Quando se trata de atenÃÃo odontolÃgica bÃsica ou especializada, crianÃas portadoras de necessidades especiais ainda representam uma parcela da populaÃÃo menos favorecida e estudada. O estudo teve o objetivo de avaliar a associaÃÃo entre presenÃa de lesÃo e experiÃncia de cÃrie a fatores de risco à cÃrie, em uma amostra de pacientes pediÃtricos portadores de necessidades especiais utilizando o critÃrio do Indice Internacional de DetecÃÃo de CÃries (ICDAS). A amostra foi composta por crianÃas de ambos os gÃneros, de 4 a 12 anos, com diagnÃsticos variados, vinculadas a projetos de extensÃo universitÃria que oferecem atendimento odontolÃgico, na Universidade Federal do Cearà (UFC) e na Universidade de Fortaleza (UNIFOR). Foi aplicado questionÃrio para acessar a saÃde geral e bucal dessas crianÃas, e, em seguida, realizou-se uma avaliaÃÃo clinica por um profissional devidamente treinado e calibrado nos critÃrios de avaliaÃÃo de cÃrie (ICDAS). A amostra deste estudo clÃnico foi construÃda por 110 crianÃas do gÃnero masculino (55%) e 90 do gÃnero feminino (45%), cuja faixa etÃria de maior prevalÃncia ocorreu no grupo de 4 a 6 anos (n= 66 crianÃas, 33%) e a categoria de diagnÃstico mais comum foi a da Neurologia (n= 109, 54,5%). O critÃrio ICDAS para prevalÃncia de cÃrie demonstrou que 172 (86%) crianÃas tiveram suas superfÃcies dentÃrias classificadas com cÃdico ICDAS maior do que 2. AnÃlise estatÃstica dos dados foi feita mediante os testes de Kruskall-Wallis, Mann-Whitney, tendo-se aplicado uma anÃlise de regressÃo logÃstica (p &#8804; 0,05). Foram detectadas algumas diferenÃas estatisticamente significantes entre os valores de ICDAS: local do estudo (ICDAS4-6DPR, p= 0,02; ICDAS4-6SPR, p=0,01; CDAS1-3 4-6D, p=0,05), estÃgio da dentiÃÃo (ICDAS CI, p= 0,08; ICDAS4-6DPR, p=0,004; ICDAS4-6SPR, p<0,001), hÃbito de verificar a higiene oral (ICDAS CI, p= 0,03; ICDAS4-6S, p= 0,03), uso do fio dental (ICDAS CI, p= 0,006; ICDAS4-6S, p= 0,01; ICDAS1-3 4-6D, p= 0,009), dieta rica em aÃÃcar (ICDAS4-6S, p= 0,01), consistÃncia dos alimentos (ICDAS 4-6 DPR, p= 0,03) e uso de mamadeira (ICDAS CI, p= 0,02; ICDAS4-6S, 0,01). A regressÃo logÃstica identificou os fatores idade (4-6 anos X2= 4,588, OR= 3,228; p=0,032), lesÃo cerebral (presenÃa X2=8,995; OR=0,196; p= 0,003), limitaÃÃo dos movimentos (presenÃa X2=5,749; OR=3,691; p= 0,016) e hÃbitos bucais deletÃrios (presenÃa X2=17,925; OR= 4,272; p= <0,001) como fatores de risco para a cÃrie dentÃria. Pode-se concluir que a amostra de crianÃas portadoras de necessidades demonstrou elevada prevalÃncia de cÃrie, em sua maioria cavitada, com identificaÃÃo de vÃrios fatores de risco. Os fatores de risco à cÃrie indicados nesta pesquisa podem guiar estudos futuros nesta populaÃÃo, alÃm de serem essenciais para estabelecer estratÃgias de controle de cÃrie durante o planejamento ou execuÃÃo do tratamento odontolÃgico. / When it comes about basic or specialized dental care, children with disabilities still represent a portion of the population less favored and studied The present study aimed to describe the profile of oral health using the ICDAS criteria and evaluate the association between lesions and caries experience with the risk factors for dental caries in patients with pediatric patients with special needs. The sample was composed by children of both gender, 4-12 years with varied diagnoses, linked to extramural projects that provide dental care at the Federal University of Cearà (UFC) and the University of Fortaleza (UNIFOR). Questionnaire was used to access the general and oral health of these children and then a clinical evaluation was made by a professional well-trained and calibrated in the evaluation of criteria of caries (ICDAS). It was observed that the sample of this clinical study was composed by 110 male children (55 %) and 90 females (45 %), where the most prevalent was the age between 4-6 years (n= 66 children, 33 %) and the category with the most common diagnosis was neurology (n= 109, 54.5 %). The ICDAS criteria for caries prevalence showed that 172 (86 %) children had their tooth surfaces classified as greater than 2 ICDAS code. Statistical analysis of data was done using the Kruskal -Wallis test , Mann - Whitney, applying logistic regression