Comprehensive gas chromatography (GC×GC) is a modern and advanced analytical method designed to separate very complex samples, when the separation efficiency of classical gas chromatography is not sufficient. GC×GC allows complete simultaneous analysis of a sample on two different columns, interconnected by special interface called the modulator. Three types of control units were set up and a robust pulse flow modulator (PFM) was developed in this work. PFM working parameters have been always optimized to allow combinations of columns with different sizes. Optimized PFM allows application of columns with 10-60 m length and 0.15-0.25 mm internal diameters for the first dimensions and with 1-10 m length and 0.25-0.32 mm internal diameters for the second dimension. For demonstration reasons, analyses of complex real samples, such as essential oils, oil derivatives and biological samples, were performed. PFM was compared with the commercial cryofocusation modulator Zoex for the selected column set and one sample (a mixture of volatile solvents) on a gas chromatograph equipped with both modulators. The average repeatability of retention times, expressed as a relative standard deviation, was approximately 2.0 % for PFM (cryofocusation about 0.5 %) and of the peak areas was approximately 3.5 %...

Introduction : Plusieurs études ont démontré que la pratique d’activité physique (AP) peut avoir un impact sur la vitalité cognitive des ainés. Le programme Musclez vos Méninges encourage les participants à être davantage actif et a été conçu pour promouvoir la vitalité cognitive. Ce mémoire vise à explorer : 1) les effets du programme sur l’AP; 2) l’effet modérateur et médiateur de l’AP sur les impacts du programme sur la cognition; 3) la corrélation entre l’AP et certaines dimensions cognitives des participants à l’entrée dans l’étude. Méthodologie: Au total, 294 personnes âgées de 60 ans et plus, intéressées à participer à un programme de vitalité cognitive ont été recrutées. Elles ont été évaluées avec des tests cognitifs (MoCA, MIA, CVLT, RBMT, MMQ, Attention, Stroop) et des instruments sur l’AP (une version adaptée du CHAMPS et le test de marche de 2 minutes du SFT). Des corrélations ont été faites à l’entrée dans l’étude et des régressions multivariées ont été réalisées pour mesurer l’impact du programme et celui de l’AP. Résultats : La participation au programme est associée à une hausse de l’AP (p< 0,05). Les analyses n’indiquent cependant pas d’effet significatif (p< 0,05) modérateur ou médiateur. À l'entrée dans l'étude, les sujets les plus actifs présentent de meilleurs résultats pour le recours aux stratégies mnésiques (p< 0,05). Conclusion: Un programme multifactoriel, incluant la promotion de l’AP, peut modifier significativement l’engagement à être physiquement actif. Des études futures devront toutefois démontrer si la pratique d’AP peut avoir un effet modérateur ou médiateur sur la vitalité cognitive. / Background: Several studies have demonstrated that physical activity (PA) could have an impact on the cognitive vitality of older adults. The Jog Your Mind program encourages participants to become more physically active and is designed to promote cognitive vitality. This study aims to explore: 1) the effect of the program on PA; 2) the moderating and mediating effects of PA on the program’s impact on cognition; and 3) the correlation between PA and various cognitive domains in participants prior to the start of the program. Methods: In total, 294 individuals aged 60 and over participated in the cognitive vitality promotion program immediately for the experimental group or one year later for the controls. They were evaluated using cognitive tests, questionnaires (MoCA, MIA, CVLT, RBMT, MMQ, QAA, Stroop) and PA instruments (an adapted version of the CHAMPS physical activity questionnaire and the 2-minute step test of the SFT). Correlations were made at the start of the study and multiple regressions were carried out to measure the impact of the program on PA. Results: Participation in the program was associated with an increase in PA (p< 0.05). However, analyses did not show a significant moderating or mediating effect of PA on cognition (p< 0.05). At the start of the study, the most active subjects obtained better results in terms of memory strategies (p< 0.05). Conclusion: These results show that a multifactorial program, including the promotion of PA, can lead participants to become more physically active. Further studies should be implemented to determine whether the practice of PA has a moderating or mediating effect on cognitive vitality.

