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Uma investigação sobre tendências metodológicas da educação matemática a partir das formações continuadas (Sergipe, 1988 a 2006)Santos, Rone Peterson Oliveira 16 April 2012 (has links)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This article presents the results of a survey about the continuum education provided by the managers of the school from the state of Sergipe who thought Mathematics from 1988 2006. The aim of this research was to analyze whether
and how the methodological trends of Mathematics Education were approached in these formation. To achieve this purpose, it was necessary, initially, the identification of the works concerned to the theme, collection of documents, such
as certificates and planning, in the file of Centro de Qualificação de Pessoal Professor Antônio Garcia Filho and interviews with teachers, who were trainers at that time. As theoretical basement, it was consulted Valente (2007). In order to understand the terminology about the formation, it was adopted Marin (1995), Destro (1995), Hypollito (2000), Nacarato (2000). To understand about the methodological trends and Mathematics Education it was made use of
D Ambrósio (1989), Mendes (2009), Fiorentini and Lorenzato (2007). From the data, besides the identification of the contents, terminology, timing of realization and teachers, it was possible to characterize the proposals of the continuum
formation in Sergipe which can be categorized into two groups. The first one, linked to the Central Nucleus of Mathematics (1988-1996), were formations organized by Mathematics teachers who held meetings with educational character and also ministered courses , lectures and workshops for the colleagues. The second group, linked to the School Development Program (2001-2007), were formations performed by professionals linked to consulting firms which
approached themes according to specific demands of each school. Regarding to the methodological trends, it s possible to say that, in the formations of the first group, there are explicit references to the Mathematics Education and to the
methodological trends. However, trough the examination of the activities it s possible to say that they were not approached in a way that can be considered as a methodology, but as a resource to make the class different. The second group presents a dispersed theme and there is no highlight to the solving problems, the mathematical games, the history of mathematics, the use of technology and the
ethno mathematics. In other words, to the second period analyzed, it is possible to say that, in the late 80s, of the twentieth century, had a greater enthusiasm with themes related to what was called methodological trends in mathematics education, but they were not worked as a methodology, but as a resource to teach different math classes. / Neste trabalho é apresentado o resultado de uma pesquisa que examinou as formações continuadas disponibilizadas pelos gestores da rede estadual de Sergipe aos professores que ensinam Matemática, nos anos compreendidos entre 1988 e
2006. O objetivo da investigação foi analisar se e como as tendências metodológicas da Educação Matemática foram abordadas nas referidas formações. Para alcançar esse propósito foi necessário, inicialmente, a identificação de
trabalhos referentes ao tema, e a coleta de documentos, como certificados e planejamentos, no arquivo do Centro de Qualificação de Pessoal Professor Antônio Garcia Filho e a realização de entrevistas com professores, que a época, atuaram como formadores. Como fundamentação teórica para o tratamento das fontes foi utilizado Valente (2007), para o entendimento das terminologias sobre as formações adotei Marin (1995), Destro (1995), Hypollito (2000), Nacarato
(2000), já para a compreensão sobre as tendências metodológicas e da Educação Matemática fiz uso dos trabalhos de D Ambrósio (1989), Mendes (2009), Fiorentini e Lorenzato (2007). A partir dos dados, além de identificar conteúdos, terminologias, período de realização, ministrantes, foi possível caracterizar as propostas de formação continuada em Sergipe que podem ser categorizadas em dois grupos. O primeiro, vinculado ao Núcleo Central de Matemática (1988-
1996), eram formações organizadas por professores que ensinavam Matemática, os quais realizavam reuniões com caráter formativo e também ministravam cursos, palestras e oficinas para os outros colegas da área. Já o segundo grupo
vinculado ao Programa de Desenvolvimento da Escola (2001-2007), são formações realizadas por profissionais vinculados a empresas de consultoria que abordavam temáticas de acordo com demandas específicas de cada escola. Em relação às tendências metodológicas, é possível afirmar que nas formações do primeiro grupo há referências explícitas à Educação Matemática e às tendências metodológicas, mas um exame das atividades desenvolvidas permite afirmar que,
a época, elas não eram abordadas de forma que possam ser consideradas como uma metodologia, mas como um recurso para tornar a aula diferente. Já as do segundo grupo apresentam uma dispersão temática e não há destaque para a
resolução de problemas, os jogos matemáticos, a história da matemática, ao uso de tecnologias e a etnomatemática. Dito de outra forma para o período analisado é possível afirmar que no final da década de oitenta, do século vinte, havia um
entusiasmo maior com temáticas relacionadas ao que era denominado de tendências metodológicas da Educação Matemática, porém elas não eram trabalhadas como uma metodologia, mas como um recurso para ministrar aulas de
Matemática diferenciadas.
