Introduction: According to the World Health Organization (WHO), tooth decay has a prevalence of 60-90 % worldwide. It is a disease of multifactorial origin and deteriorates the quality of life of human beings. In addition to its four etiologic factors, risk factors that boost the risk of the individual to the disease. Objectives: To determine the association of the presence of dental caries risk factors in children 6 years to 11 years 11 months seen at the Teaching Hospital of the Universidad Peruana de Ciencias Aplicadas. Materials and Methods: The study design is observational, descriptive, cross-sectional and retrospective. The sample was random and consisted of 382 children between 6 years to 11 years 11 months seen in the period March 2011 to February 2013 at the Teaching Hospital of the UPC. For measurement of dental caries and the Oral Hygiene Index (IHO), odontogram and simplified soft debris index was used respectively. Other variables (gender, age, use of extrinsic sugars, complaint, presence and frequency of toothbrushing) were obtained through medical records found in the data base SMILE. Statistical analysis was used the chi -square test. Results: The prevalence of caries of 82.14 % and a statistically significant association in the relationship of this disease with oral hygiene index was found. Also, no associations between the presence of cavities with variables gender, age, extrinsic sugars intake, complaint, presence and frequency of toothbrushing were found. Conclusions: There is a high prevalence of dental caries as various studies and will refer only statistically significant association was found with a variable (IHO). Is recommended for these various studies can be compared. / Según la Organización Mundial de la Salud (OMS), la caries dental tiene una prevalencia del 60-90% a nivel mundial. Es una enfermedad de origen multifactorial y deteriora la calidad de vida del ser humano. Tiene cuatro componentes etiológicos y factores de riesgo que potencian el riesgo del individuo a tenerla. Objetivos: Determinar la asociación de la presencia de caries dental con sus factores de riesgo en niños de 6 años a 11 años 11 meses atendidos en la Clínica Docente de la Universidad Peruana de Ciencias Aplicadas (UPC). Materiales y Métodos: El diseño del estudio fue de observacional, descriptivo, transversal y retrospectivo. La muestra fue aleatoria y estuvo constituida por 382 niños entre los 6 años hasta los 11 años 11 meses atendidos en el periodo de Marzo del 2011 a Febrero del 2013 en la UPC. Para la medición de caries dental e índice de higiene oral (IHO) se utilizó el odontograma y el índice simplificado de Greene y Vermillion respectivamente. Las demás variables (género, edad, golpes de azúcar, motivo de consulta, presencia y frecuencia de cepillado dental) fueron obtenidas a través de las historias clínicas provenientes de la base de datos SMILE. Para el análisis estadístico fue utilizada la prueba de Chi-cuadrado. Resultados: Se encontró una prevalencia de caries del 82.14% y una asociación estadísticamente significativa en la relación de esta enfermedad con el índice de higiene oral. Asimismo, no se hallaron asociaciones entre la presencia de caries con las variables género, edad, golpes de azúcar, motivo de consulta, presencia y frecuencia de cepillado dental. Conclusiones: Existe una alta prevalencia de caries tal como lo refieren diversos estudios y una asociación estadísticamente significativa con una variable (IHO). Se recomienda realizar diversos estudios para que estos puedan ser comparados. / Tesis

Title: Analysis of fatal accidents in the Czech Republic during scuba diving from 1997 to present Objectives: The aim of the thesis is to collect and analyze information about fatal accidents in scuba diving, which took place since 1997 to the present on the territory of the Czech Republic, to highlight their possible causes and common denominators. Another aim is to point out causal connection of factors leading to the deaths of divers through case studies of a few selected accidents. Methods: To meet the objectives of the work was used both quantitative and qualitative approach. In the quantitative part of the work were used data collections and analysis of information about the investigated accidents. In the next part of the thesis were used qualitative analysis of selected expert opinions received from expert in the field of diving. Results: The most frequent disabling injury in observed cases is a barotrauma and the most frequent cause of death is a suffocation caused by drowning . An important discovery is frequent neglecting of safety policy and overrating self capability in connection with the level of competence and experience. Keywords: diving, fatal accidents, risk factors

