This thesis reviews and augments existing evidence surrounding the psychosocial aspects of living with Type 2 diabetes. There is a specific emphasis on the factors which underpin diabetes distress in individuals with Type 2 diabetes, which pertains also to the influence of partners or spouses on psychological adjustment to diabetes. This research develops and presents a conceptual framework of the key determinants of diabetes distress, providing focus and content for an intervention to address distress among couples living with Type 2 diabetes. Chapter 1 introduces the concept of diabetes distress; including prevalence, clinical relevance, and the cognitive, interpersonal and behaviour factors which are believed to drive this condition-specific distress. There is also an emphasis on existing strategies to improve both psychological and medical outcomes in Type 2 diabetes, which identified a need to evolve psychosocial support for individuals who are struggling to manage diabetes. Importantly, this chapter provided a rationale and direction for the studies reported in prospective chapters. Chapter 2 broadens the focus of psychosocial support in diabetes, to consider also the importance of considering partners or spouses in interventions to improve health outcomes in the context of different chronic physical conditions. This systematic review conveys the benefits of partner inclusion in interventions and highlights a number of shortcomings pertaining to couples intervention work. In particular, the review identifies a scarcity of couples intervention work in the context of Type 2 diabetes. The cross-sectional questionnaire study in Chapter 3 captures the predictive influence of illness perception clusters, coping styles, and relationship quality on diabetes distress in individuals with Type 2 diabetes. Of note, this work identifies negative belief and coping patterns which coincide and exacerbate distress, and presents a novel method of distinguishing those most at risk of elevated diabetes distress. Chapter 4 investigates the influence of partners’ diabetes beliefs on diabetes distress over time. This study demonstrates the moderating influence of partners’ illness perceptions on the association between persons with Type 2 diabetes illness perceptions and diabetes distress, and reveals that such effects persist overtime. Furthermore, Chapter 5 explores narratives of diabetes distress among couples living with Type 2 diabetes and among healthcare professionals, by means of individual semi-structured interviews and focus groups. Expanding on the findings of Chapters 3 and 4, this qualitative work compares experiences of distress from the perspectives of individuals with diabetes and those who support them in a personal and professional capacity, in an attempt to understand how communication and interpersonal conflicts might emerge in day to day life. Importantly, Chapter 5 discerns a perceived need for an intervention to reduce diabetes distress in individuals with Type 2 diabetes and their loved ones, and provides direction for the design and implementation of an intervention of this nature. Chapter 6 draws upon existing and primary evidence pertaining to the cognitive, interpersonal, and behavioural factors which underpin diabetes distress, and provides recommendations for the design and implementation of an intervention to address diabetes distress in couples living with Type 2 diabetes. The feasibility study described in Chapter 7 assesses the acceptability, potential effectiveness, and practical implementation of a brief psychoeducational intervention to address diabetes distress in people with Type 2 diabetes and their partners or family members. The findings of Chapter 7 highlight important strengths and shortcomings of providing an intervention of this nature, which are expanded on in the main discussion in Chapter 8. Chapter 8 provides a broad overview of the rationale for this PhD research and reflects on the primary work undertaken to date. Crucially, this discussion chapter provides recommendations on how key strengths of the feasibility study described in Chapter 7 can be enhanced and how observed shortcomings can be addressed in future studies. Finally, there is consideration of how aspects of the intervention described in Chapters 6 and 7 may feasibly be incorporated into existing programmes of diabetes support.

