Recent research suggests that sedentary behaviours have detrimental effects on the health and well-being of children, including effects on obesity. Specifically, television viewing is consistently associated with childhood obesity. Two explanations have been proposed: 1) reduced energy expenditure, and 2) increased food intake. However, it has been suggested that the association between television viewing and childhood obesity may be better explained by an increase in energy intake than by a reduction in energy expenditure. To date, children of different weight status have not been compared in their dietary patterns in front of the television, and it is not known if total sedentary time is linked with food intake in children. The objectives of this thesis are: 1) to determine if obese children consume food more frequently while watching television than normal weight children, and 2) to examine which of television viewing or total sedentary time better predicts dietary patterns in children. Overall, our results re-affirm the notion that television viewing is associated with obesity, although physical activity plays a role in this association. Also, children who are obese consume fast food and fruits/vegetables more frequently during television watching than normal weight children. Furthermore, television viewing appears to be a better predictor of dietary patterns in children than overall sedentary time. Globally, these results provide evidence for the deleterious effects of television viewing on children’s dietary patterns and justification for future intervention studies designed to reduce television viewing in children with obesity.

Magister Scientiae - MSc / Palatal Rugae Patterns in a Sudanese Population Sample Palatal rugae are ridges resulted from symmetrical and irregular mucosal folds of tissue and located in the alveolar third of the palate. Palatal rugae identification can have a significant role in forensic identification where it is difficult to use the normal identification methods. The aim of this study is to identify and compare the palatal rugal morphological patterns in a sample of adult males and females of Sudanese population. Maxillary impression models obtained from 100 subjects (50 males and 50 females) of age group 21 – 23 years, of the dental students of University of Science and Technology, Sudan. The data were assessed based on the Thomas and Kotze classification (1983) for the length, shape and prevalence. The Independent - t - Test was used for the statistical analysis. Ethical approvals declared from the University of Science and Technology, Sudan and University of the Western Cape South, South Africa to conduct the study. Statistical analysis showed that females had significantly more number of total rugae on the right side of the palate than in males. The prevalence of the palatine rugae numbers was significantly more in females than in males. Primary rugae were distributed more significantly in females more than males. On the right side of the palate, the straight type of rugae was significantly predominant in females than in males whilst the wavy shape was more in males than in females. On the left side of the palate, the curved type of rugae was significantly more presented in males than in females whilst the diverging unification type was more in females than in males. The distribution of number of rugae shapes in both males and females were seen as straight followed by wavy and least was the circular. The total number of straight rugae was significantly more in females than in males, as well as circular rugae and diverging rugae. In contrast, curved rugae were significantly more in males than in females. There were 11 individuals who did not comply with the Thomas and Kotze classification thus was recorded as unspecified. Page iv This Sudanese study showed significant differences between males and females in the number, length and shapes of rugae. Hence, the individuality and uniqueness of palatine rugae can be used as a tool for forensic dental identification, and possibly distinction between males and females. There is also a possibility that there are ethnic differences in rugal patterns.

We conducted a cross-sectional survey to assess the anxiety, distress, and turnover intention (likelihood to leave their current job) of healthcare workers in Peru during the COVID-19 pandemic. Our results reported that 21.7% healthcare workers in Peru experienced severe anxiety, whereas 26.1% of them experienced severe mental distress. A higher level of education related with a lower level of anxiety. Younger workers had a higher level of turnover intention than their older colleagues did. Healthcare workers in the private sector had a higher turnover intention than those in the public sector. Most importantly, people who were geographically far from Lima, the epicenter in Peru, during the outbreak experienced less anxiety and mental distress, corroborating the ripple effect and disconfirming the typhoon eye theory. However, the direction of these relationships can change depending on the type of institutions (public versus private) and the type of employees' contract (full time versus part time). Our research helps provide insights for clinical professionals in identifying the vulnerable groups to mental disorders in Peru. This is the first study to assess anxiety, mental distress, and turnover intention in healthcare workers in Peru during the COVID-19 pandemic. Copyright

京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第21962号 / 社医博第93号 / 新制||社医||10(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 古川 壽亮, 教授 中山 健夫, 教授 川上 浩司 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

