El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / In this paper, we propose a technological solution integrated to a wearable device that allows measuring some physiological variables such as body mass index (BMI), steps walked in a determined day, burned calories, blood pressure and other risk factors associated with the Framingham´s score. The objective of this article is to identify the evolutionary pattern of the Framingham’s score each day in order to determine a presumptive diagnosis of high blood pressure. The technological solution was validated in the social insurance of a public hospital in Lima, Perú. The preliminary results obtained in a diagnostic test show a sensitivity level of 83.33%, a level of precision better than a traditional Framingham´s score for presumptive diagnosis of high blood pressure. Our proposal contributes to the patient’s awareness about the bad routine habits related to lifestyle and promotes the empowerment of data in order to make some changes that influence on the reduction of cardiovascular disease risk. / Revisión por pares

Aim: To explore the role of cannabis use for the availability of ecstasy as a potential pathway to subsequent first ecstasy use. Methods: Baseline and 4-year follow-up data from a prospective-longitudinal community study of originally 3021 adolescents and young adults aged 14–24 years at baseline were assessed using the standardized M-CIDI and DSM-IV criteria. Results: Baseline cannabis users reported at follow-up more frequent access to ecstasy than cannabis non-users. Higher cannabis use frequencies were associated with increased ecstasy availability reports. Logistic regression analyses revealed that cannabis use and availability of ecstasy at baseline are predictors for incident ecstasy use during the follow-up period. Testing simultaneously the impact of prior cannabis use and ecstasy availability including potential confounders, the association with cannabis use and later ecstasy use was confirmed (OR = 6.3; 95% CI = 3.6–10.9). However, the association with ecstasy availability was no longer significant (OR = 1.2; 95% CI = 0.3–3.9). Conclusions: Results suggest that cannabis use is a powerful risk factor for subsequent first onset of ecstasy use and this relation cannot be sufficiently explained by availability of ecstasy in the observation period.

There is growing evidence that patients with type 2 diabetes mellitus have increased cancer risk. We examined the association between diabetes, cancer, and cancer-related mortality and hypothesized that insulin sensitizers lower cancer-related mortality. Participants in the Diabetes Cardiovascular Risk and Evaluation: Targets and Essential Data for Commitment of Treatment study, a nationwide cross-sectional and prospective epidemiological study, were recruited from German primary care practices. In the cross-sectional study, subjects with type 2 diabetes mellitus had a higher prevalence of malignancies (66/1308, 5.1%) compared to nondiabetic subjects (185/6211, 3.0%) (odds ratio, 1.64; 95% confidence interval, 1.12-2.41) before and after adjustment for age, sex, hemoglobin A1c, smoking status, and body mass index. Patients on metformin had a lower prevalence of malignancies, comparable with that among nondiabetic patients, whereas those on any other oral combination treatment had a 2-fold higher risk for malignancies even after adjusting for possible confounders; inclusion of metformin in these regimens decreased the prevalence of malignancies. In the prospective analyses, diabetic patients in general and diabetic patients treated with insulin (either as monotherapy or in combination with other treatments) had a 2- and 4-fold, respectively, higher mortality rate than nondiabetic patients, even after adjustment for potential confounders (incidence of cancer deaths in patients with type 2 diabetes mellitus [2.6%] vs the incidence of cancer deaths in patients without type 2 diabetes mellitus [1.2%]). Our results suggest that diabetes and medications for diabetes, with the exception of the insulin sensitizer metformin, increase cancer risk and mortality.

L'effet des facteurs environnementaux physiques – conditions météorologiques sur la survenue d'une pré-éclampsie est une préoccupation relativement récente, mais diversement évalués par des études de méthodologie très hétérogène qui ne peuvent ainsi faire le tri des hypothèses physio-pathologiques. Comme le rappelait un rapport d'experts, les difficultés méthodologiques sont nombreuses, parmi lesquelles: la mesure de l’exposition et la détermination des fenêtres d'exposition, l’emploi d’une modélisation statistique adéquate, la prise en compte de l’ensemble des facteurs de confusion (facteurs de risque connus de morbidité chez les femmes enceintes ou prise en compte de la saisonnalité des naissances). Par ailleurs, l'intrication des facteurs physiques avec les facteurs sociaux, individuels ou de contexte vient compliquer l'interprétation. Aucune des études publiées jusqu'ici dans le domaine de la pré-éclampsie ne prend simultanément en compte ces 3 catégories de facteurs. Enfin, il n'existe guère d'étude française répondant à l'ensemble de ces questions alors que les modalités de suivi de la grossesse jouent un rôle important et dépendent étroitement de l'organisation socio-sanitaire du pays. Avec l’expérience d'un an dans la préparation du projet, nous proposons d'évaluer ces effets conjoints en étudiant un registre avec plus de 100 000 femmes enceintes /an suivies dans le réseau de maternités du département des Yvelines qui rassemble des territoires urbains et ruraux. / During two last decades, the effect of meteorological factors on human health, especially pregnancy, has become a growing public health concern. However, the influence of meteorological and environmental factors on the occurrence of pre-eclampsia still has to be precisely determined. The main objective of this work is to determine the influence of meteorological conditions at various time during pregnancy (date of conception, near date of conception) on the occurrence of pre-eclampsia in a large French registry of pregnant women and to determine at which moment are the women more susceptible.