Abstract   Introduction Failure in the mechanism of self-tolerance in T or B cells can lead to autoimmunity. One of the autoimmune diseases is rheumatoid arthritis (RA), which is a chronic inflammatory disease of unknown cause and is characterized by systemic inflammation, autoantibodies and joint destruction. Serology is crucial for the classification of this disease. The first autoantibody found in RA patients was Rheumatoid factor (RF). However, anti-citrullinated peptide antibodies (ACPAs), a relatively new group of autoantibodies found in 70-90% of RA patients, are diagnostically more specific than RF. Type II collagen (CII) is the most abundant protein in human cartilage. In RA patients, immunity against CII leads to cartilage degradation and loss of joint function. Already from the 1970s, antibodies to CII (anti-CII) were found in RA sera, suggesting that CII autoimmunity might be pathogenetically important. Previous studies from our group show that a subgroup of patients with high levels of anti-CII at the time of diagnosis at the same time have high levels of inflammation in the joints. This is probably caused by anti-CII immune complexes (IC) inducing pro-inflammatory cytokines from macrophages. Although anti-CII positive patients have high inflammatory activity early on, as anti-CII levels decrease during the first year, the associated inflammation also diminishes. Thus, anti-CII positive patients have a rather good prognosis. Moreover, it is assumed that since anti-CII positive patients have a better prognosis than ACPA positive, patients with elevated anti-CII at the time of diagnosis might benefit from different and milder treatment. Previous studies from the group were performed on stored patient samples from the time before modern treatments with biologic agents (1995-2005). In this study, we aimed to investigate patients belonging to a more recent RA cohort, diagnosed between 2005-2014, with the aim to investigate whether patients with the anti-CII-associated RA phenotype would respond differently depending on the use of different modern RA therapies. Patients and Methods The primary cohort consisted of 2335 RA patients and 480 non-RA controls from the Epidermiological Investigations in Rheumatoid Arthritis (EIRA) case-control study. As we run into methodological problems two subgroups with 62 and 40 RA patients from the previous anti-CII studies were investigated when modifying the ELISA procedure, as well as a group of earlier investigated patients with non-specific ELISA reactivity. Totally 2776 RA patients were investigated. All investigated patients fulfilled the American College of Rheumatology classification criteria. To measure the anti-CII levels in RA patients and healthy controls anti-CII ELISA was performed. During the experiments, several different sources of CII from human, rat and bovine origin, and two different alternative coating buffers were used. The optical density (OD) was measured at 450 nm and anti-CII concentrations were calculated against the standard curve from an RA patient with high anti-CII levels.   Results My first analysis of the EIRA cohort showed that anti-CII are higher in RA patients than in controls, but could not confirm the association with acute onset RA. This was an unexpected finding and changed the focus of this master thesis project, to modify the measurement of anti-CII. Re-investigation of EIRA I showed that a proprietary coating buffer is important in the assay. Moreover, when different samples from RA patients were tested with bovine, rat and three different lots of human CII, correlation tests with clinical measures showed that bovine collagen and a new lot of human CII- prepared by the supplying company solely for this project- showed the strongest associations. Thereafter the EIRA cohort was re-investigated with two ELISAs, using bovine and human CII coated with the proprietary buffer. At the time of thesis writing almost all of the EIRA samples have been re-analysed, and results from both the modified ELISAs show the awaited clinical associations to early inflammation.   Conclusion Keeping the integrity of triple helical collagen is very important for the identification anti-native CII in RA patients. Our results show that the use of the proprietary coating buffer appears to be instrumental in this assay, irrespective of what source of CII was used. The new lot of human CII shows significant associations with the clinical measures, but associations are somewhat stronger with bovine CII. After finalising the re-investigations, we will be able to conclude which of the two analyses is most appropriate, and the corresponding dataset will then be merged with data from the first part of the EIRA study investigated previously by other group members. As anti-CII analysis shows the association to disease activity and prognosis, it can be used for predicting prognosis of RA and choosing the appropriate therapy in newly diagnosed RA patients, which might be clinically useful for rheumatologists. Our hypothesis is that as anti-CII positive patients have strong early inflammatory response but good long-term prognosis, they might benefit from other and perhaps short-term treatment compared to other RA patients.  If this is correct, our finding can have impact on the economy as it can define the patients who will not need expensive long-term medications. As modern anti-rheumatic therapies carry the risk of infections, such individualized therapies might also benefit anti-CII positive patients.

