No description available.

No description available.

Introduction: Human papillomavirus (HPV) is the sexually transmitted etiologic agent of cervical cancer. While HPV infects both men and women, little is known about HPV infection in men. Specifically, knowledge of the prevalence of type-specific HPV infection and the distribution of these infections by anogenital anatomic site in men is incomplete. Evaluation of factors associated with HPV infection based on complete anogenital sampling and with HPV-16 antibody detection may lead to a better understanding of HPV transmission and prevention.Methods: A total of 493 asymptomatic men ages 18 to 40 years old were recruited in Tucson, Arizona, and Tampa, Florida, from 2003 to 2006. Eligibility requirements included having had sex with a woman within the past year and having no history of genital warts. Testing for HPV from anogenital swabs from six anatomic sites and semen was conducted by PCR and reverse line blot genotyping for 37 HPV types. Serum antibodies for HPV-16 were detected by ELISA. Self-administered demographic, health, and sexual history/behavior questionnaires were collected. HPV prevalence and type distributions by anatomic site were calculated, as was seroprevalence of HPV-16 antibodies. Multivariate logistic regression was used to identify independent risk factors for HPV infection at any anatomic site and for having HPV-16 antibodies.Results: HPV was detected in at least one sample for 303 (65.4%) men, with 29.2% of men having an oncogenic infection and 36.3% having a non-oncogenic infection. Multiple HPV types were detected in 27.2% of men. Factors associated with infection were a greater lifetime number of female sexual partners, currently smoking 10 or more cigarettes per day, lack of condom use, and more sexual partners in the past three months. HPV-16 antibodies were detected in the serum of 63 (12.8%) men, and detection was associated with increasing age and concurrent detection of HPV DNA in perianal or anal canal samples.Discussion: The combination of more complete anogenital sampling and sensitive HPV detection for 37 HPV types resulted in a higher HPV prevalence in asymptomatic men than previously reported. Smoking and condom use were the most important modifiable risk factors for HPV in men. These results have implications for research of HPV transmission.

The purpose of this thesis was to develop a means of predicting future injury among nursing personnel working in a hospital system. Nursing has one of the highest incidence rates of musculoskeletal injuries among U.S. occupations. Endemic to the job are tasks such as rolling, sitting, standing, and transferring large, and often times, uncooperative patients. These tasks often place large biomechanical stresses on the musculoskeletal system and, in some cases, contribute to or cause a musculoskeletal injury. Given the current nursing shortage, it is imperative to keep nurses injury-free and productive so they can provide patient care services. Even though a large number of nursing personnel are injured every year and most are exposed to these high levels of biomechanical stress, the majority of nurses are injury-free. The question then arises "Why do some nurses have injuries while others do not?" The purpose of this thesis was to determine whether individual attributes in a population of nurses were associated with risk of future injury. The subject population was comprised of 140 nursing personnel at a local hospital system hired between April 1995 and February 1999. Data on individual attributes, such as patient demographics, previous injuries, posture, joint range of motion, flexibility, and muscular strength, was ascertained during a post-offer screening on these personnel. Twenty six (19%) nurses experienced an injury associated with the axial skeleton. Chi square test for homogeneity for the categorical predictor variables, and the Student's T-test for continuous predictor variables were used to determine if any individual attributes were associated with future injuries. None of the variables were associated with a risk of future axial skeletal injury. Practical application of these results for St. Joseph Regional Health Center, and possibly other acute care facilities, directs us to stop costly pre-employment/post-offer testing for the purpose of identifying injury prone nurse applicants. Secondly, it allows the focus of limited resources to be on making the job safer through administrative and engineering controls.

Hypertension is associated with a reduction in sensitivity to pain in both animals and humans. Changes in nociception pre-date elevations in blood pressure in animals genetically predisposed to hypertension, and preliminary findings with male offspring of hypertensives indicate that genetic risk for hypertension is related to decreased pain sensitivity in humans. Sensitivity to naturalistic and laboratory pain stimuli was compared in normotensive females with and without a parental history of hypertension in three studies. Genetic risk for hypertension was associated with decreased sensitivity for blood donation venipuncture pain and electric shock, but not for menstrual pain or the cold pressor test. These findings provide modest support for the notion that hypoalgesia is present in females at risk for hypertension. Issues for future research include extension of these findings to other pain stimuli, use of multiple indices of risk, assessment of the effects of cyclic hormonal changes on the relationship between pain sensitivity and risk for hypertension, and further study of the mechanisms and pathophysiological implications of this effect.

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No description available.

Psychological stress may be a risk factor for essential hypertension. While several variables have been implicated as mediators or moderators of the relationship between stress and high blood pressure, their exact roles and level of importance remain to be elucidated. A key moderating variable may be family history of hypertension. A series of five studies examined the cardiovascular and emotional reactions to stress of normotensive individuals with and without a parental history of hypertension. In an attempt to facilitate the generalizability of the results, the studies used stressors with greater ecological validity than those used in most previous studies of this topic. This aspect of the research aided the examination of a possible mediator of group differences in cardiovascular reactivity, i.e., emotionality. Several studies observed significant group differences in cardiovascular reactivity to stress, suggesting that stress may be more likely to contribute to the development of hypertension in those with a genetic predisposition for the disorder. However, the exaggerated cardiovascular responsivity of individuals with a parental history of hypertension did not appear to be mediated by greater trait or state emotionality.

