Background: Colorectal cancer (CRC) is the third most common cancer in men and the second most common in women worldwide. Adenomas can be precursors to CRC, and inflammatory bowel disease (IBD) can present with the same symptoms as CRC. The majority of patients with CRC initially consult primary care. Symptoms associated with CRC are also common among primary care patients, but seldom caused by any significant disease. Reliable diagnostic aids would be helpful in deciding which patients to refer. Faecal immunochemical tests (FITs) are commonly used for this purpose in primary care in Sweden, but there is little evidence to support this use. Faecal calprotectin (FC) has been suggested as an additional test. Aim: To explore how doctors in primary care investigate patients with suspected CRC, the value of FITs, symptoms and presence of anaemia in diagnosing CRC and adenomas in primary care, and whether FC tests could contribute to diagnosis. Methods: Three studies (1-3) were carried out in Region Jämtland Härjedalen, Sweden. There was no screening programme for CRC. We used a point of care qualitative dip-stick 3-sample FIT with a cut-off of 25-50μg haemoglobin/g faeces, and a calprotectin enzyme-linked immunosorbent assay (ELISA) test with a cut-off of 100 μg/g faeces. 1: A retrospective, population-based study including all patients diagnosed with CRC or adenomas with high-grade dysplasia (HGD) during the period 2005-2009 that initially consulted primary care. Symptoms, FIT results, anaemia and time to diagnosis were retrieved from medical records. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated from FIT results at the region’s health centres 2008- 2009. (Paper I.) 2: A prospective cohort study including consecutive patients where primary care doctors requested FITs and/or FC tests, at four health centres, from 30 Jan 2013 to 31 May 2014. FITs, FC tests, haemoglobin and iron deficiency tests were analysed; patients and doctors answered questionnaires about symptoms. Patients were examined with bowel imaging or followed for two years. Findings of CRC, adenomas with HGD, adenomas with low grade dysplasia (LGD) ≥1 cm and IBD were registered. (Papers II and III.) 3: A qualitative study of interviews with eleven primary care doctors. We explored what made them suspect CRC, and their practices regarding investigation and referral with particular attention to their use of FITs. Qualitative content analysis with an inductive approach was used for the analysis. (Paper IV.) Results: 1: Paper I: Of 495 patients 323 (65.3%) started the investigation in primary care. FITs were analysed in 215. In 23 cases with CRC, FITs were negative; 15 (65.2%) had anaemia. In 33 cases with CRC, FITs were performed due to asymptomatic anaemia; 10 (30.3%) had negative FITs. The time from start of investigation, to the diagnosis of CRC or adenomas with HGD, was significantly longer for patients with negative FITs. 2: 377 patients (9 diagnosed with CRC, 10 with IBD) were included. Paper II: Concordance of positive answers about symptoms from patients and doctors was generally low. Rectal bleeding (recorded by 43.5% of patients and 25.6% of doctors) was the only symptom related to CRC and IBD. The FIT showed a better PPV than rectal bleeding for CRC and IBD. When patients recorded rectal bleeding, the FIT had a PPV of 22.6% and a NPV of 98.9% for CRC and IBD. Paper III: The best test for detecting CRC and IBD was the combination of a positive FIT and/or anaemia with a sensitivity, specificity, PPV and NPV of 100%, 61.7%, 11.7% and 100% respectively. The FC test had no additional value to the FIT alone. The sensitivity, specificity, PPV and NPV of the FIT for CRC in study 1 was estimated at 88.4%, 73.3%, 6.2% and 99.7% respectively. In study 2, corresponding figures were 88.9%, 67.4%, 6.3% and 99.6% respectively. 3: Paper IV: We identified four categories: “Careful listening – with awareness of the pit-falls”, “tests can help – the FIT can also complicate the diagnosis”, “to refer or not to refer – safety margins are necessary”, and “growing more confident – but also more humble”. All doctors had found their own way to handle FIT results in the absence of guidelines. Conclusion: The diagnostic process when suspecting CRC can be described as navigating uncertain waters with safety margins. FITs were often used by primary care doctors but with considerable variations in interpretation and handling of results. Rectal bleeding was the only symptom related to CRC and IBD, but the FIT showed a better PPV than rectal bleeding. The combination of a negative FIT and no anaemia may be useful as a rule-out test when CRC is suspected in primary care, and this potentially also applies when patients present with rectal bleeding. Further studies are needed to confirm this and to determine the optimal FIT cut-off value for this use.

