Submitted by Erika Demachki (erikademachki@gmail.com) on 2014-09-03T19:05:12Z No. of bitstreams: 2 Análise epidemiológica dos cânceres de pulmão e da laringe em 30 anos.pdf: 985787 bytes, checksum: 31e7777e04381a2403335ed5d4f54552 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-09-03T19:05:12Z (GMT). No. of bitstreams: 2 Análise epidemiológica dos cânceres de pulmão e da laringe em 30 anos.pdf: 985787 bytes, checksum: 31e7777e04381a2403335ed5d4f54552 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-06-26 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / Introduction: Studies have shown a relationship between smoking and various cancers, especially in the respiratory tract, causing major impact on public health. Lung cancer is the leading cause of cancer death in the world, accounting for 20 %, while Laryngeal cancer represents 3 %. Objective: To analyze trends in incidence and mortality from lung and larynx cancer in Goiania in 20 years and to assess trends in mortality for these cancers, over the past 30 years for the Brazilian regions. Methods: All incident cases of lung cancer and larynx were obtained from the database registered in Goiania RCBP/ACCG and deaths were extracted from the Mortality Information System (SIM/MS) for both, Goiania as for other Brazilian regions. Incidence rates and standardized mortality rates were calculated using the world standard population and calculating the trend used the Poisson regression model using Joinpoint Regression Program, Version 4.0.4. Graphs and tables were made using the Excel 2013 software. Results: Two points were analyzed: the first showed that the trend of incidence for lung and larynx cancers in both sexes and age groups in Goiania, were in contrast to trend mortality for lung cancer in women over 50 increased by 2.5% per year, during the study period in Goiania. The second article assessed the trends in national mortality for cancers of the lung and larynx showing that in Brazil, the mortality rates for lung cancer ranged from 14.30 to 15.52/100,000 in men and 3.99 to 7.37/100,000 in women from 1980 to 2009. Laryngeal cancer in this variation was from 3.76 to 3.59/100,000 for males and 0.47 to 0.38/100,000 in the female. The analysis of trends showed increased mortality for lung cancer in both male and female genders respectively (APC 1.7 %; 95% CI 1.6 to 1.8, p < 0.001, and APC 4.1%; 95% CI 3.9, the 4.2, p < 0.000). Mortality rates for laryngeal cancer in men the increase was 1.4 % (95% CI 1.2 to 1.5 p < 0.0001), the rate for women increased by 1.3 % (95 % 0.9 -1.6, p < 0.0001) during the study period, so there were similar for both neoplasms. Conclusion: Incidence trends were stable for lung and larynx cancer in both sexes and age groups, in contrast, for women aged over 50 years there has been increasing trends in mortality in Goiania. When Abstract xviii analyzing mortality at the national level, there was decline for lung cancer in south and southeast whereas for cancer of the larynx, there was a decrease only in southeastern Brazil. / Introdução: Estudos têm mostrado a relação entre fumo e diversos cânceres, especialmente do trato respiratório, causando grande impacto na saúde pública. O câncer de pulmão é a principal causa de morte por câncer representando 20% no mundo, enquanto que o câncer da laringe representa 3% destas mortes. Objetivo: Analisar as tendências da incidência e mortalidade por câncer de pulmão e laringe, em Goiânia, em 20 anos, bem como avaliar a tendência da mortalidade para esses cânceres nos últimos 30 anos para as regiões brasileiras. Métodos: Os casos incidentes de câncer de pulmão e laringe foram obtidos no banco de dados registrados no Registro de Câncer de base Populacional (RCBP-Goiânia) da Associação de Combate ao Câncer em Goiás (ACCG) e os óbitos foram extraídos do Sistema de Informações de Mortalidade (SIM) do Ministério da Saúde (MS), tanto para Goiânia quanto para as demais regiões brasileiras. Foram calculadas taxas de incidência e mortalidade padronizadas utilizando a população padrão mundial, e para o cálculo da tendência utilizou-se o modelo de regressão de Poisson, utilizando o software Joinpoint Regression Program, Version 4.0.4. Gráficos e tabelas foram confeccionadas utilizando o software excel 2013. Resultados: Foram analisados dois pontos: o primeiro verificou a tendência de incidência para