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nÃo hà / A coinfecÃÃo entre o VÃrus da ImunodeficiÃncia Humana (HIV) e o VÃrus da Hepatite B (HBV) possui os mesmos fatores de transmissÃo e como consequÃncia os fatores de risco associados, explicam a alta prevalÃncia destes agentes infecciosos no nosso meio. O presente estudo estimou a prevalÃncia da coinfecÃÃo HIV e HBV e descreveu as caracterÃsticas individuais que agem como fatores de risco para aquisiÃÃo desta coinfecÃÃo, com o intuito de utilizar esta informaÃÃo para o aconselhamento. A amostra utilizada foi composta pelos 805 pacientes infectados com o HIV no estado do Piauà que buscaram o LACEN-PI para monitoramento da carga viral e dos linfÃcitos T CD4+. A prevalÃncia da hepatite B (HB), utilizando o marcador anti-HBc total, foi de 29,3% e, para o HBsAg este valor ficou em 2,5%. A prevalÃncia do Anti-HBc total foi 38,3% na faixa acima dos 40 anos, 38,6% para o sexo masculino, 31,9% entre os solteiros, 47,7% entre os aposentados, 50,7% entre os que relataram antecedente de icterÃcia, 54% entre os que tiveram hepatite com diagnÃstico mÃdico, 40,7% entre os com passagem por reformatÃrio ou prisÃo, 38,1% entre usuÃrios de droga nÃo endovenosa, 35,7% entre os com contato sexual com usuÃrio de droga ilÃcita, 48,8% entre os com preferÃncia homossexual/bissexual, 44,9% entre os que disseram ter contato sexual raro com prostituta, 37,1% entre os que tiveram DST e 31,4% para os com carga viral abaixo de 10.000 cÃpias/mL de sangue. Foram observadas significÃncias estatÃsticas entre as variÃveis e a frequÃncia de positividade do anti-HBc total. As informaÃÃes deste trabalho poderÃo ser utilizadas no combate, aconselhamento e prevenÃÃo do avanÃo, do nÃmero de casos HB em pacientes HIV positivos. / The coinfection between the Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) has the same transmission factors and consequently the associated risk factors explain the high prevalence of these infectious agents in our midst. This study estimated the prevalence of HIV and HBV coinfection and described the individual characteristics that act as risk factors for acquisition of coinfection, in order to use this information for advice. The sample was composed of 805 patients infected with HIV in the state of Piauà who sought the LACEN-PI for monitoring viral load and CD4 + T lymphocytes. The prevalence of Hepatitis B (HB), using the marker anti-HBc, and was 29.3% for HBsAg this value was 2.5%. The prevalence of Anti-HBc was 38.3% aged over 40 years, 38.6% for males, 31.9% among unmarried, 47.7% among retirees, 50.7% among who reported a history of jaundice, 54% among those who were diagnosed with hepatitis, 40.7% among those passing through reformatory or prison, 38.1% among non-intravenous drug users, 35.7% with sexual contact with illicit drug users, 48.8% with a preference among homosexual / bisexual, 44.9% among those who reported having sexual contact with a prostitute rare, 37.1% among those who had STD and 31.4% for those with viral load below 10,000 copies / mL of blood. We observed statistical significance between variables and the frequency of positive anti-HBc. The information in this work could be used in combat, counseling and prevention of advancement, the number of HB cases in HIV positive patients.

Purpose: When the prevalence of physical teen dating violence (TDV) victimization is examined at the state level, significant variation exists; the prevalence ranges from 7.4% in Oklahoma and Vermont to 17.8% in Louisiana. Using U.S. states as the unit of analysis, this study sought to determine whether gender inequality is a societal level risk factor for TDV victimization. Method: Data measuring physical TDV victimization were obtained from the 2009 YRBS. To measure the level of gender inequality in each state, the Gender Inequality Index (GII) was calculated using the procedure described in the United Nations’ Human Development Report. Pearson’s correlation coefficients were calculated to determine the association between TDV victimization, the GII, and the indicators of the GII. Results: Of the 40 states included in analyses, the GII was significantly associated with the state prevalence of both total TDV victimization (r=.323, p=.042) and female TDV victimization (r=.353, p=.026). Subsequent to removal of the outlying case of Oklahoma, the GII was also significantly associated with male TDV victimization (r=.366, p=.022). Several individual GII indicators were significantly associated with TDV victimization after removing the outlying case. Ordinary least squares regression was used to create a model for TDV victimization and gender inequality. Conclusion: This is the first study to examine societal level gender inequality as a risk factor for state level TDV victimization using nationally representative data on school youth. As policy-makers implement TDV prevention policy at the state level, further research understanding potential macro-level risk factors is particularly important.

