The recent study by Cunningham, Lewis, Curnow, Glazner, and Massie [1] on the attitudes of respiratory physicians and clinic coordinators towards cystic fibrosis (CF) carrier screening drew several unsupported conclusions because the α level of 0.05 was not corrected for the large number of hypothesis tests conducted, leading to a Type 2 error and the acceptance of hypotheses that were likely false [2].

In 2019, cancer was the second leading cause of death in the United States. Colorectal cancer is the second most common cancer affecting both men and women. Colorectal screenings are an important preventive health service, with approximately half of cases detected through screening, improving life expectancy among those diagnosed. Previous research has noted differences in screening rates between racial or ethnic groups, with whites being screened at a higher rate than other racial and ethnic groups. Additionally, the prevalence of colorectal cancer is becoming more common among persons younger than 50 years old, prompting testing guidelines to be revised in 2018 that call for testing to begin at 45 instead of age 50. The purpose of this analysis is to investigate this issue further by examining differences in colorectal screening among various racial and ethnic groups. A cross-sectional study using the 2021 Behavioral Risk Factor Surveillance System for respondents from West Virginia and Oregon (combined) was used to examine colon cancer screening by various racial and ethnic populations. Individuals responding receipt of a colonoscopy or sigmoidoscopy were the primary outcome of interest. Racial and ethnic groups include whites-only, blacks-only, other races, multi-racial and those of Hispanic ethnicity. Additional covariates of interest were included in the analysis based on Andersen’s behavior model for health service utilization and includes predisposing (gender, age, education, marital status) enabling (insurance, employment status) need (body mass index, other types of cancers) factors. Bivariate and multivariate logistic regression analysis was used to examine these relationships. The study population included 2,831 adults who self-reported being screened for colon cancer. Overall 61% of white populations reported receipt of colon cancer screening compared to 54% of Black, 52% of Other, and 43% of Hispanic populations (p<0.00). Adjusting for additional covariates of interest, there were no significant differences between colon cancer screening among black populations compared to their white counterparts (aOR=.81; 95% CI=0.40-1.64). Age and education independently predicted being screened for colon cancer. Graduating from college increased an individual’s odds of being screened for colon cancer (OR= 2.1, 95% CI: 1.1-4.0). The odds also increased for individuals between the age of 55 to 64 (OR=4.2, 95% CI: 3.2-5.3) and ages 65 to 74 (OR=10.0, 95% CI: 6.8-14.8). Our study did not find significant differences in colon cancer screening by race/ethnicity in these two states. It is possible the racial and ethnic composition of the states contributed to the observed findings. West Virginia and Oregon are predominantly white. Smaller subpopulation groups within the national BRFSS dataset may not be sufficient to detect important differences in screenings. Furthermore, it is possible that several factors associated with screening (age, education) may be associated with race/ethnicity but are stronger predictors than race/ethnicity itself. Regular screening for colorectal cancer can help with detecting and treating colon cancer. Additional efforts to increase the general knowledge of colorectal cancer risks should be encouraged for individuals who did not graduate from college and are between 45 to 55 years old.

People living with HIV/AIDS (PLWHA) are 4 times more likely to have a diagnosis of depression than persons without HIV. The specific problem at a rural clinic in a southern region of the United States, was a lack of continuity in the Patient Health Questionnaire 9 (PHQ-9) screening procedures that made sure that PLWHA were screened, identified, and referred. Early identification and treatment can help patients cope with barriers that affect health outcomes. The purpose and goal of this project was to develop and implement an evidence-based depression screening protocol to improve clinical staff practices and adherence to the PHQ-9 guidelines thereby increasing the number of PLWHA who were diagnosed and treated for depression. The Iowa model of evidenced-based practice served as a guide for this project. An interdisciplinary team was assembled to develop protocols and staff training. This project compared clinic staff knowledge on depression through pre and posttests. Upon completion of staff training, the pretest had a M = 78.33 and SD = 11.146 and the posttest a M = 99.17 and a SD = 2.887. Results of a paired t test confirmed a statistically significant increase in knowledge with p < .000. Over a 4-week period, depression screenings at the study site went from 10% to 100%. Data showed that positive social change was realized when PLWHA began to get depression treatment because of proper screening, early interventions, and depression management. Although the project is designed for the PLWHA in the rural clinic, other primary care providers may find that an evidenced-based practice protocol can be useful to improve PHQ-9 depression-screening practices for patients in other clinical areas.

