published_or_final_version / Gerontology / Master / Master of Social Sciences

Bakgrund: Trycksår är idag en vanligt förekommande vårdskada. Få studier har gjorts gällande trycksår i samband med buklägeskirurgi. Syfte: Syftet var att undersöka trycksårsprevalensen bland patienter som genomgått kirurgi i bukläge och identifiera möjliga riskfaktorer för trycksår. Metod: En prospektiv deskriptiv studie med kvantitativ design. Datainsamlingen utfördes på neurokirurgiska och ortopediska kliniken under nio veckor, vid ett stort sjukhus i mellansverige. Hudobservationer och journalgranskning skedde på totalt 29 patienter. Frågeställningarna besvarades med deskriptiv statistik och analyserades med Mann Whitney U test och Chi2. Resultat: Var tredje patient som genomgått buklägeskirurgi utvecklade trycksår. Den totala trycksårsprevalensen var 34 procent, antalet trycksår per patient varierade mellan ett till sex stycken. Trycksåren varierade mellan kategori ett och två enligt EPUAPs klassiferingssystem. Det mest utsatta området var ansiktet (51 %). Identifierade riskfaktorer var högt BMI, den postoperativa kroppstemperaturen, ålder och operationens längd. Slutsats: Patienter som genomgår kirurgi i bukläge har en ökad risk att utveckla trycksår. Fortsatt kvalitetsarbete behövs för att motverka vårdskador, patientlidande, ökade vårdtider och kostnader för denna grupp patienter. För vidare utveckling inom området behövs fler och större studier. / Background: Pressure ulcer is today a frequent occuring problem in health care.  There are few studies done regarding the incidence of pressure ulcers after surgery in prone position. Aim: The aim was to investigate the prevalense of pressure ulcer among patients who have been operated upon in prone position, and to identify possible risk factors for pressure ulcer among these patients. Method: A prospective study with quantitative design was chosen. The data was collected during nine weeks at a Neurosurgical and Orthopedic ward. Skin observations and reviewing medical records were conducted for a total of 29 patients. The research questions were answered by descriptive statistics and the data was analyzed using a Mann Whitney U test and Chi2. Results: One out of three patients developed pressure ulcers after surgery in prone position. The prevalence of identified pressure ulcers in the study was 34 percent, the number of pressure ulcers per patient varied between one and six. The ulcers were classified according to EPUAPs classification and the identified ulcers were assigned class one and two. The most vulnerable part was the face (51%). Identified risk-factors are high BMI, body temperature post operatively, patients’ age and duration of surgical procedure. Conclusion: Patients undergoing surgery in prone position are more likely to develop postoperative pressure ulcers. Further preventive measures to avoid health care associated adverse events are necessary in order to reduce unnecessary patient suffering, increasing hospitalization and costs for this group of patients. For further progress in this field more extensive studies are needed

All-terrain vehicles (ATVs) were first developed and marketed in the U.S. in the 1970s. They have soared in popularity for occupational and recreational uses since that time. In 2008, there were approximately 10.2 million all-terrain vehicles (ATVs) in use in the United States. In 2001, it was estimated that 23 million Americans rode ATVs; 69% were adults and 31% children (CPSC, 2003). Deaths and injuries from ATVs have increased over time. According to the U.S. Consumer Product Safety Commission, Kentucky led the nation for ATV deaths from 2002-2006, with increasing numbers of fatalities annually. ATV use on farms is increasing across the country because the vehicles provide an efficient and reliable replacement for horses and tractors for farm work, such as checking livestock, feeding, or fence repair. Aging farmers and farmers with physical disabilities can often increase their productivity by using ATVs for their transportation needs on the farm. ATVs also serve as an inexpensive and popular recreational vehicle used by families especially in rural areas. In 2001, there were an estimated 481 ATVs per 1,000 (CI95% ± 27) farms in the southern region of the U.S. A literature review and a descriptive cross-sectional study were conducted. The specific aims of this dissertation were to: 1. Critically analyze the state of the science on ATV-related injury risk factors and explore recreational and occupational use of ATVs on farms. 2. Describe individual characteristics and demographic factors that are associated with ATV ownership and ridership among adult farmers. 3. Describe individual characteristics and environmental factors that are associated with ATV injury on farms. 4. Test models for predicting ATV ownership, ATV ridership, and ATV injury risk factors among adult farmers.

