Le premier chapitre propose une revue des différents moyens de quantification du bien-être subjectif. Il s'agit des auto-évaluations globales de satisfaction, des mesures en temps réel (DRM et ESM) et de l'indice U. Dans le second chapitre, nous exploitons la base IFLS pour tester l'hypothèse de statut relatif en Indonésie. Le bien-être des indonésiens est positivement influencé par le revenu des agents dans leur entourage. Cette influence positive est clairement plus importante pour les pauvres que pour les riches. Le troisième chapitre examine l'effet de l'obésité sur la santé mentale des femmes mexicaines. Nos résultats montrent que la grosseur des femmes exerce des effets hétérogènes sur leur bien-être émotionnel, avec notamment un effet négatif observé pour les riches contrairement aux groupes de revenu inférieurs et moyens qui semblent tirer satisfaction de leur excès de poids. Les différences également observées selon d'autres dimensions (éducation et ruralité) supportent l'hypothèse liée aux différences de normes sociales. Ce constat est robuste à des estimations alternatives considérant les biais de causalité inverse et de variables omises. Le dernier chapitre étudie la présence d'une prime de la taille dans la vie adulte d'un échantillon d'hommes actifs dans un pays relativement pauvre, l'Indonésie. Les résultats montrent que chaque accroissement d'un centimètre entraîne une augmentation du revenu de 2%. Les conditions socio-économiques des individus durant leur enfance sont à l'origine du quart de cet effet. Les capacités cognitives en expliquent seulement une petite partie. Nos résultats montrent également un effet positif de la taille sur le bonheur. / Recent years have witnessed an upsurge of interest among economists in the measurement and analysis of subjective well-being. The present thesis consists of a survey and three empirical studies relate to the determinants of subjective well-being in developing countries. The first chapter is a summary of approaches used to measure subjective well-being. It analyses the advantages and disadvantages of each approach as well as the theoretical background that lies behind them.The second investigates the presence and the sign of positional concerns in Indonesia. Estimates reveal that relative income positively affects individual well-being. This positive influence is unambiguously more important for the rich than for the poor, and is consistent to various specifications. The third chapter analyses the causal effect of obesity on the emotional well-being of Mexican women, with a special focus on the role of norms. Results point to a negative effect of obesity on emotional well-being among the rich Mexican but positive or insignificant effects among the poor. Heterogeneous effects are also observed along other dimensions such as education and rurality. This heterogeneity is attributed to contrasted body-type norms that characterize different groups. The fourth chapter tests the presence of a beneficial effect of height on different concepts of objective and subjective well-being among Indonesian men. Our analysis concludes to several height premiums. In particular, taller men receive higher wages (because they sort into more lucrative occupations), and are on average happier than their shorter peers.

Made available in DSpace on 2016-04-27T13:10:27Z (GMT). No. of bitstreams: 1 Karin Cristina de Camargo Oliveira.pdf: 1918051 bytes, checksum: b44949ca1968e77d5aacc408fa18930a (MD5) Previous issue date: 2015-09-10 / Children´s aged 0-2 attendance the growing and stature are considered a challenge for many professional nurses working in health service station but also in family health service station. There is a set of inter-ministerial actions that monitoring children aged 0-2 as priority attention, cause the vulnerability of the human being in this season of life. The knowledge and the autonomy of nurses to follow in nursing consultations of children aged 0-2 is very necessary because this is the season most important to the neurological development of the child. The nurse must have a holistic and focused