Background: Schizophrenia is a chronic, debilitating mental disorder characterized by positive (e.g., hallucinations, delusions) and negative (e.g., catatonia, flat affect) signs and symptoms. Many studies suggest that individuals born in winter or spring months are at increased risk for schizophrenia. Study Objectives: 1) To determine whether season of birth affects risk for schizophrenia in the Irish Study of High Density Schizophrenia Families (ISHDSF). 2) To examine, by computer simulation, power to detect genetic associations with schizophrenia under a variety of conditions and using different analytic strategies. 3) To test whether specific genes are associated with schizophrenia in the Irish Case Control Schizophrenia Study (ICCSS), using different analytic strategies to account for season of birth. Methods: A case-control design was used to examine the relationship between schizophrenia and season of birth. Cases were individuals from the ISHDSF diagnosed with schizophrenia. Controls were the general population of Ireland, with data provided by Ireland’s Central Statistics Office (CSO). The birth frequencies for each month or quarter were compared in the two groups by a chi square test. Computer simulations were conducted to examine power to detect schizophrenia susceptibility loci using either all cases or only cases born in high-risk months, under different conditions and models for how genetic risk and season of birth interact to influence risk for schizophrenia. Data for six genetic markers from the ICCSS were analyzed for evidence of association, using all cases, and then using only cases born in high-risk months. Setting and Study Participants: ISHDSF families were ascertained through inpatient psychiatric care facilities serving >95% of the Irish population. Diagnoses were established using DSM-III-R criteria, and birthdates were recorded for all individuals. The Irish CSO provided aggregate, population-level data for number of births in Ireland by month for the years 1976-2000 and by quarter for the years 1900-2000. The ICCSS is a sample of schizophrenic and control individuals who have been genotyped at many loci across the genome. Schizophrenics were ascertained through in- and outpatient psychiatric facilities, had diagnoses verified by an expert, and their birthdates recorded. Controls were selected from several sources, e.g. blood donation centers, and denied any lifetime history of schizophrenia. For each subject in the ICCSS, all four grandparents were born in Ireland or the United Kingdom. Results: Number of births in each month was compared for schizophrenics in the ISHDSF and general population controls, resulting in a chi square of 19.44 (p value ~ 0.054, 11 df). Simulations revealed that, in some circumstances, power to detect genetic associations was increased by restricting cases to those born in high-risk months. Analysis of data from the ICCSS revealed that restricting cases to high-risk birth months increased the evidence for association for three of six markers tested, two of which were associated with the gene FBXL21. Conclusions: Birth in the months of March, April, or May appears to be associated with elevated risk for schizophrenia in the ISHDSF. In attempting to find susceptibility loci for schizophrenia, restricting genetic association analyses to schizophrenics born in high-risk months may result in increased power to detect genetic association in some circumstances.

Bakgrund: Postpartum depression (PPD) drabbar 12 % av alla nyblivna mammor i Sverige och förekomsten av PPD i världen är 13 till 19%. PPD påminner om depression men med ytterligare symtom så som överdriven ångest och oro för barnet. PPD hos mammor kan ha långtgående negativ inverkan på barnens utveckling och psykiska välmående, vilket gör PPD till en angelägen fråga för Barnhälsovården. Barnhälsovårdsjuksköterskorna har vanligtvis tät och regelbunden kontakt med mammorna den första tiden efter barnets födelse vilket ger dem goda förutsättningar för att i ett tidigt skede identifiera PPD hos nyblivna mammor. Syfte och metod: Syftet med studien var att beskriva riskfaktorer för PPD hos nyblivna mammor. Studien genomfördes som en integrativ litteraturstudie. Resultat: Studien resulterade i fem kategorier: 1) ouppfyllda förväntningar, 2) förändrade levnadsvanor, 3) krav, 4) brist på stöd samt 5) psykosociala omständigheter. Ökad kunskap kring riskfaktorer för PPD ökar chansen att BHV-sjuksköterskorna tar tidiga symtom på PPD på allvar. / Background: Postpartum depression (PPD) affects 12% of all new mothers in Sweden and the prevalence of PPD in the world is 13-19%. PPD is similar to depression but with further symptoms such as excessive anxiety and concern about the child. PPD in mothers may have far-reaching negative impact on children´s development and mental well-being, witch makes PPD to a concern for Child health care. Maternal-and child health nurses (MCH-nurses) usually have close and regular contact with the mothers during the first period after childbirth witch gives them a particularly important role in efforts to find the mothers at increased risk of PPD. Aim and methods: The aim of the study was to describe risk factors for PPD in new mothers. The study was conducted as an integrative litterature review. Results: The study resulted in five categories: 1) unmet expectations, 2) changing lifestyles, 3) demands, 4) lack of suppot, 5) psychosocial circumstances. Increased knowledge about the risk factors for PPD increases the chance that MCH-nurses take early symptoms of PPD seriously.

