Made available in DSpace on 2014-07-29T15:04:46Z (GMT). No. of bitstreams: 1 dissertacao valeria pagotto.pdf: 851386 bytes, checksum: b69b53b1c7c85fd7e5c4a211e5bef9ef (MD5) Previous issue date: 2009-12-15 / Self-rated health is one of the most widely used indicators in studies of the elderly population. There is evidence of its reliability and its potential in predicting mortality and functional decline. The perception of health is a multidimensional and subjective individual, who usually consider a number of factors when considering their own health. The aim of this study was to estimate the prevalence of self-rated poor health and associated factors in elderly users of the Unified System of Health, Goiânia-GO. This is a cross-sectional population-based, with individuals 60 years or more. Data were collected from December 2008 to March 2009. Applied a standardized questionnaire including socioeconomic, demographic, health and lifestyle. Self-rated health was dichotomized in self-rated good health (very good / good / fair) and bad (poor / very poor). Analysis was descriptive of the study variables and the relationship between self-rated poor health and the covariates were explored through the prevalence ratio (PR) and respectives CI 95%. Multivariate analysis was performed using Poisson regression with hierarchical analysis. Were included in this analysis the variables with value p <0.20. The tests were performed in STATA 9.0. We interviewed 403 elderly and 66% were female, 29.8% aged 65 to 69, 28.8% with less than 1 year of study and 56.1% of elderly living with a partner. Self-rated poor health was reported by 27.5% of the elderly, with higher prevalence among women (29.7%) and aged 60-64 years (29.1%). In the bivariate analysis the factors associated with self-rated poor health were: living without a partner, have 3 or more conditions, have Diabetes Mellitus and Musculoskeletal Disease, was hospitalized last year, making use of 5 or more drugs and no physical activity or sport. Observing the estimates of effect, the highest prevalence ratios were: no physical activity (RP= 2.17, 95% CI 1.44-3.66), musculoskeletal diseases (RP = 1.84, 95% CI 1.26-2.68), hospitalization in the last year (RP = 1.62, 95% CI 1.10 - 2.41), diabetes (RP = 1.52, 95% CI 1.02 to 2.27).The results of this study confirm that several factors are associated with poor self-rated health. However, among elderly users of SUS in Goiania, self-evaluation is strongly associated with health conditions. Starting from the assumption that this indicator can help in objective assessment of the health status of older people, this knowledge can help steer the formulation of policies to promote health and quality of life. / A auto-avaliação do estado de saúde é um dos indicadores mais empregados em estudos com a população idosa. Existem evidências de sua confiabilidade e de seu potencial na predição da mortalidade e do declínio funcional. A percepção da saúde representa uma visão multidimensional e subjetiva do individuo, que costuma considerar uma série de fatores quando analisam sua própria saúde. O objetivo deste estudo foi estimar a prevalência da auto-avaliação do estado de saúde ruim e seus fatores associados em idosos usuários do Sistema Único de Saúde de Goiânia-GO. Trata-se de um estudo transversal, de base populacional, com idosos de 60 anos ou mais. Os dados foram coletados no período de dezembro de 2008 a março de 2009. Aplicou-se questionário padronizado incluindo variáveis socioeconômicas, demográficas, condições de saúde e estilo de vida. A auto-avaliação de saúde foi dicotomizada em auto-avaliação de saúde boa (muito boa/boa/regular) e ruim (fraca/péssima). Realizou-se análise descritiva das variáveis do estudo e as associações entre auto-avaliação do estado de saúde ruim e as co-variáveis foram exploradas através da Razão de Prevalência (RP) e respectivos IC 95%. A análise multivariada foi realizada por meio da Regressão de Poisson hierarquizada. Foram inseridas nesta análise as variáveis com p<0,20. As análises foram realizadas no STATA 8.0. Foram entrevistados 403 idosos sendo 66% do sexo feminino, 29,8% na faixa etária de 65 a 69 anos, 28,8% com menos de 1 ano de estudo e 56,1% de idosos vivendo com companheiro. A auto-avaliação do estado de saúde ruim foi referida por 27,5% dos idosos, com maior prevalência entre as mulheres (29,7%) e na faixa etária de 60-64 anos (29,1%). Na análise bivariada a os fatores associados à auto-avaliação do estado de saúde ruim foram: viver sem companheiro, ter 3 ou mais morbidades, ter Diabetes Mellitus e Doenças Osteomusculares, ter sido internado no último ano, fazer uso de 5 ou mais medicamentos e não praticar atividade física. Observando as estimativas de efeito, as maiores Razões de Prevalência foram: não praticar atividade física (RP=2,17; IC95% 1,44 3,66), doenças osteomusculares (RP=1,84; IC95% 1,26 2,68), internação no último ano (RP=1,62; IC95% 1,10 2,41) e Diabetes Mellitus (RP=1,52; IC95% 1,02 2,27). Os resultados deste estudo mostram que vários fatores estão associados à auto-avaliação ruim da saúde. No entanto, entre os idosos usuários do SUS em Goiânia, a auto-avaliação de saúde ruim está fortemente associada com as condições de saúde. Partindo-se do pressuposto que este indicador pode auxiliar na avaliação objetiva do estado de saúde dos idosos, este conhecimento pode contribuir para a orientação e formulação de políticas que visem promover a saúde e a qualidade de vida dos idosos.

