Obesity is presently one of the leading preventable causes of mortality and is an increasing issue that affects the workplace. This pilot study investigates the effects of a multidisciplinary obesity management program on employees within a community hospital setting. The purpose of this study is to assess the outcome factors of the intervention and to detect an association between the participants’ biological factors, psychological status, eating behaviors, and lifestyle components to that of their current body weight status. Methods. An evaluation of a tailored obesity management program was conducted in a corporate setting with employees of a large community hospital. The evaluation sought to determine if this program could be efficiently and effectively implemented in this corporate setting. This program also allowed an exploration of those sociological, biological, and behavioral factors that were associated with weight loss. An employee health outcomes assessment visit was used to identify, recruit and enroll overweight employees into a quasi-experimental study designed to evaluate potential impacts of a tailored weight management program. The 6-month intervention included medical assessments, nutritional coaching, activity counseling, and behavioral therapy. The following specific aims were proposed for this dissertation research: Specific Aim 1 sought to evaluate the effectiveness of the multidisciplinary weight loss program to change a series of modifiable health risk factors, body composition, clinical indicators, and biological markers from baseline to 6 months for overweight participants. Specific Aim 2 evaluated factors associated with achieving weight loss and patterns of attrition from the program. Weight and lifestyle factors included onset of obesity, family history, weight loss history, weight loss goals, self-perceptions, physical activity factors, and eating habits/patterns. Within Specific Aim 3, we determined if body composition measurements [body mass index (BMI), weight, basal metabolic rate, fat mass, percent fat, fat free mass, and total body water] correlated with standing or supine measurements of waist, hip, or thigh circumferences. We also investigated if there was a significant difference between recording measurements made in both positions. This aim sought to determine if both sets of position measurements needed to be included for subsequent weight management studies. Results. Forty-six (46) employees, with a mean age of 48.6 +/- 10.9 years and predominately female (91.3%), consented to participate in the pilot intervention, with 26 participants completing the 6 months (response = 50.9%). Statistically significant changes from baseline were seen at 6 months in the 44 participants that continued in the study after enrollment. In the intent to treat analysis, the participants, regardless of completion status, had a clinically significant (p<.0001) mean percent weight loss of 4.1% and a total weight loss of 9.3 pounds, with a corresponding 5.6% mean weight loss in those participants that completed the program. When analyzing predictors of attrition from the program, models indicated significant associations between overall program attrition and an increase in baseline systolic blood pressure (p=0.02), along with decreased compliance with eating three meals per day (p=0.04). Primary attrition (dropout < 3 months) was statistically associated with an increase in baseline systolic blood pressure (p=0.02) and decreased compliance with eating three meals per day (p=0.01). Secondary attrition (dropout between 3-6 months) was associated with decreased compliance with eating three meals per day (p=0.05) and an increase in weight loss expectations during the intervention (p=0.05). The mean absolute difference between the two techniques (standing vs. supine) was 4.14 inches for waist, hip, and thigh measurements combined. An increase in body mass index was associated with a greater magnitude of discrepancy in the measurement between the two techniques for waist circumference (p=0.02). Conclusions. The changes seen following this multidisciplinary intervention were clinically significant and advantageous for the participants. These substantial results suggest that the use of multidisciplinary weight management programs merits further investigation in larger, randomized, controlled trials.

