Adolescence is a developmental period during which boys and girls are at high risk of developing major or minor depression. Increases in fitness have been associated with lower levels of depressive symptomatology and improvements in psychological well-being, yet the mechanisms that underlie this relationship have not been thoroughly examined. Three such psychosocial variables (i.e. body satisfaction, social physique anxiety, and physical activity self-efficacy) have been identified as possible mechanisms and although they have theoretical support, additional research is needed to demonstrate empirically the potential effects of these variables. Self-report measures were used to assess the psychosocial variables and the Progressive Aerobic Cardiovascular Endurance Run (PACER) in conjunction with age, Body Mass Index [BMI], and sex was used to determine an estimate of aerobic capacity (VO2max). Path analyses were used to test the proposed model using version 6.2 EQS Multivariate Software. Results of study revealed that the boys’ and girls’ depressive scores were determined based on the extent that their fitness levels improved their satisfaction with their bodies and lowered the anxiety they experience in relation to real or imagined judgments of their physique. Although all pathways in the model were significant, with the exception of physical activity self-efficacy to depression, differences emerged between the boys and girls in terms of the strength of some of the relations amongst the variables. Limitations include restricted generalizability, self-report measures, and cross-sectional design. Results have implications for individuals in a context intended to improve physical and psychosocial well-being of adolescents.

Introduction : Offrir une information fiable et des soins oncosexologiques précoces et adaptés nécessite une meilleure compréhension des besoins des patients et de leur santé sexuelle. Objectif : Évaluer la santé sexuelle, la délivrance d'information et les besoins en soins sexologiques des patients atteints de cancer avant et pendant traitement. Méthodes : Nous avons réalisé 2 études transversales chez des patients atteints de cancer (1) dans un département de radiothérapie (étude 1 : évaluation avant radiothérapie) et (2) dans un département de cancérologie digestive (étude 2 : évaluation pendant chimiothérapie) dans un centre hospitalo-universitaire régional. Les patients ont rempli un auto-questionnaire sur leur santé sexuelle, leur qualité de vie sexuelle, l'information reçue et leurs besoins en soins sexologiques. Résultats : Les échantillons comprenaient 77 hommes et 123 femmes (étude 1) et 47 hommes et 31 femmes (étude 2). Moins d'un patient sur deux avait reçu une information, avec des femmes moins informées que les hommes avant radiothérapie. Dans les 2 études, les femmes avaient des scores de qualité de vie sexuelle plus faibles que les hommes, et au plus la moitié des patients ont stoppé ou diminué la fréquence de leurs activités sexuelles. Au plus 51% des patients ont envisagé des soins oncosexologiques. Conclusion : Ces résultats mettent en évidence la nécessité d'interventions spécifiques pour les professionnels et les patients, notamment les femmes, afin qu'elles puissent bénéficier d'une offre de soins aussi éto?ée que celle des hommes. Nos données suggèrent également la nécessité d'étudier la santé sexuelle de manière prospective, dès le diagnostic. / Introduction : Providing reliable information, early and appropriate oncosexology care require a better understanding of the patients' sexual health and care needs. Objective : To assess sexual health, information delivery and needs for sexology care of cancer patients before and during treatment. Methods : We performed 2 cross-sectional studies in cancer patients (1) in a radiotherapy department (study 1 : assessment before radiotherapy) and (2) in a digestive cancer department (study 2 : assessment during chemotherapy) of a regional university hospital. Patients filled out a self-administered questionnaire about their sexual health, Sexual Quality of Life questionnaire for Male or Female, Information they received and their needs for sexology care. Results : Studies samples was composed of 77 men and 123 women (study 1) and of 47 men and 31 women (study 2). Information was delivered to less than 1/2 patients, with women receiving less information than men before radiotherapy. In both studies, women had a decreased sexual quality of life score compared to men and up to half of patients stopped or declined in the frequency of their sexual activities. Conclusion : These results highlight the need for specific interventions for health care providers and patients, especially for women, who could benefit from oncosexological intervention like men do. Our data also suggest the need to assess sexual health in a prospective fashion from diagnosis to survivorship.