Made available in DSpace on 2014-08-20T13:57:56Z (GMT). No. of bitstreams: 1 Dissertacao_Giovanny_Vinicius_Araujo_de_Franca.pdf: 1350290 bytes, checksum: f64656537fb2ed84aef7bef88c09c3df (MD5) Previous issue date: 2010-11-05 / Objective: To estimate the prevalence of episodes of Binge Eating (BE) and to assess potential associations with nutritional status, satisfaction with current body weight, selfrated health status (SRHS) and body weight. Method: A cross-sectional populationbased study was carried out in the city of Pelotas, southern Brazil, with a sample of 2,097 individuals aged 20-59 years. BE was assessed through a questionnaire and defined as binging one or more times over the last three months before the interview. Results: The prevalence of BE and recurrent BE was 7.9% and 2.7%, respectively. In the adjusted analysis, obesity, fair/poor SRHS and body dissatisfaction remained strongly associated with BE. Discussion: This study showed a high prevalence of BE among adults in Pelotas, and its higher among younger women, fat and those who desire to weigh less. The current results are informative, but longitudinal studies would be needed to demonstrate the causal relationship between these events. / Objetivo: estimar a prevalência de episódios de compulsão alimentar (BE) e para avaliar as possíveis associações com estado nutricional, satisfação com o peso corporal atual, o estado de saúde autoavaliados (SRHS) e peso corporal. Método: Estudo transversal populacional realizado na cidade de Pelotas, sul do Brasil, com uma amostra de 2.097 indivíduos com idade entre 20-59 anos. BE foi avaliada através de um questionário e definido como compulsão uma ou mais vezes nos últimos três meses anteriores à entrevista. Resultados: A prevalência da BE e recorrente BE foi de 7,9% e 2,7%, respectivamente. Na análise ajustada, obesidade, SRHS justas / pobres e a insatisfação corporal permaneceu fortemente associada com a BE. Discussão: Este estudo mostrou uma elevada prevalência de CA entre adultos em Pelotas, e sua maior entre as mulheres mais jovens, gordura e aqueles que desejam pesar menos. Os resultados atuais são de caráter informativo, mas estudos longitudinais seriam necessários para demonstrar a relação causal entre esses eventos.

This thesis examines two aspects of social inequalities in health with three empirical studies that are based on the Swedish Level of Living survey (LNU): The relationship between accumulated occupational class positions during adulthood and health and the class-specific nature of gender differences in health. Previous research continuously finds that there are health differences by class and gender, but less is known about the extent to which accumulated class experiences in adulthood are related to health or how gender differences vary by class. The overall conclusion in this thesis is that occupational class experiences matters for health, both as historical and current experiences. Furthermore, the results highlight the importance of taking class into consideration when examining health differences between men and women, as the mechanisms that underlie the gender gaps in health are not necessarily the same for all classes. The studies can be outlined as: Study I: Class differences in working conditions is a mechanism that underlies class inequalities in health. The working class is generally more exposed to adverse working environments than non-manual employees, and when the wear and tear of these conditions accumulate over time, the length of this exposure may contribute to class inequalities in health. Thereby, accumulated time in the working class is studied as a partial explanation for class differences in health. The results suggest that the duration of time in the working class is related to a higher probability of less than good self-rated general health (SRH), given current class position. This association was also found among individuals who were no longer in working class positions and thus show that duration of experience matters, both as current and past experience. Study II: The study addresses the research gap of class-specificity in gender health inequality and seeks to further disentangle class and gender by studying gender gaps separately by class. The results show that there are class-specific gender gaps for both SRH and musculoskeletal pain, while the gender gap in psychiatric distress appears to be more general across class. Working conditions do not explain the between-class differences in gender gaps but contribute to specific gender differences in health within classes. Study III: The labour market has changed over time and has “upgraded” the class structure while at the same time the share of women in paid employment has increased. Therefore, female health may be increasingly influenced by occupational factors, such as working conditions. This study explores the class-specific nature of gender differences and investigates musculoskeletal pain and working conditions among employed men and women within classes during a time-period that spanned more than 30 years. There were class-specific gender gaps in health throughout the period. The gender gap has increased more, and is wider, among non-manual employees compared to the working classes. This development could not be explained by changes in working conditions. / <p>At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 2: Manuscript. Paper 3: Manuscript.</p>