analysis (p&#8804; 0.05). We detected some statistically significant differences between the values of ICDAS: study site (ICDAS4 - 6DPR , p= 0.02; ICDAS4 - 6SPR, p= 0.01; CDAS1-3 4 -6D, p= 0.05), dentition stage (ICDAS CI, p= 0.08; ICDAS4 - 6DPR, p = 0.004 ; ICDAS4 - 6SPR, p< 0.001), habit of checking oral hygiene (ICDAS CI, p= 0.03; ICDAS4 - 6S, p= 0.03), flossing (ICDAS CI, p= 0.006 ; ICDAS4 - 6S , p= 0.01; ICDAS1-3 4-6D, p= 0.009), diet high in sugar (ICDAS4 - 6S ,p= 0.01), food consistency (ICDAS4-6 DPR, p= 0.03) and the use of baby bottle (ICDAS CI, p= 0.02 ; ICDAS4 - 6S , p= 0.01). Logistic regression analysis identified the factors age (4-6 years X2 = 4.588, OR = 3.228, p= 0.032), brain injury (X2 = 8.995 presence, OR= 0.196 , p= 0.003) , limited range of motion (X2= 5.749 presence, OR= 3.691, p= 0.016) and bad oral habits (presence X2= 17.925, OR= 4.272 , p= < 0.001) as risk factors to dental caries. We can conclude that the sample of children with needs presented high prevalence of caries, most of them cavitated, identifying several risk factors. Risk factors for dental caries indicated in this study can guide future studies in this population, besides being essential to establish control strategies of caries during the planning or execution of dental treatment.

Racional: Aproximadamente um de cada cinco pacientes hospitalizados por pneumonia adquirida na comunidade (PAC) apresenta uma resposta clínica inadequada, sendo a mortalidade nestes pacientes de 40%. Os objetivos do estudo foram: determinar a incidência e as variáveis de associação independente com fracasso terapêutico da PAC, e os fatores prognósticos da PAC tratada em ambiente hospitalar. Métodos: Estudo de coorte, prospectivo, multicêntrico, com 425 pacientes hospitalizados por PAC. Os pacientes foram acompanhados de forma sistemática para identificação do fracasso terapêutico e seguidos até a alta hospitalar. Resultados: A incidência de fracasso terapêutico foi de 14,6% (62/425). Os preditores independentes de risco para o fracasso foram: insuficiência renal aguda à admissão (OR 2,9; IC 95% 1,2-7,2; p=0,017), progressão radiológica (OR 29,8; IC 95 8,1-109,7%; p<0,001), derrame pleural (OR 3,4; IC 95% 1,3-8,6; p=0,010), relação PaO2/FiO2 inferior a 250 à admissão (OR 2,7; IC 95% 1,1-6,7; p=0,017) e PSI classe V (OR 2,7; IC 95% 1,1-7,0; p=0,042). A mortalidade geral foi de 7,5%, e de 40,3% nos pacientes com fracasso. O fracasso terapêutico foi o principal fator independente de mortalidade na PAC (OR 85,3, IC 95% 18,8-387,4, p<0,0001). Conclusão: O fracasso terapêutico da PAC é freqüente, está associado a marcadores clínicos, radiológicos e laboratoriais identificáveis desde a admissão hospitalar (ou nos primeiros dias de acompanhamento), sendo o principal preditor independente de mortalidade. / Rational: One out of five patients hospitalized for community-acquired pneumonia (CAP) might have an inadequate response to empirical antimicrobial treatment, and the mortality among these patients may reach rates of up to 40%. The aims of the study were to: quantify the incidence of empirical treatment failure in CAP, identify risk factors for therapeutic failure and prognostic factors in CAP. Methods: Prospective, multicenter cohort study of 425 hospitalized patients for CAP. The systematic identification of treatment failure required a daily follow-up until hospital discharge. Results: The incidence of treatment failure was 14.6% (62/425). The independent risk factors associated with therapeutic failure in a logistic analysis were: acute renal failure (OR 2.9; 95% CI 1.2-7.2; p=0.017), radiological progression (OR 29.8; IC 95 8.1-109.7%; p<0.001), pleural effusion (OR 3.4; 95% CI 1.3-8.6; p=0.010), PaO2/FiO2 ratio < 250 (OR 2.7; 95% CI 1.1-6.7; p=0.017) e pneumonia severity index Class V (OR 2.7; 95% CI 1.1-7.0; p=0.042). Mortality was significantly higher in patients with therapeutic failure (40.3% vs. 7.5%). Treatment failure was the main prognostic factor associated with CAP (OR 85.3; 95% CI 18.8-387.4, p<0.0001). Conclusion: The treatment failure is frequently found and it is associated with clinical, radiological and laboratorial markers. It is also an important independent predictor of mortality in CAP.

