<p>Obesity is a major public health issue across all age groups. The obesity-related health outcomes of children and adolescents are unique and varied, and therefore need to be studied separately. In response, obesogenic environments have been the focus of attention in recent research. Important contributions have been made to focus on social (e.g., economic) and physical (e.g., geographical) environments based on their role in either hindering or facilitating opportunities for healthy eating. However, research on the policy environment is noticeably absent. Schools have been the setting for focused interventions, particularly in the area of obesity and nutrition. However, there is a paucity of research in this area in Ontario, and virtually no Canadian research has examined the secondary school setting. Therefore, this research focuses on local level factors shaping school nutrition policy implementation in Ontario, Canada.</p> <p>The Analysis Grid for Environments Linked to Obesity (ANGELO) Framework was adopted to organize and conceptualize the local level policy environment. In the first phase of the study, a documentary analysis was undertaken to investigate the relationship between regional and upper level policies and technical reports. Results reveal distinct differences across federal, provincial and regional levels, including: 1) the availability of nutritious food in schools and having nutrition education as part of the curriculum were key components of the physical environment across federal and provincial levels; 2) federal and provincial priorities are guided by a health promotion framework, and a partnership approach to policy implementation; and, 3) gaps in regional level policy include incorporating nutrition education in the curriculum, and making the link between nutrition and obesity.</p> <p>The second phase of study includes qualitative key informant interviews with community-and school-level school nutrition policy and program stakeholders (n=22) in nine schools three Ontario school boards, in order to understand local level factors shaping school nutrition policy implementation. The cost of healthy food for sale, revenue loss (economic), proximity of schools to off site food outlets (physical), the restrictive nature of policy, and the role of key stakeholders (political), the role of stigma and school culture (sociocultural), act as local level barriers to policy implementation. Findings suggest the need for consultation and communication between stakeholders, and strategies to reduce stigma and improve the school nutrition culture.</p> <p>In the third and final phase of study three focus group interviews were conducted with secondary students (n=20) in two Ontario school boards in fall 2012. School boards were selected to represent both high-and low-income neighbourhoods. Results reveal high priced policy-compliant food for sale, lower revenue generation capacity, and more students purchasing food off-campus at nearby outlets. Limited designated eating spaces, and time constraints act as local level barriers to healthy eating. Student input on cafeteria menus and school community gardens, can facilitate healthy school nutrition environments. Community partnerships with key external stakeholders are needed to leverage financial and human resources to support school nutrition. Future policies need to consider the social context and conditions surrounding school nutrition. This research makes a number of theoretical, methodological and substantive contributions to the public health, adolescent health, and school health policy literature. Policy implications and future research directions are provided.</p> / Doctor of Philosophy (PhD)

Esta pesquisa teve como objetivo realizar um diagnóstico das condições de saúde de população idosa de uma Comunidade Negra Remanescente de Quilombo (CNRQ) do município de Alcântara - MA, baseado no referencial teórico do modelo de Campo da Saúde, proposto por Lalonde (1974). Trata-se de uma pesquisa de campo, do tipo descritiva, exploratória e transversal, realizada com 27 idosos com idade entre 60 e 90 anos, residentes na comunidade quilombola Cajueiro I, Alcântara - MA. Após preparação do campo, a coleta de dados foi realizada em três etapas: elaboração e validação do roteiro para entrevistas, realização de entrevistas com os sujeitos e análise dos dados, que foram categorizados e organizados em planilhas, procedendo-se a cálculos estatísticos. Esta pesquisa teve aprovação do CEP da EERP/USP, bem como da Secretaria Municipal de Saúde de Alcântara - MA e das lideranças locais. Os resultados revelaram que a população de Cajueiro I é constituída por 225 indivíduos (52,5% do sexo masculino e 47,5% feminino), que constituem 66 