Problématique : Les prématurés évoluent dans l’unité néonatale qui présente une intensité lumineuse parfois forte et variable, ce qui a pour effet de provoquer une instabilité physiologique, ainsi qu’une augmentation du niveau d’activité motrice chez ces derniers. Par ailleurs, le contrôle de l’éclairage à l’unité néonatale favorise la stabilité physiologique et réduit le niveau d’activité motrice des prématurés. Deux méthodes de contrôle de l’éclairage ont été étudiées, soit l’éclairage tamisé constant et l’éclairage cyclique. Or, la méthode de contrôle de l’éclairage la plus appropriée au système nerveux immature des prématurés est inconnue et il y a ambivalence en ce qui concerne les résultats des études ayant évalué ces deux modes de contrôle de l’éclairage. But : Le but de cette étude était de mesurer les effets de l’éclairage cyclique versus l’éclairage tamisé constant sur la stabilité physiologique et le niveau d’activité motrice de prématurés nés entre 28 et 32 semaines d’âge gestationnel. Méthode : Un essai clinique randomisé a été réalisé. Les 38 prématurés recrutés dans une unité néonatale de niveaux II et III d’un hôpital universitaire, ont été randomisés dans l’un des deux groupes d’intervention, soit le groupe exposé à l’éclairage tamisé constant ou celui exposé à l’éclairage cyclique. Ces deux types d’éclairage ont été appliqués pendant 24 heures. La stabilité physiologique a été mesurée par le score Stability of the Cardio Respiratory System in Premature Infants (SCRIP) et le niveau d’activité motrice a été mesuré avec un accéléromètre (Actiwatch®). L’intensité lumineuse à laquelle les prématurés ont été exposés a été mesurée de façon continue à l’intérieur de l’incubateur à l’aide d’un photomètre. Résultats : L’analyse des données révèle qu’il n’y aucune différence significative entre les deux groupes d’intervention en ce qui a trait à la stabilité physiologique (valeur-p du score SCRIP de 0,54 à 0,96) et au niveau d’activité motrice (valeur-p de 0,09 à 0,88). Les participants des deux groupes ont manifesté une stabilité physiologique et un niveau d’activité motrice comparables. Conclusion : Des interventions de contrôle de l’éclairage doivent être adoptées à l’unité néonatale, que ce soit des interventions qui permettent la mise en œuvre de l’éclairage cyclique ou de l’éclairage tamisé constant, dans le but de favoriser l’adaptation du prématuré à l’environnement de l’unité néonatale. Des recherches additionnelles sont requises afin d’identifier la méthode de contrôle de l’éclairage (éclairage cyclique ou éclairage tamisé constant) qui doit être implantée à l’unité néonatale. / Problem statement: After birth, preterm infants evolve in the neonatal intensive care unit (NICU) characterized by a high and variable lighting which differs significantly from the dimmed intra-uterine environment. Exposure to high or variable NICU lighting can create physiological instability in preterm infants as well as increasing their motor activity level. An appropriate control of the NICU lighting can prevent the adverse effects of exposing infants to inadequate levels of lighting. To date, it appears that two methods of lighting control have been discussed and studied: near dark lighting and cycled lighting. At the same time, it is acknowledged that there is ambiguity about the results of studies which have evaluated these two NICU lighting methods. Therefore, the optimal NICU lighting remains unknown and further research is needed to identify the lighting mode witch promote preterm infant’s adaptation to the NICU environment. Purpose: The objective of this research was to evaluate the effects of cycled lighting versus near dark lighting on the physiological stability and motor activity level of preterm infants born between 28 and 32 weeks of gestation. Methods: A randomized controlled trial (RCT) allowed the assessment of preterm infants' physiological stability and motor activity level. 38 preterm infants born between 28 to 32 weeks of gestational age were recruited from a level II and III NICU university affiliated hospital. Each infant were randomly allocated to one of the following groups for 24 hours: cycled lighting or near dark lighting. Physiological stability was assessed by the SCRIP score, while the motor activity level was evaluated by an accelerometer (Actiwatch®). The light intensity level was continuously measured with a light meter to ensure that the lighting mode assigned was respected. Results: The analysis conducted indicates no significant difference between the two intervention groups in regard to physiological stability (score SCRIP = p-value 0.54 to 0.96) and the motor activity level (p- value 0.09 to 0.88). This lack of significant difference between the two groups indicates that the participants in the two groups demonstrated a comparable physiological stability state and a comparable level of motor activity when exposed to near dark lighting or cycled lighting. Conclusion: Guidelines to decrease bright light, either near dark or cycled light should be adopted in NICUs to control preterm infant’s’ exposure to light. Further research is required to identify the method of lighting control (cycled lighting or near dark lighting) which should be implanted in the neonatal unit.