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Gestão de pessoas em hospitais universitários: situação atual e tendências / People Management in University Hospitals: current situation and trendsLigia Fumiko Minami Neves de Oliveira 25 April 2013 (has links)
Esta pesquisa é um estudo exploratório, descritivo, de natureza prospectiva, de abordagem quanti-qualitativa. Os objetivos foram: identificar a percepção de gestores de Hospitais Universitários da cidade de São Paulo, em relação aos fatores que estariam produzindo novas tendências no gerenciamento de pessoas e quais mudanças projetam nos modelos de gestão de pessoas; identificar os focos de atenção e as dificuldades quanto ao gerenciamento de políticas de gestão de pessoas, mediante as tendências no macrocontexto e mapear as lacunas entre as tendências identificadas, focos de atenção e dificuldades e as competências requeridas para gestores que atuam no âmbito da gestão dos hospitais universitários; formular propostas nas quais o desenvolvimento dos gestores de pessoas na área da saúde esteja alinhado às novas demandas da próxima década. O estudo teve como cenário três HUs e contou com a participação de nível estratégico. Para atingir os objetivos formulados, foi empregada a técnica Delphi, com a finalidade de melhor compreender o cenário atual e a tendência na gestão de pessoas em hospitais universitários. Os resultados mostraram que a Gestão de Pessoas sofrerá mudanças significativas nos próximos 10 anos (86,7%) pois deverão incidir predominantemente nas práticas e instrumentos de gestão (50%). As Tendências de Mudança no Ambiente consideradas de grande impacto e que podem afetar as decisões sobre estratégias e políticas de gestão de pessoas dos HUS foram: a busca da qualidade dos processos e produtos, questionamento do papel social da instituição, cidadania e direitos do consumidor e mudanças na tecnologia aplicada aos processos produtivos e organizacionais nos HUs. Em relação aos Princípios que Orientarão os Modelos de Gestão de Pessoas, cinco foram considerados de alta relevância: o empowerment, gestão de RH coerente com o negócio da organização, comprometimento da força de trabalho com os objetivos organizacionais, educação corporativa e autodesenvolvimento. Constatou-se que estes princípios foram parcialmente introduzidos e deverão ser os principais focos de atenção dos gestores para a próxima década. Em relação às Políticas de Gestão de Pessoas, das 13 políticas de gestão consideradas mais relevantes no futuro, os gestores apontaram: benefícios proporcionalmente menores na remuneração (média 7,9), benefícios flexíveis definidos com a participação dos funcionários (média 7,8) e maior poder de decisão das chefias sobre a remuneração de sua equipe (média 7,5), como tendo alto grau de dificuldade para implementação dessas políticas na Gestão de Pessoas dos HUs. Em relação ao Formato da Função RH nos HUs, três tendências foram consideradas relevantes que serão consideradas nas decisões sobre gestão de pessoas: as decisões passarão para o gerente da unidade (93,3%), migração de funções de gestão de pessoas corporativas para as unidades (93,3%) e o principal papel da área será fornecer novos processos e conhecimentos para os clientes internos (93,3%). Os resultados indicam que o profissional que trabalhará na função de gestão de pessoas deverá ter três qualificações consideradas como importantes: experiência profissional na área de gestão de pessoas, domínio em informática e conhecimentos em gestão de negócios. As competências consideradas muito importantes foram: trabalho em equipe e liderança. Os gestores indicaram um conjunto de oito competências, também relevantes: orientação para resultados, capacidade técnica, flexibilidade, promotor de mudança cultural e de atitudes, orientação para cliente, motivação, negociação e capacidade para ouvir e compreender o outro. Conclusão: a gestão de pessoas está em processo de mudança nos HUs. A formação acadêmica, assim como as instituições prestadoras de serviços de saúde devem buscar, o alinhamento da formação profissional, desenvolvendo competências para a gestão de pessoas, como também contribuir para o desenvolvimento dos profissionais que deverão exercer a função gerencial, destacando o Programa Pró-Saúde como proposta para uma formação integrada. / This is an exploratory, descriptive, prospective study, with a quantitative and qualitative approach. The aims were: to identify the perception of managers of University Hospitals in the city of São Paulo, in relation to the factors that are producing new trends in people management and what changes these provoke in the people management models; to identify the focus of attention and