Background : Studies of self-rated oral health are always done at either the individual level or the aggregate level. Partitioning individual and neighbourhood sources of variation also enables explorations of the influences of people’s social context on their self-rated oral health. Objective : The main objective of the study was to examine the influence of the social context in which people live on their self-rating of their oral health, independent of individual indicators of good oral health. Method : This study used a secondary analysis of data on a nationally representative sample of 2 907 South African adults (aged ≥ 16 years) who had participated in the 2007 annual South African Social Attitude Survey (SASAS). The 2007 SASAS used a multi-stage probability sampling strategy, with census enumeration areas as the primary sampling unit. Using an interviewer-administered questionnaire, the information obtained included socio-demographic data, the respondents’ level of trust in people (a proxy measure for social capital), oral health behaviours and self-rated oral health. Using the 2005 General Household Survey (GHS) (persons’ n=107 987; households’ n=28 129), the living environment characteristics of participants of the SASAS were obtained, including sources of water and energy supply and household cell phone ownership as a proxy measure for social networking. A mixed-effects model was then constructed to determine factors associated with a self-rating of oral health as ‘very good/good’. Results : Of the respondents, 51.7% were female. Among the respondents, 76.3% self-rated their oral health as good. There was a significant gender modifying effect, thus analyses was stratified by gender. The odds of self-rating oral health as good was significantly higher only among females living in areas with higher household cell phone ownership density, even after controlling for potential confounders. At the individual level, trust was positively associated with good self-rated oral health only among males, and higher social ranking in the society was positively associated with good self-rated oral health only among females. Overall, 55% of the total variance in self-rated oral health was explained by factors operating at the individual level, whereas 18% of the total variance was explained by factors operating at the community level. Self-report of recent oral health problems such as toothache and oral malodour were significantly associated with lower odds of self-rating their oral health as good, as was with reporting less frequent brushing. Conclusion : Good self-rated oral health may be positively associated with indicators of higher levels of social capital both at the level of the individual and the community and with less physical impairments of oral functioning. Furthermore, the findings indicate that unlike men’s oral health ratings, women’s oral health ratings are more likely to be influenced by women’s social relationships with others in the society. Copyright / Dissertation (MSc)--University of Pretoria, 2011. / School of Health Systems and Public Health (SHSPH) / Unrestricted

This thesis deals with self-rated health and consumption of fruits and vegetables in the Czech part of the HAPIEE study. The recommended amount of 400 g of fruit and vegetable consumption was met at 49,2% of men and 70,1% of women participating in the study. In the case of a higher 600 g recommendation it was 23,3% men and 42,6% women. The relationship between self-rated health and fruit and vegetable consumption was analyzed using the logistic regression method. Health was better assessed by those who consumed fruits and vegetables in the interval of 258-549g (2nd and 3rd quintiles of fruit and vegetable consumption). Those who consumed less or more fruits and vegetables rated their health worse. There were no differences in the relationship between self-rated health and consumption of fruits and vegetables among the sexes, although men had a higher chance of rating their health as bad than women. Key words: self rated health, fruit and vegetable intake, fruit, vegetable, regression