This study uses latent class analysis and latent transition analysis to model and compare patterns of offending over time for males and females by: (1) identifying qualitative dimensions of offending; (2) modeling how patterns of offending change over time; and (3) exploring factors related to patterns of offending. This is a secondary analysis of data from the Edinburgh Study of Youth Transition and Crime, a longitudinal study consisting of a cohort of about 4,000 young people from secondary schools in the City of Edinburgh who responded to questionnaires administered between 1988 and 2001, when they were about 12, 13, 14, and 15 years old. Previous studies of offending have used trajectory modeling to explore the course of offending from onset to termination, but the models are generally based on a count of types of offences aggregated across individuals over time, making it difficult to determine whether individuals exhibit more versatility or specialization in offending or switch offences from one point in time to another. In addition, most of the studies on patterns of offending have focused primarily on males. An understanding of patterns of offending over time for both males and females is important for the design and selection of developmentally appropriate prevention/treatment strategies. The present study adds to the literature by (1) further exploring the small and understudied literature on offence transitions; (2) examining more closely the development of female offending separately from and in relation to male offending; and (3) exploring a range of factors (criminogenic and non-criminogenic) related to the development of offending for both males and females. While the same number of qualitative dimensions (latent classes) characterised male and female offending in this study, there were some structural differences. There was also evidence of shifts in the qualitative dimensions for males and females over time. Finally, those factors classified as criminogenic were more likely to differentiate among the latent classes than those classified as non-criminogenic.

<p>Curricula should be strengthened by teaching the curability of STIs and the importance of STI treatment to prevent HIV transmission. This study focused on the control of sexually transmitted infections as a key HIV prevention strategy. Sexually transmitted infections act as a strong cofactor in the sexual transmission of HIV. Effective STI management can limit the spread of HIV.</p>

Tyrimo tikslas – aprašyti bendruosius virusinių hepatitų, ŽIV ir kitų lytiškai plintančių infekcijų dėsningumus ir įvertinti HAV, HBV, HCV infekcijos paplitimą neatlygintinų kraujo donorų, duodančių pirmą kartą kraują, populiacijoje. Metodika. Tyrimui vykdyti gautas Vilniaus regioninio biomedicininių tyrimų etikos komiteto leidimas. Atlikta pirmą kartą neatlygintinai duodančių kraujo donorų anoniminė anketinė apklausa VŠĮ Nacionaliniame kraujo centre. Imunofermentiniu metodu buvo nustatomi: anti-HAV ir anti-HCV, anti-HBcor, anti-HBs, HBsAg. Nukleino rūgščių amplifikacijos testas taikytas HBV DNR ir HCV RNR nustatymui. Įvertinant ŽIV ir kitų lytiškai plintančių infekcijų ir virusinių hepatitų tendencijas buvo taikytas Mantel‘io testas ir paprastoji tiesinė regresija. Virusinių hepatitų serologinių žymenų paplitimas išreiškiamas procentais, įverčio tikslumui įvertinti apskaičiuotas pasikliautinis intervalas (PI) 95%, kategorinių duomenų analizei panaudotas &#967;² testas ir Fišerio tikslusis testas. Rizikos veiksnių įtaką vertinta taikant binarinę logistinę regresiją. Duomenų suderinamumui vertinti pasirinktas Hosmer‘io-Lemeshow‘o &#967;2 suderinamumo kriterijus. Vertinant, kaip modelio teoriniai dydžiai atitinka realiuosius, naudotas Cox’o ir Snell’o kriterijus, klasifikacinė analizuojamų požymių lentelė. Veiksnių įtaka įvertinta panaudojant šansų santykį su 95 % PI. Skirtumas statistiškai reikšmingas, kai p &#8804; 0,05. Rezultatai. Tyrime dalyvavo 200 kraujo donorų. Analizei... [toliau žr. visą tekstą] / Aim: to describe epidemiology of the viral hepatitis A, B, C, HIV and other sexually transmitted infections (STD) and to estimate prevalence of HAV, HBV, HCV infections among first time non-remunerated blood donors population. Methodology: The study received approval from Vilnius Regional Biomedical Research Ethics Committee. First time non-remunerated blood donors participated in anonymous questionnaire survey in NGO National Blood Center. For anti-HAV, anti-HCV, anti-HBs, anti-Hbcor and HBsAg detection was used immunoenzyme method and for HBV DNR ir HCV RNR - nucleic acid amplification test. The Mantel trend test and linear regression method was used to evaluate the trend of viral hepatitis, HIV and other sexually transmitted infections. The prevalence of viral hepatitis serological markers was expressed in percentage points, the precision was evaluated at the confidence intervals (CI) of 95%, the comparison of categorical data was made using &#967;2 test and Fisher‘s exact test. For data analysis the following tests were used: for the risk factors – binary logistic regression; goodness of fit – Hosmer-Lemeshow &#967;2 test; Cox and Snell R Square, Classification Table. The statistical significance level p &#8804; 0.05. Results: A total of 200 respondents haven been interviewed. Only 188 first time non-remunerated blood donors were selected for further analysis. Respondents minimum of age was 18 and maximum - 52 (Mean=22,6; Med=20,0), 47,9 % (n=90) of them were males, 52,1... [to full text]