the difficulties regarding the management of policies for managing people, through the trends in the macro context, and to map the gaps between the trends identified, foci of attention and difficulties, and the competences required for managers who work in the management context of university hospitals; to formulate proposals in which the development of managers of people in the health field is aligned to the new demands of the next decade. The study had three UHs as the scenario and counted on the participation of the strategic level. To achieve the formulated aims, the Delphi technique was employed, in order to better comprehend the current situation and the trends in people management in university hospitals. The results showed that People Management will suffer significant changes in the next 10 years (86.7%) which should focus predominantly on practices and management instruments (50%). The Trends of Change in the Environment considered high impact and that can affect decisions on strategies and policies for managing people of the UHs were: the search for the quality of the processes and products, questioning the social role of the institutions, citizenship and consumer rights, and changes in technology applied to the production and organizational processes in the UHs. Regarding the Principles that will Guide the People Management Models, five principles were considered highly relevant: empowerment, HR management consistent with the business of the organization, commitment of the workforce with the organizational objectives, corporate education and self-development. It was observed that these principles had been partially introduced and will have to be the main focus of attention of the managers for next the 10 years. Regarding the People Management Policies, of the 13 management policies considered most relevant for the future, the managers indicated: proportionately less benefits in the remuneration (mean 7.9), flexible benefits defined by the participation of the employees (mean 7.8) and greater power of decision of the directors regarding the remuneration of their staff (mean 7.5) as having a high degree of difficulty in implementing these People Management policies of the UHs. In relation to the Format of the HR Function in the UHs, three trends were considered excellent and that they will be taken into consideration in the decisions regarding people management: the decisions will go to the manager of the unit (93.3%), migration of corporative people management roles to the units (93.3%) and the primary role of the area will be to provide new processes and knowledge for the internal clients (93.3%). The results indicate that the professional who will work in the role of people management, must have three qualifications regarded as very important: professional experience in the area of people management, expertise in IT and knowledge of business management. The competences considered very important were: teamwork and leadership. The managers indicated a set of eight competences that are also relevant: guidance for results, technical expertise, flexibility, promotion of cultural change and attitudes, guidance for the client, motivation, negotiation and the ability to listen and comprehend the other. Conclusion: people management is in the process of change in UHs. The academic formation, as well as institutions providing health services, should seek both the alignment of the professional formation, developing people management competences, as well as to contribute to the development of the professionals who will undertake the management role, highlighting the Pro-Health Program as the proposal for integrated formation.
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Analýza dopadů novely zákona o spotřebitelském úvěru na bankovní sektor ČR / Analysis of the impacts of the Amendment to the Consumer Credit Act on the banking sector of the Czech RepublicPotužníková, Lenka January 2017 (has links)
The subject of the thesis called Analysis of the impacts of the Amendment to the Consumer Credit Act on the banking sector of the Czech Republic is the Amendment to the Consumer Credit Act effective since 1.12.2016 and its presumed impact on banking sector including the consideration of the justification of some provisions of the Act. The objective of this thesis is a clear summary of fundamental changes which waste from new legislative and outlining the related questions, mapping the consumer credit market tendencies from macro and micro view and recognition of possible risks and opportunities related to the amendment. The data are processed using the simple descriptive statistics method with use of graphic methods and word comments.