Le tryptophane, un acide aminé essentiel, est soit utilisé pour la synthèse protéique et la synthèse de sérotonine, soit dégradé en plusieurs métabolites appelés collectivement les kynurénines. L’expression et l’activité des enzymes de la voie des kynurénines sont stimulées par l’inflammation. La synthèse des kynurénines est donc susceptible d’être augmentée chez les individus obèses. En effet, l’obésité est caractérisée par une inflammation chronique à bas bruit du tissu adipeux, reflétée par l’augmentation de facteurs inflammatoires circulants qui contribuent à l’apparition de l’insulinorésistance et du diabète de type 2. Plusieurs métabolites de la voie des kynurénines pourraient être des facteurs de risque pour le développement de l’insulinorésistance. La chirurgie bariatrique est actuellement le traitement le plus efficace pour l’obésité sévère, elle permet une perte de poids significative ainsi qu’une diminution des facteurs inflammatoires circulantes et une amélioration de l’insulinorésistance et du diabète. Il a été démontré que l’expression d’IDO1, la première enzyme de la voie des kynurénines, est plus élevée dans le tissu adipeux des individus obèses. Le ratio kynurénine sur tryptophane, qui reflète l’activité D’IDO1, est également augmenté chez les individus obèses.Notre objectif a été de caractériser l’expression des enzymes de la voie des kynurénines dans le tissu adipeux et d’évaluer les concentrations des kynurénines dans les sérums de patientes obèses pour rechercher si certains de ces facteurs pouvaient être reliés à l’apparition du diabète. Ces études ont été réalisées dans une cohorte de femmes obèses normoglycémiques et diabétiques. Puis dans un second temps nous avons étudié les conséquences de la perte de poids induite par la chirurgie bariatrique sur les concentrations circulantes des kynurénines et évalué si les variations des concentrations des kynurénines pourraient expliquer en partie l’amélioration du diabète observée après la chirurgie.Dans cette étude, nous avons montré que plusieurs enzymes de la voie sont plus exprimées dans le tissu adipeux des individus obèses que des minces. L’augmentation de l’expression des enzymes dans le tissu adipeux des individus obèses provient d’une part de la présence de macrophages pro-inflammatoires dans le tissu adipeux et également de la réponse des adipocytes aux stimuli pro-inflammatoires. En parallèle, nous avons montré que les concentrations circulantes des kynurénines et le ratio kynurénine sur tryptophane augmentent avec l’IMC et qu’ils diminuent un an après la chirurgie bariatrique. Dans notre étude, comme attendu, la chirurgie bariatrique est associée à une amélioration voire à une rémission du diabète. Nous avons montré également que le maintien des concentrations d’acide kynurénique et d’acide quinolinique sont associés respectivement à la rémission du diabète et à l’amélioration des traits cliniques qui définissent le diabète. La diminution des concentrations en acide xanthurénique après la chirurgie est associée au contraire à une amélioration des traits cliniques qui définissent le diabète. / Tryptophan, an essential amino acid, is either used in protein synthesis or metabolized via the serotonin or the kynurenine pathway. The kynurenine pathway is the main route of tryptophan degradation and generates several metabolites collectively called “kynurenines”. The expression of kynurenine pathway enzymes is induced by inflammatory mediators. Consequently kynurenine synthesis could be induced in individuals with obesity. In fact, obesity is characterized by a chronic low grade inflammation of the adipose tissue reflected by increased serum levels of inflammatory factors which are known to contribute to the development of obesity-induced insulino-resistance. Some metabolites of the kynurenine pathway have been proposed to be risk factors for the development of insulin resistance. Bariatric surgery is currently the most effective treatment for severe obesity and results in a significant weight loss, a decreased level of inflammatory factors and an amelioration of glucose homeostasis. The first enzyme of the kynurenine pathway, IDO1, is known to be more expressed in the adipose tissue of individuals with obesity compared to lean individuals. The kynurenine over tryptophan ratio reflects the activity of IDO1 and is also increased in individuals with obesity.Our objective was to characterize the expression of the kynurenine pathway enzymes