<p>Probiotika, nyttiga bakterier som är välgörande för människan, förekommer allt mer i olika produkter riktade till små barn – alltifrån droppar och kapslar till modersmjölksersättningar och grötar. Inom barnhälsovården saknar barnsjuksköterskan/ distriktssköterskan vägledning och riktlinjer angående probiotika i små barns kost. Syftet med litteraturstudien var att undersöka evidens angående probiotikas hälsoeffekter i preventivt syfte på friska små barn. Metoden var en litteraturstudie baserad på 20 vetenskapliga artiklar. Analysen resulterade i att probiotika var säkert att ge till friska små barn. Samtliga studier gav enhetligt resultat, att inga nackdelar fanns med att ge små barn probiotika. Inga negativa hälsoeffekter med probiotika kom fram i denna litteraturstudie. Positiva hälsoeffekter av stor betydelse fick barn som erhållit probiotika vid kolik, då snabb lindring inom en vecka framkom. Ett övervägande positivt resultat sågs vid användning av probiotika till små barn för att förebygga eksem. Probiotika minskade även frånvaron från dagis då infektionssjukdomar minskade hos barnen. Antibiotikaförskrivningen sjönk också hos de förskolebarn som fått probiotika. Probiotikas positiva hälsoeffekter kan användas till rådgivning och rekommenderas till små barn av barnsjuksköterskan/ distriktssköterskan inom barnhälsovården. Fördjupad forskning är önskvärd då utökad eller kombinationer av flera probiotiska bakteriestammar kan ge utökade hälsoeffekter.</p> / <p>Probiotics, beneficial and useful bacterias for the human body, occur more often in different products targeted to small children – in everything from drops and capsules to formula and porridge. Within the child health care, the pediatric- and the district nurse lacks guidance and guidelines concerning probiotics in small children's diet. The aim with the literature review was to examine evidence concerning probiotics health effects in prevention, in small children. The method was a literature review based on 20 scientific articles. The analysis resulted in that probiotics were safe to give to healthy small children. All studies gave uniformly results and showed no disadvantages with giving small children probiotics. No negative health effects were detected in this literature review. Positive health effects of great importance have shown be beneficial within treatment of colic with probiotics given to infants since relief occurred within a week. A predominately positive result was seen in use of probiotics to small children in order to prevent eczemas came to light. Probiotics also decreased absence from day care centers since infection diseases were reduced among the children. Antibiotic prescriptions also decreased when probiotics were used to pre-school children. The positive health effects of probiotics can be used for health recommendations to small children within the child health care by the pediatric- and the district nurse. Extended research is desirable since increased or and combinations of several probiotic bacterium stutters can give increased health effects.</p>

Probiotika, nyttiga bakterier som är välgörande för människan, förekommer allt mer i olika produkter riktade till små barn – alltifrån droppar och kapslar till modersmjölksersättningar och grötar. Inom barnhälsovården saknar barnsjuksköterskan/ distriktssköterskan vägledning och riktlinjer angående probiotika i små barns kost. Syftet med litteraturstudien var att undersöka evidens angående probiotikas hälsoeffekter i preventivt syfte på friska små barn. Metoden var en litteraturstudie baserad på 20 vetenskapliga artiklar. Analysen resulterade i att probiotika var säkert att ge till friska små barn. Samtliga studier gav enhetligt resultat, att inga nackdelar fanns med att ge små barn probiotika. Inga negativa hälsoeffekter med probiotika kom fram i denna litteraturstudie. Positiva hälsoeffekter av stor betydelse fick barn som erhållit probiotika vid kolik, då snabb lindring inom en vecka framkom. Ett övervägande positivt resultat sågs vid användning av probiotika till små barn för att förebygga eksem. Probiotika minskade även frånvaron från dagis då infektionssjukdomar minskade hos barnen. Antibiotikaförskrivningen sjönk också hos de förskolebarn som fått probiotika. Probiotikas positiva hälsoeffekter kan användas till rådgivning och rekommenderas till små barn av barnsjuksköterskan/ distriktssköterskan inom barnhälsovården. Fördjupad forskning är önskvärd då utökad eller kombinationer av flera probiotiska bakteriestammar kan ge utökade hälsoeffekter. / Probiotics, beneficial and useful bacterias for the human body, occur more often in different products targeted to small children – in everything from drops and capsules to formula and porridge. Within the child health care, the pediatric- and the district nurse lacks guidance and guidelines concerning probiotics in small children's diet. The aim with the literature review was to examine evidence concerning probiotics health effects in prevention, in small children. The method was a literature review based on 20 scientific articles. The analysis resulted in that probiotics were safe to give to healthy small children. All studies gave uniformly results and showed no disadvantages with giving small children probiotics. No negative health effects were detected in this literature review. Positive health effects of great importance have shown be beneficial within treatment of colic with probiotics given to infants since relief occurred within a week. A predominately positive result was seen in use of probiotics to small children in order to prevent eczemas came to light. Probiotics also decreased absence from day care centers since infection diseases were reduced among the children. Antibiotic prescriptions also decreased when probiotics were used to pre-school children. The positive health effects of probiotics can be used for health recommendations to small children within the child health care by the pediatric- and the district nurse. Extended research is desirable since increased or and combinations of several probiotic bacterium stutters can give increased health effects.

