Thesis (Ed.D.)--Boston University.

Thesis (Ph. D.)--West Virginia University, 2007. / Title from document title page. Document formatted into pages; contains xii, 245 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 221-245).

A research report submitted to the Faculty of Heath Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Science in Medicine in the field of Tropical Diseases (Epidemiology & Biostatistics) Johannesburg, / Objective. The aim of this paper was to systematically evaluate available evidence on tobacco smoking as a risk factor for pulmonary tuberculosis. Methods. Relevant reports were identified by a systematic electronic search of Medline, Pubmed, Nioshtic, Toxline and Embasse. Methodological quality of all selected publications was assessed using a standardized checklist. Information was collected on all major study characteristics. Inter-study heterogeneity was examined qualitatively and statistically using the DerSimonian and Laird method. Results. Five case-control studies and 1 cohort study were included in the systematic review. All the 6 studies revealed a relationship between tobacco smoking and pulmonary tuberculosis. Heterogeneity across studies hampered overall statistical pooling of results, however pooled risk ratios for sub-groups were determined / IT2018

As some references suggested that tobacco smoking behavior increases the risk of persistent pain and poorer recovery, but some demonstrated that nicotine decreased pain sensitivity. Both contrary conclusions make clinicians confused on how to manage the patients with tobacco smoking habit. This study conducted a retrospective way to evaluate the relationship between acute postoperative pain management and tobacco smoking behavior. This study included 511 Patients underwent general surgery were assigned to smokers or non-smokers. Site of surgery, type and duration of anesthesia were extracted from the anesthetic record. Information regarded each patient's gender, age, preoperative weight, past medical history, postoperative course, all non-opiate sedatives and opiate analgesics used in the first 72 hours were collected and recorded. Morphine administered via a patient-controlled analgesia (PCA) device was the preferred method of analgesia for these patients. Anesthesia was standardized. Exclusion criteria included the patients underwent major thoracic cardiovascular surgery, the patients with significant lung lesion, the patients with conscious disturbance, and the patients with allergic history to morphine. The results showed that of the sense of pain, the smoking group in the second day the pain scores significantly higher than non-smoking group (p<0.001), indicated that smoking patients were had more pain than non-smoking patients after surgery. And of the analgesic drug effects, the smoking group in the second and third day analgesic doses and the total analgesic doses were significantly higher than non-smoking group (p<0.023), showed that smoking patients significantly used more analgesic than non-smoking group after surgery. Smoking was associated with pain indeed existence.

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2005. / Vita. Includes bibliographical references (leaves 15-200).

Thesis (M.S.)--Georgia State University, 2006. / Title from title screen. Yu-Sheng Hsu, committee chair; Gengsheng (Jeff) Qin, Xu Zhang, committee members. Electronic text (116 p.) : digital, PDF file. Description based on contents viewed May 17, 2007. Includes bibliographical references (p. 61-67).

