The associations between coping styles, measured by COPE Test, dispositional version (Carver,Scheier and Weintraub, 1989), and Health Status inferred through a performance status, measured by Karnofsky's Index of Behavioral Performance are examined. The study focuses upon 28 oncological in patients. Positive moderate Pearson's correlations were found between these two variables in this correlational-descriptive study. These were interpreted in the following sense: the larger use of the style, the less health status among the scales suppression of competent activities, procrastination of coping, instrumental social support, focusing and releasing of emotions and behavioral disengagement. The active coping scale presented a negative correlationwith regard to Performance Status as a health measure. / Se estudian las asociaciones entre estilos de afrontamiento medidos a través del Test de Estimación del Afrontamiento COPE-versión disposicional (Carver, Scheier y Weintraub. 1989) y Estado de Salud inferido a través del Estatus Performance, medido a través del Índice de EjecuciónConductual de Karnofsky, en un grupo de 28 pacientes oncológicos hospitalizados de ambos sexos. La investigación alcanza el nivel descriptivo-correlacional, y se encontraron asociaciones entre ambas variables expresadas en correlaciones Pearson positivas y moderadas interpretadas en el siguiente sentido: a mayor empleo del estilo, menor estatus de salud entre las escalas supresión de actividades competentes, postergación del afrontamiento, apoyo social instrumental, enfocar y liberar emociones y desentendimiento conductual. La escala afrontamiento activo, presentó una correlación negativa respecto al Estatus Performance como medida de salud.

A mortalidade materna representa um evento de grande magnitude e transcendência que impacta negativamente à saúde no Brasil e no mundo. Integra o campo dos direitos humanos, sexuais e reprodutivos. Este estudo teve como objetivo geral caracterizar as razões de mortalidade materna no Estado do Rio Grande do Sul, entre o período de 1999 a 2008. Entre os objetivos específicos, a análise da RMM e RMME para as variáveis sociodemográficas, período de ocorrência e causa obstétrica do RS e das sete macrorregiões do Estado, no mesmo período; a distribuição espacial da RMM nos anos de 1999, 2003 e 2008 do RS nas macrorregiões e a verificação da mortalidade materna a partir do Programa de Humanização no Pré-Natal e Nascimento no RS. O estudo é do tipo ecológico, série temporal de agregado humano. A população foi de 845 óbitos maternos em mulheres entre 10 e 49 anos, ocorridos no Estado do RS no período de 1999 a 2008. As variáveis foram coletadas do SIM e do SINASC e, a partir deles, foram calculadas as RMM e as RMME, sendo analisadas por meio de regressão de Poisson com seus intervalos de confiança de 95%; no modelo de regressão, o ano foi usado como variável explicativa. Foram apresentados os valores do exponencial dos coeficientes, que mostram a variação nas razões de mortalidade materna no período analisado, juntamente com os seus respectivos intervalos de confiança de 95% e o valor-P do teste de Wald. Foram elaborados gráficos para análise de tendência, utilizando médias móveis da RMM para o Estado do RS. A distribuição espacial foi por meio da visualização da mortalidade materna nas macrorregiões do Estado do RS, nos anos de 1999, 2003 e 2008. Os principais resultados mostraram que a morte materna no Estado manteve-se com pouca oscilação nos dez anos de estudo e com valores acima do preconizado pela OMS. As macrorregiões identificadas com maiores valores da RMM são a Centro-Oeste, Norte e Serra. As características para morte materna são de mulheres acima de 30 anos de idade, com baixa escolaridade, menos de três anos de estudo e de cor/raça branca. Entre as características obstétricas do óbito, observou-se que no período da gestação/parto/aborto até 42 dias encontrou-se o maior período de risco, assim como as causas obstétricas diretas são a maioria. E, entre estas causas, a hipertensão arterial e a hemorragia estão entre os principais motivos de óbito materno no RS. Portanto, este estudo mostrou um panorama da saúde materna no Estado do RS e de suas macrorregiões, ficando claro que ao longo dos anos deste estudo não houve melhora do indicador, indicando que as políticas públicas, como PHPN, não impactaram na saúde materna e reprodutiva das mulheres. Esses resultados nos remetem a repensar o sistema e o atendimento de saúde da mulher, especialmente na atenção ao pré-natal. A morte materna é um evento que