Introdução: As dimensões de justiça social, de democracia, de cidadania, do ser sujeito de direito e do direito à saúde que a proteção social congrega tornam este campo revelador de todas estas questões. O campo das políticas sociais foi e ainda permanece um campo de discordâncias motivadas sobretudo por assuntos que dizem respeito a financiamento das políticas, ao significado de ser protegido socialmente e de proteger alguém socialmente. As necessidades que predispõem uma pessoa a ser beneficiário da proteção social são resultado de várias forças que estão colocadas na sociedade e vão desde as apostas e do que produz o sistema econômico vigente até o significado que cada pessoa pode atribuir aos próprios direitos. Neste percurso há as disputas sociais; a repercussão dos direitos na vida de cada um. Objetivos: desvelar sentidos atribuídos pelos sujeitos da pesquisa à proteção social nos diferentes contextos social e regional; identificar relações estabelecidas pelos sujeitos da pesquisa entre os diversos planos relacionados à proteção social e a própria proteção social; identificar o que os sujeitos da pesquisa identificam como relação entre proteção social e saúde. Métodos: entrevista em profundidade com o apoio de tópicos de interesse. A análise e discussão das narrativas resultantes será feita sob a perspectiva da hermenêutica-dialética. Resultados: Vê-se a necessidade de avançar, defender e divulgar questões referentes aos direitos sociais, à proteção social e direito à saúde. O entendimento sobre a proteção social pode ser melhorado no sentido de refletir na defesa dos próprios direitos e nos direitos da sociedade. Evidencia-se que o contexto de vida dos sujeitos de pesquisa reflete todo o panorama histórico em que se vê acolhida a proteção. Foram encontradas desde narrativas que elaboram a lógica da proteção social e seu campo até elaborações que não expressam esta lógica. A percepção dos próprios direitos surge limitada em alguns aspectos como se não fosse possível elaborar o próprio lugar na sociedade. Essa realidade também aparece na discussão sobre os determinantes sociais da saúde e o direito à saúde. Considerações finais: Considera-se a partir dos resultados que estratégias podem ser elaboradas para que a defesa da proteção social possa ser mantida socialmente, seja no local de estudo ou em locais para onde o debate possa ser portado. O modo como as pessoas têm vivido e a forma como se identificam com a questão dos próprios direitos sinaliza que há um campo a ser trabalhado no sentido de avançar questões que vão alicerçar o 11 Estado de Bem-Estar Social que se pretende no Brasil. A arquitetura da necessidade de proteção social ainda é evidente no local de estudo. Perpassam esse debate as questões atuais sobre a situação política do Brasil (2016) e o projeto social no qual queremos apostar para garantir os direitos sociais e, principalmente o direito à saúde que ampara a qualidade de vida e os modos de vivenciá-la. / Introduction: The dimensions of social justice, democracy, citizenship, be subject to law and the right to health that social protection brings together make this field shows all of these issues. The field of social policies was and still remains a field of disagreements motivated mainly by matters that concern the financing of policies, the meaning of being socially protected and protect someone socially. The needs which predispose a person to be beneficiaries of social protection are the result of various forces that are placed in society, ranging from the bets and that produces the economic system in force until the meaning that each person can assign their own rights. In this way there is the social struggles; the impact of human in the life of each one. Objectives: to reveal meanings attributed by the research subjects to social protection in the various contexts of social and regional; identify relations established by the research subjects between the various plans related to social protection and the social protection; identify what the research subjects identified as relation between social protection and health. Methods: indepth interview with the support of topics of interest. The analysis and discussion of the resultant narratives will be done under the perspective of the hermeneutic-dialectic. Results: One sees the need to move forward, defend and promote matters relating to social rights, social protection and the right to health. The understanding of the social protection can be improved in order to reflect on the defense of their rights and the rights of society. It is evident that the life context of research subjects reflects the landscape history in which we see safe haven to protect. Have been found since narratives that elaborate the logic of social protection and their field until elaborations that do not express this logic. The perception of their rights is limited in some respects as if it were possible to draw up their own place in society. This fact also appears in the discussion on the social determinants of health and the right to health. Final considerations: It is from the results that strategies can be developed to ensure that the defense of social protection can be maintained socially, either in place of or in places where the debate can be ported. The way people have lived and how they identify with the issue of own rights indicates that there is a field to be worked in order to move forward issues that will underpin the Welfare State that if you want to in Brazil. The architecture of the need for social protection is still evident in the study site. Pervades this debate current issues on the political situation in 13 Brazil (2016) and the social project in which we bet to guarantee social rights, and especially the right to health that sustains the quality of life and the modes of experience it.