O tabagismo vem sendo considerado um grave problema de saúde pública pela OMS visto que milhares de pessoas morrem anualmente vítimas de doenças relacionadas ao tabaco. O objetivo desta pesquisa foi analisar o padrão do consumo do tabaco entre os acadêmicos da área de saúde da Universidade de São Paulo Campus de Ribeirão Preto no ano letivo de 2009. Trata-se de um estudo epidemiológico, descritivo, modelo inquérito, com uma abordagem metodológica quantitativa. Participaram 745 alunos de três cursos da área de saúde: Medicina, Enfermagem Bacharelado e Enfermagem Licenciatura de ambos os sexos. Foi utilizado um questionário baseado no questionário adotado pelo INCA para avaliação do tabagismo e o Teste de Fagerström para Dependência Nicotínica utilizado para medir o grau de Dependência Nicotínica. A prevalência de fumantes foi de 57 indivíduos (7,7%). Os homens constituíram a maior parte dos fumantes (52,6%) enquanto as mulheres ficaram um pouco abaixo (47,4%). A média de idade foi de 21,9 para fumantes e de 20,8 anos para os não fumantes. A idade de experimentação do cigarro concentrou-se na faixa dos 11 aos 17 anos. Os amigos foram os maiores influenciadores na experimentação do tabaco (78,2%), seguido do cinema/TV (10,2%) e fumo dos pais (6,1%). A maioria dos entrevistados (61,8%) declarou que o pai e/ou mãe fumam ou já fumaram. Em relação à renda familiar, a maioria (48,5%) ficou acima dos seis salários mínimos vigentes à época da pesquisa. A religião mostrou-se como um fator de proteção ao vício do tabaco, pois 16,1% dos tabagistas não possuíam religião. Grande parte dos entrevistados (79,9%) acredita que pode exercer alguma influência no paciente na cessação do hábito de fumar bem como revelam-se um modelo de comportamento para seu paciente (65%). Nesse sentido, a maioria (55,7%) também acredita que os profissionais que fumam são menos propensos a aconselhar seus pacientes a parar de fumar. O desejo de parar de fumar foi manifestado por 63,2% dos fumantes e a Dependência Nicotínica avaliada ficou como Baixa ou Muito Baixa na maioria dos tabagistas. A experimentação de outros produtos do tabaco foi observada em 58,3% de toda a amostra e 86% dos fumantes declararam já ter experimentado a maconha. Entre os não fumantes esse número foi de 22,8%. Na comparação com a prevalência encontrada em 1986 houve uma queda acentuada de 14,2% neste ano para 7,7% em 2009. A tendência de declínio da prevalência de fumantes nos estudantes da área de saúde parece seguir os mesmos caminhos da sociedade em geral, mas esse percentual ainda é muito alto especialmente por tratar-se de estudantes da saúde. Espera-se que este estudo viabilize uma discussão por setores da sociedade e acadêmicos em geral para propor medidas preventivas e de controle do tabagismo entre universitários, sobretudo nos estudantes da área de saúde. / Smoking habits have been considered a serious public health problem by the OMS (WHO em ingles) since thousands of people die from smoking-related diseases. The aim of the current report was to evaluate pattern and prevalence of smoking among public health students at the University of São Paulo (College of Ribeirão Preto) during the 2009-2010 school years. The results were statistically elaborated by using descriptive methods. This study was conducted with 745 medicine and nursing (bachelor and graduation degrees) students who answered a questionnaire adopted by INCA and the Fagerström Teste for Nicotine Dependence. The prevalence of current smoking was 7.7% (57 students - 52.6% were male and 47.4% female), where the influence of friends (78.2%), movies, tv (10.2%) and the parents (6.1%) were the most cited reason to commence such habit. Most subjects informed that they have started smoking at the age group of 11 to 17 years old. 61.8% of the interviewed had a smoking family member (father and/or mother). Religion practice is probably a factor that prevents the tobacco addiction because 16.1% of the smokers are atheist. 79.9% of the interviewed stated that they provide information to their patients about smoking risks and assume they could be a role model for their patients (65%). In addition, 55.7% of the students believe that professionals in the public health care who smoke are less inclined to advise their patients to stop smoking. 63.4% of the students reported to be willing to quit smoking and the nicotine dependence assessed was considered lower or very lower. Smokers (86%) and non-smokers (22,8%) reported having experimented pot. A significant decrease in smoking prevalence among public health student at the University of São Paulo (College of Ribeirão Preto) was observed comparing data from a study in 1986 (that reported a smoking prevalence of 14.2%). Thus, our data corroborates the world trend decline in prevalence of smokers in public health students. However, the number of smokers in health professionals is still high. Knowledge of prevalence of smoking is needed to implement adequate institutional programs to help reduction of smokerers, especially among health professional who were supposed to be a role model to our society.

