Orientador: Tirza Aidar / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciencias Humanas / Made available in DSpace on 2018-08-06T06:10:50Z (GMT). No. of bitstreams: 1 Belon_AnaPaula_M.pdf: 999877 bytes, checksum: 35afba21b9b0ad79c323d894c75e5ec6 (MD5) Previous issue date: 2006 / Resumo: O cenário demográfico que se delineia no Estado de São Paulo é caracterizado pelo aumento envelhecimento relativo populacional e da participação relativa e das taxas de mortalidade por neoplasias malignas entre as causas de óbito. A estreita associação entre mortes por neoplasias malignas e a população idosa reforça a importância deste estudo, que apresenta como proposta investigar a relação entre as condições de vida dos idosos e a mortalidade por neoplasias de colo de útero, mama feminina e próstata para o Estado de São Paulo no ano de 2000. Parte-se do pressuposto que as desigualdades socioeconômicas se expressam nos diferenciais da mortalidade por neoplasias entre idosos e seu comportamento ao longo do tempo. Resgata-se as dimensões socioeconômicas e demográficas da mortalidade, numa tentativa de não se restringir à simples mensuração da desigualdade em saúde. Elege-se, como variáveis socioeconômicas para compor perfil socioeconômico dos idosos, os anos de estudo e rendimento domiciliar per capita, tendo como categorias de referência o analfabetismo funcional e o rendimento igual ou superior a 5 s.m. per capita. Para tanto, o Estado de São Paulo é dividido em Direções Regionais de Saúde (DIR) e a população idosa em grupos etários qüinqüenais e por sexo. Os anos censitários, que auxiliam a compreensão da evolução temporal, são 1980, 1991 e 2000. Através de análises de correlação e graus de dispersão, a dissertação aponta como resultados que: (1) ocorre um aumento mais significativo das taxas específicas de mortalidade por neoplasias entre idosos com idades mais avançadas no decorrer dos anos; (2) quanto maior a participação relativa do analfabetismo funcional entre os responsáveis pelo domicílio, menor são os riscos de morrer por neoplasias malignas; (3) quanto maior a proporção de domicílios com rendimento per capita igual ou superior a 5 s.m., maiores são as taxas específicas de mortalidade; (4) a localização e distribuição dos centros de saúde de alta complexidade, segundo as DIR¿s influem na magnitude das taxas; (5) as neoplasias de mama feminina e próstata apresentam maiores índices de correlação entre as taxas e as variáveis socioeconômicas, sendo que o comportamento de colo de útero seria mais aleatório / Abstract: There is a demographic scenery for the State of São Paulo (Brazil) characterized by population ageing and an increasing rate of death, among this population, caused by malignant neoplasms. Based on these findings, this study intends to investigate the relation between socioeconomics and demographic pointers and mortality by malignant neoplasms ¿ uterine cervical, feminine breast and prostate ¿ among the aged population of the State of São Paulo and its health regional services during the year of 2000. Presuming that the socioeconomics inequalities are expressed in the mortality rates by malignant neoplasms among aged people, it was elected as variables to compose the socioeconomic profiles, schooling and per capita domicile income. The reference categories are determined as functional illiteracy and the income of 5 minimal salaries or above per capita. The State of São Paulo is divided by the ¿regional health services¿ (DIR) and the aged population by sex in 5-aged groups. The census years which helps to understand the time evolution are 1980, 1991 and 2000. Through descriptive analysis as well as linear models adjusts, the results suggest that: (1) there is a significative increase in the mortality rates by malignant neoplasms among the eldest and this tendency does not present a homogeneity aspect among the DIR¿s; (2) the rate of mortality due to feminine breast and prostata cancers is, unexpectedly, higher in the more developed regions; (3) in areas with health centers of high complexity for cancer treatment, the same tendency occurs, i.e. the highest levels of deaths as a consequence of neoplasms in aged population were observed. / Mestrado / Saude e Morbi-mortalidade / Mestre em Demografia

This descriptive correlational study was designed to examine the relationship between situational control, and both psychological and physical well-being, in the institutionalized elderly. A convenience sample of 52 elderly institutionalized subjects was selected from two intermediate care facilities. The subjects completed the Perceived Weil-Being Scale, the Situational Control Of Daily Activities Scale, and the Subject Information Sheet. All residents were found to have an overall perception of situational control. However, residents perceived a lack of control for the daily activities of eating and grooming. The majority of residents obtained a moderately high score on the psychological well-being and physical well-being scales. No significant relationship was found between situational control and psychological well-being, or situational control and physical well-being. A significant positive relationship was found between psychological well-being and physical well-being. / Applied Science, Faculty of / Nursing, School of / Graduate