não pode esperar; a proteção da vida das mulheres em idade reprodutiva é um dever do Estado e uma obrigação dos profissionais que atendem essas mulheres. / Maternal mortality represents an event of major magnitude and transcendence that negatively impacts health in Brazil, as well as all over the world. It encompasses human, sexual and reproductive rights. The general purpose of this study was characterizing the ratios for maternal mortality in the state of Rio Grande do Sul (RS) between 1999 and 2008. The specific purpose is the analysis of MMR and SMMR for sociodemographic variables, period of occurrence and obstetric cause in all the state and its seven macro-regions along the same period; spatial distribution of MMR in 1999, 2003 and 2008 of RS in the macro-regions, and the monitoring done on maternal mortality by the Humanization Program of Prenatal Period and Birth in the state (HPPB). The type of this study is ecological, time series of human aggregate. The population/sample was of 845 maternal deaths of women between 10 and 49 years of age, happened in RS between 1999 and 2008. Variables were collected from the System of Information on Mortality and the System of Information on Live Births, and based on them, the MMR and SMMR have been calculated through Poisson regression with confidence intervals of 95%; in the regression model, where the year was used as an explicative variable. The exponential values of the coefficients were presented, showing the variation in the ratios for maternal mortality in the period analyzed, as well as with its respective confidence intervals of 95% and the p-value of the Wald test. Graphs were designed for tendency analysis using moving averages of the MMR for the state of RS. Spatial distribution was done through the visualization of maternal mortality in the macroregions of RS in 1999, 2003 and 2008. The most relevant results show that maternal mortality in this state has not oscillated much in the ten years of the study, with rates higher than those recommended by WHO. The macro-regions identified with the highest MMR values are the Mid-West, North and Hilly Region. Characteristics related to maternal mortality are: women above 30 years of age, with poor education (less than three years) and white. Regarding the obstetric characteristics of the death, it has been observed that in the period of gestation/delivery/abortion up to 42 days was the period with the greater risk, and direct obstetric causes prevail. Among these causes, blood hypertension and hemorrhage are among the main reasons for maternal death in RS. Therefore, this study shows an outlook of maternal health in the State of RS and its macro-regions, making it obvious that along these years there has not been an improvement in this indicator, thus suggesting that public policies such as HPPB have not impacted maternal and reproductive health of women. These results recommend us to rethink the system of assistance to women’s health, especially regarding the prenatal period. Maternal death is an event which cannot be overlooked; protecting women’s lives in reproductive age is a duty of the State and an obligation of the professionals who assist these women. / La mortalidad materna representa un evento de gran magnitud y trascendencia que repercute negativamente en la salud del Brasil y en el mundo. Se integra el campo de los derechos humanos, sexuales y reproductivos. Este estudio tuvo como objetivo caracterizar las razones de mortalidad materna en el estado de Rio Grande do Sul, entre el período 1999 a 2008. Entre los objetivos específicos, el análisis de la RMM y el RMME por las variables sociodemográficas, el tiempo de ocurrencia y causa obstétrica de RS y siete regiones geográficas del estado, en el mismo período, la distribución espacial de la SPR en 1999, 2003 y 2008 del RS en la macro regiones y la verificación de la mortalidad materna por el Programa de Humanización del Prenatal y Nacimiento en la RS. El estudio es del tipo ecológico, de series de tiempo de agregación humana. La población era de 845 muertes maternas en mujeres de entre 10 y 49 años de edad en el estado de RS en el período 1999 a 2008. Las variables se recogieron en la tarjeta SIM y SINASC, y de ellos se calcularon MMR y RMME se utilizó la regresión de Poisson con intervalos de confianza de 95% en el modelo de regresión, el año se utilizó como variable explicativa. Se presentan los valores de los coeficientes exponenciales, mostrando la variación en tasas de mortalidad materna en el período analizado, junto con sus respectivos