O objetivo do trabalho foi descrever, em uma perspectiva histÃrica, o perfil epidemiolÃgico da peste no Estado do Cearà a partir de 1900 e a evoluÃÃo das aÃÃes de controle desse agravo no perÃodo de 1980 a 2008. Realizou-se um estudo descritivo, de natureza histÃrica, com associaÃÃo da abordagem da histÃria oral, para construÃÃo dos cenÃrios epidemiolÃgicos e operacionais e uma revisÃo de informaÃÃes histÃrico-epidemiolÃgicas do programa de controle. Para consubstanciar as informaÃÃes obtidas, foram realizadas entrevistas abertas com especialistas na Ãrea. Os registros histÃricos dos casos humanos foram recuperados somente a partir de 1935 e perÃodos de intensa atividade e outros de quiescÃncia foram identificados. Destaca-se que na dÃcada de 1980 a peste persistiu, atà 1986, de forma endÃmica na Serra da Ibiapaba. No perÃodo de 1982 a 1985 ocorreu um surto na Serra de Baturità tendo sido confirmados 89 casos humanos, registrada elevada densidade populacional de roedores e verificado considerÃvel incremento das aÃÃes do programa. Na dÃcada de 1990 apenas trÃs casos humanos foram confirmados na Serra da Ibiapaba e em 2005 mais um caso foi confirmado na Serra da Pedra Branca. O declÃnio dos casos humanos a partir de 1986 levou à reduÃÃo de todas as aÃÃes. Por vÃrias dÃcadas as aÃÃes do Programa de Controle da Peste (PCP) incluÃam educaÃÃo em saÃde, busca ativa de atividade pestosa e coleta de espÃcimes para anÃlises bacteriolÃgicas e sorolÃgicas. InquÃritos sorolÃgicos em carnÃvoros domÃsticos (cÃes e gatos) predadores de roedores foram introduzidos na rotina do PCP em 1989 visando o monitoramento da circulaÃÃo da Y. pestis e se revelou a ferramenta mais eficaz para detecÃÃo da atividade da zoonose. Foram detectados picos de positivaÃÃo em 1997, 2001 e 2005, e mesmo assim essa atividade vem sendo enfraquecida no estado e a recomendaÃÃo atual à restringir os inquÃritos sorolÃgicos apenas a amostras caninas. Os focos do Cearà estÃo localizados nos complexos ecolÃgicos das Serras de BaturitÃ, do Machado, das Matas, da Pedra Branca, de Uruburetama, da Ibiapaba e Chapada do Araripe. As aÃÃes inicialmente desenvolvidas nos focos como unidade ecolÃgica, apÃs a divisÃo polÃtico/administrativa das Ãreas, com a descentralizaÃÃo, passaram a ser organizadas em nÃvel de Regionais. Os focos do Cearà destacam-se como os mais importantes no Brasil, tanto pela ocorrÃncia de casos humanos quanto pela evidÃncia de circulaÃÃo permanente da bactÃria. A persistÃncia da peste no estado deve, pois, ser considerada uma ameaÃa real e permanente de acometimento humano nessas regiÃes, que pode estender-se para outros lugares, inclusive centros urbanos, tornando-se imperativo que os profissionais de saÃde estejam preparados. Por isso, para garantir o monitoramento dos focos na totalidade, torna-se imprescindÃvel a manutenÃÃo da vigilÃncia na perspectiva de foco, para permitir a adoÃÃo de medidas de controle adequadas para proteÃÃo das populaÃÃes humanas nas Ãreas focais / Our objective was to describe, in a historical perspective, the epidemiological profile of plague in the State of Cearà since 1900 and the evolution of the activities of the disease control from 1980 to 2008. We carried out a descriptive study using an historical approach based on the oral history for the construction of epidemiological and operational scenarios and a review of the historical and epidemiological information about the plague control program. To strengthen the information obtained, we conducted interviews with experts in the area. Historical records of human cases have been recovered only from 1935, and periods of intense activity and others of quiescence were identified. It is noteworthy that in the years 1980 plague persisted as endemic in Serra da Ibiapaba until 1986. In the period from 1982 to 1985 there was an outbreak in Serra de Baturità with 89 confirmed human cases; a rise of the rodentsâ population and significant increasing in the activities of the program were observed. In the 1990s, only three human cases were confirmed in Serra da Ibiapaba and in 2005 another case was confirmed in Serra da Pedra Branca. The decline of human cases after 1986 led to the reduction of the program activities. For several decades the activities of the Plague Control Program (PCP) included health education, active search for plague activity and collection of specimens for bacteriological and serological analysis. Serological surveys in domestic carnivores (dogs and cats) predators of rodents were introduced into the routine of PCP in 1989 to monitor Y. pestis activities in the foci proving the most effective tool to detect the zoonosis activities in the foci. In spite of the occurrence of positivity peaks detected in 1997, 2001 and 2005, this activity has been diminished in the state and the present recommendation is to restrict the serological surveys to canine samples only. The Cearà foci are located in the ecological complexes of the âserrasâ BaturitÃ, Machado, Matas, Pedra Branca, Uruburetama, Ibiapaba and Araripe. The foci area were formerly dealt as ecological units; however after the political/administrative division of the areas, in view of the âdecentralization processâ, they are now scattered among the âRegionaisâ. The Cearà foci are among the most important in Brazil, both by the number of human cases and by evidence of the permanent circulation of the bacterium. The persistence of plague in the state should therefore be considered a real and permanent risk in these regions, which may extend to other places, including urban centers, making it imperative that health professionals are prepared. Therefore, to ensure the monitoring of the foci, it is essential to maintain surveillance under the ecological approach, to enable the adoption of appropriate control measures for protection of human populations in focal areas

