Thesis (M.D.S.)--University of Hong Kong, 1988. / Also available in print.

This study focuses on how diabetic patients manage to handle their disease,what has facilitated and what has impaired that process. The approach was to use a qualitative method as to enable the researcher to fathom the patients' point of view and to highlight their own experiences.Thus, the study is observational, describing processes, and does not aspire to give verification of the processes described. The study is based on interviews with 48 insulin dependent diabetic patients including newly diagnosed patients, patients who were regarded as well adapted with long duration of the disease but with no complications, and patients who had developed vascular complications. They were chosen in that way as to give a broad range of experiences representing different faces of the illness. It was found that the self-management of diabetes is an intricate matter, embodying categories that could be expressed as; Walking a fine line, Managing oneself physically, Managing oneself emotionally, Mastering life, Evading the problem of managing and Managing the health care system. Walking a fine line elucidates much of the behavioural variation in the data. It captures the patient's need to balance his emotional and physiological state, as well as his interactions with the health care system. Patients who manage the balancing act may enjoy good health but they are walking a fine line between maintaining this state and falling below par. It seemed that the ideal situation of interaction between the health care system and the patient was not applied in the context of the diabetic patients' everyday life. Patients had to invest considerable effort to cope, not just with their own condition, which is complex enough, but with the system officially charged to help them. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1990, härtill 5 uppsatser.</p> / digitalisering@umu

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 47-01, page: . Adviser: John Herbold. Includes bibliographical references.

Thesis--Universidad de Sevilla. / "Apéndice demografico": p. 134-180. Includes bibliographical references (p. 132-134).

Submitted by Rafael Santana (rafael.silvasantana@ufpe.br) on 2017-05-12T19:50:28Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERT SIMONE RODRIGUES.pdf: 840511 bytes, checksum: a445aa96244c86b1afbc75027547e96a (MD5) / Made available in DSpace on 2017-05-12T19:50:28Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERT SIMONE RODRIGUES.pdf: 840511 bytes, checksum: a445aa96244c86b1afbc75027547e96a (MD5) Previous issue date: 2016-04-20 / CAPES / As doenças bucais constituem uns dos grandes problemas de saúde pública mundial. Das repercussões que as doenças bucais, sabidamente reconhecidas, causam nos indivíduos sem envolvimento sistêmico, estas podem e são bem maiores quando nos referimos aos pacientes portadores de outras doenças crônicas. O objetivo dessa dissertação foi avaliar os fatores associados ao impacto nas atividades diárias relacionadas à saúde bucal de adolescentes cardiopatas. Trata-se de um estudo observacional, do tipo série de casos, realizado no Complexo Hospitalar do Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), localizado em Recife – PE, no período de março/setembro de 2015. Foram elegíveis 83 adolescentes, de ambos os sexos, com idade entre 15 e 19 anos que estavam em atendimento ambulatorial na Cardiologia Pediátrica do IMIP no período da coleta de dados. Avaliaram-se características sócio demográficas, psicossociais, comportamentais, acesso aos serviços odontológicos, clínicas (cárie dentária e presença de placa bacteriana visível) e o impacto da saúde bucal nas atividades diárias através do instrumento Oral Impact on Daily Performances (OIDP). Os dados foram analisados através do programa SPSS versão 13.0. Os resultados estão apresentados com suas respectivas frequências absolutas e relativas. Para a análise estatística do OIDP, os escores produzidos foram dicotomizados, de modo a criar uma variável binária: ≥ 1 resposta positiva = com impacto negativo; 0 resposta positiva = sem impacto negativo. Com o propósito de identificar possíveis fatores associados (sócio demográficos, psicossociais, comportamentais, acesso aos serviços odontológicos e frequência de cárie dental e/ou presença de placa bacteriana visível) ao impacto negativo nas atividades diárias foi utilizado o Teste Exato de Fisher. Consideradas significantes as variáveis que obtiverem um valor p < 0,05. A frequência de adolescentes cardiopatas com pelo menos um impacto negativo na saúde bucal afetando seu desempenho diário nos últimos 6 meses foi de 89,2%. A análise dos possíveis fatores associados constatou que reprovação escolar (p = 0,024) e motivo da última consulta ao dentista (p = 0,007) demonstraram associação significativa com o impacto negativo nas atividades diárias relacionada a saúde bucal. Adolescentes mais vulneráveis que frequentam serviços odontológicos quando possuem dor apresentam mais impacto negativo na qualidade de vida relacionada a saúde bucal. / known recognized cause in individuals without systemic involvement, these can and are much higher when we refer to patients with other chronic diseases. The purpose of this thesis was to evaluate the factors associated with the impact on daily activities related to oral health of adolescents with heart disease. This is an observational study, the number of cases of type held in the Hospital Complex of Integrative Medicine Institute Prof. Fernando Figueira (IMIP), located in Recife - PE in the period March / September 2015. 83 adolescents were eligible, of both sexes, aged between 15 and 19 years who were in outpatient care in Cardiology IMIP Pediatric the period of data collection. They evaluated sociodemographic characteristics, psychosocial, behavioral, access to dental, medical services (dental caries and the presence of visible plaque) and the impact of oral health on daily activities through the instrument Oral Impact on Daily Performances (OIDP). Data were analyzed using SPSS version 13.0. The results are shown with their absolute and relative frequencies. For statistical analysis OIDP the produced scores were dichotomized, to create a binary variable: ≥ 1 = positive response with a negative impact; 0 Positive response = no negative impact. In order to identify possible associated factors (demographic social, psychosocial, behavioral, access to dental care and frequency of dental caries and / or presence of visible plaque) to the negative impact on daily activities was used Fisher's exact test. Considered significant variables that obtain a p-value <0.05. The frequency of cardiac adolescents with at least a negative impact on oral health affects their daily performance in the last 6 months was 89.2%. The analysis of possible factors associated found that school failure (p = 0.024) and reason for the last visit to the dentist (p = 0.007) showed a significant association with the negative impact on daily activities related to oral health. Most vulnerable adolescents attending dental services when they have pain have more negative impact on quality of life related to oral health.