look in the family to promote monitoring and consequent child's healthy growth 0-2 years seeking their unabridged care. The use of software in the specific work of nursing teaching allows self-directed study respecting each individual is learning time, and serve as a permanent educational tool for several professionals. The software was developed using Flash® multimedia, which produces images and animations in vector language, they are compacted files able to webcast or optical and magnetic media. Researcher authored the drawings used. 19 students from 3rd year of nursing college Faculty of Medical and Health Sciences of the Catholic University of Sao Paulo and an information technology specialist participated in the research. Students using the assessment instruments pre-test and post-test about their knowledge carried out the didactic software evaluation through. An instrument was used to assess their perception as to the applicability, suitability and interaction of educational software, containing four dimensions with Likert scale. The results of perception instrument illustrated good acceptance of developed digital tool by the students. The assessment instruments pre-test and post-test demonstrated cognitive gain to 18 participants, the results of perception instrument illustrated good acceptance of developed digital tool, because the minimum score obtained by size was 0.79. In the open field, hereof all comments regarding the tool were rated positive. It concluded the software had good adhesion by the research participants like a teaching tool on the children´s aged 0-2 growing and stature. It is a continuing education alternative for students and nursing professionals who will support and reference for child nursing consultation in this age group / O acompanhamento do crescimento e desenvolvimento da criança de 0 a 2 anos é considerado um desafio para muitos profissionais enfermeiros que atuam nas unidades básicas de saúde como também nas unidades saúde da família. Existe um conjunto de ações interministeriais que tornam o acompanhamento das crianças na faixa etária de 0 a 2 anos prioritária devido à vulnerabilidade do ser humano nesta fase da vida. A faixa etária de 0 a 2 anos é a mais importante do desenvolvimento neuropsicomotor da criança sendo necessário o conhecimento e a autonomia do enfermeiro para acompanhamento nas consultas de enfermagem. Buscando a integralidade do cuidado, o enfermeiro deve ter um olhar holístico e centrado na família para promover o acompanhamento e consequente crescimento saudável da criança. O uso de softwares no ensino da enfermagem permite o estudo autodirigido respeitando o tempo de aprendizagem de cada indivíduo, além de servir de ferramenta de educação permanente para os profissionais. Este estudo teve como objetivos elaborar um software sobre o crescimento e desenvolvimento da criança de 0 a 2 anos, com o uso de desenhos, animações, esquemas, vídeos e sons que simulam a consulta de enfermagem e ilustram características importantes à atuação do enfermeiro nesta faixa etária do ser humano, e avaliá-lo enquanto ferramenta de ensino e educação permanente para enfermeiros. O software foi desenvolvido com o uso do autor de multimídia Flash® que elabora imagens e animações em linguagem vetorial, são arquivos compactos capazes de transmissão pela Web ou mídias ópticas e magnéticas; os desenhos utilizados foram de autoria da pesquisadora. Participaram do estudo 19 estudantes do 3º ano da graduação em enfermagem da Faculdade de Ciências Médicas e da Saúde da Pontifícia Universidade Católica de São Paulo e um especialista em Tecnologia de Informação que efetuou a avaliação técnica da ferramenta desenvolvida. A avaliação didática do software foi realizada por meio de seu uso pelos estudantes utilizando-se pré e pós-teste de conhecimentos. Foi aplicado um instrumento para avaliar a percepção dos mesmos quanto a aplicabilidade, adequabilidade e interação do software educacional, contendo 4 dimensões com escala tipo Likert. Os resultados mostraram que o software foi concluído e bem avaliado pelos participantes. Os instrumentos