Disease maps are geographical maps that display local estimates of disease risk. When the disease is rare, crude risk estimates can be highly variable, leading to extreme estimates in areas with low population density. Bayesian hierarchical models are commonly used to stabilize the disease map, making them more easily interpretable. By exploiting assumptions about the correlation structure in space and time, the statistical model stabilizes the map by shrinking unstable, extreme risk estimates to the risks in surrounding areas (local spatial smoothing) or to the risks at contiguous time points (temporal smoothing). Extreme estimates that are based on smaller populations are subject to a greater degree of shrinkage, particularly when the risks in adjacent areas or at contiguous time points do not support the extreme value and are more stable themselves. / A common goal in disease mapping studies is to identify areas of elevated risk. The objective of this thesis is to compare the accuracy of several fully Bayesian hierarchical models in discriminating between high-risk and background-risk areas. These models differ according to the various spatial, temporal and space-time interaction terms that are included in the model, which can greatly affect the smoothing of the risk estimates. This was accomplished with simulations based on the cervical cancer rate of Kentucky and at-risk person-years of the state of Kentucky's 120 counties from 1995 to 2002. High-risk areas were 'planted' in the generated maps that otherwise had background relative risks of one. The various disease mapping models were applied and their accuracy in correctly identifying high- and background-risk areas was compared by means of Receiver Operating Characteristic curve methodology. Using data on Multiple Sclerosis (MS) on the island of Sardinia, Italy we apply the more successful models to identify areas of elevated MS risk.

Inflammation contributes to the etiology of type 2 diabetes (T2D) and cardiovascular disease (CVD). Therefore, it is of interest to investigate how diet relates to plasma inflammatory proteins, particularly whole grain and fibre intakes, as these factors have been associated with lower CVD and T2D risk. Only a limited number of observational studies have examined these relationships. The objective of this study was to investigate the cross-sectional relationships of whole and refined grain and dietary fibre intakes with plasma inflammatory proteins. There was a strong inverse relationship between whole grain intake and plasminogen activator inhibitor type 1 (PAI-1) (β =-0.102; SE=0.038; p=0.0077), and a positive relationship between refined grain intake and PAI-1 (β=0.076; SE=0.034; p=0.0251). Additionally, dietary fibre was related to lower concentrations of C-reactive protein (β=-0.034; SE=0.010; p=0.0008) and fibrinogen (β=-1.207; SE=0.505; p=0.0171). This research suggests that whole and refined grain and fibre intakes may influence inflammatory protein concentrations.

Inflammation contributes to the etiology of type 2 diabetes (T2D) and cardiovascular disease (CVD). Therefore, it is of interest to investigate how diet relates to plasma inflammatory proteins, particularly whole grain and fibre intakes, as these factors have been associated with lower CVD and T2D risk. Only a limited number of observational studies have examined these relationships. The objective of this study was to investigate the cross-sectional relationships of whole and refined grain and dietary fibre intakes with plasma inflammatory proteins. There was a strong inverse relationship between whole grain intake and plasminogen activator inhibitor type 1 (PAI-1) (β =-0.102; SE=0.038; p=0.0077), and a positive relationship between refined grain intake and PAI-1 (β=0.076; SE=0.034; p=0.0251). Additionally, dietary fibre was related to lower concentrations of C-reactive protein (β=-0.034; SE=0.010; p=0.0008) and fibrinogen (β=-1.207; SE=0.505; p=0.0171). This research suggests that whole and refined grain and fibre intakes may influence inflammatory protein concentrations.

Thesis (Ph. D.)--University of Texas Health Science Center at Houston, School of Public Health, 2007. / "August 2007." Advisor: Benjamin C. Amick, III. Includes bibliographical references.

Thesis (Ph. D.)--University of Oklahoma. / Includes bibliographical references.

Thesis (M.A.) in Mathematics and Statistics--University of Maine, 2002. / Includes vita. Includes bibliographical references (leaf 45).

No description available.

No description available.