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Virtualization Security Threat Forensic and Environment SafeguardingZahedi, Saed January 2014 (has links)
The advent of virtualization technologies has evolved the IT infrastructure and organizations are migrating to virtual platforms. Virtualization is also the foundation for cloud platform services. Virtualization is known to provide more security into the infrastructure apart from agility and flexibility. However security aspects of virtualization are often overlooked. Various attacks to the virtualization hypervisor and its administration component are desirable for adversaries. The threats to virtualization must be rigorously scrutinized to realize common breaches and knowing what is more attractive for attackers. In this thesis a current state of perimeter and operational threats along with taxonomy of virtualization security threats is provided. The common attacks based on vulnerability database are investigated. A distribution of the virtualization software vulnerabilities, mapped to the taxonomy is visualized. The famous industry best practices and standards are introduced and key features of each one are presented for safeguarding the virtualization environments. A discussion of other possible approaches to investigate the severity of threats based on automatic systems is presented.
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Digital Transformation - Rollen för Big Data, Internet of Things och CloudComputing / Digital Transformation - The role of Big Data, Internet of Things and CloudComputingEide, Linn, Paredes Degollar, Daniel January 2016 (has links)
Förändringar i affärsvärlden och på marknaden leder till att företag idag ständigt ställs införnya utmaningar. Vi befinner oss i ett digitaliserat samhälle som är under ständig förändring.Det är något som företag måste förhålla sig till. Företagen står inför utmaningen attdigitalisera sin verksamhet för att förhålla sig till en förändrande marknad och allt merdigitaliserade kunder. Utökande av kommunikationsnät och infrastruktur har möjliggjort förkunder att verka i en mer uppkopplad miljö än tidigare. För att verksamheter ska vara med ispelet bland de konkurrenskraftiga organisationerna, leder det till en av anledningarna till attföretagen kommer i kontakt med IT-trender inom digitalisering som Big Data, Internet ofThings och Cloud Computing. Affärsmodellen är en huvudsaklig aspekt att ta hänsyn till ochjustera vid digitalisering. Studien syftar därmed till att undersöka rollen för de tre nämnda ITtrendernai en verksamhet och hur affärsmodellen faktiskt påverkas. Studiens slutsatser visarpå att användandet av de tre IT-trenderna är låg idag och vad gäller affärsmodellen har detskett en låg påverkan på även om medvetenhet finns i hur den bör påverkas. IT-trendernafinns dock ständigt på agendan och kommer spela en stor roll framöver inom verksamhetersamtidigt som affärsmodellen kommer få en större påverkan. / Changes in the business world and on the market means that companies today are constantlyfaced with new challenges. We are in a digitized society that is constantly changing. It issomething that companies must adhere to. The companies face the challenge of digitizing itsoperations to respond to a changing market and increasingly digitized customers. Extension ofnetworks and infrastructure has enabled customers to work in a more connected world thanbefore. For businesses to be included in the game among the competitive organizations, itleads to one of the reasons that companies will use the IT trends in digitization as Big Data,Internet of Things and Cloud Computing. The business model is a main aspect to be takeninto account and adjust for digitization. The study thus aims to examine the role of these threeIT trends in the business and how the business model actually is affected. The study's findingsshow that the use of the three IT trends are low today, and in terms of the business model hasbeen a low impact on even if consciousness is how it should be affected. The IT trends are,however, constantly on the agenda and will play a big role in the future in the activities whilethe business model will have a larger impact.
