Abstract Introduction Most countries including Australia are experiencing an ageing of their population, with an increasing proportion of frail older persons requiring hospitalisation from acute illness. The aging process places the older person at risk of geriatric syndromes, such as falling, dependency in performance of Activities of Daily Living and instrumental Activities of Daily Living, confusion, bladder and bowel incontinence. New or deteriorating geriatric syndromes are a frequent occurrence among hospitalized older patients. Hospital associated factors associated with these outcomes include complications of medical therapies; polypharmacy and excessive bed rest. Few studies have been conducted into factors predicting risk of negative outcomes in older patients admitted to medical units of acute care teaching hospitals. If available, a screening tool with few predictive factors, able to be administered close to the time of admission could be used to identify patients at lower and higher risk. It is imperative that such a tool is developed empirically and tested for its accuracy in identifying patients at high risk. Aims of the research The first aim was to identify the proportion of patients aged ≥ 70 years, admitted to acute care medical units that experienced a negative outcome. These outcomes included falls during hospitalisation, presence of new or a significant decline in existing pressure ulcers, significant decline in independently performing Activities of Daily Living (ADLs), requiring increased care needs at discharge, readmission to hospital with 28 days of the index hospitalisation, bladder and bowel incontinence, and delirium. The second aim was to identify factors predicting the risk of two of these negative outcomes: requiring a higher level of care at discharge, and experiencing a decline in independently performing ADLs. Based on the predictive factors, two screening tools to identify patients at risk were developed and validated. Method A prospective cohort study of 413 acute general medical patients, aged ≥ 70 years and consecutively admitted to an acute care metropolitan 700-bed teaching hospital was conducted. Consenting patients expected to remain in hospital for more than 48 hours were included. Patients were excluded if they were admitted to intensive or coronary care units, admitted for terminal care only or were transferred from a general medical to another unit within 24 hours of admission to the ward. Trained research nurses assessed patients and used the interRAI Acute Care instrument to collect information on candidate predictive variables and negative outcomes. Patients were assessed within 36 hours of admission and at discharge to obtain information on predictive variables and negative outcomes. Patients were also followed daily to identify any instances of transient negative outcomes during hospitalisation and at 28 days following discharge to identify any instances of readmission to hospital. The 413 cases were randomly split into 309 cases in the development cohort and 104 cases in validation cohort. Logistic regression models were used to identify the predictive factors independently associated with two negative outcomes, requiring a higher level of care at discharge and experiencing a decline in independently performing ADLs. Findings At least one negative outcome was experienced by 53% of the development and 63% of the validation cohort. The most common negative outcomes experienced were: delirium (27%; 23%), a significant decline in ADLs (19%, 22%), requiring a higher level of care at discharge (16%, 16%), and readmission to hospital within 28 days of discharge (17%, 28%) in the development and validation cohorts respectively. The logistic regression analysis identified four independent factors associated with requiring higher levels of care at discharge: ‘short term memory problems’ (OR 4.21, 95% CI 1.79, 9.89; p=0.001); ‘dependence in toilet use’ (OR 3.51, 95% CI 1.14, 10.84; p=0.029); ‘dependence in hygiene’ (OR 2.76, 95% CI 1.16, 6.56; p=0.021), and ‘use of community services prior to admission’ (OR 2.41, 95% CI 1.12, 5.16; p= 0.024). A screening tool developed to assess patients at lower and higher risk had a sensitivity, specificity, positive predicted value (PPV) and negative predictive value (NPV) of 77.27%, 73.66%, 36.56% and 94.29% respectively. Reasonable accuracy was evident when tested in the validation sample. Sensitivity, specificity, PPV and NPV were 60%, 76.32%, 33.33% and 90.63% respectively. Predictive factors associated with a significant decline in ADLs were: ‘history of falling’(OR 2.21, 95% CI 1.12, 4.36; p= 0.023), ‘no interest in things enjoyed normally’ (OR 4.30, 95% CI 1.92, 9.64; p=0.000), ‘dependence in management of finances’ (OR 3.93, 95% CI 1.63, 9.48; p =0.002) and ‘hearing problems’ (OR 2.38, 95% CI 1.05, 5.39; p =0.038). The screening tool had sensitivity, specificity, PPV and NPV in the development cohort of 74.55%, 69.13%, 36.6% and 92% respectively and 45%, 65.79%, 25.7% and 82% respectively in the validation sample. Conclusion The tools require further validation in larger samples in diverse settings. Future research should focus on developing a screening tool that could predict risk of a number of negative outcomes to enhance the provision of quality patient care.