O tabagismo vem sendo considerado um grave problema de saúde pública pela OMS visto que milhares de pessoas morrem anualmente vítimas de doenças relacionadas ao tabaco. O objetivo desta pesquisa foi analisar o padrão do consumo do tabaco entre os acadêmicos da área de saúde da Universidade de São Paulo Campus de Ribeirão Preto no ano letivo de 2009. Trata-se de um estudo epidemiológico, descritivo, modelo inquérito, com uma abordagem metodológica quantitativa. Participaram 745 alunos de três cursos da área de saúde: Medicina, Enfermagem Bacharelado e Enfermagem Licenciatura de ambos os sexos. Foi utilizado um questionário baseado no questionário adotado pelo INCA para avaliação do tabagismo e o Teste de Fagerström para Dependência Nicotínica utilizado para medir o grau de Dependência Nicotínica. A prevalência de fumantes foi de 57 indivíduos (7,7%). Os homens constituíram a maior parte dos fumantes (52,6%) enquanto as mulheres ficaram um pouco abaixo (47,4%). A média de idade foi de 21,9 para fumantes e de 20,8 anos para os não fumantes. A idade de experimentação do cigarro concentrou-se na faixa dos 11 aos 17 anos. Os amigos foram os maiores influenciadores na experimentação do tabaco (78,2%), seguido do cinema/TV (10,2%) e fumo dos pais (6,1%). A maioria dos entrevistados (61,8%) declarou que o pai e/ou mãe fumam ou já fumaram. Em relação à renda familiar, a maioria (48,5%) ficou acima dos seis salários mínimos vigentes à época da pesquisa. A religião mostrou-se como um fator de proteção ao vício do tabaco, pois 16,1% dos tabagistas não possuíam religião. Grande parte dos entrevistados (79,9%) acredita que pode exercer alguma influência no paciente na cessação do hábito de fumar bem como revelam-se um modelo de comportamento para seu paciente (65%). Nesse sentido, a maioria (55,7%) também acredita que os profissionais que fumam são menos propensos a aconselhar seus pacientes a parar de fumar. O desejo de parar de fumar foi manifestado por 63,2% dos fumantes e a Dependência Nicotínica avaliada ficou como Baixa ou Muito Baixa na maioria dos tabagistas. A experimentação de outros produtos do tabaco foi observada em 58,3% de toda a amostra e 86% dos fumantes declararam já ter experimentado a maconha. Entre os não fumantes esse número foi de 22,8%. Na comparação com a prevalência encontrada em 1986 houve uma queda acentuada de 14,2% neste ano para 7,7% em 2009. A tendência de declínio da prevalência de fumantes nos estudantes da área de saúde parece seguir os mesmos caminhos da sociedade em geral, mas esse percentual ainda é muito alto especialmente por tratar-se de estudantes da saúde. Espera-se que este estudo viabilize uma discussão por setores da sociedade e acadêmicos em geral para propor medidas preventivas e de controle do tabagismo entre universitários, sobretudo nos estudantes da área de saúde. / Smoking habits have been considered a serious public health problem by the OMS (WHO em ingles) since thousands of people die from smoking-related diseases. The aim of the current report was to evaluate pattern and prevalence of smoking among public health students at the University of São Paulo (College of Ribeirão Preto) during the 2009-2010 school years. The results were statistically elaborated by using descriptive methods. This study was conducted with 745 medicine and nursing (bachelor and graduation degrees) students who answered a questionnaire adopted by INCA and the Fagerström Teste for Nicotine Dependence. The prevalence of current smoking was 7.7% (57 students - 52.6% were male and 47.4% female), where the influence of friends (78.2%), movies, tv (10.2%) and the parents (6.1%) were the most cited reason to commence such habit. Most subjects informed that they have started smoking at the age group of 11 to 17 years old. 61.8% of the interviewed had a smoking family member (father and/or mother). Religion practice is probably a factor that prevents the tobacco addiction because 16.1% of the smokers are atheist. 79.9% of the interviewed stated that they provide information to their patients about smoking risks and assume they could be a role model for their patients (65%). In addition, 55.7% of the students believe that professionals in the public health care who smoke are less inclined to advise their patients to stop smoking. 63.4% of the students reported to be willing to quit smoking and the nicotine dependence assessed was considered lower or very lower. Smokers (86%) and non-smokers (22,8%) reported having experimented pot. A significant decrease in smoking prevalence among public health student at the University of São Paulo (College of Ribeirão Preto) was observed comparing data from a study in 1986 (that reported a smoking prevalence of 14.2%). Thus, our data corroborates the world trend decline in prevalence of smokers in public health students. However, the number of smokers in health professionals is still high. Knowledge of prevalence of smoking is needed to implement adequate institutional programs to help reduction of smokerers, especially among health professional who were supposed to be a role model to our society.