de avaliação (pré-teste e pós-teste) demonstraram ganho cognitivo para 18 respondentes; os resultados do instrumento de percepção ilustraram boa aceitação da ferramenta digital desenvolvida, pois a pontuação mínima obtida por dimensão foi 0,79. No campo aberto deste instrumento todos os comentários a respeito da ferramenta avaliada foram positivos. Concluiu-se que o software teve boa adesão pelos participantes da pesquisa enquanto ferramenta de ensino sobre o crescimento e desenvolvimento da criança de 0 a 2 anos. Trata-se de uma alternativa de educação permanente para alunos e profissionais da área da enfermagem que servirá de apoio e referência para a consulta de enfermagem da criança nesta faixa etária

Η διαδικασία της αύξησης ελέγχεται από έναν πολύπλοκο συνδυασμό πολλών παραγόντων σε διάφορα επίπεδα, που περιλαμβάνουν ενδογενείς παράγοντες, όπως είναι ο γονότυπος, οι ορμόνες, οι παράγοντες αύξησης και εξωγενείς παράγοντες, όπως είναι η διατροφή και η επίδραση του περιβάλλοντος. Οι ορμονικοί παράγοντες, που επηρεάζουν την αύξηση είναι κυρίως η αυξητική ορμόνη (GH) και οι ινσουλινόμορφοι αυξητικοί παράγοντες (IGFs). Στην διαδικασία της αύξησης συμμετέχουν, όμως, και άλλες ορμόνες, όπως η θυροξίνη, τα επινεφριδιακά ανδρογόνα, τα στεροειδή του φύλου, τα γλυκοκορτικοειδή, η βιταμίνη D, η λεπτίνη και η ινσουλίνη, που αλληλεπιδρούν με τον άξονα GH-IGF. Η αυξητική ορμόνη εκκρίνεται στην κυκλοφορία από τα σωματότροπα κύτταρα του πρόσθιου λοβού της υπόφυσης, υπό την επίδραση δύο υποθαλαμικών ορμονών του εκλυτικού παράγοντα της αυξητικής ορμόνης (GHRH), που διεγείρει την έκκριση της GH και της σωματοστατίνης (SS), που αναστέλλει την έκκρισή της. Μέχρι σήμερα στην διεθνή βιβλιογραφία έχουν περιγραφεί πολλές μεταλλάξεις του γονιδίου της GH ως αιτία κοντού αναστήματος στα παιδιά. Η παρούσα μελέτη εξέτασε ομάδα 11 παιδιών με κοντό ανάστημα, ρυθμό αύξησης κάτω από την 2η εκατοστιαία θέση και καθυστερημένη οστική ηλικία. Όλοι οι ασθενείς υπεβλήθησαν σε λεπτομερή κλινική εξέταση και πλήρη εργαστηριακό έλεγχο. Από την κλινική εξέταση και τον εργαστηριακό έλεγχο αποκλείστηκε η παρουσία κάποιας συστηματικής πάθησης. Στην συνέχεια υπεβλήθησαν σε προκλητές δοκιμασίες έκκρισης της GH, με κλονιδίνη και L-Dopa, σε έλεγχο της 24ωρης έκκρισης της GH και τη δοκιμασία γένεσης του IGF-I. Με βάση τα εργαστηριακά αποτελέσματα της έκκρισης της GH η ομάδα των ασθενών διαχωρίστηκε σε αυτούς με ιδιοπαθές κοντό ανάστημα (10 περιπτώσεις) και ένα ασθενή με νευροεκκριτική δυσλειτουργία της GH (GHND), ο οποίος είχε μειωμένη 24ωρη έκκριση GH. Από τους ασθενείς αυτούς ελήφθησαν βιοψίες ούλων, στους καλλιεργημένους ινοβλάστες των οποίων έγιναν οι μελέτες αύξησης των ινοβλαστών και περιφερικό αίμα, από το οποίο έγινε εξαγωγή γονιδιωματικού DNA. Έγινε πολλαπλασιασμός των γονιδίων του υποδοχέα της GH (GHR) και του γονιδίου της GH (GH1) με την αλυσιδωτή αντίδραση πολυμεράσης (PCR) και προσδιορισμός της αλληλουχίας τους. Ανιχνεύτηκαν μεταλλαγές στους 6 από τους 11 ασθενείς, που μελετήθηκαν, οι οποίες εντοπίζονταν στο ιντρόνιο 4 του γονιδίου GH1 και ένας ακόμη ασθενής που έφερε μεταλλάξεις στα ιντρόνια 1 και 2. Οι μεταλλάξεις αυτές δεν επηρέαζαν την διαδικασία του ματίσματος και τον σχηματισμό του mRNA και απομακρύνονταν με το μάτισμα. Στην βιβλιογραφία αναφέρονται περισσότεροι από 10 πολυμορφισμοί του γονιδίου GH1 που εντοπίζονται κυρίως στα ιντρόνια του γονιδίου και κάποιοι από αυτούς έχουν συσχετιστεί με ελαττωμένη έκφραση του γονιδίου GH1. Στον ασθενή με την GHND περιγράφηκε μια μεταλλαγή στη θέση +7 του ιντρονίου 4 του γονιδίου GH1. RT-PCR του GH1 cDNA έδειξε ότι η μετάλλαξη αυτή είναι υπεύθυνη για το εσφαλμένο μάτισμα του mRNA, με αποτέλεσμα την απαλοιφή του εξονίου 5 από το ώριμο μετάγραφο. Ο ασθενής με τη μεταλλαγή είναι ετεροζυγώτης και η ίδια μεταλλαγή σε ετερόζυγη κατάσταση, βρέθηκε και στους δύο γονείς του ασθενούς, οι οποίοι έχουν επίσης κοντό ανάστημα. Η μεταλλαγή αυτή οδηγεί στην παραγωγή μικρότερου μορίου GH. Η βιοδραστικότητα του παραγόμενου ανώμαλου μορίου της GH εκτιμήθηκε με την προσθήκη ορού του ασθενούς σε καλλιέργειες φυσιολογικών ινοβλαστών, με τη μέθοδο ενσωμάτωσης στο