Orientadores: Regina Maura Bueno Franco, Eliete Maria Silva, Jancarlo Ferreira Gomes / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-21T03:30:34Z (GMT). No. of bitstreams: 1 Rebolla_MayraFrozoni_M.pdf: 5078074 bytes, checksum: 0e330cef23d1c66a5672e38240041608 (MD5) Previous issue date: 2012 / Resumo: Parasitoses intestinais são frequentes na população usuária do Sistema Único de Saúde de São Sebastião da Grama, município do interior do estado de São Paulo. Durante a ocorrência de um surto de gastroenterite em uma das creches do município, objetivou-se investigar a ocorrência de enteroparasitos nos trabalhadores e crianças das instituições municipais urbanas de educação infantil, avaliar o desempenho de técnicas diagnósticas na detecção de Giardia duodenalis em amostras fecais provenientes de creche, local de surto de gastroenterite, e implantar um programa de controle desta parasitose, o "Programa de Controle da Giardiose em Creches e Pré-escolas" (PCGCP) a fim de avaliar a adesão de gestores, trabalhadores e famílias das crianças às medidas higiênicas no ambiente escolar infantil. Para tanto se utilizou amostras fecais de 172 crianças e 33 trabalhadores, processadas pelos métodos Three Fecal Test Conventional® e Modified®, diagnosticando-se 89,53 % das crianças e 71,87 % dos trabalhadores positivos para parasitos e comensais. Blastocystis hominis foi o parasito intestinal de maior prevalência entre as crianças (86,62 %) e trabalhadores (65,62 %). Os casos de monoparasitismo foram mais frequentes que os de poliparasitismo entre as crianças e os trabalhadores estudados, bem como a prevalência de protozoários foi maior que a de helmintos. O modelo de regressão logística evidenciou associação significativa entre criança atendida na creche e a frequência de infecção por enteroparasitos (p = 0,01), por G. duodenalis (p = 0,00), por B. hominis (p = 0,02), e pelos protozoários intestinais (p = 0,01). Entre criança menor de um ano e a frequência de infecção por G. duodenalis (p = 0,00), e entre crianças cujos domicílios não possuíam coleta de lixo e a frequência de infecção por helmintos (p = 0,03). Os resultados obtidos utilizando-se os métodos de Faust et al. e ELISA foram concordantes substancialmente, contudo, a presença de resultados falsos positivos verificados no imunoensaio limitam sua aplicabilidade como teste diagnóstico em uma situação de surto. Como ferramenta de controle e prevenção da giardiose, foi implantado e avaliado o PCGCP nestes ambientes do estudo. A adesão e ativo engajamento dos gestores, trabalhadores e famílias das crianças ao PCGCP foi considerada satisfatória, e os resultados sugerem que o treinamento das práticas para se evitar a giardiose deva ser mantido de forma permanente a fim de se alcançar uma efetiva prevenção nos ambientes escolares infantis / Abstract: Intestinal parasites are common in the population using the Unified Health System of São Sebastião da Grama, a municipality in the state of São Paulo. The aims of this study to investigate the occurrence of intestinal parasites in children and workers of urban municipal institutions of early childhood education, to evaluate the performance of diagnostic techniques for detection of Giardia duodenalis in stool samples from daycare centers, where outbreaks of gastroenteritis occur. To implement a program to control this parasite, the "Program of Control of Giardiasis in Day Care Centers and Preschools" (PCGCP), in order to assess the commitment of managers, workers and children?s families to hygienic measures within these school environments. For this purpose we used fecal samples from 172 children and 33 workers, processed using the Conventional and Modified Three Fecal Test® method. As a result, 89,53 % of the children and 71,87 % of workers were diagnosed positive for pathogenic parasites and commensals. Blastocystis hominis was the most prevalent intestinal parasite among children (86,62 %) and employees (65,62 %). Monoparasitism cases were more frequent than those of multiple parasitic infections among children and workers. The prevalence of protozoa was greater than that of helminths. The logistic regression model revealed a significant association between child attended in the day care center and the frequency of infection with intestinal parasites (p = 0,01), by G. duodenalis (p = 0,00), by B. hominis (p = 0,02), and the intestinal protozoa (p = 0,01). Higher indices were found among children under one year of age (frequency of infection with G. duodenalis (p = 0,00)) and among children whose homes had no waste collection (frequency of helminth infection (p = 0,03)).The results obtained using the methods of Faust et al. and ELISA were substantially consistent. However, the presence of false positive results observed in the immunoassay limits its applicability as a diagnostic test in an outbreak situation. As a tool for control and prevention of giardiasis, the program PCGCP was implemented and its adherence was evaluated in the sites investigated, places considered at the scope of this study. The commitment and active engagement of managers, workers and families with children to PCGCP was considered satisfactory, and the results suggest that training practices to avoid giardiasis should be made permanent for an effective prevention in day care centers and preschools environments to be achieved / Mestrado / Parasitologia / Mestre em Parasitologia