Diss. Stockholm : Karolinska institutet, 2005.

Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 145-160).

Desenvolvemos estudo entre trabalhadores de uma destilaria do interior paulista com o objetivo de identificar o perfil de trabalhadores do sexo masculino quanto aos fatores de risco cardiovasculares. O referencial teórico foi o Modelo de “Campo de Saúde" que compõe os elementos de biologia humana, meio ambiente, estilo de vida e organização dos serviços de saúde. A população estudada constituiu-se de 123 trabalhadores, com idade entre 18 e 71 anos, que desenvolviam atividades no setor da indústria. Os dados foram obtidos através da entrevista individual feita pelo pesquisador na própria destilaria onde os mesmos atuavam. Ao término de cada entrevista procedeu-se a verificação da pressão arterial pelo método indireto, em seguida o exame antropométrico que constituiu-se da medida de peso e altura. Os níveis tensionais foram obtidos através de duas medidas com utilização do aparelho oscilométrico da marca Dixtal (modo automático) e manguitos de bolsa de borracha compatíveis com a circunferência braquial do indivíduo. Com relação a biologia humana, 10,6% dos trabalhadores apresentou obesidade grau I, 17,0% obesidade grau II; em 11,4% dos indivíduos identificamos valores de pressão arterial sistólica ³ 140 mmHg e em 12,2% com pressão arterial diastólica ³ 90 mmHg; quanto aos antecedentes familiares, 32,5% referiram história familiar positiva de doença hipertensiva, 26,0% de acidente vascular cerebral e 27,6 de diabetes melitus. Quanto ao meio ambiente, 60,2% possuíam o 1º grau incompleto, 49,6% eram casados e 97,6% tinham o único emprego. No tocante ao estilo de vida, 40,7% referiram realizar algum tipo de atividade física, 16,3% eram fumantes, 65,9% indicaram consumo de bebida alcoólica e 49,6% referiram ingerir alimentos preparados com muito sal. Em relação ao atendimento de saúde todos trabalhadores participantes no estudo possuíam convênio médico, além daquele oferecido pela própria empresa. Os dados revelam existência de hábitos autocriados que podem ser modificados e que se constituem em fatores de risco cardiovascular; realçamos a necessidade de promoção de ações educativas visando à prevenção dessas doenças. / This study was developed among workers of a distillery in the interior of São Paulo State aiming at identifying the profile of male workers with regard to risk factors of cardiovascular diseases. The theoretical framework was based on the “Health Field" Model, which composes the elements of human biology, environment, lifestyle and organization of health services. The studied population consisted of 123 workers aged 18 to 71 years who performed their activities in the factory. Data were obtained by means of individual interviews conducted by the researcher in the facilities of the distillery where the subjects worked. At the end of each interview, each individual’s arterial pressure was measured by means of the indirect method, which was followed by the assessment of their anthropometric measures, namely height and weight. Tension levels were obtained through two measurements with the use of an oscillometric device (automatic mode) manufactured by Dixtal and rubber-bag cuffs which were compatible with the individual’s brachial circumference. With regard to human biology, 10.6% of the workers presented level-1 obesity and 17% had level-2 obesity, 11.4% of the individuals, systolic arterial pressure values were found to be 140mmHG and in 12.2% diastolic arterial pressure values were found to be 90mmHG. Concerning their family history, 32,5% reported a family history with the presence of hypertensive disease consisting of cerebral vascular accidents (26.0%) and diabetes mellitus (27.6%). As to the environment, 60.2% had incomplete elementary school education, 49.6% were married and 97.6% had only one job. Concerning lifestyle, 40.7% reported the habit to perform some type of physical activity, 16.3% were smokers, 65.9% indicated the consumption of alcoholic beverages and 49.6% reported to ingest food prepared with a high amount of salt. As to healthcare, all the workers participating in the study had a medical insurance in addition to that provided by the company. Data showed the existence of self-created habits which consisted in risk factors of cardiovascular diseases. Since such habits can be modified, the need to promote educational action aiming at the prevention of such diseases is emphasized.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser. NB: Spikblad saknas.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed Sept. 19, 2008). Includes bibliographical references (p. 117-128).