<p>ABSTRACT</p><p>Billions of people are living without access to safe hygienic means of personal sanitation. The sanitation gap is wide in developing countries where more people are increasingly becoming urbanised. Sanitation related diseases are some of the leading cause of mortality and morbidity among the population in developing countries especially children under age of 5 years. The responsible institutions are faced with challenge to provide suitable and affordable services to this increasing population. In Uganda, the urban poor are residing in the peri urban areas with inadequate sanitation facilities. The provision of conventional sanitation facilities are seen not be sustainable options due to contamination of both surface and underground water sources, congested housing structure and at the same time makes recycling and reuse of nutrients difficult.</p><p>This study investigated attitudes towards urine diverting toilets in one of the peri urban areas in Kampala, with the aim of finding out strategies to improve on awareness of ecological sanitation as well as popularise their use as alternative sanitation. Respondents’ views were collected through face to face interviews with 40 household respondents using a semi structured questionnaire and field observations of the household’s toilet in use as well as solid waste disposal. Four focus group discussions and 6 key informant interviews were also performed.</p><p>The respondents’ acceptance of the urine diverting toilets was relatively positive. Most of the respondents reported that the ecosan toilets are a viable option due to congested housing pattern, desire to own a toilet (for those who never had a toilet before), improved privacy, and convenience among other factors. Respondents who have no urine diverting toilets also preferred urine diverting toilets and expressed their willingness to replicate them. It was also found that residents in Kamwokya II parish prefer a double vault design to one which uses bucket. The findings also reveal that reuse of sanitized urine and faecal matter within the community is not possible since there is no space for urban agriculture. However, the respondents acknowledged a willingness to eat or buy food from a garden fertilized with sanitized urine and faecal matter. It was also found that there are no cultural and religious beliefs against reuse of sanitized urine and faecal matter. Some challenges that affected implementation of the pilot project were people’s reluctance to adopt at the beginning, delayed completion of some facilities and part time employees. Currently there is limited replication of toilets because of low cash income among the residents, delayed completion of some facilities and sceptical views by some residents.</p><p>Among the difficulties faced in use of toilet include forgetfulness by some people to spray ash after defecating, misplaced water entering the toilet vault during cleaning, children playing with the urine container etc. The provision for anal cleansing for Muslims, squat hole covers, closed urine chamber among others were suggested for system improvements. The study recommends more awareness campaigns through social marketing of toilet and reuse of nutrients, modification of design, government’s commitment and household change of behaviours are fundamental for encouraging more adoption and replication of the toilets.</p>

Poor water quality is a global health concern affecting one billion people around the world. It is important to monitor water sources in order to maintain the quality of our drinking water and to avoid disease outbreaks. Targeting Escherichia coli as a faecal indicator is a widely used procedure, but the current methods are time consuming and not adequate to prevent spreading of faecal influence.   This Master thesis demonstrates the development of a near infrared fluorescence flow cytometer sensor system targeting Escherichia coli, using fluorescently labeled chicken IgY antibodies. The near infrared light was chosen to avoid fluorescence from blue-green algae that are present in the water source.   The hardware was developed with a 785  nm laser line to detect Alexa Fluor 790 labeled antibodies, using a photomultiplier tube or two different CMOS cameras. The antibodies were labeled using a commercial labeling kit, and evaluated using antibody binding assays and the developed hardware.   The IgY antibodies were successfully labeled with Alexa Fluor 790 and the function was maintained after the labeling process. The result demonstrates the principles of the sensor system and how it solved to the problem with fluorescence from blue-green algae. An aperture was used to overcome the suboptimal laser and filter setup, and to increase the sensitivity of the system. However, only a small fraction of the cells could be detected, due to challenges with the focal depth and loss of sensitivity in the photomultiplier tube at near infrared wavelengths. Further development is required to create a working product.