A trend toward non-institutionalization of the elderly, in conjunction with the increasing size of the elderly population has resulted in the development of a variety of community programs and services to help meet their complex and diverse health care needs in the community setting. Although there is substantial documentation pertaining to the needs of the elderly in the community and the available services (Lifton, 1989; Padula, 1983; Starrett, 1986; Wallace, 1987), this documentation has been generated primarily by health care professionals and agencies, rather than from the perspectives of the elderly themselves. Adult Day Care [ADC] programs were established in the late 1960s as one means of attempting to meet the needs of the frail elderly in the community (Padula, 1983). On the surface, these programs appear to be effective in meeting the needs of clients through the provision of nursing services and a wide variety of therapeutic programs and social activities. This exploratory descriptive study was based on the premise that there exists a need to gain insight into the clients' perspectives regarding the ways in which ADC services are instrumental in meeting their perceived needs. Data were collected and analyzed to identify the self-perceived needs of ADC clients and their perceptions of how the ADC nursing services were instrumental in assisting them to meet these needs. Two interviews were conducted with each of the 11 ADC participants comprising the sample, using a semi-structured interview guide developed by the researcher. The two needs most commonly identified by participants included the need to cope with a range of concurrent and/or successive losses, and the need to establish new support systems. Participants identified the most significant components of the nursing role as those of the provision of emotional support through counselling, and the provision of health monitoring services. Participants viewed the overall ADC program as important in assisting them to meet their needs by providing access to social outings, individualized care, emotional support, and the opportunity to enhance their self-esteem, confidence, and feelings of belongingness. / Applied Science, Faculty of / Nursing, School of / Graduate

The treatment of spontaneous pneumothorax in the civilian population can be influenced by the age of the patient and the presence of associated pulmonary disease. The medical records of 130 patients who presented with 168 occurrences of SP were reviewed during an 11-year period (1973 to 1984). Follow-up was from a minimum of 30 months to 13 years (mean 6.3 years). The therapeutic options included observation alone (40 occurrences), thoracentesis (6 occurrences), chest tube thoracostomy (102 occurrences), and thoracotomy (20 occurrences). Treatment of SP should be prompt with the objective of complete re-expansion of the lung and prevention of recurrent pneumothorax. This should be accomplished by the use of chest tube thoracostomy with early addition of thoracotomy as necessary. Selected use of thoracentesis can be effective. The use of observation alone can be dangerous and is associated with a higher recurrence rate.

No / INTRODUCTION: Care home residents are at particular risk from medication errors, and our objective was to determine the prevalence and potential harm of prescribing, monitoring, dispensing and administration errors in UK care homes, and to identify their causes. METHODS: A prospective study of a random sample of residents within a purposive sample of homes in three areas. Errors were identified by patient interview, note review, observation of practice and examination of dispensed items. Causes were understood by observation and from theoretically framed interviews with home staff, doctors and pharmacists. Potential harm from errors was assessed by expert judgement. RESULTS: The 256 residents recruited in 55 homes were taking a mean of 8.0 medicines. One hundred and seventy-eight (69.5%) of residents had one or more errors. The mean number per resident was 1.9 errors. The mean potential harm from prescribing, monitoring, administration and dispensing errors was 2.6, 3.7, 2.1 and 2.0 (0 = no harm, 10 = death), respectively. Contributing factors from the 89 interviews included doctors who were not accessible, did not know the residents and lacked information in homes when prescribing; home staff's high workload, lack of medicines training and drug round interruptions; lack of team work among home, practice and pharmacy; inefficient ordering systems; inaccurate medicine records and prevalence of verbal communication; and difficult to fill (and check) medication administration systems. CONCLUSIONS: That two thirds of residents were exposed to one or more medication errors is of concern. The will to improve exists, but there is a lack of overall responsibility. Action is required from all concerned.