Bakgrund: Sockersötade drycker är drycker till vilka sockerarter tillsatts. Dessa drycker konsumeras globalt och många gånger överskrids rekommendationerna om intag av tillsatt socker, vilket kan leda till negativa hälsoeffekter. Sockersötade drycker kan öka risken att drabbas av övervikt, fetma och typ 2-diabetes som i sin tur är riskfaktorer för att utveckla bukspottkörtelcancer. Det finns därför ett ökat intresse att undersöka den potentiellt ökade cancerrisken vid konsumtion av sockersötade drycker. Syfte: Syftet var att undersöka om intag av sockersötade drycker kan öka risken att drabbas av bukspottkörtelcancer. Metod: Arbetet är en litteraturstudie där vetenskapliga artiklar sökts med databasen PubMed. Sökorden var ”sugar-sweetened beverages” och ”pancreas cancer”. Av de artiklar som erhölls inkluderades observationsstudier och kliniska studier. Utifrån ytterligare inklusions- och exklusionskriterier valdes sju studier ut och granskades. Resultat: Resultat från tre av sju studier visar att det inte förekommer något samband mellan konsumtion av sockersötad dryck och risk för bukspottkörtelcancer medan resultat från tre studier påvisar samband. Resultat från en studie visar att det finns samband hos kvinnor men inte hos män. Slutsats: Hälften av studierna visar ett samband mellan konsumtion av sockersötad dryck och en ökad risk att drabbas av bukspottkörtelcancer. För att minska risken kan det således vara fördelaktigt att följa de rekommendationer som finns kring tillsatt socker. / Background: Sugar-sweetened beverages are beverages to which sugars are added. These beverages are consumed globally and many times the recommendations on added sugar are exceeded, which can lead to negative health effects. Sugar-sweetened beverages may increase the risk of overweight, obesity and type 2 diabetes which are risk factors for developing pancreatic cancer. Thus, there is an increased interest to study the potentially increased cancer risk associated with the consumption of sugar-sweetened beverages. Aim: The aim was to examine whether consumption of sugar-sweetened beverages can increase the risk of pancreatic cancer. Method: This work is a literature study using scientific articles searched with the database PubMed. The search terms were “sugar-sweetened beverages” and “pancreas cancer.” Of the articles obtained, observational studies and clinical studies were included. Based on inclusion and exclusion criteria, seven studies were selected and reviewed. Results: Results from three of seven studies show that there is no relationship between consumption of sugar-sweetened beverages and risk of pancreatic cancer, while results from three other studies show that there is a relationship. Results from one study show that there is a relationship in women but not in men. Conclusion: Half of the studies shows that there is a relationship between consumption of sugar-sweetened beverages and increase the risk of pancreatic cancer. To reduce the risk, it can be beneficial to follow the recommendations that exist regarding added sugar.

Objective The central Appalachian region of the United States is disproportionately burdened with cardiovascular disease (CVD); however, the level of literacy about CVD among residents has not been well studied. This study aimed to examine the prevalence and factors of CVD health literacy (HL) among a sample of patients/caregivers, providers/professionals, and community stakeholders. Methods In 2018, data were collected from central Appalachian residents in six states: Kentucky, North Carolina, Ohio, Tennessee, Virginia, and West Virginia. CVD HL status was determined by assessing correct responses to five interrelated questions about basic knowledge of CVD. Multiple logistic regression analyses were used to examine the associations between potential factors and CVD HL status. Results Of the total respondents (N = 82), <50% correctly answered all 5 CVD HL questions. Multiple logistic regression analyses showed that compared with respondents with advanced college degrees, those with a college degree or less were more likely to have low HL for "typical symptom of CVD,""physical exercise and CVD,""blood pressure and CVD,"and "stress and CVD."In addition, compared with respondents younger than 50 years, those 50 years and older were 3.79 times more likely to have low HL for "physical exercise and CVD."Conclusions These results suggest the incorporation of CVD HL into CVD care and that educational attainments should be part of CVD policies and programs in the region.