ABSTRACT Billions of people are living without access to safe hygienic means of personal sanitation. The sanitation gap is wide in developing countries where more people are increasingly becoming urbanised. Sanitation related diseases are some of the leading cause of mortality and morbidity among the population in developing countries especially children under age of 5 years. The responsible institutions are faced with challenge to provide suitable and affordable services to this increasing population. In Uganda, the urban poor are residing in the peri urban areas with inadequate sanitation facilities. The provision of conventional sanitation facilities are seen not be sustainable options due to contamination of both surface and underground water sources, congested housing structure and at the same time makes recycling and reuse of nutrients difficult. This study investigated attitudes towards urine diverting toilets in one of the peri urban areas in Kampala, with the aim of finding out strategies to improve on awareness of ecological sanitation as well as popularise their use as alternative sanitation. Respondents’ views were collected through face to face interviews with 40 household respondents using a semi structured questionnaire and field observations of the household’s toilet in use as well as solid waste disposal. Four focus group discussions and 6 key informant interviews were also performed. The respondents’ acceptance of the urine diverting toilets was relatively positive. Most of the respondents reported that the ecosan toilets are a viable option due to congested housing pattern, desire to own a toilet (for those who never had a toilet before), improved privacy, and convenience among other factors. Respondents who have no urine diverting toilets also preferred urine diverting toilets and expressed their willingness to replicate them. It was also found that residents in Kamwokya II parish prefer a double vault design to one which uses bucket. The findings also reveal that reuse of sanitized urine and faecal matter within the community is not possible since there is no space for urban agriculture. However, the respondents acknowledged a willingness to eat or buy food from a garden fertilized with sanitized urine and faecal matter. It was also found that there are no cultural and religious beliefs against reuse of sanitized urine and faecal matter. Some challenges that affected implementation of the pilot project were people’s reluctance to adopt at the beginning, delayed completion of some facilities and part time employees. Currently there is limited replication of toilets because of low cash income among the residents, delayed completion of some facilities and sceptical views by some residents. Among the difficulties faced in use of toilet include forgetfulness by some people to spray ash after defecating, misplaced water entering the toilet vault during cleaning, children playing with the urine container etc. The provision for anal cleansing for Muslims, squat hole covers, closed urine chamber among others were suggested for system improvements. The study recommends more awareness campaigns through social marketing of toilet and reuse of nutrients, modification of design, government’s commitment and household change of behaviours are fundamental for encouraging more adoption and replication of the toilets.