Tidigare forskning pekar på att det kan finnas samband mellan vissa psykologiska faktorer och utveckling av depression och ångest. Därför var syftet med denna studie att undersöka huruvida olika psykologiska faktorer påverkar risken att utveckla depression samt ångest vid en uppföljning efter tre år. Studien baserades på data som insamlats vid det första (T1) och det andra (T2) mättillfället i den longitudinella populationsbaserade Miljöhälsostudien i Västerbotten. Samplen i denna undersökning bestod av deltagare som inte hade ångest (n=1930), och deltagare som inte hade depression (n=2120) vid T1. I studien undersöktes i vilken utsträckning upplevelse av utmattning, insomni, känsla av hjälp- och hopplöshet, stress, självskattad ohälsa, ångest och depression vid T1 ökade risken för depression respektive ångest vid T2. Logistiska regressionsanalyser visade på en signifikant ökad risk för att utveckla depression vid T2 (Oddskvot; OK=1.99-3.64) för samtliga riskfaktorer. Riskfaktorerna depression, utmattning, hjälp- och hopplöshet och självskattad ohälsa ökade risken för att utveckla ångest vid T2 signifikant (OK=2.37-3.78). Sammanfattningsvis visar resultaten att riskfaktorerna indikerar en i varierande grad ökad risk för att utveckla depression och ångest. Kännedom om riskfaktorer kan vara ett betydelsefullt stöd för att i ett tidigt skede sätta in interventioner och därmed förhindra senare insjuknande i depression och ångest. / Previous research suggests that there may be a link between certain psychological factors and development of depression and anxiety. The purpose of this study was therefore to investigate how different psychological factors affect the risk of developing depression and anxiety in a follow-up three years later. The study was based on data from baseline (T1) and follow-up (T2) in the Västerbotten Environmental Health Study, a longitudinal population- based study. The sample consisted of participants who did not have anxiety (n = 1930), and participants who did not have depression (n = 2120) at T1. The study examined the extent to which experience of exhaustion, insomnia, feelings of helplessness and hopelessness, stress, low self-rated health, anxiety and depression at T1 increased the risk of depression and anxiety at T2, respectively. Logistic regression analyses showed a significantly increased risk of developing depression at T2 (Odds ratio; OR = 1.99-3.64) for all risk factors. The risk factors depression, exhaustion, feelings of helplessness and hopelessness and low self-rated health significantly increased the risk of developing anxiety at T2 (OR = 2.37-3.78). In conclusion, the results show that the risk factors indicate a varying degree of increased risk of developing depression and anxiety. Knowledge of risk factors is important as support for initiating interventions at an early stage and thus preventing later onset of depression and anxiety.