The diploma thesis is of a special pedagogy type and focuses on speech therapy. The thesis deals with the role of parents during the development of communication skills of preschool children in particular. The thesis is divided into the theoretical part and the practical part. The introductory chapter of the theoretical part characterizes a child of preschool age with regard to the development of motor skills, cognitive processes and social skills. The second chapter discusses the issue of communication skills of preschool children in more detail. It includes risk factors for speech development, the most common impairments of communication skills of preschool children and the possibilities of speech therapy intervention. The third chapter is devoted to the family environment in connection with its influence on the development of a child's communication skills. This chapter describes the parental styles, risk factors of the family environment and support options related to the child's speech development. The practical part of the diploma thesis presents the results of a questionnaire survey, the main goal of which was to analyze the approach of parents to the development of communication skills of preschool children. It is therefore a research of a quantitative nature. The partial goals of the...

Introduction: Lower extremity (LE) work-related musculoskeletal disorders (WMSDs) are known to occur with cumulative exposure to occupational and personal risks. The objective of this dissertation study was to find if creating a quantifiable risk detection model for the LE was feasible. The primary product of the literature review conducted for this study resulted in focusing the attention of the model development process onto creating the initial model of the LE for assessing knee disorder risk factors. Literature Review: LE occupational disorders affect numerous industries and thousands of people each year by affecting any one of the musculoskeletal systems deemed susceptible by the occupational and personal risk factors involved. Industries known to be affected tend to have labor intensive job descriptions. Some of the numerous industry examples include mining, manufacturing, firefighting, and carpet laying. Types of WMSDs noticed by the literature include bursitis, osteoarthritis, stress fractures, tissue inflammation, and nerve entrapment. In addition to the occupationally related disorders that may develop, occupationally related discomforts were also taken into consideration by this study. Generally, both the disorders and the discomforts can be traced to either a personal or occupational risk factor or both. Personal risk factors noted by the literature include a person's physical fitness and health history (such as past injuries). Meanwhile, occupational risks can be generalized to physical postures, activities, and even joint angles. Prevalence data over a three year interval (2003-2005) has found that LE WMSDs make up on average approximately 7.5% of all the WMSD cases reported to the US Occupational Safety and Health Administration (OSHA). When the literature is refined to the information pertaining to occupational knee disorders, the mean prevalence percentage of the same three year range is about 5%. Mean cost for knee injuries were found to be $18,495 (for the year between 2003 and 2004). Methodology: Developing a risk model for the knee meant using groups of subject matter experts for model development and task hazard analysis. Sample occupational risk data also needed to be gathered for each of a series of tasks so that the model could be validated. These sample data were collected from a sample aircraft assembly plant of a US aerospace manufacturer. Results: Based on the disorder and risk data found in the literature, a knee risk assessment model was developed to utilize observational, questionnaire, and direct measure data collection methods. The final version of this study's knee model has an inventory of 11 risk factors (8 occupational and 3 personal) each with varying degrees of risk exposure thresholds (e.g., high risk, moderate risk, or minimal risk). For the occupational risk assessment portion of the model, the results of task evaluations include both an occupational risk resultant score (risk score) and a task risk level (safe or hazardous). This set of results is also available for a cumulative (whole day) assessment. The personal risk assessment portion only produces a risk resultant score. Validation of the knee risk model reveals statistically (t (34) = 1.512, p = 0.156), that it is functioning as it should and can decide between hazardous and safe tasks. Additionally, the model is also capable of analyzing tasks as a series of cumulative daily events and providing an occupational and personal risk overview for individuals. Conclusion: While the model proved to be functional to the given sample site and hypothetical situations, further studies are needed outside of the aerospace manufacturing environment to continue testing both the model's validity and applicability to other industrial environments. The iterative adjustments generated for the occupational risk portion of the model (to reduce false positives and negatives) will need additional studies that will further evaluate professional human judgment of knee risk against this model's results. Future investigations must also make subject matter experts aware of the minimal risk levels of this knee risk assessment model so that task observational results are equally comparable. Additional studies are moreover needed to assess the intimate nature between variable interactions; especially multiple model defined minimal risks within a single task.