famílias, com densidade domiciliar de 3,4 pessoas por família. Quanto aos dados relacionados à biologia humana, 96,3% dos sujeitos referiram possuir alguma doença, sendo informado HAS por 70,4% deles. Da história familiar de doenças, destaca-se a HAS como maior prevalência entre os familiares. Entre os entrevistados, 62,9% referiram uma condição de saúde \"ruim ou regular\" e 37% consideraram sua saúde como \"boa ou muito boa\". Em relação ao ambiente social e físico, a renda familiar referida por 81,5% foi de 1 a 3 salários mínimos; destacam-se a baixa escolaridade dos sujeitos (92,6%) e analfabetismo de 75% entre as mulheres. Foi relatado por 44,4% dos entrevistados consumo de água encanada, porém, sem nenhum tratamento, nem na captação nem para uso no domicílio, e prática inadequada dos resíduos sólidos (77,8% referiram queima dos resíduos). Quanto ao estilo de vida, 88,9% dos sujeitos referiram não praticar nenhuma atividade física, e possuir hábitos alimentares com predomínio de ingesta de carboidratos e baixa ingestão de frutas, legumes e verduras, e também de sal, açúcar e gorduras. Foi referido consumo ocasional de bebida alcóolica (37%) e tabagismo (7,4%); 51,9% dos sujeitos referiram estresse, atribuído em 92,86% das situações, a relações familiares. Conclui-se que as condições de saúde dessa população quilombola são afetadas pelos fatores de risco considerados no modelo de Campo da Saúde, sendo passíveis de intervenção dos serviços públicos, principalmente de saúde, no que diz respeito ao acesso e à organização dos serviços públicos, não apenas da saúde, mas também daqueles ligados ao saneamento da água, esgotos e resíduos sólidos, além de transporte. Considera-se de grande relevância uma ação efetiva para o planejamento e execução de políticas que venham favorecer a promoção da saúde da comunidade estudada e de outras semelhantes / This research aimed to realize a diagnosis of the health conditions of the elderly population in Remaining Black Community Quilombo (RBCQ) of the town of Alcântara of the State of Maranhão, Brazil, based on the theoretical reference of the model of Field of Health proposed by Lalonde (1974). This is a field research, descriptive, exploratory, cross-sectional, conducted with 27 elderly individuals aged between 60 and 90 years, residents in quilombola community Cajueiro I of Alcântara - Maranhão. After preparation of the field for research, data collection was conducted in three stages: development and validation of the screenplay for interviews, conducting interviews with the subjects and data analysis, were categorized and organized in spreadsheets, then proceeding to the calculations of statistical. This research was approved by the Research Ethics Committee of the Nursing College of Ribeirão Preto, University of São Paulo as well as the Municipal Health Department of Alcântara - Maranhão and the local leaders. The results revealed that the population of Cajueiro I is composed of 225 individuals (52.5% male and 47.5% female), that constitute 66 families with household density of 3.4 persons per family. Regarding to human biology data, 96.3% of subjects reported having any disease, the hypertension being reported by 70.4% of them. Of the family history of disease stands out the hypertension as higher prevalence in relatives. Among the interviewees, 62.9% reported \"fair or poor health\" and 37% considered their health as \"good or very good\". Regarding the social and physical environment, family income was reported by 81.5% of 1 to 3 minimum salaries; highlight the low education of the subjects (92.6%) and 75% illiteracy among women. Was reported by 44.4% of the respondents consumption of piped water; however, no treatment in the uptake or for home use, and inadequate practice of solid waste (77.8% reported burning of waste). As for lifestyle, 88.9% of subjects reported not practice any physical activity and possess dietary habits with predominant ingestion of carbohydrates and low intake of fruits and vegetables and also salt, sugar and fats. Was reported occasional consumption of alcoholic beverages (37%) and smoking (7.4%); 51.9% of the subjects reported stress attributed in 92.9% of the cases the family relations. It is concluded that the health conditions of this population quilombola are affected by risk factors considered in the model Field of Health, being amenable to intervention of public services, especially health, regarding to access and organization of public services, not just health, but also those related to water sanitation, sewage and solid waste and transportation. It is considered of great relevance for effective action for planning and implementing policies that will encourage health promotion of the community studied and the like