A obesidade e a perda dental são importantes problemas de saúde pública mundial e ambas as condições ocasionam desfechos adversos à saúde. Em estudos prévios, a existência de associação entre essas condições tem sido observada; no entanto, evidências ainda são inconclusivas, embora muitos estudos indicam que fatores de risco comuns estão relacionados com ambos os problemas. O objetivo principal foi avaliar a associação entre o índice de massa corporal e a perda dental em uma população adulta. O método utilizado baseou-se em dados transversais que foram coletados através de questionários autopreenchíveis e medidas antropométricas foram aferidas em 3.930 funcionários tecnicoadministrativos de uma universidade no Rio de Janeiro, participantes da Fase 1 (1999) do Estudo Pró-Saúde. Perda dental autorreferida (4 categorias) foi o desfecho de interesse e obesidade foi a variável de exposição principal. Os dados sobre os aspectos da dieta, acesso e utilização dos serviços de saúde, fatores socioeconômicos, hábitos e comportamentos de saúde e dados demográficos foram utilizados como covariáveis. Em comparação com aqueles com IMC< 25 kg/m², as pessoas com sobrepeso (IMC≥ 25 e <30 Kg/m²) e obesidade (IMC≥ 30 Kg/m²) apresentaram uma maior chance de perda dental, OR = 1,6 (IC 95% 1,4-1,9) e OR = 2,1 (IC 95% 1,8-2,5), respectivamente. Ajustando por potenciais fatores de confusão, os indivíduos com sobrepeso e obesidade tiveram um OR estatisticamente não significativo para perda dental, respectivamente OR=0,8 e OR=0,9. Os resultados são consistentes com a hipótese de que a associação entre obesidade e perda dental resulte de fatores de risco comuns. / Obesity and tooth loss are important public health problems worldwide, and both conditions cause adverse health outcomes. In previous studies, an association between these conditions has been observed; however, evidence is still inconclusive, although many studies indicate that common risk factors are related to both problems. The main objective of this study was to evaluate the association between overweight/obesity and tooth loss in adults. Cross-sectional data was collected through and self-administered questionnaires and anthropometric measurements in 3,930 civil servants at a university in Rio de Janeiro, participants in Phase 1 (1999) of the Pró-Saúde Study. Self-reported tooth loss (4 categories) was the outcome of interest, and obesity was the main independent variable. Data on aspects of diet, access and utilization of health services, socioeconomic factors, health habits and behaviors as well as demographic data were used as covariates. Compared with those with BMI< 25 kg/m², overweight people (BMI≥ 25 and <30 kg/m²) and obesity (BMI≥ 30 kg/m²) had a greater chance of tooth loss, OR=1.6 (95% CI 1.4-1.9) and OR=2.1 (95% CI 1.8-2.5), respectively. Adjusting for potential confounding factors, overweight and obese participants showed no statistically significant higher odds for tooth loss, respectively, OR=0.8 and OR=0.9.The results are consistent with the hypothesis that the association between obesity and tooth loss is the result of common risk factors.