Greywater is domestic household wastewater without inputfrom the toilet, i.e. wastewater from sinks, the shower,washing machine and dishwasher in a home. Source separation ofgreywater can be a strategy to enhance recirculation of plantnutrients and/or improve water use. The risk for transmissionof disease when reusing greywater is largely dependent on thecross-contamination by faeces. High levels of faecalindicators, mainly thermotolerant coliform bacteria, have beenreported in greywater, indicating substantial faecal pollution.However, growth of indicator bacteria within the system leadsto an overestimation of thefaecal input and thus the hygienerisk. The faecal input of the greywater in Vibyåsen,Sollentuna, North of Stockholm, was estimated to be 0.04 ±0.02 g faeces person-1 day-1 from the quantification of thefaecal sterol coprostanol, compared to 65 g, 5.2 g and 0.22 gp-1 d-1 using E. coli, enterococci and cholesterolrespectively. Prevalence of pathogens in the population and the faecalload based on coprostanol concentrations were used to form thebasis of a screening-level quantitative microbial riskassessment (QMRA) that was undertaken for rotavirus, Salmonellatyphimurium, Campylobacter jejuni, Giardia intestinalis andCryptosporidium parvum, looking at the treatment required to bebelow an acceptable level of risk (10-3) for reuse or dischargeof the greywater. The different exposure scenarios simulated–groundwater recharge, direct contact, irrigation andrecreational water–showed that a reduction of 0.7–3.7 log was needed for rotavirus, with the measured level offaecal load in Vibyåsen. The other pathogen of concern wasCampylobacter, where a 2.2 log reduction was needed forgroundwater recharge. The infectious dose of Salmonella is highand the excretion numbers of Giardia cysts and Cryptosporidiumoocysts low, resulting in no treatment requirements for theseorganisms under these circumstances. Pathogen input fromcontaminated food via the kitchen sink had a minor effect onthe microbiological quality of the greywater. Studies on virusoccurrence in greywater as well as validation of the faecalload of greywater at another site would give valuable input forfuture QMRAs. Greywater treatment efficiency studies, especially on virusremoval, are scarce and more investigations are warranted.Active sludge may not be a suitable technique for greywater dueto the low carbon content in this flow. Chemical precipitationhas the advantage of removing phosphorus as well as virusesefficiently and it is suggested as one possible method fortreating greywater. Otherwise the most common practice forgreywater treatment in Sweden is soil infiltration. However, itis suggested that the recommendations for wastewaterinfiltration also be observed for greywater, despite the lowfaecal load, due to the simulated results on virus reductionneeded. <b>Key words:</b>greywater, greywater reuse, greywatertreatment, microbial risk assessment, groundwater recharge,irrigation, recreational water, faecal contamination, indicatorbacteria, index organisms, faecal sterols, bacteriophages,enteric pathogens, rotavirus, Salmonella, Campylobacter,Giardia, Cryptosporidium, Legionella / NR 20140805

Bacterial water pollution is a significant problem because it is associated with reduction in the ‘quality’ of water systems with a potential impact on human health. Faecal indicator bacteria (FIB) are usually used to monitor the quality of water, and to indicate the presence of pathogens in water bodies. However, enumeration alone does not enable identification of the precise origin of these pathogens. This study aimed to monitor the quality of bathing water and associated fresh water in and out of the ‘bathing season’ in the UK, and to evaluate the use of microbial source tracking (MST) such as the host-specific based polymerase chain reaction (PCR) and quantitative PCR (qPCR) to recognize human and other animal sources of faecal pollution. The culture-dependent EU method of estimating FIB in water and sediment samples was performed on beach in the South Sands, Kingsbridge estuary, Devon, UK- a previously ‘problematic’ site. FIB were present at significant levels in the sediments, especially mud, as well as fresh water from the stream and pond flowing onto South Sands beach. However, the quality of bathing water was deemed to be ‘good’ and met with the EU bathing water directive 2006. Using MST it was possible to successfully classify the nature of the source from which the bacteria came. PCR was applied to detect the Bacteroides species 16S rRNA genetic markers from human sewage and animal faeces. All water and sediment samples displayed positive results with a general Bacteroides marker indicating the presence of Bacteroides species. Host-specific PCR showed the human Bacteroides genetic marker only in the sediment of the stream. However, limitations in the ‘types’ of probes available and in the persistence of these markers were identified. Thus, novel dog-specific Bacteroides conventional PCR and qPCR primer sets were developed to amplify a section of the 16S rRNA gene unique to the Bacteroides genetic marker from domestic dog faeces, and these were successfully used to quantify those markers in water samples at a ‘dog permitted’ and ‘dog banned’ beach (Bigbury-on-Sea, Devon, UK). Generic, human and dog Bacteroides PCR primer sets were also used to evaluate the persistence of Bacteroides genetic markers in controlled microcosms of water and sediment at differing salinities (< 0.5 and 34 psu) and temperature (10 and 17 ºC). The rates of decline were found did not differ significantly over 14 and 16 days for the water and sediment microcosms, respectively. Beach sediments which were studied in this project may act as a reservoir for adhesive FIB, and this was confirmed using fluorescence in situ hybridisation (FISH). The similarity in the persistence of these Bacteroides 16S rRNA genetic markers in environmental water and sediment suggests that viable but non-culturable (VBNC) Bacteroides spp. do not persist in the natural environment for long. Therefore, 16S rRNA genetic markers can be of value as additional faecal indicators of bathing water pollution and in source tracking. Thus, in this study MST methods were successfully used and in future applications, dog-specific primer sets can be added to the suite of host-specific Bacteroides genetic markers available to identify the source(s) of problem bacteria found on failing beaches.