Title: Characteristics of the active lifestyles of school children Objective: To provide information on the active lifestyle of today's youth, to show proper and improper factors to identify and assess the active lifestyle of selected pupils. Methods: Anonymous questionnaire was chosen as a most suitable method. Questionnaries were distributed into two primary schools located in South Bohemia region and were filled in by second-degree pupils. Town of Tábor and České Budějovice participate in this survey. Results and interpretations are presented in tables and plotted. Results: Surveyed second degree pupils proved themself largely positive attitude to physical education and sport. More than half of respondents are regularly doing sport. Key words: youth, lifestyle, physical activity, nutrition, risk factors

UNIVERZITA KARLOVA V PRAZE Přírodovědecká fakulta Katedra sociální geografie a regionálního rozvoje ANALÝZA CESTOVNÍHO RUCHU V CHUDINSKÝCH ČTVRTÍCH MĚSTA MEDELLÍNU ANALYSIS OF TOURISM IN INFORMAL SETTLEMENTS IN THE CITY OF MEDELLÍN Diplomová práce Josef Jedlička 2016 Vedoucí diplomové práce: RNDr. Jiří Vágner, Ph.D. Analysis of tourism in informal settlements in the city of Medellín Abstract The aim of this thesis is to point out the growing phenomena of tourism in informal settlements. Visiting of such an area elicits discussion about controversy, ethics codex breaking and voyeurism across complete academic spectrum. For this reason, the thesis is focused on perception analysis of tourists, residents and travel agencies, which are the main participants in this touristic sector. First part of this thesis is engaged in general description of problematics, historical framing and classification in the structure of tourism. The next part is revealing attitudes of the world experts in significant regions with a respect to informal settlements excursions intensity. The last part is dedicated to the results of own research from the city of Medellín which is after compared with the global situation. Conclusion points out possible continuing of this study and highlights aspects, which would help to uncover causes so...

Master of Science / Family Studies and Human Services / Farrell J. Webb / Relationship and risk factors of infidelity within intimate and romantic relationships were examined using the Relationship and Risk factors influencing Infidelity Model (RRIM). It is based in part on Sternberg’s (1998) theoretical construct known as the triangular theory of love. Relationship factors included demographics, and relationship, development, strengths, and dynamics. Risk factors included sexual compatibility, and relationship problems. Data gleaned from Wave IV of the National Longitudinal Study of Adolescent Health (Add Health) measured a subsample of approximately 1,000 respondents (n = 939) young adults from 24 to 32 years of age (M = 28.64, SD = 1.79, Mdn = 28.61) and was designed to test the accuracy of the RRIM. Hierarchical logistic regression was used to explicate the relationships found across the elements within the RRIM. The overall results revealed that the RRIM correctly classified that 72.2% of the men and 78.8% of women were not likely to commit infidelity. The final results revealed that the level of commitment, the feeling of love, and the frequency of sex within the relationship were statistically significantly likely to influence infidelity between both men and women. Meanwhile, education and believing that one’s relationship would be permanent were statistically significantly likely to influence infidelity for women, but not for men. Although these results are encouraging, limitations were found within the RRIM and problems generated from using the Add Health must be acknowledged as several measures were not reliable. Future investigations should focus on how role models within young adults immediate and external environment influence their participation in committing infidelity.

