In the school subject of the natural sciences it is imperative that the students are given opportunities to ”talk science”, since the dialogues that occur in the classroom have a significant importance for the students’ abilities to engage in meaning-making in their learning process. Hence, the student and teacher interaction in the classroom and the feedback given there play a significant role in the students’ learning process. The aim of this study is to contribute to the development of formative assessment tools that can mediate the students’ meaning-making in natural sciences subjects in upper-secondary school. I have designed and tested a method of oral peer-assessment that enables dialogue-interaction in the natural science-classroom where the students, under supervision of the teacher, get to use each other as learning-resources in groups. The oral formative peer-assessment has been conducted in form of a design-based study in two upper-secondary school classes where each teacher taught natural sciences. The data collected include conversations in small groups, between groups and with the teacher. Data was analysed based on different types of talk (exploratory, cumulative and disputational talk) and type and level of feedback that was given in the classroom. The results showed that the students were given different opportunities for meaning-making, where the lack of subject-knowledge, difficulties with peer-assessment and physical artefacts were seen to significantly affect the learning process. The analyses of the interaction in the classroom showed that the teachers, in both studies, gave a direct feedback, where the students got the opportunity to compare and support their results in a dialogue with each other and the teacher. This type of feedback is considered highly efficient for learning. This study shows that the oral formative peer-assessment is a tool that teachers can use, and adapt to their practices, in order to create interactions in the classroom that can increase the students’ meaning-making. / I de naturvetenskapliga ämnena är det viktigt att eleverna ges förutsättningar att ”prata naturvetenskap” eftersom talet som sker i klassrummet har en mycket stor betydelse för elevernas möjligheter att skapa mening i det naturvetenskapliga lärandet. Interaktionen i klassrummet och den återkoppling som ges har därför stor betydelse för elevernas inlärning. Med syfte att bidra till utveckling av redskap för formativ bedömning som kan mediera elevernas meningsskapande i naturvetenskaplig undervisning på gymnasiet, har jag designat och testat en metod som möjliggör dialogisk interaktion i det naturvetenskapliga klassrummet där eleverna under ledning av läraren gruppvis får använda varandra som läroresurser i en muntlig kamratbedömningsövning. Den muntliga formativa kamratbedömningen har genomförts i form av en designbaserad studie i två gymnasieklasser där ämnesområden i naturkunskap behandlades av lärarna. Datainsamlingen inkluderar samtal som har förts inom grupper, mellan grupper och med läraren. Data analyserades utifrån olika typer av samtal (exploratory, cumulative och disputational talk) och typ samt nivå på den återkoppling som gavs i klassrummet. Elevsamtalen inom grupperna visade att delaktigheten var stor men att typen av kommunikation gav eleverna olika förutsättningar till meningsskapande där bristen på ämneskunskaper, ovana vid kamratbedömning och fysiska artefakter kan anses vara av stor betydelse för läroprocessen. Analysen av interaktionen i klassrummet visade att läraren i de båda studierna använde direkt återkoppling som gav eleverna möjlighet att jämföra och motivera sina resultat i en dialog med varandra och läraren, vilken anses vara en typ av återkoppling som är mycket effektfull för inlärningen. Studien visar att den muntliga formativa kamratbedömningsövningen i sin ursprungliga form är ett redskap som lärare kan använda och anpassa till sina praktiker för att skapa interaktioner i klassrummet som kan öka elevernas meningsskapande.