Orientador: Evelina Dagnino / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciencias Humanas / Made available in DSpace on 2018-08-05T14:07:32Z (GMT). No. of bitstreams: 1 Gazeta_AlexandrePerles_M.pdf: 864526 bytes, checksum: 8fb0337463402f64e00d2f07bef23eeb (MD5) Previous issue date: 2005 / Resumo: Este estudo tem por objetivo verificar, através da análise das experiências de participação via Conselhos Municipais de Saúde de Araraquara e São Carlos, no período de duas gestões distintas, 1997-2000 e 2001-2004, em que medida as diferentes orientações políticas das gestões municipais, nestas cidades, influenciaram os processos participativos nos respectivos Conselhos e têm contribuído ou inibido a democratização da gestão e ampliação da esfera pública. As gestões do primeiro período pertencem a partidos políticos com orientação política pouco favorável à participação e as gestões do segundo período pertencem a partidos político com orientação política comprometida com o projeto participativo. Nossa investigação foi orientada pela hipótese de que as gestões municipais do período de 2001-2004, de partidos políticos de esquerda, foram responsáveis por mudanças no sentido da ampliação da participação nos Conselhos Municipais de Saúde, devido à orientação política favorável ao projeto participativo. Procuramos ao longo do estudo analisar a natureza e o efeito dos incentivos dos gestores à participação e ao controle social, assim como também nos preocupamos em desvendar os mecanismos que bloqueiam a partilha efetiva do poder nos Conselhos. Os resultados obtidos confirmaram nossa hipótese a respeito da correlação positiva entre gestões municipais com orientação política favorável ao projeto participativo e a ampliação da participação e controle social. No entanto identificamos também que nas gestões comprometidas com o projeto participativo e democratizante, a ampliação da participação não se realizou como um processo linear onde a participação foi sendo ampliada sem contradições e tensões / Abstract: This study aims to verfiy at what point the different political orientations in the cities administration influenced the process of social participation int their health city councils and the way they been countributing or impiring the democratization process of the management and increasing the public sphere. We analysed two experiences concerning the public participation through the health cities councils in the cities of Araraquara and São Carlos, during two distinct terms, ¿1997-2000¿ and ¿2001-2004¿. The management in the first period was taken over by political parties less favorable tuo the public participation. The second one belongs to political parties whose the political orientation is engaged to public participation process. Our investigation was orinented by the hypothesis that in the city managements of second turn (2001-2004), belonging to left-wing political parties, were responsible for changes in the increase of public participation in the health city councils, due to the political orientation favorable public participation process. Throughout this study were analysed the essence and the effect of the administrations incentive to public participation and social control. We were also concerned in revealing the mechanisms that block the sharing of the power in the city councils. The results the we abtained confirmed our hypothesis about positive relation among the city managements in wich the political orientation is favorable two public participation project and the increase of public participation and social control. However we also found out that in the management engaged in the social participation project the increase of this participation didn't happened as linear process in wich the public participation was been increased whout contradictions and tensions / Mestrado / Estado e Politicas Publicas / Mestre em Ciência Política