L'approche criminologique de la délinquance du mineur permet de mettre en lumière les facteurs jouant un rôle dans le processus délinquantiel. Si certaines analyses s'attachent à démontrer l'influence déterminante de l'environnement familial sur la délinquance du mineur, ces propos méritent d'être nuancés. La famille est le modèle de socialisation primaire de l'enfant. Un contexte familial, régi des comportements déviants ou une autorité défaillante, entraînerait dès lors des conséquences criminogènes pour l'enfant. Pour autant, celui-ci ne reproduit pas automatiquement le schéma familial et bénéficie d'une intégration sociale.Dès lors, les analyses multifactorielles de la délinquance mettent en évidence l'importance des autres facteurs environnementaux dans le passage à l'acte du mineur, celui-ci évoluant par la rencontre d'agents extérieurs à la famille.L'influence des facteurs tels que l'école et les groupes de pairs peut se manifester de telle sorte que cette hypothèse remettrait en cause la théorie selon laquelle la famille est un facteur déterminant. Si ces analyses se justifient, elles demeurent incomplètes, soulevant alors la question du lien entre la délinquance juvénile et le fonctionnement de la société occidentale. / A criminalogy approach makes it possible to highlight decisive factors of the delinquency process (ou the criminal process). Some analysts aims to prove the importance of familial context on juvenile delinquency although these explanations seems insufficient. Family is the primary socialisation instance and familial background with deviant behaviors and defaulting authority could thus have an impact on juvenile delinquency. One can observe however that children sometimes do not reproduce the family scheme and are socially integrated. Consequently, a multi-factors analysis of delinquency points up the importance of other contextual factors, among them the external agents to the family encounters, in explaining the first acts of delinquency. Influence of factors as education and peer group imply the questioning of the familial background considered as a key factor of juvenile delinquency. If verified, these analysis remain nonetheless an incomplete explanation, while raising the question of the causal relationship between juvenile delinquency and the workings of Western society.

Pour appréhender l'ensemble du problème addictif et proposer une prise en charge appropriée, une évaluation multifactorielle est nécessaire. Les données récentes soulignent que le champ des addictions aux substances doit être étendu au champ des addictions comportementales. Une des lacunes dans la compréhension des troubles addictifs et de leur prise en charge pourrait être due à un manque d'outils d'évaluation standardisés qui évaluent l'ensemble des composantes de l'addiction et leurs répercussions dans différents domaines de la vie du sujet. Dans le champ des addictions aux substances, l'Addiction Severity Index (ASI) est l'outil le plus utilisé mondialement. L'ASI est un instrument qui évaluent les sujets pour la clinique ou la recherche. En France, notre groupe de recherche utilise l'ASI depuis 1992 pour la clinique et la recherche. Nous avons décidé de modifier l'ASI en y ajoutant de nouvelles sections. Depuis 2006, la version française modifiée de l'ASI présente donc des items évaluant l'usage de tabac (Section Tabac) et également des items permettant l'évaluation des comportements addictifs sans substance comme le jeu, le jeu d'argent et de hasard et les troubles du comportement alimentaire. L'objectif général de cette thèse était d'étudier la validité de la version française modifiée de l'Addiction Severity Index (ASI) chez des sujets pris en charge pour au moins une addiction dans des centres de soins spécialisés en addictologie. Les résultats montraient une très bonne validité des données de consommations de substances rapportées par les sujets. Les sections Tabac et Jeu / Jeu d'argent et de hasard avaient été montrées comme valides. La version modifiée de l'ASI semble être un bon outil permettant l'évaluation de la sévérité de l'ensemble des comportements addictifs. Cette adaptation fait de l'ASI modifié le premier outil qui permet d'évaluer l'ensemble des troubles addictifs et qui ne mesure pas uniquement la quantité, la durée et l'intensité de ces troubles. Elle va permettre d'aider le clinicien à mettre en place une prise en charge la plus adaptée et aux chercheurs de caractériser et de comparer les différentes addictions afin de dégager des différences et des similitudes. / A multidimensional assessment is key to understand the addiction problem and to develop an appropriate treatment plan. Recent findings support the scope that addictive disorders should include non-substance use disorders. A significant problem in understanding and managing the addictive disorders may be related to the lack of standardized instruments for assessing problems or other aspects of life that are affected by these pathologies. For the assessment of substance users exists a widely used instrument, the Addiction Severity Index (ASI). The ASI is an instrument that assesses subjects for both clinical and research purposes. In France, our research group used the ASI since 1992 for both clinical and research purposes. We decided to modify the French translation of the ASI and added some new items. Since 2006, the French modified ASI includes items to assess tobacco use but also non-substance addictive behaviors including gaming, gambling and eating disorders. The overall objective of this dissertation was to assess the validity of the French modified ASI in several samples of clients who sought treatment in outpatient addiction clinics. The findings showed a good validity of the self-reported substance use. The validity of the Tobacco section as well as the Gaming/Gambling section have been shown. The French modified ASI is a suitable instrument for assessing any type of addiction-related disorders. This adaptation makes the modified ASI the first instrument that assesses all possible addictive behaviors regardless of the type of the addiction and that measures more than just the quantity, duration, and intensity of addictive behaviors. ASI may be helpful for clinicians in helping them to design the best treatment plans for a patient, for policy makers to objectively understand the need in treatment, care centers or other institutions but also for researchers to measure contemporary issues in addiction treatment and to find similarities and differences between type of addiction.

