Le but de ce travail est d’étudier le lien suspecté entre l’inflammation buccale et la survenue des AVC ischémiques. Dans les pays occidentaux, l’incidence des infarctus cérébraux est en augmentation malgré les campagnes de prévention visant à limiter l’exposition aux facteurs de risque classiques des pathologies ischémiques. Près de 9% des accidents vasculaires cérébraux sont sans étiologie connue. Le facteur déclenchant de l’AVC ischémique ou le « key trigger » reste inconnu. Des études récentes montrent qu’un AVC ischémique est plus susceptible de se déclencher dans la semaine qui suit un événement infectieux. De ce fait, l’inflammation buccale entraînant une élévation de différents biomarqueurs inflammatoires est susceptible de favoriser la survenue des AVC. Dans un premier temps, une méta-analyse a été effectuée afin de faire la synthèse des données étudiant la relation entre l’inflammation buccale et la survenue des AVC. Elle a montré que le risque d’avoir un AVC ischémique fatal augmente de 38% chez les sujets atteints de parodontite sévère. Dans un deuxième temps, deux études cliniques observationnelles ont été mises en place afin de renforcer la validité des liens épidémiologiques supposés et d’apporter de nouveaux éléments dans la compréhension des mécanismes physiopathologiques liant l’inflammation buccale et la survenue des AVCI. Les résultats montrent une relation entre le degré d’inflammation buccale et les marqueurs biologiques athéromateux et inflammatoires. En effet, nos résultats montrent une augmentation des taux de CRP, de VLDL, de triglycérides et une diminution des taux de HDL lors d’une atteinte parodontale sévère. C’est la perte osseuse parmi les marqueurs cliniques de l’inflammation buccale aisément évaluable sur un panoramique dentaire, qui est la plus significativement liée au risque de la survenue des AVC ischémiques. Les résultats de cette thèse suggèrent que la présence d’un contexte buccal inflammatoire favoriserait la survenue le développement d’un AVCI. En outre, nos résultats confirment la nécessité d’une coopération entre l’odontologue et le neurologue afin d’améliorer la prise en charge du risque vasculaire chez un patient ayant un AVCI avec une inflammation buccale. / The aim of this work is to investigate the suspected link between oral inflammation and the occurrence of ischemic stroke. In Western countries, the incidence of ischemic stroke is rising despite prevention campaigns aiming at limiting the exposure to common risk factors for ischemic diseases. Nearly 9% of strokes are of unknown etiology. The triggering factor for ischemic stroke or "trigger key" remains unknown. Recent studies have shown that ischemic stroke is more likely to occur in the week following an infectious event. Therefore, oral inflammation, that causes a rise in various inflammatory biomarkers is studied as potentially increasing the risk of stroke. Firstly, a meta-analysis was performed to synthesize data about the relationship between oral inflammation and the occurrence of stroke. It has shown that the risk of fatal ischemic stroke increases by 38% in patients with severe periodontitis. Secondly, two observational clinical studies have been implemented to strengthen the validity of the supposed epidemiological links and bring new elements in our understanding about the pathophysiological mechanisms linking oral inflammation and the occurrence of ischemic stroke. The results show a proportional relationship between the degree of oral-inflammation and biological assessments that demonstrate pro-atherosclerotic and pro-inflammatory state. Indeed, we observe an increase in CRP levels, VLDL triglycerides and a decrease in HDL in patients with severe periodontal disease. Bone loss, that is easily measurable on a dental panoramic radiograph, appears to be the main risk factor of the occurrence of ischemic stroke.The results of this thesis show that the presence of an inflammatory oral environment is an additional marker for the discovery of a cardiovascular risk in patients combining other conventional risk factors of ischemic stroke. In addition, our results suggest the need for cooperation between the neurologists and odontologists to improve the management of cardiovascular risk in patients with ischemic stroke and oral inflammation.