o câncer de pulmão, e da laringe em ambos os sexos e grupos etários em Goiânia, cujo resultado demonstrou estabilidade no período estudado. A tendência da mortalidade para o câncer de pulmão, em mulheres acima de 50, aumentou em 2,5% ao ano, em Goiânia. As tendências da mortalidade no Brasil, para os cânceres de pulmão e da laringe, mostraram que as taxas de mortalidade variaram de 14,30 a 15,52/100000, em homens e 3,99 a 7,37/100000, em mulheres, para o câncer de pulmão, entre 1980 a 2009. Para o câncer da laringe essa variação foi 3,76 a 3,59/100000 no sexo masculino e 0,47 a 0,38/100000 no feminino. A análise de tendências evidenciou aumento da mortalidade para o câncer de pulmão em ambos os sexos, masculino e feminino, respectivamente (Média Percentual Anual (MPA) 1,7% IC95% 1,6 a 1,8; p<0,001; e MPA 4,1% IC95% 3,9 a 4,2; p<0,000). As taxas de mortalidade Resumo xvi para câncer da laringe para os homens aumentou 1,4% ao ano (IC95% 1,2- 1,5 p<0,0001), para as mulheres, esse aumento foi 1,3% (IC95% 0,9 -1,6; p<0,0001), portanto foram semelhantes para ambos os sexos. Conclusão: As tendências de incidência se mantiveram estáveis para o câncer de laringe e do pulmão, em ambos os sexos e grupos de idade, em contrapartida, para mulheres com idade acima de 50 anos houve tendências de aumento da mortalidade em Goiânia. Ao analisar-se a mortalidade a nível nacional, observou-se declínio para o câncer de pulmão no sul e sudeste enquanto que para o câncer da laringe, houve declínio apenas na região sudeste do Brasil.

Foram estudadas 456 gestantes adolescentes « 18 anos) atendidas em pré-natal multiprofissional no Hospital das Clínicas da FMUSP entre agosto de 1997 e maio de 2002, sem patologias clínicas e com início do pré-natal antes da 283 -semana, Investigou-se retrospectivamente fatores que pudessem estar associados com o alto risco descrito de pré-eclâmpsia para esse grupo etário. A incidência de pré-eclâmpsia (PA ~ 140x90 em duas ocasiões e proteinúria significativa) foi de 6,14%, embora em adicionais 13% tenha ocorrido hipertensão sem confirmação da doença em questão, perfazendo a taxa de 19,74% para a presença de qualquer tipo de hipertensão na gravidez. As pacientes com pré-eclâmpsia receberam dieta hipossódica em 59% das vezes e medicação hipotensora, em 43% , sendo a média de proteinúria de 1,27g em 24 h. Tais pacientes apresentaram mais parto cesárea, principalmente por desproporção céfalo-pélvica e distocia funcional, que estava associada com maior risco para indução do parto. O tempo de intemação e de analgesia foi significantemente maior, assim como o uso de anestesia tipo bloqueio (raqui ou peridural). A gravidez resultou em mais recém nascidos grandes para a idade gestacional (GIG), assim como mais recém-nascidos pequenos para a idade gestacional, com os demais dados neonatais equivalentes com o resto das adolescentes. Na análise univariada, estiveram associadas com o diagnóstico de pré- eclâmpsia as seguintes variáveis: estado conjugal solteira ao final da gravidez, a raça negra, o antecedente familiar de pré-eclâmpsia, o peso matemo ao início do pré- natal, o ácido úrico com 32 e 36 semanas, a hipocalciúria com 36 semanas e a placenta localizada lateralmente com 26 e 30 semanas, assim como o ganho de peso semanal a partir da 213 semana e a pressão arterial sistólica e diastólica a partir da 253 semana. Na análise multivariada, permaneceram independentes e significativos apenas as variáveis antecedente familiar (OR=3,85), estado civil solteira (OR=2,80) e o ácido úrico com 32 sem (OR=I,76). Assim, parece que o mecanismo fisiopatológico associado a pré-eclâmpsia comporta não somente dados biológicos e genéticos, como também questões psicossociais e nutricionais, que necessitam ser melhor estudadas / They were studied 456 adolescent pregnant woman «18 years) assisted in comprehensive prenatal care in the Hospital das Clinicas of the College of Medicine of the São Paulo University between August of 1997 and May of 2002, without clinical pathologies and with beginning of the prenatal before for 28th week. It was investigated in retrospective study factors that could be associated with the high described risk of preeclampsia for that age group. The preeclampsia (~140x90 in two occasions and significant proteinuria) incidence it was of 6,14%, although in additional 13% have happened hypertension without