Although typical clinical onset does not occur until adulthood, cardiovascular disease (CVD) may have a long natural history with accumulation of risks beginning in early life and continuing through childhood and into adolescence and adulthood. Therefore, it is important to adopt a life-course approach to explore accumulation of risks, as well as identifying age-defined windows of susceptibility, from early life to disease onset. This thesis examines characteristics in adolescence and adulthood linked with subsequent risk of CVD. One area is concerned with physical and psychological characteristics in adolescence, which reflects inherited and acquired elements from childhood, and their association with occurrence and outcome of subsequent stroke and coronary heart disease many years later. The second area focuses on severe infections and subsequent delayed risk of CVD. Data from several Swedish registers were used to provide information on a general population-based cohort of men. Some 284 198 males, born in Sweden from 1952 to 1956 and included in the Swedish Military Conscription Register, form the basis of the study cohort for this thesis. Our results indicate that characteristics already present in adolescence may have an important role in determining long-term cardiovascular health. Stress resilience in adolescence was associated with an increased risk of stroke and CHD, working in part through other CVD factors, in particular physical fitness. Stress resilience, unhealthy BMI and elevated blood pressure in adolescence were also associated with aspects of stroke severity among survivors of a first stroke. We demonstrated an association for severe infections (hospital admission for sepsis and pneumonia) in adulthood with subsequent delayed risk of CVD, independent of risk factors from adolescence. Persistent systemic inflammatory activity which could follow infection, and that might persist long after infections resolve, represents a possible mechanism. Interventions to protect against CVD should begin by adolescence; and there may be a period of heightened susceptibility in the years following severe infection when additional monitoring and interventions for CVD may be of value.

This study is a qualitative interview study consisting of twelve semi-structured interviews, conducted in ten different organizations. The purpose of this thesis is to study and shed light on how systematic workplace health promotion is carried out, with the employee survey as a starting point. During 2016, new regulations came into force, clarifying employers’ increased responsibilities for staff’s workplace health situation. The collected data were thematized and subsequently analyzed with a deductive approach. The results suggest that the systematic work generally starts with a situation analysis, often in the form of an employee survey, but that the studied organizations then proceed in very different ways. Common to those engaged in an active workplace health promotion is that the work is structured in an outer and an inner cycle. In the outer cycle, inventory, planning, monitoring and evaluation occur. In the inner cycle practical work is performed, such as employee surveys, feedback of results, focus areas with desired position and workshops, as well as a work plan which is incorporated in the business plan. These two cycles are connected, but are worked at independently of each other.

Introduction. Sunbeds emit ultraviolet (UV) radiation to produce a cosmetic tan and are classified by the World Health Organization as first-group carcinogens: they have been significantly associated with increased risk of melanoma and non-melanoma skin cancer. Despite this, controversies still exist: since sunbeds are able to increase serum vitamin D, the sunbed industry relentlessly tries to promote them as a safe therapeutic measure; and some authors have recently expressed scepticism about the carcinogenicity of sunbeds. Moreover, differences between European countries in terms of prevalence of use have not been extensively studied and a better understanding of the determinants of use in Europe is much needed. Similarly, the association of sunbed use with skin cancer risk factors is poorly understood. Euromelanoma is a skin cancer prevention campaign conducted all over Europe. It offers a once-a-year screening during which participants’ data, including sunbed