intervalos de confianza de 95% y el valor de P de la prueba de Wald. Se prepararon tablas de análisis de tendencias, utilizando medias móviles de la vacuna MMR para el estado de RS. La distribución espacial fue a través de la visualización de la mortalidad materna en las regiones geográficas del estado de RS, en 1999, 2003 y 2008. Los principales resultados mostraron que la mortalidad materna en el estado se mantuvo con pocas variaciones en los diez años de estudio y por encima de los valores recomendados por la OMS. Las macro regiones identificadas con los valores más altos de la RMM son el medio oeste y el norte de la Sierra. Las características de las muertes maternas corresponden a mujeres de más de 30 años de edad, bajo nivel educativo, menos de tres años de estudio y de color blanco / carrera. Entre las características obstétricas de defunción, se observó que durante el embarazo / parto / aborto hasta 42 días se reunió con el periodo de mayor riesgo, así como las causas obstétricas directas son la mayoría. Y entre estas causas, la hipertensión y las hemorragias son las principales causas de muerte materna en la República Srpska. Por lo tanto, este estudio mostró una foto de la salud materna en el estado de RS y de sus regiones macro, dejando en claro que en los últimos años de este estudio no hubo una mejora del indicador, lo que indica que las políticas públicas, como PHPN, no tuvo ningún impacto en la salud materna y reproductiva las mujeres. Estos resultados nos llevan a repensar el sistema y el cuidado de la salud de las mujeres, especialmente en la atención a la atención prenatal. La muerte materna es un evento que no puede esperar, para proteger las vidas de las mujeres en edad reproductiva es el deber del Estado y la obligación de los profesionales que tratan a estas mujeres.

Syfte: Arbetet är en experimentell studie i samarbete med Lidköpings kommun där syftet är att undersöka om konditionshöjande motion och ökad VO2-max kan sänka blodtrycket och öka upplevd hälsa, och minska den upplevda arbetsbelastningen. Metod: En grupp kvinnor anställda inom hemvården har under en period genomfört en intervention med ett aktivitetsprogram. Innan och efter interventionsperioden har de, och en kontrollgrupp, genomgått tester för att mäta blodtryck och VO2-max. De har också i samband med testerna, via ett frågeformulär, svarat på frågor om sin hälsa, fysiska aktivitetsnivå samt sin upplevda hälsa och arbetsbelastning. Resultat: Det finns inga signifikanta skillnader mellan grupperna varken innan eller efter interventionsperioden. Det finns inte heller några signifikanta skillnader av interventionsgruppens resultat innan och efter interventionsperioden. Slutsats: Studien kan inte svara på om konditionshöjande motion och en ökad syreupptagningsförmåga kan sänka blodtrycket och öka den upplevda hälsan och minska den upplevda arbetsbelastningen. Stickprovet har varit för litet. På grund av detta, och pga. av att ett frivilligt deltagande i studien omöjliggör ett slumpvis urval, kan undersökningen inte sägas vara representativt för gruppen av människor som det avser att studera. / Aims: To examine if an increased oxygen uptake and moderate to vigorus physical exercise, could lower blood pressure and increase the level of perceived health and lower the level of perceived workstrain, in women working with elderly care. The work is an experimental study in cooperation with Lidköpings kommun. Methods: An experimental group have participated in a period of exercise in a given program. Before, and after the period of exercise the participants and a controlgroup have undergone tests to measure their bloodpressure and VO2-max. In connection with the tests a survey with questions abouth their physical activitylevel and ther perceived health and workstrain were answered. Results: No significant differences could be seen between the experimental group and the controlgroup in any parameter, neither before or after the experimental period. No significant differences could be seen in the results of the experimental group, before or after the experimental period. Conclusion: The study could not answer the questions whether an increased oxygen uptake and moderate to vigorus exercise, could lower bloodpressure and increase the level of perceived health and lower the level of perceived workstrain. The sampel of individuals who participated is too small. In relation to that, and that voluntary participation makes a random selection of individuals an impossibility, makes this study not representative to those people it aims to study.

