This thesis explores mental health problems relating to war and natural disaster and suicidal behaviour in the Nicaraguan population. The more specific aims of the study were to assess the prevalence and sociodemographic correlates of mental disorder in a community-based study during time of war (Paper I), to assess the mental health impact of Hurricane Mitch in 1998 (Paper II), to assess the incidence of hospitalized parasuicide cases and groups at risk (Paper III), and to examine suicide intent among attempters relating to gender, suicide method and sociodemographic factors and identify predictors for repetition of an attempt (Paper IV). Method: Based on 4453 family food ration books for families living in an urban area of León, Subtiava, 219 families including 746 adults were selected through a systematic sampling procedure. The study was conducted in 1987 during the war. We were able to reach 584 adults for interview according to the Present State Examination for ICD-9 diagnoses and Self-Report Questionnaire (Paper I). In Paper II, 496 adult primary health care attendees were interviewed six months after Hurricane Mitch according to the Harvard Trauma Questionnaire and were diagnosed for post-traumatic stress disorder (PTSD) according to DSM-IV. In Papers III and IV, all cases from León city admitted to HEODRA Hospital for a suicide attempt over a three-year period (n=233) were interviewed regarding sociodemographic factors and method, time and place of the suicide attempt. A subgroup of 204 cases was interviewed using the Suicide Intent Scale (SIS). Out of those 106 cases were followed-up regarding repetition of attempt or completed suicide after a mean period of 1172 days. Results: In the Paper I study, the one-month prevalence of any mental disorder was 28.8% for men and 30.8% for women. Among men, alcoholism was the most common diagnosis, whereas neurosis, crisis reaction and depression were dominant among women. Alcoholism was scored as the second most severe disorder after psychosis in terms of functional level. In the Mitch study six months after the hurricane, traumatic events were common and 39% reported death or serious injury of a close relative as a result of the hurricane. The prevalence of PTSD ranged from 4.5% in the least damaged area to 9.0% in the worst damaged area. At the prolonged follow-up six months later, half of the cases still retained their diagnosis. Trauma-related symptoms were common and death of a relative, destroyed house, female sex, illiteracy and previous mental health problems were associated with a higher level of symptoms. Suicidal ideation was reported among 8.5% and was significantly associated with previous mental health problems and illiteracy. The studies regarding hospitalized parasuicides showed the highest rate among girls aged 15–19 years (302 attempts per 100 000 inhabitants and year). After drug intoxication, pesticide was the second most common method and most often used by men (23%). Half of the women had recent contact with health care services before attempting suicide. There were significant peaks regarding time of attempt in terms of seasonal and diurnal distribution. Overall scores regarding seriousness of the intent (SIS) were equal between the sexes, but the pattern of SIS items showed significant gender differences in terms of relation to background factors and method used. For women, having a child was one factor associated with higher seriousness. Factor analysis of SIS items revealed a four-factor solution, explaining 59% of the variance. Risk for fatal repetition was 3.2% after three years and for non-fatal repetition 4.8%. During follow-up, three men (11%) had completed suicide but no women. We failed to identify any predictors for repetition from background factors or SIS. Conclusion: The studies have identified different groups at risk for mental health problems relating to war and disasters. Parasuicide rates equalled those from European countries. Whereas young girls dominated, attempts among men were more severe in terms of the methods used and completed suicide at follow-up. SIS seemed to give a meaningful pattern among women but not for men. In our study, seriousness of attempt in terms of method or suicide intent did not predict repetition. Overall non-fatal repetition rate was very low as compared to other studies.