Background: Nuclear and conventional weapons industry workers are at risk for exposures to beryllium, asbestos, high explosives and barium, all of which are implicated in the pathogenesis of pneumoconiosis. Beryllium has also been shown to cause sensitization (BeS) carrying a risk of progression to Chronic Beryllium Lung Disease (CBD). Data are lacking on the epidemiology of beryllium related health effects in conventional munitions workers and limited studies have been published on the prevalence of BeS in workers with minimal exposure. Data on the prevalence of pneumoconiosis in nuclear weapons workers is also lacking. The main objectives of this study were to determine prevalence and risk factors for beryllium sensitization in former nuclear and conventional munitions workers and rates of and risk factors for pneumoconiosis in former nuclear weapons workers, both cohorts from the Iowa Army Ammunition Plant (IAAAP) in Burlington, IA. Methods: Former nuclear weapons workers were offered chest x-ray (CXR) and blood screening for sensitization with beryllium lymphocyte proliferation test (BeLPT) as part of the Department of Energy (DoE) Former Worker Medical Screening Program. Conventional munitions workers were offered BeLPT and clinical follow-up if sensitized, as part of a Department of Defense (DOD) funded study. Chest x-rays were reviewed by three readers according to the International Labour Organization's Classification system for Radiographs for Pneumoconioses (ILO system). Exposures under study were characterized qualitatively by the industrial hygiene team and based on former worker interviews and historical industrial hygiene records. Results: The prevalence of beryllium sensitization in nuclear and conventional munitions workers was found to be slightly higher than in other workforces and weapons worker populations at low risk for exposure. The prevalence of parenchymal disease was higher in these nuclear weapons workers than in other DoE studies, while the prevalence of coincident parenchymal and pleural and isolated pleural disease was lower than in other nuclear weapons populations. Workers who occasionally dressed the copper-beryllium alloy tools were found to have an increased risk of beryllium sensitization, compared to those in administrative or other jobs with insignificant potential for exposure on site. Exposure to beryllium, asbestos, high explosives or barium was not associated with lung disease in this population. Conclusions: The findings from this study have potential policy implications for DOE and DOD to extend or implement beryllium surveillance and lung disease screening for their workforces and better control use of the copper-beryllium alloy tools in their production processes.

This thesis deals with the structural design of hydraulic raking screens placed before a sewage treatment plant. The first part describes various possibilities of water treatment from individual particles. The second part deals with basic parameters of screens and calculations of propelling power for previously chosen structure. Furthermore, a strength check of structure under the most unfavourable load is performed. Drawings of the whole assembly of hydraulic raking screens, plus a few selected components are attached to the thesis.