use and phenotype, are collected via questionnaires.Objectives. To thoroughly describe prevalence, determinants, and risks associated with sunbed use in Europe. To this aim we performed literature reviews (3 publications) and an extensive analysis of the Euromelanoma database, which included data from 30 European countries (2 publications).Methods. For the 3 reviews we searched the most used databases for any literature published in English using all pertinent keywords. As for the 2 Euromelanoma studies, participants filled in questionnaires about demographics and risk factors, including type/duration of sunbed use. Multivariate analyses adjusted for all confounders were employed to assess factors independently associated with sunbed use in each country.Results. Our reviews showed that: (i) European sunbed users are typically young women, sun seekers, and smokers, mostly from northern countries, going to tanning studios with aesthetic motives, although exceptions exist; (ii) in case of vitamin D deficiency, the risk/benefit ratio is clearly in favour of vitamin D supplementation instead of sunbed use; (iii) all epidemiological criteria for causality apply to the relationship between sunbed use and melanoma. The Euromelanoma studies included 227,888 individuals (67.4% females, median age 44) from 30 countries. Overall prevalence of sunbed ever use was 10.6%. Prevalence was higher in northern, sun-deprived countries, with the exception of Italy and Spain. Females displayed higher prevalence than males in all countries. Geographic particularities were found in four regions: Iberian (prevalence ten times higher in Spain than Portugal), Balkan (prevalence disproportionately higher among women), Baltic (highest prevalence among young adults), and Scandinavian (highest prevalence among adolescents). Ever sunbed use was independently associated with nevus count >50 [summary odds ratio (SOR)=1.05 (1.01-1.10)], atypical nevi [SOR=1.04 (1.00-1.09)], lentigines [SOR=1.16 (1.04-1.29)], and suspicion of melanoma [SOR=1.13 (1.00-1.27)]. Conclusions. After a thorough literature revision, we concluded that the debate over whether sunbed use contributes to melanoma should be definitively closed and that sunbeds are not a safe option to increase vitamin D levels. The Euromelanoma analysis on sunbeds and skin cancer risk factors suggests that avoidance/discontinuation of sunbed use should always be encouraged, especially, but not exclusively, for individuals with high-risk phenotypes. The data about prevalence/determinants of sunbed use have public health relevance for future, tailored interventions aimed at reducing indoor tanning in Europe. / Introduction. Les bancs solaires émettent des radiations ultraviolettes (UV) pour induire un bronzage cosmétique. Ils sont classés par l’Organisation Mondiale de la Santé comme carcinogènes de premier groupe: ils sont significativement associés à un risque accru de mélanome et de cancers cutanés non-mélanome. Malgré ça, des controverses existent toujours :comme leur utilisation permet d’accroitre le taux sérique de vitamine D, l’industrie du bronzage artificiel n’a cessé de les promouvoir comme thérapeutique sans danger et certains auteurs ont récemment mis en doute la carcinogénicité des bancs solaires. Par ailleurs, les différences entre les pays européens en terme de prévalence et de facteurs déterminant l’utilisation des bancs solaires n’ont pas été clairement étudiées. De la même façon, la relation entre bronzage artificiel et facteurs de risque de cancérisation cutanée reste floue. Euromelanoma est une campagne pan-européenne annuelle de prévention de cancers cutanés, où des questionnaires récoltent les données des participants (usage des bancs solaires, phénotype et informations cliniques inclus).Objectifs. Décrire de manière approfondie la prévalence, les déterminants et les risques associés à l’utilisation des bancs solaires en Europe. Dans ce but, nous avons réalisé des revues de littérature (3 publications) et une analyse extensive de la base de données Euromelanoma qui couvre 30 pays européens (2 publications).Méthodes. Pour les 3 revues, nous avons cherché dans toute la littérature publiée en anglais sur les moteurs de recherche les plus utilisés, en employant des mots clés pertinents. Les participants des 2 études Euromelanoma ont rempli des questionnaires colligeant les facteurs démographiques