This thesis addresses various food safety issues and investigates them from an economic perspective within four different, but related, studies. The studies are intended to provide policy-makers and other decision-makers in the industry with valuable information that will help them to implement better mitigation strategies and policies. The studies also present some applications of advancements in choice modelling, and thus contribute to the literature. To address these issues, various surveys were conducted in the UK.The first study investigates different stakeholder groups’ perceptions of responsibility among the stages of the meat chain for ensuring the meat they eat does not cause them to become ill, and how this differed with food types. The means by which this is achieved is novel, as we elicit stakeholders’ relative degrees of responsibility using the Best-Worst Scaling (BWS) technique. BWS is particularly useful because it avoids the necessity of ranking a large set of items, which people have been found to struggle with. The results from this analysis reveal a consistent pattern among respondents of downplaying the extent of their own responsibility. The second study explores people’s perceptions of various food and non-food risks within a framework characterised by the level of control that respondents believe they have over the risks, and the level of worry that the risks prompt. The means by which this is done differs from past risk perception analyses in that it questions people directly regarding their relative assessments of the levels of control and worry over the risks presented. The substantive analysis of the risk perceptions has three main foci concerning the relative assessment of (i) novel vs. more familiar risks, (ii) food vs. non-food risks, (iii) differences in the risk perceptions across farmers and consumers, with a particular orientation on E. coli. The third study investigates consumers’ willingness to pay (WTP) for reductions in the level foodborne health risk achieved by (1) nanotechnology and (2) less controversial manners in the food system. The difference between consumers’ valuations provides an implicit value for nanotechnology. This comparison is achieved via a split sample Discrete Choice Experiment study. Valuations of the risk reductions are derived from conditional, heteroskedastic conditional, mixed, and heteroscedastic mixed logit models. General results show the existence of heterogeneity in British consumers’ preferences and variances, and that the value of nanotechnology differs for different types of consumers. The fourth study investigates consumers’ perceptions of trust in institutions to provide information about nanotechnology and its use in food production and packaging. It is shown how the use of BWS and Latent Class modelling of survey data can provide in-depth information on consumer categories useful for the design of effective public policy, which in turn would allow the development of best practice in risk communication for novel technologies. Results show heterogeneity in British consumers’ preferences. Three distinct consumer segments are identified: Class-1, who trust “government institutions and scientists” most; Class-2, who trust “non-profit organisations and environmental groups” most; and Class-3, who trust “food producers and handlers, and media” most.

Magister Scientiae (Medical Bioscience) - MSc(MBS) / Maternal smoking is known to cause serious health risks to the unborn child. Recent studies implicate nicotine as the causative factor. Maternal nicotine exposure during pregnancy and lactation interferes with foetal and neonatal lung growth and development,rendering the lung more susceptible to damage and diseases. Therefore, the aim of this study was to investigate: 1) the effect of maternal exposure to nicotine (1mg/kg BW/day) during all phases of lung development: 2) and vitamin C supplementation (0.5mg/kg BW/day) to prevent the adverse effects of maternal nicotine exposure on lung development in the offspring. This is based on studies in our laboratories which suggested that nicotine reduces the blood and tissue vitamin C content of the mother,thereby rendering the neonate more susceptible to oxidation damage. The chief motivation of this study was to establish whether an anti-oxidant, such as vitamin C, can be administered to smoking pregnant and lactating mothers in order to combat the deleterious effects of nicotine on the lung development of their offspring. It was found that although maternal nicotine exposure had no significant effect on the growth parameters of the offspring, it did have an effect on the development of the lung, compromising the ability of the lung to act as an organ of gaseous exchange. There was a decrease in the surface area available for gas exchange. The change occurred after the lung reached maturation and resembled microscopic emphysema. Vitamin C supplementation was unable to fully protect the neonatal lung against the adverse effects of maternal nicotine exposure; it however partially protected the neonatal lung against structural deterioration. Supplementation with vitamin C definitely offers possibilities as a prophylactic to combat the detrimental influence of maternal nicotine-exposure on foetal and postnatal lung development.

The thesis is primarily oriented on economic aspects of health systems. It contains the analysis and description of health risks, health-insurance systems (models) and current status of Czech health system. Czech health system is described and scarified. Analysis of weak points, status of reforms and also a design of possible solutions are integral parts of this thesis. Both public and commercial approaches to health and insurance systems are involved, including current commercial insurance products which are available on Czech market.