Submitted by Maria Aparecida (cidazen@gmail.com) on 2017-04-17T14:40:28Z No. of bitstreams: 1 Artur Serra Neto.pdf: 1623382 bytes, checksum: 3e4d7be8002e1effda972266671ac31c (MD5) / Made available in DSpace on 2017-04-17T14:40:28Z (GMT). No. of bitstreams: 1 Artur Serra Neto.pdf: 1623382 bytes, checksum: 3e4d7be8002e1effda972266671ac31c (MD5) Previous issue date: 2017-03-20 / Introduction: Attention Integrated Subsystem Health of the Federal Civil Servants (SIASS) was created to support the Care Policy Health Care Server. Has aimed to coordinate and integrate actions and programs in the health care areas, official expertise, promotion, prevention and health monitoring of servers of the federal administration. From the perception as an expert medical SIASS-UFMA Unit, the following question arose: What are the conditions that generate more departures on the servers? Is there a relationship with your desktop? Objective: To describe the epidemiological profile of the main pathologies that affect civil servants attended at the medical expertise of industry and correlate them with their work environment. Methodology: From reports obtained from the electronic medical record, SIAPE HEALTH, in the years 2011, 2012 and 2013 was made a descriptive analysis and later, to make the association of categorical variables with the years collection was performed nonparametric chi -square of independence (χ2). Results: The sick servants are mostly women, in the age group of 31 to 40 years (p <0.0001), who work in the University Hospital exercising the function of nursing professionals and suffering from musculoskeletal disorders and mental disorders. Doctors, the secondlargest in the hospital, are away for a few days from musculoskeletal and gastrointestinal diseases. Road policemen working in an often dangerous environment are also affected by mental and musculoskeletal disorders. It was evident that the work environment of the University Hospital needs a more detailed analysis and a better interaction with the three axes of this policy. Conclusion: It is not only the physical environment that brings problems, but all the psycho-emotional involvement of their working relationships. Not being able to consider these diseases as occupational, but in many of them there is a relation with the work environment. It is concluded that this information can help the managers of the institution in the formulation of preventive measures so as to avoid further sick leave and promote a healthier environment. / Introdução: O Subsistema Integrado de Atenção à Saúde do Servidor Público Federal (SIASS) foi criado para subsidiar a Política de Atenção à Saúde do Servidor. Possui como objetivo coordenar e integrar ações e programas nas áreas de assistência à saúde, perícia oficial, promoção, prevenção e acompanhamento da saúde dos servidores da administração federal. A partir da percepção como médico perito da Unidade SIASS-UFMA, surgiu o seguinte questionamento: Quais as patologias que mais geram afastamentos nos servidores? Existe alguma relação com seu ambiente de trabalho? Objetivos: Traçar um perfil epidemiológico das principais patologias que acometem os servidores públicos atendidos no setor de perícia médica e correlacioná-las com seu o ambiente de trabalho. Metodologia: A partir de relatórios obtidos no prontuário eletrônico, SIAPE SAUDE, nos anos de 2011, 2012 e 2013 foi feito uma análise estatística descritiva e posteriormente, para se fazer a associação das variáveis classificatórias com os anos de coleta foi realizado o teste não paramétrico de qui-quadrado de independência (χ2). Resultados: Os servidores adoecidos são em sua maioria mulheres, na faixa etária de 31 a 40 anos (p<0,0001), que trabalham no Hospital Universitário exercendo a função de profissionais da enfermagem e que sofrem de doenças osteomusculares e transtornos mentais. Os médicos, segunda maior categoria dentro do hospital, se afastam por poucos dias por doenças osteomusculares e gastrointestinais. Policiais rodoviários que trabalham em ambiente muitas vezes perigoso são acometidos igualmente de transtornos mentais e osteomusculares. Ficou evidente que o ambiente de trabalho do Hospital Universitário precisa de uma análise mais detalhada e uma melhor interação com os três eixos desta política. Conclusão: Não é só o ambiente físico que traz problemas, mas todo envolvimento psico-emocional das suas relações de trabalho. Não podendo considerar essas doenças como ocupacionais, mas em muitas delas há uma relação com o ambiente laboral. Conclui-se que estas informações possam auxiliar os gestores da instituição na formulação de medidas preventivas para que se evitem mais afastamentos por motivo de doença e se promova um ambiente mais salutar.