in the adipose tissue of women with severe obesity and to evaluate serum levels of the kynurenine pathway metabolites to determine whether these factors could be associated with the appearance of diabetes. This study was performed in women with severe obesity with or without type 2 diabetes. Then we investigated the consequences of weight loss induced by bariatric surgery on levels of circulating kynurenines in order to evaluate whether these variations could explain the improvement in glucose control and type 2 diabetes remission after one year follow-up.In this study, we have shown that several kynurenine pathway enzymes were more expressed in the adipose tissue of women with obesity compared to lean controls. This increase is due to the presence of pro-inflammatory macrophages in the adipose tissue and also comes from the adipocyte response to inflammatory stimuli. In addition, we observed that the serum level of kynurenine and kynurenine over tryptophan ratio are higher in women with higher BMI and they both decrease one year after bariatric surgery. In addition, we observed that the serum level of kynurenine and kynurenine over tryptophan ratio are higher in women with higher BMI and they both decrease one year after bariatric surgery. As expected, bariatric surgery is associated with the improvement and even the remission of type 2 diabetes. We have shown that higher levels of kynurenic acid and quinolinic acid one year after the surgery are associated respectively with type 2 diabetes remission and better glucose homeostasis and that lower levels of xanthurenic acid are associated with better glucose homeostasis.

Les objectifs de ce travail étaient l’évaluation de stades précoces et tardifs de l’arthrose grâce à une étude histologique et biologique de l’arthrose sur un modèle de rupture de ligament croisé crânial chez le lapin (RLCC) et l’évaluation de l’effet de l’âge sur l’évolution de la maladie. L’étude biologique a été réalisée par le dosage sérique d’un marqueur de la dégradation du collagène de type II, le CTX-II, jusqu’à 20 semaines post-chirurgie. Chez les animaux adultes, les concentrations du CTX-II étaient influencées par la chirurgie et par le développement de la pathologie. Chez les jeunes animaux, les niveaux de CTX-II étaient plus élevés en début d’étude et diminuaient au cours du temps. Chez ce groupe d'animaux, les taux de CTX-II n’étaient pas modifiés par l’intervention chirurgicale. L’étude histologique a été réalisée avec une analyse histomorphologique du cartilage et des analyses histomorphométriques du cartilage et de l’os sous-chondral. L’évaluation histologique a permis d’observer des changements liés à l’arthrose chez tous les animaux opérés. Les altérations au niveau du cartilage étaient plus sévères chez les animaux adultes que chez les jeunes, ces derniers présentant une meilleure capacité de compensation à l’instabilité articulaire. Il a été démontré que l’analyse de la plaque osseuse sous-chondrale a permis de distinguer les animaux opérés des animaux non-opérés dans les 2 groupes d’âge, mais les surfaces articulaires affectées n’étaient pas toujours les mêmes. En conclusion, ce travail suggère l’intérêt du CTX-II dans l’évaluation de l’arthrose, mais aussi la pertinence d’effectuer plusieurs temps d’analyse pour mieux connaître l’évolution de la maladie. Les analyses histologiques ont permis de mettre en évidence des changements au niveau du cartilage et de l’os sous-chondral. Les différences observées entre les lapins adultes et les jeunes remettent en question l'utilisation d’animaux trop jeunes dans les études portant sur l’arthrose / The goals of this work were the evaluation of early and late stages of osteoarthritis through a histological and biological study of osteoarthritis using a rabbit model of the anterior cruciate ligament transaction (ACLT) and the evaluation of the effect of age on the evolution of the disease. Biological study was performed with longitudinal analysis of serum level of CTX-II, a marker a type II collagen degradation. In adult animals, serum concentration of CTX-II was influenced by the ACLT surgery and varied with time. In the young rabbits, the serum levels of CTX-II were more elevated at the beginning of study and decrease after. In this animal group, the rates of CTX-II were not influenced by surgical operation. Histological study was accomplished with both histomorphological analysis of the cartilage and with histomorphometric study