Na região do Vale do Ribeira, os resíduos de mineração foram dispostos diretamente sobre o solo, nas proximidades da empresa responsável pelo beneficiamento e fundição do minério de chumbo (Pb) (próximo à Vila Operária – município de Adrianópolis-PR). A escória de fundição enriquecida em metais potencialmente tóxicos (MPT), primeiramente foi disposta na forma de pilha. Em 2006, parte desta escória foi transferida para um aterro de resíduo sólido localizado a 50 m do antigo depósito e parte continuou no antigo local de disposição. As escórias que continuaram no antigo local foram espalhadas e cobertas com um solo residual. Esta cobertura não foi realizada de forma adequada, sendo que em algumas porções da área é possível ver as escórias, estando estas em contato direto com os animais (principalmente, ovinos e bovinos). Visando avaliar a influência da disposição das escórias na contaminação do solo de superfície e basal, foram coletadas amostras em distintas profundidades e em duas linhas de caminhamento principais (NS e EW) na área da antiga disposição. Nestas amostras foram realizadas caracterizações geotécnicas, geoquímicas e microbiológicas. Os ensaios realizados foram: granulometria conjunta, limites de Atterberg, capacidade de troca catiônica (CTC) e superfície específica (SE), matéria orgânica (MO), potencial hidrogeniônico (pH), potencial redox (Eh), condutividade elétrica (CE), delta pH (ΔpH), microscopia eletrônica de varredura com espectrômetro de energia dispersiva acoplado (MEV/EDS), mineralogia por difração de raios-x (DRX), fluorescência de raios-x (FRX), determinação da concentração pseudo-total (absorção atômica – AA; espectrometria de emissão atômica - ICP/AES), solubilização, lixiviação, extração sequencial, avaliação da comunidade microbiana por RCP-EEGD (ou PCR-DGGE) e sequenciamento do gene RNAr 16S via ILLUMINA. A avaliação da contaminação foi realizada considerando índice de geoacumulação (Igeo ), fator de enriquecimento (FE ou EF), Código de Avaliação de Risco (CAR ou RAC) e potencial de risco ecológico (Eir). O pH em H2O observado no depósito foi de 6,5 a 7,6, indicando que o meio é ligeiramente ácido. Já o Eh foi considerado oxidante. A CE foi especialmente elevada nas amostras superficiais (0-20 cm) e nos perfis coletados na linha de caminhamento EW. A CTC média foi de 14,3 cmolc/kg, sendo esta característica da caulinita. Quanto ao teor de matéria orgânica observou-se variação de 0,3 a 5,4 g/kg, sendo o valor médio de 2,14 g/kg. A base do depósito possui média de 68% de finos e índice de plasticidade de 2 a 35%. Para a base do depósito (de 60 a 100 cm) observou-se concentrações pseudo-totais de MPT bem inferiores ao topo. Em relação ao solo superficial observou-se elevada concentração pseudo-total, principalmente de Pb (média de 6.268,85 mg/kg) e Zn (média de 20.261,50 mg/kg). As concentrações de Cd observadas foram acima dos valores de background da área (média de 12,19 mg/kg). A concentração de MPT nas amostras coletadas na linha de caminhamento EW foram superiores às de NS, estando mais elevadas naquelas mais próximas à antiga empresa de beneficiamento. A partir dos ensaios de solubilização, lixiviação e extração sequencial, notou-se que o Pb e o Cd estão mais prontamente solúveis. Verificou-se para o Cd menor concentração pseudo-total, quando comparado com o Pb e Zn, todavia, observou-se para esse metal maior índice de geoacumulação, maior risco ecológico e maior mobilidade. A ordem obtida para os MPT, de acordo com o risco potencial, utilizando as frações mais móveis foi Cd > Pb ≈ Zn. Obteve-se maior diversidade e riqueza bacteriana nas amostras com maior concentração pseudo-total de metais, maior Igeo e maior Eir . Nas amostras superficiais foram identificadas bactérias tolerantes a presença de MPT, como Rhodoplanes, Kaistobacter, Sphingomonas, Flavobacterium, Cellvibrio, Rheinhermera e Pseudomonas. Assim, conclui-se que a porção superficial do perfil e mais próxima a empresa que beneficiou o minério está mais contaminada e com maior risco que a basal. A partir desses resultados pode-se inferir que a integração de conhecimentos é fundamental na avaliação da contaminação em áreas de mineração. / In the Ribeira Valley region, mining wastes were placed directly on the soil near the company responsible for the processing and smelting of lead ore (Pb) (near of the Vila Operária – Adrianópolis-PR). The slag enriched in potentially toxic metals (PTM) was initially deposited in piles. In 2006 part of the slag was moved to a solid waste landfill located 50 m from the old deposit and part remained at the former disposal site. The slag that remained in the old deposit were spread out evenly and covered with a residual soil. This coverage was not performed adequately, and in some areas of the deposit the slag is on the soil surface, being in direct contact with animals (mainly sheep and cattle). In order to assess the contamination of slag disposal on soil, samples were collected at various depths and in two main transverse lines (NS and EW) in the area of the old deposit. Geotechnical, geochemical and microbiological characterization were performed in these samples. The assays carried out were: granulometry, Atterberg limits, cation exchange capacity (CEC) and specific surface (SS), organic matter (OM) content, hydrogenation potential (pH), redox potential (Eh), electrical conductivity (EC), delta pH (ΔpH), scanning electron microscopy coupled with energy dispersive spectrometer (SEM/EDS), mineralogy using X-ray diffraction (XRD), x-ray fluorescence (XRF), determination of pseudo-total concentration (atomic absorption - AA; inductively coupled plasma atomic emission spectroscopy - ICP/AES), solubilization, leaching, sequential extraction, microbial community evaluation by PCR-DGGE and sequencing of the 16S RNAr gene via ILLUMINA. The evaluation of the contamination was conducted using the geoaccumulation index (Igeo), enrichment factor (EF), Risk Assessment Code (RAC) and potential ecological risk (Eir). The mean pH in H2O observed in the deposit varied from 6.5 to 7.6 (slightly acid) and Eh was considered oxidant. EC was especially high in the surficial samples (0-20 cm) and in the profiles collected in the EW transverse line. The medium CEC was 14.3 cmolc/kg, characteristic of kaolinite. The organic matter content varied from 0.3 to 5.4 g/kg, with a mean value of 2.14 g/kg. The base of the deposit is constituted with a medium of 68% of fines and plasticity index of 2-35%. It was observed that the base of the deposit (60 to 100 cm) has a considerably lower pseudo-total concentration of PTM when compared to the topsoil. In the surficial soil it was observed high pseudo-total concentration, mainly Pb (mean of 6,268.85 mg/kg) and Zn (mean of 20,261.50 mg/kg). The Cd concentrations were above the background values of the area (mean of 12.19 mg/kg). The PTM concentration in samples collected in the EW transverse line were higher than those of NS, being specially higher in the samples closer to the former beneficiation company. According to the results obtained from the solubilization, leaching and sequential extraction assays, it was noted that Pb and Cd are more readily soluble. A lower pseudo-total concentration was observed for Cd, when compared to Pb and Zn, however, a higher geoaccumulation index, greater ecological risk and greater mobility was observed for this metal. The order for PTM, according to the potential risk, using the more mobile fractions was Cd > Pb ≈ Zn. Greater diversity and bacterial richness were obtained in the samples with higher pseudo-total concentration of metals, higher Igeo and greater Eir. In the surficial samples, bacteria tolerant to the presence of PTM, such as Rhodoplanes, Kaistobacter, Sphingomonas, Flavobacterium, Cellvibrio, Rheinhermera and Pseudomonas were identified. Thus, it is concluded that the surface portion of the profile closer to the former smelting company is more contaminated and with greater risk than the basal portion. From the results it can be inferred that the integration of knowledge is fundamental in the evaluation of the contamination in mining areas.

This thesis deals with the risk analysis and risk management of a construction project, their detailed characteristics and classification. In the practical part, knowledge and findings from the theoretical part are applied to a project aimed at the reconstruction and completion of an indoors swimming pool in the town Kuřim. In the course of the risk analysis assessment, important information on the project were given, furthermore, risks were identified, the intensity of their impact and likelihood of their development was established, and measures to reduce the risks were recommended.

