Epidemiological studies are the prototype for elucidating patterns of disease based on known exposures. In this thesis, study of both case-control and cohort epidemiological studies were analyzed in the sector of Alzheimer's disease. More specifically, the scope of research involved the exposure of race, black or white, and the onset of disease. This research is significant because white based studies are predominant in Alzheimer's disease and minimal research has been done that links the relationship between race and the disease. Several epidemiological studies which include a substantial portion of the black community were reviewed and discussed. Quantitative and qualitative research in this study determined that blacks have a much higher risk than their white counterparts for obtaining the onset of Alzheimer's disease, with some studies producing an RR of 2.9 when comparing the two races. The relative risks for elucidation of causation between this linkage produced in each study varied significantly. One study analyzed and presented provided results that were largely inconsistent with other data in this project. Studies presented allowed epidemiologists and physicians to concentrate on more elusive risk factors such as the apolipoprotein e4 allele after black populations that had more of a risk of the onset of Alzheimer's disease were isolated through epidemiological research found in this thesis. In short, this project explored and discussed a sector of Alzheimer's disease that is largely unexplored and fuels additional research centering race and the disease given the projected increase in black elderly populations in the community and need for advancements in the field.

Motivation The prevalence of cardiovascular disease is on the increase in sub-Saharan Africa largely owing to lifestyle changes associated with urbanisation. Traditional diets are being replaced with diets high in saturated fat and sugar. In addition to the nutritional transition, urbanisation in developing African countries also contributes to a more sedentary lifestyle. Together these trends contribute to a higher prevalence of obesity and hypertension that are major risk factors for the development of cardiovascular disease. Adipose tissue is now widely recognised as an endocrine organ that secretes numerous inflammatory mediators as well as adipocytokines such as leptin. The primary role of leptin is to induce satiety after a meal and to suppress appetite. However, in recent years the role of leptin in the development of obesity-related cardiovascular disease has gained increasing attention and interest. Furthermore, leptin levels not only differ with regard to gender but also ethnicity. Africans have higher leptin levels than Caucasians due to higher subcutaneous fat in Africans. Furthermore, the prevalence of hypertension and stroke are also greater in the African population. Taken together, it is important to investigate mechanisms by which elevated leptin may contribute to the development of cardiovascular disease, especially in cardiovascular disease-prone Africans. Aim The general aim of this study is to increase our understanding of the role of leptin in cardiovascular disease development by investigating associations of leptin with markers of sympathetic activity, endothelial dysfunction, and cardiovascular reactivity and recovery in Africans and Caucasians. Methodology Data from the SABPA (Sympathetic activity and Ambulatory Blood Pressure in Africans) study was used and presented in the original research articles described in Chapter 2, 3 and 4. This study included 409 African and Caucasian schoolteachers working in the Potchefstroom district in the North West Province of South Africa. Groups were stratified by ethnicity, gender and ethnicity or obesity in order to demonstrate potential differences. We performed cardiovascular measurements and determined levels of leptin, renin, cortisol, plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (vWF) and urinary albumin-to-creatinine ratio (ACR). Independent t-tests were done to compare means between groups and Chi-square tests to compare proportions. Pearson’s correlations were determined to investigate associations as well as partial correlations after minimal adjustment for potential confounders. Multiple regression analyses were performed to investigate independent associations of leptin with cardiovascular and biochemical markers according to the specific focus of each research manuscript. Results and conclusions of the individual manuscripts  Leptin may contribute to obesity-related hypertension through its sympatho-activating effects. In the first research article (Chapter 2), we compared mean leptin levels and markers of autonomic activity between Africans and Caucasians. We also investigated associations between markers of autonomic activity and leptin. Africans had higher leptin, body mass index, blood pressure and heart rate compared to Caucasians. Furthermore, Africans also demonstrated reduced heart rate variability that is indicative of autonomic imbalance. Markers of autonomic activity that collectively reflected sympathetic overactivity associated with leptin in both Africans and Caucasians, independent of significant covariates and confounders including body mass index. These findings suggest that leptin may contribute to the development of hypertension by inducing autonomic dysfunction.  