Made available in DSpace on 2014-12-17T15:38:58Z (GMT). No. of bitstreams: 1 LilianePB_DISSERT.pdf: 1713227 bytes, checksum: 172042a5e305fa3b00cf58b20b09b38c (MD5) Previous issue date: 2012-06-01 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Locus of control is a construct that seeks to explain people's perceptions about the source of control of events, if the subject's own - internal - or belonging to some element outside of oneself - external. The location of individual s locus of control will suffer influence of their developmental period. During adolescence, individuals turn to the construction of their identity, and the structuring of sexual identity is a relevant part of this process, since the roles of males and females are the most important from the socio-cultural point of view. One of the roles that adolescents can take is the mother or father. We chose to head the adolescents who are not mothers and fathers, and question them about their concepts of parenthood. It is hypothesized that adolescents with internal locus of control will probably develop concepts of maternity and paternity in which they attach to themselves the responsibility for children. The aim of this study was to relate the locus of control s predominant dimension in adolescence and the way that these young people conceptualize parenthood. This is an exploratory analytical cross-sectional study accomplished with 400 adolescents from the classes of the sixth to ninth grade of high school at public schools in Natal / RN. We used as protocols: structured questionnaire involving sociodemographic questions and questions about the concept of parenthood, and the Multifactorial Scale of Locus of Control. Data were analyzed using descriptive and inferential statistics, with the aid of statistical package SPSS 18.0. The results regarding questions about the concept of maternity and paternity were analyzed using the analysis program often ALCESTE 4.7. The results showed that for boys and girls, maternity and paternity were characterized by the acquisition and assumption of responsibilities of adulthood. This concept is supported by the locus of control s classification of individuals, since most of the subjects of this study was characterized as individuals who tend to take responsibility for their life's events. For young people from lower classes (as the subjects of this research), the project of autonomy and social mobility is realized by the constitution of his own family and the ability to sustain it / L?cus de Controle ? um constructo que pretende explicar a percep??o das pessoas a respeito da fonte de controle dos eventos, se pr?prias do sujeito interno ou pertencente a algum elemento fora de si pr?prio externo. A localiza??o do l?cus de controle do indiv?duo sofrer? tamb?m influ?ncia do per?odo do desenvolvimento em que se encontra. Durante a adolesc?ncia, os indiv?duos se voltam para a constru??o da sua identidade, sendo que a estrutura??o da identidade sexual ? parte relevante desse processo, j? que os pap?is de g?nero masculino e feminino s?o os mais importantes do ponto de vista sociocultural. Um dos pap?is sociais que o adolescente pode assumir ? o de m?e ou de pai. Optou-se por abordar os adolescentes que ainda n?o s?o m?es e pais, e question?-los sobre seus conceitos de maternidade e paternidade. Hipotetizava-se que adolescentes com l?cus de controle interno provavelmente desenvolveriam conceitos de maternidade e paternidade em que atribuem a eles mesmos a responsabilidade pela crian?a. Objetivou-se relacionar a dimens?o predominante do l?cus de controle na adolesc?ncia e maneira como estes jovens conceituam maternidade e paternidade. Trata-se de um estudo explorat?rio anal?tico de corte transversal, realizado com 400 adolescentes das turmas do 6o ao 9o ano do Ensino M?dio de escolas p?blicas de Natal/RN. Os sujeitos foram distribu?dos proporcionalmente entre as oito escolas selecionadas, em cada distrito de Natal. Foram utilizados como protocolos: question?rio estruturado, envolvendo quest?es sociodemogr?ficas e quest?es