confirmation of the disease, with the global rate of 19,74% for the presence of any hypertension type in the pregnancy. The patients with preeclampsia received low sodium diet in 59% of the times and medication, in 43%, being the average of proteinuria of 1,27g in 24 h. These patients had more Cesarean section, mainly for cefalo-pelvic disproportion and functional distocia, that was associated with larger risk for induction of the labor. The time of intemment and of analgesia it were larger, as well as the use of block anesthesia. The pregnancy resulted in more newborn big for the gestational age (010), as well as newborn small for the gestational age, with the other neonatal data equivalent with the general population of teenagers. In the univariate analysis, It was associated with the preeclampsia diagnosis the following variables: unmarried woman at the end ofthe pregnancy, the black race, the antecedent ofpreeclampsia in the relatives, the maternal weight at the beginning of the prenatal care, the uric acid with 32 and 36 weeks, the hipocalciuria with 36 weeks and the lateral placenta with 26 and 30 weeks, as well as the weekly gain of weight after the 21 st week and the systolic and diastolic blood pressure after the 25th week. ln the multivariate analysis , the following variables were independent and significant: family antecedent (OR=3,85), unmarried woman (OR=2,80) and the uric acid with 32 weeks (OR=1,76). Thus, it seems that the mechanism associated with preeclampsia behaves not only biological and genetic data, as well as subjects psychosocial and nutritional issues, that need to be studied better

Made available in DSpace on 2017-07-10T17:37:23Z (GMT). No. of bitstreams: 1 Luciano_Stefanello.pdf: 1381556 bytes, checksum: 6bd57829a5462b5319b07e3a1fb7ba7a (MD5) Previous issue date: 2016-08-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Cassava culture has great importance for agriculture and for populations mainly those in development, for being a culture with high rusticity and productivity, but diseases have been reducing the productivity and invalidating croplands, as in the case of root rot. Therefore the aim of this study was to investigate the potential of Trichoderma to control root rot in cassava caused by Fusarium and Phytophthora, and to investigate the ability of Trichoderma to promote the development of culture and the use of Trichoderma combined with different varieties in both systems. Initially in vitro tests were performed with 23 isolates of Trichoderma spp., the pair of test cultures, production of volatile and non-volatile antimicrobial compounds, against Phytophthora drechsleri development and Fusarium solani, under field conditions cassava planting was realized using the range Fécula Branca in conventional system where at planting was performed spraying spore suspension six of Trichoderma isolates on cuttings in the planting furrow. A second experiment was performed in two culture systems with two varieties with and without Trichoderma harzianum application. For nonvolatiles antimicrobial compounds the isolate studied presented a high ability to reduce mycelial growth of P. drechsleri and F. solani with inibiting up to 100%, to evaluate nonvolatiles antimicrobial compounds produced by Trichoderma the results were less expressive with the maximum inhibition value of 23,87%. for the first experiment under field conditions,the isolated TLB 14 promoted a better root development, consequently providing more productivity, for the incidence of disease the isolates TOD2A, TLB14 and TI2 presented lower incidence. for the second experiment under field conditions, about the plant stand it was lower in range Baianinha and using T. harzianum, the incidence of brown streak was lower in conventional tillage and the productivity was higher in convencional tillage and using T. harzianum / A cultura da mandioca possui grande importância para as populações principalmente aquelas em desenvolvimento, por ser uma cultura com alta rusticidade e produtividade. No entanto doenças vem reduzindo a produtividade e inviabilizando áreas de cultivo como é o caso das podridões radiculares. Portanto o objetivo deste trabalho foi verificar o potencial de Trichoderma em controlar podridão radicular na mandioca causada por Fusarium e Phytophthora, além de investigar a capacidade do Trichoderma em promover o