The main focus of bone loss and Osteoporosis (OP) research has been limited almost entirely to women, but OP has become increasingly common in older men and the impact of hip fracture on mortality may actually be greater in men. OP is a major cause of morbidity and mortality in developed countries, at a cost that currently exceeds $10 billion per year in the United States (US) alone. Osteoporotic fractures affect 50 % of women and 20-30% of white men and 4% of black men over the age of 50 years. These statistics may even increase because of increasing life expectancy. Few studies focusing on Blacks have been published to date and very little is known regarding the bone health and the aetiology and prevalence of OP and fractures among older South African blacks. From the above information it is clear that OP is of considerable clinical and economic importance. Without information on the patterns and determinants of bone loss, the formulation of rational prevention and treatment strategies in these groups is not possible. The aim of the study described in this thesis was to investigate the influence of the dietary factors (iron, vitamin C, and protein) and lifestyle factors (alcohol and tobacco smoking) on osteoporotic fractures and bone mineral density in older South African black men using a case-control study design. Sixteen black male patients with fractures of the proximal femur, the proximal humerus or the distal radius and who conformed to the inclusion and exclusion criteria were included in the study. An equal amount of age-matched (K? years), apparently healthy black men with no previous fracture (of the proximal femur and humerus and distal radius), were recruited as a control group. Dual energy X-ray absorptiometry (DEXA) was used for the measurement of the lumbar vertebrae and the proximal femur (hip). Questionnaires were used to gather demographic and medical information, data on physical activity and dietary intakes. Anthropometric measurements and blood samples were taken. Appropriate biochemical analyses were done with standard methods. Both the cases and controls were osteoporotic according to the mean lumbar spine BMD determined in both groups. The BMD was only marginally lower in the cases than in the controls and therefore not statistically significant. The mean tobacco pack years of the cases (13.29) [95% CI: 4.44; 22.141 were almost double that of the controls (7.43) [1.83; 13.031 but it was not statistically significant (p=0.55). Tobacco pack years were negatively associated with BMD of the lumbar spine (p=0.008) even after controlling for possible confounding SUMMARY factors (p=0.001). Malnutrition, as indicated by the low dietary intakes of energy, protein, vitamin C, iron and low BMI, could play a role in the lower bone mineral density (BMD) observed in the cases. The mean protein intakes of the cases (56.1 19) [46.49; 65.741 were very low compared to the recommended 639 per day. This low protein intake was also significantly less compared to the controls (739) [58.28; 88.311. lron intake tended to be lower in the cases compared to the controls (p=0.09). lron intake was not associated with BMD, however, in the stepwise regression analysis; iron intake came out as a possible predictor of BMD of both the lumbar spine and hip, although it was not statistically significant. The BMI was c 19 kg/m2 in 50% of the cases and the controls. S-GGT, a marker of alcohol intake, was significantly increased in the cases with a mean value of 65.88ulL opposed to the 36.33UIL in the control group. S-GGT was the most important predictor of BMD in both the hip and the lumbar spine. There was a significant statistical correlation between lumbar spine BMD (p=0.04); hip BMD (p=0.02) and s-GGT. In conclusion it can be said that malnutrition played a vital role in the low BMD aggravated by the use of tobacco from a young age and alcohol in excessive amounts over weekends. From the results of this study it can be recommended that any intervention programme should focus on alcohol abuse, tobacco smoking and improvement in nutritional status. Children should be encouraged not to smoke and be educated on the detrimental effects of alcohol. It is important to address dietary risk factors associated with OP, namely to increase the overall nutrition of the South African black male with low cost protein and calcium products. Vitamin C enhances iron absorption and may be beneficial for bone collagen. The increased intake thereof by using seasonal fruit can therefore be recommended. / Thesis (M.Sc. (Dietetics))--North-West University, Potchefstroom Campus, 2004.