The Obstructive Lung Disease in Northern Sweden study's (OLIN) overall aim is prevention of obstructive airways diseases; asthma, chronic bronchitis and chronic obstructive pulmonary disease (COPD). The first part of the OLIN study was a cross- sectional study in three phases, which aimed to estimate the prevalence obstructive lung diseases and to collect data on possible determinants of diseases. This thesis is based on the first part of the OLIN study, and on a postal survey mainly performed in order to evaluate the external validity of the first part of the project Aims: * To assess the prevalences of asthma, chronic bronchitis and respiratory symptoms in adults. * To compare the influence of various diagnostic criteria on prevalence. * To identify subjects with obstructive lung diseases, in particular asthma, for case-referent and prospective longitudinal studies. * To examine whether the trend towards an increase in the prevalence of asthma persists. * Study factors that may influence the development of obstructive lung diseases; age, gender, smoking habit, occupation, socio-economic group, population density and area of domicile. The first part of the OLIN study consisted of three phases. A postal questionnaire regarding respiratory symptoms and diseases, smoking habit and profession was sent to all subjects aged 35-36 y, 50-51 y and 65-66 y (n=6,610) living in eight representative areas of Sweden's northernmost province; 86% completed the questionnaire. Those reporting symptoms suspicious of asthma or chronic bronchitis (n=l,340), together with a stratified sample (n=315) of those not suspected of having the diseases according to the postal questionnaire, were invited to structured interviews and lung function tests. The prevalence of asthma, 5- 6% according to both the postal questionnaire and to the structured interview, prompted a validity study, which included bronchial provocation tests. While the prevalence remained unchanged, the validity study better identified the subjects with asthma and chronic bronchitis, thus improving the representativeness of the subjects with the diseases. In 1992, the study base was expanded by a postal questionnaire study which included 20/489 subjects 20-69 y in order to assess whether the prevalence had changed, to create possibilities to estimate the incidence, and to be better able to detect determinants of diseases. The results show that the prevalence of asthma in adults in 1992 was 7-8% according to postal questionnaire and was considerably higher, approximately 10%, in young adults. Further, the prevalence of asthma in 1986-1987 in subjects aged 35-36 y, 50-51 y and 65-66 y was 5% by using a combination of epidemiological and clinical methods. Various operational criteria yielded a prevalence of 4-7%. Between 1986 and 1992 the prevalence of asthma in these age groups increased with 1% according to the postal questionnaire. Chronic bronchitis in subjects aged 35-36 y was 3% in 1986-1987. The prevalence of chronic bronchitis increased with age, particularly in men. The mean prevalence in the three age groups 35-36 y, 50-51 y and 65-66 y was 12% in men and 8% in women. Chronic bronchitis was strongly associated with smoking, age and a family history of obstructive airways disease. Regarding socioeconomic group chronic bronchitis was related to manual workers in industry and to self- employed other than professionals, and it was particularly common in miners and in those employed in agriculture. The strongest risk factor for asthma was a family history of asthma, and asthma was more common in manual workers in service, in non-manual assistant employees as well as in farmers. The results also indicate the presence of an urban factor in asthma in northern Sweden, in spite of the fact that respiratory symptoms in general tended to be more common in the colder interior of the province compared with the coastal area. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1993, härtill 7 uppsatser</p> / digitalisering@umu

The geographic disparity of multiple sclerosis has been noted in the literature for well over a century. The frequency of the disease varies significantly both within countries and in different parts of the world. The goal of this project is to give new insight regarding the etiology of multiple sclerosis. Several theories regarding the etiology of the disease have been reviewed, including a geographic theory, a nutritional theory, and a genetic theory. Although the geographic and nutritional theories have been thoroughly investigated by researchers, neither of them provides a conclusive explanation for the etiology of the disease, and there are discrepancies with respect to both theories. The purpose of this study is to reveal the discrepancies in the epigenetic theories regarding the etiology of multiple sclerosis and to demonstrate the correlation of multiple sclerosis prevalence and the migration and settlement history of Northern Europeans, thus conferring the passage of a genetic susceptibility to the disease.

Bakalauro darbą sudaro dvi dalys – teorinė ir empirinė. Teorinėje dalyje analizuojama literatūra apie psichoaktyvias medžiagas, jų rūšis, poveikį ir padarinius žmogaus organizmui. Yra apžvelgiami narkotinių medžiagų vartojimo paplitimo rodikliai Europoje ir Lietuvoje, psichoaktyvių medžiagų vartojimo prevencija. Empirinėje dalyje analizuojamas psichoaktyvių medžiagų vartojimo paplitimas tarp Šiaulių universiteto I – IV kurso studentų. / Undergraduate work have two main parts the theoretical and the empirical. The theoretical part analyzes the literature on psychoactive substances, their types, impacts and consequences of the human body. In receiving, the most common drugs used by second course students, and the rarestthe first course students.Using/ treated among the most common substance cannabis and hashish are both among University students, and between Lithuania, the European youth. These substances are most prevalent among fourth course students, while at least - the second course students. The empirical analysis in psychoactive substance use among University I - IV course students.