This follows an earlier study of the same data set, which, through its findings, presented new questions that are investigated in this study. Both studies used a prospective controlled design, wherein women receiving genetic counseling for breast cancer risk were randomized into two groups. Subjects receiving an audiotaped recording of their genetic consultation (tape group) were compared to subjects who also had a genetic consultation but did not receive an audiotaped recording of it (no-tape group). Participants were drawn from attendees at the genetic clinics of two London hospitals and included 115 women with a family history of breast cancer. Cancer worry and psychological distress were assessed before genetic consultation (baseline), and at one- and six-month follow-ups by post. Objective risk was estimated by the geneticist during the consultation, and subjective risk was assessed at one month follow-up. The goals of the current study were to investigate relationships between cancer worry, psychological distress, and recall of genetic risk for breast cancer in a sample of women receiving genetic counseling for breast cancer risk, and to investigate the role sociodemographic variables on cancer worry, psychological distress, or risk recall for these women. Results for this sample of women with a family history of breast cancer found that there were consistent relationships between cancer worry, psychological distress, objective risk, and subjective risk before and after genetic consultation. This suggests that women=s psychological responses are appropriate to their level of cancer risk. There were no differences found between the tape and no-tape groups for objective or subjective risk, or for nearness of recall accuracy or degree of under-/over-estimation. Provision of an audiotaped recording of the genetic consultation did not appear to enhance recall of risk information. The role of sociodemographic variables on the psychological and risk variables assessed in this study was very minor. Age was mildly correlated with cancer worry, and employment was predictive of cancer worry only at baseline.

Diarrheal diseases are a leading cause of childhood morbidity and mortality globally and in East Africa. Determining diarrheal disease risk factors and their strength of association to diarrheal disease in this region is necessary to identify and prioritize future research questions and interventions. Demographic and Health Surveys (DHS) Program Data on child health in Burundi, Rwanda, and Tanzania from 2010 were used and simple and multiple logistic regressions were completed to determine factors that predicted diarrheal disease. Diarrhea that occurred in the two weeks prior to data collection was reported for 24.80% of Burundian, 13.1% of Rwandan, and 13.91% of Tanzanian children under five. In Burundian children, increased risk of diarrhea was associated with unimproved sanitation, young mothers, and the mother’s education level (secondary school or less). In Rwandan children, increased risk of diarrhea was associated with more than 30-minute travel time to water source, rainy season, young mothers, mother’s lack of education, and low wealth index. In Tanzanian children, increased risk of diarrhea was associated with rainy season and young mothers. The impact of improved water source and sanitation facility on diarrheal disease is not consistent across the literature or results of this study. Future research should include information on hygiene practices, type of water storage container and types of household water treatment. Further, pathogen specific research, such as molecular fingerprinting, would assist to link the source to the disease. These additions would provide a more comprehensive understanding of risk factors for and sources of diarrheal disease globally and in East Africa.

