbračnoj zajednici, nizak nivo obrazovanja i lo&scaron; materijalni status. Pu&scaron;ači su imali oko dva puta veću &scaron;ansu da budu fizički neaktivni u odnosu na nepu&scaron;ače, dok je stanovni&scaron;tvo koje je konzumiralo alkohol imalo manju &scaron;ansu da bude fizički neaktivno u slobodno vreme. Gojazne osobe, kao i fizički neaktivne osobe su lo&scaron;ije ocenjivale svoje zdravlje. Gojazne osobe (bez obzira na nivo fizičke aktivnosti) su imale oko 3,5 puta veću &scaron;ansu za pojavu multimorbiditeta u odnosu na osobe sa optimalnom telesnom masom koje su fizički aktivne u slobodno vreme. Gojazne osobe su imale četiri puta veću &scaron;ansu za arterijsku hipertenziju i skoro četiri puta veću &scaron;ansu za dijabetes u odnosu na normalno uhranjene osobe. Gojaznost i fizička neaktivnost u slobodno vreme su značajni javnozdravstveni problemi kod odraslog stanovni&scaron;tva u Vojvodini na &scaron;ta ukazuju visoke prevalencije, velika zastupljenost među vulnerabilnim kategorijama stanovni&scaron;tva, nejednakost u frekvenciji između različitih socio-ekonomskih kategorija stanovni&scaron;tva, preventabilnost, povezanost sa lo&scaron;ijom samoprocenom zdravlja i hroničnim bolestima.</p> / <p>Obesity and physical inactivity are one of the most significant risk factors for chronic noncommunicable diseases, which are one of the most important public health problems in the world and also in our country. The aim of the study was to evaluate the prevalence of obesity and leisure time physical inactivity among the adult population of Vojvodina, and also to evaluate the association of demographic, socio-economic and behavioral factors with obesity and leisure time physical inactivity. The study is part of the National Health Survey of Serbia, a cross-sectional study conducted in year 2013 by the Ministry of Health of Republic of Serbia on a representative stratified two-stage sample. The study included 3337 participants aged 20 and over who resided in Vojvodina. The instruments were questionnaires designed in line with the European Health Interview Survey questionnaire, and data on body mass and body height were measured. Results showed that in year 2013 every fourth adult person in Vojvodina was obese, and every third overweight. There was no increase in prevalences compared to year 2000, although they remained high. Odds of obesity increased until age 75, and afterwards decreased. The highest odds of obesity were among persons who were married or living with a partner. Obesity was associated with socio-economic factors only among women. The predictors of obesity among women were: low level of education, low wealth index and unemployment/economical inactivity. Former smokers had two times higher odds of obesity, compared to smokers, while persons who consumed alcohol in the last 12 months had lower odds to be obese. Leisure time physical inactivity, as well as transport related physical inactivity were important predictors of obesity. Prevalence of leisure time physical inactivity was very high (89%). With increasing age, odds of physical inactivity increased. Predictors of physical inactivity were female gender, being married or living with a partner, low level of education and low wealth index. Smokers had two times higher odds of physical inactivity in comparison to nonsmokers, while persons who consumed alcohol in the last 12 months had lower odds of physical inactivity. Obese and physically inactive persons were more likely to assess their health as average, poor or very poor. Obese persons (regardless of the level of physical activity) had three and a half times higher odds of multimorbidity compared to persons with healthy weight who were physically active. Obese persons had four times higher odds of arterial hypertension and almost four times higher odds of diabetes. Obesity and physical inactivity are important public health problems among the adult population in Vojvodina due to high prevalences in population, especially among vulnerable groups, inequality in frequency among different socio-economic groups, preventability and association with poor health perception and chronic diseases.</p>

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