Background Physical and mental health is important for coping with the high requirements of medical studies that are associated with a higher risk for severe stress, insomnia, smoking, harmful alcohol consumption and easier access to drugs. Health behaviors of medical students influence not just their own health but also the health of their future patients. We examined whether socio-cultural factors can explain differences in students’ health status and health-promoting behaviors. Methods A multicenter cross-sectional survey in Germany (Dresden, Munich) and Hungary (Budapest, Pécs) enclosed international medical students in their 1st, 3rd and 5th academic years. The students were invited to voluntarily and anonymously complete a questionnaire on different aspects of health behavior during obligatory seminars and lectures in 2014. The response rate of the total sample was 56.2 % (n = 2935); the subgroup analysis enclosed data of German (n = 1289), Hungarian (n = 1057) and Norwegian (n = 148) students. Results A high number of Norwegian students (84.5 %) assessed their health status as very good/excellent. In comparison, only 60.3 % of the Hungarian and 70.7 % of the German participants reported a very good/excellent health status. The distributions were comparable between the study sites. Although gender, financial situation and nationality were significant health status predictors, they could explain only 8.2 % of the total variance of health status in the multivariable model. A comparably high number of Hungarian students (95.3 % vs. 67.4 % German and 56.7 % Norwegian) reported that they can currently do a lot/very much for their health. In contrast, a significant number of Norwegians (73.0 % vs. 63.7 % Hungarian and 51.5 % German) reported that they currently do a lot/very much for their health (chi2-test, p ≤ 0.001). Financial situation, study site and study year were the strongest predictors for health promotion activities (Nagelkerkes R2 = 0.06). Conclusions Based on our study, gender and study year played only a minor role in the health status and health promotion beliefs and activities of medical students. Structural (study site) and somewhat socio-cultural factors (nationality, financial situation) mainly explained the differences regarding health promoting behaviors. Obligatory, free-of-charge courses for health promotion (activity and relaxation) should be included in study curriculums.

Submitted in fulfilment of the requirements of the Master of Applied Science in Food and Nutrition, Durban University of Technology, Durban, South Africa, 2016. / Background: The occurrence of absenteeism observed at the Coastal KZN FET College is very large. However, absenteeism of this magnitude is not inconsistent with observations from other educational institutions and work places around the world. Generally, absenteeism is coupled to the absence of good health, the presence of one or more non-communicable disease and the paucity of physical exercise undertaken by the personnel. Absenteeism in the work place results in avoidable financial costs to the employer, the employee, and the country as a whole. The wealth of literature shows that health concerns concerning adults are diet related. Diabetes, heart disease, hypertension, obesity, cancer and other non-communicable diseases (NCD’s) are increasing at an alarming rate, daily. A double-burden plagues South Africa: on the one hand there is over-nutrition (an excessive consumption of nutrients); while on the other there is under-nutrition (an insufficient intake of nutrients by certain groups of individuals). Factors such as urbanisation, globalisation, physical inactivity and consumer financial buying power have a significant influence on these health concerns. Aim: The data gathered in this study will be used to develop nutrition wellness education material as a component of a wellness programme for staff members at the Swinton Campus of the KZN Coastal FET College in Mobeni. Methodology: A needs analysis was undertaken to determine whether nutrition wellness education material as a component of a wellness programme for the institution was appropriate. Three 24-hour recall questionnaires gathered from the staff, data on eating habits and nutrient intake were undertaken/collected. A food frequency questionnaire collected data on the frequency and variety of foods eaten. A health questionnaire gathered data on self-reported illnesses, consumption of alcohol, and smoking habits. The demographics of the group, living conditions, and amount of money earned and spent on food was assessed through a socio-demographic questionnaire. Anthropometric measurements assessed included blood pressure, waist circumference, BMI and Waist-to-height-ratio (WHtR). Results: The sample consisted of 138 participants of which 44% (n=61) were men and 56% (n=77) were women. Less than 50% of the respondents were food secure: only 65 persons (47.1%) in the sample always had money to purchase food. In this group 63.93% of the men and 71.43% of the woman were obese. Subsequently 86% of the women exceeded the waist cut-off point of 88cm while 16.39% of the men were above the 102cm cut-off point. Findings revealed that 42.62% of the men and 25.9% of the women had pre-hypertension while 8.20% of the men and 5.90% of the women were hypertensive. This study indicated that this group was nutrient deficient. The fruit and vegetable intake was between 134.44g - 175.69g per day for men and 