Background: Despite a declining trend in the incidence of gastric cancer (GC), it is still a major global public health concern of the 21st century. It afflicts one million people and kills 750,000 annually. It is believed that both genetic and environmental factors contribute to the gastric carcinogenesis. However geographic variation and immigrant studies highlight the role of environmental factors. Objective: To evaluate the association of GC with the environmental factors of diet, helicobacter pylori (H. pylori) infection, lifestyle and occupation as well as family history in Iran. Methodology: A population based case-control study was conducted in the Northwest of Iran where one of the highest incidence rates of the world has been reported. Two hundred and seventeen cases of GC and 394 age and gender matched controls were recruited. Participants were interviewed using a structured questionnaire which elicited information on demographic characteristics, socioeconomic status, family and medical history, lifestyle (smoking, alcohol drinking and substance abuse) and occupation. Ten milliliters of each subject???s blood was collected for blood grouping and to investigate presence of IgG antibodies against H. pylori using an ELISA kit which had been locally validated for this study. Results: Diet and H. pylori infection were found to be the most important determinants of GC in this study. High intake of allium vegetables and fruit, especially citrus fruit, appears to play a protective role. In addition to the consumption of fruit and vegetables, consumption of fresh fish was also inversely associated with GC. On the other, hand consumption of red meat and dairy products were positively associated with the risk of GC. Other dietary practices were also found to be important factors in the etiology of GC. People who had a preference for higher salt intake and drinking strong and hot tea were at higher risk. Finally, H. pylori infection was found to increase the risk of GC. Conclusion: This study has provided important and original information about the etiology of gastric cancer particularly in the Iranian context. These findings could be used in planning preventive strategies for this malignancy, which is a major health problem in Iran.

This study explores the meaning of occupation, defined as a “conceptual entity… [which] includes all the things that people do in their everyday life” (Sundkvist & Zingmark, 2003, p. 40). Using a phenomenological hermeneutic method informed by the writings of Martin Heidegger (1889-1976) and Hans-Georg Gadamer (1900-2002), this study provides an understanding of the meaning of occupation interpreted from the perspective of 12 New Zealand adults who experienced a disruption to their occupations. The review of the literature suggests that early writers from the time of the Bible identified that occupation is not ‘wide open’, there are many factors that shape how and when a person engages in an occupation, which in turn shapes the meaning of occupation. Within the occupational therapy literature, discussion of the meaning of occupation is overshadowed by describing and defending practice. In occupational science scholars and researchers have focused largely on understanding occupation from a conceptual perspective rather than the ontological meaning of occupation. The exploration of the meaning of occupation is being advanced by only a few. In this study participants told their stories about their occupations. Data were analysed by indentifying key themes and engaging in a hermeneutic thinking process of going back to the work of Heidegger and Gadamer. Writing and re-writing was the method used to bring new understandings to the data. The findings of this thesis suggest that the meaning of occupation is complex, and tends to remain hidden. Analysis focuses on the call, Being-with, and possibilities. The call to occupation seems to be in response to what it is we care about or what concerns us. Being-with others while engaging in an occupation creates a bond and mood; the meaning of occupation changes depending on who the occupation is done with or without. The meaning of occupation is also revealed in the possibilities that are opened up or closed down. Occupation shows both ourselves and others what it is we are capable of in the journey of who it is we are becoming. Each of these facets of meaning work in unison and can be likened to three cogs in a wheel, each interconnected with the others. The thesis concludes by recognising that not all voices have been heard and argues for uncovering more about the meaning of occupation from the perspective of lived experience. A challenge is made to consider the meaning of occupation not as something that is individually derived but as something that is connected to the broader context of the world and others in the world.

The notion of recovery from mental illness has become a significant force in mental health policy, practice and literature. As a process, recovery can been described as the lived experience of personal growth and search for meaning after the onset of mental illness. The following phenomenological inquiry seeks to understand the meaning of day-to-day activities for 13 people in recovery from mental illness. In the recovery literature there has recently been a growing interest in the everyday aspects of recovery. Routine interactions between people and the human and non-human environment have been recognised as being significant in the recovery process. Additionally, there has been a call within occupational therapy literature for research focused on exploring the experience and meaning of different forms of occupation. This study aims to address and add to these areas of interest within the current literature. Recovery narratives were collected from the participants in two phases, using an open ended conversational style of interview. The first phase focused on gathering stories that reflected the lived experience of recovery for eight participants. The recorded interviews were transcribed and analysed using the hermeneutic philosophy of Martin Heidegger. In the second phase of interviewing a further five participants shared their stories. In this round the conversations were focused on some of the dynamics of activity and recovery that had emerged as broad themes in the first phase. This allowed further depth to be added to the data and subsequent analysis. The interpretation focused on descriptions of engagement in activity during different periods of the participants’ recovery journeys. It was important to dwell with the stories and allow themes of experience and meaning to emerge. Particular phrases and words were highlighted and their meaning explored if they showed something of the participants’ lived experience. Through a process of writing, reflecting and re-writing the findings were refined and clarified over time. Everyday activity was found to be an important medium for change as well as a recovery outcome in itself. Findings add to existing understandings about occupation as a medium for healing and transformation within the context of recovery from mental illness. In particular, the study highlights the dynamics at play in different modes of doing and the way in which carers can influence the experience and meaning of activity.

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