The municipal district of Ametista do Sul, located in the north of the state of Rio Grande do Sul is eminent in the production of amethysts which occur in geodos in the interior of spills of basalt of Formação Serra Geral. The extraction of amethyst is made in large horizontal profundities in underground galleries. The process of plow involves tasks such as the perforation of the rock which is made in a dry way and the use of explosives, both of them create mineral dust with silica (SiO2) which remains in suspension a lot of time inside the gallery, causing the inhalation and the risk of developing lung diseases, among them the silicosis, a incidence of silicosis in prospectors of Ametista do Sul. In order to do that, it was carried out a survey in medical report, home visits to the prospectors that were out of work. Relevant information was selected in the medical reports, such as age, occupation time, smoker or non-smoker, diagnosis of the illness, incident symptoms and clinical exams carried out. The results found in the medical reports showed that 44% have silicosis and 56% do not have the diagnosis of the disease but present the symptoms of it. During the home visits, it was found 23 prospectors away from work due to the high evolution of silicosis. In the interviews with the prospectors, the results showed that 78% do not have silicosis, 11% have the disease and 11% do not know whether they have the disease because they have not done the exam for the diagnosis, or those who did the exam have not gotten the medical diagnosis yet. In this context, it was checked that it is necessary changes in the technique of work especially in the perforation method through the use of water as well as improvements in the process of ventilation that is insufficient; in addition to better inspection and control in the use of toxic components of explosives which also affect the respiratory ways of the prospectors. / O município de Ametista do Sul, localizado ao norte do estado do Rio Grande do Sul é destaque na produção de ametistas que ocorrem em geodos no interior de derrames de basalto da Formação Serra Geral. A extração de ametista é realizada em grandes profundidades horizontais em galerias subterrâneas. O processo de lavra envolve tarefas como a perfuração da rocha que é feita a seco e a utilização de explosivos, sendo que ambas geram poeira mineral com sílica (SiO2) que permanece em suspensão durante muito tempo no interior da galeria, propiciando a inalação e o risco de desenvolver doenças pulmonares, entre elas a silicose, uma doença crônica e incurável. Assim, esta pesquisa, teve como objetivo verificar a incidência de silicose em garimpeiros de Ametista do Sul. Para isso, foi realizado um levantamento de dados em prontuários médicos, visitas domiciliares aos garimpeiros afastados do trabalho devido à silicose e entrevistas. Nos prontuários médicos foram selecionadas informações relevantes como idade, tempo de trabalho na profissão, tabagista ou não, diagnóstico de doença, sintomas incidentes e exames clínicos realizados. Os resultados encontrados nos prontuários médicos mostraram que 44% tem silicose e 56% não tem o diagnóstico da doença mas apresentam os sintomas da mesma. Nas visitas domiciliares, foram encontrados 23 garimpeiros afastados do trabalho devido elevado grau de evolução de silicose. Nas entrevistas com os garimpeiros, os resultados mostraram que 78% não tem silicose, 11% tem a doença e 11% não sabem se possuem a doença, por não terem realizado exame para diagnóstico e ou os que fizeram o exame ainda não tinham o diagnóstico do médico. Nesse contexto, verificou-se que é necessário mudanças nas técnicas de trabalho principalmente no método de perfuração através da utilização de água e no processo de ventilação que é insuficiente nos garimpos além de maior fiscalização e controle no uso de componentes tóxicos dos explosivos que também afetam as vias respiratórias dos garimpeiros.

This presented diploma thesis deals with evaluation of the traffic noise influence on the health of the exposed population. The objectives of this thesis are based on the results of Environmental Health System in the Czech Republic (Subsystem III), which provides the long-term monitoring of the noise in the municipal environment of the chosen agglomerations. A part of the noisy location monitoring is also the questionnaire survey confirming hypothesis n.1: "At the traffic noise perceiving, there is an important psychosocial bound, which often stands in opposition to the results of the noise measurements". Furthermore, the thesis describes the results of the indicative measurement of the chosen noisy localities in comparison with same locality measurements in the technical accuracy class. The indicative gauge tests were made on the traffic-busy roads in Jihlava city. The measurement has proved the link between the intensity of the traffic flow and indicatively determined noise levels and practical applicability for the local planning or local controlling incentives solution. The results of the indicative measurements point out to breaking of the equivalent night noise levels for sleep disturbance in three chosen localities. Breaking of the equivalent day noise levels has a nature of the noise annoyance. The measured road-traffic-caused night and day noise levels may be compared to the recommendations for the risks of increased incidence of selected civilization diseases published by the World Health Organisation.