desenvolvimento da cultura e o uso de Trichoderma combinado com diferentes variedades em dois sistemas de cultivo. Inicialmente testes in vitro foram realizados com 23 isolados de Trichoderma spp., pelos testes de pareamento de culturas, produção de compostos antimicrobianos voláteis e não voláteis, frente ao desenvolvimento de Phytophthora drechsleri e Fusarium solani. Em condições de campo o plantio de mandioca foi realizado utilizando a variedade Fécula Branca em sistema convencional efetuando-se pulverização de suspenção de esporos de seis isolados de Trichoderma sobre as manivas dentro do sulco de plantio. Um segundo experimento foi realizado em condições de campo em dois sistemas de cultivo com duas variedades (IAC 90 e Baianinha) com e sem a aplicação de Trichoderma harzianum. Para compostos antimicrobianos não voláteis os isolados estudados apresentaram uma alta capacidade em reduzir o crescimento micelial de P. drechsleri e F. solani com inibição de até 100 %. Para a avaliação de compostos antimicrobianos voláteis produzidos por Trichoderma os resultados foram menos expressivos com valor de inibição máximo de 23,87 %. Para o primeiro experimento em condição de campo o isolado TLB 14 promoveu um melhor desenvolvimento radicular, consequentemente proporcionando maior produtividade, para a incidência de doença os isolados TOD2A, TLB14 e TI2 foram os que reduziram a incidência em raízes de mandioca. Para o segundo experimento em condições de campo, quanto ao estande de plantas ele foi menor na variedade Baianinha e com o uso de T. harzianum. A incidência de podridão radicular foi menor em sistema de plantio convencional e a produtividade foi maior em sistema de plantio convencional e com o uso de T. harzianum

Made available in DSpace on 2017-07-10T17:37:39Z (GMT). No. of bitstreams: 1 Rafael_Hansen_Alves.pdf: 691556 bytes, checksum: 76623d639903f7b4404dca73bdfe4314 (MD5) Previous issue date: 2010-06-30 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Caused by several species of fungus, fusarium head blight (FHB) is a disease of great economic importance in wheat (Triticum aestivum L.), causing large losses in world grain production. In Brazil the main species of fungi responsible for disease is Gibberela zeae (Schwabe.), and its the anamorphic Fusarium graminearum (Schwabe). The control by chemical treatment of the disease with the use of fungicides has low efficiency due to the difficulty of identifying the exact time of application. Therefore, the use of resistant varieties is shown as a safe and economically viable alternative for the production of wheat scab-free. To contribute to the understanding of the behavior of some Brazilian wheat cultivars for FHB, the objectives were to assess the presence or absence of reaction to FHB resistance in wheat cultivars under inoculation in field conditions and greenhouse; and identify what kind of reaction that is acting (resistance type I or type II resistance). The proposed work was developed in the field, greenhouse and laboratory. Two methodologies inoculation were applied, depending on the type of resistance to be tested, and the targets of this work were to evaluate the resistance type I and type II resistance. Twenty eight genotypes with different responses to FHB resistance were used to both evaluations. The resistance of type I was measured by spraying the spikes with suspension. In the field, dispersal of inoculum in the area was used wheat grains colonized with perithecia previously inoculated. The assessment of disease severity in the 28 cultivars was made 21 days after inoculation (DAI), the green ear stage, taking on a note on a linear scale from zero to 100, based on the scale suggested by Stack and McMullen. The evaluation of resistance of type II was performed only in the greenhouse. Obtaining spore mass acquisition was performed by scraping the plates with PDA medium colonized by Fusarium graminearum. Conidia were washed with distilled water and received the inoculum. The concentration was adjusted to 5x104 spores per mL. The count was performed by an optical microscope with the aid of a Neubauer chamber. About 10μL of the suspension of spores (macroconidia) at a concentration of 5x104 mL-1 was injected between the lemma and palea of a spikelet located at the point of infection, on both sides of the ear, using a hypodermic syringe. Evaluations