Orientador: Carlos Roberto Silveira Correa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-15T16:36:43Z (GMT). No. of bitstreams: 1 Aguirre_SvetlanaBacellar_M.pdf: 973843 bytes, checksum: d0353364deccf15f5e152e2ec818591d (MD5) Previous issue date: 2010 / Resumo: A Promoção da saúde tem encontrado inúmeras dificuldades em sua implantação principalmente devido a predominância do modelo biomédico nas ações de saúde que exclui a determinação social do processo saúde-doença e acaba limitando o objetivo maior da Atenção primária de Prevenção e Promoção da saúde. A Promoção da saúde considerada neste trabalho, que tem como eixos principais a intersetorialidade e o empoderamento, busca ampliar o paradigma biomédico incorporando outras variáveis que influenciam tanto o tratamento das doenças e a prevenção delas, quanto a busca pela saúde, em toda a sua extensa e complexa teia de determinantes. No intuito de pensar alternativas para que ações de Promoção da saúde fossem implantadas com maior força tomamos nesta pesquisa arranjos institucionais e estratégias de gestão como ferramentas para a ampliação da clínica, para a criação de espaços de co-gestão e organização do processo de trabalho.Com isso, objetivamos avaliar se a maior ou menor implantação de arranjos de gestão pelas unidades básicas de saúde interferem, sob o ponto de vista dos Agentes Comunitários de saúde (ACS) na implantação da Promoção da saúde. Pensa-se que a possibilidade de trocas de valores, de olhares, e a construção conjunta de ações de saúde entre profissionais de uma equipe de saúde, proporcionada por arranjos de gestão, poderiam interferir no discurso dos ACS por criar diferentes condições de produção do discurso desses trabalhadores. Então, considerando esse profissional como aporte importante na prática de ações de Promoção da saúde, escolheu-se neste trabalho tomar seu discurso, fruto de grupos focais e análise das falas pela técnica de Análise de Discurso.Escolheu-se seis Unidades básicas de saúde dos distritos Sul e Sudoeste do município de Campinas como campo para este trabalho.Como resultados percebe-se um maior empoderamento dos ACS quando utilizam espaços coletivos na unidade, mas não podemos afirmar que os arranjos interferem na construção de redes sociais.O difícil papel que o ACS possui na sua prática faz-se claro nesta pesquisa / Abstract: The Health Promotion has faced many difficulties in its implementation specially due to the predominance of the biomedical model in health actions that excludes the social determination of the health-illness process and ends up limitating the major objective of the primary care which is Prevention and Health Promotion. The Health Promotion in this project, that has as its main ideas the intersectoriality and the empowerment, it aims to improve the medical paradigm by incorporating other variables that influence the treatment of the illnesses and their Prevention as well as the search of health in its whole wide and complex net of determinants. With the objective of thinking about alternatives that Health Promotion actions might be put in practice with stronger forces, we have taken, in this project, institutional arrangements and management strategies as tools for clinic amplification; the creation of co-management spaces and the organization of the process of work. By that, we intended to evaluate if a bigger or smaller implementation of the management arrangements by the basic health units interferes, on the community health agents (CHA) point of view, on the implementation of the health promotion. It is defended that the possibility of a value a point of view exchange and the group construction of health actions among professionals of a health team propitiated by management arrangements, could interfere in the CHA discourse by creating different conditions of production of the discourse of these workers. So taking these professionals as an important actor in putting in practice actions of health promotion it was decided in this project to have their discourse, the result of focal groups and to analyse what was said using the technique of discourse analysis. Six basic health units in the south and southwest districts of Campinas were chosen as field for this project. As a result, it is noticed a bigger empowerment of the CHA when they use democratic management spaces in the unit, but it is not possible to assure that the institutional arrangements interfere in the construction of social nets. It is clear in this project, the difficult role that the CHA has to perform his work / Mestrado / Epidemiologia / Mestre em Saude Coletiva