Made available in DSpace on 2014-12-17T15:39:06Z (GMT). No. of bitstreams: 1 MariaGSGC_DISSERT.pdf: 2555739 bytes, checksum: 0efa18c9d47df1166ff7932c946b8297 (MD5) Previous issue date: 2014-03-14 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The lack of studies aimed at the mental health of the rural population, the social, economic, familial and emotional impact that mental disorders produce and the vulnerability that women have in this context, lead us to believe in the need to investigate the mental health demands of female rural workers, in order to subsidize the development of more effective and culturally sensitive public health programs and policies that take into account the specificities of this population. The present study aims to investigate the prevalence of common mental disorders (CMD) and the possible factors associated with the emergence of such disorders among women living in a rural settlement in Rio Grande do Norte. This survey has a quantitative and qualitative character with an ethnographic approach. As methodological strategies, we made use of an adapted version of the socio-demographic and environmental questionnaire prepared by The Department of Geology/UFRN s Strategic Analysis Laboratory to evaluate the quality of life of the families from the rural settlement and the mental health screening test Self-Reporting Questionnaire (SRQ-20) to identify the prevalence of CMD in adult women from the community. Complementing the role of methodological tools, we use the participant observation and semi-structured interviews with women who presented positive hypothesis of CMD attempting to comprehend the crossings that build the subjective experience of being a woman in this context. The results point to the high prevalence of CMD (43.6%) and suggest the link between poverty, lack of social support, unequal gender relations and the occurrence of CMD. We also verified that the settled women do not access the health network to address issues relating to mental health and that the only recourse of care offered by primary health care is the prescription of anxiolytic medication. In this context, the religiosity and the work are the most important strategies for mental health support among women / A car?ncia de estudos voltados ? sa?de mental da popula??o rural, o impacto socioecon?mico, familiar e afetivo que os transtornos mentais produzem e o lugar de vulnerabilidade que as mulheres ocupam nas ?reas rurais, imp?em a necessidade de investigar a realidade de mulheres assentadas e trabalhadoras rurais, visando subsidiar a elabora??o de programas e pol?ticas p?blicas de sa?de mais eficazes e culturalmente sens?veis que levem em conta as especificidades dessa popula??o. Diante disso, o presente estudo tem como objetivo investigar a preval?ncia de transtornos mentais comuns (TMC) e os poss?veis fatores associados ? emerg?ncia de tais transtornos entre mulheres residentes de um assentamento rural do RN. Metodologicamente, trata-se de uma pesquisa que parte de uma abordagem quantitativa e qualitativa de inspira??o etnogr?fica. Inicialmente aplicamos uma vers?o adaptada do question?rio s?cio-demogr?fico-ambiental elaborado pelo Laborat?rio de An?lises Estrat?gicas da UFRN/Departamento de Geologia para avaliar a qualidade de vida das fam?lias do assentamento e o instrumento de rastreamento em sa?de mental Self-Reporting Questionnaire (SRQ-20) para identificar a preval?ncia de TMC nas mulheres adultas da comunidade. Complementando o rol de ferramentas, nos valemos da observa??o participante do cotidiano do assentamento e entrevistas semiestruturadas com as mulheres que apresentaram hip?tese positiva de TMC buscando apreender os atravessamentos que constroem a experi?ncia subjetiva de ser mulher nesse contexto. Os resultados apontam a alta preval?ncia de TMC (43,6%) e sugerem a articula??o entre pobreza, falta de redes de apoio social e comunit?ria, rela??es desiguais de g?nero e a ocorr?ncia de TMC. Constatamos ainda que as assentadas n?o acessam a rede de sa?de para tratar de quest?es relativas ? sa?de mental e que o ?nico recurso de cuidado ofertado pela aten??o prim?ria ? prescri??o de medica??o ansiol?tica, destacando-se a religiosidade e o trabalho como os mais importantes fatores de suporte ? sa?de mental entre as mulheres no contexto do assentamento rural