Leptin exerts direct vascular effects and may thereby contribute to increased cardiovascular disease risk in the obese. We therefore investigated associations between circulating markers of endothelial dysfunction (PAI-1, vWF and ACR) and leptin in lean and obese groups, irrespective of ethnicity (Chapter 3). As expected, leptin and plasminogen activator inhibitor-1 antigen levels were higher in the obese group. We found no differences for von Willebrand factor antigen and urinary albumin-to-creatinine ratio. In the obese group, all markers of endothelial dysfunction were positively associated with leptin in univariate analysis. However, after full adjustment in multiple regression analyses, only the association with plasminogen activator inhibitor-1 remained significant. Higher leptin levels in the obese may possibly induce endothelial dysfunction through mechanisms related to thrombotic vascular disease.  Greater cardiovascular reactivity to stress and prolonged recovery thereafter associates with increased cardiovascular disease risk. In the final research article (Chapter 4), we therefore investigated the relationship between cardiovascular reactivity and recovery to acute stress, induced by the cold pressor test, and leptin in Africans and Caucasians. Africans demonstrated greater cardiovascular reactivity compared to Caucasians. Associations of blood pressure, stroke volume, cardiac output, total peripheral resistance and arterial compliance reactivity with leptin were investigated during the stressor application and 1, 3 and 5 minutes post-stressor. There were no independent associations between cardiovascular reactivity and leptin during the stressor, and a few correlations at 1 and 3 minutes post-stressor. Associations were mostly evident at 5 minutes post-stressor and in Africans. We argue that higher leptin levels relate to impaired post-stress recovery and thereby could contribute to hypertension development in Africans. General conclusion Elevated leptin relates to sympathetic overactivity, vascular damage and delayed post-stress recovery, and thereby could contribute to increased cardiovascular disease risk. / PhD (Physiology), North-West University, Potchefstroom Campus, 2015

Motivation The prevalence of cardiovascular disease is on the increase in sub-Saharan Africa largely owing to lifestyle changes associated with urbanisation. Traditional diets are being replaced with diets high in saturated fat and sugar. In addition to the nutritional transition, urbanisation in developing African countries also contributes to a more sedentary lifestyle. Together these trends contribute to a higher prevalence of obesity and hypertension that are major risk factors for the development of cardiovascular disease. Adipose tissue is now widely recognised as an endocrine organ that secretes numerous inflammatory mediators as well as adipocytokines such as leptin. The primary role of leptin is to induce satiety after a meal and to suppress appetite. However, in recent years the role of leptin in the development of obesity-related cardiovascular disease has gained increasing attention and interest. Furthermore, leptin levels not only differ with regard to gender but also ethnicity. Africans have higher leptin levels than Caucasians due to higher subcutaneous fat in Africans. Furthermore, the prevalence of hypertension and stroke are also greater in the African population. Taken together, it is important to investigate mechanisms by which elevated leptin may contribute to the development of cardiovascular disease, especially in cardiovascular disease-prone Africans. Aim The general aim of this study is to increase our understanding of the role of leptin in cardiovascular disease development by investigating associations of leptin with markers of sympathetic activity, endothelial dysfunction, and cardiovascular reactivity and recovery in Africans and Caucasians. Methodology Data from the SABPA (Sympathetic activity and Ambulatory Blood Pressure in Africans) study was used and presented in the original research articles described in Chapter 2, 3 and 4. This study included 409 African and Caucasian schoolteachers working in the Potchefstroom district in the North West Province of South Africa. Groups were stratified by ethnicity, gender and ethnicity or obesity in order to demonstrate potential differences. We performed cardiovascular measurements and determined levels of leptin, renin, cortisol, plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (vWF) and urinary albumin-to-creatinine ratio (ACR). Independent t-tests were done to compare means between groups and Chi-square tests to compare proportions. Pearson’s correlations were determined to investigate associations as well as partial correlations after minimal adjustment for potential confounders. Multiple regression analyses were performed to investigate independent associations of leptin with cardiovascular and biochemical