Suicide is a prevalent and international problem which has substantive economic and psychological consequences. This has led to governments placing prevention of suicide as a priority on healthcare agendas. Recognition has been given to vulnerable groups in society that have been identified as being at particularly high risk of self-harm and suicide. This includes those in contact with mental health and forensic services. There is a great deal of literature that has considered the risk factors, processes and mechanisms associated with suicide. Comparatively only a small amount of literature has looked at the concept of suicidality within restricted samples such as psychiatric inpatients and prisoners. This may be as a consequence of extensive ethical and procedural processes that are involved in conducting research in such settings. This results in it being necessary to continually make generalisations from community based literature, meaning that factors relating specifically to such settings may be overlooked or underestimated. In the first paper, the initial sections consider existing risk assessments and models of suicidality. Predominantly being structured around static risk factors, means they are often criticised for lacking predictive utility and specificity. Literature examining dynamic psychosocial factors of suicidality in restricted samples was reviewed and 20 articles were identified. A wide range of dynamic correlates are presented. These form a theoretical model of suicidality specific to restricted samples. The clinical and theoretical implications are discussed in terms of risk assessment procedures and adapting and shaping interventions in accordance with the findings. Developing risk assessments around more dynamic factors will allow for greater sensitivity and prediction of those at greatest risk of imminent harm. The second, empirical paper supports the promotion of recovery focused practice and explores the relationship between suicidality and perceived personal agency in patients in secure mental health settings; Personal agency having previously been suggested as conferring resilience to suicidality. Psychometric measures and experience sampling methodology were utilised to examine the relationship. Perceptions of personal agency were found to confer resilience against suicidality. Change in perceptions of personal agency was not associated with suicidality but the overall level of personal agency was. Implications for service delivery are discussed with emphasis given to fostering perceptions of agency, control and self-efficacy and promoting inclusion, empowerment and person centred care. The final paper provides a personal and a critical reflection on the research process. It highlights and discusses clinical and theoretical strengths and limitations of the two papers and considers the methodological processes of both papers in more detail. Further reflections on how practice could be adapted in line with the findings are given. Future directions for research within secure settings are considered, in the hope of maintaining the drive for research with this vulnerable and often overlooked population.

Orientador: José Dirceu Ribeiro / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T12:49:38Z (GMT). No. of bitstreams: 1 Fogaca_HamiltonRosendo_M.pdf: 8991786 bytes, checksum: 91d4f715bcd18e742accd8443097b1cc (MD5) Previous issue date: 2014 / Resumo: Introdução: A sibilância no primeiro ano de vida pode ocorrer de modo isolado e ocasional (SO) ou recorrente (SR), caracterizando a Síndrome do Lactente Sibilante (SLS). Ambas são condições clínicas frequentes, heterogêneas e causadas por numerosas doenças e situações de agravos às vias aéreas e se manifesta clínica e laboratorialmente como vários fenótipos. Os numerosos estudos de prevalência de SO e SLS em lactentes têm evidenciado os seguintes fatores de riscos associados: antecedentes familiares para asma, hábitos alimentares e ocupacionais durante a gestação, tabagismo passivo, ausência de amamentação no seio materno, gênero, hábito de frequentar creche, poluentes ambientais: fumaça de cigarro, sensibilização a aeroalérgenos de ácaros, baratas e epitélios de animais, pneumonia, infecções respiratórias virais pelo vírus sincicial respiratório (VSR) e rinovírus (HRV), uso de antibióticos e paracetamol. Objetivo: Verificar a prevalência e fatores de risco para sibilância ocasional (SO) e recorrente (síndrome do lactente sibilante - SLS) em uma população de lactentes na cidade de Blumenau, Santa Catarina, no sul do Brasil. Método: Pais de lactentes entre 12-15 meses de idade que responderam o questionário escrito (QE-EISL) utilizado no Estudio Internacional de Sibilância en Lactantes (EISL). Resultados: Entre 1269 lactentes incluídos, a prevalência de sibilância e SLS foi de 715/1269 (56,34%) e 372/1269 (29,31%), respectivamente, e maior nos meninos. O primeiro episódio de sibilância ocorreu com 5,55±2,87 meses. Dos 479/715 (66,99%) lactentes que sibilaram, o primeiro episódio ocorreu nos primeiros seis meses de vida. Entre 372/715 (52,03%) apresentam três ou mais episódios (SLS). Fatores associados à sibilância: pneumonia, uso de corticoide oral, resfriado, creche, pais com asma e/ou alergia, mãe com emprego, gênero, ausência de aleitamento materno exclusivo,presença de mofo no domicilio. Fatores associados com SLS: chiado, diagnóstico de asma, visitas a serviço de emergência, uso de corticoide oral/inalatório, pneumonia, bronquite, dispneia,ir a creche, uso de broncodilatador, familiar com asma, ausência de aleitamento materno exclusivo, mãe com emprego, presença de cachorro na residência. Conclusão: A prevalência da sibilância na população estudada é elevada, multifatorial, e com fatores de risco intrínsecos e extrínsecos, incluindo: infecções do trato respiratório, alergia nos pais, hábito de frequentar creche e idade precoce de chiado. A elevada prevalência e altos índices de fatores de risco intrínsecos na população estudada ressaltam a necessidade e a oportunidade para estudos epidemiológicos e genéticos nesta população. Por outro lado, estratégias para que as mães aumentem o período de amamentação no seio e evitem creches para seus filhos antes dos seis primeiros meses de vida devem ser estimuladas / Abstract: Introduction: The wheezing in the first year of life may occur in isolation and occasional (SO) or recurrent featuring Squeaky Infant Syndrome (SLS). Both are common, heterogeneous and caused by many diseases and conditions of the airways diseases and clinical conditions manifested as various clinical and laboratory phenotypes. Studies in Brazil and other countries have shown that SLS and OS in the first year of life are common, with a prevalence ranging from 13 to 80.3% among different centers. Despite the high prevalence of SLS, the disappearance of the same, after early childhood, is referenced in the literature. The high prevalence becomes necessary to know the severity and risk factors involved in these syndromes, the first year of life in different regions of our country. Numerous studies on the prevalence of SO and SLS in infants have shown the following risk factors associated with: family history of asthma, food and occupational habit during pregnancy, passive smoking, lack of breastfeeding breastfed, gender, habit of attending daycare environmental pollutants: tobacco smoke, sensitization to airborne allergens from dust mites, cockroaches and animal epithelia, pneumonia, viral respiratory infections by respiratory syncytial virus and rhinovirus, antibiotics and paracetamol. Therefore, it becomes necessary to know the severity and risk factors for the population of infants in different regions of our country. Objective: To determine the prevalence and risk factors for occasional (OW) and recurrent wheezing (wheezy baby syndrome - WBS). Method: Parents of infants between 12-15 months of age, who responded the international written questionnaire (WQ-EISL) used in the Estudio Internacional de Sibilância en Lactantes (EISL). Results: Among 1269 infants included, the prevalence of OW and WBS was 715/1269 (56.34%) and 372/1269 (29.31%), respectively, being bigger in boys. The first episode of wheezing occurred with 5.55±2.87 months. Of 479/715 (66.99%) wheezing infants, the first episode occurred in the first six months of life. Between 372/715 (52.03%) had three or more episodes. Factors associated with wheezing were: pneumonia, oral corticosteroids, cold, day care center, parents with asthma and/or allergies, mother with employment, gender, exclusive breastfeeding and mold. Factors associated with WBS were: cold, asthma diagnosis, visits to the emergency service, use of oral/inhaled corticosteroids, pneumonia, bronchitis, dyspnea, day care center, use of bronchodilator, familiar with asthma, lack of breastfeeding breastfed, mother employment and presence of a dog in residence. Conclusion: The prevalence of wheezing in our population is high (56.34%), multifactorial, with intrinsic and extrinsic risk factors including: respiratory tract infections, allergic parents, the habit of attending childcare and early age of wheezing. The high prevalence and high rates of intrinsic risk factors in the population, stressed the need and opportunity for epidemiological and genetic studies in this population. Furthermore, strategies for mothers to increase the period of breast feeding and avoid dacare centers before the first six months of life of their children should be encouraged / Mestrado / Saude da Criança e do Adolescente / Mestre em Ciências