Bakgrund: Att arbeta i en miljö där hälsofarlig rök och risk för smitta förekommer innebär en risk för operationssjuksköterskans hälsa. På universitetssjukhuset finns riktlinjer om när mun- och andningsskydd ska användas. Syfte: Att undersöka om operationssjuksköterskorna på universitetssjukhuset har fullgoda kunskaper om sjukhusets riktlinjer angående mun- och andningsskydd. Att undersöka förutsättningarna för operationssjuksköterskorna att kunna följa riktlinjerna, deras upplevelse av riktlinjernas tillgänglighet samt vilka faktorer som avgör operationssjuksköterskornas val av mun- och andningsskydd. Metod: Studien är en deskriptiv enkätstudie med tvärsnittsdesign och kvantitativ ansats. Enkäter delades ut till operationssjuksköterskor på universitetssjukhuset vilka är verksamma på operationssal. För att bli godkänd i sin kunskap krävdes att respondenten hade 100 % rätta svar på kunskapsfrågorna. Data från enkäterna hanterades deskriptivt och analyserades med Mann Whitney u-test och Chi-två-test. Resultat: Hos 62 % fanns inte fullständiga kunskaper om universitetssjukhuset riktlinjer angående mun- och andningsskydd. Vidare upplevde 60 % att riktlinjerna inte är lättillgängliga. Resultatet visade att 24 % ansåg sig alltid kunna följa riktlinjerna. Slutsats: Resultatet visar att kunskapen gällande riktlinjerna är ofullständig vilket innebär att en stor del av operationssjuksköterskorna i studien riskerar sin hälsa i sitt arbete. För att operationssjuksköterskorna ska kunna uppdatera sina kunskaper bör universitetssjukhuset utforma tydligare riktlinjer angående mun- och andningsskydd i ett samlat dokument. / Background: OR nurses work in a place where there is hazardous smoke and contagion. This represents a risk to their health. The teaching hospital has guidelines for when to use facial protective devices. Aim: To see if the OR nurses at the teaching hospital have complete knowledge about the hospital guidelines regarding facial protective devices, and to study the OR nurses’ ability to follow the guidelines. The study will also determine the nurses’ perception of the availability of the guidelines and which factors determine the OR nurses’ choice of facial protective devices. Method: This is a descriptive questionnaire study with a cross-sectional design and a quantitative approach. The questionnaires were distributed to OR nurses who work in the operating room. In order to pass the test about the guidelines the respondent had to get 100 % correct answers. Data from the questionnaire were described and analyzed using Mann Whitney U test and Chi-square test. Result: Of the OR nurses, 62 % were lacking complete knowledge about the guidelines regarding facial protective devices. Furthermore, 60 % perceived the guidelines as not easily accessible. The result showed that 24 % always considered themselves to be able to follow the guidelines. Conclusion: The result shows a lack of knowledge regarding the guidelines. This means that a big part of the OR nurses in this study risk their health at work. To enable the OR nurses to update their knowledge, the teaching hospital should develop clearer guidelines on facial protective devices in one single document.

The health and mental health status of rural populations has often been neglected as a research priority; particularly in the case of rural youth. The purpose of this study is to examine the differences in depressed mood and suicide ideation of urban and rural youth and to determine what factors are associated with depressed mood and suicide ideation. More specifically, this study will examine depressed mood and suicide ideation of urban and rural youth (grades 5 to 8) in the Saskatoon Health Region (SHR) using data from the Student Health Survey. This project involved secondary data analysis of SHR’s Student Health Survey. There were 5,783 grade 5-8 students that participated in the survey. The final logistic regression models revealed similarities and differences between urban and rural youth in the risk factors that predicted the likelihood of students reporting symptoms of depressed mood and suicide ideation. For depressed mood, both urban and rural youth reported their relationship with their parents, their general mental health, low self-esteem, and suicide ideation as risk factors for depressed mood. Gender, age, having been drunk, and feeling like an outsider at school were risk factors for depressed mood in urban youth, while rural students reported that their living situation, their perception of their weight, being physically bullied, and being electronically bullied increased their likelihood of reporting symptoms of depressed mood. In terms of suicide ideation, both urban and rural youth were more likely to report depressed mood and a poor relationship with their parents as risk factors. Urban youth also reported being Aboriginal, that they had tried smoking, and being victims of physical bullying as risk factors. No additional risk factors were found for rural youth. This data will help to address local and national gaps in the literature about the mental health status of youth in rural populations. This research may inform policies and programming in both the health and education sectors.