Orientadores : Thales Rocha de Mattos Filho, Francisco Carlos Groppo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-04T03:41:21Z (GMT). No. of bitstreams: 1 Motta_RogerioHeladioLopes_D.pdf: 659292 bytes, checksum: 254fb5f4f10c3501c081c5129d2db30f (MD5) Previous issue date: 2005 / Doutorado / Farmacologia, Anestesiologia e Terapeutica / Doutor em Odontologia

Master of Public Health - MPH / The overall aim of this study was to evaluate quality of STI services in Umjindi local municipality. A concrete objective was to investigate the health system issues that may have a negative impact in the provision of quality STI service in the local municipality. These include accessibility of the STI services to the community, training of health workers in syndromic management, availability of necessary equipment and supplies for STI management, turn-around time for blood results and infrastructure of the facilities. / South Africa

Doctor Pharmaceuticae - DPharm / The effect of industrialisation has thrust the pharmaceutical profession into a clinical paradigm where the approcah to pharmaceutical decisions is more disease and patient orientated. Consequently, South African community pharmacies are inundated with requests from the public for advice and treatment on a wide range of medical conditions, including sexually transmitted infections (STI's). Although community pharmacies are often the first port of call for undiagnosed STI, limited diagnostic skills and legally-imposed prescribing restrictions preclude pharmacists from providing the necessary clinical management. The overarching goal of this dissertation was to present objective arguments and evidences (new and existing) around an expanded role for pharmacists in STI partner management. / South Africa

Objectives: To develop and validate a survey that can be used to measure key infection prevention and control (IP&C) structures and processes in LTC facilities. Methods: This study was designed using a three-phase methodology. In Phase I, six structural and process composite indices were developed based on the 2004 PHAC recommendations for IP&C in LTC and other literature. During the second phase of the study, a group of 7 experts in LTC IP&C used the Delphi methodology to validate and further develop the survey based on group consensus. Five Safety Principles published by the Institute of Medicine were also provided to the experts so they could be used to complement and further develop the concepts covered by the survey. The Delphi phase began in April and ended in October 2007; 114 worksheets were sent to experts to support the consensus-reaching process. Once the validity of a survey draft had been established based on expert-group consensus, it was pilot-tested in Phase III using 20 randomly selected LTC facilities in Fraser Health. Findings: The three-phase methodology used in this study was very useful and innovative way to further develop and validate the literature-based survey developed in Phase I for IP&C in long term care. In addition, by merging two bodies of knowledge and thought into the process, concepts and components that are not explicitly described in IP&C literature yet were felt to be key in program success, were incorporated into the measurement tool. Using Delphi, the experts expressed a need for IP&C professionals working in LTC to increase their knowledge, understanding and use of safety theory and strategies. They also felt that interdisciplinary work, the development of a culture of safety, and the development clear and simple IP&C systems are key ways in which infections can be prevented and outbreaks quickly controlled. In Phase III, the pilot-study analysis demonstrated the utility, validity and reliability of the survey. In addition, the analysis showed that there is a tendency for facilities to have lower levels of components within the Leadership Index and the ICP Index. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