The main focus of bone loss and Osteoporosis (OP) research has been limited almost entirely to women, but OP has become increasingly common in older men and the impact of hip fracture on mortality may actually be greater in men. OP is a major cause of morbidity and mortality in developed countries, at a cost that currently exceeds $10 billion per year in the United States (US) alone. Osteoporotic fractures affect 50 % of women and 20-30% of white men and 4% of black men over the age of 50 years. These statistics may even increase because of increasing life expectancy. Few studies focusing on Blacks have been published to date and very little is known regarding the bone health and the aetiology and prevalence of OP and fractures among older South African blacks. From the above information it is clear that OP is of considerable clinical and economic importance. Without information on the patterns and determinants of bone loss, the formulation of rational prevention and treatment strategies in these groups is not possible. The aim of the study described in this thesis was to investigate the influence of the dietary factors (iron, vitamin C, and protein) and lifestyle factors (alcohol and tobacco smoking) on osteoporotic fractures and bone mineral density in older South African black men using a case-control study design. Sixteen black male patients with fractures of the proximal femur, the proximal humerus or the distal radius and who conformed to the inclusion and exclusion criteria were included in the study. An equal amount of age-matched (K? years), apparently healthy black men with no previous fracture (of the proximal femur and humerus and distal radius), were recruited as a control group. Dual energy X-ray absorptiometry (DEXA) was used for the measurement of the lumbar vertebrae and the proximal femur (hip). Questionnaires were used to gather demographic and medical information, data on physical activity and dietary intakes. Anthropometric measurements and blood samples were taken. Appropriate biochemical analyses were done with standard methods. Both the cases and controls were osteoporotic according to the mean lumbar spine BMD determined in both groups. The BMD was only marginally lower in the cases than in the controls and therefore not statistically significant. The mean tobacco pack years of the cases (13.29) [95% CI: 4.44; 22.141 were almost double that of the controls (7.43) [1.83; 13.031 but it was not statistically significant (p=0.55). Tobacco pack years were negatively associated with BMD of the lumbar spine (p=0.008) even after controlling for possible confounding SUMMARY factors (p=0.001). Malnutrition, as indicated by the low dietary intakes of energy, protein, vitamin C, iron and low BMI, could play a role in the lower bone mineral density (BMD) observed in the cases. The mean protein intakes of the cases (56.1 19) [46.49; 65.741 were very low compared to the recommended 639 per day. This low protein intake was also significantly less compared to the controls (739) [58.28; 88.311. lron intake tended to be lower in the cases compared to the controls (p=0.09). lron intake was not associated with BMD, however, in the stepwise regression analysis; iron intake came out as a possible predictor of BMD of both the lumbar spine and hip, although it was not statistically significant. The BMI was c 19 kg/m2 in 50% of the cases and the controls. S-GGT, a marker of alcohol intake, was significantly increased in the cases with a mean value of 65.88ulL opposed to the 36.33UIL in the control group. S-GGT was the most important predictor of BMD in both the hip and the lumbar spine. There was a significant statistical correlation between lumbar spine BMD (p=0.04); hip BMD (p=0.02) and s-GGT. In conclusion it can be said that malnutrition played a vital role in the low BMD aggravated by the use of tobacco from a young age and alcohol in excessive amounts over weekends. From the results of this study it can be recommended that any intervention programme should focus on alcohol abuse, tobacco smoking and improvement in nutritional status. Children should be encouraged not to smoke and be educated on the detrimental effects of alcohol. It is important to address dietary risk factors associated with OP, namely to increase the overall nutrition of the South African black male with low cost protein and calcium products. Vitamin C enhances iron absorption and may be beneficial for bone collagen. The increased intake thereof by using seasonal fruit can therefore be recommended. / Thesis (M.Sc. (Dietetics))--North-West University, Potchefstroom Campus, 2004.