Desenvolvemos estudo entre trabalhadores de uma destilaria do interior paulista com o objetivo de identificar o perfil de trabalhadores do sexo masculino quanto aos fatores de risco cardiovasculares. O referencial teórico foi o Modelo de “Campo de Saúde” que compõe os elementos de biologia humana, meio ambiente, estilo de vida e organização dos serviços de saúde. A população estudada constituiu-se de 123 trabalhadores, com idade entre 18 e 71 anos, que desenvolviam atividades no setor da indústria. Os dados foram obtidos através da entrevista individual feita pelo pesquisador na própria destilaria onde os mesmos atuavam. Ao término de cada entrevista procedeu-se a verificação da pressão arterial pelo método indireto, em seguida o exame antropométrico que constituiu-se da medida de peso e altura. Os níveis tensionais foram obtidos através de duas medidas com utilização do aparelho oscilométrico da marca Dixtal (modo automático) e manguitos de bolsa de borracha compatíveis com a circunferência braquial do indivíduo. Com relação a biologia humana, 10,6% dos trabalhadores apresentou obesidade grau I, 17,0% obesidade grau II; em 11,4% dos indivíduos identificamos valores de pressão arterial sistólica ³ 140 mmHg e em 12,2% com pressão arterial diastólica ³ 90 mmHg; quanto aos antecedentes familiares, 32,5% referiram história familiar positiva de doença hipertensiva, 26,0% de acidente vascular cerebral e 27,6 de diabetes melitus. Quanto ao meio ambiente, 60,2% possuíam o 1º grau incompleto, 49,6% eram casados e 97,6% tinham o único emprego. No tocante ao estilo de vida, 40,7% referiram realizar algum tipo de atividade física, 16,3% eram fumantes, 65,9% indicaram consumo de bebida alcoólica e 49,6% referiram ingerir alimentos preparados com muito sal. Em relação ao atendimento de saúde todos trabalhadores participantes no estudo possuíam convênio médico, além daquele oferecido pela própria empresa. Os dados revelam existência de hábitos autocriados que podem ser modificados e que se constituem em fatores de risco cardiovascular; realçamos a necessidade de promoção de ações educativas visando à prevenção dessas doenças. / This study was developed among workers of a distillery in the interior of São Paulo State aiming at identifying the profile of male workers with regard to risk factors of cardiovascular diseases. The theoretical framework was based on the “Health Field” Model, which composes the elements of human biology, environment, lifestyle and organization of health services. The studied population consisted of 123 workers aged 18 to 71 years who performed their activities in the factory. Data were obtained by means of individual interviews conducted by the researcher in the facilities of the distillery where the subjects worked. At the end of each interview, each individual’s arterial pressure was measured by means of the indirect method, which was followed by the assessment of their anthropometric measures, namely height and weight. Tension levels were obtained through two measurements with the use of an oscillometric device (automatic mode) manufactured by Dixtal and rubber-bag cuffs which were compatible with the individual’s brachial circumference. With regard to human biology, 10.6% of the workers presented level-1 obesity and 17% had level-2 obesity, 11.4% of the individuals, systolic arterial pressure values were found to be 140mmHG and in 12.2% diastolic arterial pressure values were found to be 90mmHG. Concerning their family history, 32,5% reported a family history with the presence of hypertensive disease consisting of cerebral vascular accidents (26.0%) and diabetes mellitus (27.6%). As to the environment, 60.2% had incomplete elementary school education, 49.6% were married and 97.6% had only one job. Concerning lifestyle, 40.7% reported the habit to perform some type of physical activity, 16.3% were smokers, 65.9% indicated the consumption of alcoholic beverages and 49.6% reported to ingest food prepared with a high amount of salt. As to healthcare, all the workers participating in the study had a medical insurance in addition to that provided by the company. Data showed the existence of self-created habits which consisted in risk factors of cardiovascular diseases. Since such habits can be modified, the need to promote educational action aiming at the prevention of such diseases is emphasized.

Thesis (M.S.)--Uniformed Services University of the Health Sciences, 2005. / Typescript (photocopy).