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2012-07-19T21:14:03Z No. of bitstreams: 1 Helana Cristina Alves V Lima Incidencia e fatores de risco associados... 2011.pdf: 793768 bytes, checksum: a96bd31b1f3f1ee9dcf815c3bc18e379 (MD5) / Made available in DSpace on 2012-07-19T21:14:03Z (GMT). No. of bitstreams: 1 Helana Cristina Alves V Lima Incidencia e fatores de risco associados... 2011.pdf: 793768 bytes, checksum: a96bd31b1f3f1ee9dcf815c3bc18e379 (MD5) Previous issue date: 2011 / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, Brasil / A leptospirose é um problema de saúde pública em comunidades carentes do Brasil. As formas leves são subdiagnosticadas por causa da inespecificidade da apresentação clínica. São necessários estudos para determinar a frequência da leptospirose em comunidades carentes e identificar características que permitam predizer o risco de leptospirose entre pacientes com síndrome febril aguda (SFA). Este trabalho tem como objetivos determinar a prevalência da leptospirose em pacientes atendidos por SFA, determinar a incidência das formas leves e graves e identificar fatores preditores para a doença. Para tanto, de 01 de abril de 2009 a 31 de março de 2010, foi estabelecida uma vigilância de base populacional para atendimentos por SFA na comunidade de Pau da Lima, em Salvador, Bahia. Uma amostragem dos casos de SFA identificados foi investigada para leptospirose com o uso de microaglutinação (MAT) em amostras de sangue pareadas. Formas graves foram identificadas por um sistema de vigilância hospitalar. Os casos de SFA positivos e negativos foram comparados quanto ao perfil sociodemográfico, clínico e epidemiológico para identificar características preditoras da doença. A vigilância identificou 5.712 atendimentos por SFA em moradores com idade≥5 anos, sendo 1.729 (30%) recrutados e 1.479 (85%) avaliados quanto ao diagnóstico. Os recrutados foram semelhantes aos não recrutados quanto às características demográficas e clínicas. Dos pacientes avaliados, 1% foi confirmado como caso de leptospirose, sendo 14 casos leves autolimitados e 1 caso grave. A incidência anual de leptospirose leve estimada para a comunidade foi de 84/100.000 habitantes. No mesmo período foram identificados nove casos de leptospirose grave em residentes da comunidade estudada. A incidência de leptospirose grave foi de 14/100.000 habitantes. As seguintes características sociodemográficas e exposições ambientais nos 30 dias que precederam a doença foram associadas ao diagnóstico de leptospirose nos pacientes com SFA: sexo masculino; receber Bolsa Família; ter contato peridomiciliar com lama, com lixo, com esgoto; residir até 10 metros de esgoto aberto; presença de ratos no peridomicílio; ter contato ocupacional com esgoto; e trabalhar como agente de limpeza. Concluiu-se que carga da leptospirose é maior do que a identificada apenas com base nos casos graves. Características demográficas, clínicas e epidemiológicas devem ser utilizadas para predizer o risco de leptospirose. / Leptospirosis is a public health problem in Brazil's poor communities. The mild forms are underdiagnosed because of nonspecific clinical presentation. Studies are required to determine the incidence of leptospirosis in poor communities and identify characteristics that allow to predict the risk of leptospirosis among patients with acute febrile syndrome (AFS). This work aims to determine the prevalence of leptospirosis in patients served by AFS, determine the incidence of serious and light shapes and identify factors predictors for the disease. To this end, of the March 31, 2010, April 1, 2009 was established a population-based surveillance for attendances by SFA in the community of Pau da Lima, Salvador, Bahia. A sampling of cases identified SFA was investigated for leptospirosis using micro-agglutination test (MAT) in paired blood samples. Severe forms have been identified by a hospital surveillance system. The AFS cases were positive and negative compared to socio-demographic profile, to identify clinical and epidemiological characteristics of predictives of the disease. The surveillance identified 5,712 attendances by AFS in residents aged ≥ 5 years, 1,729 (30) recruited and 1,479 (85) evaluated with diagnosis. The recruited were similar to those not recruited as clinical and demographic characteristics. Of patients evaluated, 1% was confirmed as cases of leptospirosis, of which 14 being mild and 1 severe. The annual incidence of leptospirosis estimated for a community was light of 84/100.000 inhabitants. There is no same period were identified nine serious cases of leptospirosis in residents of the community studied. A severe leptospirosis incidence was of 14/100.000 inhabitants. As the following socio-demographic characteristics and environmental exposures. The following socio-demographic characteristics and environmental exposures during the 30 days preceding the disease were associated with the diagnosis of leptospirosis in patients with AFS: male, receiving Bolsa Familia, peridomestic have contact with mud, garbage, sewage, living within 10 meters of open sewage, presence of rats in animal sheds have contact with sewage occupational and work as a cleaning agent. In conclusions, the burden of leptospirosis is higher than identified based only in severe cases. Demographic, clinical and epidemiological research should be used to predict the risk of leptospirosis

Contexte : En France, le cancer de la prostate est une maladie fréquente de l’homme âgé et la première cause de cancer. Il est associé à une survie de 70 % à 10 ans. Différentes options thérapeutiques sont recommandées dans la prise en charge de ce cancer, parmi lesquelles l’hormonothérapie (ou thérapie par déprivation d’androgène, ADT). Le profil de sécurité de l’hormonothérapie et des différentes modalités qui la composent est remis en question depuis le milieu des années 2000 avec plusieurs auteurs ayant évoqué un sur-risque cardiovasculaire comparativement aux patients non traités. Les résultats de ces études étant discordants, l’hypothèse d’une hétérogénéité entre les différentes modalités d’ADT a été évoquée mais n’a pas été directement investiguée. Objectif : L’objet de ce travail a été d’évaluer l’hypothèse d’une hétérogénéité qualitative entre les différentes modalités d’ADT indiquées dans le cancer de la prostate. Méthodes : De façon originale par rapport aux études précédemment publiées, une méta-analyse des essais cliniques randomisés et des études observationnelles, « METADTCR », a été réalisée comparant la morbidité et mortalité cardiovasculaire ischémique ainsi que la mortalité toutes causes au sein des différentes modalités d’ADT. Dans un second temps, une étude observationnelle, « ADTCR », utilisant la base de données de l’Assurance Maladie couplée aux données de remboursement hospitalières, a été réalisée afin de suivre spécifiquement, sur une cohorte nationale de patients avec un cancer de la prostate initiant une hormonothérapie, l’apparition d’évènements ischémiques (accidents vasculaires cérébraux ischémiques et infarctus du myocarde). Résultats - Conclusion : Concernant METADTCR, les essais cliniques se sont révélés extrêmement peu contributifs quant au risque de morbidité et mortalité cardiovasculaire ; la méta-analyse des études observationnelles souffrant d’une hétérogénéité substantielle au niveau des différentes comparaisons étudiées, la question du risque de morbidité et mortalité cardiovasculaire subsistait. Concernant ADTCR, une hétérogénéité du risque d’évènements ischémiques a été constatée entre les différentes modalités d’ADT : comparativement aux agonistes GnRH, un sur-risque d’évènements ischémiques a été identifié avec le blocage androgénique complet et une diminution du risque observée avec les anti-androgènes. La comparaison d’intérêt pour les cliniciens concernait celle avec l’antagoniste GnRH : aucune différence statistiquement significative n’a été observée. La plausibilité pharmacologique expliquant un potentiel sur-risque d’évènements ischémiques entre ces deux modalités n’a par ailleurs pas emporté la conviction et nous conforte dans l’hypothèse de l’absence de différence de risque. Ces résultats viennent compléter les recommandations françaises et européennes de prise en charge du cancer de la prostate quant à la différence de profil de sécurité de certaines modalités d’ADT en matière d’évènements ischémiques à court terme (< 2 ans). / Context: In France, prostate cancer is a frequent disease in elderly men, and the first cause of cancer. It is associated with a 70 % survival at 10 years. Different therapeutics options are recommended in prostate cancer management, including hormonotherapy (or androgen deprivation therapy, ADT). Safety of ADT modalities is challenged since mid of 2000’s when some authors evoked an increased cardiovascular risk in ADT-treated patients compared to non-treated patients. Results of these studies appeared conflicting, and heterogeneity of cardiovascular risk across ADT modalities was evoked but not directly investigated. Objective: Our aim was to assess the hypothesis of qualitative heterogeneity across the different ADT modalities used for prostate cancer. Methods: Through a new approach compared to previously published studies, we firstly conducted a direct and network meta-analysis of both randomized controlled trials and observational studies, “METADTCR”, comparing ischemic cardiovascular morbidity, mortality and overall death across the different ADT modalities. Secondly, we set up a population-based cohort study, “ADTCR”, using French Health Insurance database (SNIIRAM/DCIR) linked to hospital reimbursement data (PMSI), including men with prostate cancer who initiated an ADT, and measuring the occurrence of ischemic diseases (myocardial infarction or ischemic stroke). Results – Conclusion: As regards METADTCR, randomized controlled trials gave too few data related to cardiovascular morbidity and mortality; observational studies meta-analysis suffered from substantial inconsistency and eventually the question of cardiovascular risk morbidity and mortality remained. In ADTCR, a heterogeneous risk of ischemic events was observed across ADT modalities: compared to GnRH agonists, an increased risk of ischemic events was identified with combined androgen blockade, and a decrease risk with anti-androgen alone. The most interesting comparison concerned GnRH antagonist: no statistically significant difference was observed. Pharmacological plausibility for a potential increased risk of ischemic events between GnRH agonists and antagonist is not convincing to date and the hypothesis of no risk difference might be true. These results add valuable information to the French and European guidelines for prostate cancer management as regards the safety profile of the different ADT modalities in term of short term ischemic events onset (< 2 years).

Avec l'amélioration de la prise en charge du cancer colorectal (CCR), on constate une augmentation croissante du nombre de personnes en longue rémission de ce cancer. Cependant, le CCR et ses traitements peuvent avoir des répercussions physiques et psychologiques à long terme. L'objectif était d'évaluer la QdV et la réinsertion de patients en longue rémission d'un CCR, 5, 10 et 15 ans après le diagnostic, comparées à des témoins de population générale. Etude constituée de cas de CCR tirés au sort à partir des 3 registres des tumeurs et de témoins tirés au sort à partir des listes électorales. Les participants ont complété 5 auto-questionnaires : le SF-36 et le QLQC30, le MFI-20 et le STAI, et un questionnaire de conditions de vie. Au total, 542 cas de CCR et 1181 témoins ont été inclus. Globalement, la QdV des patients était comparable à celle des témoins 15 ans après le diagnostic. Les patients atteints du cancer du rectum ont été plus affectés physiquement et ont ressenti davantage de fatigue. Quant à la réinsertion, les patients ont reporté des changements positifs tels que l'an1élioration de leur relation conjugale. Cependant les patients ont noté plus de difficultés lors de démarches de souscription à un prêt. En terme de QdV, cette étude a démontré qu'elle était globalement satisfaisante chez les patients en longue rémission de leur CCR. Ils ont reporté dans leur vie sociale et familiale plus de changements positifs que les témoins, signe d'une adaptation à la maladie. Mais il persiste encore des difficultés d'ordre professionnel et financier. Il parait nécessaire de maintenir la prise en charge médico-psycho-sociale des personnes en longue rémission d'un CCR / Given enhancing managing of colorectal cancer (CRC), we note an increasing number of long term cancer survivors. However, CRC and its treatment can cause long term physical and psychological effects. The goal was to evaluate quality of life and reintegration in long term CRC survivors, 5, 10, and 15 years after diagnostic, in comparison with population controls. Study consisted of CRC cases, randomly selected from files of three cancer registries and controls randomly selected from electoral rolls. Participants completed five self-administrated questionnaires: SF-36 and QLQC30, MFI-20 and ST Al, and a life conditions questionnaire. Five hundred forty two CRC cases and l, 181 controls were included. Globally, survivors QOL was comparable with that of controls, 15 years after diagnosis. Rectal cancer survivors were more affected in physical field and perceived more fatigue. In reintegration analyses, cancer survivors reported more positive changes than controls, as strengthening in marital relationships. However, survivors met more difficulties in loan and insurance requests. In term of QOL, this study demonstrated it was globally satisfactory in long term CRC survivors. In term of reintegration they reported positive changes and less negative changes in social and marital life, sign of an adaptation to cancer. However, they still met difficulties in professional and financial position. lt seems to be necessary to strength medical and psychosocial follow-up of CRC survivors.

Par sa fréquence et sa gravité, le cancer colorectal pose un problème majeur de santé publique en France et touche majoritairement les sujets âgés. Peu d’études évaluant la qualité de vie au diagnostic de ces patients et son impact sur leur survie ont été menées en population générale. Ce travail s'appuie sur une étude de population réalisée par le Registre Bourguignon des cancers digestifs portant sur les patients âgés de 65 ans ou plus et diagnostiqués entre 2003 et 2005 en Saône et Loire. Parmi les 401 patients éligibles, 246 ont renvoyé un questionnaire à au moins un des temps d'étude. Les non-répondeurs étaient plus âgés et diagnostiqués avec un stade tumoral plus avancé. La qualité de vie des patients s'améliorait avec le temps. Elle n'était pas modifiée par la présence de traitements adjuvants. La qualité de vie au diagnostic était un facteur pronostique indépendant de la survie des patients quand elle était évaluée par les patients eux-mêmes. La concordance entre le niveau de qualité de vie déclaré par les patients et l'appréciation de leur qualité de vie par le médecin traitant était moyenne à faible En conclusion, cette étude montre que chez les patients âgés, l'administration d'un traitement adjuvant n’entraîne pas d'altération de la qualité de vie à court et moyen terme, confirmant la nécessité de ne pas prendre uniquement en compte l'âge chronologique lors de la décision thérapeutique. Enfin, elle souligne l'importance de l'évaluation de la qualité de vie par le patient lui-même, y compris dans un contexte d'étude épidémiologique en population réalisée auprès de patients âgés dont il est parfois difficile d'obtenir la participation à une étude. / Colorectal cancer is one of the most common malignancies in France and predominantly affects older patients. Few studies evaluating baseline quality of life of those patients, its short term evolution and its prognosis value on patients' survival have been performed in the context of a population-based study. This work is based on a prospective longitudinal cohort study performed by the Burgundy Digestive Cancer Registry. All patients aged 65 and over, diagnosed with a new colorectal cancer and registered by the Registry between 2003 and 2005 were eligible. Among the 401 eligible patients, 246 fulfilled at least one questionnaire. Non-respondents were older and diagnosed with a more advanced cancer stage.Patients' quality of life improved with time. Quality of life was affected neither by the presence of adjuvant treatment, nor by the palliative or curative intent of cares. Quality of life was an independent prognosis factor of survival, only when assessed by patients themselves. The agreement between the levels of quality of life declared by patients and the level of quality of life estimated by patients' general practitioner was low. In conclusion, this study shows that quality of life is of major importance when evaluating elderly colorectal cancer patients' care. For those patients, adjuvant treatment did not seem to impact quality of life or its evolution with time, suggesting that chronological age should not determine candidacy for treatments. Lastly, it underlines the value of elderly patients' rating of their quality of life in the context of a population based study, even if getting this assessment is challenging.

Bakgrund: Sjuksköterskeyrket är ett legitimerat yrke, där det huvudsakliga ansvarsområdet är omvårdnad. Sjuksköterskan arbetar utifrån olika kompetenskrav och kärnkompetenser. Det är vanligt att sjuksköterskor säger upp sig, som kan ses som ett allmänt globalt problem. Många nyutexaminerade sjuksköterskor upplever ohälsa under sin första tid inom yrket, vilket även handledare och chefer har uppmärksammat. Syfte: Syftet var att beskriva nyutexaminerade sjuksköterskors erfarenheter inom yrket på sjukhus. Metod: En kvalitativ litteraturbaserad metod användes, med Fribergs (2017) analysmetod för att beskriva nyutexaminerade sjuksköterskors erfarenheter. Tolv artiklar som söktes fram i databasen CINAHL analyserades. Resultat: Tre teman: Närstående och arbetsplatsen hade en betydande roll, Känslan av otillräcklighet och Organisatoriska faktorer av betydelse, samt i sju subteman: Positivt stöd, Bristande stöd, Den psykisk ohälsan var överväldigande, Att inte känna sig beredd och finna balans, Från självkritik till självsäkerhet, Teamet och kollegor och De brister som påverkade NeS och patientsäkerheten. Konklusion: Resultatet visade att negativa erfarenheter var övervägande, såsom ohälsa, självkritik och bristande färdigheter. Positiva erfarenheter kom aldrig utav sig självt, stödet var avgörande från kollegor, teamet och organisationen. / Background: The nurse profession is a registered profession, where the main area of responsibility is nursing. Nurses work on the basis of competence requirements and core competencies. There are many nurses resigning their jobs, which can be seen as a global problem. Many newly graduated nurses experience illness during their first time period, which has also been recognized by supervisors and managers. Aim: The aimwas to describe newly graduated nurses experiences within the profession on hospitals. Method: A qualitative literature-based method was used, with Friberg's (2017)analysis method to describe newly graduated nurses experience. Twelve articles that were sought out in the database CINAHL were analyzed. Findings: Three themes: Relatives and the workplace had a significant role, A feeling of inadequacy and Organizational factors of importance, and in seven subthemes: Positive support, Deficient support, The psychological illness was overwhelming, To not feel prepared and finding balance, From self-criticism to self-confidence, The team and colleagues and The shortcomings the af ected NeS and patient safety. Conclusion: The result have shown that negative experiences were predominant, such as illness, self-criticism and lack of skills. Positive experiences never came by itself, the support was crucial from colleagues, the team and the organization.

Aim:  The present study aimed to determine if foreign-born women from different countries of birth have a greater risk of GDM compared to Swedish-born women and to what extent income might mediate this relationship. Methods: This cross-sectional type study included 835279 women, of which 151,642 were foreign-born and 683637 were Swedish-born women who gave birth to their first singleton child in Sweden between 1997 to 2016. Register data from the Swedish Medical Birth Register, the Swedish Total Population Register, and the Longitudinal Integrated Database for Health Insurance and Labour Market Studies was used. Multiple Logistic Regression analysis and the Karlson-Holm-Breen methods were used to explore the relationship between GDM and country of birth and to estimate the proportion of the association explained by income. Results:  Foreign-born women demonstrated higher odds ratios for developing GDM than Swedish-born women. South East Asian women showed the highest risk of GDM (OR: 4.40, CI: 4.01-4.81) followed by Africa (OR: 3.42, CI: 3.07-3.81) and Middle East &amp; North Africa (OR: 2.92, CI: 2.67-3.20) respectively. Income partially explained the risk of GDM differences between foreign-born and Swedish-born women, accounting for 26% of the association. However, the proportion explained by income varies from 8.9% to 23.0% by country of birth. Conclusions:  A disparity exists in the risk of GDM based on country of birth, and Foreign-born women are more likely to have GDM and need additional support, including prenatal care and treatment. Since income only partially explains this association, other factors that may explain the association need to be explored.

Teknik framställs som ett viktigt ämne i förskolans läroplan. Samtidigt utrycker många förskolelärare en brist på kunskap om att undervisa i tek-nikämnet. I studien ska jag ge ett exempel på en undervisningsaktivitet. Då studien genomförs inom ramen för designbaserad forskning bygger den på en aktivitet som jag har planerat och genomfört med några barn i förskolan. Syftet med studien var att ta reda på hur de yngre barnen kunde interagera med en dammsugare som ett tekniskt system. För att få reda på det användes en kvalitativ metod. Barnen videoinspelades och därefter observerade jag videoinspelningen och transkriberade den. Resultatet presenteras i olika teman med olika underrubriker i form av situationer som uppstod. Situation-erna analyserades och kopplades till tidigare forskning och teorier. I resultaten framkom att barnen visade förståelse för hur dammsugaren fungerade men att det var skillnad på om barnet var ett år eller tre år. En treåring kunde visa vad som krävdes för att dammsugaren skulle starta, förståelse för dess funktion och uppbyggnad. En ettåring visade mest förståelse för hur dammsugaren är uppbyggd och ser ut. Resultatet visade också att barnen utforskade genom sina kroppar och olika sinnen. Barnen visade att de upplevde med sin hörsel genom att hålla för sina öron, de fysiskt hoppade över dammsugaren, de provade även att dammsuga olika föremål. Barnen utforskade och prova nya sätt att använda dammsugaren på. / Technology is presented as an important subject in the preschool curriculum. Many preschool teachers lack knowledge of technology. In the study I give an example of a teaching activity. The study is an example of a design-based study, and it is based on an activity that I have planned and conducted with preschool children. The purpose of the study was to find out how the younger children interact with a vacuum cleaner as a technical system. To find it out I use a qualitative method. The children were video recorded as they engaged with the activity, and then I observed the videotape and transcribed it. The result was presented in different categories with subheadings of those situa-tions that happened. The situations were analysed and connected to earlier science and theories. The result showed that the children showed a lot of understanding for the vacuum cleaner, their understanding was different depending on if the child was one or three years old. A three year old showed how to start the vacuum cleaner, and an understanding for the function and the construction. A one year old showed most understanding for how the vacuum cleaner looks like and the construction. The result also showed that the children explored through their bodies and different senses. The children showed that they experienced through hearing by cover their ears. They jumped over the vacuum cleaner and tried to vacuum different objects. The children explore and try new ways to use the vacuum cleaner.

Résumé Les préoccupations et comportements alimentaires entourant le poids sont omniprésentes chez les jeunes adolescentes et femmes qui habitent dans les cultures occidentales où les formes corporelles sont orientées vers un idéal ultra-mince. L’objectif de cette étude est d’examiner si une plus grande exposition aux endroits faisant la promotion de la minceur est associée à des préoccupations pour le poids plus élevées chez les femmes. Cette étude fait partie d’un projet intitulé ¨Social, cultural, and economic disparities and disordered eating: Understanding the contribution of neighbourhood and individual level factors¨ (Gauvin, Steiger, & Brodeur, 2009). Un échantillon de 1288 femmes âgées entre 20 et 40 ans et résidant à Montréal depuis au moins 12 mois ont répondu à un sondage téléphonique. Des régressions logistiques ont comparé les femmes se situant dans le quintile le plus élevé des préoccupations de poids avec les femmes dans les autres quintiles en fonction de leur exposition 15 jours ou plus dans des endroits faisant la promotion de la minceur. De plus, une analyse de sensibilité a vérifié si l’association demeurait significative à d’autres niveaux d’exposition. Les facteurs confondants ont été contrôlés statistiquement. Les résultats démontrent qu’une fréquentation d’au moins 15 jours par mois d’endroits faisant la promotion de la minceur est associée à des préoccupations plus élevées pour le poids. Aussi, fréquenter ces lieux entre 15 et 20 jours/mois est aussi associé à des préoccupations de poids élevées. Des interventions de santé publique pourraient viser la diminution des pressions socioculturelles vers la minceur. / Abstract Weight and eating-related disorders and behaviours are common among adolescent girls and young women in Western societies, where thin bodies are highly valued. The goal of this study was to examine whether or not more frequent exposure to places promoting thinness is associated with greater weight concerns among women. This study was part of a larger investigation entitled ¨Social, cultural, and economic disparities and disordered eating: Understanding the contribution of neighbourhood and individual level factors¨ (Gauvin, Steiger, & Brodeur, 2009). A sample of 1288 women aged 20 to 40 years and living in Montreal for at least 12 months responded to a telephone survey. Logistic regression analyses were performed comparing women in the highest quintile of weight concerns to women in other quintiles on frequentations of thin-promoting places 15 days or more. Further, a sensitivity analysis was performed to verify whether or not an association exists between high weight concerns and different levels of exposure to places promoting socio-cultural standards for thinness. A series of confounding variables were statistically controlled. Results showed that exposure to places promoting socio-cultural standards for thinness at least 15 days per month was significantly associated with greater weight concerns among women despite controlling for confounding variables. Further, going to places promoting thinness between at least 15 through 20 days/month was also associated greater weight concerns among women. Public health interventions could aim at reducing societal pressures to thinness.

Introduction: In January 2005, a nationwide mandatory bicycle helmet law for children under the age of 15 was introduced in Sweden. In the current study, the effect of this law was evaluated by analyzing national trends in hospital admissions due to bicycle-related head injuries during the period 1998-2011. Methods: An interrupted time-series design with segmented regression analysis was used to evaluate the intervention effect on head injuries as a percentage of all injuries (%HI) among cyclists in age- and sex-specific groups. Effect was measured as a change in level and/or slope of the trend at the time of legislation. Results: A total of 35261 cyclists (0-54 years) were hospitalized due to a bicycle injury during the study period. Linear regression analyses of the entire study period (not segmented) showed significant year-to-year decreases in the %HI of 1.3-1.7% in all age and sex-specific groups (p &lt; .0001). Results from the segmented regression analysis showed that, at the time of legislation, a significant drop in level occurred among males under 15 years (-4.5% [95% CI: -7.7% to -1.3%], p = .01) and a significant change in slope occurred among females aged 30-54 years (-1.6% [95% CI: -2.9% to -0.2%], p = .025). Conclusions: The law seems to have had an effect on males in the target population (&lt;15 years). Although no significant changes were observed among females in this group as an immediate result of the law, the difference in %HI between genders was minimal at the end of the study period due to the steeper general decline among females. / Inledning: I Sverige infördes en cykelhjälmslag för barn under 15 år den första januari 2005. Syftet med denna studie var att studera effekten av denna lag genom att analysera nationella trender i andelen huvudskador bland svenska cyklister under tidsperioden 1998-2011. Metod: Segmenterad regressionsanalys applicerades på tidsseriedata (interrupted time-series design) för att utvärdera om ett trendbrott när det gäller andelen cykelrelaterade huvudskador sammanföll med lagens införande i olika köns- och åldersspecifika grupper. Effekt mättes som en skillnad i regressionslinjens riktning och nivå. Resultat: Inom åldersgruppen 0-54 år vårdades totalt 35261 cyklister under studieperioden. Linjära regressionsanalyser (ej segmenterade) visade att mellan 1998-2011 minskade andelen huvudskador årligen minskade med 1,3–1,7 % i samtliga studerade köns- och åldersspecifika grupper. Den segmenterade regressionsanalysen visade att samtidigt som cykelhjälmslagen infördes skedde en signifikant skillnad i regressionslinjens nivå bland pojkar under 15 år (-4,5 % [95 % CI: -7,7 % till -1,3 %], p = 0,01) och en signifikant skillnad i regressionslinjens riktning bland kvinnor i åldersgruppen 30-54 år (-1,6 % [95 % CI: -2,9 % till -0,2 %], p = 0,025). Slutsats: Den svenska cykelhjälmslagen verkar ha haft en betydande inverkan på trenden i cykelrelaterade huvudskador bland pojkar under 15 år. Även om något liknande fenomen inte framstod bland flickor i interventionsgruppen bör det noteras att skillnaden i andelen huvudskador mellan könen i slutet av studieperioden var minimal.