sobre o conceito de maternidade e paternidade, e a Escala Multifatorial de L?cus de Controle. Os dados foram analisados utilizando-se a estat?stica descritiva e inferencial, com aux?lio do pacote estat?stico SPSS 18.0. Os resultados referentes ?s quest?es sobre o conceito de maternidade e paternidade foram analisados com aux?lio do programa de an?lise de freq??ncia, ALCESTE 4.7. Os resultados revelaram que para meninos e meninas, a maternidade e paternidade s?o caracterizadas pela aquisi??o e assun??o de responsabilidades da vida adulta. Tal conceitua??o encontra respaldo tamb?m na classifica??o dos sujeitos quanto ao l?cus de controle, j? que a maioria dos sujeitos dessa pesquisa foi caracterizada como indiv?duos que tendem a assumir a responsabilidade pelos eventos da sua vida. Para jovens de classes populares, o projeto de autonomia e ascens?o social se concretiza pela constitui??o da pr?pria fam?lia e pela capacidade de cuidar e sustent?-la

L’hémochromatose HFE est une maladie du métabolisme du fer liée au gène HFE dont la principale mutation est C282Y. L’objectif général de ce travail était d’étudier l’influence de facteurs génétiques et non génétiques sur l’expression phénotypique de patients atteints d’hémochromatose HFE. Cette étude prospective incluait les patients C282Y/C282Y etC282Y/H63D inclus en protocole de saignées entre janvier 2004 et décembre 2011 au centre de santé brestois de l’EFS-Bretagne. Dans un premier temps, nous avons étudié l’influence du génotype C282Y/H63D sur la survenue d’une surcharge en fer. Nous avons confirmé que le variant H63D doit être considéré comme un facteur de susceptibilité dont l’expression est liée à la présence de co-facteurs responsables d’une hyper ferritinémie. Ensuite, nous avons étudié le rôle des grossesses et de l’alimentation sur l’expression phénotypique du génotype C282Yhomozygote. Nous avons montré qu’il existe bien une différence d’expressivité clinique liée au sexe chez les patients C282Y/C282Y. Cependant, nos données n’ont pas confirmé l’effet protecteur typiquement attribué aux grossesses pour expliquer la plus lente accumulation de fer chez les femmes. Cette étude a également mis en évidence une association modérée entre la consommation d’aliments riches en fer et le degré de surcharge en fer des patients C282Yhomozygotes traités par phlébotomies. Ce travail contribue à mieux comprendre l’hétérogénéité phénotypique observée dans l’hémochromatose HFE. La finalité est de pouvoir repérer précocement les sujets les plus à risque de développer les surcharges en fer les plus sévères et par conséquent des complications cliniques. / HFE hemochromatosis is a disorder of iron metabolism related to the HFE gene whose mainmutation is C282Y. The overall aim of this study was to investigate the influence of genetic and non genetic factors on phenotypic expression of patients with HFE hemochromatosis. This prospective study included the C282Y/C282Y and C282Y/H63D patients enrolled in a phlebotomy program between 2004 and 2011 in a blood centre of western Brittany (Brest, France). First, weassessed the weight of the C282Y/H63D genotype in the occurrence of iron overload. We confirmed that H63D is a discrete genetic susceptibility factor whose expression is most visible in association with other co-factors responsible for hyper ferritinemia. Then we investigated the effect of pregnancies and iron-rich diet on phenotypic expressivity of the C282Y/C282Y genotype. We have shown that there is a difference in clinical expression related to gender in C282Y/C282Ypatients. However our findings did not confirm that pregnancies protect against iron accumulationin women. This study established a moderate link between dietary iron intake and the degree of iron overload in HFE hemochromatosis patients who come to medical attention. This work contributes to a better understanding of the phenotypic heterogeneity observed in HFE hemochromatosis. The purpose is to identify precociously subjects the most at risk of developing iron overload and therefore clinical complications.