Orientador: Antonio Wilson Sallum / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-07-31T15:15:35Z (GMT). No. of bitstreams: 1 Pereira_AdrianadeFatimaVasconcelos_M.pdf: 2257759 bytes, checksum: 984f7789e8f218a9b8d01a755a8863ae (MD5) Previous issue date: 2001 / Resumo: O fumo é considerado fator de risco para a doença periodontal. Os fumantes apresentam maior profundidade de sondagem, recessão gengival, perda de inserção clínica, perda óssea e perda dentária, quando comparados com os não fumantes.O propósito desse estudo foi analisar a influência do consumo de cigarros no desenvolvimento da doença em 40 indivíduos de 25 a 70 anos, bem como a quantidade de cigarros consumidos por dia em fumantes leves « 1 O cigarros) e fumantes pesados ( > 10 cigarros) e tempo de duração do hábito de fumar em curta duração « 10 anos) e longa duração (> 10 anos), necessários para observar valores significantes do índice de placa, índice gengival, recessão gengival, profundidade de sondagem e perda de inserção clínica. Os resultados demonstraram que os valores dos parâmetros clínicos adotados foram similares, havendo diferença estatisticamente significante ( p < O, 01) na comparação entre sextantes anteriores e posteriores, bem como os fumantes leves apresentaram valores maiores para o IP, IG, R e PS e os fumantes de longa duração obtiveram valores maiores para todos os critérios. Isto nos permite concluir que o fumo é um fator modificador da progressão da doença periodontal / Abstract: Smoking is considered a risk factor for periodontal disease. Smokers have shown higher probing depth, gingival recession, clinical attachment loss, bone loss and tooth loss when compared to non- smokers. The purpose of this study was to analyze the influence of cigarette smoking on development of disease in 40 individuais aged 25 to 70 years old as well as the quantity of cigarette smoked by day in light smokers ( < 10 cigarettes) and heavy smokers ( > 10 cigarettes)and smoking duration habit in short duration ( < 10 years) and long duration ( > 10 years), which is necessary to observe significant values for plaque index, gingival index, gingival recession, probing depth and clinical attachment loss. The results have shown that the values of ali the parameters used were similar regarding to significant statistical ( p < O, 01) in comparison of anterior and posterior sextants, as well as light smokers showed higher values to PI, GI R, PD and CAL. Heavy smokers have showed higher values to ali the parameters . It leads us to conclude that smoking is a modifying factor for the progression of periodontal disease / Mestrado / Periodontia / Mestre em Clínica Odontológica

Terrorism är ett växande samhällsproblem som kräver insatser riktade mot de bakomliggande riskfaktorerna för att ett preventivt arbete ska kunna bedrivas gynnsamt. Säkerhetspolisen har gjort ett utlåtande där de informerar om att hotnivån för terrorangrepp i Sverige har ökat under de senaste åren. Syftet med studien är därför att identifiera riskfaktorer för terrorism. För att uppnå detta genomfördes en systematisk litteraturstudie. Flertalet sökningar genomfördes i tre olika databaser vilka utmynnade i elva studier som kom att ligga till grund för resultatet. Resultatet visade att det finns olika riskfaktorer för terrorism. Övergripande kategorier som identifierats är individegenskaper, mental hälsa, sociala faktorer, politik, religiös tillhörighet och sociala medier. De mest framträdande riskfaktorerna var individegenskaper inklusive mental hälsa och de sociala faktorerna. Resultatet visade tydliga tecken på en logisk följd från en barndom präglad av problematik till ett avvikande högriskbeteende i vuxen ålder. Det är av stor vikt att berörda yrkesgrupper besitter rätt kunskap för att effektivt kunna identifiera en potentiell terrorist i tid. Individer som visar tendenser för våld och sympatier för våldsbejakande extremism kan likaså anses tillhöra en riskgrupp för involvering i terrorism. Att förhindra individer från att ta steget till ett våldsbeteende eller terrorism skulle inte bara på en mikronivå gynna individen och dess omgivning utan även samhället som stort. De emotionella skador och ekonomiska förluster som terrorangrepp medför kan förminskas med ett fungerande preventivt arbete. / Terrorism is a growing problem in our society and needs interventions targeting the underlying causes to enable a favorable work of prevention. Säkerhetspolisen (The Swedish Security Service) regularly informs about the level of threat for terror attacks in Sweden. During the last years the threat level has increased. The purpose of the study is therefore to identify risk factors for terrorism. To achieve this, a systematic literature review has been performed. Multiple searches were made in three different databases which culminated in eleven studies that came to be the foundation for the result. The result showed that terrorism has multiple different explanations. Categories that have been identified are individual characteristics, mental health, social factors, politics, religion and social medias. The most prominent risk factors were individual characteristics including mental health and social factors. The result also showed clear signs of a logic sequence from a childhood marked by problems to a deviant high risk behavior in adulthood. It is essential that concerned professions have the right knowledge to enable efficient identification of potential terrorists in time. Individuals with tendencies for violence and sympathies for violent extremism can be placed in a high risk group for involvement in terrorism. To stop individuals from moving towards violent behavior and terrorism would not just on a micro level be beneficial for the individual itself and it’s surroundings, but also for the society. The emotional damages and economic losses that come with terror attacks can be reduced with a functional work of prevention.