Made available in DSpace on 2017-07-10T19:07:24Z (GMT). No. of bitstreams: 1 Dissertacao Teresa Cristina Duarte2.pdf: 1829449 bytes, checksum: 419957adc9e2fc6e56bc77a39c2d786b (MD5) Previous issue date: 2014-02-20 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The biomedical model institutionally assumed in Healthcare today has been unable to achieve comprehensiveness regarding individual care. The conflict this sector is facing has required a deeper understanding of the human being, whos meaning is found in the context. Among the many challenges facing health professionals embedded in a context of borders, there is the understanding of aspects involving cultural differences and social representations, which motivated the proposition of this very research. In order to investigate how health professionals in the plurilcultural border scenario build their discursive practices, representations of health and desease, three research questions were developed: a) How the (re) meaning of the concept of health and disease and the role of interdisciplinarity in the current context representations of health and desease, three research questions were developed has been made? b) How the representations of cultural differences influence their professional practice? c) What representations are formed by health professionals on health and disease? To answer these questions a qualitative / interpretive methodological approach was followed. The generation of data for the analysis was conducted through audio-recorded semi-structured interviews with 10 participants. A field diary was also used. As categories emerged from the formulated representations regarding cultural differences and their influences in professional practices we have: cultural plural due to differences present in all relationships, the presence of practices flexibility adopted by health professionals facing the individual‟s cultural needs and the paradox between recognizing the importance of culture and the lack of it‟s effective application, indicated primarily by the biomedical model of health. The representations of health and desease by health professionals allowed to observe the acceptance of this concept as a dynamic process that is individually established with an overview divided into three categories: the relation with well-being; the dynamic process; the individual perceptions. Through the analysis it was evident that contact with people from other cultures leads to changes which, in most cases, were positive in the sense that the professional has become more open, flexible and attentive to the other, a factor that contributes to health and disease representation to be conditioned by external factors and determined by the individual. / O modelo biomédico institucionalmente assumido na Saúde, hoje, tem se apresentado incapaz de alcançar a integralidade no atendimento ao sujeito. O conflito pelo qual esse setor tem passado revela que o trabalho nesta área tem exigido conhecimentos mais profundos do ser humano, que encontra sentido no contexto. Entre os muitos desafios colocados aos profissionais da área da Saúde, inseridos em um contexto de fronteiras, há o de compreender aspectos que envolvem as diferenças culturais e suas representações sociais, o que motivou a proposição da presente pesquisa. Com o objetivo de investigar como os profissionais da Saúde no cenário pluricultural de fronteira constroem, em suas práticas discursivas, representações sobre saúde-doença, foram elaboradas três perguntas de pesquisa: a) Como foi sendo (re)significado o conceito de saúde e doença e qual o papel da interdisciplinaridade no contexto atual?; b) Como as representações sobre diferenças culturais influenciam em suas práticas profissionais? e c) Quais representações são construídas pelos profissionais da Saúde sobre a saúde e a doença? Para responder às perguntas, foi seguida a abordagem metodológica qualitativa/interpretativista. A geração de dados para a análise foi realizada por meio de entrevistas semiestruturadas realizadas com dez participantes, gravadas em áudio. Também foi utilizado diário de campo. Surgiram como categorias das representações formuladas sobre as diferenças culturais e a influência delas nas práticas profissionais: as culturas plurais que apareceram devido às diferenças presentes em todas as relações, a presença da flexibilidade das práticas adotadas pelos profissionais da Saúde diante da necessidade cultural do indivíduo e o paradoxo entre reconhecer a importância da cultura e a falta de aplicação prática, apontados principalmente pelo modelo biomédico vigente de Saúde. As representações de saúde e de doença pelos profissionais da Saúde permitiram observar a aceitação deste conceito como sendo um processo dinâmico que se estabelece individualmente, ideia geral dividida em três categorias: a relação com o bem-estar; o processo dinâmico; as percepções individuais. Ficou evidente, pelas análises, que o contato com pessoas de outras culturas provoca mudanças, que, em sua maioria, mostraram-se positivas no sentido de que o profissional apresenta-se mais aberto, flexível e atento ao outro, fator que contribui para representar que saúde e doença são condicionadas por fatores externos e determinadas pelo indivíduo.