of both cartilage and sub-chondral bone. Histological evaluation showed osteoarthritis changes in all operated animals. Changes of the cartilage appeared more severe in the adult group compared to the young rabbits, suggesting that these last have a better compensation capacity during articular instability. Bony changes allowed to differentiate operated animals from the unoperated, but the affected articular surfaces were not always the same. In conclusion, this study suggest the interest of the CTX-II biomarker in the evaluation of osteoarthritis, but also the pertinence to perform several time points of analysis to know better the disease evolution. The histological analysis allowed to put in an obvious place changes at the levels of the cartilage and of the sub-chondral bone. Difference noticed between the adult animals and the young rabbits offers a new look for the use of too young animals in osteoarthritis studies

nÃo hà / A diabetes à considerada um fator de risco significativo para a ocorrÃncia de doenÃas periodontais. Entretanto, à necessÃrio que estudos a respeito deste assunto seja realizado em diferentes populaÃÃes, com diferentes caracterÃsticas. O objetivo deste estudo transversal foi avaliar os parÃmetros clÃnicos periodontais de diabÃticos do tipo 2 com diferentes padrÃes de controle glicÃmico. Foram selecionados portadores desta doenÃa, de ambos os gÃneros, residentes na sede do municÃpio de Sobral - CearÃ. Estes deveriam ser nÃo-fumantes, com idade igual ou superior a 40 anos, possuir pelo menos 6 dentes na arcada dentÃria e fazer uso de medicaÃÃo hipoglicemiante. Os indivÃduos foram submetidos ao exame clÃnico periodontal: Ãndice de placa visÃvel (IP), sangramento gengival (IG), sangramento à sondagem (SS), profundidade de sondagem (PS) e recessÃo gengival (RG), realizado por um examinador previamente calibrado. Os indivÃduos foram divididos em trÃs grupos de acordo os nÃveis de hemoglobina glicada â Hb1Ac (Controlados - C: Hb1Ac ≤ 7%, n=103; Descontrolados - D: 7,1% ≤ Hb1Ac ≤ 9%, n= 60; Elevado Descontrole = E: Hb1Ac ≥ 9,1%, n=22). NÃo foram observadas diferenÃas significantes em relaÃÃo Ãs mÃdias de idade em anos, mÃdia de dentes presentes, IP, IG e SS. Verificou-se diferenÃa significante entre os grupos para as mÃdias de Hb1Ac e tempo de diagnÃstico da doenÃa. NÃo foi verificada associaÃÃo estatisticamente significante entre elevados nÃveis glicÃmicos e a maior presenÃa de dentes e de sÃtios periodontais com PS ≥ 6 mm. Entretanto quando foram analisados apenas os indivÃduos que apresentaram 20 ou mais dentes isso foi observado. Assim, pÃde-se concluir que o pobre controle glicÃmico dos diabÃticos do tipo 2, foi associado a maior presenÃa de periodontite apenas nos indivÃduos com elevado nÃmero de dentes. / Diabetes is a significant risk factor for the occurrence of periodontal diseases. Studying the relationship of both diseases in different populations with heterogeneous characteristics are still necessary to better understand them. The aim of this cross-sectional study was to evaluate the clinical periodontal parameters of type 2 diabetes patients with different levels of glycemic control. There were selected type 2 diabetics residing in the urban area of Sobral, Ceara. They must be non-smokers, aging 40 years or more and presenting at least and 6 teeth in their mouth. All had to be using any medication to control the glycemic level. Subjects were assigned to three groups based on their respective glycated hemoglobin levels - Hb1Ac (Control - C: Hb1Ac ≤ 7%, n=103; Moderate control - M: 7,1% ≤ Hb1Ac ≤ 9%, n= 60; Poor control = P: Hb1Ac ≥ 9,1%, n=22). The following clinical data were obtained from all patients: Plaque Index (PI), Gingival Index (GI), bleeding on probing (BOP), probing depth (PD) and gingival recession (GR). The mean age, number of teeth, PI, GI and BOP did not show any significance between groups. But this was observed for Hb1Ac mean levels and time of diabetes diagnosis. The presence of at least one periodontal site with PD ≥ 6 mm was considered for the diagnosis of periodontitis. There was no association between the increase of the glycemic level and the presence of periodontitis. However, data from patients presenting at least 20 teeth showed a significant association between periodontal diseases and higher glycemic levels. It can be concluded that the poor glycemic control was associated to the presence of periodontitis only in subjects with high number of teeth.

Orientador: Vera Lúcia Scatena / Banca: Marccus Vinícius da Silva Alves / Banca: Simone de Pádua Teixeira / Banca: Silvia Rodrigues Machado / Banca: Julio Antonio Lombardi / Abstract: The embryology and the seed development of Eriocaulaceae and Cyperaceae were studied here in order to contribute to the taxonomy and phylogeny of both families. The results given by different genera of Eriocaulaceae allowed us to strengthen the embryological uniformity of the family. The endothecial thickenings of the baseplate-type, the spiraperturate pollen grains, the antipodal cyst closely associated to the hypostase, and the operculated endotestal seeds are synapomorphies of Eriocaulaceae within Poales. The use of the character number of microsporangia of anthers in genera delimitation is not consistent, while those related to the seed coat seem to be more stable in establishing relationships between genera. The overall embryological features pointed out the necessity of a taxonomic revision in Eriocaulaceae, aiming at a more natural classification of its taxa. In Cyperaceae, the embryology and the fruit development were investigated in species of Hypolytrum and Rhynchospora, showing that most of these aspects are also uniform within the family. The endothecial thickenings of the spiral type, the Cyperaceous-type of simultaneous microsporogenesis, the trinucleate pollen grain of the pseudomonad type, the formation of a funicular obturator closely associated with the hypostase of the ovule, the Onagrad-Juncus variation embryogeny, and the fruit of the achene type with silica deposition clearly distinguish this family amongst the other Poales. Hypolytrum differs from Rhynchospora as well as from the other genera of Cyperaceae already studied for the spherical pseudomonads, with reticulate exine and central arrangement in the microsporangia, the micropyle formed by both the integuments, and the conspicuous parietal tissue which indicate its position as a basal group in the family. Moreover, the number and the ...(Complete abstract, click electronic address below). / Doutor

The rapid progress of n-type metal oxide thin film transistors (TFTs) has motivated research on p-type metal oxide TFTs in order to realise metal oxide-based CMOS circuits which enable low power consumption large-area electronics. Cuprous oxide (Cu2O) has previously been proposed as a suitable active layer for p-type metal oxide TFTs. The two most significant challenges for achieving good quality Cu2O TFTs are to overcome the low field-effect mobility and an unacceptably high off-state current that are a feature of devices that have been reported to date. This dissertation focuses on improving the carrier mobility, and identifying the main origins of the low field-effect mobility and high off-state current in Cu2O TFTs. This work has three major findings. The first major outcome is a demonstration that vacuum annealing can be used to improve the carrier mobility in Cu2O without phase conversion, such as oxidation (CuO) or oxide reduction (Cu). In order to allow an in-depth discussion on the main origins of the very low carrier mobility in as-deposited films and the mobility enhancement by annealing, a quantitative analysis of the relative dominance of the main conduction mechanisms (i.e. trap-limited and grain-boundary-limited conduction) is performed. This shows that the low carrier mobility of as-deposited Cu2O is due to significant grain-boundary-limited conduction. In contrast, after annealing, grain-boundary-limited conduction becomes insignificant due to a considerable reduction in the energy barrier height at grain boundaries, and therefore trap-limited conduction dominates. A further mobility improvement by an increase in annealing temperature is explained by a reduction in the effect of trap-limited conduction resulting from a decrease in tail state density. The second major outcome of this work is the observation that grain orientation ([111] or [100] direction) of sputter-deposited Cu2O can be varied by control of the incident ion-to-Cu flux ratio. Using this technique, a systematic investigation on the effect of grain orientation on carrier mobility in Cu2O thin films is presented, which shows that the [100] Cu2O grain orientation is more favourable for realising a high carrier mobility. In the third and final outcome of this thesis, the temperature dependence of the drain current as a function of gate voltage along with the C-V characteristics reveals that minority carriers (electrons) cause the high off-state current in Cu2O TFTs. In addition, it is observed that an abrupt lowering of the activation energy and pinning of the Fermi energy occur in the off-state, which is attributed to subgap states at 0.38 eV below the conduction band minimum. These findings provide readers with the understanding of the main origins of the low carrier mobility and high off-state current in Cu2O TFTs, and the future research direction for resolving these problems.