京都大学 / 新制・課程博士 / 博士(社会健康医学) / 甲第23612号 / 社医博第118号 / 新制||社医||11(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 近藤 尚己, 教授 伊佐 正, 教授 髙橋 良輔 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

Introduction Oral Non-steroidal anti-inflammatory drugs (NSAID) is an analgesia and is commonly used by people with osteoarthritis (OA). Oral NSAID is currently recommended as the second level of treatment for OA, and could be considered if physical activity, topical NSAID or paracetamol do not supply sufficient pain relief.   Aim To investigate how frequently oral NSAID is used in a sample of New Zealanders with OA and also to investigate the exposure to heightened risk of adverse events while using oral NSAID.   Method A cross-sectional survey was conducted to collect information about the use of oral NSAID by people with self-reported OA. The survey included 75 participants who were over the age of 45 with an average age of 70.6 years.   Results While having OA, 57,3% of the sample reported oral NSAID use. The results also show that 52% of the participants with cardiovascular (CV), gastrointestinal (GI) or renal comorbidities used oral NSAID, and 17,3% of them also combined that NSAID with medication for their comorbidity. Concerning the heightened risks of adverse events, 21% of the participants did acquire the analgesia over the counter (OTC), and 76,6% stated that they were over the age of 65.    Conclusion A majority of the participants in the study with self-reported OA take NSAID as an analgesia. Also, the study shows that NSAID is commonly used among participants with co-morbidity, which is similar to figures presented in previous studies in the area. However, the small sample size limits its generalizability to a larger population. / Introduktion Orala icke-steroida antiinflammatoriska läkemedel (NSAID) är en grupp smärtstillande mediciner som är vanligt använt av personer mer artros. Orala NSAID-preparat rekommenderas idag som en andrahandsbehandling och kan övervägas om fysisk aktivitet, topikala NSAID-preparat eller paracetamol inte ger tillräcklig smärtlindrande effekt.   Syfte Att undersöka hur vanligt användandet av orala NSAID-preparat är i ett stickprov av personer med artros i Nya Zeeland samt att undersöka exponering av orala NSAID-preparat i subgrupper med ökad risk för biverkningar vid användande av orala NSAID-preparat.   Metod En tvärsnittsstudie genomfördes för att samla in information kring användning av orala NSAID-preparat av personer med självrapporterad artros. Studiepopulationen bestod av 75 personer över 45 års ålder med en medelålder på 70,6 år.   Resultat 57,3% av deltagarna använder orala NSAID-preparat som behandling för sin självrapporterad artros. Gällande subgrupper med ökad risk för biverkning av NSAID användning visar studien att 52% av deltagare med kardiovaskulära, gastrointestinala eller njurpåverkade sjukdomar använder orala NSAID-preparat och av dessa kombinerar 17,3% NSAID-preparaten med medicin för sin samsjuklighet. Av deltagarna som uppgav att de använder orala NSAID-preparat erhåller 21% av dessa NSAID-preparaten receptfritt över disk. Av deltagare som var 65 år eller äldre uppgav 76,6% att de använder orala NSAID-preparat för behandling av artros.   Slutsats En majoritet av deltagarna med självrapporterad artros tar orala NSAID-preparat i smärtstillande syfte för sin artros. Studien visar också att NSAID ofta används bland deltagare med samsjuklighet, vilket motsvarar presenterade siffror från tidigare studier inom området. Den lilla stickprovsstorleken begränsar emellertid studiens generaliserbahet gentemot en större population.