Introdução: As dimensões de justiça social, de democracia, de cidadania, do ser sujeito de direito e do direito à saúde que a proteção social congrega tornam este campo revelador de todas estas questões. O campo das políticas sociais foi e ainda permanece um campo de discordâncias motivadas sobretudo por assuntos que dizem respeito a financiamento das políticas, ao significado de ser protegido socialmente e de proteger alguém socialmente. As necessidades que predispõem uma pessoa a ser beneficiário da proteção social são resultado de várias forças que estão colocadas na sociedade e vão desde as apostas e do que produz o sistema econômico vigente até o significado que cada pessoa pode atribuir aos próprios direitos. Neste percurso há as disputas sociais; a repercussão dos direitos na vida de cada um. Objetivos: desvelar sentidos atribuídos pelos sujeitos da pesquisa à proteção social nos diferentes contextos social e regional; identificar relações estabelecidas pelos sujeitos da pesquisa entre os diversos planos relacionados à proteção social e a própria proteção social; identificar o que os sujeitos da pesquisa identificam como relação entre proteção social e saúde. Métodos: entrevista em profundidade com o apoio de tópicos de interesse. A análise e discussão das narrativas resultantes será feita sob a perspectiva da hermenêutica-dialética. Resultados: Vê-se a necessidade de avançar, defender e divulgar questões referentes aos direitos sociais, à proteção social e direito à saúde. O entendimento sobre a proteção social pode ser melhorado no sentido de refletir na defesa dos próprios direitos e nos direitos da sociedade. Evidencia-se que o contexto de vida dos sujeitos de pesquisa reflete todo o panorama histórico em que se vê acolhida a proteção. Foram encontradas desde narrativas que elaboram a lógica da proteção social e seu campo até elaborações que não expressam esta lógica. A percepção dos próprios direitos surge limitada em alguns aspectos como se não fosse possível elaborar o próprio lugar na sociedade. Essa realidade também aparece na discussão sobre os determinantes sociais da saúde e o direito à saúde. Considerações finais: Considera-se a partir dos resultados que estratégias podem ser elaboradas para que a defesa da proteção social possa ser mantida socialmente, seja no local de estudo ou em locais para onde o debate possa ser portado. O modo como as pessoas têm vivido e a forma como se identificam com a questão dos próprios direitos sinaliza que há um campo a ser trabalhado no sentido de avançar questões que vão alicerçar o 11 Estado de Bem-Estar Social que se pretende no Brasil. A arquitetura da necessidade de proteção social ainda é evidente no local de estudo. Perpassam esse debate as questões atuais sobre a situação política do Brasil (2016) e o projeto social no qual queremos apostar para garantir os direitos sociais e, principalmente o direito à saúde que ampara a qualidade de vida e os modos de vivenciá-la. / Introduction: The dimensions of social justice, democracy, citizenship, be subject to law and the right to health that social protection brings together make this field shows all of these issues. The field of social policies was and still remains a field of disagreements motivated mainly by matters that concern the financing of policies, the meaning of being socially protected and protect someone socially. The needs which predispose a person to be beneficiaries of social protection are the result of various forces that are placed in society, ranging from the bets and that produces the economic system in force until the meaning that each person can assign their own rights. In this way there is the social struggles; the impact of human in the life of each one. Objectives: to reveal meanings attributed by the research subjects to social protection in the various contexts of social and regional; identify relations established by the research subjects between the various plans related to social protection and the social protection; identify what the research subjects identified as relation between social protection and health. Methods: indepth interview with the support of topics of interest. The analysis and discussion of the resultant narratives will be done under the perspective of the hermeneutic-dialectic. Results: One sees the need to move forward, defend and promote matters relating to social rights, social protection and the right to health. The understanding of the social protection can be improved in order to reflect on the defense of their rights and the rights of society. It is evident that the life context of research subjects reflects the landscape history in which we see safe haven to protect. Have been found since narratives that elaborate the logic of social protection and their field until elaborations that do not express this logic. The perception of their rights is limited in some respects as if it were possible to draw up their own place in society. This fact also appears in the discussion on the social determinants of health and the right to health. Final considerations: It is from the results that strategies can be developed to ensure that the defense of social protection can be maintained socially, either in place of or in places where the debate can be ported. The way people have lived and how they identify with the issue of own rights indicates that there is a field to be worked in order to move forward issues that will underpin the Welfare State that if you want to in Brazil. The architecture of the need for social protection is still evident in the study site. Pervades this debate current issues on the political situation in 13 Brazil (2016) and the social project in which we bet to guarantee social rights, and especially the right to health that sustains the quality of life and the modes of experience it.