Chlorophyllin (CHL), a water-soluble derivative of the green plant pigment, chlorophyll, is an effective antimutagen and anticarcinogen in various model systems when used as a modulator against a class of carcinogens that, in general, have a structure consisting of at least three fused rings. Dibenzo[a,l]pyrene (DBP), an extremely potent environmental carcinogen, has been isolated from urban air samples, tobacco smoke, and coal smoke condensate. A study was conducted to evaluate the complex interrelationships among dietary DBP doses with co-exposure to a range of CHL doses. In order to achieve adequate statistical power in the generation of multiple dose-response curves, this dose-dose matrix experiment utilized over 12,000 rainbow trout. The resulting DNA adducts were assessed and evaluated as biomarkers of exposure to discern their relationship with the final tumor outcome. CHL was highly effective in reducing DBP-initiated DNA adduct formation in the liver and stomach and strongly inhibited tumor formation in the liver (56-79% inhibition), stomach (30-68%), and swim bladder (over 80% at the highest DBP dose). Molecular dosimetry revealed adduct formation to be predictive of final tumor response in both organs regardless of CHL dose. Other parameters evaluated were consistent with CHL-mediated protection. A clinical CHL preparation, evaluated in a human population subsequent to the seminal demonstration of CHL chemopreventive properties against AFB��� in trout (1), revealed CHL to be just as effective in reducing biomarkers of alfatoxin exposure to humans (2). Dietary administration of this clinical preparation along with DBP in the rainbow trout demonstrated CHL protective capacity against DBP-initiated multi-organ DNA adduct formation and final tumor incidence. Sucrose was evaluated, deemed unlikely to be sequestered in a complex with CHL, and was used as a control in a pharmacokinetic study evaluating the biodistribution of DBP with and without CHL. The results provide evidence against a non-specific masking mechanism for CHL-mediated blocking of DBP (or aflatoxin)-initiated tumorigenesis. CHL at multiple doses provided significant protection against multi-dose DBP-initiated DNA adduction and tumor formation in multiple organs. CHL-mediated protection, primarily by reduced carcinogen biouptake and consistent with a complexation mechanism, is supported by these results. / Graduation date: 2003

Background HIV/AIDS has always been a concern since it first came up in 1981 in the field of medicine and public health. The trend of overall HIV epidemic has slow down through over 30 years fighting against the disease. Yet, being the largest population nowadays, young people still face high risk of HIV/AID. Sexual transmitted diseases, similar with HIV infection, are also a serious concern in young people. Peer education is widely used in the sexual education in young people. No review focused on the school-based peer education while most young people received their sexual education in schools. This systematic review aims to evaluate the effectiveness of school-based peer education on HIV/STD prevention and evaluate the factors that are likely to influence the effect of school-based peer education. Method Searching through PubMed and Cochrane Library, a literature review was carried out on the relevant articles about the evaluation of school-based peer education in developing and developed countries around the world from 2000-01-01 to 2014-05-31. Findings 10 experimental studies were chosen in this review, including 3 randomized controlled trials. Among 10 studies, 8 found significant improved about the general knowledge of HIV/STD and all studies showed positive change in attitude and risk perception in the peer-led education. However, no studies found significant effect of peer education on the behavioral change regarding condom use, postponing sexual intercourses and the reduction of sexual partners, etc. The interaction of peer education and the quality of peer-educators plus other demographical factors such as socioeconomic status and religions may influence the effect of school-based peer-led education. Conclusion School-based peer education was demonstrated to be effective on the prevention of HIV/STD in knowledge and attitude improvement, similar with other kinds of peer education. Peer educators and interactions between educators and educatees play important roles in the peer education. Yet, the effect of school-based education still requires long-term assessment. / published_or_final_version / Public Health / Master / Master of Public Health