The endangered Arabian oryx, Oryx leucoryx faces a wide range of issues that potentially have adverse effects on their welfare while they are free-ranging in their natural habitat, housed in captivity for conservation breeding or when they are translocated from the wild to captivity or vice versa. Furthermore, the global increase in the number of captive Arabian oryx (currently more than 95 % of the world population of about 8000 individuals), gives rise to particular concern for their welfare and health within captive conditions. Thorough assessment of the welfare of animals involves physiological and behavioural measures. Methods for assessment of welfare in Arabian oryx have not been established and the present studies aim at establishing physiological tools for assessment of welfare. Therefore, the present studies developed and applied new methods for non-invasive assessment of welfare in the Arabian oryx (using faecal samples), and established reference values for a range of haematological, biochemical and clinical parameters. The potential disturbances in these parameters were investigated after immobilisation and tranquillisation and post- transportation. Two enzyme immuno-assays (EIA I and II) for faecal glucocorticoid metabolites (FGM) were validated by stimulation and suppression of the hypothalamic-pituitary-adrenal axis through injection of synthetic adrenocorticotropic hormone (ACTH) and dexamethasone, respectively. These studies established a lag-time of 14 ± 1 h between secretion of glucocorticoids into the blood stream and excretion of the measured FGM. Faecal incubation at 30°C for 3 days showed that EIA I measured more stable faecal glucocorticoid metabolites than EIA II, and has greater potential for application in field conditions. This method was found to be invaluable for measuring stress and hence assessment of welfare status, and its use is recommended in planning welfare improvements. Measurement of FGM successfully detected the stress of road transportation (630 km for 8-10 h), showing an increase 2 days after transport, followed by recovery to basal FGM levels after re-housing for up to 11 days. Releasing oryx to the wild, in Oman, and tracking for 11 days, after transportation 50-70 km from the captive site (Arabian Oryx Sanctuary, Jaaluni), caused an increase in FGM to the highest levels seen in these studies, and suggests a high level of stress was experienced after release of oryx. Published reference values for haematological, biochemical, hormonal and clinical parameters for Arabian oryx are limited, with little information for non-immobilised and non-tranquillised oryx or consideration of possible age and sex differences. Therefore, reference values and inter-percentile ranges (2.5 and 97.5 percentiles) were established for 32 parameters, in separate groups of male and female adult oryx, without using immobilising or tranquillising chemicals during capture. The haematological parameters investigated were white blood cell count and differentiation (%) of cell types (neutrophils, lymphocytes, monocytes, eosinophils, basophils), number of platelets, red blood cell count, haemoglobin concentration and haematocrit, erythrocyte cell volume, erythrocyte haemoglobin content and concentration, serum osmolality and ions (sodium, potassium, chloride, calcium, magnesium and phosphorus). Biochemical parameters investigated were serum urea, glucose, total protein, albumin and plasma lactate concentrations. Clinical parameters investigated were body temperature, heart and respiratory rates. Hormonal parameters measured were cortisol, free-thyroxine, free-triiodothyronine and insulin concentrations. Near basal values for serum cortisol were measured in Arabian oryx sampled within 2 min, while values were significantly higher in oryx sampled within 5-10 min. The