Ideologisk motiverad våldsbejakande extremism är ett resultat av en radikaliseringsprocess. Detta är ett stort problem och skolan har ett ansvar att arbeta preventivt mot detta problem. Syftet är att göra en systematisk litteraturstudie om hur skolan och lärare kan arbete på ett framgångsrikt sätt i syfte att minska riskerna för radikalisering. För att göra detta är det viktigt att ha koll på vilka faktorer som kan leda till radikalisering, vilka arbetsmetoder som har en preventiv effekt. Detta arbete är viktigt eftersom den svenska skolan har en central uppgift att fostra aktiva och demokratiska samhällsmedborgare. Detta är ett stort område och aktiva forskare har olika synsätt på radikaliseringsprocessen vilka presenteras i form av ett analysschema. Radikalisering sker till följd av att en individ utsätts för riskfaktorer sprungna ur psykiska och sociala problem. Det kan exempelvis handla om mental ohälsa, polarisering eller uppfostran. För att arbeta preventivt mot att elever radikaliseras har ett antal olika program som utformats. Exempel på sådana program är British prevent och Toleransprojektet. Dessa program innehåller framgångsfaktorer, detta innebär att vissa sätt att arbeta på eller vissa områden att arbeta kring har en preventiv effekt mot radikalisering. Framgångsfaktorerna kan bland annat innefatta värdegrundsarbete, relationskompetens hos lärare eller ökad tolerans bland eleverna.

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Notre thèse explore les facteurs de risque et les modèles des facteurs sur le marché boursier chinois A-share. Notre étude est basée sur le contexte du modèle facteur de Fama-French (FF). Tout d'abord, au chapitre 1, nous réexaminons l'applicabilité du Modèle Fama-French à Trois Facteurs (FF3F) et du dernier Modèle Fama-French à Cinq Facteurs (FF5F), compte tenu de plusieurs caractéristiques spéciales du marché boursier chinois. Les résultats empiriques montrent que le Modèle FF3F peut expliquer la majorité des variations de séries chronologiques des rentabilités des actions chinoises A-share. Au cours de la période d'échantillonnage, le marché bêta et le facteur SMB sont des déterminants importants pour expliquer la variation transversale des rentabilités des actions, cependant nous ne trouvons aucune prime de valeur. D’après la comparaison des performances des modèles FF3F et FF5F en présence de facteurs de rentabilité et d'investissement, le Modèle FF5F ne semble pas capturer plus de variations de rentabilités espérées que le modèle à trois facteurs, à l'exception des six portefeuilles pondérées en valeurs qui formés à partir de la taille et de la rentabilité opérationnelle.Dans le chapitre 2, nous examinons si les facteurs FF, SMB et HML, sont des proxys d'innovations de variables d'état sélectionnées (rendement de dividende agrégée, taux de T-bonds en un mois, l’écart de terme et l’écart de défaut) qui décrivent, sur la période recherche, les opportunités futures d'investissement sur le marché boursier chinois A-share. Les régressions chronologiques et les régressions des séries transversales sont réalisées sur cinq modèles comparatifs en utilisant l'approche à deux étapes Fama-MacBeth. Les facteurs FF ne perdent pas leur pouvoir explicatif, avec ou sans la présence des innovations des quatre variables d’états sélectionnées, à la fois dans les examens de séries chronologiques et les examens transversaux. Nous trouvons que l'information contenue dans l'innovation de rendements de dividende agrégés semble totalement capturée par la combinaison du marché bêta et du facteur de taille. Les facteurs FF ont pu jouer un rôle limité de capturer d'opportunités d'investissement alternatives représentées par les innovations des quatre variables d'état sélectionnées.Dans le chapitre 3, nous étudions si les facteurs FF sont des proxys de facteurs de risque de détresse et si différentes méthodes de construction des facteurs entraînent des résultats différents. Les résultats empiriques suggèrent qu'il n'y a pas de preuve significative que les facteurs FF représentent un risque de détresse sur le marché boursier chinois A-share. En comparant les résultats des régressions des séries chronologiques à partir de deux méthodes différentes, la performance du facteur de risque de détresse basé sur le DLI semble légèrement meilleure que celui basé sur le O-score. Cependant, le facteur de risque de détresse n'est pas un déterminant important des rentabilités transversales moyennes, et les facteurs FF ne peuvent pas représenter le facteur de risque de détresse dans la section transversale du marché boursier chinois A-share. / This dissertation is to explore the risk factors and factor models on Chinese A-share stock market based on the context of Fama-French (FF) factor model. First of all, chapter 1 re-examines the applicability of Fama-French Three-Factor (FF3F) Model and the latest Fama-French Five-Factor (FF5F) Model considering several special features of Chinese stock market. FF3F Model can explain a majority of time-series variation of the Chinese A-share stock returns. The market beta and SMB are important determinants in explaining the cross-sectional variation in the average stock returns over the sample period; however, we find no value premium. Comparing