Este trabalho visa a analisar as medidas judiciais adotadas para enfrentar os riscos e agravos à saúde decorrentes da exposição a substâncias perigosas em áreas contaminadas no município de São Paulo, tendo em vista que no Brasil não há uma política específica para ser aplicada no caso em questão. São abordadas as formas de enfrentamento do problema, com ênfase na Ação Civil Pública (ACP). O caso da área contaminada da Vila Carioca foi escolhido para ser objeto de estudo por se tratar de problema atual e de conseqüências sociais diversas, além de figurar entre um dos mais graves problemas ambientais da cidade. O trabalho versa sobre a experiência, na área jurídica, de órgãos públicos com atribuições para proteção da saúde humana, entre eles: Centro de Vigilância Sanitária, Ministério Público e Cetesb. A importância e a efetividade das medidas judiciais para a garantia do direito à saúde, a preservação do meio ambiente e o bem-estar da população, particularmente no tocante às áreas contaminadas na cidade de São Paulo, também são discutidas. O Capítulo I discute o desenvolvimento econômico e suas implicações com o direito à saúde e o direito ambiental, à luz da Constituição Federal. O Capítulo II trata da proteção ambiental e dos riscos ambientais do espaço urbano e sua relação com as políticas para o desenvolvimento das cidades, além de apresentar um breve histórico da regulação de risco e das atividades produtivas poluidoras. O Capítulo III aborda alguns meios processuais coletivos de proteção e de implementação dos direitos fundamentais, com enfoque maior na ACP. O Capítulo IV aborda um estudo de caso relacionado com a contaminação de solo no bairro da Vila Carioca, região sul da cidade. Conclui-se discutindo os entraves jurídicos e a falta de controle do Poder Público no que se refere à defesa dos direitos coletivos em face do estudo de caso em questão. / The aim of the present work is to analyze the judicial orders adopted to tackle health risks resulting from exposure to hazardous substances in contaminated areas of the city of São Paulo, since there is no specific Brazilian policy to rule this issue. Ways of tackling the problem are discussed, with emphasis on the Civil Public Action (ACP). The case of Vila Carioca was chosen not only for being a current problem with several social consequences, but also for being one of the major environmental problems affecting the city of São Paulo in recent years. This study focuses on the juridical experience of public institutions responsible for community health, such as: the Sanitary Surveillance Center (Centro de Vigilância Sanitária), Department of Justice (Ministério Público) and the Technology and Environmental Sanitation Company (Cetesb). In addition, it shows the importance and effectiveness of judicial orders to guarantee the right to health, protection of the environment and public welfare, especially regarding the contaminated areas in the city of São Paulo. Chapter I discusses the economic development and its implications as to the right to health and the environmental laws, examined through the lens of the Brazilian Federal Constitution. Chapter II discusses environmental protection and hazards in urban areas and the policies which rule the development of cities. In addition, it gives a brief account of risk regulations with reference to polluting production activities. Chapter III discusses some collective legal procedures for protection and implementation of fundamental rights, focusing mainly on the ACP. Chapter IV discusses a case study of soil contamination in Vila Carioca, located in the south of São Paulo. Finally, the study discusses the legal obstacles and failures of the Public Authority in defending the collective rights concerning the case examined.

This diploma thesis deals with the current state of nanosafety. The aim of this paper was to review and critically analyze approaches to facilitate the risk assassment of nanomaterials. In the first part it provides an overview of the most important methods and software tools that are used in this field. Methods were analyzed against a set of relevant criteria. Criteria include consideration of exposure, life cycle and physicochemical properties, transparency, applicability and the field of application. Different criteria were chosen for the software tools. Based on results, a new approach was suggested. The approach takes the form of a diagram based on questions. The purpose of the suggested approach is to recommend the most relevant method, tool or their combination to assess the safety of a nanomaterial depending on known characteristics. The approach was also implemented in a software tool.