Railway level crossing collisions in Australia are a major cause of concern for both rail and road authorities. Despite the fact that the number of railway crash fatalities in Australia has fallen in recent years, level crossing collisions constitute a significant proportion of the national rail toll. Although rail transport is presently one of the safest forms of land transport, collisions at level crossings are three times more likely to involve fatalities as compared to all other types of road crashes (Afxentis, 1994). With many level crossing fatalities and injuries resulting in coronial inquests, litigation and negative media publicity, the actions of rail and road infrastructure providers and the behaviour of motorists, pedestrians and rail users, come under close scrutiny. Historically, research in this area has been plagued by the rail/road interface and the separation of responsibilities between rail and road authorities reflecting the social and political context in which they are contained. With the recent rail reform in Australia, safety at level crossings has become a key priority area. Accordingly, there is a need to better understand the scope and nature of motorist behaviour at level crossings, in order to develop and implement more effective countermeasures for unsafe driving behaviour. However, a number of obstacles have hindered research into the area of level crossing safety. As with many road crashes, the contributing causes and factors are often difficult to determine, however a recent investigation of fatal collisions at level crossings supports the notion that human fault is a major contributor (Australian Transport Safety Bureau, 2002a). Additionally, there is a lack of reliable data available relating to the behavioural characteristics and perceptions of drivers at level crossings. Studies that do exist have lacked a strong theoretical base to guide the interpretation of results. Due to the lack of financial viability of continuing to approach risk management from an engineering perspective, the merits of human factor research need to be examined for suitability. In Australia, there has been considerable recognition regarding the importance of human factor approaches to level crossing safety (Australian Transport Council, 2003). However, little attempt has been made by authorities to scientifically develop and measure the effectiveness of road safety educational interventions. Therefore, there exists a significant need for developing targeted road safety educational interventions to improve current risk management solutions at level crossings. This research program is the first of its kind in investigating motorist behaviour at level crossings and the measuring the effectiveness of educational interventions for improving driving safety. Although other ‘educational’ campaigns exist in this field, no campaign or intervention has been guided by empirical research or theory. This thesis adopted a multidisciplinary approach to theory, reviewing perspectives from psychology, sociology and public health to explain driver behaviour at level crossings. This array of perspectives is necessary due to the variety of behaviours involved in collisions and near-misses at level crossings. The motivation underlying motorist behaviour determines to a large extent how successful behaviour change strategies (e.g. educational interventions) may be. Fishbein’s Integrated Model of Behaviour Change (IM) based largely on the health belief model, theory of reasoned action and theory of planned behaviour (Fishbein, 2000), assisted in the planning and development of a ‘oneoff’ targeted educational intervention specific for three different road user groups and in questionnaire development to ascertain the present context of motorist behaviour at level crossings. As no known research has been conducted that utilizes any psychosocial model to explain or predict level crossing behavior within different road user groups, this research program used this model as an exploratory tool rather than a tool to asses the model’s capacity in explaining such behaviour. The difference between this model and others is the inclusion of two important constructs in driving: skills (or abilities) and environmental factors. Fishbein (2003) suggests that the model recognises the lack of skills (or abilities) and/or environmental constraints may prevent a person from acting on their intentions, in light of the fact that intention is viewed as the primary determinant of behaviour. While the majority of behaviour change theories are limited by a range of conceptual and contextual factors (Parker, 2004), the IM was used to assist this research program as it appeared to be the most applicable model to examining level crossing safety. A variety of data collection methods were used in this research program as much of what is currently known about level crossing collisions is derived from coroner’s findings and statistics. The first study (Study One) was designed to extend this knowledge by undertaking a more thorough examination of contributing factors to level crossing crashes and the road user groups at risk. This study used the method of ‘triangulation’ (i.e. combining research methods to give a range of perspectives) whereby both qualitative (focus groups) and quantitative (modified Delphi technique) research designs were utilised (Barbour, 1999, Bryman, 1992). With the discipline of road safety research requiring methodological strategies that will enhance efforts to conceptualise the multi-faceted nature of motorist behaviour at level crossings, this application provided the robustness required. Results from the Delphi technique indicated that older, younger and heavy vehicle drivers are considered to be three of the highest risk road user groups by experts in the field. For the older driver group, experts agreed that errors in judgment were the most important issue