Orientador: José Ricardo de Albergaria Barbosa / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T02:17:56Z (GMT). No. of bitstreams: 1 Vemba-Cidade_CasteloPedro_D.pdf: 1650381 bytes, checksum: 57909f2c0597a104881cfafff2f54a1a (MD5) Previous issue date: 2013 / Resumo: Estudos atuais demonstram um aumento da população idosa mundial. No Brasil os idosos representam cerca de 9% da população, sendo aproximadamente 21 milhões de pessoas com mais de 60 anos. Este trabalho analisou características epidemiológicas de pacientes idosos vítimas de trauma de face atendido pela Área de Cirurgia Buco-Maxilo-Facial da Faculdade de Odontologia de Piracicaba (FOP) - Unicamp, na cidade de Piracicaba e região, no período de abril de 1999 a dezembro de 2012. A análise foi direcionada a dados relativos de variáveis populacionais como idade, gênero, cor, etiologia do trauma, lesões corporais na face ou não, incluindo fraturas de face ou não e fraturas associadas, tratamento instituído, tempo decorrido entre o trauma e o tratamento, além do período de proservação e complicações. Foram analisados dados dos pacientes, através de preenchimento de um formulário clínico especificamente elaborado para a anotação de dados relativos ao estudo de traumatismos faciais. Foram excluídos do trabalho pacientes com preenchimento incompleto das informações. Um total de 237 pacientes idosos foram avaliados, 127 (53,6%) pacientes do gênero masculino e 110 (46,4%) do gênero feminino, a queda foi a causa mais frequente com 146 casos (61,6%) do total, com maior incidência no terço médio de face com 114 fraturas (48,1%), sendo que os ossos próprios do nariz 47 casos (19,8%) e o osso zigomático 42 casos (17,7%), da mesma forma que em relação ao tratamento, dos 237 pacientes avaliados 101 casos (42,6%) foram tratados conservadoramente, 28 casos (11,8%) foram submetidos à cirurgia e em 18 casos (7,6%) não foi realizado nenhum tratamento. O presente estudo mostrou que a queda foi à causa com maior predominância, resultando em fraturas do terço médio com indicação cirúrgica cada vez menor neste grupo de população, exceto em casos onde a função esteja comprometida, tendo-se em conta as alterações fisiológicas, psicológicas decorrentes do envelhecimento. / Abstract: Recent studies demonstrated an increase in the elderly population. In Brazil the elderly represent about 9% of the population, approximately 21 million people over 60 years. This study examined the epidemiological characteristics of elderly victims of facial trauma attended by Area Surgery Maxillo-Facial, Piracicaba Dental School (FOP) - Unicamp, in Piracicaba city and region, from April 1999 to December 2012. The analysis was directed at population data for variables such as age, gender, race, trauma etiology, injury to the face or not, including facial fractures or not and associated fractures, treatment given, time elapsed between injury and treatment, beyond the period of follow up and complications. We analyzed data of patients by completing a form specifically designed for clinical annotation data for the study of facial trauma. Were excluded from the study patients with incomplete filling of the information. A total of 237 elderly patients were evaluated, 127 (53.6%) patients were male and 110 (46.4%) females, the fall was the most frequent cause in 146 cases (61.6%) of total with the highest incidence in the middle third of the face with 114 fractures (48.1%), sit the bones of the nose 47 cases (19.8%) and zygoma 42 cases (17.7%), and the total patients evaluated with respect to treatment of 237 patients evaluated, 101 cases (42.6%) were treated conservatively, 28 cases (11.8%) underwent surgery and 18 cases (7.6%) underwent treatment. This study showed that the fall was the most predominant cause, resulting in fractures of the middle third and decrease less surgical indications for this group, except in cases where the function is compromised, and sings in the physiological, psychological resulting from aging. / Doutorado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Doutor em Clínica Odontológica