reference values established in these studies are considered valuable tools for diagnosis of disease and physiological alterations in male and female Arabian oryx. To investigate the possible effects of the common practice of immobilisation and tranquillisation on physiological and biochemical status, two restraint chemicals (xylazine and perphenazine enanthate) were evaluated. Xylazine (an immobilising agent) caused changes in many clinical, hormonal, haematological and biochemical parameters; respiratory rate decreased by 74 %, heart rate decreased by 58 %, causing a decrease in red blood cell count, haemoglobin concentration and haematocrit, serum albumin and total protein concentration. Xylazine also induced a decrease in serum insulin, which probably caused the observed increase in serum glucose. Perphenazine enanthate (a long-acting tranquilliser) was found to have no adverse effects on most parameters, which generally remained in the reference ranges. However, a reduction in blood haematocrit and related parameters (red blood cell count and plasma haemoglobin concentration) occurred, 1-3 days after injection. The tranquilliser also plays a role in reducing stress and significantly reduced serum cortisol 2-3 days after injection in oryx held in captivity compared to oryx that received a saline (control) injection. FGM increased significantly one day after injection of perphenazine enanthate and saline, suggesting the animals were initially stressed by the handling and venipuncture, taking into consideration the lag-time from cortisol secretion to appearance of FGM. The baseline concentration of serum cortisol was used in assessing the stress caused by handling before and after transporting Arabian oryx for 630 km (8-10 h) and the acute effects of handling and injections. Increased serum cortisol was always associated with leukocytosis, neutrophilia and lymphopenia. Serum cortisol of non-transported oryx was reduced by the tranquilliser perphenazine enanthate, but transportation of tranquillised Arabian oryx during hot ambient temperature (maximum 42 °C) resulted in fatigue and prevented reaching a clear conclusion of the role of the tranquilliser in reducing transport stress. Non-tranquillised oryx transported at a maximum of 26-30 °C showed a similar level of stress as implied by the level of faecal glucocorticoid metabolites, but without fatigue. However, the tranquilliser induced calmness in Arabian oryx for up to 7 days, which facilitated capture and handling. Therefore, perphenazine enanthate has a potential to be used in the management practices, such as movement and transport of Arabian oryx. This thesis discusses the current and future welfare issues that face Arabian oryx in captivity, upon release and in the wild. Additional methods are proposed for thorough assessment and improvement of welfare to complement the methods established by the present studies.

O presente estudo teve como objetivo avaliar o efeito de níveis crescentes de inclusão de polpa cítrica na dieta de equinos, através da avaliação da palatabilidade, digestibilidade aparente e características físico-químicas das fezes. As dietas foram compostas por 60% da energia proveniente do volumoso (feno de Coast Cross) e 40% do concentrado, com níveis crescentes de inclusão de polpa cítrica (0, 7, 14, 21 e 28%). Para a realização do experimento, foram realizados dois testes. O primeiro ensaio consistiu na determinação da palatabilidade dos concentrados, através do teste de preferência. Para isso foram utilizados 15 equinos, por um período de 10 dias, totalizando 150 observações, em delineamento inteiramente casualizado. As variáveis observadas foram primeira ação, primeira escolha e razão de ingestão. Para a realização do ensaio de digestibilidade e características físico-químicas das fezes, foram