Insufficient sleep may be associated with obesity via increased energy intake and/or decreased energy expenditure. The present study therefore aimed to investigate effects of sleep restriction on energy balance in healthy young adults. Participants (14 men, 13 women) aged 35.3 ± 1.0 y with 23.6 ± 0.2 kg/m2 BMI completed a randomized, crossover study exposed to short and habitual sleep with 4 wk washout. Controlled diets were provided during the first 4 d, followed by 2 d of ad libitum eating. Ad libitum energy intake, energy expenditure and physical activity level were determined as well as energy balance and body weight. Results showed that ad libitum energy intake (p = 0.031), as well as total fat (p = 0.018) increased after short compared with habitual sleep, but physical activity level, energy expenditure, energy balance, and body weight remained unaffected by sleep duration. In conclusion, sleep deprivation elevates energy intake, which may lead to positive energy balance over time and increase the risk of weight gain and/or obesity.

Insufficient sleep may be associated with obesity via increased energy intake and/or decreased energy expenditure. The present study therefore aimed to investigate effects of sleep restriction on energy balance in healthy young adults. Participants (14 men, 13 women) aged 35.3 ± 1.0 y with 23.6 ± 0.2 kg/m2 BMI completed a randomized, crossover study exposed to short and habitual sleep with 4 wk washout. Controlled diets were provided during the first 4 d, followed by 2 d of ad libitum eating. Ad libitum energy intake, energy expenditure and physical activity level were determined as well as energy balance and body weight. Results showed that ad libitum energy intake (p = 0.031), as well as total fat (p = 0.018) increased after short compared with habitual sleep, but physical activity level, energy expenditure, energy balance, and body weight remained unaffected by sleep duration. In conclusion, sleep deprivation elevates energy intake, which may lead to positive energy balance over time and increase the risk of weight gain and/or obesity.

Made available in DSpace on 2016-12-08T15:59:04Z (GMT). No. of bitstreams: 1 Mauren.pdf: 2397977 bytes, checksum: 4c0edca38f15777114f48955cb690ef6 (MD5) Previous issue date: 2013-02-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This study aimed the analysis of the elderly perception who participated in the Academy of the Best Age (AMI) from Joinville, SC, related to the enrollment and permanency reasons, the activity level (NAF) and services provided. It´s an epidemiological, crossed and descriptive study. 255 elderly, both genres, goers from 17 AMIs participated. The tools used were: a diagnostic record, a semi structure interview about the reasons, its satisfaction and suggestions. The IPAQ was applied adapted for seniors to evaluate the NAF. To analyze the data, descriptive statistics was used, to the categorical variables, the Qui-Square Test and for the numerical variables the Kruskal-Wallis Test. For the variable associations and the NAF, the Logistic Regression was used. Most of the participants are women (62, 7%) age average 67,75(6,28), from which 47,2% consider their health good however 72,2% have some disease highlighting hypertension (47,5%). From the seniors 82,3% are happy with the services and 55,3% with the infrastructure. Half of them started the program to improve their health and 57,3% went on because they feel well. Around 60% suggested an extension on the opening hours, 27,1% suggested cleaning the park and 24,7% installing roofing. Most of them (84,7%) was categorized as active enough. There was no association among socio demographic data and NAF neither between NAF and that the health condition turns the physical activity (AF) practice difficult. There was no association between the senior s satisfaction and the services and the infrastructure with NAF. The same happened with the enrollment reasons and NAF. There was an association between the reason to stay in AMI due the health and NAF. The suggestions to improve the services