Two anthropometric measurements were evaluated as possible risk factors for concussions among university contact-sport athletes: head and neck circumference ratio (HNCR) and body mass index (BMI). Athletes (N=575) competing in intercollegiate football, hockey, and soccer were followed prospectively for concussions over a 4-year period. A total of 86 concussions occurred, with a higher incidence among the female athletes. For HNCR, there was no consistent association observed with the exception of female hockey players. For BMI, there was no consistent association observed with the exception of male soccer players. Linear regression analysis revealed a statistically significant inverse association between HNCR and BMI among concussed athletes for both genders (p<0.001). In conclusion, the novel HNCR was found to be a valid and reliable measurement ratio that may have potential clinical applications in predicting the risk of sustaining a concussion among contact-sport athletes.

Au Québec, en 2007, plus de 1 384 000 voyages internationaux ont été effectués. Ce nombre est 50 % plus élevé qu'il ne l'était en 2000. Conséquemment, le comité consultatif québécois sur la santé des voyageurs (CCQSV) a émis, comme priorité en 2008, de dresser un portrait actuel de l'épidémiologie et du fardeau lié aux maladies acquises en voyage. OBJECTIFS Décrire l'épidémiologie des 4 maladies à l'étude au Québec, entre 2004 et 2007. Secondairement, comparer certains résultats avec une étude antérieure pour 3 de ces maladies et valider une variable nommée "ÉPISODE ACQUIS HORS QUÉBEC" ajoutée au fichier provincial des maladies à déclaration obligatoire (MADO) en 2003. DEVIS : Étude descriptive transversale des cas de fièvre typhoïde, d'hépatite A, de malaria et de shigellose. DONNÉES ET MÉTHODOLOGIE: Les cas des quatre maladies à l'étude, inscrits dans le fichier MADO, entre les années 2004 et 2007, ont été analysés avec l'information disponible dans les enquêtes épidémiologiques. Pour les cas de shigellose, un échantillonnage a eu lieu. Les variables ont été colligées par un seul évaluateur à l'aide d'une grille pré-testée. La qualité des données a été validée par une double collecte et une double saisie. Lorsque possible, les données concernant l'ensemble des voyageurs, et non seulement les cas, ont été tirées des données sur les voyages internationaux de STATISTIQUE CANADA. La sensibilité et la spécificité de la variable "épisode acquis hors Québec" ont été calculées en comparant l'information inscrite au fichier MADO avec celle des questionnaires d'enquête épidémiologique des directions de santé publique, considérés comme l'étalon or. L'étude de Provost et al. (2006) a été utilisée aux fins de comparaisons. RÉSULTATS: La proportion de cas liés aux voyages a été calculée : malaria (78,3 %), fièvre typhoïde (73,4 %), shigellose (50 %) et hépatite A (35,8 %). Le nombre de cas déclarés durant la période varie de 55 cas pour la fièvre typhoïde à 760 cas pour la shigellose. L'incidence annuelle moyenne (par 100 000 personnes) liée aux voyages pour la période 2004-2007 est de 0,59 pour la malaria, 0,13 pour la fièvre typhoïde, 0,49 pour la shigellose et 0,44 pour l'hépatite A. Les immigrants qui retournent visiter la famille et les amis (VFA). sont importants en proportion chez les cas de malaria (52,9 %). Les cas d'hépatite A surviennent davantage durant les voyages de plus de deux semaines (75,6 %). Une proportion importante des cas d'hépatite A provient de l'Afrique (28,3 %). Le sous-continent indien obtient le rapport du nombre de cas sur le nombre de voyages le plus élevé pour la fièvre typhoïde, l'hépatite A et la shigellose. La shigellose se démarque des autres maladies avec une majorité de cas chez les touristes (76,1 %) et les cas surviennent principalement lors de courts séjours d'une semaine ou moins (39,6 %). La variable "ÉPISODE ACQUIS HORS QUÉBEC" du fichier MADO présente encore une proportion importante de dossiers ou l'information est inconnue (28,6 %) pour les maladies à l'étude. En excluant les données inconnues, la variable présente une sensibilité de 97,5 % et une spécificité de 98,5 %. Comparativement à la période 2000-2002, la proportion de cas chez les VFA a augmentée pour la malaria et la fièvre typhoïde. La proportion de cas de malaria contractés en Afrique sub-saharienne a aussi augmentée (87,2 % vs 72 % en 2000-2002). CONCLUSIONS Les 4 maladies à l'étude sont encore des maladies fréquentes chez les voyageurs internationaux québécois. Les voyageurs à destination de l'Afrique et du sous-continent indien méritent une attention spéciale, tout particulièrement les voyageurs du type VFA. Les touristes devraient être avisés du risque de shigellose malgré la vaccination contre d'autres maladies. Il est recommandé d'uniformiser le format des questionnaires d'enquête au niveau provincial et de sensibiliser les professionnels à l'importance de saisir le pays d'acquisition au fichier MADO. Malgré l'excellente sensibilité et spécificité de la variable, il est conseillé de l'utiliser avec prudence.