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The purpose of this study was to evaluate masticatory muscle (MM) and temporomandibular joint (TMJ) pain patients regarding the prevalence of Posttraumatic Stress Disorder (PTSD) symptoms, and evaluate the level of psychological dysfunction and its relationship to PTSD symptoms in these patients. This study included 445 adult patients (male = 42, female = 403). Psychological questionnaires included the Symptom Check List-90-Revised (SCL-90-R), the Multidimensional Pain Inventory, the Pittsburgh Sleep Quality Index and the PTSD Check List Civilian. The total sample of patients was divided into two major groups: The MM group (n=242) and TMJ group (n=203). Each group was divided into three subgroups according to the presence of a stressor and severity of PTSD symptoms. Thirty six patients (14.9%) in the MM group and 20 patients (9.9%) in the TMJ group presented symptomatology of PTSD. MM and TMJ pain patients in the positive PTSD subgroups scored higher on all scales of the SCL-90-R (p = .000) than the other two subgroups and reached levels of distress that were indicative of psychological dysfunction. MM and TMJ pain patients in the positive PTSD subgroups were more often classified as dysfunctional than as adaptive copers and presented with more sleep disturbances than patients in the no stressor and negative PTSD subgroups. A somewhat elevated prevalence rate for PTSD symptomatology was found in the MM than in the TMJ group. Significant levels of psychological dysfunction appear limited to temporomandibular disorder patients with symptoms of PTSD.

Globally, workplace bullying is a growing phenomenon which affects millions of employees. It is characterised by frequency of incidence, duration and reaction on the side of both the perpetrator and victim, ultimately caused by power struggles in ineffective working environments. The impact on both the Company and employee is significant and there is a negative impact on the employment relationship. It may lead to reduced performance and productivity, individual health problems, impact on job satisfaction and foster intentions to quit. The primary objective of this research was to determine the prevalence of workplace bullying in a South African Information Technology (IT) company, and determine the impact of this construct on job satisfaction and intention to quit. A cross-sectional survey design was used. The constructs were measured by means of a biographical questionnaire, the Negative Acts Questionnaire Revised, a Job Satisfaction Questionnaire and an Intention to Quit Questionnaire. Cronbach’s Alpha coefficients were used to assess the validity and reliability of the measuring instruments. The phi-coefficient was used to determine effect size and power of the chi-square tests for independence (Aron, Elliot, & Aaron, 2011). The research method for the articles consisted of a literature review and an empirical study. The statistical analysis was carried out using the SPSS 20.0 programme (SPSS 2012). Article 1 focuses on the prevalence and measurement of workplace bullying in an IT company. Descriptive statistics (frequencies) and cross tabulations were used to describe the data. Significant relations were found in constructs within the negative acts, and also between the negative acts and biographical information. Article 2 focuses on the relation between workplace bullying, job satisfaction and the intention to quit in an IT company. Descriptive statistics (frequencies, means, standard deviations, skewness and kurtosis) were determined to describe the data, principal component analysis was used and an Oblimin rotation was performed to determine the constructs for analysis. Pearson’s correlation coefficients and multiple regression analysis were used to determine the relationship between these constructs. Significant relations and difference are found between the various individual constructs and the scores of the negatives acts, job satisfaction and intention to quit. Conclusions are made for the current research, limitations discussed and recommendations for future research are put forward. / Thesis (MCom (Labour relations management))--North-West University, Vaal Triangle Campus, 2013