for this group when driving at level crossings. Risk taking by younger drivers, such as trying to beat the train across the crossing, was viewed as the central issue for the younger driver group. Like the younger driver group, a concern by experts with the heavy vehicle group was intentional risk taking at level crossings. However, experts also rated the length of heavy vehicles a major concern due to the possibility of a truck over-hanging a crossing. Results from focus groups with train drivers in Study One indicated that there are unique problems associated with crossings in rural/regional areas compared to urban areas. The metropolitan train drivers generally experienced motorist behaviour at active crossings with flashing lights and boom gates while the regional train drivers experienced behaviours at active crossings with boom gates, crossings with lights only and passive crossings with stationary signs. In the metropolitan train driver group, experiences of motorist behaviour at level crossings included: motorists driving around boom gates, getting stuck under boom gates, queuing over congested crossings and driving through the crossing after the red lights commence flashing. The behaviour of motorists driving around boom gates was noted to occur quite regularly. The majority of metropolitan train drivers reported that it was a common occurrence for motorists to drive through a crossing when the lights are flashing both before and after the booms were activated and some crossings were named as ‘black spots’ (locations where motorists repeatedly violate the road rules). Vehicles protruding into the path of the train and motorists entering congested crossings and then panicking and driving backwards into the boom gates were also mentioned. Regional train drivers indicated that motorists not stopping or giving way to trains is a continual problem at passively controlled crossings (i.e. no boom gates or flashing lights). Regional train drivers generally agreed that the majority of motorists obey protection systems; however some motorists drive through flashing lights or drive around boom gates. Other high risk behaviours included motorists attempting to beat the train across the crossing, speeding up to go through flashing lights, and general risk taking by younger drivers in particular. Motorists not allowing enough time to cross in front of the train or hesitating (stopstarting) at crossings were also noted to be at high risk. There was a general perception by regional train drivers that motorists are unable to judge the speed and distance of an approaching train to determine a safe gap during which to cross. Local motorists were also reported to be a problem at level crossings for regional train drivers. A theme common to regional and metropolitan train drivers was the risk of catastrophic consequence associated with level crossing collisions. The reasons given for this were the threat of derailment, serious property damage, the high risk of a fatality, personal injury and, most earnestly, the potential for enduring psychological consequences. Drivers uniformly spoke about the continual fear they had of being involved in a collision with a heavy vehicle, and many spoke of the effects that such collisions had on train drivers involved. For this reason, train drivers were said to consider any near-miss incident involving trucks particularly serious. The second study undertaken as part of this research program (Study Two), involved formative research as part of the planning, development and delivery of behavioural interventions for each of the three road user groups identified in Study One. This study also used both qualitative and quantitative data collection methods to provide methodological triangulation and ensure reliability of the data. The overall objective of the qualitative data collection was to obtain rich data using a qualitative mode of inquiry, based on the key variables of attitudes, norms, self-efficacy (perceived behavioural control), perceived risk, environmental constraints and the skills/abilities of drivers. The overall objective of the quantitative data collection was to prioritise the issues identified in order to direct and allocate project resources for intervention planning, development and delivery. This combined recruitment strategy was adopted as it was an appropriate and practical data collection strategy within the qualitative and exploration methodology. Information obtained from each of the groups was critical in assisting, guiding, and identifying priority areas for message and material development. The use of focus groups and one-on-one interviews provided insights into why drivers think or do what they do at level crossings. The qualitative component of this study found that for the older driver group, regional drivers hold a greater perception of risk at level crossings than urban older drivers, with many recalling near-misses. Participants from the urban older driver group indicated that level crossings are not as dangerous as other aspects of driving, with many participants being doubtful that motorists are killed while driving at level crossings. Both urban and regional younger drivers tended to hold a low perception of risk for driving at level crossings, however many participants reported having great difficulty in judging the distance a train is from a crossing. Impatience for waiting at level crossings was reported to be the major reason for any risk taking at level crossings in the younger driver group. Complacency and distraction were viewed by heavy vehicle participants as two of the major driver factors that put them at risk at level crossings, while short-stacking (when the trailer of the truck extends onto the crossing), angle of approach (acute or obtuse angle) and lack of advance warning systems were seen as the major engineering problems for driving a truck at level crossings. The