DNA της βρώμο-δεοξυουριδίνης (BrDU), η οποία έδειξε μειωμένη σύνθεση DNA συγκρινόμενη με την σύνθεση DNA παρουσία ορού φυσιολογικών ατόμων. Δηλαδή η περίπτωση αυτή οικογενούς κοντού αναστήματος, το οποίο κληρονομείται κατά τον επικρατούντα χαρακτήρα, οφείλεται σε μεταλλαγή στο ιντρόνιο 4 του γονιδίου GH1. / Growth can be defined as an increase in size by accretion of tissue. The control of the growth process is affected by many complex interacting factors including internal cues such as the genotype, external factors such as nutrition and environment, and internal signaling systems such as hormones and growth factors. The principal hormones influencing growth are Growth Hormone (GH) and the Insulin-like Growth Factors (IGFs), but many other hormones contribute, such as thyroxine, adrenal androgens, sex steroids, glucocorticoids, vitamin D, leptin and insulin, often channeled through interaction with the GH-IGF axis. GH is secreted from the anterior pituitary into the circulation. The pattern of GH secretion is determined primarily by the interaction between the hypothalamic peptides Growth Hormone Releasing Hormone (GHRH) and somatostatin (SS). Many mutations of the GH1 gene have been described as the cause of short stature in children. The present study examined 11 children with severe short stature, growth velocity below the 2nd centile and delayed bone age. All patients underwent thorough clinical examination and laboratory investigation in order to exclude an underlying chronic disease. Also GH secretion provocative studies, 24 hr endogenous secretion studies and IGF-I generation test were carried out. According to the results of these tests the patients we studied were divided in two groups: 10 of the patients had idiopathic short stature (ISS) and 1 patient had GH neurosecretory dysfunction (GHND). Fibroblast cultures were established from gingival biopsies obtained from the patients and genomic DNA was extracted from peripheral blood leukocytes. GH1 and GH receptor (GHR) genes were amplified by PCR and sequenced. Hot spot mutations were detected in GH1 intron 4 in 6 patients and mutations in introns 1 and 2 were detected in 1 patient. These mutations did not affect the splicing of the primary RNA transcript. A novel deletion of thymine 7 bp downstream from the 3' splice site of intron 4 was found in the patient who had GHND. RT-PCR of GH1 cDNA showed that this mutation causes aberrant GH mRNA splicing, changes the read frame, creates a new stop codon and results in the deletion of exon 5. This was also confirmed by restriction enzyme analysis of the mutant cDNA. Both short parents and the patient are heterozygotes for this mutation. BrDU incorporation in the DNA of normal fibroblast cultures in the presence of the patient’s blood serum showed reduced DNA synthesis compared to fibroblasts cultured in medium with normal human serum. Addition of high concentrations of GH (4 μg/ml) to the culture medium containing the patient’s serum led to a near normal DNA synthesis. This is a new case of familial short stature inherited as a dominant trait, due to a mutation in intron 4 of the GH1 gene.

The objective of this thesis was to determine the association of leg length (LL), a marker of early childhood conditions, with metabolic abnormalities underlying type 2 diabetes. Utilizing data from a population at-risk for diabetes, the associations of LL with i) insulin resistance (IR) and beta-cell dysfunction and ii) a continuous metabolic syndrome risk score (MetScore) were analyzed. Results showed that shorter LL was associated with IR and beta-cell dysfunction, and that the combination of short legs and large waist (a marker of adult obesogenic conditions) was associated with the greatest IR. Height, a marker of overall childhood conditions, was found to be inversely associated with the MetScore. Therefore, both adverse childhood conditions and early-late life mismatched conditions may increase the risk for diabetes through differing pathways. Improving childhood conditions (i.e. nutritionally or economically) may be an important strategy to prevent diabetes.