were performed at 7, 14 and 21 days after inoculation by counting the spikelets with symptoms of the disease, excluding the two infected spikelets. The FHB occurred in two periods in the field with greater variation among the 28 cultivars tested in the first season. For resistance type I, nine and nineteen cultivars had the lowest severity, respectively, in field and greenhouse conditions, showing that they are sources of resistance. In accessing the resistance of type II, BRS Umbu, CEP Nova Era, CEP Raizes, BRS 208 e Frontana not proved to be sources of resistance. Already BRS Guamirim, CD 120, Onix, Rubi, CEP 50, BRS 179, Pampeano, Abalone, CD 114, IPR 85, Safira, BRS Louro, CD 117, CDF 2002116, CD 115, BRS177, CD 0529 and BRS Camboim showed the lowest values for AUDPC thus demonstrating the potential for type II resistance to FHB / Causada por diversas espécies de fungo, a giberela e uma doença que possui grande importância econômica na cultura do trigo (Triticum aestivum L.), ocasionando perdas sensíveis na produção mundial de grãos. No Brasil a principal espécie de fungo responsável pela moléstia e Gibberela zeae (Schwabe.), sendo sua forma anamófica Fusarium graminearum (Schwabe). O controle através de tratamento químico da doença com o uso de fungicidas apresenta baixa eficiência devido a dificuldade de identificação do momento exato da aplicação. Portanto, a utilização de variedades resistentes mostra-se como uma alternativa segura e viável economicamente para a produção de trigo livre de giberela. Visando contribuir para o conhecimento do comportamento de algumas cultivares brasileiras de trigo em relação a giberela, os objetivos deste trabalho foram avaliar a presença ou ausência da reação de resistência a giberela em cultivares de trigo, sob inoculação em condições de campo e casa de vegetação; e identificar qual e o tipo de reação que esta atuando (resistência tipo I ou resistência tipo II). O trabalho proposto foi desenvolvido a campo, casa de vegetação e em laboratório. Foram utilizadas duas metodologias de inoculação, conforme o tipo de resistência a ser testada, sendo que, foram alvo do presente trabalho a avaliação da resistência tipo I e resistência tipo II. Para ambas as avaliações foram utilizadas 28 genótipos de trigo com diferentes reações de resistência a giberela. A resistência do tipo I foi medida através da inoculação de plantas em casa de vegetação, através de borrifamento das espigas, com suspensão de esporos. No campo, para dispersão do inoculo na área foi utilizado grãos de trigo colonizados com peritécios previamente inoculados. A avaliação da severidade da doença nos 28 cultivares foi feita 21 dias apos a inoculação (DAI), no estádio de espiga verde, atribuindo-se uma nota em uma escala linear de zero a 100, baseada na escala sugerida por Stack e McMullen. A avaliação da resistência do tipo II foi realizada somente em casa de vegetação. A obtenção de esporos em massa foi realizada através da raspagem de placas com meio BDA colonizadas por Fusarium graminearum. Os conídios foram lavados com água destilada e obtido o inoculo. A concentração foi ajustada para 5x104 esporos por mL. A contagem foi realizada em microscópio óptico com o auxilio da Câmara de Neubauer. Aproximadamente 10μL da suspensão de esporos (macrogonídios) na concentração de 5x104 mL-1 foi injetada entre a lema e a palea de uma espigueta localizada no ponto de infecção, nos dois lados da espiga, utilizando uma seringa hipodérmica. As avaliações foram realizadas aos 7, 14 e 21 dias apos a inoculação, contando-se as espiguetas com sintomas da doença, excluindo as duas espiguetas que foram inoculadas. A giberela ocorreu nas duas épocas a campo com maior variação entre as 28 cultivares testadas na primeira época. Para a resistência do tipo I nove e dezenove cultivares obtiveram os menores valores de severidade, respectivamente, em campo e em casa de vegetação, demonstrando serem fontes de resistência. Na avaliação da resistência do tipo II, as cultivares BRS Umbu, CEP Nova Era, CEP Raízes, BRS 208 e Frontana não demonstraram serem fontes de resistência. Já as cultivares BRS Guamirim, CD 120, Onix, Rubi, CEP 50, BRS 179, Pampeano, Abalone, CD 114, IPR 85, Safira, BRS Louro, CD 117, CDF 2002116, CD 115, BRS 177, CD 0529 e BRS Camboim apresentaram os menores valores para AACPD demonstrando assim, potencial para a resistência do tipo II a giberela