Orientador: Lúcia Helena Reily / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-16T00:03:43Z (GMT). No. of bitstreams: 1 Nogueira_JersonAparecidoSousa_M.pdf: 2504001 bytes, checksum: 4523a1b012256741c2746c21f566e1c1 (MD5) Previous issue date: 2010 / Resumo: Nesse estudo investiga-se a constituição da assembléia na Unidade de Internação do Serviço de Saúde Dr. Cândido Ferreira, no contexto da Reforma Psiquiátrica e do Movimento Antimanicomial, bem como das diretrizes do Ministério da Saúde. O trabalho pretende subsidiar a produção de conhecimentos acerca desse tipo de procedimento, através da contextualização histórica, bem como promover reflexões sobre a contribuição deste dispositivo de abordagem grupal como uma intervenção que integra funcionários e usuários, favorece o exercício da autonomia e da cidadania e possibilita que o usuário seja protagonista do seu próprio processo terapêutico. A pesquisa é de natureza qualitativa, utilizando fontes orais e documentos históricos como atas, fotografias e relatórios. Fundamenta-se em teóricos como Franco Basaglia, Paulo Amarante, Michel Foucault, Erving Goffman e Norbert Elias. Os resultados afirmam a importância da assembleia como um instrumento terapêutico, de organização da estrutura, funcionamento e dinâmica do cotidiano e um espaço de formação e aprimoramento de pessoal. Evidenciou-se que a representação da assembleia, na memória dos entrevistados, se diferencia a partir do lugar que cada um ocupa dentro do contexto institucional. Trata-se de um dispositivo do Movimento Antimanicomial que promove um espaço de diálogo democrático e exercício de cidadania, num ambiente de acolhimento, colocação / Abstract: This study presents an investigation of the constitution of the assembly at the Unidade de Internação of the Dr. Cândido Ferreira Health Service within the context of the psychiatric reform and deinstitutionalization movement, conforming to guidelines of the Health Ministry. The study aims to contribute to the production of knowledge about group procedures, specifically the assembly, by researching its history. Another aim is to promote discussion on how group approaches function as intervention techniques intended for integrating staff members and health system users, so as to enhance the exercise of autonomy and citizenship. The assembly works toward enabling the user to be the main actor in his own therapeutic process. The study is qualitative in nature, and the data analyzed included oral sources and historical documents such as meeting minutes, photographs, reports and other documents. Authors such as Franco Basaglia, Paulo Amarante, Michel Foucault, Erving Goffman and Norbert Elias were used to support the discussion. The results confirm the value of the assembly as a therapeutic instrument; it is an important asset for structural organization, functioning and daily dynamics. It is also an important ally as a formation and in-service development tool for staff. The study showed that the representation of the assembly in the interviewees' remembrances differs according to the place each person occupies within the institutional context. It is a resource used in the deinstitutionalization movement to promote a venue for democratic dialogue and for exercising citizenship within a welcoming environment, where requests and suggestions can be presented, and where therapeutic issues have a space to develop / Mestrado / Saude, Interdisciplinaridade e Reabilitação / Mestre em Saúde, Interdisciplinaridade e Reabilitação

Orientador: Roberto Vilarta / Tese (doutorado) ¿ Universidade Estadual de Campinas, Faculdade de Educação Física / Made available in DSpace on 2018-08-23T08:50:43Z (GMT). No. of bitstreams: 1 Pereira_CynaraCristinaDominguesAlves_D.pdf: 4730564 bytes, checksum: e1f0c1591e60bd9dc32222ece84bf23a (MD5) Previous issue date: 2013 / Resumo: INTRODUÇÃO: No mundo todo, a alta prevalência de sedentarismo da população trabalhadora é preocupante. A falta de prática de atividade física aumenta os riscos em relação aos prejuízos da qualidade de vida, bem como, a morbidade e mortalidade destes indivíduos. As evidências científicas atuais, apesar de serem fundamentais, são insuficientes para indicar quais ações aplicadas no ambiente corporativo podem contribuir na minimização das condições de risco do sedentarismo. OBJETIVO: Comparar a associação de diferentes práticas de atividade física - atividade física sistematizada (AFS), grupos de treinamento físico programado (TFP) e grupos de aconselhamento à prática de atividade física (GA) sobre o nível de atividade física (NAF) e a percepção da qualidade de vida (QV) de trabalhadores do setor administrativo (ADM) de uma comunidade universitária. MÉTODO: Na fase I foram avaliados 645 sujeitos pertencentes à comunidade de ensino superior (discentes, docentes e trabalhadores ADM) e na fase II foram estratificados da amostra total 165 trabalhadores ADM que foram avaliados e aleatorizados, além do grupo controle (GI), para uma das 3 intervenções: (GII= AFS; GIII=AFS +TFP e GIV= AFS+ GA). As variáveis sociodemográficas, socioeconômicas e de saúde (formulário socioeconômico e de