No / Epidemiologic research has shown that multifocal spectacle wearers (bifocal and progressive addition lenses [PALs]) are more than twice as likely to fall than are nonmultifocal spectacle wearers, with this risk further increasing when negotiating stairs. The present study investigated whether step and stair descent safety is improved by using single-vision distance lenses. METHODS: From a stationary standing position on top of a block, 20 long-term multifocal wearers stepped down (from different block heights) onto a lower level wearing bifocal, progressive addition, or single-vision distance lenses. RESULTS: Use of single-vision distance spectacles led to an increased single-limb support time, a reduced ankle and knee angle and vertical center-of-mass velocity at contact with the lower level, and a reduced ankle angular velocity and vertical center-of-mass velocity during initial landing (P < 0.03). These findings indicate that landing occurred in a more controlled manner when the subjects wore single-vision distance spectacles, rather than tending to "drop" onto the lower level as occurred when wearing bifocals or PALs. CONCLUSIONS: Use of single-vision distance spectacles led to improvements in landing control, consistent with individuals' being more certain regarding the precise height of the lower floor level. This enhanced control was attributed to having a view of the foot, step edge, and immediate floor area that was not blurred, magnified, or doubled and that did not suffer from image jump or peripheral distortions. These findings provide further evidence that use of single-vision distance lenses in everyday locomotion may be advantageous for elderly multifocal wearers who have a high risk of falling.

Time poverty—the experience of insufficient time for rest, leisure, and self-development—has emerged as a critical issue in modern societies, intersecting with and potentially exacerbating social inequalities. This dissertation explores various dimensions of time poverty in the United States and South Korea. Through three interconnected studies, I examine long-term trends in relative time poverty, the association between time poverty and life satisfaction, and cohort effects on subjective and relative time poverty. The first paper examines time poverty trends among adults in the United States over the last 20 years. Using the 2003-2022 American Time Use Survey, I show long-term trends in time poverty rates for the US adult population, analyzing variations by key sociodemographic factors including gender, family structure, and race/ethnicity. Time poverty rates initially decreased from the early 2000s through the early 2010s, followed by an upward trend starting in 2013, with a brief dip during the 2020 COVID-19 peak and reaching a high point in 2022. Throughout the study period, time poverty was most prevalent among women, adults living with multiple young children, and individuals of Asian, Native Hawaiian, Pacific Islander, or Hispanic descent. Logistic regression analyses confirmed that being a woman, having children, and engaging in paid work were significantly associated with higher odds of experiencing time poverty. The second paper investigates the association between time poverty and life satisfaction among working-age adults in South Korea. Using the 2019 Korean Time Use Survey, I conducted descriptive analyses and employed generalized ordered logistic regression to examine the relationship between time poverty and life satisfaction. Time poverty was measured in both subjective and relative terms. Results showed that subjective time poverty was more common than relative time poverty among working-age adults, with both types most pronounced between ages 35 and 44 and more prevalent among men than women. Regression models demonstrated a significant negative association between subjective time poverty and life satisfaction, with the largest effects observed among those reporting severe subjective time poverty. The association between relative time poverty and life satisfaction appeared mostly statistically insignificant. The third paper studies how cohort membership influences subjective and relative time poverty among Korean adults across different age groups and periods. Utilizing four waves of the Korean Time Use Survey data from 2004 to 2019, I employed age-period-cohort detrended models to detect nonlinear fluctuations around linear trends for cohort-specific deviations. Results revealed a general decline in occasional subjective time poverty across cohorts but an increase in chronic subjective time poverty and relative time poverty among those in their 20s and 30s across successive cohorts. Significant variations in subjective and relative time poverty were found across different cohorts, with notable shifts occurring between the 1970s and 1980s cohorts. Subgroup analyses indicated varying effects based on gender, education level, and number of children in the household, with more prominent effects observed for cohorts born in the 1970s. By investigating these aspects across different contexts, this dissertation highlights the complex nature and far-reaching consequences of time poverty on individual well-being and social dynamics. The findings underscore how time poverty reflects changing societal values and structures, particularly in relation to work-life balance, family dynamics, and cohort shifts in time use patterns. This research contributes to our understanding of evolving social inequalities and may inform policies aimed at promoting more equitable use of time across diverse populations, ultimately addressing the broader implications of time poverty in modern societies.