the performance of both FF3F Model and FF5F Model on Chinese A-share stock market, in the presence of profitability and investment factors, FF5F Model seems not capture more variations of expected stock returns than the three-factor model except the six value-weighted portfolios formed on size and operating profitability.Chapter 2 examines whether FF factors SMB and HML proxy for the innovations of selected state variables (aggregate dividend yield, one-month T-bill rate, term spread and default spread) that describe future investment opportunities on Chinese A-share stock market during the research period. Both time-series and cross-sectional regressions are performed on five comparative models using Fama-MacBeth two-stage approach. FF factors don’t lose their explanatory power with or without the presence of the innovations of selected four state variables in both the time-series and cross-sectional examinations. We find that the information contained in innovation of aggregate dividend yields seems totally captured by the combination of market beta and size factor. FF factors might have played a limited role in capturing alternative investment opportunities proxied by innovations of the selected four state variables.Chapter 3 investigates whether FF factors proxy for distress risk factor and whether different methods of constructing factors result in the different outcomes. The empirical results suggest that there is no significant evidence that FF factors are proxying for distress risk on Chinese A-share stock market. Comparing the time-series regression results by using two different methods, the distress risk factor constructed based on DLI seems to perform slightly better than that constructed based on O-score in capturing time-series average returns. However, the distress risk factor is not an important determinant of cross-sectional average returns, and FF factors cannot proxy as distress risk factor in the cross-section on Chinese A-share stock market.

Syskonrelationen är den längsta relationen i livet. Därtill utgör syskonrelationen en viktig arena för barns utveckling. Trots detta finns det få studier där syskonrelationen undersöks i relation till barnmisshandel. I följande studie undersöktes skillnader i den självskattade stöd- och konfliktnivån i syskonrelationen, mellan barn som rapporterade svår barnmisshandel och barn i en kontrollgrupp, samt om kön förändrade dessa skillnader. Vidare undersöktes om stöd- och konfliktnivån påverkade den upplevda nivån av psykosomatiska problem hos barn som rapporterade svår barnmisshandel. Studien genomfördes på ett urval av 1 392 pojkar och flickor mellan 15-16 år, med data från projektet Longitudinal Research on Development in Adolescence (LoRDIA). Barn som rapporterade svår barnmisshandel upplevde signifikant lägre stödnivå och signifikant högre konfliktnivå i sin syskonrelation, än barnen i kontrollgruppen. Skillnaderna var signifikanta både för pojkar och flickor, men pojkar upplevde ett signifikant lägre stöd i sin syskonrelation än flickor. Nivån av syskonstöd och syskonkonflikt påverkade emellertid inte nivån av psykosomatiska problem hos barn som rapporterade svår barnmisshandel. Effektstorlekarna var små i majoriteten av resultaten, vilket tyder på att syskonrelationer är komplexa fenomen som vid sidan av barnmisshandel och kön, även påverkas av en rad andra faktorer. Resultaten diskuteras i ljuset av tidigare forskning och i relation till anknytningsteori, kompensationshypotesen, kongruenshypotesen och könssocialisation. / The relation between siblings is one of the longest throughout the life span. Moreover, the sibling relationship constitutes an important context for children’s development. Nevertheless, in the context of child maltreatment, it remains largely understudied. In this study, we examined the differences in self-reported sibling support and sibling conflict, between children who reported severe child maltreatment and children in a control group, as well as if these differences were affected by gender. Furthermore, we examined whether the level of sibling support and sibling conflict affected the extent of psychosomatic problems experienced by children who reported severe child maltreatment. The study was conducted on a sample of 1 392 boys and girls between the ages of 15-16, using data from the research project Longitudinal Research on Development in Adolescence (LoRDIA). Children who reported severe child maltreatment experienced significantly less sibling support and significantly higher sibling conflict than the control group. These differences were significant for both boys and girls, although boys experienced significantly less sibling support than girls. The level of sibling support and sibling conflict, however, did not affect the extent of psychosomatic problems in children who reported severe child maltreatment. Effect sizes were small in the majority of the results, suggesting that sibling relationships is a complex phenomenon that, besides child maltreatment and gender, may be affected by a number of other factors as well. The results are discussed in light of previous research, and in relation to attachment theory, the compensation hypothesis, the congruence hypothesis, and gender socialization.