et de risque, le type et la durée d’utilisation des bancs solaires. Des analyses multi-variées ont permis d’évaluer les facteurs indépendamment associés à l’usage des bancs solaire dans chaque pays.Résultats. Les revues de littérature ont montré que :(i) les utilisateurs européens sont typiquement des femmes jeunes/adultes, amatrices de soleil, fumeuses, ressortissantes des pays nordiques, motivées par des raisons esthétiques et préférant les centres de bronzage, même si des exceptions existent ;(ii) dans le cas d’une carence en vitamine D, le rapport risque/bénéfice est clairement en faveur de la supplémentation en vitamine D plutôt que du bronzage artificiel ;(iii) tous les critères épidémiologiques de causalité s’appliquent à la relation entre les bancs solaires et le mélanome. Les études Euromelanoma ont été réalisées sur 227,888 individus (67.4% femmes, âge médian 44 ans) issus de 30 pays. La prévalence globale d’utilisation des bancs solaires était 10.6%, mais était plus élevée dans les pays nordiques et non ensoleillés, l’Italie et l’Espagne faisant exception. Dans tous les cas, les femmes avaient une prévalence d’utilisation plus élevée que les hommes. Des particularités géographiques ont été relevées dans 4 régions :la péninsule ibérique (prévalence 10 fois plus élevée en Espagne qu’au Portugal), les Balkans (disproportions excessives de prévalence entre femmes et hommes), les pays baltiques (la prévalence la plus élevée chez les jeunes/adultes), et scandinaves (la prévalence la plus élevée chez les adolescents). Avoir utilisé au moins une fois un banc solaire était indépendamment associé avec :un nombre de naevi >50 [summary odds ratio (SOR)=1.05 (1.01-1.10)], la présence de naevi atypiques [SOR=1.04 (1.00-1.09)] et des lentigines [SOR=1.16 (1.04-1.29)] et la suspicion de mélanome [SOR=1.13 (1.00-1.27)]. Conclusions. La revue complète de la littérature nous permet d’affirmer que le débat sur la relation causale entre bancs solaires et mélanome doit être clos et que leur utilisation pour corriger un déficit sérique en vitamine D n’est pas sans danger. L’analyse Euromelanoma sur l’utilisation des bancs solaires et les facteurs de risque de cancer cutané suggère que le bronzage artificiel devrait toujours être dissuadé, spécialement mais pas exclusivement chez les individus avec des phénotypes à haut risque. Les données de la prévalence et des facteurs déterminant l’utilisation des bancs solaires constituent un intérêt de santé publique et devraient permettre de cibler les actions nécessaires à la réduction du bronzage artificiel en Europe. / Doctorat en Sciences médicales (Médecine) / info:eu-repo/semantics/nonPublished

Introduction Patients with serious psychiatric disorders have an increased morbidity and mortality in somatic diseases and elevated prevalence of both diabetes and prediabetes. This increased frequency of somatic diseases is believed to be associated with life style choices and side effects of the antipsychotic medication. Aim In our study we investigated the prevalence of diabetes and prediabetes and compared metabolic risk factors and treatments between patients with and without serious psychiatric disorders in patients with diabetes in Region Örebro County (RÖC). Material and methods The prevalence of diabetes and prediabetes was determined in 944 patients identified from psychiatric outpatient clinics in RÖC. Information about risk factors and treatments were acquired by retrospective examination of medical records. Results Diabetes was identified in 113 patients and prediabetes in 42 patients. In patients with diabetes and serious psychiatric disorders men had significantly higher levels of HbA1c (p<0.01) and creatinine (p<0.01) compared to women, whereas women had higher BMI (p<0.05). No significant differences in HbA1c and BMI were found between patients with psychiatric disorders and all patients in RÖC with diabetes. Patients with psychiatric disorders did however have a significantly higher number of current smokers and a lower prescription of antihypertensive medication. Conclusions The prevalence of diabetes and prediabetes were 12.0% and 4.4%, respectively, in patients with serious psychiatric disorders. Our study indicates no difference in glycaemic control between psychiatric and non-psychiatric patients with diabetes, but there are differences in certain risk factors connected to diabetes.