Esta pesquisa teve como objetivo realizar um diagnóstico das condições de saúde de população idosa de uma Comunidade Negra Remanescente de Quilombo (CNRQ) do município de Alcântara - MA, baseado no referencial teórico do modelo de Campo da Saúde, proposto por Lalonde (1974). Trata-se de uma pesquisa de campo, do tipo descritiva, exploratória e transversal, realizada com 27 idosos com idade entre 60 e 90 anos, residentes na comunidade quilombola Cajueiro I, Alcântara - MA. Após preparação do campo, a coleta de dados foi realizada em três etapas: elaboração e validação do roteiro para entrevistas, realização de entrevistas com os sujeitos e análise dos dados, que foram categorizados e organizados em planilhas, procedendo-se a cálculos estatísticos. Esta pesquisa teve aprovação do CEP da EERP/USP, bem como da Secretaria Municipal de Saúde de Alcântara - MA e das lideranças locais. Os resultados revelaram que a população de Cajueiro I é constituída por 225 indivíduos (52,5% do sexo masculino e 47,5% feminino), que constituem 66 famílias, com densidade domiciliar de 3,4 pessoas por família. Quanto aos dados relacionados à biologia humana, 96,3% dos sujeitos referiram possuir alguma doença, sendo informado HAS por 70,4% deles. Da história familiar de doenças, destaca-se a HAS como maior prevalência entre os familiares. Entre os entrevistados, 62,9% referiram uma condição de saúde \"ruim ou regular\" e 37% consideraram sua saúde como \"boa ou muito boa\". Em relação ao ambiente social e físico, a renda familiar referida por 81,5% foi de 1 a 3 salários mínimos; destacam-se a baixa escolaridade dos sujeitos (92,6%) e analfabetismo de 75% entre as mulheres. Foi relatado por 44,4% dos entrevistados consumo de água encanada, porém, sem nenhum tratamento, nem na captação nem para uso no domicílio, e prática inadequada dos resíduos sólidos (77,8% referiram queima dos resíduos). Quanto ao estilo de vida, 88,9% dos sujeitos referiram não praticar nenhuma atividade física, e possuir hábitos alimentares com predomínio de ingesta de carboidratos e baixa ingestão de frutas, legumes e verduras, e também de sal, açúcar e gorduras. Foi referido consumo ocasional de bebida alcóolica (37%) e tabagismo (7,4%); 51,9% dos sujeitos referiram estresse, atribuído em 92,86% das situações, a relações familiares. Conclui-se que as condições de saúde dessa população quilombola são afetadas pelos fatores de risco considerados no modelo de Campo da Saúde, sendo passíveis de intervenção dos serviços públicos, principalmente de saúde, no que diz respeito ao acesso e à organização dos serviços públicos, não apenas da saúde, mas também daqueles ligados ao saneamento da água, esgotos e resíduos sólidos, além de transporte. Considera-se de grande relevância uma ação efetiva para o planejamento e execução de políticas que venham favorecer a promoção da saúde da comunidade estudada e de outras semelhantes / This research aimed to realize a diagnosis of the health conditions of the elderly population in Remaining Black Community Quilombo (RBCQ) of the town of Alcântara of the State of Maranhão, Brazil, based on the theoretical reference of the model of Field of Health proposed by Lalonde (1974). This is a field research, descriptive, exploratory, cross-sectional, conducted with 27 elderly individuals aged between 60 and 90 years, residents in quilombola community Cajueiro I of Alcântara - Maranhão. After preparation of the field for research, data collection was conducted in three stages: development and validation of the screenplay for interviews, conducting interviews with the subjects and data analysis, were categorized and organized in spreadsheets, then proceeding to the calculations of statistical. This research was approved by the Research Ethics Committee of the Nursing College of Ribeirão Preto, University of São Paulo as well as the Municipal Health Department of Alcântara - Maranhão and the local leaders. The results revealed that the population of Cajueiro I is composed of 225 individuals (52.5% male and 47.5% female), that constitute 66 families with household density of 3.4 persons per family. Regarding to human biology data, 96.3% of subjects reported having any disease, the hypertension being reported by 70.4% of them. Of the family history of disease stands out the hypertension as higher prevalence in relatives. Among the interviewees, 62.9% reported \"fair or poor health\" and 37% considered their health as \"good or very good\". Regarding the social and physical environment, family income was reported by 81.5% of 1 to 3 minimum salaries; highlight the low education of the subjects (92.6%) and 75% illiteracy among women. Was reported by 44.4% of the respondents consumption of piped water; however, no treatment in the uptake or for home use, and inadequate practice of solid waste (77.8% reported burning of waste). As for lifestyle, 88.9% of subjects reported not practice any physical activity and possess dietary habits with predominant ingestion of carbohydrates and low intake of fruits and vegetables and also salt, sugar and fats. Was reported occasional consumption of alcoholic beverages (37%) and smoking (7.4%); 51.9% of the subjects reported stress attributed in 92.9% of the cases the family relations. It is concluded that the health conditions of this population quilombola are affected by risk factors considered in the model Field of Health, being amenable to intervention of public services, especially health, regarding to access and organization of public services, not just health, but also those related to water sanitation, sewage and solid waste and transportation. It is considered of great relevance for effective action for planning and implementing policies that will encourage health promotion of the community studied and the like