markers according to the specific focus of each research manuscript. Results and conclusions of the individual manuscripts  Leptin may contribute to obesity-related hypertension through its sympatho-activating effects. In the first research article (Chapter 2), we compared mean leptin levels and markers of autonomic activity between Africans and Caucasians. We also investigated associations between markers of autonomic activity and leptin. Africans had higher leptin, body mass index, blood pressure and heart rate compared to Caucasians. Furthermore, Africans also demonstrated reduced heart rate variability that is indicative of autonomic imbalance. Markers of autonomic activity that collectively reflected sympathetic overactivity associated with leptin in both Africans and Caucasians, independent of significant covariates and confounders including body mass index. These findings suggest that leptin may contribute to the development of hypertension by inducing autonomic dysfunction.  Leptin exerts direct vascular effects and may thereby contribute to increased cardiovascular disease risk in the obese. We therefore investigated associations between circulating markers of endothelial dysfunction (PAI-1, vWF and ACR) and leptin in lean and obese groups, irrespective of ethnicity (Chapter 3). As expected, leptin and plasminogen activator inhibitor-1 antigen levels were higher in the obese group. We found no differences for von Willebrand factor antigen and urinary albumin-to-creatinine ratio. In the obese group, all markers of endothelial dysfunction were positively associated with leptin in univariate analysis. However, after full adjustment in multiple regression analyses, only the association with plasminogen activator inhibitor-1 remained significant. Higher leptin levels in the obese may possibly induce endothelial dysfunction through mechanisms related to thrombotic vascular disease.  Greater cardiovascular reactivity to stress and prolonged recovery thereafter associates with increased cardiovascular disease risk. In the final research article (Chapter 4), we therefore investigated the relationship between cardiovascular reactivity and recovery to acute stress, induced by the cold pressor test, and leptin in Africans and Caucasians. Africans demonstrated greater cardiovascular reactivity compared to Caucasians. Associations of blood pressure, stroke volume, cardiac output, total peripheral resistance and arterial compliance reactivity with leptin were investigated during the stressor application and 1, 3 and 5 minutes post-stressor. There were no independent associations between cardiovascular reactivity and leptin during the stressor, and a few correlations at 1 and 3 minutes post-stressor. Associations were mostly evident at 5 minutes post-stressor and in Africans. We argue that higher leptin levels relate to impaired post-stress recovery and thereby could contribute to hypertension development in Africans. General conclusion Elevated leptin relates to sympathetic overactivity, vascular damage and delayed post-stress recovery, and thereby could contribute to increased cardiovascular disease risk. / PhD (Physiology), North-West University, Potchefstroom Campus, 2015

nÃo hà / CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior / A ciÃncia de si, a consciÃncia sobre as ciÃncias e sobre as dificuldades e equÃvocos da CiÃncia sÃo campos que dÃo origem a esta tese e suas propostas reflexivas. A pesquisa realizada propÃe uma contribuiÃÃo ao debate de educaÃÃo nos capÃtulos sobre: a africanidade e o eurocentrismo, a realidade vivida pela populaÃÃo afrodescendente na vida acadÃmica, a ciÃncia sentida pela populaÃÃo negra e os embates cotidianos do fazer cientÃfico na sociedade e na vida das populaÃÃes negras brasileiras e africanas. Recorre a desvendar a produÃÃo cientÃfica do ocidente, a questionar os seus princÃpios e bases epistÃmicas, assim como as formas do seu desenvolvimento, tendo como ancora a realidade vivida e a observaÃÃo dos conflitos vivenciados pela populaÃÃo negra nos territÃrios universitÃrios. A ciÃncia, o poder e o poder da ciÃncia enfeixam o debate que problematiza sobre as caracterÃsticas das CiÃncias e sobre como seus paradigmas conversam com o racismo cientÃfico e epistÃmico atravÃs de seu corpo sistematizado de conhecimento. A pesquisa realizada teve como objetivos de: 1) analisar e compreender as ciÃncias no Ocidente e a inserÃÃo das populaÃÃes negras (como sujeitos e/ou como objetos de pesquisa) no territÃrio cientÃfico; 2) Conhecer e compreender a formaÃÃo educacional, acadÃmica e cientÃfica de uma populaÃÃo africana (guineense); e 3) Conhecer o/a intelectual guineense e como ele/a pode nos ajudar a compreender o fenÃmeno do racismo antinegro e antiafricano na CiÃncia Ocidental. E a partir dessas diretrizes chegar Ãs bases do conhecimento africano, em que sÃo estudadas as visÃes dos pesquisadores africanos e de Guine Bissau sobre ciÃncia, conhecimento, educaÃÃo, sociedade. Aqui os pesquisadores guineenses nos ajudam a compreender o fenÃmeno do racismo antinegro e antiafricano na CiÃncia Ocidental e o trabalho conclui apontando sobre as razÃes da necessidade de distanciamento das