Sarcopenia is a condition that is most common in aged animals, and is characterized by the loss of skeletal muscle mass and integrity, and can lead to physical disability and poor quality of life. Since skeletal muscle protein synthesis can be limited by the availability of amino acids, supplementation of limiting amino acids to ameliorate the progression of sarcopenia has become a topic of interest in companion animal research. Although there is some data to support the idea that amino acid supplementation improves maintenance of muscle mass in aged horses, the cellular mechanisms behind that improvement have yet to be elucidated. Therefore, the objective of this study was to examine the effect of amino acid supplementation in aged horses on markers of whole body and muscle protein metabolism. In a cross-over design, six old horses were studied while receiving each of three treatments in a replicated Latin square design. For all three treatments, horses received 1.8% BW/d of timothy hay cubes and 0.5% BW/d of experimental concentrate. The three treatments included a control (CON) treatment concentrate that was designed to meet all requirements of mature horses when fed in combination with the timothy hay cubes, and two supplemented concentrates, LYS/THR with additional lysine and threonine (40 mg/kg BW/d and 31 mg/kg BW/d, respectively), and LYS/THR/MET with additional lysine, threonine, and methionine (40 mg/kg BW/d, 31 mg/kg BW/d and 11mg/kg BW/d respectively). In each 15 d period, following a 9-day adaptation, horses were fitted with a collection harness, and total urine and feces were collected for 72 hours for assessment of nitrogen balance and creatinine output. Blood samples were taken directly before feeding and 30, 60, 90, 120, 150, 180, 210, and 240 minutes post-feeding for analysis of plasma urea nitrogen (PUN), glucose, insulin, and plasma amino acid concentrations. Muscle biopsy samples were taken for analysis of proteins in the mTOR pathway. Additionally, horses underwent stable isotope infusion procedures, and comparisons of phenylalanine kinetics were used to determine whole-body rates of protein synthesis and degradation. There was no significant effect of treatment on creatinine output (P=0.58), relative abundance of proteins in the mTOR pathway (P>0.05), nitrogen retention (P=0.70), or phenylalanine kinetics (P>0.05). PUN concentrations were significantly (P=0.0058) higher for LYS/THR and LYS/THR/MET than for CON. Atrogin-1 activation was significantly higher for the pre-feeding CON sample compared to the post-feeding CON sample. Lack of significant difference in creatinine output suggests that there were not significant differences in muscle mass between treatments. Lack of significant differences in mTOR protein activation suggests that amino acid supplementation did not result in improvements in protein synthesis. Lack of significant differences in nitrogen retention and phenylalanine kinetics suggests that whole-body protein metabolism was not improved. Additionally, higher PUN concentrations in the supplemented diets suggests that the supplemented amino acids being provided were catabolized. However, increased activation of Atrogin-1 in the pre-feeding CON samples, but not the pre-feeding samples of supplemented treatments, suggests amino acid supplementation may have reduced protein degradation in the post-absorptive state. Data from the present study suggests that amino acid availability may not have been limiting protein synthesis in the sedentary aged horses in the present study.

published_or_final_version / Sports Science / Master / Master of Science in Sports Science

The objective of this study was to compare the effects on eating behavior, lipids, lipoproteins, lipid peroxidation, and glycemic control in women with type 2 diabetes of a high-monounsaturated fat diet (HM) compared to a high-carbohydrate diet (HC). In an outpatient feeding study, ten hypertriglyceridemic postmenopausal type 2 diabetic women alternately for six weeks consumed the HM and HC diets. On the HM diet, 45% of total calories were consumed as carbohydrate and 40% as fat (27% monounsaturated) compared to 55% carbohydrate and 30% fat (10% monounsaturated) in the HC diet. At the beginning and end of each diet phase, total lipids, lipoproteins, lipid peroxidation, and glycemic variables were measured. For 8 days in each diet phase eating pattern frequency, palatability of foods, hunger and fullness were assessed. At the end of each diet phase, taste testing to determine preference for fat was conducted. Total cholesterol was significantly decreased on the HC diet. Serum triglyceride, very low density lipoprotein (VLDL) triglyceride and cholesterol, and apolipoproteins A-1 and B were not significantly different on the two diets. When comparing initial to final values, both diets lowered LDL-C; however, the change was greater on the HM diet. Lipid peroxidation variables improved when the HM diet was consumed. Glycemic variables improved on both diets. No significant differences between total number of eating episodes on the HM and HC diet phases were found. Both diets were rated as highly palatable. Hunger and fullness ratings varied within and between subjects. However, fullness was more commonly experienced than hunger on both HM and the HC diet. Preference for fat was not found at the end ofHM or HC diets. However, subjects differed significantly in ratings for liking of foods that were salty, sour, and bitter when compared to nondiabetic women. Consumption of the HM and HC diets did not result in deterioration of lipid status. The HM diet by virtue of less oxidation of the LDL particle and improvement of glycemic control provides an important advantage over the HC diet. A description of eating behavior of women with type 2 diabetes emerged. / Graduation date: 2000