Chilean red chili peppers contaminated with aflatoxins were reported in a previous study. If the development of gallbladder cancer (GBC) in Chile is associated with a high level of consumption of aflatoxin-contaminated red chili peppers, such peppers from other countries having a high GBC incidence rate may also be contaminated with aflatoxins. We aimed to determine whether this might be the case for red chili peppers from Bolivia and Peru. A total of 7 samples (3 from Bolivia, 4 from Peru) and 3 controls (2 from China, 1 from Japan) were evaluated. Aflatoxins were extracted with acetonitrile:water (9:1, v/v) and eluted through an immuno-affinity column. The concentrations of aflatoxins B1, B2, G1, and G2 were measured using high-performance liquid chromatography (HPLC), and then the detected aflatoxins were identified using HPLC-mass spectrometry. In some but not all of the samples from Bolivia and Peru, aflatoxin B1 or aflatoxins B1 and B2 were detected. In particular, aflatoxin B1 or total aflatoxin concentrations in a Bolivian samples were above the maximum levels for aflatoxins in spices proposed by the European Commission. Red chili peppers from Bolivia and Peru consumed by populations having high GBC incidence rates would appear to be contaminated with aflatoxins. These data suggest the possibility that a high level of consumption of aflatoxin-contaminated red chili peppers is related to the development of GBC, and the association between the two should be confirmed by a case-control study.

Background: Patients who have suffered an acute ischemic stroke (AIS) and are smokers may have a better outcome following thrombolytic therapy when compared with non-smokers. While this finding is controversial, data on baseline clinical risk factors to predict treatment efficacy of thrombolytic therapy using ambulatory status in patients who suffered AIS and are smokers is not common. Methods: Between 2010 and 2016, retrospective data on patients who have suffered an AIS and received recombinant tissue plasminogen activator (rtPA) were obtained from Greenville health system registry. Assessment of clinical risk factors and the likelihood of an improvement in post-stroke ambulation among smokers and non-smokers was carried out using multivariate logistic regression. Results: Of 1001 patients, 70.8% were smokers and 29.2% non-smokers. Among the smokers and non-smokers, 74.6% and 84.6% improvement in ambulation respectively at discharge. The odds of improved ambulation decrease among smokers as age group increases compared to those below 50 [(60–69 years, aOR, 0.30, 95% C.I, 0.108–0.850, p < 0.05), (70–79 years aOR, 0.27, 95% C.I, 0.096–0.734, p < 0.05), (80+ years aOR, 0.16, 95% C.I, 0.057–0.430, P < 0.01). Patients with National Institute of Health Stroke Scale Score (NIHSS) score > 7 (reference <7) were 91% less likely to have improved ambulation among smokers and non-smokers (aOR, 0.09, 95% C.I, 0.055–0.155, P = 0.01), and (aOR, 0.08, 95% C.I, 0.027–0.214, P = 0.01) respectively. Atrial fibrillation was an independent predictor of decreased improvement in ambulation only among smokers (aOR, 0.58, 95% C.I, 0.356–0.928 P < 0.05). Conclusion: Our findings suggest that elderly smokers with atrial fibrillation would benefit more from aggressive management of atrial fibrillation than non-smokers.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19368号 / 医博第4045号 / 新制||医||1011(附属図書館) / 32382 / 新制||医||1011 / 京都大学大学院医学研究科医学専攻 / (主査)教授 髙折 晃史, 教授 吉村 長久, 教授 山田 泰広 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM