Measuring disparities in Quality of Life (QOL) can be challenging due to the vast amount of factors to be included. This study attempts to measure disparities in QOL using a newly developed Urban Health Index (UHI). Using 128 census tracts in City of Atlanta in Georgia as an example, this study selects six variables that are related to QOL. Their geometric mean is then used to construct a single numeric value for each census tract. The QOL disparity ratio is then determined by the upper and lower 10% of the data. The slope of disparity is calculated using the remaining 80% of the data. The results show that urban health index may be an affective indicator of QOL in a city.

Orientador: Regina Maria Innocencio Ruscalleda / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-14T18:06:29Z (GMT). No. of bitstreams: 1 Rodrigues_IaraGuimaraes_M.pdf: 2544338 bytes, checksum: bdac7f99ac4abc0e0fc23e7cf8a9801b (MD5) Previous issue date: 2009 / Resumo: Objetivo: Investigar o perfil dos idosos da comunidade de Campinas, classificados segundo o nível de condição de vida do bairro onde residem, quanto a gênero, idade, velocidade da marcha, ocorrência de quedas no ultimo ano, medo de cair e desempenho em Atividades Avançadas de Vida Diária (AAVDs). Participantes: Fizeram parte deste Estudo 264 idosos com 65 anos ou mais, recrutados em domicilio, em setores censitários urbanos pertencentes a áreas de abrangência de Centros de Saúde classificados pelo Índice de Condições de Vida, um indicador de vulnerabilidade social Procedimentos: Os dados faziam parte do banco eletrônico de uma pesquisa populacional e foram coletados por instrumentos de auto-relato, com exceção da medida de marcha que foi coletada por teste de execução Resultados: 71,21% eram mulheres; 72,73% não referiram quedas no ultimo ano; 57,58% referiram medo de cair; 62,50% obtiveram uma media velocidade da marcha e 66,70% eram independentes para as AAVDs. As mulheres tiveram um numero de quedas significantemente mais alto do que os homens e também mais medo de cair. As AAVDs mais freqüentemente realizadas pelos idosos dizem respeito a sociabilidade desempenhada em casa e na igreja e as menos desempenhadas são relativas a participação em instituições de lazer e de educação para idosos. O indicador de baixo ICV apareceu significativamente associado com menor funcionalidade em AAVDs. Conclusão: A maioria dos sujeitos da pesquisa não relatou quedas no ultimo ano, porem relataram medo de cair. Observou-se uma ocorrência significativa de quedas, medo de cair e maior lentidão da marcha no sexo feminino, embora exista uma tendência das mulheres realizarem em media um percentual maior das AAVDs em relação aos homens. Idosos pertencentes ao grupo de alto ICV obtiveram melhor desempenho da marcha e aqueles com baixo ICV apareceram significativamente associados com uma menor funcionalidade em AAVDs, confirmando nossa hipótese de estudo. Contudo, estudar o perfil dos idosos de uma comunidade, pode alem de demonstrar a necessidade de intervenções, contribuir nos planejamentos de políticas publicas / Abstract: Objective: To investigate the profile of the elderly community of Campinas, classified by level of living conditions in the district where they reside, in terms of gender, age, speed of walking, with falls last year, fear of falling and performance in Advanced Activities of Daily Living (AAVDs). Participants: Participants were 264 elderly people aged 65 years or older, recruited in their residence in census tracts belonging covering areas of health centers classified by the Index of Living Conditions, an indicator of social vulnerability Procedures: The data were part of electronic banking population survey were collected and given to self-report, except the measure of progress which was collected by running test. Results: 71.21% were women, 72.73% did not report falls in the previous year; 57.58% reported fear of falling; 62.50% had an average speed of walking and 66.70% were independent for AAVDs. Women had a number of falls significantly higher than men and also more afraid of falling. The AAVDs most often done by older people relate to sociability played at home and at church and performed less are associated with participation in institutions of education and leisure for the elderly. The indicator of low ICV appeared significantly associated with less functionality in AAVDs. Conclusion: Most of the research subjects reported no falls in the last year, but reported fear of falling. There was a significant occurrence of falls, fear of falling and slower speed of walking in women, although there is a tendency for women making on average a higher percentage of AAVDs with men. Seniors in the group of high ICV showed a better performance of motion and those with low ICV appeared significantly associated with functionality in AAVDs, confirming our hypothesis of the study. However, studying the profile of the elderly in a community, can also demonstrate the need for interventions, help in the planning of public politics / Mestrado / Mestre em Gerontologia