Made available in DSpace on 2016-08-19T17:47:08Z (GMT). No. of bitstreams: 1 Dissertacao-EmniellePintoBorgesMoreira.pdf: 2297829 bytes, checksum: a30e1d39006389163a9c6afaeca65f24 (MD5) Previous issue date: 2016-06-23 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Currently in Brazil the arboviruses - dengue, zika virus and chikungunya fever - pose serious public health problems, especially because there are not vaccines against these diseases, which, in turn, increases the importance of controlling the vector, Aedes aegypti. The identification of high risk areas for transmitting dengue assists the study of the vector dispersion process. The objective of this study was to analyze the spatial-temporal distribution of dengue cases in residents of São Luís, Maranhão, Brazil, reported in the Information System for Notifiable Diseases (SINAN), relating them to the seven health districts (DS) of the county. This is an ecological study of secondary data of cases and deaths from dengue in residents of São Luís, Maranhão, Brazil, reported and confirmed in SINAN from 2000 to 2011. Statistical analysis was performed using STATA, version 10.0 and for the preparation of maps we used the model of discrete spatial variation and QGIS 2.8.1 software. During the study period there were reported and confirmed 17,318 cases of dengue with highest absolute frequencies in 2005, 2007, 2010 and 2011. There was a predominance among the the mixed race people. The first half of the year had more frequent cases. There was recorded an increase of occurrence of the disease in children under 15 and increased hospital admissions from 2002. The four serotypes were identified during the study period. In all of the DS there were reports of dengue cases, with greater concentration in DS Bequimão. The use of the space-time analysis tool in dengue cases allowed us to visualize and understand more holistically the areas of risk and vulnerability to disease in São Luís, especially in the urban area. / Atualmente no Brasil as arboviroses dengue, zika vírus e febre de chikungunya representam sérios problemas de saúde pública, especialmente porque não se dispõe de vacinas contra essas doenças, o que, por sua vez, aumenta a importância do controle do vetor, o Aedes aegypti. A identificação de espaços de maior risco para a transmissão da dengue auxilia os estudos do processo de dispersão do vetor. O objetivo deste trabalho foi analisar a distribuição espaço-temporal de casos de dengue de residentes em São Luís, Maranhão, Brasil, notificados no Sistema de Informação de Agravos de Notificação (SINAN), relacionando-os com os sete distritos sanitários (DS) do Município. Trata-se de estudo ecológico de dados secundários dos casos e óbitos de dengue em residentes de São Luís, Maranhão, Brasil, notificados e confirmados no SINAN de 2000 a 2011. Na análise estatística foi utilizado o STATA®, versão 10.0 e na elaboração dos mapas utilizou-se o modelo de variação espacial discreta e o software QGIS 2.8.1®. No período estudado foram notificados e confirmados 17.318 casos de dengue com maiores frequências absolutas em 2005, 2007, 2010 e 2011. Houve predomínio do sexo feminino e da raça parda. O primeiro semestre concentrou maior frequência de casos. Registram-se aumento da ocorrência da doença em menores de 15 anos, aumento de internações hospitalares a partir de 2002, tendo sido identificados os quatro sorotipos no período estudado. Em todos os DS houve registros de casos de dengue, com maior concentração no DS Bequimão. O uso de ferramenta de análise espaço-temporal nos casos de dengue permitiu visualizar e compreender de forma mais holística, as áreas de risco e de vulnerabilidade à doença no município de São Luís, sobretudo no perímetro urbano.

Embora sejam grandes os progressos com a promulgação da Constituição de 1988, que garante constitucionalmente a saúde como direito de todos e dever do Estado, esse direito não tem sido assegurado no mesmo nível e com a mesma qualidade de atenção, em especial, para a população negra. Depois de uma revisão sobre a história a influência das teorias racialistas e de gênero como categoria de análise na medicina, discute-se uma síntese da história recente das práticas médicas no Brasil e a reflexão critica sobre essas práticas centradas no tecnicismo. O objetivo deste estudo, parte da linha de pesquisa Pesquisa Psicossocial da Desigualdade: Relações Étnico-raciais, foi descrever que sentidos e significados médicos e médicas conferem aos temas médico-sociais na sua trajetória e formação, especialmente como concebem os determinantes sociais de gênero e raça Foram entrevistados 25 médicos (13 médicos e 12 médicas) que orientam e são preceptores de alunos da residência médica em um hospital universitário. O roteiro abordava o perfil sócio-demográfico e sua trajetória profissional; o seu nível de conhecimento e contato com os determinantes sociais (pobreza, gênero, cor/raça, nacionalidade, religião dos diferentes grupos populacionais) durante a formação acadêmica; que fatores consideravam relevantes para uma boa relação médico-paciente; seu conhecimento sobre Direitos Humanos e os princípios do Sistema Único de Saúde; as experiências na relação médico-paciente e de cuidado. Depois de um aquecimento propiciado pela situação da entrevista, entre os resultados, o estudo permitiu observar como os médicos entrevistados reconhecem alguns marcadores sociais da diferença que se transformam em desigualdade, os lugares sociais diferentes para homens e mulheres, brancos, amarelos e negros, lugares de maior ou menor privilégio e de obstáculo para o sucesso técnico. As diferenças e desigualdade de gênero foram mais fáceis de serem explicitadas e os entrevistados articulavam um repertório levemente maior para o tema. Todos os entrevistados, em algum momento, usaram o discurso sobre o instintivo e natural, e a maior parte deles compreende o masculino e o feminino de um modo muito conservador, com problemas para encontrar definições para perguntas supostamente