This item was digitized as part of the Million Books Project led by Carnegie Mellon University and supported by grants from the National Science Foundation (NSF). Cornell University coordinated the participation of land-grant and agricultural libraries in providing historical agricultural information for the digitization project; the University of Arizona Libraries, the College of Agriculture and Life Sciences, and the Office of Arid Lands Studies collaborated in the selection and provision of material for the digitization project.

This item was digitized as part of the Million Books Project led by Carnegie Mellon University and supported by grants from the National Science Foundation (NSF). Cornell University coordinated the participation of land-grant and agricultural libraries in providing historical agricultural information for the digitization project; the University of Arizona Libraries, the College of Agriculture and Life Sciences, and the Office of Arid Lands Studies collaborated in the selection and provision of material for the digitization project.

No abstract available. / Thesis (MMed)-University of KwaZulu-Natal, Durban, 2006.

The convergence of compelling evidence that transmission of HIV from a pregnant woman living with HIV to her foetus can be significantly interrupted due to advances in antiretroviral and obstetrical interventions, and worrisome epidemiologic data documenting a rise in HIV infection among Canadian women, spurred the development in Canada and world wide of policies and programmes aimed at increasing the number of pregnant women who are tested for HIV. Responding to innovative therapy reducing perinatal HIV transmission risk by increasing the number of pregnant women who agree to test for HIV is clearly an important prevention objective. However, the process must be accomplished in a way that is of most benefit to the pregnant woman herself and in a way that does not compromise a pregnant woman's rights to the established Canadian principles of HIV counselling and testing. / Working with pregnant women in Ontario, the province with the highest level of HIV infection among Canadian women, this thesis articulates and interprets their experiences of prenatal HIV counselling and testing and details their perspectives on best practices. The pregnant women's evidence-based recommendations for the re-design of prenatal HIV testing programmes are provided. These unique data have important utility for federal and provincial policy makers as HIV counselling and testing policies and programmes that encompass and are grounded in pregnant womens' experiences and perspectives are likely to be maximally acceptable and thereby increase the number of pregnant women who can be apprised of prophylactic treatment to take care of their own health needs as well as those of their unborn children. / In order for pregnant women to increase control over their own health and that of their unborn children, there is clear value in all pregnant women being afforded the opportunity to know their HIV status. However, the voices of the women in this study suggest that the autonomy rights of pregnant women may well be at risk in a programme in which the current emphasis is on potential HIV infection of the foetus rather than on potential or actual infection of the pregnant woman.

The high levels of HIV prevalence amongst young people in sub-Saharan African countries, have led to the clarion call for researchers to investigate the determinants to young people's sexual risk-taking behaviour while others are exploring the usage of entertainment education (EE) so that effective prevention and interventions may be developed. One critical aspect is that research efforts so far have been hampered by the adoption of models and perspectives that are narrow and do not adequately capture the complexity associated with young people's sexual experiences. The distinctiveness of this study is therefore grounded in the focus on the risky sexual practices students engage in and their underlying risk and protective multisystemic factors and their response to the EE interventions, in particular the Scrutinise Campus Campaign. Thus, using the Problem Behaviour Theory, Reception Theory and the Social Cognitive Learning Theory, this study investigates the phenomena of students' sexual risk behaviour and their response to the Scrutinise Campus campaign. The study is situated within the interpretative paradigm. It used a hermeneutic phenomenological methodology underpinned by in-depth interviews, focus group discussions, participant observation and field notes to draw data for this study. The study sample included students and the Scrutinise Campus Campaign officers. Findings of this study sustain the conclusion that students' sexual risk behaviour is influenced by interrelated, interactional and transactional factors from the multisysternic factors: biological, environmental/social, behavioural and personality domains that either instigate or buffer against students' sexual risk behaviour. However, Scrutinise Campus campaign's messages do not fully address students' sexual risk practices and their underlying factors as experienced by students. It is critical to employ a comprehensive and continuum of EE interventions that are broad in scope arid target factors from multiple systems of influence including the multisystemic factors. Most significantly, sources of protective influence should not be ignored when designing and implementing EE prevention programmes and, to the extent possible, both risk arid protective factors should be addressed in the interventions. This may help to effectively address students' sexual-risk taking behaviour in universities. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2012.

Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2005. / A diet high in fat results in dietary-related diseases, which have reached epidemic proportions in South Africa. Nutritional labelling has the potential to alter consumers’ knowledge of attitude and behaviour towards their fat intake. The purpose of the study was to investigate the effects of nutritional labelling on the population’s fat-intake through a systematic literature review. Electronic databases, reference lists of relevant studies and the Internet were searched, to identify studies that could help to answer the problem statement. Relevant citations were independently identified by two investigators based on the established inclusion-criteria. After this the full text of the selected citations were obtained and filtered independently by each investigator based on the inclusion- and exclusion criteria. The characteristics of each study was recorded in specially developed data extraction forms by the investigator herself and was checked by a second investigator. The primary objective of the study was to investigate nutritional labelling on food packaging. Two other forms of labelling were included to gain a more concise perception of consumers’ knowledge and practices regarding information on fat. These other forms were point-of-sale labelling (in supermarkets, in restaurants, by vending machines) and experimental labelling (labels spesifically designed to indicate the fat-content of a food item). A total of 59 relevant studies were included based on the inclusion-criteria. Although only a few studies assessed the effect of labelling on diet, there was evidence that the use of labels resulted in lower fat intake. Women older than 35 years with higher education levels, who used nutritional supplements, and who were in the maintenance stage of change to a lower fat diet, and who believed in the importance of nutrition, were between 50% to 80% higher users of information about fat than their counterparts. Fat is the food component which was most looked at on the food label (50% to 80%). Small changes in fat intake occured due to point-of-sale labelling, but labelling programmes which combined labelling with additional information on fat (e.g. pamphlets), increased visibility and nutrition education programmes, were more successful. People generally perceived products lower in fat as less pleasant, but sensory judgement of the products labelled with a low fat content were related to a person’s beliefs and concerns towards fat. Nutritional labelling can be an effective measure, which can be used to reduce the population’s fat intake; however, more research is needed to assess the effect of labelling on fat content of their diet. Regulations and education is needed to enhance the consumer’s trust in and capability in the use of labelling to make better food choices and to alter their diet. The success of labelling is dependant on a well-educated and motivated population, as well as the necessary information in a format which is understandable to the consumer.