were not linked to NAF. There was an association with NAF and suggested roofing . In the logistic regression crude analyses, it was observed that don t enroll due health reason and considering a bad health state enlarged the chances to be not enough active by the elderly. In the adjusted analyses income between 2 or 3 salaries and health status doesn t impair the AF practice are the factors that decrease the seniors chances to be not enough active. The AMI study revealed the public subscribed the novelty and improvement. The elderly health conditions and NAF can improve due these programs, since they offer appropriate infrastructure. The systematic revision shows studies related to public parks, environment perception and AF. However on ATIs, there are blanks in literature. This study is a first step, since ATIs grow and so do the seniors in them. It is suggested that the new studies evaluate the seniors characteristics, interests and NAF as well as the impact of these gyms and the public life quality. / Este estudo objetivou analisar a percepção dos idosos participantes da Academia da Melhor Idade (AMI) de Joinville, SC, quanto aos motivos de ingresso e permanência, nível de atividade física (NAF) e serviços prestados. Trata-se de um estudo epidemiológico, transversal e descritivo. Participaram 255 idosos, ambos os sexos, frequentadores de 17 AMIs. Os instrumentos utilizados foram: ficha diagnóstica, entrevista semiestruturada sobre motivos; satisfação e sugestões. Aplicou-se o IPAQ, adaptado para idosos, para avaliar o NAF. Para análise dos dados utilizou-se estatística descritiva, para variáveis categóricas o Teste Qui-Quadrado e para variáveis numéricas o Teste Kruskal-Wallis. Para a associação das variáveis e o NAF utilizou-se Regressão logística. A maioria dos sujeitos é mulher (62,7%), média de idade 67,75(6,28) anos, 47,2% considera sua saúde boa, porém 72,2% possui alguma doença, destacando a hipertensão arterial (47,5%). Dos idosos, 82,3% estão satisfeitos com os serviços prestados e 55,3% com a infraestrutura. Metade ingressou para melhorar a saúde e 57,3% permanece por sentir-se bem. Cerca de 60% sugeriu ampliação do horário de atendimento, 27,1% sugeriu melhorar a limpeza da praça e 24,7% a instalação de coberturas. A maioria (84,7%) classificou-se como suficientemente ativa. Não houve associação entre dados sociodemográficos e NAF e entre a percepção de saúde e NAF. Observou-se associação entre dores lombares e NAF e entre NAF e estado de saúde dificultar a prática de atividade física (AF). Não houve associação entre a satisfação dos idosos com os serviços prestados e infraestrutura com o NAF. O mesmo ocorreu entre motivos de ingresso e NAF. Observou-se associação entre o motivo permanecer na AMI pela saúde e NAF. Sugestões para aperfeiçoar os serviços prestados não associaram-se ao NAF. Houve associação entre NAF e sugestão instalação de cobertura . Na análise bruta da regressão logística observou-se que não ingressar pelo motivado saúde e considerar o estado de saúde ruim aumentam as chances dos idosos serem insuficientemente ativos. Na análise ajustada, renda entre 2 e 3 salários mínimos e estado de saúde não dificultar a prática de AF são fatores que diminuem as chances dos idosos serem insuficientemente ativos. O estudo da AMI revelou que esse público aderiu à novidade e interessa-se pelo aperfeiçoamento. As condições de saúde e o NAF dos idosos podem melhorar através destes programas, desde que ofereçam infraestrutura e atendimento apropriados. Considera-se o presente estudo um passo inicial em pesquisas relacionadas às academias em espaços públicos para idosos, visto que as ATIs crescem de forma acelerada, assim como o ingresso dos idosos nestas. A revisão de literatura aponta estudos relacionados a parques públicos, percepção do ambiente e AF. Entretanto em relação às ATIs, existem lacunas na literatura. Sugere-se que novos estudos sejam desenvolvidos tanto para avaliar as características, interesses e NAF dos idosos, como verificar o impacto dessas academias na saúde e qualidade de vida desse público.