Cette thèse porte sur les différents facteurs impliqués dans le traitement des relatives, notamment le traitement des relatives sujet et objet ainsi que celui de l’attachement des relatives sujet. En prenant appui sur les approches multifactorielles, (Trueswell et Tanenhaus, 1994 ; Spivey et Tanenhaus, 1998), j’insiste sur l’insuffisance de l’approche monofactorielle souvent adoptée dans l’analyse du traitement des relatives, et je mets en avant le rôle des propriétés fines des langues. Je propose alors dans cette thèse de dépasser les notions de langue avec un avantage pour la relative sujet ou objet, ou avec une préférence avec attachement haut ou bas.Je présente d’abord les ressemblances et différences des propriétés des relatives dans les quatre langues étudiées : l’anglais, le cantonais, le français et le mandarin. Cette description permet de mieux appréhender leur rôle dans le traitement, notamment pour comprendre les différences constatées dans les expériences entre les langues.Je me concentre ensuite dans les deux Parties suivantes sur l’interaction entre des facteurs principalement syntaxiques, cognitifs et grammaticaux en jeu dans le traitement des relatives, avec des expériences de jugements d’acceptabilité et de mouvements oculaires avec le paradigme monde visuel (relatives sujet et objet dans les quatre langues étudiées, et attachement en anglais et en français). Je poursuis par une réflexion sur l’approche multifactorielle en tenant compte des facteurs liés aux domaines sémantique et pragmatique. Pour cela, j’observe le traitement des relatives sujet et objet en français et en anglais dans une étude de corpus, des expériences de jugements d’acceptabilité, de lecture par autoprésentation segmentée, et de mouvements oculaires en lecture. Enfin, pour élargir les facteurs en jeu dans le traitement des relatives au-delà du domaine linguistique, je montre l’influence d’un domaine non linguistique (amorçage mathématique) sur le domaine linguistique (attachement) en français avec des expériences de choix restreints, et de mouvements oculaires avec le paradigme monde visuel. / The present dissertation focuses on the factors implied in relative clause processing, mainly subject/object relative clauses and relative clause attachment. Based on previous multifactorial approaches (Trueswell et Tanenhaus, 1994; Spivey et Tanenhaus, 1998), I show that the usual monofactorial way of thinking about processing is inadequate and that fine-grained language properties should also be taken into account. I propose to go beyond the notion of subject/object languages or high/low attachment languages. I present the relative clause properties in four languages (English, Mandarin, Cantonese and French). This description is necessary to grasp their influence in processing, especially the differences observed across languages in experiments. Based on the linguistic description, I look at the interaction between cognitive, syntactic and grammatical factors in relative clause processing. I present acceptability judgment tasks and visual world eye-tracking experiments in order to analyse subject/object relatives in the four languages, and relative clause attachment in English and French. In line with the multifactorial approach, I analyse the influence of semantics and pragmatics in relative clause processing, especially in French and English. For that, I show a corpus study, acceptability judgment and self-paced reading tasks and eye-tracking while reading experiments. Finally, to broaden the perspective beyond the linguistic domain, I show the influence of other non-linguistic factors on relative clause processing, by presenting visual world eye-tracking and forced choice experiments about the influence of mathematical priming on relative clause attachment in French.

Residents in nursing facilities are more prone to falls than those living in the community. Injuries resulting from falls impact residents, their families, and healthcare costs. The gap in nursing practice was the lack of a comprehensive fall-prevention program in a long-term care facility that had experienced high fall rates among residents. This project addressed whether an educational program using the American Medical Directors Association's clinical practice guideline and the Centers for Disease Control and Prevention's STEADI (Stopping Elderly Accidents, Deaths, & Injuries) toolkit for fall- prevention improved the self-efficacy of direct-care staff in preventing falls among residents in a long-term care facility. The practice-focused question focused on whether education on the use of an integrated multifactorial fall-prevention guideline would increase confidence of long-term care staff in reducing falls in long-term care residents. The evaluation used the 11-item Self-Efficacy for Preventing Falls-Nurse scale for 5 licensed nursing staff and the 8-item Self-Efficacy for Preventing Falls-Assistant scale for 21 nursing assistants. The positive change in self-efficacy scores of nurses and nursing assistants after the education program was greatest for face-to-face team communication regarding fall risk and individual resident prevention plans. The use of best-practice guidelines that improve fall risk-assessment and use of fall precautions to decrease the number of falls and falls with injury has the potential to bring about positive social change by improving the nursing care of nursing home residents, resulting in improved resident safety and quality of life.