Petrol and ethanolic extracts of six asteraceous weeds were added to artificial diet and screened for inhibition of larval growth on variegated cutworm, Peridroma saucia (Hbn.). Petrol and ethanolic extracts of Artemisia tridentata and Chamomilla suaveolens and ethanolic extracts of Chrysothamnus nauseosus and Centaurea diffusa were highly inhibitory at five times the naturally occurring concentrations. The two C. suaveolens extracts and the ethanol extract of A. tridentata were active at the natural concentration (100%) and were further examined at 20, 40, 60, and 80% of this level. Inhibition of larval growth was directly related to concentration for each of the three extracts tested. EC₅₀'S (effective concentration to inhibit growth by 50% relative to controls) for the three extracts were 36-42% of the naturally occurring level in the plants. Nutritional indices were calculated for second instar P. saucia feeding on the active ethanolic A. tridentata extract and the petrol extract from C. suaveolens. The relative growth rate (RGR) of P. saucia larvae fed the ethanolic extract of A. tridentata in artificial diet was significantly lower than that in larvae fed diet with the petrol extract of C. suaveolens and larvae on control diet. Dietary utilization was significantly lower for larvae fed the A. tridentata extract. Results of a field trial indicated that a single treatment of A. tridentata extract at the equivalent of 0.2 g/ml could protect cabbage significantly better than the carrier solvent (30% aq ethanol) or distilled water as measured by a visual damage estimate. An insecticide standard, deltamethrin (17.9 µg/1 with 0.4% Superspred TM ), suppressed pest damage significantly better than the A. tridentata-extract treatment. A residual oviposition deterrency to Pieris rapae was found in the field results. Caged experiments in the laboratory confirmed the contact oviposition deterrency of the A. tridentata extract at 0.2 g/ml. Offspring of field-collected P. saucia larvae grew 2.5-fold heavier than larvae from the laboratory colony. However, diet with the A. tridentata extract inhibited both field-collected and laboratory reared saucia larvae equally when compared to their respective controls fed untreated diet. In summary, these results indicate the potential benefit of using specific unrefined plant extracts for growth inhibitors and oviposition deterrents against insect pests. The contribution of individual phytochemicals in the A. tridentata ethanolic extract to growth inhibition or oviposition deterrency is currently speculative. / Land and Food Systems, Faculty of / Graduate

The objectives of this thesis are : 1) To provide a review of the literature on the significance, pathogenesis, diagnosis and management of secondary infections in the Intensive Care Unit. 2) To present the findings of a study of the technique of selective parenteral and enteral antisepsis regimen (SPEAR) in the patient population of the Respiratory ICU at Groote Schuur Hospital, aimed at reducing the incidence of secondary infection and, further to evaluate the study in terms of the effect of SPEAR on the incidence of secondary infection and its influence on the mortality due to secondary infection. 3) To present the findings of the effect of SPEAR on patient bacterial colonisation in the ICU, and to evaluate its longterm influence on the microbial flora of the ICU.