124.00g - 183.30g per day for women. Energy, dietary fibre, vitamin A, vitamin D, calcium, magnesium and iodine were below the nutrient adequacy ratio. There were positive correlations between age and systolic blood pressure, waist circumference and systolic blood pressure, waist circumference and diastolic blood pressure and waist-to-height ratio and BMI. Conclusion: Central obesity and to a lesser extent hypertension as well as deficiencies in nutrients and minerals were present in this group. Although the participants indicated a good variety of food, the quality and quantities consumed were not adequate. A link between diet, physical activity and diseases of lifestyle has been demonstrated. A need for nutrition education as a component of the wellness programme is indicated. Nutrition education is important both within and outside the workplace. To make lifestyle changes it is essential that education and knowledge is made available. Behavioural habits including eating habits are principally learnt. If bad behaviour habits can be learnt, good behaviour habits can also be instilled. The proposed intervention is aimed at reducing the incidence of absenteeism and decreasing the presence of non-communicable diseases. It is important for staff members at a FET college to be present in the classroom so that education of quality can be conveyed to learners. Further, the good health of staff members facilitates the ability of teachers to perform their important task of educating young minds at all educational institutions. / M

Background Physical and mental health is important for coping with the high requirements of medical studies that are associated with a higher risk for severe stress, insomnia, smoking, harmful alcohol consumption and easier access to drugs. Health behaviors of medical students influence not just their own health but also the health of their future patients. We examined whether socio-cultural factors can explain differences in students’ health status and health-promoting behaviors. Methods A multicenter cross-sectional survey in Germany (Dresden, Munich) and Hungary (Budapest, Pécs) enclosed international medical students in their 1st, 3rd and 5th academic years. The students were invited to voluntarily and anonymously complete a questionnaire on different aspects of health behavior during obligatory seminars and lectures in 2014. The response rate of the total sample was 56.2 % (n = 2935); the subgroup analysis enclosed data of German (n = 1289), Hungarian (n = 1057) and Norwegian (n = 148) students. Results A high number of Norwegian students (84.5 %) assessed their health status as very good/excellent. In comparison, only 60.3 % of the Hungarian and 70.7 % of the German participants reported a very good/excellent health status. The distributions were comparable between the study sites. Although gender, financial situation and nationality were significant health status predictors, they could explain only 8.2 % of the total variance of health status in the multivariable model. A comparably high number of Hungarian students (95.3 % vs. 67.4 % German and 56.7 % Norwegian) reported that they can currently do a lot/very much for their health. In contrast, a significant number of Norwegians (73.0 % vs. 63.7 % Hungarian and 51.5 % German) reported that they currently do a lot/very much for their health (chi2-test, p ≤ 0.001). Financial situation, study site and study year were the strongest predictors for health promotion activities (Nagelkerkes R2 = 0.06). Conclusions Based on our study, gender and study year played only a minor role in the health status and health promotion beliefs and activities of medical students. Structural (study site) and somewhat socio-cultural factors (nationality, financial situation) mainly explained the differences regarding health promoting behaviors. Obligatory, free-of-charge courses for health promotion (activity and relaxation) should be included in study curriculums.

Introducción El presente estudio tuvo como objetivo evaluar los determinantes sociales que explican mejor la prevalencia de anemia infantil que continúa elevada en el Perú. Materiales y métodos Se incluyó datos registrados en la Encuesta Demográfica y de Salud Familiar (ENDES). Se calculó la desigualdad absoluta y relativa para cada año desde el 2004 al 2017 con datos consolidados. Además, se obtuvo los datos de hemoglobina sanguínea registrados a través de datos individuales para los años 2010 y 2017. Finalmente, se realizó un análisis descomposición de Oaxaca - Blinder para establecer que determinantes sociales explican la brecha de la desigualdad en la distribución del promedio de la hemoglobina entre ricos y pobres para estos dos años. Resultados El análisis de descomposición de Oaxaca identificó que la brecha entre el promedio de hemoglobina entre los ricos y pobres fue explicada por las diferencias en las variables educación materna (11%), región (14%), el grupo de edad (2%) y de otras variables no estudiadas (46%) en el año 2017. En el 2010 la brecha es explicada únicamente por la región (23%) y de otras variables no implicadas en el estudio (60%). Además, la desigualdad absoluta y relativa no se ha modificado sustancialmente ni antes ni durante la implementación del “Plan Nacional 2014-2016”. Conclusión La brecha de desigualdad sobre la prevalencia de anemia se mantuvo elevada durante el tiempo estudiado. La educación materna, la región y grupo etario explicaron la desigualdad en los