BACKGROUND: One of the most common long-term problems after bariatric surgery is weight regain, occurring between 18 and 24 months after surgery in 30% of patients.1 Weight regain after bariatric surgery supports the concept that obesity is a chronic, progressive disease that needs constant follow-up.2 To ensure long-term post-operative success, patients are recommended to adopt comprehensive lifestyle changes, which include adhering to a diet of at least 60-120 g/day of protein and engaging in mild exercise 20 min/day 3-4 days/week.3–7 Based on the current literature there is growing evidence that patients' health behaviors, including physical activity and protein intake, may play a significant role in weight loss and other postoperative outcomes.8–11 However, there is little long-term evidence for behaviors important for sustained weight loss following bariatric surgery. OBJECTIVE: The purpose of our research initiative was to determine whether protein intake and physical activity have an effect on maintaining weight loss in patients who underwent bariatric surgery 1-2 years earlier. METHODS: Our study included 368 patients who underwent bariatric surgery at Boston Medical Center from 06/01/2016-05/31/2017. We extracted baseline clinical data from electronic medical records (EMR), including gender, self-identified race, weight, height, date of birth, date of enrollment in the bariatric surgery program, and surgery date. We also collected self-reported physical activity (calculated as active metabolic equivalent [MET]-hours) and 24-hour dietary recall information from patients who had this data available in their EMR at least 1-year post surgery (n=121, 80.2% female), and assessed weight status through 06/01/2019. We conducted a retrospective analysis to observe the association of lifestyle factors with weight maintenance post-bariatric surgery. Prevalence and odds ratio (OR) were calculated for % weight regain (<2% vs. ≥2%) by active MET-hours & percent protein in diet, with adjustment for age, gender, race, and time to nadir weight. We ran additional analysis to test the combined effect of physical activity and high protein diet by comparing percent weight regain in those consuming a low protein diet (with any activity level) to those consuming moderate-high protein & lower active METS-hour vs. moderate-high protein & higher active METS-hour. RESULTS: Our study implemented two novel ways to examine physical activity and dietary recalls in the context of bariatric surgery patients, and how they influenced percent weight regain of nadir weight. Our results show that patients had an average of 84.4 pounds of weight loss at 1-year post operation, the average nadir weight was 179.0 pounds. However, many participants experienced weight regain after achieving their nadir weight. In fact, the average weight regain was 5.8 pounds. Patients who had active MET-hours <1.5 (n=78) had an average of 5.77 pounds regained after reaching nadir weight, compared to patients who had an active MET-hour ≥1.5 (n=43) who had an average of 5.89 pounds regained. But after adjusting for age, gender, and race, those who were less active (active MET-hours <1.5) did not have significantly higher odds of gaining more that 2% of their nadir weight back during out follow-up period (OR = 0.71 [CI 0.32-1.60]). Protein intake was defined as either a low protein intake (<26.7% protein of total diet) or moderate-high protein intake (≥26.7% protein of total diet). A patient consuming a low protein diet had 2.71 (CI 1.16 – 5.29) times the odds gaining ≥ 2% of their weight back from nadir compared to patients who consumed a moderate-high protein diet, after adjusting for age, sex, and race (p-value <0.05). After adjustments, those with moderate-high protein and low activity had 1.84 (CI 0.69-4.94) times the odds of ≥2% weight regain of nadir weight compared to patients who were moderate-high protein and higher activity, which, although not statistically significant, may be an important relationship to explore further. CONCLUSION: The findings indicate that consuming a moderate-high protein diet while engaging in physical activity tend to gain less weight after bariatric surgery in comparison to consuming less protein. There is also some evidence that those achieving moderate-high protein levels see an added benefit on weight maintenance if they are physically active. Future prospective longitudinal studies and strategies are needed to investigate implications further and define the magnitude of the association between protein intake, physical activity and bariatric surgery, as well as targeting various demographic subpopulations who might stand to benefit more from certain lifestyle interventions post-bariatric surgery.

Thesis (MPH.) -- University of Limpopo, 2020 / The purpose of this study was to determine the prevalence of gestational diabetes mellitus (GDM) and the associated risk factors in the Greater Giyani Area, Mopani District. Quantitative cross-sectional descriptive study was conducted to determine the prevalence rate and risk factors of GDM. Data was collected using questionnaire and data entry form. One hundred and one (101) pregnant women who were attending antenatal clinic visits at Nkhensani Hospital, Nkhensani Gateway Clinic and Giyani Healthcare Centre participated in the study. The SPSS programme was used and p-value of <0.05 was considered significant. The study found that the prevalence of GDM in the area was 1.9%. Pregnant women above 30 years with secondary education, employed, obese and at gestational age of 31-35 weeks were more likely to present with GDM. A family history of diabetes was significantly associated with development of GDM. In conclusion, the universal screening approach for GDM needs to be adopted by all health institutions.