Orientador: Ana Maria Segall Correa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-03T05:49:20Z (GMT). No. of bitstreams: 1 Patella_RoseineFortes_M.pdf: 21656384 bytes, checksum: a411b353da2b069b334fa693980d77d0 (MD5) Previous issue date: 2001 / Resumo: O objetivo deste estudo foi analisar o impacto da assistência oferecida pelo Programa de Vigilância para crianças nascidas sob risco (PRNR) sobre as intemações hospitalares e a mortalidade de crianças menores de um ano de idade em Santos/SP. Foi estudada uma coorte histórica retrospectiva de crianças expostas e não expostas ao Programa no período de 1"de Julho de 1997 até 30 de Junho de 1998. Dos 6554 bebês nascidos neste período, 1208 foram classificados como sob risco (RNRs). Foram então divididos em dois grupos: G.A. (acompanhados pelo PRNR = 675) e G.N.A. (não acompanhados pelo PRNR = 553). O seguimento foi delineado para controlar variáveis presumidas como fatores de confundimento como peso ao nascer, hospital de nascimento, localidade de residência e aleitamento ao seio além de outras variáveis psicossociais. Os RNRs do grupo G.A. foram então classificados em duas categorias de acordo com a assistência recebida. Foram considerados sob Assistência Adequada (ADEQ) os recém-nascidos que cumpriram três condições principais: - Ter realizado a primeira consulta médica e atividades de monitoramento em até 10 dias após o nascimento, ter recebido visita domiciliar (VD), e, pelo menos 7 consultas médicas durante o período de seguimento. Foram considerados sob Assistência Não Adequada (NADEQ) aqueles que não atingiram os critérios completos referidos. Foram encontrados 712 bebês no primeiro grupo e 496 no segundo. O risco relativo para intemação hospitalar considerando bebês não expostos ao programa (NADEQ) e os expostos (ADEQ) não foi estatisticamente significativo. Os Grupos GA e GNA foram diferentes ao considerar-se variáveis sociais. O primeiro (GA) mostrou freqüência mais alta de desemprego entre pais ou responsáveis e muitos moravam em localidades caracterizadas como as mais pobres na cidade. O risco relativo para intemação hospitalar no primeiro ano apontou para proteção para as crianças do G.N.A. O perfil de seguimento dos RNRs (G.A.) mostrou que 61,6% deles chegaram para a primeira consulta médica após dez dias; quase a metade (41,8%) compareceu a menos de sete consultas pediátricas; quase um terço deles (28,4%) nunca recebeu uma VD. Apesar da assistência oferecida pelo PRNR foram identificados 13 óbitos entre os RNRs da coorte estudada. Estudos adicionais seriam necessários para esclarecer melhor as características dos cuidados de saúde que deveriam ser oferecidos, em tais condições sociais, a recém-nascidos de alto risco no seu primeiro ano de vida / Abstract: The objective of this study was to analyze the impact of the assistance provided by the Surveillance Program for children bom at risk (PRNR) on hospital admissions and mortality of children under one year of age in Santos/SP. A historic retrospective cohort of children exposed and non-exposed to the program was studied from the 1st of July 1997 to the 30th of June 1998. From 6554 babies bom in this period, 1208 were classified as at risk (RNRs). They were then divided in two groups: G.A. (followed by the PRNR = 675) and G.N.A. (not followed by the PRNR = 553). The followup was designed to control for variables presumed to be confounders, like birth-weight, hospital of birth, neighborhood of residence, and breastfeeding, besides other mother's psychosocial variables. The RNRs of G.A. groups were then classified in two categories according to the assistance received. Adequate Assistance (ADEQ) was considered for those newboms who met tree main conditions: - first medical appointment and monitoring activity within 10 days afier birth, having received a home visit (VD), and, at least 7 medical consultations during the follow-up period. Non-Adequate Assistance (NADEQ) was assigned to those who did not meet the full ADEQ criteria. There were 712 babies in the first group and 496 in the second. The relative risk for hospital admission considering babies not exposed to the program (NADEQ) and those exposed (ADEQ) was not statistically significant. The GNA and GA groups were different considering social variables. This last group had higher frequency of unemployment among parents or family's responsible person and most of then were leaving in the neighborhood characterized as the poorest in the city. The relative risk for hospital admission in the first year of life pointed out to protection towards children of the G.N.A. The follow-up profile of the RNRs (G.A.) showed that 61,6% of them arrived after ten days at the 1st appointment, almost half (41,8%) attended less than seven pediatric consultations; almost a third of them (28,4%) never received a VD. Despite the assistance provided by the PRNR 13 deaths were acknowledged among RNRs in the study cohort. Further studies would be necessary to better clarify the characteristics of health care that should be offered, under such social conditions of the high-risk newbom in their first year of life / Mestrado / Saude Coletiva / Mestre em Saude Coletiva