simples. No caso da desigualdade racial, observamos que houve uma polarização: de um lado a negação das desigualdades entre brancos e não brancos, do outro temos a valorização da identidade branca, compondo bem com o racismo à brasileira. O contexto social foi associado à pobreza mais que qualquer outro indicador da desigualdade social. Cenas de racismo e sexismo institucional foram frequentes. Os poucos entrevistados que tinham uma noção mais sofisticada sobre gênero e raça eram aqueles que contaram com a oportunidade de desenvolver uma atividade de extensão, a iniciação científica ou que tiveram uma formação mais generalista, mais social. A trajetória trilhada na faculdade contribui, portanto, para a formação / Brazil\'s 1988 Constitution grants health as a human right to all and a duty of the State. Although great progress has been made since its enactment, this right has not been ensured at the same level and with the same service quality, particularly with regard to Afro-Brazilians. With close attention to history and the influence of racial and gendered theories, this article discusses the recent history of medical practices in Brazil and provides critical reflection on those practices that are centered on technique. The main purpose of this study, a part of the Psycho-social research on inequality: ethnic-racial relations research line, is to describe the meanings and significance that doctors give to medical social issues in their education. Special attention is given to their conception of the social determinants of gender and race. Twenty-five doctors (13 men and 12 women) were interviewed. All of them mentor medical students pursuing their residency at a University Hospital. The interviews script centered on their socio-demographic profile, their professional path and the degree of knowledge or contact with social determinants (poverty, gender, race/color, nationality, religion of the different population groups) during their academic formation, the factors they considered as relevant to a good doctor-patient relationship, their knowledge of Human Rights and the principles of the Sistema Único de Saúde (SUS) and their experiences in the care and doctor-patient relationships. Among its results, the study shows how the interviewed doctors recognize several social markers of difference that convert into inequity, the different social places for men and women, the white, the people of Asian descent and the black, places of greater or lower privilege and obstacle for technical success. The gender differences and inequalities were more easily explained and respondents articulated a slightly larger repertoire for the topic. All of the interviewees, at some moment, used the discourse on the instinctive and the natural, and most of them have a very conservative comprehension of the feminine and the masculine, and encountered problems in finding definitions for apparently simple questions. With regards to racial inequality, there was a polarization: on the one hand, the denial of inequalities among the white and the non white, on the other, a consistent evaluation of white identity, linked to the Brazilian racism. The social context was associated with poverty rather than any other indicator of social inequality. Evidence of racism and sexism were frequently observed in the interviews. The few interviewees that had a more sophisticated notion of gender and race were those who had had the chance to develop an extracurricular activity, the scientific initiation, or those who had had a more generalist and social education. Thus, the experience acquired during university contributes to the formation of their notions of social determinants in health

Homelessness is a pressing social and health concern that affects Māori disproportionately. This research explores the provision of mental health services to Māori who are homeless. The thesis has two primary aims. First, to document the experiences of Māori homeless people who live with mental health concerns and their relationships with mental health professionals. Second, to document the experiences of mental health professionals and how they interact with, provide care for, and build relationships with Māori Homeless. The skills of, and the difficulties faced by these professionals in provisions of quality of care are also considered. Three male and three female homeless participants were recruited from the Waikato and Auckland regions. All participants had received care from Non Governmental Organisations (NGOs) and/or District Health Board services (DHB). Participating mental health professionals included one female and five males. Mental health professionals included counsellors, therapists, psychologists, social workers, crisis team coordinator, and a cultural advisor. All participants took part in individual semi-structured interviews conducted in an open and conversational manner. Key themes for homeless participants included their general life histories of mental illness, mental health service use, relationship with professionals, cultural issues, and concerns that Māori homeless wanted to discuss. Key themes for mental health professionals included their approaches when working with homeless people, relationship building, barriers to working with this group and possible solutions, linking with other professionals or organisations, and issues mental health professionals wanted to discuss. Findings highlight the importance of strong therapeutic relationships between homeless clients and mental health professionals, the need for more joined up (multi-level agency) approach to service delivery, and the importance of Māori ideology in restoring wellbeing and dignity. Findings suggest that the effectiveness of mental health service delivery relies in part on information provided by stakeholders. Information provided by homeless people and mental health professionals informs both service delivery and the ways in which practitioners can best support the needs of homeless people.