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Les tendances pianistiques des années 1985-2010 à travers trois concours internationaux : Chopin de Varsovie, Long-Thibaud de Paris et Tchaïkovski de Moscou / The piano trends over the years 1985-2010 through three international competitions : Chopin in Warsaw, Long-Thibaud in Paris and Tchaikovsky in MoscowZelvyte Giusiano, Indre Eugenija 23 January 2014 (has links)
Cette thèse permet de mettre en lumière divers aspects de l’interprétation pianistique contemporaine. Pour cela, trois concours internationaux ont été choisis – Chopin de Varsovie, Long-Thibaud de Paris et Tchaïkovski de Moscou – de façon à exposer au mieux, à travers des épreuves de ce genre, la situation de l’art pianistique à une échelle mondiale sous des rapports divers : social et historique en relation avec chacune de ces compétitions, technique dans la chaîne compositeur-interprète-auditeur, et artistique sur la base de l’étude des interprétations des finalistes durant la période 1985-2010, sans oublier les enjeux de l’évaluation dans ce cadre.L’analyse générale de la situation actuelle a mis en évidence l’utilité de ces concours dans la vie musicale contemporaine. Si les valeurs esthétiques du monde actuel ne stimulent pas réellement la formation de personnalités d’une grande force et d’une réelle profondeur, un certain nombre de signes positifs semblent toutefois se dégager de ces manifestations. / The scientific work reveals various aspects of contemporary piano performance. Three international piano competitions were chosen – Chopin in Warsaw, Long-Thibaud in Paris and Tchaikovsky in Moscow – because it is through events like these ones that is exposed to its best the situation of pianistic art on a global scale. Given the complexity of our questions, we have shared our research in several areas: social and historical related to each analyzed musical competition, technical according to the chain composer-performer-listener, and artistic based on the study of interpretations of the finalists during the period 1985-2010, preceded by issues evaluation in this context.The general analysis of the current situation has highlighted the need of these competitions in contemporary musical life. If the aesthetic values of the modern world do not actually stimulate the formation of deep and strong personalities, a number of positive signs, however, seem to emerge from these events.
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Home-leaving and Parenthood : Timing of home-leaving and the relation to childbearing behavior in SwedenAdenfelt, Oskar January 2017 (has links)
Objective: This thesis examines the timing of having the first child in relation to when Swedish men and women leave the parental home. The aim is to explain if any childbearing trends can be detected based on whether one leaves the parental home at a younger or older relative age than the current age norms. The timing of having the first child might be affected by either a speed up/slow down effect (one continues to experience other stages of adulthood faster or slower relative to people of the same age) or an age-norm effect (one tries to counter-act deviation from the home-leaving norm by speeding up or delaying childbearing to align with people of the same age). Method and Data: Event history analysis is applied using a multivariate piece-wise constant hazard model. The data comes from Swedish register data based on records of the entire Swedish population between 1 January 1953 and 31 December 2012. Results: The results indicate that Swedish women who leave the parental home younger than the norm run a greater risk of having their first child sooner after leaving the parental home relative to women of the same age. Swedish men who leave the parental home younger than the norm, on the other hand, run a greater risk of having the first child later after leaving the parental home relative to men of the same age. Swedish men who leave the parental home later than the norm run a greater risk of having their first child sooner after leaving the parental home relative to men of the same age while the opposite is true for women. However, the effects of timing of leaving the parental home are relatively small, which can be explained by the very long and stable mean durations found. The peak durations of intensities, i.e. number of years between leaving the parental home and having the first child, for men and women can be found after 10–12 years. The peak durations of intensities are remarkably similar between the genders. Conclusion: Swedish women who leave the parental home earlier than the norm are more likely to experience a speed-up effect in terms of childbearing and a slow down effect when leaving the parental home later than the norm. Thus, women stick to breaking the normative timing of the life course events once they have started. Swedish men, on the other hand, are more likely to try and catch up with age norms and instead postpone having the first child when leaving the parental home earlier than the norm and speed up having a child when leaving the parental home later than the norm. Men are thus more likely to time having children with men of the same age. / Stockholm University SIMSAM Node for Demographic Research
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Méthodologie d’aide à l’innovation par l’exploitation des brevets et des phénomènes physiques impliqués / Innovation aid methodology through patent exploitation and physical phenomena involvedValverde, Ulises 10 December 2015 (has links)