Orientadores: Maria José Martins Duarte Osis, Maria Yolanda Makuch / Texto em português e inglês / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-20T22:13:44Z (GMT). No. of bitstreams: 1 Higinio_MariaAmeliaRalio_M.pdf: 1701742 bytes, checksum: 6ec7b417df29b6225b504b575fc549b3 (MD5) Previous issue date: 2012 / Resumo: Objetivo: Avaliar a experiência de mulheres brasileiras com a prática de exercícios físicos para lidar com sintomas da síndrome pré-menstrual (SPM), e a experiência de ginecologistas brasileiros com a indicação dessa prática. Sujeitos e métodos: realizou-se um estudo descritivo, com análise secundária de dados da pesquisa "Tensão pré-menstrual: perspectiva e atitude de mulheres, homens e médicos ginecologistas no Brasil". Foram analisados os dados dos questionários das 948 mulheres entrevistadas no estudo original que referiram ter ou já ter tido sintomas da SPM; e 48 entrevistas semidirigidas com médicos ginecologistas (23 homens e 25 mulheres). Essas pessoas foram selecionadas e entrevistadas nas seguintes cidades: Campinas (Região Sudeste), Canoas (Região Metropolitana de Porto Alegre, Região Sul), Salvador e Camaçari (Região Metropolitana de Salvador, na Região Nordeste), Manaus (Região Norte), Campo Grande (Região Centro-Oeste), e Brasília (Distrito Federal). Para entrevistar as mulheres foi utilizado um questionário estruturado e pré-testado, e para as entrevistas semidirigidas com médicos (as) utilizou-se um roteiro organizado com perguntas de partida e de aprofundamento, desenvolvidas com base nos objetivos do estudo. Realizou-se análise bivariada dos dados quantitativos para avaliar a associação entre as seguintes variáveis e a prática de exercícios físicos para lidar com sintomas da SPM: estatus socioeconômico, idade, escolaridade, estado marital, cor, religião, trabalho remunerado, histórico reprodutivo, interferência da SPM na vida conjugal, familiar, laboral e de lazer; consulta médica motivada por sintomas da SPM, orientações recebidas nessa consulta, incluindo a prática de exercícios físicos. Realizou-se análise temática de conteúdo das entrevistas semidirigidas, pautada nas seguintes categorias de análise: Percepção sobre as principais queixas das mulheres relacionadas à SPM, causas da SPM, abordagem com as pacientes, indicações/ tratamentos para melhora dos sintomas, perspectiva em relação à eficácia das indicações/tratamentos. Resultados: Dentre as mulheres que referiram ter sintomas de SPM, apenas 8% mencionaram realizar exercícios físicos como forma de lidar com isso. Mais de um terço (38,6%) das mulheres que tinham sintomas de SPM disse ter consultado um médico, e 21,9% das que consultaram afirmaram que lhes foi indicado realizar exercícios físicos; 70% delas disseram ter seguido essa orientação. Os médicos ginecologistas referiram indicar a prática de exercícios físicos como parte de um conjunto de recomendações e prescrições para as mulheres que consultam pelos sintomas da SPM. Os profissionais consideravam que a prática de exercícios físicos era um recurso eficiente para ajudar a minimizar os sintomas, porém não acreditavam que as mulheres aderissem integralmente à sua recomendação, pois isso exigia mudança de estilo de vida. Conclusões: Mulheres e médicos (as) atribuíam valor positivo à prática de exercícios físicos como forma de lidar com sintomas da SPM. Porém, foi pequena a proporção de mulheres que, de fato, recorriam a essa prática. Os médicos, ao indicarem a prática de exercícios físicos como forma de lidar com os sintomas da SPM, inseriam-na em um conjunto de orientações voltadas a uma vida saudável, aliada aos tratamentos medicamentosos / Abstract: Objective: To evaluate the perspective and experience of Brazilian women regarding the practice of physical exercise as a mean to deal with the symptoms of the premenstrual syndrome (PMS), and of gynecologists with respect to recommending this practice for the same purpose. Subjects and Methods: Descriptive study based on a secondary analysis of quantitative and qualitative data collected for the study "Premenstrual syndrome: Brazilian women, men and physicians perspectives and attitudes". Data of 948 women who declared they had at least one SPM symptom, and of 48 gynecologists were analysed. All participants, women and physicians were selected in six major Brazilian cities: Campinas (São Paulo state, southeast region), Canoas (Rio Grande do Sul state, south region), Salvador e Camaçari (Bahia state, northeast region) Manaus (Amazonas state, north region), Campo Grande (Mato Grosso do Sul state, central west region) and Brasília (Federal District). Women responded a structured questionnaire and qualitative semi-structured interviews were conducted with gynecologists. The possible association between the following variables and the practice of physical exercise to deal with the symptoms of PMS was evaluated: socioeconomic level, age, schooling, marital status, ethnicity, religion, paid employment, reproductive history, whether PMS interfered with the woman's marital life, family life and working and leisure activities, medical consultations motivated by PMS symptoms, and guidance received at this consultation, including whether she was advised to practice physical exercise. For the qualitative data, thematic content analysis was performed based on the following categories of analysis: the perception of women's principal complaints regarding PMS, the causes of PMS, ways of dealing with women with PMS, recommendations/treatments to improve symptoms, and the physician's perspective in relation to the efficacy of recommendations/treatments. Results: Of the 948 women, who reported PMS symptoms, 8% reported having performed physical exercise to deal with these symptoms and slightly over one-third had consulted a physician. Of the women who consulted a doctor, 21.9% reported that they had received the indication to perform physical exercise of which 70% reported that they had followed the indication. The majority of the gynecologists reported recommending the practice of physical exercise to women consulting with PMS symptoms and considered the practice of physical exercise an effective tool for minimizing PMS symptoms. However, some believed that women fail to comply fully with this recommendation, since it requires changes in their lifestyle. Conclusions: Women and gynecologists attributed a positive value to the practice of physical exercise as a way of dealing with PMS symptoms; however, the proportion of women who adopted this practice was small. Gynecologists recommended the practice of physical exercises as part of a set of guidelines aimed at healthy living, however this recommendation was usually combined with drug or hormonal treatments / Mestrado / Fisiopatologia Ginecológica / Mestra em Ciências da Saúde