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.

Contexte: Les facteurs de risque comportementaux, notamment l’inactivité physique, le comportement sédentaire, le tabagisme, la consommation d’alcool et le surpoids sont les principales causes modifiables de maladies chroniques telles que le cancer, les maladies cardiovasculaires et le diabète. Ces facteurs de risque se manifestent également de façon concomitante chez l’individu et entraînent des risques accrus de morbidité et de mortalité. Bien que les facteurs de risque comportementaux aient été largement étudiés, la distribution, les patrons d’agrégation et les déterminants de multiples facteurs de risque comportementaux sont peu connus, surtout chez les enfants et les adolescents. Objectifs: Cette thèse vise 1) à décrire la prévalence et les patrons d’agrégation de multiples facteurs de risque comportementaux des maladies chroniques chez les enfants et adolescents canadiens; 2) à explorer les corrélats individuels, sociaux et scolaires de multiples facteurs de risque comportementaux chez les enfants et adolescents canadiens; et 3) à évaluer, selon le modèle conceptuel de l’étude, l’influence longitudinale d’un ensemble de variables distales (c’est-à-dire des variables situées à une distance intermédiaire des comportements à risque) de type individuel (estime de soi, sentiment de réussite), social (relations sociales, comportements des parents/pairs) et scolaire (engagement collectif à la réussite, compréhension des règles), ainsi que de variables ultimes (c’est-à-dire des variables situées à une distance éloignée des comportements à risque) de type individuel (traits de personnalité, caractéristiques démographiques), social (caractéristiques socio-économiques des parents) et scolaire (type d’école, environnement favorable, climat disciplinaire) sur le taux d’occurrence de multiples facteurs de risque comportementaux chez les enfants et adolescents canadiens. Méthodes: Des données transversales (n = 4724) à partir du cycle 4 (2000-2001) de l’Enquête longitudinale nationale sur les enfants et les jeunes (ELNEJ) ont été utilisées pour décrire la prévalence et les patrons d’agrégation de multiples facteurs de risque comportementaux chez les jeunes canadiens âgés de 10-17 ans. L’agrégation des facteurs de risque a été examinée en utilisant une méthode du ratio de cas observés sur les cas attendus. La régression logistique ordinale a été utilisée pour explorer les corrélats de multiples facteurs de risque comportementaux dans un échantillon transversal (n = 1747) de jeunes canadiens âgés de 10-15 ans du cycle 4 (2000-2001) de l’ELNEJ. Des données prospectives (n = 1135) à partir des cycle 4 (2000-2001), cycle 5 (2002-2003) et cycle 6 (2004-2005) de l’ELNEJ ont été utilisées pour évaluer l’influence longitudinale des variables distales et ultimes (tel que décrit ci-haut dans les objectifs) sur le taux d’occurrence de multiples facteurs de risque comportementaux chez les jeunes canadiens âgés de 10-15 ans; cette analyse a été effectuée à l’aide des modèles de Poisson longitudinaux. Résultats: Soixante-cinq pour cent des jeunes canadiens ont rapporté avoir deux ou plus de facteurs de risque comportementaux, comparativement à seulement 10% des jeunes avec aucun facteur de risque. Les facteurs de risque comportementaux se sont agrégés en de multiples combinaisons. Plus précisément, l’occurrence simultanée des cinq facteurs de risque était 120% plus élevée chez les garçons (ratio observé/attendu (O/E) = 2.20, intervalle de confiance (IC) 95%: 1.31-3.09) et 94% plus élevée chez les filles (ratio O/E = 1.94, IC 95%: 1.24-2.64) qu’attendu. L’âge (rapport de cotes (RC) = 1.95, IC 95%: 1.21-3.13), ayant un parent fumeur (RC = 1.49, IC 95%: 1.09-2.03), ayant rapporté que la majorité/tous de ses pairs consommaient du tabac (RC = 7.31, IC 95%: 4.00-13.35) ou buvaient de l’alcool (RC = 3.77, IC 95%: 2.18-6.53), et vivant dans une famille monoparentale (RC = 1.94, IC 95%: 1.31-2.88) ont été positivement associés aux multiples comportements à risque. Les jeunes ayant une forte estime de soi (RC = 0.92, IC 95%: 0.85-0.99) ainsi que les jeunes dont un des parents avait un niveau d’éducation postsecondaire (RC = 0.58, IC 95%: 0.41-0.82) étaient moins susceptibles d’avoir de multiples facteurs de risque comportementaux. Enfin, les variables de type social distal (tabagisme des parents et des pairs, consommation d’alcool par les pairs) (Log du rapport de vraisemblance (LLR) = 187.86, degrés de liberté = 8, P < 0,001) et individuel distal (estime de soi) (LLR = 76.94, degrés de liberté = 4, P < 0,001) ont significativement influencé le taux d’occurrence de multiples facteurs de risque comportementaux. Les variables de type individuel ultime (âge, sexe, anxiété) et social ultime (niveau d’éducation du parent, revenu du ménage, structure de la famille) ont eu une influence moins prononcée sur le taux de cooccurrence des facteurs de risque comportementaux chez les jeunes. Conclusion: Les résultats suggèrent que les interventions de santé publique devraient principalement cibler les déterminants de type individuel distal (tel que l’estime de soi) ainsi que social distal (tels que le tabagisme des parents et des pairs et la consommation d’alcool par les pairs) pour prévenir et/ou réduire l’occurrence de multiples facteurs de risque comportementaux chez les enfants et les adolescents. Cependant, puisque