Tato práce se zabývá znečištěním ovzduší pevnými prachovými částicemi v lokalitách města Brna. V teoretické části je pojednáno o možných zdrojích prachových částic, o chemickém složení a velikostní klasifikaci polétavých částic a dalších fyzikálně-chemických charakteristikách. Další část je věnována zdravotním rizikům prašnosti. V této souvislosti práce pojednává o anatomii dýchacího systému a účincích prachu na něj. Jsou taktéž rozebrány zdravotní efekty prachového znečištění, včetně uvedení možných nemocí respiračního a kardiovaskulárního systému, jejichž může být prach příčinou. V praktické části byl proveden sběr prachu. Byly vybrány celkem čtyři lokality, kde byly prováděny odběry vzorků. Následně byly stanoveny koncentrace polétavých částic PM10 a PM2,5. Dále byly u vybraných lokalit stanoveny koncentrace těžkých kovů a polyaromatických uhlovodíků vázaných na prachových částicích. V závěru bylo provedeno srovnání s legislativou a stanovena zdravotní rizika.

No description available.

<p>Pre-modern societies were subjected to risks attributed to fate, and human-made hazards that were considered manageable. Late-modern society is increasingly exposed to emerging environmental health risks that are products of the modernization process itself (e.g. genetically modified organisms). These risks result from broad changes in the environment and/or human activity. Some of these provoke high public perceptions of risk, and often institutions and communities must respond to these in the absence of scientific knowledge.</p> <p>This dissertation explores the determinants of the perception of food allergies – a recent addition to the environmental risk landscape. A recently assembled national database on food allergies was analyzed using multivariate logistic regression (n=3,462). In parallel, a media analysis of nine years of Canadian newspaper coverage of food allergy issues (n = 598 articles) explored the role of a primary source of risk communication.</p> <p>Results revealed a number of important determinants at the individual-level , as well as a number of experiential (e.g. exposure to food allergy-related information) and attitudinal covariates . The policy environment, was also implicated as an important modifying factor for risk perceptions. The media analysis revealed how food allergies are being constructed by different social actors through the news media, with substantial implications for public understanding. The dissertation concludes with a description of a conceptual framework for characterizing public response to emerging environmental health. This tool may prove crucial for increasing the understanding of the links between people, perceptions, and places as new environmental risks continue to emerge on the landscape.</p> / Doctor of Philosophy (PhD)

Sexual minority men are at an increased risk for negative outcomes, including mental health disorders, suicide, substance abuse, and sexual risk behaviors. Internalized Homophobia (IH), roughly defined as sexual orientation-related self-hatred among gay men, has been linked to these outcomes. Since its publication in 1983, the predominant measure of IH used in psychological research has been the Nungesser Homosexual Attitudes Inventory (Nungesser, 1983). The scale is potentially dated, and there is a relative paucity of investigation into its psychometric properties; findings derived through its use may be in question. The current effort describes two studies designed to address these concerns. Study I includes a principal components analysis of the scale using data obtained from an internet sample (N = 486), resulting in suggested revisions for the broader scale, and proposed brief versions of the Self and Disclosure subscales. Study II used data obtained from a second internet sample (N = 884) to further evaluate scale structure and properties. Analyses include confirmatory factor analyses of the original scale, Shidlo's revised version (1994), the suggested alternative, and the Brief Self and Disclosure scales proposed in Study I. Of the three versions of the overall scale, the suggested alternative proposed in Study I exhibited the most favorable fit and highest item loadings. Internal consistency for the suggested alternative was equal to that of the larger NHAI and Shidlo-revised scales. External validity was evaluated through correlations with mental health and suicide, substance use, sexual risk, and orientation-based victimization. Strong results in the expected direction were found only in the instance of mental health, with negative attitudes towards homosexuality being associated with increases in depression and anxiety scores as measured by the Hospital Anxiety and Depression Scale. The suggested scale alternative and Brief Self and Disclosure scales performed similarly to the more extensive NHAI and Shidlo-revised scales, leading to a recommendation for their use in research. Finally, findings from the current effort are discussed in relation to the broader social context impacting the lives and development of sexual minority men. / Psychology