saúde e critério de classificação econômica do Brasil), NAF (IPAQ curto), percepção da QV (WHOQOL- bref), barreiras à prática de atividade física (NEWS) e estágios de prontidão para a mudança de comportamento em relação à atividade física (EPMC) foram analisadas por meio eletrônico. No início da pesquisa todas as variáveis foram coletadas (fase I) e repetidas na pré- intervenção e após 16 semanas de intervenção (fase II), totalizando a duração da pesquisa em 10 meses. RESULTADOS: Na fase I os grupos discentes e trabalhadores ADM descreveram, respectivamente, características sociodemográficas e socioeconômicas com similitudes: F (71,1%; 67,2 %), jovens entre 17 e 29 anos (81,9%; 50%), solteiros (80,0%; 58,3%), com renda mensal entre 1 e 3 salários mínimos (43,8%; 51,4%) e nível socioeconômico D (42,0%; 44,0%) e os docentes inversamente, a não ser pelo tempo de estudo. O NAF (suficientemente ativos- 64%) e o EPMC contemplação (41,4%) não apresentaram diferenças entre os grupos. Já a saúde foi pior para os trabalhadores ADM (presença de morbidades - 29,9%) e QV Total e a QV Geral foi maior para os docentes (73,5±23,2; 81±13,5) e trabalhadores ADM (70,1±22,6; 76,2±15,8) do que discentes (68,6±21,6; 74,4±16,0). Na fase II, pré- intervenção os grupos descreveram características sociodemográficas, socioeconômicas e de saúde sem diferenças. Pós- intervenção, o NAF apresentou maiores impactos nos grupos GIII-AFS + TFP (284,4%) e GIV- AFS + GA (243,3%), quando comparados aos outros grupos GI- Controle (- 83, %) e GII-AFS (-8,4%). A QV destacou maiores diferenças nos grupos GIII-AFS + TFP (9,8%) e GII-AFS (5,7%), quando comparados aos outros grupos GIV- AFS + GA (-0,4) e GI- Controle (0,1%). Todos os mecanismos de intervenção associados à prática de AFS foram mais relevantes quando comparados ao grupo que não participou das intervenções. CONCLUSÃO: Os programas de atividade física aplicados no local de trabalho exerceram influência positiva sobre o NAF e QV do trabalhador ADM. Os programas associados com maior frequência, compostos por vivências práticas e educacionais, foram os que apresentaram os melhores resultados / Abstract: BACKGROUND: The high prevalence of sedentary working population worldwide is worrisome because a lack of physical activity increases the risk of injury in relation to quality of life and morbidity and mortality. The current scientific evidences, despite being fundamental, are insufficient to indicate what actions implemented in the corporate environment can contribute in minimizing risk conditions of inactivity. OBJECTIVE: To compare the combination of different practices of physical activity-systematized physical activity (AFS), scheduled physical training groups (TFP), and counseling groups for physical activity (GA) - and its influence on the level of physical activity and perception of quality of life for workers in the administrative sector of the higher education community. METHOD: During phase I will be assessed 645 subjects belonging to the higher education community (students, teachers and workers in the administrative sector) and in Phase II will be stratified sample and evaluated total 165 workers in the administrative sector will be randomized, and the control group (GI), to one of three interventions: (GII = AFS, GIII = AFS + TFP and GIV = GA). Will examine the social demographic, socioeconomic and health (socioeconomic and health form and classification criteria of economic BRAZIL), physical activity (IPAQ short), perceived quality of life (WHOQOL-bref), barriers to physical activity (NEWS) and stages of readiness for behavior change (EPMC) in relation to physical activity by electronic. All variables will be collected prior to the start of Phase I, the pre-intervention and after 16 weeks of intervention in phase II, the total duration of the study at 10 months. RESULTS: In phase I the groups described students and workers in the administrative sector, respectively, with social demographic and socioeconomic similarities: F (71.1%; 67.2%), young people between 17 and 29 years (81.9%; 50%), single (80.0%; 58.3%), with a monthly income between 1 and 3 minimum wages (43.8%, 51.4%) and socioeconomic level D (42.0%; 44.0%) and teachers conversely, except the period of study. The physical activity level (sufficiently active- 64%) and EPMC contemplation (41.4%) did not differ between groups. Already health was worse for workers in the administrative sector (presence of comorbidities - 29.9%) and Total quality of life and General quality of life was greater for teachers (73.5 ± 23.2; 81 ± 13.5) and workers in the administrative sector (70 , 1 ± 22.6; 76.2 ± 15.8) than students (68.6 ± 21.6; 74.4 ± 16.0). In phase II, pre-intervention groups reported social demographic characteristics, socioeconomic and health without differences. Post-intervention, the level of physical activity had higher impacts on GIII-AFS + TFP (284.4%) and GIV-AFS + GA (243.3%) when compared to other groups Control- GI (- 83%) and GII-AFS (-8.4%). The largest differences in quality of life highlighted GIII-AFS + TFP (9.8%) and GII-AFS (5.7%), when compared to other groups GIV-AFS + GA (-0.4) and Control-GI (0.1%). All intervention mechanisms associated with the practice of AFS were more relevant when compared to the group that did not participate in interventions. CONCLUSION: The activity programs implemented in the workplace exerted positive influence on the level of physical activity and Quality of life of workers in the administrative sector. The programs associated with greater frequency, composed of educational practices and experiences, presented the best results / Doutorado / Atividade Fisica, Adaptação e Saude / Doutora em Educação Física

Abstrakt: Zdravotní stav populace a výdaje na něj vynaložené v současnosti jsou, a v budoucnosti bezesporu budou, jedněmi z nejostřeji sledovaných ukazatelů v lidském společenství. Těžištěm výzkumu této práce je porovnat výši výdajů plynoucích do zdravotní péče a zdravotní stav populace vybraného vzorku zemí. Analýza statistických dat odkryje, zda objem výdajů vede k lepšímu zdravotnímu stavu či nikoliv. Výzkum se opírá o veřejně přístupná, retrospektivní, statistická data referenčních států, jejichž porovnáním získám informace nutné k vyvození závěrů. Výsledek práce může dokázat, zda vyšší výdaje vedou k lepšímu zdravotnímu stavu populace či nikoliv a zda existuje výdajové optimum, nad které jsou výdaje čím dál méně efektivní. Analytická část obsahuje ekonomická a medicínská data vybraného vzorku dvanácti států, rozděleného na tři skupiny dle stupně rozvinutosti. V syntetické kapitole porovnám získaná data a vyvodím závěry položených hypotéz. Dále nastíním důvody akcelerující úrovně výdajů na zdravotní péči v USA a porovnám řadu ekonomických i medicínských ukazatelů s průměry zemí OECD. V závěru práce shrnu zjištěné výsledky a pokusím se nastínit optimální výši výdajů vzhledem k úrovni zdravotního stavu populace.

Orientador: Gastão Wagner de Sousa Campos / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-17T18:41:43Z (GMT). No. of bitstreams: 1 Paraguay_NestorLuizBruzziBezerra_M.pdf: 1065233 bytes, checksum: f8ef4e8e4144623567e9f17a6d76a3a0 (MD5) Previous issue date: 2011 / Resumo: Esta pesquisa tem como cerne principal de reflexão a disciplina MD-945, sub-módulo de Planejamento e Gestão. Neste sub-módulo as equipes dos centros de saúde da atenção primária, escolhem uma caso clinico no qual estejam sentindo dificuldade na coordenação clinica, adesão do paciente ao tratamento e/ou investigação diagnóstica. Estes pacientes apresentam em geral um alto grau de complexidade no seu processo saúde-doença, implicando assim numa abordagem e planejamento terapêutico singular e holístico, abordando as esferas do biopsicosocial e consequentemente mobilizando uma coordenação clinica multiprofissional e intersetorial. Nesta metodologia de ensino, os alunos e docentes constroem um Projeto Terapêutico Singular (PTS) e discutem com a equipe de referencia as metas de curto, médio e longo prazo, a coordenação clinica e as responsabilidades. A pesquisa é qualitativa, com uso da metodologia de estudo de casos e entrevistas semi-estruturadas á fim conhecer os significados e percepções na construção do PTS para os alunos, usuários e profissionais de referencia. O corpo do material de análise é constituído pelos PTS, entrevistas dos alunos, usuários e profissionais de referencia e os documentos relacionados às diretrizes pedagógicas da Faculdade de Ciências Médicas (FCM) e do Ministério da Educação e Cultura (MEC). Nestas entrevistas pesquisamos com os alunos: - o aprendizado e a percepção pessoal na construção do PTS e os componentes pedagógicos esta disciplina em relação ao contexto de ensino da FCM. O paradigma clinico deste sub-módulo em relação aos modelos de assistência praticados no âmbito da graduação da FCM. Nas entrevistas com os usuários, após o PTS encontramos uma reaproximação com o Centro de Saúde e os demais níveis de saúde, a promoção de uma rede social de apoio e uma coordenação clinica mais integrada. Nas entrevistas com os alunos, constatou-se