les variables de type distal (telles que les caractéristiques psychosociales des jeunes et comportements des parents/pairs) peuvent être influencées par des variables de type ultime (telles que les caractéristiques démographiques et socioéconomiques), les programmes et politiques de prévention devraient également viser à améliorer les conditions socioéconomiques des jeunes, particulièrement celles des enfants et des adolescents des familles les plus démunies. / Background: Behavioural risk factors including physical inactivity, sedentary behaviour, cigarette smoking, alcohol drinking, and being overweight are major modifiable causes of chronic diseases such as cancer, cardiovascular diseases and diabetes. These lifestyle risk factors also co-occur in individuals and lead to increased risks of chronic diseases morbidity and mortality. Although single behavioural risk factors have been extensively studied, little is known about the distribution, clustering patterns and potential determinants of multiple behavioural risk factors for chronic diseases, particularly in children and adolescents. Objectives: This thesis aims 1) to describe the prevalence and clustering patterns of multiple chronic disease behavioural risk factors in Canadian children and adolescents; 2) to explore potential individual, social and school correlates of multiple chronic disease behavioural risk factors in Canadian children and adolescents; and 3) to assess, based on the conceptual framework of this study, the longitudinal influence of selected individual (sense of self, sense of achievement), social (social relations, others’ behaviours) and school (collective commitment to success, comprehension of rules) distal variables (variables situated at an intermediate distance from behaviours), as well as selected individual (demographics and personality traits), social (parental socioeconomic characteristics) and school (type of school, supportive environment, disciplinary climate) ultimate variables (variables situated at an utmost distance from behaviours) on the rate of occurrence of multiple chronic disease behavioural risk factors in Canadian children and adolescents. Methods: Cross-sectional data (n = 4724) from Cycle 4 (2000-2001) of the National Longitudinal Survey of Children and Youth (NLSCY) were used to describe the prevalence and clustering patterns of multiple behavioural risk factors in Canadian youth aged 10-17 years. Clustering was assessed using an observed to expected ratio method. Ordinal logistic regression was used to explore correlates of multiple behavioural risk factors in a cross-sectional sample (n = 1747) of Canadian youth aged 10-15 years from Cycle 4 (2000-2001) of the NLSCY. Prospective data (n = 1135) from Cycle 4 (2000-2001), Cycle 5 (2002-2003) and Cycle 6 (2004-2005) of the NLSCY were used to assess the longitudinal influence of selected distal and ultimate variables (as described above in the objectives) on the rate of occurrence of multiple behavioural risk factors in Canadian youth aged 10-15 years; this analysis was performed using longitudinal Poisson models. Results: Sixty-five percent of Canadian youth had two or more behavioural risk factors compared to only 10% with no risk factor. Behavioural risk factors clustered in multiple combinations. Specifically, the simultaneous occurrence of all five risk factors was 120% greater in males (observed/expected (O/E) ratio = 2.20, 95% confidence interval (CI): 1.31-3.09) and 94% greater in females (O/E ratio = 1.94, 95% CI: 1.24-2.64) than expected by chance. Older age (odds ratio (OR) = 1.95, 95% CI: 1.21-3.13), caregiver smoking (OR = 1.49, 95% CI: 1.09-2.03), reporting that most/all of one’s peers smoked (OR = 7.31, 95% CI: 4.00-13.35) or drank alcohol (OR = 3.77, 95% CI: 2.18-6.53), and living in a lone-parent family (OR = 1.94, 95% CI: 1.31-2.88) increased the likelihood of having multiple health risk behaviours. Youth with high self-esteem (OR = 0.92, 95% CI: 0.85-0.99) and youth from families with post-secondary education (OR = 0.58, 95% CI: 0.41-0.82) were less likely to have a higher number of behavioural risk factors. Finally, social distal variables (caregiver smoking, peer smoking, peer drinking) (Log-likelihood ratio (LLR) = 187.86, degrees of freedom = 8, P < 0.001) and individual distal variables (such as self-esteem) (LLR = 76.94, degrees of freedom = 4, P < 0.001) significantly influenced the rate of occurrence of multiple behavioural risk factors. Individual ultimate variables (age, sex, anxiety) and social ultimate variables (parental education, household income, family structure) exerted a less pronounced influence on the rate of co-occurrence of behavioural risk factors among youth. Conclusion: The results suggest that public health interventions should primarily target the individual distal (such as self-esteem) and social distal variables (such as parental smoking, peer smoking and peer drinking) to reduce or prevent the occurrence of multiple behavioural risk factors among youth. However, since distal variables (such as psychosocial characteristics and others’ behaviours) may be influenced by ultimate variables (such as demographic and socioeconomic characteristics), prevention programs and policies should also aim to improve the socioeconomic conditions of children and adolescents, particularly those of youth from less affluent families.