L’objectif de ce travail de thèse est de développer une méthodologie d’extraction de connaissances à partir de brevets pour aider les concepteurs dans la phase de résolution de problèmes industriels. La méthodologie est fondée sur trois piliers : la définition, la recherche / analyse et l’innovation. La définition exhaustive de la fonction principale du système industriel cible le champ de recherche et permet la récupération de mots clés initiaux grâce à une analyse approfondie de l’existant. La recherche itérative des brevets se base sur la décomposition fonctionnelle et sur l’analyse physique. L’analyse intègre la décomposition fonctionnelle énergétique pour déceler les énergies, les flux fonctionnels transmis et les phénomènes physiques impliqués dans le processus de conversion énergétique afin de sélectionner des effets physiques potentiellement pertinents. Pour délimiter le champ d’exploration nous formulons des requêtes de recherche à partir d’une base de données de mots clés constituée par des mots clés initiaux, des mots clés physiques et des mots clés technologiques. Une matrice des découvertes basée sur les croisements entre ces mots clés permet le classement des brevets pertinents. La recherche des opportunités d’innovation exploite la matrice des découvertes pour déceler les tendances évolutives suivies par les inventions. Les opportunités sont déduites à partir de l’analyse des cellules non pourvues de la matrice des découvertes, de l’analyse par tendances d’évolution et du changement de concept par la substitution du convertisseur énergétique. Nous proposons des tendances d’évolution construites à partir de lois d’évolution de la théorie TRIZ, d’heuristiques de conception et de règles de l’art de l’ingénieur. Un cas d’application concernant l’étude d’évolution et la proposition de nouveaux systèmes de séparation de mélanges bi-phasiques en offshore profond met en valeur la méthode. / The aim of this thesis work is the development of a methodology for knowledge extraction from patents to assist design engineers in the industrial problem-solving phase. The methodology is based on three pillars: definition, search / analysis and innovation. A comprehensive definition of the main function of the industrial system delimits the research field and allows the retrieval of initial keywords through a detailed analysis of what is currently available. The iterative patent search is based on functional decomposition and physical analysis. The analysis phase uses energy functional decomposition to identify energies, transmitted functional flows and physical phenomena involved in the energy conversion process in order to select potentially relevant physical effects. To delineate the exploration field we formulate search queries from a keywords database composed by initial, physical, and technological keywords. A discovery matrix based on the intersections between these keywords allows the classification of pertinent patents. The research for innovation opportunities exploits the discovery matrix in order to decipher the evolutionary trends followed by inventions. Opportunities are deduced from an analysis of the discovery matrix empty cells, an analysis of the evolution trends, and from changing the concept by energy converter substitution. We propose evolution trends constructed from the evolution laws of TRIZ theory, design heuristics, and rules of the art of the engineering. An application case concerning the study of the evolution and the proposal of innovative biphasic separation systems in deep offshore highlights the method.
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Populační vývoj a emigrace ze zemí Maghrebu / Population development and emigration of Maghreb's countriesVokatá, Petra January 2017 (has links)
Population development and emigration of Maghreb's countries Abstract The main aim of diploma thesis is to map the migratory situation and trends of all area since 1990 up to the present in context of the population development in region of Maghreb's countries. This all is in connection with the population growth of the states - natural and total. Apart from the analysis of the whole Maghreb as one unit, the demographic parameters are in detail assessed on the example Tunisia. It is estimated that migratory streams of the inhabitants of North Africa's countries are largely directed to Europe. The analasis is focused on the breakdown of the target countries, emigrants and on changes during the reporting period. The analasis uses conventional demographic indicators, its own methods of processing often difficult available data at the same time and empirical investigation. The initial basis of analyzing given issues show the theoretical conception of population development in Arabic countries, with emphasis on demographic transition and dependent migratory transition. Analysis revealed that none of Maghreb's countries has not yet completed demographic transition, the second stage of the demographic transition since 2000 suspended. Keywords: migration, migratory trends, population development, population growth,...
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Late-life functional capacity and health among Finnish war veterans:Veteran Project 1992 and 2004 surveysLeskinen, R. (Riitta) 16 September 2015 (has links)
Abstract
Becoming involved in war is an experience that has the potential to shape later-life health. The aim of the present study was to explore Finnish Second World War veterans’ health status and the determinants of self-rated health (SRH) and functional capacity, especially the ability to walk, and to identify risk factors and their combinations that predict late-life mortality among veterans.
The study population comprised Finnish Second World War veterans who participated in the Veteran 1992 and Veteran 2004 Project surveys. In 1992, a postal questionnaire was sent to all 242,720 war veterans living in Finland. The follow-up survey, the Veteran 2004 Project, was conducted with a randomized sample of veterans who participated in the Veteran 1992 Project. The total number of participants in the baseline survey was 177,989 men and 48,745 women, and in the follow-up survey, 4,348 men and 651 women. The response rate was high in both surveys: 93% in 1992 and 87% in 2004. All analyses were conducted separately for men without disability, men with disability and women.