Although the association between social inequality and poor adult health is well established, the mechanisms by which inequality is translated into poor adult health are less clear. Increasingly, evidence suggests that many adult health problems and health disparities have their origins in early life; the developmental origins of health and disease (DOHaD) hypothesis provides an explanatory mechanism linking adverse early life conditions with permanent structural or functional changes that increase the risk for disease. This hypothesis is consistent with bioarchaeological research noting reduced lifespan among individuals exhibiting signs of childhood stress. The principal aim of this dissertation is to contribute a bioarchaeological perspective to health disparities research by investigating how health disparities can be measured and understood in the past. This study focuses on early life conditions as a source of adult health disparity by examining a skeletal sample for the association between childhood stress and adult longevity; the relationship between childhood stress and the presence of adult health conditions; and sex, ancestry, and regional differences in these relationships. The study sampled 830 age-documented, U.S. born African American males and females and Euro-American males from the Terry and the Hamann-Todd anatomical collections, representing socially-marginalized individuals from the late 19th- to early 20th centuries. Enamel hypoplasia, femoral length, and vertebral neural canal diameters represented childhood stress; skeletal fractures, tibial periostosis, and the diseased, missing, and filled tooth index represented adult health. Longevity was modeled with Kaplan-Meier survival curves and adult health relationships were modeled with logistic regression. Additionally, cause of death data from historic health department publications and the study sample morgue records were examined for disparity in the epidemiological transition from infectious to degenerative cause of death. The study found mixed results for all analyses. There was no reduction in longevity for the presence of enamel hypoplasia, short femoral length, or reduced thoracic neural canal diameter. African American males had statistically significant reduced longevity for small lumbar vertebral neural canal diameters. African American males from the Hamann-Todd Collection and Euro-American males from both collections had significant relationships between vertebral neural canal diameters and adult conditions; these relationships varied among the groups but in most cases demonstrated reduced odds for having the adult condition for individuals with smaller canal diameters. African American females had no differential survival or relationships between variables over the lifecourse. All groups except for the Terry Collection Euro-American males continued to have more infectious disease deaths than degenerative disease deaths. The study results contribute to disparities research by demonstrating that the consequences of childhood stress varied by sex and ancestry and by demonstrating within-population variation in timing of the epidemiological transition. Additionally, the study results support the contention of greater male sensitivity to environmental conditions and contributes evidence supporting the DOHaD hypothesis.