Background Within the last century, Type 2 diabetes mellitus has become one of the major health concerns both in the US and globally. Overall prevalence and incidence of the disease within younger populations including adolescents and young adults has sharply increased since 1990 and is estimated to increase further if no actions are taken. It is estimated that 5.7 million people have a form of diabetes. Of the total estimated prevalence of T2DM, 25% of persons with diabetes are unaware they have the disease. This study aims to identify populations most at risk as well as to label important risk factors associated with the rise of T2DM within the young adult population. Objectives This study aimed to measure the prevalence of diagnosed and undiagnosed T2DM among different populations based on ethnicity, socioeconomic status, and weight classification among a representative sample of young adults within the United States. This study also aims to identify and quantify associated risk factors of T2DM among young adults, and address current preventative and treatment measures. Methods Six two-year samples of the National Health and Nutrition Examination Survey (NHANES) containing a total of 62,160 individuals were compiled into one dataset. Of these, 11,874 young adults aged 20-40 were selected into the study. Prevalence of diagnosed and undiagnosed T2DM was calculated for specific populations. The study also aimed to identify important risk factors through univariate and multivariate binomial logistic regression analysis. Results Among young adults aged 20-40, overall prevalence of T2DM was found to be 1.4% (CI: 1.2-1.6%). Of observed diabetes cases, an alarming 20.1% (N = 68) were categorized as undiagnosed. Significant increases in risk were observed within older age groups, overweight and obese weight categories, individuals living below poverty and within minority racial/ethnic groups. Weight, measured by both BMI (OR: 10.7; CI:5.88-19.44) and waist circumference (OR: 5.29; CI: 3.18-8.79), was identified as the most influential risk factor, and should be a main area of focus in development of interventions. Increases in activity levels, both at work and during leisure-time, were found to decrease one’s risk of having T2DM. Discussion Type 2 diabetes has become a major health concern within the past decades, and will continue to be an area of focus in the future. If current trends of diabetes among the young continue, significant burden will be placed on both health facilities as well as on the economy. Based on the findings from this study, further research should be place on prevention methods aimed at altering life-style behaviors such as diet and exercise early in one’s life. Based on the alarming prevalence of undiagnosed cases, continued research and support should also be place on access to care for minorities, especially persons of Latin American decent.

The quantification of human papillomavirus (HPV) oncogene transcripts, E6 and E7, may be predictive of viral oncogenesis and cancer progression. The main objectives of this study were to determine the HPV genotype prevalence and distribution in Edmonton, Alberta, and characterize a quantifiable association of HPV E6/E7 mRNA expression with the presence of cervical disease. Successful clinical trial design and patient enrolment lead to the first controlled characterization of HPV genotype epidemiology in Alberta. HPV-16 was identified as the most prevalent genotype, followed by several non-vaccine genotypes (HPV-31, -52). Despite rigorous experimentation and a significant correlation between high-risk HPV infection and cervical lesions (p<0.05), absolute quantification of viral oncogenesis was unsuccessful. The ability to quantify oncogene transcriptional activity may, in time, revolutionize cervical cancer screening programmes, akin to the Pap smear several decades ago. However, as experienced in this study and in others, great challenges and even greater questions remain unanswered.

This research investigated underlying issues that were critical to the success of the bifocal trial and comprised of three studies. The first study evaluated if Chinese-Canadian children were suitable subjects for the bifocal trial. The high prevalence of myopia in Chinese children suggests that genetic input plays a role in myopia development, but the rapid increase in prevalence over the last few decades indicates environmental factors are also important. Since this bifocal trial was conducted in Canada, this work aimed to determine whether Chinese children who had migrated to Canada would still have high myopia prevalence and a high rate of myopia progression. The second study determined the optimal bifocal lens power for myopia treatment and the effect of incorporating base-in prism into the bifocal. In the majority of published myopia control studies, the power of the prescribed near addition was usually predetermined in the belief that the near addition would always help to improve the near focus. In fact, the effect of near addition on the accommodative error might be quite different even for individuals in which the same magnitude of accommodation lag had been measured. Therefore, this work was necessary to guide the selection of bifocal and prism powers most suitable for the subsequent bifocal trial. The third study, the ultimate goal of this research, was to conduct a longitudinal clinical trial to determine if bifocals and prismatic bifocals could control myopia progression in children.