promedios de hemoglobina. / Introduction The present study aimed to evaluate the social determinants that better explain the prevalence of childhood anemia, which is still high in Peru. Materials and methods Data registered in the Demographic and Family Health Survey (ENDES) were included. Absolute and relative inequality was calculated for each year from 2004 to 2017 with consolidated data. In addition, the blood hemoglobin data registered through individual data for the years 2010 and 2017 was obtained. Finally, a decomposition analysis of Oaxaca - Blinder was carried out to establish that social determinants explain the inequality gap in the distribution of the average of the hemoglobin between rich and poor for these two years. Results The decomposition analysis of Oaxaca identified that the gap between the average hemoglobin between the rich and the poor was explained by the differences in the variables maternal education (11%), region (14%), age group (2%) and of other variables not studied (46%) in 2017. In 2010 the gap is explained only by the region (23%) and of other variables not involved in the study (60%). Furthermore, absolute and relative inequality has not changed substantially either before or during the implementation of the "National Plan 2014-2016". Conclusion The inequality gap on the prevalence of anemia remained high during the time studied. Maternal education, region and age group explained the inequality in hemoglobin averages. / Tesis

An increase in the diversity of Early Bronze Age (EBA) burial practices is well documented in central and southern Moravia between 2200-1500 BC. Apart from scarce cremations and pithoi burials, two more frequent parallel burial types appear. One is the standard burials in cemeteries, the other burials in settlement pits, the latter considered a deviation until recently. Thanks to recent excavations and new quantification procedures, however, abundance of settlement burials as well as uniformity and predictability of body deposition and grave equipment in pit burials has been shown. My intention is to show the existence of two parallel burial rites on the basis of bioarchaeological and archaeological evidence. I focus on the reconstruction of health and social status of individuals buried in settlement pits and graves. I observe the amount of demographic variability, diseases and trauma within each group. I suppose the distribution of diseases according to age, sex and archaeological record will be similar within each of the groups. As a result, we may speak about two equivalent burial practices. If deviations are encountered within settlement pits, however, we should speak about deviations or burials determined for a minority and homogeneous segment of population. Skeletons originate in two...

iv Abstract This thesis uncovers the long-term development of overweight and obesity prevalence in the Czech Republic and finds the associations with relevant lifestyle risk factors and determinants of health. Periodically collected interview and examination survey data from 1993 to 2019 are standardised and used to perform a pooled analysis to inspect trends within the cross-sectional units. The binomial logistic regression is used to estimate changes in the odds of being overweight given a set of socio-economic and lifestyle-related predictors, and to inspect time trends in their magnitude and significance. Adjustment to historical data is calculated to account for methodological changes in BMI classification scheme to ensure comparability of survey outcomes. In addition, the response bias in self-reported anthropometric measurements is confirmed and quantified. Finally, the most recent data (2019) for obesity rates are updated accordingly to reflect this finding. The true prevalence of overweight in the Czech adult population is calculated to 75.8% for men and 58.8% for women, which is higher than interview survey results by 7.7 and 9.6 percentage points respectively. These adjusted results may be utilised by users of survey outcomes to build their analyses on validated data, together with other...

Racial/ethnic groups are disproportionately affected by obesity and other risk factors for chronic diseases. African immigrants are an increasing segment of the U.S. population at greater risk for obesity than other immigrants living in the United States. Public health organizations that aid immigrants could benefit from information about changing dietary patterns. The purpose of this study was to explore the association between dietary acculturation and obesity among African immigrant adults living in the United States, controlling for length of stay, English proficiency, region of residence, and other sociodemographic factors. Acculturation theory guided this study. The research design was quantitative cross-sectional with secondary data from 798 adult immigrants of African origin who completed the New Immigrant Survey. Forward stepwise logistic regression analyses indicated that when controlling for sociodemographic factors, dietary acculturation was a significant predictor of obesity. Language proficiency, income, marital status, childhood living environment, and age were statistically significant predictors of obesity. Findings may be used by clinicians, dieticians, and other health care professionals to develop obesity prevention and control strategies that specifically serve African immigrants to prevent obesity and its associated deadly complications.