The primary purpose of this study was to determine the social determinants of arts festivals with reference to the ABSA KKNK. This goal was achieved by firstly analysing the event/festival phenomenon and the role thereof in event/festival tourism. Secondly, a literature study was conducted in order to examine the role of the community in supporting events/festivals. And thirdly, the results of the empirical research were discussed. Lastly, conclusions were drawn from the research and recommendations were made with regard to the social determinants of events/festivals. Literature indicated that events/festivals are central to daily living as perhaps never before and it can also be said that events/festivals play certain social, economic, cultural and environmental roles. Events/festivals can have various positive impacts on a community, such as job opportunities, economical growth and upliftment of the community. However it can also create various negative impacts such as crime, prostitution and damage to the environment. It is important to increase the number of positive impacts and decrease the number of negative impacts. This may improve the support of the community for the event/festival and improve the sustainability of the event/festival. The support of the community is also influenced by aspects such as community concern, ecocentric attitudes, community attachment. These social support determinants were measured by means of a questionnaire, as adapted from Gursoy and Kendall (2006) and it was therefore the objective of the questionnaire to analyse the social determinants that that may improve community support. The survey was distributed in the community of Oudtshoorn in 2007 and the determinants, as well as the relationship between the determinants and support for the event/festival, were based on structural equation modeling. A total of 279 questionnaires were completed during the festival. Respondents were, in general, more positive about the festival than negative. The results of the structural equation modelling suggest that community attachment and benefits and costs perceived are the most important social determinants in gaining local support for the ABSA KKNK. In the case of this study, ecocentric attitudes and issues of community concern did not influence the level of support given to the event/festival. / Thesis (M.A. (Tourism))--North-West University, Potchefstroom Campus, 2011.

The primary purpose of this study was to determine the social determinants of arts festivals with reference to the ABSA KKNK. This goal was achieved by firstly analysing the event/festival phenomenon and the role thereof in event/festival tourism. Secondly, a literature study was conducted in order to examine the role of the community in supporting events/festivals. And thirdly, the results of the empirical research were discussed. Lastly, conclusions were drawn from the research and recommendations were made with regard to the social determinants of events/festivals. Literature indicated that events/festivals are central to daily living as perhaps never before and it can also be said that events/festivals play certain social, economic, cultural and environmental roles. Events/festivals can have various positive impacts on a community, such as job opportunities, economical growth and upliftment of the community. However it can also create various negative impacts such as crime, prostitution and damage to the environment. It is important to increase the number of positive impacts and decrease the number of negative impacts. This may improve the support of the community for the event/festival and improve the sustainability of the event/festival. The support of the community is also influenced by aspects such as community concern, ecocentric attitudes, community attachment. These social support determinants were measured by means of a questionnaire, as adapted from Gursoy and Kendall (2006) and it was therefore the objective of the questionnaire to analyse the social determinants that that may improve community support. The survey was distributed in the community of Oudtshoorn in 2007 and the determinants, as well as the relationship between the determinants and support for the event/festival, were based on structural equation modeling. A total of 279 questionnaires were completed during the festival. Respondents were, in general, more positive about the festival than negative. The results of the structural equation modelling suggest that community attachment and benefits and costs perceived are the most important social determinants in gaining local support for the ABSA KKNK. In the case of this study, ecocentric attitudes and issues of community concern did not influence the level of support given to the event/festival. / Thesis (M.A. (Tourism))--North-West University, Potchefstroom Campus, 2011.