ideias de verdade e universalidade de CiÃncia e do estabelecimento de um campo autÃnomo na produÃÃo de conhecimento das e para as populaÃÃes negras. / The science of the self, the consciousness about the sciences and the misconceptions of science are fields that give rise to this thesis and its reflective proposals. The research carried out offers a contribution to the debate on education in the chapters on africanity and eurocentrism, on the reality lived by the afrodescendant population in academic life, on the science felt by the black population and on the daily conflicts of scientific action that fall on society and In the lives of black, Brazilian and African populations. The research seeks to uncover the scientific production of the West, to question its principles and epistemic bases, as well as the forms of its development, based on the reality lived and the observation of the conflicts experienced by the black population in the university territories. The science, power, and power of science envelop the debate that questions the characteristics of science and how its paradigms talk to scientific and epistemic racism through its systematized body of knowledge. The research carried out had as objectives: 1) to analyze and understand the sciences in the West and the insertion of the black populations (as subjects and / or as objects of research) in the scientific territory; 2) To know and understand the educational, academic and scientific education of an African (Guinean) population; And 3) To know the Guinean intellectual and how he / she can help us to understand the phenomenon of anti-Black and anti-African racism in Western Science.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O tema desta dissertaÃÃo cabe dentro de um tema mais geral que à o da histÃria das populaÃÃes negras no CearÃ. Trata-se de um tema com diversos aspectos e muitas polemicas, tais como a existÃncia de negros no estado, mas faz parte de uma postura social que tem sido alvo da pesquisa historiogrÃfica e da educaÃÃo nos Ãltimos 10 anos no estado do CearÃ. Alto Alegre à um distrito do municÃpio de Horizonte, parte perifÃrica da grande regiÃo metropolitana de Fortaleza. A comunidade de quilombo de Alto Alegre à uma comunidade rural negra com mais de um sÃculo de existÃncia, no entanto a literatura apresenta poucas referÃncias a esta existÃncia. A pesquisa realizada trabalha com os conceitos de afrodescendÃncia e populaÃÃo negra baseada nos aspectos histÃricos e nÃo biolÃgicos. Utiliza o conceito de bairro rural negro e traÃa o conjunto do conhecimento com base na historia oral, tendo como foco a memÃria negra, como memÃria coletiva organizada com foco na cultura e no patrimÃnio cultural da populaÃÃo negra. A pesquisa teve como eixo os fatos econÃmicos e as relaÃÃes sociais estabelecidas pela comunidade de Alto Alegre dentro de um territÃrio onde figuram os grupos sociais negros, Ãndios e brancos, esses Ãltimos representados pelos posseiros considerados como donos da terra. O estudo mostrou uma trajetÃria de comunidade marcada pelas mudanÃas nas formas de trabalho e nas perspectivas de vida, mas com a presenÃa de forte identidade cultural, entremeada de mudanÃas significativas de costumes e de religiÃo. O municÃpio de Horizonte està dentro de uma regiÃo de forte industrializaÃÃo e de constante intervenÃÃo geogrÃfica pelo estado atravÃs de construÃÃo de grandes obras como a rodovia BR-116, e os canais de integraÃÃo e do trabalhador. / The subject of this dissertation is part of a more general theme concerning whit the black population history in the state of Cearà - Brazil. This is an issue with many aspects and many polemics, such as the existence of black people in the state, but is part of a social attitude which has been the subject of historical research and education in the last 10 years in our graduate program. Alto Alegre is the name of a district of Novo Horizonte city. This city is at the periphery of the large metropolitan region of Fortaleza. The community of maroon Alto Alegre is a black rural community with more than a century of existence, yet the literature contains few references to this existence. The research work with the concepts of afro - dependency and black population based on the historical aspects and not biological. Uses the concept of black rural district and outlines the set of knowledge based on oral history, focusing on the black memory, organized as a collective memory with a focus on culture and cultural heritage of the black population. The research was shaft the economic facts and the social relations established by the community of Alto Alegre in a territory where social groups include blacks, indians and white settlers regarded as represented by the landowners. The study showed a trend of community marked by changes in the forms of work and life prospects, but with the presence of strong cultural identity, interspersed with significant changes in customs and religion. The city of Horizonte is within a region of strong industrialization and geographical constant intervention by the state through the construction of large works such as the BR-116, and channels of integration and the worker.