Objectives: To investigate the preventive potential of the Developmental Origins of Health and Disease (DOHaD) hypothesis as it pertains to emotion dysregulation and psychopathology by: i) elucidating the impact of modifiable perinatal risk factors, and ii) examining whether a postnatal intervention can improve infant emotion regulation. Methods: Studies 1 and 2 used data from the Canadian Healthy Infant Longitudinal Development (CHILD) cohort and the Maternal-Infant Research on Environmental Chemicals (MIREC) cohort to examine if modifiable perinatal risk factors (including prenatal diet quality) confounded the link between prenatal metabolic complications and offspring psychopathology. Study 3 used MIREC data to examine if prenatal diet quality was linked to a biomarker of emotion regulation in infants (autonomic nervous system (ANS) function). Studies 4 and 5 used data from 40 infants of mothers diagnosed with postpartum depression (PPD) and 40 healthy control infants matched on infant age sex and socioeconomic status. These studies examined if infant emotion regulation (Study 4) and mother-infant physiological synchrony (a marker of dyadic emotion regulation-Study 5) improved following maternal cognitive behavioral therapy (CBT) for PPD. Results: In Studies 1 and 2, prenatal diet quality accounted for significant variance in the links between prenatal metabolic complications and offspring psychopathology. In Study 3, poor prenatal diet quality was associated with adverse ANS development in offspring. In Studies 4 and 5, infants exhibited more adaptive emotion regulation and mother-infant synchrony improved following maternal receipt of CBT for PPD. v Conclusions: Elucidating the impact of modifiable perinatal risk factors on offspring psychopathology provides meaningful targets for intervention, and postnatal interventions may improve offspring emotion regulation and could reduce the risk of psychopathology. This work highlights the importance of the perinatal period as a time during which modifiable risk factors can be identified and intervened upon to reduce mental disorder risk across the lifespan. / Dissertation / Doctor of Philosophy (PhD) / Healthy brain development is important for health and success in life. However, risk factors such as the mother’s poor physical and mental health during pregnancy and in the first postnatal year can increase the risk of emotion and behaviour problems in offspring. Therefore, the objectives of this thesis were to i) identify links between modifiable pre and postnatal risk factors and poorer offspring brain development and ii) determine if intervening on one of these risk factors might improve offspring brain development. Results from this thesis show that an unhealthy maternal diet in pregnancy was linked to more offspring emotion, behaviour, and brain development problems and that treating postpartum depression in mothers may improve offspring brain development. This work suggests that identifying and intervening on modifiable risk factors is important to improve early brain development and may prevent the development of mental disorders later in life.

(English) Smoking is the leading cause of premature mortality and morbidity globally (WHO, 2018). Within the Czech Republic (CR) tobacco consumption ranks among the highest in the world, and tobacco control measures rank among the poorest globally (Joossens and Raw, 2014; American Cancer Society, 2018). Smoking related chronic diseases and the loss of active part of life are an enormous and growing burden on the Czech system. There is urgency to invest in efforts that will control and decrease the demand for tobacco products (OECD, 2017). Experiences and lessons learned in tobacco control (TC) by other countries, such as Canada, may provide valuable insight to help guide Czech decision makers in identifying policy best buys moving forward. The basic research carried out as part of this PhD project focuses specifically on a comparison of TC in Canada and the CR. It also includes: 1) a national cross-sectional survey of all organizations involved in TC to describe capacity and involvement in TC measures outlined by the WHO Framework Convention on Tobacco Control (FCTC) (Fraser et al. 2019); 2) a prospective cohort study which describes the results of intensive smoking cessation treatment offered by Centers for Tobacco Dependent (CTD) (Králiková et al. 2014); 3) a cross sectional survey of patients...

This study investigates frailty, defined as the accumulation of deficits in physiological functioning, by applying the Skeletal Frailty Index (SFI) to a skeletal sample (N=67) recovered from the Mississippi State Asylum (MSA), and in a comparative sample, the Terry Collection. The SFI was statistically modified to increase its utility here. Variables that influence frailty, including age, sex, stress in early-life, and resilience, were assessed relative to four SFIs: Overall, Nutritional, Activity, and Infection. This study finds that the predicted relationships between the SFIs and the aforementioned variables are largely absent in the MSA sample. When compared to individuals in the Terry, MSA individuals generally manifest a lower prevalence of biomarkers but have reduced longevity, which suggests that MSA patients experienced higher frailty and lower resilience. This may be attributable to negative biosocial experiences over the life course prior to institutionalization, but primarily to often-negative environmental conditions during institutionalization.