Objetivo: avaliar a relação entre o tipo facial e as variações da inclinação do Plano Oclusal e do ângulo ANB em indivíduos com oclusão normal. Material e Método: a amostra foi composta por 98 telerradiografias em norma lateral de 98 indivíduos (47 homens e 51 mulheres) com idade média de 15,2 anos (desvio padrão de 1,4 anos), com oclusão normal e perfil harmonioso. As radiografias foram digitalizadas em escala 1:1 eo programa Nemoceph (Nemotec® - Espanha), foi usado para a análise cefalométrica, que incluiu as cinco variáveis que segundo Ricketts definem o padrão facial, a relação sagital (SNA, SNB, ANB, N.S.Ba, SN.Go-Me, ANB individualizado, AP-BP e Wits)e ainclinação do Plano Oclusal (PLO.Linha S-N, PLO.PF, PLO.PP, PLO.XiPm e PLO.PM). Os dados foram analisados estatisticamente com um nível de significância de 5%. Resultados: acomposição dos tipos faciais foi: 11% dólicofaciais, 39% mesofaciais e 50% braquifaciais. Os valores médios e intervalo de confiança de 95% das variáveis que avaliaram a inclinação do plano oclusal, para os tipos faciais dólico, meso e braqui foramrespectivamente: PLO.SN: 21,7° (± 2,14°), 17,0° (± 1,10°) e 15,1° (± 1,43°); PLO.PF: 13,5° (±1,77)°, 10° (SD 1,01°) and 8,1° (± 1,25°); PLO.PP: 12,2° (±1,99°), 9.1° (± 1,31°) e 8,1° (± 1,21°); PLO.Xi-Pm: 20,5° (± 1,76°), 19,2° (± 0,96°) e 16,4° (± 1,12°); PLO.PM: 17,5° (± 2,02°), 15,3° (± 1,27°) e 12,1° (± 1,19°). Os valores médios das variáveis que avaliam a relação sagital maxilomandibular respectivamente foram: ANB: 3,8° (± 0,98°), 2,5° (± 0,62°) e1,3° (± 0,53°); distância AP-BP: 7,3mm (± 2,19mm), 3,4mm (± 0,94mm) e 1,9mm (± 0,78mm); ANB Individualizado: 4,7° (± 0,70°), 4,4° (± 0,43°) e 3,7° (± 0,39°); Wits: 1,8mm (± 1,27mm), -2,4mm (± 0,83mm) e -3,5mm (± 0,92mm). Conclusões: Tanto as variáveis que avaliam a inclinação do Plano Oclusal como as variáveis que avaliam a relação sagital maxilo-mandibular ANB e AP-BP, caracterizam-se diferencialmente segundo o tipo facial, observando-se um decréscimo dos valores do tipo dólicofacial para o braquifacial. / Objective: evaluate the relation between the facialtype and the inclination of the occlusal plane and ANB angle in individuals with normal occlusion.Material and Methods: the sample was composed of 98 radiographs, in lateral norm, of 98 individuals (47 men, 51 women), with an average age of 15.2 years (standard deviation of 1.4 years), normal occlusion and harmonic profile.The radiographs were digitalized in a 1:1 scale and the software Nemoceph (Nemotec® - Spain) was used for the cephalometric analysis, which included Rickettsfive variables thatdetermine the facial type, the saggital relation (SNA, SNB, ANB, N.S.Ba, SN.Go-Me, ANB individualized, AP-BP and Wits) and theinclination of the occlusal plane (OPL.S-N, OPL.PF, OPL.PP, OPL.XiPmand OPL.PM). The data was analyzed statistically with a significance level of 5%.Results: the composition of the sample by facial type was: 11% dolichofacial, 39% mesofacial e 50% braquifacial. The averagevalues and 95% confidence interval of the variables that measured the inclination of the occlusal plane, for the dolichofacial, mesofacial and braquifacialgroups were,respectively: OPL.SN: 21.7° (± 2.14°), 17.0° (± 1.10°) and 15.1° (± 1.43°); OPL.PF: 