SANTOS, Marlene Pereira dos. Incursões na história e memória da comunidade de quilombo de Alto-Alegre - município de Horizonte – CE. 2012. 153f. – Dissertação (Mestrado) – Universidade Federal do Ceará, Programa de Pós-graduação em Educação Brasileira, Fortaleza (CE), 2012. / Submitted by Márcia Araújo (marcia_m_bezerra@yahoo.com.br) on 2014-02-25T14:08:15Z No. of bitstreams: 1 2012-DIS-MPSANTOS.pdf: 7720145 bytes, checksum: 33572fd28544756b5a8ee6d686ac3cb5 (MD5) / Approved for entry into archive by Márcia Araújo(marcia_m_bezerra@yahoo.com.br) on 2014-02-25T14:41:20Z (GMT) No. of bitstreams: 1 2012-DIS-MPSANTOS.pdf: 7720145 bytes, checksum: 33572fd28544756b5a8ee6d686ac3cb5 (MD5) / Made available in DSpace on 2014-02-25T14:41:20Z (GMT). No. of bitstreams: 1 2012-DIS-MPSANTOS.pdf: 7720145 bytes, checksum: 33572fd28544756b5a8ee6d686ac3cb5 (MD5) Previous issue date: 2012 / The subject of this dissertation is part of a more general theme concerning whit the black population history in the state of Ceará - Brazil. This is an issue with many aspects and many polemics, such as the existence of black people in the state, but is part of a social attitude which has been the subject of historical research and education in the last 10 years in our graduate program. Alto Alegre is the name of a district of Novo Horizonte city. This city is at the periphery of the large metropolitan region of Fortaleza. The community of maroon Alto Alegre is a black rural community with more than a century of existence, yet the literature contains few references to this existence. The research work with the concepts of afro - dependency and black population based on the historical aspects and not biological. Uses the concept of black rural district and outlines the set of knowledge based on oral history, focusing on the black memory, organized as a collective memory with a focus on culture and cultural heritage of the black population. The research was shaft the economic facts and the social relations established by the community of Alto Alegre in a territory where social groups include blacks, indians and white settlers regarded as represented by the landowners. The study showed a trend of community marked by changes in the forms of work and life prospects, but with the presence of strong cultural identity, interspersed with significant changes in customs and religion. The city of Horizonte is within a region of strong industrialization and geographical constant intervention by the state through the construction of large works such as the BR-116, and channels of integration and the worker. / O tema desta dissertação cabe dentro de um tema mais geral que é o da história das populações negras no Ceará. Trata-se de um tema com diversos aspectos e muitas polemicas, tais como a existência de negros no estado, mas faz parte de uma postura social que tem sido alvo da pesquisa historiográfica e da educação nos últimos 10 anos no estado do Ceará. Alto Alegre é um distrito do município de Horizonte, parte periférica da grande região metropolitana de Fortaleza. A comunidade de quilombo de Alto Alegre é uma comunidade rural negra com mais de um século de existência, no entanto a literatura apresenta poucas referências a esta existência. A pesquisa realizada trabalha com os conceitos de afrodescendência e população negra baseada nos aspectos históricos e não biológicos. Utiliza o conceito de bairro rural negro e traça o conjunto do conhecimento com base na historia oral, tendo como foco a memória negra, como memória coletiva organizada com foco na cultura e no patrimônio cultural da população negra. A pesquisa teve como eixo os fatos econômicos e as relações sociais estabelecidas pela comunidade de Alto Alegre dentro de um território onde figuram os grupos sociais negros, índios e brancos, esses últimos representados pelos posseiros considerados como donos da terra. O estudo mostrou uma trajetória de comunidade marcada pelas mudanças nas formas de trabalho e nas perspectivas de vida, mas com a presença de forte identidade cultural, entremeada de mudanças significativas de costumes e de religião. O município de Horizonte está dentro de uma região de forte industrialização e de constante intervenção geográfica pelo estado através de construção de grandes obras como a rodovia BR-116, e os canais de integração e do trabalhador.