No description available.

Orientadores: Antonia Paula Marques de Faria, Luis Alberto Magna / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-20T01:20:07Z (GMT). No. of bitstreams: 1 Rim_PriscilaHaeHyun_D.pdf: 2205542 bytes, checksum: edfaaae7ed2a5aac688ce4f677a0d05a (MD5) Previous issue date: 2012 / Resumo: Introdução: A degeneração macular relacionada à idade (DMRI) é uma das principais causas de cegueira no mundo desenvolvido, acometendo indivíduos com mais de 65 anos. É uma condição multifatorial degenerativa e progressiva, ocasionando perda da visão central de um ou ambos os olhos e afetando a independência do idoso. Vários fatores de risco estão associados com essa condição incluindo fatores oculares, genéticos, demográficos, nutricionais, médicos e ambientais, mas não há estudo sistemático dos mesmos na população brasileira. Seria oportuno conhecê-los, considerando estabelecer eventuais estratégias para prevenção e diagnóstico precoce, pois apesar dos notáveis avanços na terapêutica da DMRI, o impacto socioeconômico dessa condição e de suas complicações tenderá a aumentar com o envelhecimento da população. Objetivos: Identificar os fatores de risco associados ao desenvolvimento e progressão da DMRI em uma população brasileira. Métodos: Realizado estudo transversal com grupo controle envolvendo 236 participantes com idade >50 anos incluindo 141 indivíduos afetados e 95 controles sem DMRI, todos pacientes assistidos no serviço de Oftalmologia do Hospital de Clínicas da Unicamp. Todos os participantes foram submetidos a exame oftalmológico completo incluindo fundoscopia, retinografia e angiografia e responderam a um questionário contendo perguntas sobre fatores demográficos, antecedentes médicos e oculares, história familial de DMRI, estilo de vida, hábitos de tabagismo e etilismo. Resultados: Dos 141 portadores de DMRI, 99 (71%) indivíduos apresentavam DMRI da forma avançada em pelo menos um dos olhos (57% DMRI neovascular e 13% atrofia geográfica) e 42 (30%) da forma inicial da doença (DMRI seca leve ou moderada). Os indivíduos afetados apresentaram acuidade visual (média de 20/200) significativamente menor do que os controles (média de 20/40) e mais de 50% dos pacientes com DMRI eram portadores de cegueira ou visão subnormal, (RR 9,89; 95%CI 3,79-25,81). Houve diferença significativa em relação aos fatores como: idade (RR 1.51; 95% CI: 0,88-2,58), história familial de DMRI (RR 6,58; 95% CI: 1,94-22,31), presença de doença cardiovascular (DCV) (RR 2,39; 95% CI: 1,08-5,28), altos níveis de colesterol plasmático (RR 1,49; 95% CI: 0,84-2,65) e sedentarismo (RR 1,39; 95% CI: 0,82-2,37). Não houve diferença significativa em relação ao sexo, IMC, catarata e/ou cirurgia de catarata, cor da pele, cor da íris, exposição solar, uso de antioxidantes, hipertensão arterial sistêmica, diabetes, tabagismo e etilismo na comparação entre pacientes e controles. Quanto ao tipo de DMRI, foi observada associação significativa em relação à presença de doença cardiovascular e a DMRI avançada (RR 2,29; 95% CI: 0,81-6,44). O nível de colesterol nos portadores de DMRI inicial foi mais alto que os de DMRI avançada (RR 1,67; 95% CI: 1,09-4,80). A correlação de 0,351 foi obtida na análise discriminante (stepwise), onde os fatores antecedentes familiais, idade, sedentarismo e dislipidemia foram considerados. Conclusão: Verificou-se na amostra estudada que os principais fatores de risco para DMRI são: idade, história familial de DMRI, doença cardiovascular, dislipidemia e sedentarismo. Entre estes fatores, indivíduos com DCV apresentaram risco aumentado para o desenvolvimento da forma avançada da DMRI e a hipercolesterolemia foi predominante naqueles com DMRI inicial. Como a DCV e a DMRI na forma avançada aparentemente apresentam vários fatores de risco em comum, foi feita recomendação final de que poderiam ser prevenidas conjuntamente por meio de programas de promoção da saúde do idoso envolvendo combate a fatores como hipertensão arterial, diabetes, obesidade (alto IMC), tabagismo, etilismo e maus hábitos alimentares, embora isoladamente não fossem estatisticamente significativos no presente estudo. Também foi destacado o papel da hereditariedade