Background: In the context of transitional Vietnam, hypertension has been shown to be one of the ten leading causes of morbidity and mortality in hospitals. However, population-based data on hypertension are to a large extent lacking. This thesis aims to characterise the current epidemiology of hypertension in the adult Vietnamese population and provide preliminary evidence for developing effective community-based hypertension management programmes nationwide. Methods: The study was conducted during 2002-2010. It includes two national surveys of the adult population aged 25 years and older, randomly selected in eight provinces in different regions of Vietnam, as well as a community-based programme on hypertension management in two communes of Bavi district. The survey on hypertension and associated risk factors, which included 9,832 adults, applied the WHO STEP-wise approach. The survey on hypertension-related knowledge and health seeking behaviour included 31,720 adults, using a structured questionnaire. For the community-based study, three-year follow-up data on 860 hypertensives was used to assess the effectiveness of the hypertension control model. Main findings: Hypertension prevalence was high (overall 25.1%, 28.3% in men and 23.1% in women). The proportions of hypertensives aware, treated and controlled were unacceptably low (48.4%, 29.6% and 10.7% respectively). Most Vietnamese adults (82.4%) had good knowledge about high blood pressure. People received their information on hypertension from mass media (newspapers, radio, and especially television). Most people would choose a commune health station (75%) if seeking health care for hypertension. The programme on hypertension control was able to run independently at the commune health station. Severity of hypertension and effectiveness of treatment were the main factors influencing people’s adherence to the programme. The hypertension control programme successfully reduced blood pressure (systolic blood pressure: -2.2 mmHg in men and -7.8 mmHg in women; diastolic blood pressure: -4.3 mmHg in men and -6.8 mmHg in women), the estimated CVD 10-year risk (-2.5% in women), and increased the proportions of treatment (22% in men and 13.6% in women) and control (11% in men and 17.3% in women) among hypertensive people. Suggestions for hypertension control: (1) Address the general population by developing community interventions, particularly salt reduction; (2) Provide interventions to individuals at high risk of a CVD event, including multi-drug treatment within patient-centred primary health care. (3) Set up a hypertension care network based in the existing health care system; (4) Improve and strengthen capacity and skills of medical staff in cardiac care, particularly staff at primary care level.

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The South African society is characterised by high levels of risk factors which can have a significantly negative impact on the development of children. The impact of risk factors from an early age can hinder intellectual and emotional growth during the critical stage (middle childhood) of development. Middle childhood can be described as the relatively tranquil period during which patterns and routines are embedded and cognitive-, social-, emotional- and self-conceptualisation are formed. Children are daily exposed to risks and stressful events that can lead to negative outcomes. The impact of risks and adversity sets challenges for the child that test his/her coping abilities and perseverance within a given period and situation. The idea behind resilience is to accept these challenges through utilising protective factors and decreasing the effects of risk factors. The Children’s Coping Strategies Checklist of Ayers and Sandler (1999) was used to assess resilience and The Resilience and Youth Development Module (RYDM) of WestEd (1999 & 2002) to measure participants’ perceptions of the school, home, environment and peer group as external protective domains as well as participants ability in seven psychosocial internal assets and their experience of certain risk factors. A biographical questionnaire was used to gather demographic information of the learners. The findings indicated positive coping abilities (resilience), protective perceptions of external and internal assets and low levels of risk experience (resilience) in the majority of participants. Significant differences were found between boys and girls and between the age groups 10 and 13 years. Theoretically, these findings indicate resilience in the majority of this group of learners who reside in a socio-economically deprived milieu characterised by risk factors. / Thesis (M.A. (Psychology))--North-West University, Vaal Triangle Campus, 2011