que o PTS foi construído dialogicamente integrando teoria e prática e com um planejamento terapêutico holístico integrando as esferas do bio-psico-social. Estes aspectos, a percepção dos alunos é que no curso de graduação o paradigma clinico predominante é o biomédico, onde a prática médica tenta se aproximar do modelo de ciência no qual o cientista é imparcial, focando o objeto de estudo na doença e causando assim a dessubjetivação do doente .Estes paradigmas, clinico e pedagógico, apresentam interdependência e características comuns que são a ausência de espaços para a subjetividade dos pacientes e dos alunos. Esta dicotomia entre o saber e o sentir, entre o saber estruturado e a subjetividade, entre o saber científico e o domínio dos afetos é fundada na modernidade como uma garantia para a prática científica e encontra na medicina um modelo característico desta cultura ocidental. Esta pesquisa aponta para o uso de metodologias problematizadoras centradas no aluno e no seu processo de aprender á aprender, que integrem teoria e prática e que possibilitem espaços de reflexão e aprendizado sobre a relação medico - paciente.Considera importante no planejamento terapêutico uma abordagem do contexto social, psíquico, familiar e biológico e a construção da autonomia do usuário / Abstract: This research's core is the MD-945 subject, sub module of planning and management. On this sub module the primary care health center choose a clinical case, which they are having some difficulties on clinical coordenation, pacient adherence to the treatment and/or diagnostic investigation. In general, those acients present an high level of complexity on their health-disease process, what implies in a student/ teacher terapheutic, singular and holistic planinng and approach, which include biopsicosocial sphere and consenquently one multiprofessional and intersectorial clinical coordenation. Furthermore, the tudentes and teachers built an Singular Terapheutic Project (PTS), discuss the short, mid and long term clinical coordenation and responsabilities and with the reference group. In addition to that, this reaserach is qualitative that uses the case study methodology and semi-structured interviews in order to know the meanings and perceptions on the PTS construction to the patients, reference professional roups and students. The analysis material consists on: PTS; student's, reference group's and pacient's interviews; documents related to the pedagogical guidelines from FCM and MEC. On the students interviews it was reserached that: - the learnig and personal perception on the PTS construction and the pegagogical components of this discipline in relation to the FCM teaching context;- the clinical paradigma on this submodule in relation to the practiced assistance model at the FCM graduation. After the PTS, on the patients interviews we could find a reapproximation of them with the primary care health center and other health system levels, besides that there was a promotion of an support social network and more consolidated clinical coordenation. On the students interviews, it was observed that the PTS was diological built wich fused the practice with the theory, and united the bio-psico-social sphere in a holistic therapeutic planning. Moreover, on those aspects the student perception is that in the graduation course of study the main clinical paradigma is the biological one, where the medical practice trys to pproach the science model on wich the scientist is imparcial, and he focuses the study object n the disease, and that causes the lack of subjectivity of the patient. Those paradigmas, clinical and pedagocical, present interdependence and common characteristics that are: absence of the patient's and student's ubjectivity. These division between the know and feel, the structured knowledge and subjectivity, the scientific perception and the affection domain is founded on the modernity with a guarantee to the scientific practice and encounter on medicine a peculiar model based on the ocidental culture. On top of that, this research points out to the use of problematized methodology centered on the student and his rocess of learning to learn, wich integrates the theory and the practice, and that creates reflexion and learning spaces about the medical-patient relationship. It is important to consider the social, psicosocial, familiar and biological aspects and the patient's autonomy construction on the therapeutic planning / Mestrado / Política, Planejamento e Gestão em Saúde / Mestre em Saude Coletiva