Abstract Sciatica is a common musculoskeletal disorder, especially among the working-age population. It causes huge costs to society through work absenteeism and hospital treatments. The common cause of sciatica is the herniated lumbar disc compressing the nerve root. The neurological deficit resulting from this compression can be either sensory or motor-related. Earlier studies have shown both genetic and environmental factors to exist in the aetiology of sciatica. The aim of this study was to investigate how individual, physical and work-related risk factors associate with sciatica, and to determine the prevalence of sciatic pain among Finnish adolescents. The data used in this study were from large, population-based Finnish surveys: the Northern-Finland Birth Cohort 1986, the Mobile Clinic Health Examination Survey, the Mini-Finland Health Survey, Health 2000, the Young Finns Study, and the Helsinki Health Studies. The results of this study showed that sciatic symptoms are already common among adolescents. Young women in particular reported sciatic pain more often than men. Low back pain at the age of 16 predicted sciatic pain at the age of 18. Physically demanding work, smoking and obesity were found to predict an increased risk of hospitalization for sciatica. In the Mobile Clinic Health Examination Survey, leisure-time physical activity protected men from hospitalization for sciatica, whereas among women obesity increased this risk. Occupation also modified the effects of various risk factors. In the Mini-Finland Health Survey, overweight and obese participants who had been exposed to whole body vibration in their work were at a higher risk of hospitalization due to sciatica. In addition, lifting and carrying heavy objects at work, or sedentary work involving the handling of heavy objects predicted an increased risk of hospitalization for sciatica. Heavy or very heavy work protected against hospitalization for sciatica. A meta-analysis of four prospective cohort studies showed that walking and cycling to work reduced the risk of hospitalization for sciatica. This thesis extends our knowledge regarding the risk factors for sciatica. Its results show that these risk factors are complex and can modify each other’s effects. Thus, further research on the interactions of the various risk factors is needed. / Tiivistelmä Iskias on etenkin työikäisten keskuudessa yleinen sairaus, joka aiheuttaa paljon työkyvyttömyyttä ja sairaalahoitoja ja siten kustannuksia yhteiskunnalle. Iskiaksen taustalla on yleensä välilevyn pullistuma, joka painaa hermojuuria. Hermojuuren puristuksesta aiheutuva neurologinen puutosoire voi olla joko sensorinen tai motorinen. Aiemmat tutkimukset ovat osoittaneet iskiaksen taustalla olevan sekä geneettisiä että ympäristötekijöitä. Tämän tutkimuksen tavoitteena oli selvittää yksilöllisten, fyysisten ja työhön liittyvien riskitekijöiden yhteyttä iskiakseen sekä tutkia iskiaskivun yleisyyttä suomalaisilla nuorilla aikuisilla. Aineistoina tutkimuksessa käytettiin laajoja väestöpohjaisia suomalaisia aineistoja: Pohjois-Suomen syntymäkohorttia 1986, Autoklinikka- ja Mini-Suomi-aineistoja sekä Terveys 2000-, Young Finns- ja Helsinki Health Study -tutkimuksia. Tutkimuksessa selvisi, että iskiasoireet ovat yleisiä jo nuorilla aikuisilla ja etenkin naiset raportoivat iskiaskipua useammin miehiin verrattuna. 16-vuotiaana ilmennyt alaselkäkipu oli myös yhteydessä iskiasoireisiin 18 vuoden iässä. Työn fyysisen rasittavuuden, tupakoinnin ja lihavuuden todettiin lisäävän sairaalahoitoon johtaneen iskiaksen riskiä. Autoklinikka-aineistossa vapaa-ajan fyysinen aktiivisuus suojasi miehiä sairaalahoitoon johtaneelta iskiakselta, naisilla taas ylipaino lisäsi iskiaksen riskiä. Lisäksi ammatti näytti muokkaavan riskitekijöiden assosiaatioita. Mini-Suomi-aineistossa ylipainoiset ja lihavat henkilöt, jotka olivat altistuneet työssään koko kehon tärinälle, olivat korkeammassa riskissä sairaalahoitoon johtaneen iskiaksen suhteen. Töissä raskaiden esineiden nostaminen tai kantaminen tai painavien esineiden käsittelyä sisältävä istumatyö lisäsivät myös iskiaksen riskiä. Raskas tai erittäin raskas fyysinen työ taas näytti suojaavan sairaalahoitoon johtaneelta iskiakselta. Neljän prospektiivisen kohorttitutkimuksen meta-analyysissä selvisi, että työmatkapyöräily tai -kävely vähensivät sairaalahoitoon johtaneen iskiaksen riskiä. Tämä väitöstutkimus kasvattaa ymmärtämystä iskiaksen taustalla olevista riskitekijöistä. Tulokset osoittavat, että iskiaksen riskitekijät ovat moniulotteisia ja voivat muokata toistensa vaikutuksia, joten lisätutkimusta eri riskitekijöiden välisistä interaktioista tarvitaan.