The United States relies on its vast network of roadways to transport people, goods, and services across the nation. These roads need to be maintained to an acceptable level in order to effectively provide a safe, reliable, and efficient road. The use of infrastructure management systems (IMS) has aided in keeping an inventory of existing roads, identifying assets in need of repair, and assisting in allocating funds for maintenance, repair, and rehabilitation. The current practice in the United States has shown a lack of consistency in the way assets are rated in each state. Individual states have employed their own methodology for rating each asset type. This makes comparison of assets between states difficult. Several methods in use have provided a way to effectively rate an asset, but no method exists that can be used to compare ratings in different states. To successfully maintain the network of roads across the United States, a method to assess assets between states is necessary. Consistency between states in their data collection, rating calculation, and rating reporting are all necessary to identify poor sections of roadway. Another useful reporting item will be a condition rating of all the assets contained within a corridor. A corridor is a series of travel routes which move people between two major points of interest. By analyzing corridor level condition ratings, it will be possible to examine the overall condition of all the corridor sections across the nation and identify sections that need assistance in raising their condition. The objective of this thesis was to develop a framework for rating assets at the corridor level. The framework was developed to be applied to any asset contained within a roadway and allow the combination of individual asset ratings into a single corridor rating. The final methodology not only reports the overall corridor condition, but the functional and structural health of each individual asset, the rating of all of an asset type within a corridor, and performance indicators for individual items on a single asset. The methodology was tested using data provided by the Virginia Department of Transportation (VDOT) to test if the methodology would produce ratings similar to those in use. For the application methods were developed for two major roadway assets; pavements and bridges. The product of this thesis is a general framework which can be applied to roadway corridors to assess the overall condition of all the assets contained within the corridor's boundaries. It can be used in conjunction with an IMS to help improve and maintain the overall condition of the roads, which are critical to the United States. Without unification of condition rating methods into a single method it will never be possible to compare assets from every state in the nation. / Master of Science

Objective: Measure the association between School Health Index (SHI) scores and student health outcomes related to physical activity (PA) and nutrition. Design: Cross-sectional design utilized to collect SHI scores and administer questionnaires regarding nutrition and PA behaviors, knowledge and the home environment in 5 counties of southwest Virginia. Participants: Staff, administrators and students (grades 4, 7, 10; n = 1094) in 27 schools in 5 school divisions. Main Outcome Measures: SHI scores were obtained from school surveys while LWP score, student BMI percentile and fitness (mile run, PACER) measures were obtained from school data. The School Physical Activity and Nutrition questionnaire was used to measure student nutrition, PA behaviors and knowledge, and the home food environment was measured through a validated questionnaire. Analysis: Two-sided Pearson's correlation (p<0.05) measuring associations between SHI score and student health outcomes of BMI percentile, one mile/PACER, nutrition and PA behaviors and health knowledge and beliefs. Results: SHI was negatively correlated with BMI percentile for 4th grade students (-0.472, p<0.001) and positively correlated with BMI percentile for 8th grade students (0.679, p<0.001). SHI was positively correlated with 4th grade mile run (0.412, p<0.001), 8th grade mile run (0.218, p<0.001) and 4thgrade PACER (0.414, p<0.001). Conclusion: Behavioral influences are multifactorial and factors outside the school environment may affect the correlations between these variables. Application: Data concerning the influence of the school health environment can be used towards making evidence-based changes to school health programs. / Master of Science

Background Surgery induces insulin resistance that might be alleviated by a nutritional drink given preoperatively. The authors hypothesized that some of the beneficial effects of the drink could be attributed to the volume component (approximately 1 L) rather than to the nutrients. Methods Sixty patients scheduled for elective total hip replacement under spinal anesthesia were recruited to a clinical trial, and randomly allocated to preoperative fasting, to oral ingestion of tap water, or to oral ingestion of a carbohydrate drink. An intravenous glucose tolerance test calculated glucose clearance and insulin sensitivity on the day before surgery, in the postoperative ward, and on the day after surgery. Other parameters were stress (cortisol in plasma and urine), muscle catabolism (urinary 3-methylhistidine), and wellbeing. Results Fifty-seven patients completed the study. In the postoperative ward, the glucose clearance and the insulin response had decreased from the previous day by 23% and 36%, respectively. Insulin sensitivity did not decrease until the next morning (−48%) and was due to an increased insulin response (+51%). Cortisol excretion was highest on the day of surgery, while 3-methylhistidine increased 1 day later. Follow-up on the third postoperative day showed an average of 1.5 complications per patient. Wellbeing was better 2 weeks after than before the surgery. None of the measured parameters differed significantly between the study groups. Conclusions Preoperative ingestion of tap water or a nutritional drink had no statistically significant effect on glucose clearance, insulin sensitivity, postoperative complications, or wellbeing in patients undergoing elective hip surgery. / <p>Funding Agencies|Olle Engkvist Byggmastare Foundation||Stockholm County Council|2009-0433|</p>