Objective: To determine risk factors for cavitated caries incidence and extent of cavitated caries among adolescents. Methods: Three hundred and three Iowa Fluoride Study (IFS) subjects met inclusion criteria for interval between dental examination and the responses from the IFS (ages 13.5 to 17.0) and the Block Kids Food Frequency (ages 13.0 to 17.0) questionnaires, respectively. The analyses focused on the outcome variables of net cavitated caries incidence and net cavitated caries increment counts, respectively. The independent IFS questionnaire variables related to demographics, fluorides, oral hygiene, beverage intakes, dental visits, sealants and previous caries incidence variables, respectively, whereas, Block's questionnaire variables related to intakes of solid foods and beverages, respectively. Two sets of analyses, logistic and negative binomial regression analyses, were conducted to assess the associations between risk factors and net cavitated caries incidence and increment counts from 13 to 17, respectively. Results: In multivariable logistic regression analyses, significant (p<0.05) negative associations were found between age 13 to 17 net cavitated caries incidence and greater frequency of consumption of vegetables, greater brushing frequency and greater frequency of sugar-free beverage consumption. Additionally, significant (p<0.05) positive associations were found between age 13 to 17 net cavitated caries incidence and both net cavitated caries incidence from 9 to 13 and frequency of consumption of solid-foods in the combined category of presumed moderate cariogenicity. The significant interaction effect showed that the effect of the presence/ absence of sealants varied for girls vs. boys. In multivariable negative binomial analyses assessing the association between net cavitated caries increment count from 13 to 17 and risk factors, significant (p<0.05) positive associations were found with greater intake of foods predominant in starch, presence of sealants, greater baseline age, cavitated caries increment count from 9 to 13, and greater frequency of consumption of foods predominant in added sugar, respectively. Significant (p<0.05) negative associations were found between net cavitated caries incidence and greater frequency of consumption of foods predominant in fiber and natural sugar and greater daily fluoride intake from water. However, daily fluoride intake from water was not statistically significant with the significant interaction effect included between baseline age and net cavitated caries increment count from 9 to 13 (dichotomized as Y/N). Conclusion: Presence of sealants, frequency of consumption of vegetables and previous cavitated caries incidence from 9 to 13 were associated with outcomes of incidence and extent of cavitated caries observed among IFS adolescents. The differences in findings for risk factors for incidence and extent of cavitated caries are due in part to the nature of the outcome variables (count vs. dichotomous), emphasizing the need to consider both outcomes in future studies of adolescent caries.

This dissertation is related to the understanding of catalytic reactions of metal oxides. For several decades, the surfaces and bulk of materials have been probed to determine additional properties that relate to photocatalytic applications. This investigation furthers these efforts by the (a) modification of a metal oxide surface to isolate known influences of chemical properties and (b) proposing and utilizing a novel methodology for attribution of photocatalytic activity to a discernable influence. For the first effort, by effectively utilizing a known technique for a new application on a metal oxide, such isolations can be made despite unfavorable states. For the second effort, a reduction in the influence of surface states for metal oxides is effectively performed, providing the isolation of influences originating from the bulk. The challenge with such a proposal is verifying such bulk states have been adequately isolated as external influences would obviously distort any conclusions. Thus, techniques to both create such bulk states and eliminate unwanted combinations thereof are additionally required and must be provided for. Lastly, a determination of the photocatalytic activity is made to these states and results are provided.