utilizados cinco equinos, em delineamento quadrado latino 5x5. Avaliou-se a digestibilidade aparente dos nutrientes e as características de cor, consistência, pH, concentração e relação entre ácidos graxos de cadeia curta e capacidade tamponante a pH 5 e a pH 6, das fezes. Observou-se efeito da inclusão da polpa cítrica (P&lt;0,001) sobre a primeira ação, sendo que 66,91% dos animais cheiraram os concentrados, enquanto 33,09% comeram, e também para a primeira escolha (P&lt;0,001),onde os tratamentos 0, 7 e 14% apresentaram maior preferência. Para a razão de ingestão, também houve diferença (P&lt;0,001) entre os tratamentos, sendo que o concentrado controle o mais consumido. Não foi observado efeito (P&gt;0,05) dos níveis de inclusão de polpa cítrica sobre a digestibilidade aparente dos nutrientes. Para as características das fe zes não houve efeito de tratamento (P&gt;0,05) na consistência e cor. A coloração se manteve esverdeada, e a consistência foi classificada como normal (escore 3).Não houve efeito de tratamento (P&gt;0,05) para o pH, concentração e relação entre ácidos graxos de cadeia curta e capacidade tamponante das fezes. O valor médio observado de pH foi de 6,62, e a capacidade tamponante a pH 5 e pH 6 foi de 16,53 e 5,13 mmol/L, respectivamente. Os cavalos têm a capacidade de identificar a presença da polpa cítrica nos concentrados, e preferem concentrados sem a inclusão. A adição de polpa cítrica em até 28% não afeta negativamente a digestibilidade dos concentrados e as características físico-químicas das fezes, sendo uma alternativa de ingrediente na formulação de dietas para equinos. / The purpose of this study was to evaluate the citrus pulp inclusion in horses diet, through evaluation of palatability, apparent digestibility and feces physicochemical characteristics. The diets were composed of 60% of the energy from roughage (Coast Cross hay) and 40% from concentrate with increasing levels of citrus pulp (0, 7, 14, 21 and 28%).To perform the experiment, there were two distinct tests. The first experiment consisted in determining the concentrates palatability. Fifteen horses were used, for a 10-day period, totaling 150 observations, in a randomized design. The variables were first action, first choice and intake rate. For the digestibility test and feces physicochemical characteristics, five horses were used in 5x5 Latin square design. Were evaluated the nutrients digestibility and the feces characteristics of color, consistency, pH, concentration and relation between short-chain fatty acids, and buffering capacity at pH 5 and pH 6. There was an effect of the citrus pulp inclusion (P&lt;0.001) on the first action, 66.91% of the animals smelled the concentrates, while 33.09% ate. For the first choice there was also significant difference (P&lt;0.001) and 0, 7 and 14% treatments had a higher preference. For the intake rate there were differences (P&lt;0.001) between treatments, being the control concentrate the most consumed. There was no effect (P&gt;0.05)of the citrus pulp levels on nutrient digestibility. For feces characteristics there were no treatment effect (P&gt;0.05) in consistency and color. The color remained green, and consistency were classified as normal (score 3). There was no treatment effect (P&gt;0.05) for pH, concentration and relation between short-chain fatty acids, and buffering capacity of the feces, the mean pH value observed was 6.62, and the buffering capacity at 5 and 6 was 16.53 and 5.13 mmol / L respectively. Horses have the ability to identify the citrus pulp presence in concentrates, but they prefer the concentrates without citrus pulp inclusion. Addition of citrus pulp does not adversely affect the concentrates digestibility or the feces physicochemical characteristics, being an alternative ingredient in the horses diets formulation.