The objective of this thesis was to determine the association of leg length (LL), a marker of early childhood conditions, with metabolic abnormalities underlying type 2 diabetes. Utilizing data from a population at-risk for diabetes, the associations of LL with i) insulin resistance (IR) and beta-cell dysfunction and ii) a continuous metabolic syndrome risk score (MetScore) were analyzed. Results showed that shorter LL was associated with IR and beta-cell dysfunction, and that the combination of short legs and large waist (a marker of adult obesogenic conditions) was associated with the greatest IR. Height, a marker of overall childhood conditions, was found to be inversely associated with the MetScore. Therefore, both adverse childhood conditions and early-late life mismatched conditions may increase the risk for diabetes through differing pathways. Improving childhood conditions (i.e. nutritionally or economically) may be an important strategy to prevent diabetes.

Hintergrund: Der Insulin-like growth factor receptor (IGF1R) spielt eine zentrale Rolle bei Wachstumsprozessen. Heterozygote IGF1R-Mutationen führen durch eine partielle IGF1-Resistenz zu Kleinwuchs. Methoden: Auxologische und endokrinologische Daten des Patienten wurden erhoben. Anhand von Fibroblasten wurde die IGF1R-Deletion charakterisiert und die Auswirkungen auf die mRNA- und Protein-Expression sowie die Signaltransduktion untersucht. Ergebnisse: Der Junge, der eine heterozygote Exon 6 Deletion im IGF1R – durch Alu-Rekombination verursacht – und eine heterozygote SHOX-Variante (p.Met240Ile) in seinem Genom vereint, kam ‚appropriate for gestational age‘ zur Welt, entwickelte aber postnatal eine Wachstumsretardierung. Die Endokrinologischen Daten waren unauffällig. Der Patient zeigt keine Stigmata, die bei anderen IGF1- oder SHOX-Mutationsträgern beschrieben wurden. Durch Nonsense-Mediated mRNA Decay kommt es zu einer Dosisreduktion der IGF1-Rezeptoren und einer entsprechenden verminderten Aktivierung der Rezeptoren, nicht aber des Signalwegs. Zusammenfassung: Der Patient trägt eine bisher unbeschrieben heterozygote IGF1R-Deletion, die zu Kleinwuchs führt. Ursächlich dafür ist eine durch die Mutation verursachte Dosisreduktion der IGF1-Rezeptoren.

Qualitative research based on a half standardized interview with seniors is aimed at identifying the seniors´ perception of the dignity concerning dignity of merit, moral strength and personal identity, and the related values of every human being, also known as Menschenwürde {--} human dignity. The results show the risk of loss or reduction of dignity in old age. The reasons are external and internal. External reasons include the approach of society and individuals to the elderly, (un) availability of social services for seniors and their families and also the social system. Internal reasons involve the change of the inner self, reduction of self-sufficiency, financial provision, degree of independence, evaluation of the past life, the age and gender. In the highest risk of loss of dignity are the very old, individuals dependent on the care of others and women. The research makes us think about creating decent living conditions for the elderly. The issues of supportive background creation and available home care services for the elderly and possibilities of a better support for families caring for dependent and dying elderly persons are also addressed. On an individual level it is necessary to instruct people, who come into contact with the elderly, with risk factors that may decrease dignity of the elderly and to gain skills for assistance to enhance seniors´ dignity by an appropriate and sensible approach. Perception of dignity changes with a social system. Dignity is an important component of the quality of life perception. Attention must be paid to this issue also in the future. With prolonged longevity of an individual and an active participation in community life up to the old age it should be reconsidered since what age an individual is regarded as old. For example, according to the WHO the early old age starts at 60 years of age. This is what young seniors perceive negatively. They do not consider themselves old even when they are 65 years old.