As a validation study, this study addressed an under-researched area of bronchopulmonary cancer mortality and incidence. The association between altitude and bronchopulmonary cancer mortality and incidence was investigated using data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research. The theoretical framework for my study was Bronfenbrenner's ecological model. This model emphasizes the relevance of social and physical environments that influence patterns of disease and injury and shape responses to these patterns of disease and injury. The age-adjusted bronchopulmonary cancer mortality and incidence rates per 100,000 people in the highest elevation and lowest elevation states were investigated. The data used in this study spans from 2006 to 2014. In this study, bivariate statistics were used to analyze the data. The relevant technique of performing an unpaired t-test was used. After performing age, gender, and race-stratified analysis, no significant difference in cancer mortality and incidence was found within the following three groups: Black or African American, Asian or Pacific Islander, and American Indian or Alaska Native. This was a new finding, as previous studies did not stratify for race. Cancer mortality and incidence were found to be lower in both the male and female groups for the highest elevation states. Cancer mortality and incidence were also found to be lower in all age categories for the highest elevation states. A positive social change impact of this study is that this research provides the groundwork for future studies to probe what in the environment is lowering the bronchopulmonary cancer mortality and incidence for the White population.

Cardiovascular disease (CVD) is a major contributor to chronic diseases. High blood pressure and other modifiable cardiovascular risk factors are on the increase in Nigeria. The purposes of this study were to (a) explore associations among high blood pressure, social economic status, and health status awareness and (b) measure the incidence and prevalence of cardiovascular diseases in 3 states of Nigeria: Lagos, Ekiti, and Ondo. Participants (N = 368) were selected through stratification and randomization. Data were collected in person with the aid of validated questionnaire, which measured socioeconomic status as well as other variables in Lagos, Ado Ekiti, Ijesa-Isu, and Akure. Logistic regression and correlation analyses showed no significant difference in the regional incidence and prevalence of cardiovascular disease (F (4, 362) = 1.23, p = 0.30); and there was no significant relationship between the health status variable and the standard of living variable. Due to the fact that only 3 out of 36 states were sampled, this study is not generalizable and some other cardiovascular diseases modifiable risks factors that were not measured could have reacted differently in analysis. This study's results set precedence by promoting cardiovascular health. When disseminated, the results of this study will help advocate for a change process that curtails cost and decreases the general burden of CVDs in other, similar areas. Recommendations include measuring this incidence and prevalence of CVDs in all 36 states of Nigeria and exploring the interactions between culture, religion, health, and beliefs.

No description available.

This thesis describes the impact of contact lens-related microbial keratitis in terms of incidence and severity. Disease outcome is defined by visual outcome, costs to the healthcare system, costs to the individual and duration of disease. A successful 12-month surveillance study was conducted of the populations of Australia and New Zealand to detect all cases of contact lens-related microbial keratitis. A random telephone survey of 32,000 households in Australia and 7,500 in New Zealand accurately determined the level of use of various contact lenses in the community. The impact of new contact lens types: silicone hydrogels and daily disposables were investigated. Increased risk persisted in overnight wear with silicone hydrogel materials. Microbial keratitis associated with silicone hydrogel materials had slightly shorter disease duration however other factors had a stronger influence on severity. Rigid gas permeable and frequent replacement soft lenses when used for daily wear constitute the lowest risk. Cost analysis was developed in a hospital case series of microbial keratitis. This analysis was applied in the surveillance study including cases managed in the private health care sector. Disease duration and associated costs are novel indices of severity for contact lens-related disease. The most dramatic effects on disease severity were seen with the type of organism involved. Keratitis attributed to environmental organisms (Gram-negative bacteria, Acanthamoeba, fungi and Nocardia species) were 10x more likely to cause loss of visual acuity, had longer duration of symptoms and incurred higher costs. Importantly, delays in receiving treatment increased disease duration and associated costs. Greater awareness of the need for specialist healthcare is indicated amongst health care providers and contact lens wearers. The hypothesis that overnight wear in silicone hydrogel lenses would not increase the risk of infection has been disproven. This information is of value to practitioners who are responsible for informing contact lens wearers about the risk of contact lens-related infections and should be weighed against the benefits of continuous wear. The identification of factors which contribute to the outcomes of disease will be used in education campaigns amongst health care providers and contact lens wearers to minimise the impact of disease.