Percutaneous endoscopic gastrostomy (PEG) is currently a popular method of administering enteral feeding. Most of these patients are elderly, debilitated, and chronically ill. They are on a number of medications and have multiple diseases. With impaired consciousness and swallowing disability, these patients are prone to develop pneumonia. In order to identify possible risk factors, we followed 24 men who underwent PEG for the occurrence of pneumonia or until they died. We then analyzed the medical records of these patients for potential risk factors for pneumonia. The presence of esophagitis during PEG placement endoscopy and history of pneumonia prior to PEG were significant risk factors. Advanced age and cerebrovascular accident (CVA) tended to indicate a higher risk of pneumonia. Taking these risk factors into consideration may be beneficial in the management of such patients.

We investigated the association of Bell's palsy (BP) with the subsequent risk of Parkinson's disease (PD) using a case-control study design. We matched 196 incident cases of PD in Olmsted County, MN, to 196 general population controls with same age (±1 year) and sex, and we reviewed the complete medical records of cases and controls in a medical records-linkage system to detect BP. Six of the 196 patients with PD and none of the 196 controls were diagnosed with BP before PD (exact binomial probability, P = 0.02). The median age at occurrence of BP was 49.5 years (range, 15-84 years) and the median time between BP and the onset of PD was 27.5 years (range, 2-54 years). The findings were similar using a standardized incidence ratio (SIR) approach, but were not statistically significant. This initial association between BP and PD awaits replication.

Introduction: Adolescents with substance abuse is a comprehensive subject area within social work, this group of adolescents are a vulnerable group with widely different needs and conditions. The substance abuse amongst adolescents can cause serious consequences in the shape of mental illness, failures at school and/or social problems. Mental illness, failures at school and difficulties during childhood such as family and relationship problems are the most central risk factors for young people to develop an addiction. Aim: The purpose of this study is to analyze why young people in Sweden develop an addiction and what the consequences the addiction might lead to. Method: This is a literature study that includes various scientific articles that concern the subject area of young people with substance abuse. Results: The results show that there is no single variable that causes an adolescent to develop substance abuse, but that the combination of different factors can affect the development of the problem. The three key variables for development of substance abuse are family problems, school problems and mental illness. These three variables prove to be not only risk factors for developing a substance abuse but are also consequences of the substance abuse itself. Conclusion: In summary, it is the combination of different risk factors that leads to an adolescent developing a substance abuse and that these complex risk factors also are consequences of the problem itself.

The number one killer of women in the United States is cardiovascular disease (CVD). Cardiovascular risk factors (CVRFs) include advancing age, cigarette smoking, diabetes, dyslipidemia, family history, hypertension, obesity, sedentary lifestyle and high intake of saturated fats and low dietary fiber. A women’s risk for development of CVD dramatically increases after menopause and with the number of CVRFs. CVD is often preventable. Evidence supports addressing CVRFs reduction early (in the pre-menopausal years) through heart-healthy behaviors such as increasing physical activity, promoting healthy eating, moderate alcohol consumption and not smoking. Therefore, understanding premenopausal women’s CVRFs knowledge is an important area of inquiry. In addition, the Nemcek Wellness Model suggests that self-nurturance, as well as knowledge, may be an important factor for explaining women’s wellness behaviors. Thus, the purpose of this study was to investigate knowledge of CVRFs, level of self-nurturance and the performance of heart-healthy behaviors in women ages 35 to 55 years. This study used a cross sectional survey design and venue sampling. The survey included demographic questions, the Self Nurturance Survey, the Heart Disease Facts Questionnaire, the Physical Activity Questionnaire, Prime Screen, and questions about financial strain, cigarette smoking, and alcohol use. The sample included 136 women (survey response rate = 57%), the majority of whom were white (94.9%), married (80.1%), did not smoke (80.1%) and rarely drank alcohol (57.4%). Results indicated that study participants were very knowledgeable about CVRFs. (Mean knowledge score = 19.53, possible range = 0 to 25 with higher scores indicating greater knowledge). Knowledge did not predict physical activity (p = .07), diet (p = .08) or smoking status (p = .11) in this sample. Self-nurturance was moderately correlated (r = .33) with consuming a heart-healthy diet. Hypotheses derived from the Nemcek Wellness Model were not supported in this study. More research is needed to identify factors that will help women translate knowledge into heart-healthy behaviors.