Motivation: Cardiovascular disease (CVD) is one of the leading causes of mortality and morbidity in South Africa and worldwide. Various investigations have confirmed the hypothesis that elevated plasma homocysteine (Hcy) levels may be linked to vascular disease, and it has become clear that hyperhomocysteinemia is an independent risk factor for atherosclerosis and atherothrombosis. Extensive research on the influence of vitamin supplementation leading to the lowering of homocysteine levels has been done, but extensive research on the effect of physical activity on high homocysteine levels is lacking. The interaction of vitamin supplementation in combination with physical activity has also not been investigated. If a conditioning exercise programme can demonstrate a lowering effect on elevated homocysteine levels, it will confirm the importance of physical activity as a less expensive alternative for a better lifestyle that can also continue to lower morbidity and mortality rates. Objective: This study examined the effect of a conditioning program, vitamin supplement and a combination of both on Hcy levels in men with coronary heart disease risk factors. Methods: In a randomized, placebo-controlled, blinded crossover study, 84 men matched for physical activity (PA) levels, age and risk factors were randomly assigned to one of 4 groups [A = physical conditioning, 20-30 min; 70-80% (THR), 8 = physical conditioning + supplement, C = supplement (12,5 ug vitamin 812; 200 ug folic acid) or D = control). Groups A, B, and C were crossed over according to the Latin square design. Total plasma homocysteine, maximal oxygen consumption (V02max) and body composition (BMI & Fat %) were measured before and after each 12-week intervention period. A 6-week washout period separated the crossovers. Results: The experimental and control groups presented similar baseline characteristics and the profile analysis of the V02max values and Hcy concentrations indicated positive results (multivariate p-value <0.0001), due to the fact that the four groups repeated measurements, presented different patterns. A phase effect for the V02max values and a phase and interaction effect for the Hcy concentrations were indicated, though all the subjects were requested to maintain their normal daily routine (eating pattern, PA levels and alcohol consumption) for the duration of the study. The lack of compliance to the conditioning programme makes it impossible to draw conclusions for V02max values. The poor compliance lead to a small sample size that eventually leads to less statistical power. Conclusion: This study found that a 12-week conditioning programme had no effect on Hcy concentrations. The results of this study make it impossible, due to poor compliance, to suggest that the effect of increased PA on homocysteine may play an important role in the prevention and treatment of CVD. It is, therefore, recommended that more studies should be conducted to further investigate the effect of PA and vitamin supplements on tHcy levels. / Thesis (M.Sc. (Human Movement Science))--North-West University, Potchefstroom Campus, 2006.

Prediction for future coronary artery disease (CAD) from high-density lipoprotein (HDL) and triglyceride (TG) measurements are based off of a single measurement that has been shown to be variable. To better determine risk for CAD based on blood lipids, studies in the postprandial state are warranted. To assess the reproducibility of TG clearance, 10 men underwent three trials of a 70g oral fat loading test with blood samples collected every two hours for eight hours. These trials were all scheduled at least one week apart. Men who had fasting TG concentrations > 250 mg - dL -' were excluded from the study. Each subject presented to the laboratory having abstained from exercise for 24 hours and alcohol 72 hours prior to the upcoming trial. Each subject was also provided with a standardized frozen dinner to eat the night before at a time which allowed the subject to be 12 hours fasted for the next days' trial. To specifically assess postprandial lipemia, TG concentrations were plotted against bi-hourly collection times to form a curve. The area under this curve was then calculated to determine PPL area. Itwas found that there was no significant difference in area under the TG curve (p = 0.25) for any of the three trials (1096 ± 168, 948 ± 105, and 995 ± 127 mg - dL -' - 8 • hr-' respectively for trials one, two, and three). Pearson correlations between trials were 0.79 for trials one and two, 0.82 for trials two and three, and 0.90 for trials one and three. Also, there was no significant difference in peak TG (p = 0.34) on each of the three trial days (167 ± 27, 150 ± 16, and 151 ± 19 mg • dL -1 in peak TG for trials one, two, and three respectively). Time taken to reach peak TG concentrations (p = 0.20) or time to return to baseline TG (p = 0.27) were not significantly different across three trial days. The men in this study reached peak TG concentrations in this study in 3.2 ± 0.5, 4.0 ± 0.4, 4.0 ± 0.3 hours respectively for trials one, two, and three. Time to return to baseline was 6.8 ± 0.6, 7.4 ± 0.4, 7.8 ± 0.4 hours for trials one through three respectively. Correlations between trials and the lack of a difference between trials using repeated measures ANOVA in regards to PPL area gives some preliminary evidence that some postprandial measures such as PPL area and can be reproduced across trials. However, the intra-individual variation was 19 ± 4% which provides no additional support for reproducibility of PPL. Additionally, results from this study, as well as all others pertaining to the study of reproducibility of PPL are specific to the protocol used and the method of interpretation. / School of Physical Education