Made available in DSpace on 2014-08-20T13:49:18Z (GMT). No. of bitstreams: 1 Luciane G da Silva.pdf: 886455 bytes, checksum: f38d456501fecb57ccf797bfdcb900c0 (MD5) Previous issue date: 2011-03-25 / the workers in education, nowadays, face problems like the increase of the students matriculated, lack of equipments and essential material or lack of maintenance of the ones that exist, lack of infrastructure and material resources, and others. The knowledge of the work conditions and their reflection in the teacher´s health, especially at those who work with childhood education, is very important to give information that helps public politician s managers to create measures that comprehend improvements, to both work environment and population involved health. Objectives: To investigate the work and health conditions of preschool teachers from the public schools in Pelotas, RS. Methodology: Descriptive study. All the preschool teachers of the city and the state will be part of this study. The collect of the data will be performed using a pretested and codified questioner, comprehend socioeconomic, demographic, work conditions and health (musculoskeletal problems, the level of physical activity, the voice problems correlated and the minor psychological disorders) variables. The instrument used to determinate the level of physical activity will be the long version of the International Physical Activity Questionnaire (IPAQ), performing an interview regarding the previous week, including questions about the frequency and duration of the realization of moderated and intense physical activity and walking. The minor psychological problems or the minor psychiatric disease will be identified by the SRQ Self-Report Questionnaire, instrument comprising 20 questions (SRQ-20) that can be answered by self-report or interview. The identification of the musculoskeletal problems will be by the report of the presence of pain or uneasiness located at the body, according to Kuorinka et al. (1987). Problems related to the voice will be investigated by the Brazilian versions of the V-RQOL (Hogikyan & Sethuraman, 1999), which received the name Qualidade de Vida em Voz QVV (Behlau et al. 2009) / Os trabalhadores em educação, atualmente, encontram problemas como aumentos de alunos matriculados, ausência de equipamentos e materiais essenciais ou falta de manutenção dos existentes, insuficiência de infra-estrutura e de recursos materiais, entre outros. O conhecimento das condições de trabalho e suas repercussões na saúde dos professores, em especial dos que trabalham na educação infantil, é de grande valia no sentido de fornecer informações que auxiliem órgãos gestores de políticas públicas a criarem medidas que contemplem melhorias, tanto no ambiente de trabalho como para a saúde dessa população. Objetivo: investigar as condições de trabalho e saúde de professores pré-escolares da cidade de Pelotas/RS. Metodologia: Estudo descritivo no qual participarão todos os professores pré-escolares que atuam em escolas municipais e estaduais da zona urbana da cidade de Pelotas/RS. A coleta de dados será realizada através de questionário pré-testado e codificado contendo questões sobre variáveis socioeconômicas, demográficas, condições de trabalho e saúde (problemas musculoesqueléticos, nível de atividade física, problemas relacionados à voz e transtornos psiquiátricos menores). O instrumento utilizado para determinar o nível de atividade física será a versão do Questionário Internacional de Atividade Física (IPAQ) na forma longa, com a aplicação de entrevista referente à semana anterior, contendo perguntas em relação à freqüência e duração da realização de atividades físicas moderadas, vigorosas e da caminhada. Os problemas psiquiátricos menores ou doenças psíquicas menores serão identificados por meio do SRQ- Self-Report Questionnaire, instrumento constituído de 20 perguntas (SRQ-20) que podem ser respondidas através de autopreenchimento ou de entrevista. A identificação dos problemas musculoesqueléticos será através da referência de dor ou mal-estar localizado nas diversas localizações corporais, conforme recomendação de Kuorinka et al (1987). Problemas relacionados à voz serão mensuradas pelo Protocolo de Qualidade de Vida e Voz (QVV) (Behlau et al. 2009), versão brasileira do Voice- Related Quality of Life (V-RQOL) (Hogikyan & Sethuraman, 