In a cross-sectional study, SRH and functional capacity was found to be better among 80–84-year-old Finnish war veterans in 2004 compared with 1992, although the prevalence of many diseases increased during the follow-up.
Among the 4,999 veterans who participated in both surveys, the majority rated their health as improved or unchanged during the follow-up. Walking difficulties and cardiovascular (CVD), musculoskeletal and neurological diseases were found to be predictors of declined SRH. When exploring functional capacity among veterans, neurological and musculoskeletal diseases, but especially walking difficulties, predicted veterans’ future functional impairment as many as 12 years in advance, and worsening of these conditions was associated with impaired activities of daily living.
During an average 9.9-year follow-up, walking difficulties alone or together with multimorbidity and/or with a third risk factor was the most important risk factor for total and for CVD mortality among all veteran groups.
In conclusion, the majority of veterans rated their SRH as improved or unchanged during the follow-up. The importance of walking difficulties as a determinant of SRH and functional capacity and as a predictor of mortality was confirmed. / Tiivistelmä
Tutkimuksen tarkoituksena oli arvioida suomalaisten toisen maailmansodan veteraanien terveydentilaa ja tutkia, mitkä tekijät vaikuttavat veteraanien itsearvioituun terveyteen ja toimintakykyyn (erityisesti kävelykykyyn) sekä tunnistaa ne riskitekijät ja tekijäyhdistelmät, jotka ennustavat kuolleisuutta.
Tutkimuspopulaationa käytettiin Veteraaniprojekti 1992 ja Veteraaniprojekti 2004 -tutkimuksiin osallistuneita veteraaneja. Vuonna 1992 kysely lähetettiin postitse jokaiselle Suomessa tuolloin asuneelle 242 720 veteraanille. Seurantatutkimukseen valittiin 5 750 veteraanin satunnaisotos vuoden 1992 tutkimukseen osallistuneista. Veteraaniprojekti 1992 -tutkimukseen osallistui 177 989 miestä ja 48 745 naista ja seurantatutkimukseen 4 348 miestä ja 651 naista. Osallistumisprosentti oli 93 % (1992) ja 87 % (2004). Analyysit tehtiin erikseen veteraanimiehille joilla ei ollut invaliditeettia, invalidimiehille ja naisille.
Poikkileikkaustutkimuksessa tarkasteltiin 80–84-vuotiaiden veteraanien terveyttä ja toimintakykyä vuosina 1992 ja 2004. Vuonna 2004 veteraanit arvioivat terveytensä ja toimintakykynsä paremmiksi kuin samanikäiset veteraanit vuonna 1992, vaikka monet sairaudet yleistyivät seuranta-aikana.
Suurin osa molempiin kyselyihin vastanneista 4 999 veteraanista arvioi terveytensä joko parantuneen tai pysyneen ennallaan seuranta-aikana. Veteraanien kokemat kävelyvaikeudet, sydän- ja verisuonisairaudet, tuki-ja liikuntaelinsairaudet sekä neurologiset sairaudet ennustivat itsearvioidun terveyden heikkenemistä. Sydän- ja verisuonisairauksia lukuun ottamatta edellä mainitut tekijät ennustivat myös toimintakyvyn laskua jopa 12 vuotta etukäteen. Myös kävelykyvyn heikkeneminen ja sairauksien paheneminen seuranta-aikana ennustivat toimintakyvyn laskua.
Kävelyvaikeudet joko yksin tai yhdessä multimorbiditeetin ja/tai jonkin kolmannen riskitekijän kanssa oli tärkein sekä kokonaiskuolleisuutta että sydän- ja verisuonitautikuolleisuutta ennustava tekijä kaikissa veteraaniryhmissä keskimäärin 9,9 vuoden seuranta-aikana.
Yhteenvetona voidaan todeta, että enemmistö tutkimukseen osallistuneista veteraaneista arvioi terveytensä joko parantuneen tai pysyneen ennallaan seuranta-aikana. Koetut kävelyvaikeudet ovat erittäin tärkeä itsearvioitua terveyttä, toimintakykyä ja kuolleisuutta ennustava tekijä.
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