13.5° (±1.77)°, 10° (SD 1.01°) and 8.1° (± 1.25°); OPL.PP: 12.2° (± 1.99°), 9.1° (± 1.31°) and 8.1° (± 1.21°); OPL.Xi-Pm: 20.5° (± 1.76°), 19.2° (± 0.96°) and 16.4° (± 1.12°); OPL.PM: 17.5° (± 2.02°), 15.3° (± 1.27°) and 12.1° (± 1.19°). The average values and 95% confidence interval of the variables that measure the maxilar-mandibular saggital relation were respectively: ANB: 3.8° (± 0.98°), 2.5° (± 0.62°) and1.3° (± 0.53°);distance AP-BP: 7.3mm (± 2.19mm), 3.4mm (± 0.94mm)and 1.9mm (± 0.78mm); ANB Individualized: 4,7° (± 0.70°), 4.4° (± 0.43°) and 3.7° (± 0.39°); Wits: 1.8mm (± 1.27mm), -2.4mm (± 0.83mm)and -3.5mm (± 0.92mm). Conclusion: Both variables that measure the inclination of the occlusal plane and the variables that measure the ANB and AP-BP maxillomandibularsaggital relation have different characteristics according to the facial type, being observed a decrease in values from the dolichofacial type to the brachifacial type.

Thesis (D.Sc.)--University of the Witwatersrand, Faculty of Health Sciences, 2012.

The amount of violent media that is consumed on a daily basis by the average American and the empirically proven effects associated with such regular consumption have led scholars to consider violent media a public health threat, the risks of which, the public may not even fully appreciate (Huesmann, Dubow, & Yang, 2013). Previous research in the field of public health communication has found that different forms of evidence in public health risk messages are more or less effective in changing behavior depending on individual recipient characteristics (de Wit, Das & Vet, 2008; Reinard, 1988; Slater & Rouner, 1996). The present research investigated the effectiveness of different forms of evidence (narrative or statistical) in decreasing violent media consumption by increasing an individual's risk perceptions and negative attitude associated with violent media. In accordance with the Theory of Planned Behavior (Ajzen, 1991), it was hypothesized that these risk perceptions and attitudes would predict intentions toward violent media consumption, as well as subsequent consumption. The study was conducted via MTurk with a sample of one hundred and fifty participants (53% Male). Results showed that an individuals' violent media consumption predicted their attitude toward violent media (p = .035), and that their risk perception and attitude toward violent media significantly predicted their intentions to decrease violent media consumption (ps < .05). Though no significant difference was found between the effect of narrative and statistical evidence on general violent media consumption, exploratory analyses of effects on specific forms of media showed that narrative evidence resulted in a significant decrease in violent video game consumption (p = .042). Additionally, age predicted risk perception, the older the participant the less risk they perceived in violent media consumption (p = .010). Future research should investigate the effect of including all elements of the Theory of Planned Behavior on the ability of different evidence types to change behavior, and perhaps extend the time frame within which change is measured in order to maximize the ability to observe any true change in behavior.