quantitative component of this study involving research with train drivers found that at the aggregate train driver level, it is apparent that train drivers consider motorists’ deliberate violations of the road rules and negligently lax approach to hazard detection as the predominant causes of dangerous driving at level crossings. Experts were observed to rank risk taking behaviours slightly lower than train drivers, although they agreed with train drivers that ‘trying to beat the train’ is the single most critical risk taking behaviour observed by motorists. The third study (Study Three) involved three parts. The aim of Part One of this study was to develop targeted interventions specific to each of the three road user groups by using Fishbein’s theoretical model (Integrated Model of Behaviour Change) as a guide. The development of interventions was originally seen as being outside of the scope of this project, however it became intertwined in questionnaire development and thus deemed to be within the realms of the current mode of inquiry. The interventions were designed in the format of a pilot radio road safety advertisement, as this medium was found to be one of the most acceptable to each of the road user groups as identified in the formative research undertaken in Study Two. The interventions were used as a ‘one-off’ awareness raising intervention for each road user group. Part Two involved the investigation of the present context of unsafe driving behaviour at level crossings. This second part involved the examination of the present context of motorist behaviour at level crossings using key constructs from Fishbein’s Integrated Model of Behaviour Change (IM). Part Three involved trialing a pilot road safety radio advertisement using an intervention and control methodology. This part investigated the changes in pre and post-test constructs including intentions, self-reported behaviour, attitudes, norms, selfefficacy/ perceived behaviour control, perceived risks, environment constraints and skills/ability. Results from this third study indicated that younger drivers recognise that level crossings are potentially a highly dangerous intersection yet are still likely to engage in risk taking behaviours. Additionally, their low levels of self-efficacy in driving at level crossings pose challenges for developing interventions with this age group. For the older driver sample, this research confirms the high prevalence of functional impairments such as increasing trouble adjusting to glare and night-time driving, restricted range of motion to their neck and substantial declines in their hearing. While factors contributing to the over-representation of older drivers in collisions at level crossings are likely to be complex and multi-faceted, such functional impairments are expected to play a critical role. The majority of heavy vehicle drivers reported driving safely and intending to drive safely in the future, however, there is a sub-set of drivers that indicate they have in the past and will in the future take risks when traversing crossings. Although this sub-set is relatively small, if generalised to the larger trucking industry it could be problematic for the rail sector and greater public alike. Familiarity was a common factor that was found to play a role in driving intention at level crossings for all three road user groups. This finding supports previous research conducted by Wigglesworth during the 1970’s in Australia (Wigglesworth, 1979). Taken together, the results of the three studies in this research program have a number of implications for level crossing safety in Australia. Although the ultimate goal to improve level crossing safety for all motorists would be to have a combination of engineering, education and enforcement countermeasures, the small number of fatalities in comparison to the national road toll limits this. It must be noted though that the likelihood of creating behavioural change would be increased if risk taking at level crossings by all motorists was detected and penalised, or alternatively, if perceptions of such detection were increased. The instilling of fear in drivers with the threat of punishment via some form of sanction can only be achieved through a combination of a mass media campaign and increasing police presence. Ideally, the aim would be to combine fear of punishment with the guilt associated with the social non-acceptability of disobeying road rules at level crossings. Such findings have direct implications for improving the present context of motorist behaviour at level crossings throughout Australia.

Thanks to the latest achievements in diagnostics, surgery and oncology, the overall perspective of colorectal cancer has changed significantly. There are no doubts that we deal with a complex disease, requiring multidisciplinary approach and assessment. Only this approach can enable patients to survive longer and maintain acceptable quality of there lives. Taking a long view over several decades, the steep rise in incidence of this malignancy was strongly alarming. It is partly a penalty for a prolongation of life expectance, since one of the risk factors is age. Knowing the way of life and dietary customs of our ancestors, one cannot deny that the change of lifestyle including dietary habits, as well as decrease of physical activity, obesity, stress, unsuitable thermal processing of food produced in bulk, consumption of immoderate amount of red meat, limited intake of raw vegetable and fruits, excessive intake of xenobiotics, such as medication or cosmetic products, excessive alcohol consumption, particularly beer, nicotinism, environmental pollutants, etc. contribute to the increase of this cancer incidence. All the above mentioned factors have led over the time to a formation and development of numerous so called civilization diseases, among which rates the colorectal cancer (CRC). Despite the...