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13233号 / 論医博第2173号 / 新制||医||1036(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 川村 孝, 教授 横出 正之, 教授 福原 俊一 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Objectives: As unrecorded alcohol use contributes to a substantial burden of disease, this study characterises this phenomenon in newly independent states (NIS) of the former Soviet Union with regard to the sources of unrecorded alcohol, and the proportion of unrecorded of total alcohol consumption. We also investigate associated sociodemographic characteristics and drinking patterns. Design: Cross-sectional data on overall and unrecorded alcohol use in the past 7 days from WHO STEPwise Approach to NCD Risk Factor Surveillance (STEPS) surveys. Descriptive statistics were calculated at the country level, hierarchical logistic and linear regression models were used to investigate sociodemographic characteristics and drinking patterns associated with using unrecorded alcohol. Setting: Nine NIS (Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkmenistan and Uzbekistan) in the years 2013–2017. Participants: Nationally representative samples including a total of 36 259 participants. Results: A total of 6251 participants (19.7%; 95% CI 7.9% to 31.5%) reported alcohol consumption in the past 7 days, 2185 of which (35.1%; 95% CI 8.2% to 62.0%) reported unrecorded alcohol consumption with pronounced differences between countries. The population-weighted average proportion of unrecorded consumption in nine NIS was 8.7% (95% CI 5.9% to 12.4%). The most common type of unrecorded alcohol was home-made spirits, followed by home-made beer and wine. Older (45–69 vs 25–44 years) and unemployed (vs employed) participants had higher odds of using unrecorded alcohol. More nuanced sociodemographic differences were observed for specific types of unrecorded alcohol. Conclusions This contribution is the first to highlight both, prevalence and composition of unrecorded alcohol consumption in nine NIS. The observed proportions and sources of unrecorded alcohol are discussed in light of local challenges in policy implementation, especially in regard to the newly formed Eurasian Economic Union (EAEU), as some but not all NIS are in the EAEU.

Background: In clinical practice, it is frequently observed that patients with hypertension often coexist with dyslipidemia. However, studies on atherosclerotic indices and the prevalence of hypertension are still limited. The purpose of this study was to assess the relationship between atherosclerotic indices and the prevalence of hypertension in Chinese adults without type 2 diabetes mellitus. Methods: In this paper, a cross-sectional study was conducted based on 117,056 adults in 11 Chinese cities (Shanghai, Beijing, Wuhan, Suzhou, Shenzhen, Changzhou, Nantong, Guangzhou, Hefei, Nanjing, and Chengdu) from 2010 to 2016. Besides, the raw data was obtained from the public database (www.Datadryad.org), while eight atherosclerosis indices namely the atherogenic coefficient (AC), Castelli's risk index I (CRI-I) and II (CRI-II), the atherogenic index of plasma (AIP), the cholesterol index, the lipoprotein combined index (LCI), non-high-density lipoprotein cholesterol (non-HDL-C) and triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) were analyzed in this study. Apart from that, two groups of continuous variables were measured using the Mann-Whitney test, and categorical variables were analyzed using the Chi-square test. Differences between multiple groups of continuous variables were investigated using Kruskal-Wallis one-way analysis of variance (ANOVA) and Dunn's test. Furthermore, Spearman correlation analysis and multivariate logistic regression analyses were performed to assess the relationship between atherosclerotic indices and blood pressure levels, and the prevalence of hypertension, respectively. The results of multivariate logistic regression analyses were expressed as the odds ratio (OR) and their corresponding 95% confidence intervals (CIs). Moreover, the receiver operating characteristic (ROC) curve was depicted to further analyze the predictive value of the atherosclerotic indices on the prevalence of hypertension. Results: The atherosclerosis indices were higher in the hypertensive population compared to those in the normotensive population. Meanwhile, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were linearly and positively correlated with atherosclerotic indices. In addition, multivariate logistic regression analysis showed that the cholesterol index and non-HDL-C were observed to be positively associated with the prevalence of hypertension (p for trend < 0.05). Moreover, the prevalence of hypertension increased by 3.7% (OR: 1.037; 95% CI: 1.009-1.065; p = 0.009) and 6.1% (OR: 1.06; 95% CI: 1.033-1.091; p < 0.001), respectively, as per 1-standard deviation (SD) increase in the cholesterol index and non-HDL-C. Beyond that, ROC analysis demonstrated that the cholesterol index and non-HDL-C have a good predictive value for the prevalence of hypertension in women, with under the ROC curve (AUC) of 0.659 and 0.684 and cut-off values of 47.94 and 134.34 mg/dl, accordingly. Conclusions: In Chinese adults without type 2 diabetes mellitus, atherosclerotic indices were significantly higher in hypertensive populations compared with those in normotensive populations, regardless of hypertension levels. Meanwhile, SBP and DBP were linearly and positively related to atherosclerotic indices. Besides, the cholesterol index and non-HDL-C were independent risk factors for the prevalence of hypertension, and they could be adopted for effectively predicting the prevalence of hypertension in women.

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