Title: The analysis of risk factors for tendinopathy in runners Objectives: The aim of this thesis is to find out the most important risk factor for development of Achilles tendinopathy, detect the most relevant diagnostic approach with preventive monitoring for Achilles tendinopathy and evaluate the best treatment for Achilles tendinopathy in runners. Methods: The diploma thesis is in form of literary review. The Scopus, PubMed and Web of science databases were used to search for studie using a combination of keywords. A total of 1084 titles were identified. Due to duplicates 402 titles were excluded. On the basis of the name of the article 51 titles were included. On the basis of the availability 50 titles were included. On the basis of the abstract 46 titles were included. Finally 29 titles were included in this review. Results: The most important risk factor for development of Achilles tendinopathy was training intensity for distances 1500-3000 m, week running volume >65 km or being new to running. The most relevant diagnostic approach for Achilles tendinopaty was clinical examination assessing pain (Achilles tendon pain, positive palpation test) and function (pain during physical aktivity) of Achilles tendon. This approach serves as indication for sonographic assessment of Achilles tendon...

Hypertension, a medical condition, predisposes to other cardiovascular diseases, and can be impacted by the social determinants of health (SDOH). Self-measured blood pressure monitoring (SMBP) is an evidence-based approach to hypertension control, but not much is known about the influence of SDOH on SMBP. This dissertation aims to: 1) highlight the SDOH factors whose relationship with SMBP have been explored in research studies; 2) examine the relationship between SDOH and SMBP among United States (U.S.) adults with high blood pressure; and 3) examine the current state of SMBP in the U.S., highlight policy implications from the empirical study and provide recommendations. Aims 1 and 2 were informed by an adapted SDOH framework, which comprised of upstream structural determinants, and downstream intermediary determinants. Aim 1 was achieved via a scoping review of studies across three databases following the PRISMA-SCR checklist. Aim 2 was achieved via a cross-sectional analysis of data from adult respondents to the 2019 Behavioral Risk Factor Surveillance System, with self-reported hypertension. Bivariate and Multiple Logistic regression analyses were conducted. Aim 3 involved a literature scan on policy concerning SMBP, highlighting the policy implications of findings from the empirical study, and providing recommendations for policy/practice. For aim 1, findings suggest that research studies examined the relationship of relatively more structural determinants, than the few, but highly significant intermediary determinants, with SMBP. For aim 2, looking at the structural determinants, males and those who identify as Black and other minority racial groups were more likely to report SMBP. For intermediary determinants, respondents who consumed fruits, vegetables, and exercised were likely to report SMBP, while those who smoke, who drink, and those with poor mental health days were less likely to report SMBP. Respondents with health coverage and whose provider recommended SMBP were likely to report SMBP use. Those ≥65 years were more likely to report SMBP. For aim 3, I recommend that the Centers for Medicare and Medicaid Services lead policy efforts on SMBP reimbursements. Also, healthcare practices should strengthen their technological infrastructure e.g., telehealth to promote access, and Electronic Health Records to promote efficient data collection and tracking.

The gap between demand and supply for antibiotics in the healthcare sector has seen a steady growth over the past decades, further increasing the risk of antibiotic resistance and unavailability in the Swedish healthcare sector and market. The thesis is part of the work of the multisectoral platform, PLATINEA, which is working towards better availability of antibiotics. This study focuses on analysing the supply structure of antibiotics and pharmaceutical supply chains using a risk assessment model. A literature review of previous research has been done to identify risk factors, understand their importance and develop the risk assessment model. The risk assessment model uses these risk factors to assess the supply risk of an antibiotic. The study is designed in a quantitative manner, where the antibiotics are classified as very high, high, medium, and low risk of shortage using risk scores. Expert opinions were collected using a self-completion questionnaire, in which experts allocate weights that measure the importance of said risk factors. Weights were used to measure value of risk for antibiotics using MCDA process. The outcomes of the study are (1). the weights of risk factors given by industry experts, (2). the developed multi-criteria risk assessment model, (3). ranking of selected 39 antibiotics from high to low supply risk, based on re-assessed risk scores.