Este estudo teve como objetivo avaliar a toxicidade do sedimento da Enseada de Ubatuba através de testes de toxicidade, utilizando-se fase aquosa e sedimento total antes e depois do aumento da população de veraneio e a contaminação por esgoto urbano. Realizaram-se testes de toxicidade com a água intersticial e interface água/sedimento e larvas de L. variegatus. No testes com sedimento total utilizou-se anfípodo T. viscana. Utilizaram-se as análises de esteróis fecais para verificar a contaminação por esgoto. Foram coletadas em 17 estações. Uma estação do canto direito da Praia do Itaguá foi a única que obteve toxicidade nos três testes na campanha após o aumento da população de veraneio. Para os testes com a fase aquosa, uma estação próxima ao Instituto de Pesca e duas na Praia do Perequê-Açú foram tóxicas nas duas campanhas. Apresentaram contaminação por esgoto e toxicidade para os testes de fase aquosa três estações do canto direito da Praia do Itaguá, uma próxima ao Rio Acaraú, outra em frente ao Rio Grande e também uma na Praia do Perequê-Açú. Uma estação próxima a saída do Rio Grande apresentou indício de contaminação por esgoto, mas não obteve toxicidade na fase aquosa. O aumento da população de veraneio mostrou uma maior toxicidade para os testes com a fase aquosa e uma diminuição do número de sobreviventes de anfípodos. A Enseada de Ubatuba apresentou toxicidade nos testes com fase aquosa em quase todas as estações após o aumento da população, assim deve ser monitorada com freqüência e melhorar a infra-estrutura de saneamento. / The goal of this study was to evaluate the toxicity of the sediment in Ubatuba small Bay through toxicity tests using liquid phase and the total sediment before and after the increase of the floating population and the sewage contamination. The liquid phase was evaluated through toxicity test with interstitial water and water/sediment interface, both with embryos of L. variegatus. The tests with total sediment were utilized amphipod T. viscana. The analyses with chemical faecal steroids marks was utilized for the sewage contamination in the sediment. It was realized samples in 17 stations. One station localized in the right corner of Itaguá beach, was the only one that showed toxicity in the three of the tests in the campaign after the increase of the floating population, two tests with de liquid phase in one station, localized near to Pesca Institute, two stations, localized in the Perequê-Açu beach, was toxic in both campaigns. Contamination by urban sewage and toxicity tests of liquid phase was observed in three stations localized in the right corner of Itaguá beach, other near the mouth of the Acaraú river, and another in front of Grande river and as well one station in the Perequê-Açu beach. One station near the mouth of Grande river had showed indication of contamination by urban sewage, but the liquid phase showed no sign of toxicity. The increase of the floating population showed a high toxicity for the test with liquid phase and a decrease in the number of survives in the amphipods tests. The small bay of Ubatuba showed toxicity in the liquid phase tests in almost of all stations after the increase in the floating population, then the region must be monitored with frequency and it is necessary to improve the structure of the sanitation in the area.

Background: Rectal hyposensitivity (RH) is associated with functional hindgut disorders. It is hypothesized to involve afferent pathway dysfunction. However, little is known regarding its clinical impact. Aims: To assess whether RH is: • clinically important and associated with specific symptoms; • secondary to afferent neuronal dysfunction; and • primarily a pelvic abnormality. Methods: Epidemiological studies were conducted: (1) a case-controlled study stratified by sensory status, assessing symptoms of constipation and incontinence, health status and quality of life; (2) an observational study exploring RH in faecal incontinence in men; (3) an observational study examining the impact of RH on defaecatory urge. Pathophysiological studies were also conducted: (1) transmission of visceral sensory information was evaluated using rectal evoked potentials;(2) somatic sensory function and visceral efferent function were examined in patients with and without RH. Results: RH is associated with constipation. Patients with RH have more severe symptoms and worse health status and quality of life. Constipated patients report altered defaecatory urge compared to controls, most notably in those with RH. RH is associated with concurrent constipation and evacuatory dysfunction in males with incontinence. Patients with RH have delayed evoked potential latencies, without alteration of cortical activation. A proportion have elevated somatic sensory thresholds although efferent function is similar between groups. Conclusions: 1. In patients with constipation, those with RH have a worse clinical phenotype, with poorer health status and quality of life. Patients with constipation, (particularly those with RH), have alteration of defaecatory urge. 2. RH and constipation may contribute to incontinence in males where sphincter dysfunction is less important. 3. RH is associated with delayed afferent transmission indicating primary afferent pathway dysfunction. In a proportion, reflecting a possible generalised sensory neuropathy. These studies confirm that intact rectal sensation is fundamental to normal hindgut function. Impaired visceral sensation is thus an important therapeutic target.