Previous studies proposed that Neandertals had one third higher energetic cost of locomotion than anatomically modern humans. Greater cost of locomotion could disadvantage Neandertals in competition with anatomically modern humans and could be a factor in their extinction. Greater cost of Neandertal locomotion was ascribed to their shorter lower limb and greater body mass. However, Neandertals differed also in other morphological parameters that were not considered in estimation of their locomotor cost. In this dissertation we model locomotor cost of Neandertals and anatomically modern humans using previously described relation between muscle force production and energetic cost of movement. We estimate the key locomotor parameters using a model developed by us from osteometric data from literature (n =50) and from our measurement (n = 21), and from kinematic data of 26 individuals. Further, we analyze the effect of relative lower limb length (in relation to body mass) and crural index on energetic cost of locomotion. Our results suggest that walking of Neandertal males was 9-14% energetically more demanding than walking of anatomically modern males. Nevertheless, the walking cost of Neandertal females was similar to that of anatomically modern females. Inclusion of lower limb proportions into the...

Hintergrund: Der Insulin-like growth factor receptor (IGF1R) spielt eine zentrale Rolle bei Wachstumsprozessen. Heterozygote IGF1R-Mutationen führen durch eine partielle IGF1-Resistenz zu Kleinwuchs. Methoden: Auxologische und endokrinologische Daten des Patienten wurden erhoben. Anhand von Fibroblasten wurde die IGF1R-Deletion charakterisiert und die Auswirkungen auf die mRNA- und Protein-Expression sowie die Signaltransduktion untersucht. Ergebnisse: Der Junge, der eine heterozygote Exon 6 Deletion im IGF1R – durch Alu-Rekombination verursacht – und eine heterozygote SHOX-Variante (p.Met240Ile) in seinem Genom vereint, kam ‚appropriate for gestational age‘ zur Welt, entwickelte aber postnatal eine Wachstumsretardierung. Die Endokrinologischen Daten waren unauffällig. Der Patient zeigt keine Stigmata, die bei anderen IGF1- oder SHOX-Mutationsträgern beschrieben wurden. Durch Nonsense-Mediated mRNA Decay kommt es zu einer Dosisreduktion der IGF1-Rezeptoren und einer entsprechenden verminderten Aktivierung der Rezeptoren, nicht aber des Signalwegs. Zusammenfassung: Der Patient trägt eine bisher unbeschrieben heterozygote IGF1R-Deletion, die zu Kleinwuchs führt. Ursächlich dafür ist eine durch die Mutation verursachte Dosisreduktion der IGF1-Rezeptoren.:Inhaltsverzeichnis I Abkürzungsverzeichnis - 4 - 1 Bibliographische Beschreibung - 7 - 1.1 Referat - 7 - 2 Einleitung und Hintergrund - 9 - 2.1 Das menschliche Wachstum - 9 - 2.2 Das IGF-System als Regulator von Wachstum u. Entwicklung - 10 - 2.3 Der IGF1-Rezeptor - 11 - 2.4 Formen des Kleinwuchses - 12 - 2.5 IGF1R-Mutationen - 13 - 2.6 SHOX-Defizienz - 14 - 2.7 Der Nonsense-Mediated mRNA Decay - 15 - 2.8 Alu-Elemente - 16 - 2.9 Überleitung - 17 - 4 Originalpublikation - 18 - 5 Zusammenfassung der Arbeit - 31 - 5.1 Patientenbeschreibung - 32 - 5.2 Experimentelle Untersuchungen - 33 - 5.3 Interpretation - 35 - 5.4 Ausblick - 37 - 6 Literaturverzeichnis - 39 - III Curriculum vitae - 50 - IV Danksagung - 52 -

Differences in height among human populations or changes in height over time may be associated with different degrees of sexual dimorphism in this feature. This thesis compared the height and sexual size dimorphism (SSD) between two groups of the population of Medieval Bohemia - rural residents and inhabitants of Prague. A sample of 179 adult skeletons from five Prague sites and 175 individuals from four rural sites, dating from the 11th to 14th century, was used. Sex was determined following the principle of primary and secondary sex diagnosis, which enabled the derivation of population-specific discriminant functions using the dimensions of the humerus, femur, tibia and talus. A subsequent analysis of body height did not show statistically significant differences either in height or in SSD between the Prague and the rural part of the population of Medieval Bohemia, despite the major changes which Czech Medieval society went through in the 13th century. Comparing our results with previously published data on the height of the Czech population during the early modern period indicates a statistically significant reduction in the magnitude of sexual size dimorphism in the population of the17th century, particularly associated with a decrease in the height of men. A significantly higher stature of...