The significance of this research lies in the fact that it makes a meaningful contribution to the development of comprehensive injury prevention programmes. The studies included in this thesis investigate technique-related intrinsic factors where injury is prevented at the expense of performance as well as intrinsic factors where there is potential for both injury prevention and performance to be simultaneously optimised. The cricket pace bowler is prone to injury due to the high load nature of the pace bowling action involving a complex sequence of forceful actions, consisting of practiced, particular movements. Various injury prevention programmes incorporating extrinsic factors have been studied and implemented previously, however the intrinsic factors associated with both injury and performance in pace bowlers have not yet been investigated sufficiently. In this thesis an overview of the literature includes the review of injuries sustained by pace bowlers, factors associated with injury and performance, and the kinematics of the pace bowling action. Premier league (amateur) cricket pace bowlers were recruited for this study. All pace bowlers were injury free at the start of the season. Details around past injuries as well as incidence of injuries were recorded throughout an eight month cricket season. Performance measures, namely ball release speed and accuracy, were measured during execution of the pace bowling action. Included in this thesis are six original papers. The first five papers investigated the association between intrinsic factors, injury and performance, while the sixth paper described abdominal muscle adaptations in the pace bowler. The first paper (Chapter 2) investigated bowlers’ ability to perform lumbo-pelvic movement control, static and dynamic balance tests at the start and at the end of a cricket season. Lumbo-pelvic movement control tests could not discriminate between bowlers who sustained an injury during the cricket season and bowlers who did not. However, performance in the single leg balance test (SLBT) (p=0.03) and the star excursion balance test (SEBT) (p=0.02) as measured at the start of the season, was better in bowlers who did not sustain an injury during the season. Paper 2 (Chapter 3) investigated lumbar proprioception (as measured by joint position sense) in the neutral lumbar spine position; as well as lumbar positions corresponding to those at front foot placement and ball release of the cricket pace bowling action in relation to previous injury and injury sustained during the cricket season under review. Lumbar reposition error in the sagittal plane (flexion-extension) was between 1.48˚ and 1.82˚ and in the frontal plane (left-right lateral flexion) it was between 0.81˚ and 0.88˚. Lumbar reposition error, as measured in two planes and in three different positions, was associated with self-reported general injuries, injuries sustained during the bowling action and especially, low back injury sustained in the past (p<0.05). From findings indicated in Papers 1, 2 and 3 (Chapters 2, 3 and 4) it can be postulated that if static balance, dynamic balance and lumbar proprioception can be improved in pace bowlers, their risk of lumbar injury may be reduced. Paper 3 and 4 (Chapter 4 and 5) investigated the relationship between kinematic angles as measured in the power phase of the pace bowling action and injury, as well as performance, respectively. In Paper 3 (Chapter 4) a difference was found between lumbar spine lateral flexion positioning (p=0.02) at the start compared to at the end of the season in injured pace bowlers. The range of flexion between front foot placement and ball release at L1 is much greater in the non-injured group than in the injured group as measured at the end of the season (p=0.03). Bowlers who did not sustain an injury during the season displayed a larger degree of absolute flexion at the start of the season than those who sustained an injury (p=0.02). Findings from Paper 4 (Chapter 5) are that the following absolute angles were positively correlated with higher ball release speeds at the start of the season: a more extended knee angle (p=0.037), a larger arm to thorax angle (p<0.0001), larger L1 (p=0.01), T10 (p<0.0001) and T7 (p<0.0001) segmental spinal lateral flexion and more global trunk left rotation (p=0.02). Paper 3 and 4 (Chapter 4 and 5) thus show that low back flexion and lateral flexion, and front knee kinematics, as found in the power phase of the pace bowling action, are associated with and may predict lower quarter injuries and performance outcomes in cricket pace bowlers. The fifth paper (Chapter 6) hypothesised that correlations between front knee angle, knee reposition error, as a measure of proprioception, and ball release speed should be present, however no such correlation could be established. The correlations between joint reposition error in 140˚ of knee extension (r=0.06), 160˚ of knee extension (r=0.30), front foot placement (r=0.22) and ball release (r=0.23) positions were not statistically significant (p>0.05). Furthermore, correlations between knee position error and reproduced knee angles were also not statistically significant (r=-0.35 to r=0.09; p>0.05). It was concluded that static knee joint position sense is not associated with dynamic knee angle during the bowling action, or with ball release speed and that dynamic mechanisms may contribute to knee angles and bowling speeds. The sixth study (Chapter 7) investigated and highlighted the possible muscle adaptations in absolute muscle thickness and activity as a consequence of the asymmetrical bowling action. The absolute thickness of the non-dominant obliquus abdominis internus (OI) was higher than that of the dominant OI at the start (p<0.0001) as well as at the end of the cricket season (p<0.0001). At the start of the season the percentage change during the abdominal drawing in manoeuvre, thus a measure of muscle activity, was higher for the non-dominant OI than for the dominant OI (p=0.02). Absolute thickness of the dominant obliquus abdominis externus (OE) at rest was significantly higher at the end of the season compared with at the start of the season (p<0.0001). During right side active straight leg raise, the activity of the left transversus abdominis (TA) was significantly higher than that of the right TA during left side active straight leg raise (p=0.03) when measured at the end of the season. These asymmetries in abdominal muscle thickness and activity may contribute to the predisposition to low back injury in cricket pace bowlers or may occur in an attempt to protect the pace bowler against injury. In conclusion, the high load nature of the pace bowling action allows for high ball release speeds to be attained but at the same time renders the pace bowler vulnerable to injury. Intrinsic factors found to be associated with both lower quarter injury and performance should be appropriately incorporated into injury prevention programmes in order to prevent the occurrence of injuries in the presence of the high load nature of the pace bowling action. Further research needs to be conducted on the effectiveness of these injury prevention programmes to prevent injury amongst pace bowlers.

Master of Public Health - MPH / Hospital acquired infections are a huge public health concern, contributing to increased hospitalisation and death in developing countries. Infection prevention and control (IPC) is a discipline which relies on practical evidence-based approaches to preventing both patients and health workers from hospital avoidable infections. However, most of these infections, in many developing countries including Zimbabwe can be attributed to lack of compliance with infection prevention and control measures by health care workers. / 2023

The reduction of intentional exposure to ultraviolet (UV) radiation is an important area of skin cancer prevention. Hillhouse et al. (Cancer 113:3257-3266, 2008) have developed an appearance-focused intervention with evidence of efficacy in lowering indoor tanning UV exposure in young women. In the current study, a subgroup approach was used to determine moderators of intervention efficacy. Undergraduate females in two regions of the United States (n = 362) were randomized into an intervention or control condition. Latent profile analysis was used to identify subgroups of indoor tanners based on patterns of indoor tanning motives. Intervention efficacy was examined within each subgroup. We found evidence for 4 subgroups of tanners: knowledgeable-appearance tanners, low-knowledge tanners, low-knowledge, relaxation tanners, and knowledgeable, low-appearance and lowrelaxation tanners. The intervention significantly reduced indoor tanning for the low-knowledge subgroup (34% of the sample). The utility of the subgroup approach in developing targeted behavioral skin cancer interventions is discussed.