Considering the diminishing availability of professional resources, increasing costs, and time requirements involved in early childhood mass screenings, parents are an essential source of information. In this study, the Survey of Speech Development (SSD) (Perry-Carson & Steel, 2001; Steel, 2000) was used to determine the accuracy of parents in reporting the speech sound inventories of their toddlers. Parents of 30 children, who were between the ages of 27 to 33 months old, completed the SSD prior to a speech and language assessment session. Based on assessment results, the children were classified as normal developing or language delayed. A 20-minute play interaction between the parent and child was recorded during the assessment and was transcribed later for analysis. Speech sounds (consonants) were coded as present or absent and comparisons were made between the parents results on the SSD and data from the 20-minute speech sample. A point-by-point reliability analysis of the speech sounds on the SSD compared to those produced in the speech sample revealed an overall parental accuracy of 75%. Further, no differences were found between parent reports and transcribed accounts for total number of different consonants. This was true for parents of both language delayed and language normal toddlers. Results suggest that if given a systematic means of providing information, parents are a reliable source of information regarding sounds their toddlers produce.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-03-22T10:52:36Z No. of bitstreams: 1 marialuciasalimmirandamachado.pdf: 7872528 bytes, checksum: 15a268af9e36f43642cae7f5a7e11723 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-04-24T02:17:04Z (GMT) No. of bitstreams: 1 marialuciasalimmirandamachado.pdf: 7872528 bytes, checksum: 15a268af9e36f43642cae7f5a7e11723 (MD5) / Made available in DSpace on 2016-04-24T02:17:04Z (GMT). No. of bitstreams: 1 marialuciasalimmirandamachado.pdf: 7872528 bytes, checksum: 15a268af9e36f43642cae7f5a7e11723 (MD5) Previous issue date: 2013-03-22 / O câncer do colo uterino ainda é um problema de saúde pública no contexto mundial, com maior gravidade nos países menos desenvolvidos. Contudo é um câncer que apresenta um longo período de evolução e pode ser detectado e prevenido através do rastreamento com o exame de Papanicolaou, o que lhe confere um dos mais altos potenciais de prevenção e cura entre todos os tipos de câncer. O presente estudo tem como objetivo avaliar a cobertura do teste de Papanicolaou e os fatores associados à realização do mesmo, em mulheres da área de abrangência de uma UAPS em Juiz de Fora/MG. Com este projeto, pretendeu-se reforçar a captação das mulheres e contribuir para o aumento do índice de cobertura da área adscrita. Foi realizado um estudo transversal de setembro de 2010 a março de 2012. Todas as mulheres, na faixa etária de 20 a 59 anos, moradoras na área de abrangência, foram recrutadas nos seus domicílios pelos agentes comunitários de saúde. Através de questionário estruturado, aplicado por pesquisadores treinados, foram coletados dados de todas as 1.301 mulheres que compareceram ao posto de saúde após o recrutamento. Os resultados do estudo mostram uma cobertura pelo exame de Papanicolaou de 78%, a maioria realizado em serviços do SUS (76%). O estudo buscou identificar, das mulheres que nunca fizeram o preventivo do colo do útero (4,7%) e das que não estavam com o preventivo em dia (17%), quais foram às principais dificuldades para a sua não realização. Das 280 mulheres que responderam a pergunta, 36% referiram não achar necessário, 25% relataram dificuldades no serviço de saúde para marcar uma consulta, menos de 10% atribuiu ao medo, incômodo e vergonha. A falta de tempo das entrevistadas respondeu por 6,7% dos relatos, seguido pelo descuido, comodismo e desânimo com 4,2%. Neste trabalho os fatores associados a não realização do preventivo do câncer do colo do útero referidos em vários estudos não foram identificados, apontando para a equidade no acesso ao exame da citologia oncótica entre as mulheres desta área de abrangência. Tal fato pode ser atribuído à atuação desta UAPS que tem como modelo de assistência a saúde a Estratégia da Saúde Família (ESF) há cerca de 10 anos. / The cervical cancer is still a problem for the public health all over the world, mainly for the underdeveloped countries. However, it is a desease that has a long evolution period and can be detected and prevented with Papanicolaou test. Because of that, this kind of cancer, among all others, has the greatest chances of prevention and cure. This study aims at evaluating the coverage of Papanicolaou test and the factors linked to its realization, on women of the coverage area of a UAPS in Juiz de Fora. Other goal of this project was to reinforce the collection of women, contributing to increasing the coverage of that area. A transversal study was done from September 2010 to March 2012. All women, between 20 to 59 years old, residents of the chosen area, were recruited at their houses by the community health workers. Through a questionnaire, applied by trained researchers, we collected the data of 1301 women, who appeared at the UBS after recruited. Results show that there is a coverage of 78% by Papanicolaou test, mainly as a SUS service (76%). This study has sought to identify the mainly difficulties for the non-realization of Papanicolaou, among women that have never done the test (4,7%) and women that were not in time with the test (17%). From the 280 women who answered the questions, 36% thought that the test was not necessary, 25% said that they have had difficulties in the health service for making an appointment, less than 10% was afraid, uncomfortable or ashamed to make it, 6,7% have had no time, and carelessness, laziness and discouragement was the cause for 4,2%. In this work, the factors linked to the non-realization of the cervical cancer test, referred in many studies, were not identified, pointing out to an equity in the access to the test of oncotic cytology, among the studied area. This fact can be attributed to the performance of UAPS, that has had as health care model the Family Health Strategy for 10 years.

This diploma thesis deals with the design of hydraulic trash rack cleaning machine for waste water treatment plant. The first part of the thesis describes methods of removing coarse impurities from intake water to technological equipment. Furthermore, a specific design including calculation and choice of the drive is made. Part of the work is also solving the course of force effects and strength analysis of the most stressed parts. The work also deals with the comparison of design solution of hydraulic and mechanical drive of the machine. The attachment contains a drawing of the cleaning machine assembly and selected welded complex.

Target of master thesis is constructional design of vertical rack with press of screenings for shaft type 501 up to 3200 mm deep. Part of this shaft system is atypical bottom with two inflows and one outflow of sewage water. According to these requirements there ware adapted dimensions and shapes of whole construction. Master thesis is divided into several parts, where is disposed construction design of rack with supplement, modification of shaft bottom and embedment of vertical rack.

This master’s thesis deals with design of mechanical screen cleaning machine for wastewater treatment plant, which will be placed in 800 mm wide and 1 850 mm deep intake canal. Thesis includes research of produced systems, construction design, drive unit design and other necessary strength and technical calculations. Thesis is supplemented by drawing of machine and its details.