In Deutschland ist eine zunehmende Kinderlosigkeit zu beklagen (Statistisches Bundesamt 2009). Die Ursachen hierfür werden primär vor dem Hintergrund der Unvereinbarkeit von Berufstätigkeit und Mutterschaft diskutiert (Schrupp 2008). Aus lerntheoretischer Perspektive wären subjektiv empfundene gesundheitliche Ein-schränkungen von Frauen nach der Geburt eines Kindes als weitere Ursache denkbar. Über die subjektiven Gesundheitseinschätzungen von Frauen im geburtshilflichen Kontext ist jedoch nur wenig bekannt. Vereinzelt finden sich Hinweise, dass Frauen ihre subjektive Gesundheit (SGH) nach der Geburt ihres Kindes trotz bestehender Morbidität sehr positiv bewerten (Bauer 2011, Schytt et al. 2005, Borrmann 2005). Ziel der Studie ist es die subjektive Morbidität, die SGH sowie die gesundheitsbezogenen Lebensqualität (GHLQ) gesunder Frauen acht Wochen und sechs Monate nach der Geburt eines Kindes zu erfassen und die Faktoren zu ermitteln, die sich beeinflussend auf SGH und GHLQ auswirken. Methode: Retrospektive, longitudinale Kohortenstudie. Basis der Sekundäranalyse bilden Daten von 1029 Erst- und Mehrgebärenden, die im Rahmen einer multizentrisch angelegten, prospektiven Interventionsstudie zum Versorgungskonzept Hebammenkreißsaal an der Hochschule Osnabrück unter Förderung des Bundesministeri-ums für Bildung und Forschung (FKZ 01 GT 0616) zum Zeitpunkt der Geburt (t0) sowie acht Wochen (t1) und sechs Monate (t2) nach der Geburt erhoben wurden. Zur Ermittlung der SGH wurde der SF-1 angewendet. Die Operationalisierung der GHLQ erfolgte über die standardisierte körperliche und die standardisierte psychische Summenskala des SF-36. Ergebnisse: Gut die Hälfte der Studienteilnehmerinnen bewertete ihre SGH zu t1 und t2 besser als gut, wobei Erstgebärende gegenüber Mehrgebärenden signifikant häufiger diese positive Einschätzung vornahmen (p<.007). Neben einer Reihe von Faktoren, die in keinem unmittelbaren Zusammenhang mit der Geburt stehen, zeigten sich geburtsspezifische Aspekte als signifikante Einflussgrößen. In der Gruppe der Erstgebärenden er-höhte sich bei Vorliegen geburtsverletzungsbedingter Beschwerden die Chance auf eine beeinträchtigte SGH zu t1 signifikant (OR 1.68, [95% KI 1.04-2.71]; p=.035). In der Gruppe der Mehrgebärenden erwies sich ein nega-tives Geburtserleben zu t2 als signifikante Einflussgröße für eine beeinträchtigte SGH (OR 7.66, [95% KI 2.17-26.99]; p=.002). Hinsichtlich der GHLQ konnten ebenfalls geburtsspezifische Aspekte als Einflussgrößen ermit-telt werden. Zu t1 erhöhten in der Gruppe der Erstgebärenden geburtsverletzungsbedingte Beschwerden die Chance auf eine verminderte GHLQ um fast das Dreifache (OR 2.83, [95% KI 1.63-4.93]; p<.001). Ein negati-ves Geburtserleben verdoppelte die Chance auf eine verminderte GHLQ in dieser Gruppe (OR 2.09, [95% KI 1.19-3.65]; p=.010). In der Gruppe der Mehrgebärenden zeigte sich das negative Geburtserleben ebenfalls als signifikante Einflussgröße (OR 3.93, [95% KI 1.14-13.53]; p=.030). Dies allerdings erst zu t2. Insgesamt konn-ten in einzelnen Subskalen des SF-36 signifikante Abweichungen zwischen der landes-, alters- und geschlechts-spezifischen Normstichprobe und dem Studiensample festgestellt werden. Schlussfolgerung: Geburtsverletzungsbedingte Beschwerden und ein negatives Geburtserleben beeinflussen die SGH und GHLQ nachhaltig. Mit dem Anspruch einer qualitativ hochwertigen geburtshilflichen Versorgung gilt es die subjektiven Gesundheitseinschätzungen von Frauen nach der Geburt eines Kindes standardisiert zu evalu-ieren. Um Ceiling-effekte zu vermeiden müssen die in anderen Bereichen bisher üblichen Erhebungsverfahren für den geburtshilflichen Kontext modifiziert werden

No description available.

Indiana University-Purdue University Indianapolis (IUPUI) / Although complex phenomena such as oral diseases can be studied using generalizable conceptual frameworks, the differences in the underlying influences across countries necessitate adaptation of existing oral health frameworks to the specific conditions in each country. The aim of this dissertation was to investigate distal (indirect) and proximal (direct) influences of oral health and their interactions with both self-reported oral pain (OP) and self-rated oral health status (SROH) in Saudi Arabia (SA). Two secondary data analyses were conducted utilizing data from the national demographic and health survey (DHS) of SA in 2017. The objective of the first study was to describe the study design, and the distal and proximal influences reported in the 2017 SA DHS. The objective of second study was to explore associations between proximal and distal factors that affect OP and SROH, using the adapted framework. Path analysis modeling was used to estimate direct, indirect, and total effects. The 2017 SA DHS used an innovative multistage stratified random-sampling technique to select the population sample by using primary health care centers’ catchment areas as the primary sampling unit. The final analysis included 29,274 adults, 9910 adolescents, and 11653 children. OP in the past year was experienced in 39% in children and, 48.5% for the adolescents, and 47.1% in adults. The proportion of respondents who reported good, very good, or excellent self-rated oral health status was 92.9 % in children, 87.1% in both adolescents and adults. In children group, OP was linked to less tooth brushing, more dental visits and less dental routine examination, while less favorable SROH was linked to less tooth brushing, more dental visits and sweets consumption. In adolescents and adults groups, OP and less favorable SROH were linked to more dental visits, complaint dental visits, less tooth brushing. Many distal influences showed significant effects (direct, indirect, and total) on OP and SROH; however, differences existed among the three age groups. The studies suggest that future investigations should focus on why Saudi residents perceive their oral health positively while the prevalence of negative oral health influences and OP was high.

No description available.