Det finns ett starkt samband mellan cigarrettrökning och förekomst av parodontit. Parodontit är dosberoende och minskning av cigarrettrökning eller tobaksstopp har potential att förhindra utveckling av parodontit samt fortsatt progression av redan existerande parodontit. / <p>Inget</p>

Introduction : Des variations de la durée de sommeil ont été associées à des perturbations biologiques pouvant affecter le risque de cancer. Seulement quatre études ont examiné la relation entre la durée de sommeil et le risque de cancer de l'ovaire et ont mené à des résultats inconsistants. Aussi, ces études ont considéré une seule mesure de la durée de sommeil collectée tardivement durant la vie adulte, potentiellement après la fenêtre étiologique d'exposition pertinente. Objectifs : Nous voulions étudier la relation entre 1) la durée de sommeil moyenne durant la vie adulte ainsi que 2) la durée de sommeil par période de la vie adulte et le risque du cancer de l'ovaire. Nous voulions aussi estimer l'association entre la durée de sommeil moyenne et le risque du cancer de l'ovaire selon le comportement tumoral (invasif/borderline) et selon le type de tumeurs invasives (Type I/Type II). Enfin, nous désirions évaluer si cette association était modifiée par des difficultés à s'endormir ou par l'usage d'hormonothérapie substitutive (HTS) parmi les femmes ménopausées. Méthodes : Les données sur les habitudes de vie et d'autres facteurs ont été collectées dans une étude cas-témoins basée sur la population réalisée à Montréal entre 2011 et 2016 (465 cas et 855 témoins). Les participantes ont rapporté leur durée de sommeil pour les périodes suivantes : 20-29, 30-39, 40-49, 50-59 ans et durant les 2 dernières années. À partir de ces données, nous avons calculé la durée de sommeil moyenne par nuit durant la vie adulte. Avec la régression logistique non-conditionnelle multivariée, nous avons estimé les rapports de cotes (OR) et les intervalles de confiance à 95 % (IC95%) de la relation entre la durée de sommeil et le cancer de l'ovaire. Résultats : Par rapport à une durée de sommeil moyenne durant la vie adulte de 7-8 h/nuit, les ORs (IC95%) étaient 1,03 (0,72-1,48), 0,98 (0,75-1,27) et 1,59 (1,05-2,40) pour <7 h, 8-9 h, et ≥9 h respectivement. Les ORs pour une durée de ≥9 h durant différentes périodes de la vie adulte suggéraient aussi une augmentation du risque, mais celle-ci était moins marquée que pour la durée de sommeil moyenne. Pour une durée de sommeil moyenne de ≥9 h, l'augmentation du risque était similaire entre les tumeurs ayant comportement invasif ou borderline; toutefois, parmi les tumeurs invasives, cette augmentation était plus forte pour les tumeurs Type I que du Type II. Enfin, les ORs pour une durée de sommeil moyenne de ≥9 h semblaient être modifiés par le fait d'avoir eu des difficultés à s'endormir, mais moins par l'usage d'HTS parmi les femmes ménopausées. Conclusion : Nos résultats suggèrent qu'une longue durée de sommeil durant la vie adulte pourrait être associée avec le risque du cancer de l'ovaire et que son effet cumulatif serait plus important. / Introduction : Variations in sleep duration have been linked to biological disruptions, which may affect cancer risk. For ovarian cancer, only four studies have examined sleep duration in relation to risk, with inconsistent findings. Also, these studies only analyzed a single measure of sleep collected in later adulthood, potentially after the etiologically relevant time window of exposure. Objectives : We wanted to study the relationship between 1) average sleep duration over the adult life as well as 2) sleep duration in different periods of the adult life and ovarian cancer risk. We also wanted to estimate the association between average sleep duration and the risk of ovarian cancer according to tumor behavior (invasive/borderline) and type of invasive tumors (Type I/ Type II). Finally, we wanted to evaluate if this association was modified by having had difficulties falling asleep or the use of hormone replacement therapy (HRT) among postmenopausal women. Methods : Data on lifestyle and other factors were collected in a population-based case-control study conducted in Montreal between 2011 and 2016 (465 cases and 855 controls). Participants reported their sleep duration for the following life periods: 20-29, 30-39, 40-49, 50-59 years old and during the last 2 years, from which we computed the average nightly sleep duration over the adult life. With multivariable unconditional logistic regression, we estimated odds ratios (OR) and 95 % confidence intervals (CI) sleep duration and ovarian cancer risk. Results : Compared to an average sleep duration in adulthood between 7-8 h/night, the ORs (95%CI) were 1.03 (0.72-1.48), 0.98 (0.75-1.27) and 1.59 (1.05-2.40) for <7 h, 8-9 h, and ≥9 h, respectively. The ORs for ≥9 h during different life periods also suggested an increased risk, though it was less pronounced than for average sleep duration. For an average sleep duration of ≥9 h, the increase in risk did not differ between tumors with invasive or borderline behavior; however, among invasive tumors, this increase in risk was greater for Type I than Type II tumors. Finally, the ORs for an average sleep duration of ≥9 h seemed to be modified by having had difficulties falling asleep, but less so by the use of HRT among postmenopausal women. Conclusion : The results suggest long sleep in adulthood may be associated with ovarian cancer risk, and that its cumulative effect might be more important.