The theme of the thesis is to propose urban efficient comfortable living in a quiet natural environment between the original settlement of Líšeň and the panel housing estate from the 1980s. The design of the new residential complex will be in line with the current trends and needs of healthy living. The land lot which the buildings will be constructed on has a trapezoidal shape with a longer side in the west-east direction, narrowing and sloping towards the east. The elevation is about 22 m to 330 m of the length of the land lot. An important feature of Líšeň is the "chapel" (Chapel of Virgin Mary the Helpful) on the opposite eastern hill. The aim of the urban study was to create a smooth transition between the old part of Líšeň (so called "Stará Líšeň") and the new part of Líšeň (so called "Nová Líšeň”), with an emphasis on environmental and social aspects. The territory is divided by compositional and a viewing axes, which are meeting in the social space, formed by the social center with a dominant open space and covered facilities in an adjacent building located in its highest western part. In front of this building, there is a small square followed by the central area with a residence lawn, a public grill and a playground for children. This part finishes in the east with a new water surface in the form of a bathing biotope, which is bridged by two footbridges following the compositional axes. The west side of the stairs between the footbridges continues in a landing stage. Selected combination of low-floor apartment houses and low-floor family houses elevates in height and volume from the eastern and southern boundaries of the territory towards its northwest corner. Along the western border of Novolíšeňská street, a barrier house is designed and it performs also a function of an optical dividing line from the existing panel houses. Emphasis was also put on the minimum of traffic areas. The main routes are designed as one-way roads so as to simplify the orientation in the area. Parking areas are preferably designed as covered and subterranean parking. The main priorities were the greatest extend of greenery (in the form of growing plants and green roofs) on the one hand, and the utmost preservation of a non-built-up area. The result of this study is a low-rise housing in the greenery area with the open views from the buildings to their surroundings, a generous amount of sunshine in living rooms, and an extensive social life for its inhabitants and for inhabitants of surrounded areas. Energetic efficiency was also taken into account while designing the houses. Objects are designed as simple block-shaped blocks with a rectangular or square ground plan. Residential buildings usually have a common or conjoined underground floor. The object of the barrier house has a linear character and roughly copies the western border of the territory. Its parterre is regularly interrupted in four places by passages which serve as a connection with the Novolíšeňská service road. Wood and stone were chosen as materials because of their natural character. Family houses at the southern border are terraced (in groups of 2 x 4 and 1 x 5) and intended as passive houses. Separate family houses around the water area are accessible only by foot, as no car-traffic around the water surface is allowed (however, the arrival of vehicles is possible on a walkway with a width of 3.0 m). These houses are considered as low-energy houses.

The diploma thesis deals with the proposal of optimal functional and spatial use of the area for environmentally friendly tourism in Strachotín. The location is characterized by suitable natural conditions and land for quality vineyard management. That is why I propose a winery, a cider, a distillery, accommodation with a restaurant and a wellness area in the area. I elaborate the winery object and related accommodation in more detail. The most important object is the operation of the winery. The building dominates and interacts with the adjacent accommodation and restaurant building. Parts of the facade are designed as openwork ventilated facades that create the architectural character of the buildings.

Urban and architectural study of environmentally friendly tourist area Strachotín The urban and architectural concept will take into consideration the landscape characteristics with view to the economic, social and environmental aspects.

No description available.