1999)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This dissertation consists of 2 articles that focus on the effects of a combined physical exercise program on the quality of life and health related physical fitness of adults with visual impairment. The study included 9 adults with visual impairment with a mean age of 44.9 ± 11.3 years. A training program with functional resistance and aerobic exercises was carried out 2 times a week during a 12-week period, at a Physical Activity Studio of Santa Maria, RS. There were two evaluations, one before the beginning of the training program and another at the end of it. In the first article, the level of physical activity was assessed using the International Physical Activity Questionnaire, short version and the quality of life by WHOQOL - short bref in the Portuguese version. There was also an anamnestic record to characterize the participants. The Shapiro-Wilk test was used to verify the normality of the results and the Wilcoxon test to evaluate the difference between the mean valuesobtained before and after training. After the training period, statistically significant improvements were observed in the levels of physical activity and physical and psychological domains of quality of life. In the second article, the components of health related physical fitness were assessed: body composition using Body Mass Index, waist circumference and fat percentage; flexibility through the Sit and Reach Test using Wells bench; muscular strength / endurance with the 1 minute abdominal test and arms Flex/Extension Test and cardiorespiratory capacity by the Adapted Bruce Protocol. The normality of the results was analyzed using the Shapiro-Wilk test, and the Wilcoxon test was used to assess the difference between the means. After training there was a statistically significant improvement in height, diastolic blood pressure, cardiorespiratory fitness, strength of upper limbs and trunk. It was concluded that a 12-week combined exercise program, positively modified several aspects of quality of life and health related physical fitness of people with visual impairments. / Esta dissertação é composta por 2 artigos que tem como foco os efeitos de um programa de exercícios físicos combinados na qualidade de vida e aptidão física relacionada à saúde de adultos com deficiência visual. Participaram do estudo 9 adultos com deficiência visual com média de idade de 44,9±11,3 anos. Foi realizado um programa de treinamento com exercícios físicos resistidos funcionais e aeróbicos, 2 vezes na semana, por um período de 12 semanas, em um Espaço de Atividades Físicas da cidade de Santa Maria, RS. Foram realizadas duas avaliações, uma anteriormente o início do treinamento e outra ao término do mesmo. No primeiro artigo, o nível de atividade física foi avaliado através do Questionário Internacional de Atividades Física, versão curta e a qualidade de vida através do WHOQOL bref abreviado na versão em português. Também foi aplicada uma Ficha Anamnética para caracterizar os participantes. Foi utilizado o teste Shapiro Wilk para verificar a normalidade dos resultados e o teste Wilcoxon para avaliar a diferença entre as médias obtidas antes e após o treinamento. Após o período de treinamento foi verificado melhoras estatisticamente significativas nos níveis de atividade física e nos domínios físico e psicológico da qualidade de vida. No segundo artigo, foram avaliados os componentes da aptidão física relacionada a saúde: composição corporal, através do Índice de Massa Corporal, Circunferência da Cintura e Percentual de Gordura; flexibilidade através do Teste de Sentar e Alcançar no banco de Wells; força/resistência muscular através do Teste de Abdominal em 1 minuto e do Teste de Flexão/Extensão dos Braços e a capacidade cardiorrespiratória através do Protocolo Adaptado de Bruce. Para análise estatística verificou-se a normalidade dos resultados através do teste Shapiro Wilk, e foi utilizado o teste Wilcoxon para avaliar a diferença entre as médias. Após o treinamento verificou-se melhoras estatisticamente significativa na estatura, pressão arterial diastólica, capacidade cardiorrespiratória, força de membros superiores e de tronco. Concluiu-se que um programa de exercícios físicos combinados de 12 semanas modificou positivamente vários aspectos da qualidade de vida e da aptidão física relacionada a saúde de pessoas com deficiência visual.