The South African society is characterised by high levels of risk factors which can have a significantly negative impact on the development of children. The impact of risk factors from an early age can hinder intellectual and emotional growth during the critical stage (middle childhood) of development. Middle childhood can be described as the relatively tranquil period during which patterns and routines are embedded and cognitive-, social-, emotional- and self-conceptualisation are formed. Children are daily exposed to risks and stressful events that can lead to negative outcomes. The impact of risks and adversity sets challenges for the child that test his/her coping abilities and perseverance within a given period and situation. The idea behind resilience is to accept these challenges through utilising protective factors and decreasing the effects of risk factors. The Children’s Coping Strategies Checklist of Ayers and Sandler (1999) was used to assess resilience and The Resilience and Youth Development Module (RYDM) of WestEd (1999 & 2002) to measure participants’ perceptions of the school, home, environment and peer group as external protective domains as well as participants ability in seven psychosocial internal assets and their experience of certain risk factors. A biographical questionnaire was used to gather demographic information of the learners. The findings indicated positive coping abilities (resilience), protective perceptions of external and internal assets and low levels of risk experience (resilience) in the majority of participants. Significant differences were found between boys and girls and between the age groups 10 and 13 years. Theoretically, these findings indicate resilience in the majority of this group of learners who reside in a socio-economically deprived milieu characterised by risk factors. / Thesis (M.A. (Psychology))--North-West University, Vaal Triangle Campus, 2011

Purpose: When the prevalence of physical teen dating violence (TDV) victimization is examined at the state level, significant variation exists; the prevalence ranges from 7.4% in Oklahoma and Vermont to 17.8% in Louisiana. Using U.S. states as the unit of analysis, this study sought to determine whether gender inequality is a societal level risk factor for TDV victimization. Method: Data measuring physical TDV victimization were obtained from the 2009 YRBS. To measure the level of gender inequality in each state, the Gender Inequality Index (GII) was calculated using the procedure described in the United Nations’ Human Development Report. Pearson’s correlation coefficients were calculated to determine the association between TDV victimization, the GII, and the indicators of the GII. Results: Of the 40 states included in analyses, the GII was significantly associated with the state prevalence of both total TDV victimization (r=.323, p=.042) and female TDV victimization (r=.353, p=.026). Subsequent to removal of the outlying case of Oklahoma, the GII was also significantly associated with male TDV victimization (r=.366, p=.022). Several individual GII indicators were significantly associated with TDV victimization after removing the outlying case. Ordinary least squares regression was used to create a model for TDV victimization and gender inequality. Conclusion: This is the first study to examine societal level gender inequality as a risk factor for state level TDV victimization using nationally representative data on school youth. As policy-makers implement TDV prevention policy at the state level, further research understanding potential macro-level risk factors is particularly important.

The aim of my work was to identify additional genetic and non-genetic factors influencing female reproductive ageing in humans. Although approximately 50% of population variation in age at menopause is due to genetics, less than 3% of variation had been accounted for by common genetic variants. Of non-genetic risk factors, only smoking had consistently been found to have a strong effect on age of menopause. In the wider context of female reproduction, our understanding of the role of genetics in determining sex hormone levels was limited. By combining the results of research in these different areas, I hoped to improve our knowledge of the biology of female reproductive ageing. Chapter 1 is an introduction in which I discuss the biology of menopause, describe relationships with health and present current knowledge regarding non-genetic and genetic risk factors influencing menopause age. Chapter 2 is an analysis of the associations between non-genetic risk factors occurring in early life with early menopause. We identified an association between multiple births and early menopause, connecting events pre-birth, when the oocyte pool is formed, with reproductive ageing in later life. Chapter 3 is a genome-wide association study to identify genetic variants associated with levels of nine sex hormone related phenotypes. We highlighted loci of relevance to reproductive function, which suggested overlaps in the genetic basis of hormone regulation. Chapter 4 is a genome-wide association study of menstrual cycle length. We showed that a common genetic variant related to follicle stimulating hormone levels and age at menopause is associated with several reproductive traits including length of menstrual cycle. Chapter 5 is an investigation of the relationship between differences in length of normal FMR1 triplet repeat alleles and timing of menopause. We found no association between the length of normal FMR1 alleles and timing of menopause, contradicting the results of smaller studies and replicating a null result in another large study. Chapter 6 is large genome-wide meta-analysis to identify common and low-frequency genetic variants associated with age at menopause. We identified 44 regions containing 54 independent common signals and two rare missense alleles of large effect. Finally, in Chapter 7 I evaluate how this work has benefitted our knowledge of female reproductive ageing and describe directions for future research.

No description available.