desta condição e a perspectiva de que membros das famílias de portadores sejam informados sobre risco de recorrência e medidas preventivas / Abstract: Background: Age-related macular degeneration (AMD) is one of the leading causes of irreversible blindness among individuals 65 years of age or older in developed countries. It is a degenerative and complex condition causing lost of central vision that impacts the independence of the elderly. A number of major risk factors for AMD have been identified worldwide, including genetic, demographic, nutritional, lifestyle, medical, environmental, and ocular factors, but there are no systematic studies on Brazilian population until now. The knowledge of these factors will lead to the elaboration of early diagnostic and preventive strategies taking into account that despite remarkable developments in therapy, the socio-economic burden of the disease is likely to increase worldwide as the population ages. Purpose: To identify risk factors associated with the onset and progression of age-related macular degeneration in a Brazilian population aiming the assessment of possible preventive measures based in the profile of these patients. Methods: A cross-sectional study with control group was performed in 236 participants aged 50 years or older including 141 affected individuals and 95 controls without disease, all current patients from the Department of Ophthalmology-Otorhinolaryngology of Clinical Hospital, Faculty of Medical Sciences-Unicamp. Ocular examinations were performed including color stereoscopic fundus photographs and data including demographic factors, ocular and medical history, family history of AMD, lifestyle, smoking and drinking habits was obtained by questionnaire from all participants. Results: Of the 141 AMD cases, 99 (71%) had late AMD in at least one eye (57% neovascular AMD and 13% geographic atrophy) and 42 (30%) had early AMD. The visual acuity of the AMD patients (mean of 20/200) was substantially lower than controls (mean of 20/40). More than 50% of AMD cases had visual impairment among (RR 9.89; 95%CI: 3.79-25.81). Age (RR 1.51; 95% CI: 0.88-2.58), positive family history of AMD (RR 6.58; 95% CI: 1.94-22.31); presence of cardiovascular disease (CVD) (RR 2.39; 95% CI: 1.08-5.28), low physical activity level (RR 1.39; 95% CI: 0.82-2.37) and high serum cholesterol (RR, 1.49; 95% CI: 0.84-2.65) were associated to increased risk for AMD. There was no significant association with sex, IMC, cataract/cataract surgery, skin color, iris color, sunlight exposure, antioxidants intake, history of hypertension, diabetes, smoking status and alcohol consumption between the groups of AMD patients and controls. Comparing data between affected individuals, there was a significant association with history of CVD and incidence of late AMD (RR 2.29; 95% CI 0.81-6.44). There were higher levels of serum cholesterol among subjects with early AMD than those with late AMD (RR 1.67; 95% CI: 1.09-4.80). A correlation of 0.351 was obtained in discriminant analysis (stepwise), where factors such as family history, age, low physical activity and high serum cholesterol were considered. Conclusions: This findings show that the main risk factors associated to AMD in this population are: age, family history, cardiovascular disease (CVD), high level of cholesterol and low physical activity. Among these factors, patients with history of CVD were associated with increased risk to advanced AMD and higher levels of plasma cholesterol were found among individuals with early AMD. As CVD and late AMD apparently share multiple risk factors, final recommendation was made that both conditions could be prevented jointly through programmes of health promotion for the elderly. The targets include combat of hypertension, diabetes, obesity (high BMI), smoking, alcoholism and bad eating habits, although in isolation were not statistically significant in this study. The role of heredity in this condition was also highlighted as well as the prospect of family members of affected individuals to be informed about risk of recurrence and preventive measures / Doutorado / Oftalmologia / Doutor em Ciências Médicas