At the end of the 10th century the first Swedish town Sigtuna was founded, which can be recognized as the beginning of urbanization in the Mälaren valley. Christianity was growing strong and the administrative power was probably concentrated to a few magnates gathered around a king. Though, Sigtuna played an important religious and political role, the time of prosperity was short and at the end of the 13th-early 14th century the importance of the town declined. The ambition with the present thesis has been to investigate the demography of the human skeletal material excavated in Sigtuna during the period 1983-1999. The skeletons from 528 individuals from six cemeteries dated to the end of 10th century to the early 16th century have been analysed. The material was subdivided into three chronological development phases synonymous with the establishment, the peak of prosperity and the decline of the town. Well-recognized anthropological techniques were applied together with a health index and chemical tests such as stable isotopes and trace elements. The main aims were to investigate: 1) differences in the material between contemporary inhabitants in Sigtuna, 2) differences in the material between the different chronological phases, 3) differences between the osteological results achieved from Sigtuna and results from other skeletal materials and 4) if the results can be connected to the indications of urbanization. The results showed that: - Some differences between contemporary cemeteries are discernable. Variations in stable isotopes suggest dietary differences between the women at different cemeteries. Furthermore, differences in age- and sex distribution, and mean stature are discernable between some of the contemporary samples and even within a cemetery. The discrepancies may be related to prevailing social structures in Sigtuna. - A decline in health through time is demonstrated. The negative trend is particularly marked for women. In addition demographic changes suggest an increased migration of adults to Sigtuna. The health deterioration may be connected to e.g. increased population density and an increased risk of infections. - In comparison with other materials the anthropological results, including the health index, suggests that the inhabitants in Sigtuna showed an urban pattern and that the quality of life, at least in the initial phase, was relatively good. - The sex distribution shows a generally male dominance possibly caused by selective excavations except at the oldest site without an adherent church. The uneven sex distribution may, alternatively, be a result of the urban character of Sigtuna i.e. a Christian and political administrative centre. The osteological results are in line with the archaeological and historical data. It is suggested that the consequences of urbanization such as immigration, deterioration of health and social ranking, implied by several osteological parameters and the chemical analysis, acted differently through the gender lines. / <p>Revised 2014.</p>

The Air Quality Health Index (AQHI) is a 10-point scale that communicates the cumulative health risks associated with air pollution (ECCC, 2016). The general theme of this dissertation centers on an understanding of AQHI adoption while accounting for socioeconomic status (SES) in order to facilitate AQHI uptake by the public with particular focus on “at risk” populations (i.e. young children, seniors, and those with pre-existing respiratory and/or cardiovascular conditions). The study is unique since it approaches AQHI adoption consistent with the ecological model and an equity lens, and AQHI adoption is considered at the individual, organizational and community levels. The study area for this dissertation is Hamilton, Ontario, Canada. The findings from this dissertation contribute to an understanding of why AQHI is or is not being adopted and suggests potential intervention strategies to increase its uptake. Consistent with health behaviour theory, demographics (gender, age, education, area of residence), knowledge/understanding and individual risk perceptions (neighbourhood air effects on health) were found to be significant predictors of AQHI adoption. Additionally, perceived benefits of AQHI adoption included protection of health for self and those cared for via familial and/or occupational duties. While perceived barriers of AQHI adoption included lack of time required to check and follow AQHI health messages and the inability to “self-identify” as belonging to the “at risk” population. This dissertation proposes that increases in AQHI adoption may be achieved by increasing AQHI knowledge and emphasizing the benefits and relevance of AQHI such that “at risk” populations can self-identify. Additionally, AQHI uptake may be increased by providing AQHI information at a neighbourhood scale via local media sources and wearable devices. / Dissertation / Doctor of Philosophy (PhD)

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ABSTRACT The purpose of this qualitative case study was to gain an informed understanding of the views of elementary school staff about the characteristics of the Nutrition Positive incentive program including: program development, implementation strategies used by individual schools, and challenges and related concerns associated with program implementation. As an initial step in a process evaluation, knowledge was gained through document analysis, site observations and 14 semi-structured interviews with principals, teachers and nutrition coordinators in 4 Greater Saskatoon Catholic, and 4 Saskatoon Public, Saskatchewan schools. Findings were then compared and contrasted with three models for best practice from the scientific literature and related to school health, education, and promotion. <p>The results led to the following conclusions. Nutrition Positive serves as an entry point for health promotion in Saskatoon elementary schools. While providing principals, teachers and other school staff with the necessary supports to enable children to learn critical life and health skills, it is also practical and realistic. The program can easily be adapted to different age and developmental levels, and a variety of cultures. The Advisory Committee and the program manual provide multiple resources to facilitate implementation. Schools may adapt the program for use across curricula, within school timetables, and concurrent with other health-related programs. Nutrition Positive schools attempt to provide healthy, serve most often foods for student mealtimes, special events, fundraising activities, vending machines and classroom rewards. While the program appears to be sustainable, it needs to specify measurable objectives and requires a better design for its assessment, monitoring and evaluation components. It is recommended that schools include all stakeholders, including parents and students, when forming a school-based program committee. Committee members need to participate in developing written school policies and guidelines, as well as learning about healthy eating themselves. School activities and foods offered need to more consistently and uniformly compliment the curriculum and program goals and objectives. In order to expand, program materials need to be widely publicized, communicated in a timely manner, culturally relevant, and available in languages in addition to English.