Syfte: Syftet med denna studie var att undersöka sambandet mellan fysisk aktivitetsnivå, depressiva symtom och funktionshinder hos personer med Parkinsons sjukdom. Därtill kartlägga fysisk aktivitetsnivå, depressiva symtom samt funktionshinder bland personer med Parkinsons. Bakgrund: Parkinsons sjukdom är en av de mest förekommande neurodegenerativa sjukdomarna. Sjukdomen är kopplad till både motoriska och icke-motoriska symtom såsom depressiva symtom. Metod: 30 personer inkluderades i denna studie. I denna studie användes IPAQ-SF för att mäta fysisk aktivitetsnivå, MADRS-S för att mäta depressiva symtom samt WHODAS 2.0 för att skatta funktionshinder. Formulären sammanställdes i en webbenkät som publicerades via länk på Facebooksidor ägnade åt Parkinsons sjukdom. Resultat: Utav inkluderade i studien hade 4 (13.3%) låg fysisk aktivitetsnivå, 13 (43.3%) måttlig samt 13 (43.3%) hög. 16 (53.3%) klassades som väsentligen obesvärad, 11 (36.7%) som mild depression, 3 (10.0%) som måttlig samt ingen som svår depression. Bland de inkluderade var medianen för WHODAS 2.0 enligt följande: förstå och kommunicera 3.5 (2.0-5.0), förflyttning 4.5 (2.5-6.5), personlig vård 2.0 (2.0-3.5), relationer 4.0 (3.0-5.5), dagliga aktiviteter 4.5 (3.0-6.5) samt delaktighet i samhället 4.0 (3.0-6.0). Sambandet mellan fysisk aktivitetsnivå och depressiva symtom gav r=0.31 p=0.10. Sambandet mellan fysisk aktivitetsnivå och funktionshinder visade r=0.45 p=0.02. Sambandet mellan depressiva symtom och funktionshinder visade r=0.74 p=0.01. Slutsatser: En måttlig till hög fysisk aktivitetsnivå var vanligt. Likaså var förekomsten av depression omfattande. Förekomsten av funktionshinder var därutöver relativt låg. Korrelationen mellan samtliga variabler anses vara låg frånsett den mellan depressiva symtom och funktionshinder, vilken var måttlig. / Aim: The aim of this study is to explore the correlation between physical activity level, depressive symptoms and health and function in persons with Parkinson’s disease. In addition, this study aims to examine and map physical activity level, depressive symptoms and health and function among persons with Parkinson’s disease. Background: Parkinson’s disease is one the most widespread neurodegenerative diseases. The disease can present itself in either motor or non-motor symptoms, such as depressive symptoms. Method: 30 participants were included in this study. IPAQ-SF was used to measure physical activity level, MADRS-S to measure depressive symptoms and WHODAS 2.0 to measure health and function. The questionnaires were compiled in a web survey which was then posted on various Facebook pages aimed at Parkinson’s disease. Results: Among participants included 4 (13.3%) had low physical activity level, 13 (43.3%) moderate and 13 (43.3%) high. 16 (53.3%) were classed as having no depression, 11 (36.7%) as mild depression, 3 (10.0%) as moderate and none as severe depression. The median for the respective domain of were as follows: cognition 3.5 (2.0-5.0), mobility 4.5 (2.5-6.5), self care 2.0 (2.0-3.5), getting along with people 4.0 (3.0-5.5), life activities 4.5 (3.0-6.5), participation 4.0 (3.0-6.0). The correlation between physical activity level and depressive symptoms provided r=0.31 p=0.10, physical activity level and health and function r=0.45 p= 0.02 and depressive symptoms and health and function r=0.74 p=0.01. Conclusions: This study demonstrated a prominent occurance of high and moderate levels of physical activity. Likewise, the prevalence of depression was extensive. In addition, the incidence of disability was apparently low. The correlation between all variables is considered to be low apart from that between depressive symptoms and disability, which was moderate.

博士(スポーツ健康科学) / Doctor of Philosophy in Health and Sports Science / 同志社大学 / Doshisha University