Introduction: The consumption of fast food and soft drinks is a risk factor for developing overweight and obesity. This study aimed at assessing if there is association between household socioeconomic level and the consumption of fast food and soft drinks among children. Material and Methods: A cross-sectional assessment of the data from the third round (2009-2010) of the youngest cohort of the Young Lives study in Peru was conducted. Sampling was conducted in three stages: In the first one, the country was divided into equal geographical regions, excluding the 5% of the richest district; in the second stage, 20 sentinel sites were chosen and an area within each sentinel site was selected. Finally, in the third stage, eligible children were selected. Outcomes were the self-reported consumption of fast food and soft drinks (never, sometimes, and always), whereas the exposure was household socioeconomic status (in quintiles). Crude and adjusted models were created between variables of interest using Poisson regression models, with robust variance, to report prevalence ratios (PR) and 95% confidence intervals (95% CI). Results: Data of 1901 children, of which 942 (49.6%) were girls, with a mean age of 7.5 (SD: 0.5) was analyzed. A total of 24.1% (95%CI: 22.2%-26.1%) reported always consuming fast food, whilst this number was 22.4% (20.5%-24.3%) for soft drinks. Compared to the lowest socioeconomic quintile, those who were in higher socioeconomic status had more probability of consuming fast food and soft drinks (Chi-squared for trends <0.001). The highest socioeconomic quintile had a greater probability to always consume fast food (PR=1.42; 95%CI: 1.08-1.88) and soft drinks (PR=1.71; 95%CI: 1.24-2.37). Conclusions: This study shows that there is a significant association between the household socioeconomic level and the consumption of soft drinks and fast food. / Revisión por pares

This study is based on data regarding the social, economic, and demographic characteristics of 130 countries, and uses fixed effects estimation for the model analysis. It demonstrates that tourism development represents a complex process, which requires the implication of a multitude of stakeholders. Macroeconomic factors, such as GDP per capita growth and economic openness, are having a positive impact because they benefit private ownership and motivate people to open tourism-related businesses. Overall, higher carbon dioxide emissions and worse safety are having a negative effect over tourism development. Human development factors, such as education, are generally beneficial to the long-term tourism growth because they serve as positive externalities. Clustering the initial dataset based on various economic, demographic and social factors brought several new conclusions. Particularly, GDP per capita growth is not an important tourism development factor among developed countries, whereas the dummy variable for the year 2010 is a substantial one. Education and economic freedom are particularly important regressors for post-socialist states. The former is also crucial among African countries and in the Latin American region, where safety has also an essential impact over tourism development. Finally, tourism in small states would benefit the most from lower emissions,whereas in big states the best strategy for the policymaker would be to increase safety measures.

Background: Low back pain (LBP) is often associated with lumbar spinal instability (LSI). The multifidus muscle is considered a stabilizer of the spine and has been studied extensively with Rehabilitative Ultrasound Imaging (RUSI). There may be a relationshipbetween clinical signs of LSI, decreased cross-sectional area (CSA) of the multifidus and weakness. Having the ability to detect multifidus weakness without the use of RUSI may serve to be invaluable to the clinician in detecting multifidus weakness.Purpose: To investigate the relationship between the modified prone straight leg raise test (MPSLR) and CSA of the multifidusmuscle as measured by RUSI and to investigate the relationship between MPSLR and RUSI findings with the presence of low back pain symptoms that interfere with regular daily activities. Subjects: Participants consisted of two groups of subjects. One group (n=30, 87% male) comprised individuals in general good health, aged 18-55, without history of back pain. The second group (n=36, 56% male) comprised individuals aged 18-55, with history of low back pain within the past 12 months. Methodology: Subjects performed a MPSLR test to identify multifidus weakness. All subjects repeated the same test with concurrent RUSI to visualize the multifidusand measure its CSA. Results: A significant association between a positive MPSLR, asymmetry of the multifidus, and pain was observed (p r = .049, p = .696) was not observed. A sensitivity of 94% and a specificity of 63% was also discovered in the ability of the MPSLR test to detect asymmetry of themultifidus muscle within subjects. A positive MPSLR combined with a high Oswestry score of 25-30 further reinforced the probability of pain (p < .001) Conclusion: The MPSLR test demonstrated a strong association between a positive test and asymmetry of themultifidus muscle within subjects. Clinical Relevance: The MPSLR test can be used to identify patients at risk for LBP symptoms due to asymmetrical changes in the multifidus muscle of the lumbar spine, and aid in directing an appropriate rehabilitation approach to those patients in need of specific multifidus exercise prescription.

The theoretical part of the thesis summarizes the concept of environmental education in Czech curricular documents and compares the concepts of Finnish and Slovak concepts of cross-cutting issues. The aim of the diploma thesis is to find out what is the usability of educational centers of ecological education and to find out the reason why schools do not use educational centers. The research part deals with the usability of the Recommended Expected Outcomes for basic education and how the teaching of EVVO in schools really takes place. Research has shown that a certain vagueness of the FEP ZV allows schools a very free concept of EVVO. Educators lack methodologies in their subjects, where they should precisely include EVVO. The reason why teachers do not visit ecological education centers is the prices of program offers for schools.

En hälsosam kosthållning minskar risken för kardiovaskulär sjukdom och bidrar till en minskad risk för akut koronart syndrom. De nordiska näringsrekommendationerna innehåller riktlinjer för att förebygga kardiovaskulär sjukdom, och dessa har vidare kvantifierats av Livsmedelsverket. Trots de stora hälsofördelar som en sådan kosthållning medför når få svenskar de uppsatta målen och kunskapen om hur kostvanorna ser ut hos gruppen av personer som genomgått akut koronar händelse är begränsad. Syftet var att undersöka hur kosthållningen hos patienter som vårdades för akut koronart syndrom stämmer överens med de nordiska näringsrekommendationerna. För att svara på syftet användes en kvantitativ metod i form av en enkätstudie. Fyrtiotvå personer som genomgått akut koronart syndrom rekryterades genom konsekutivt urval på tre hjärtmottagningar i södra Sverige. Svarsfrekvensen var 76 procent, vilket antyder att studien har god generaliserbarhet. Samband undersöktes genom Students t-test test och Fishers exakta test. Resultatet visade att enbart två procent av patienterna nådde kostrekommendationerna gällande frukt och grönsaker, och lika stor andel nådde det rekommenderade intaget av fullkornsprodukter. För konsumtion av rött kött och charkuteriprodukter åt 88 procent i enlighet med näringsrekommendationerna. Tjugosex procent åt den rekommenderade mängden nötter och frön medan 64 procent av studiedeltagarna nådde det uppsatta målet för intag av fisk. Enbart en liten andel av studiedeltagarna hade helt uteslutit feta mejeriprodukter och smörbaserade matfetter från sin kost i enlighet med rekommendationerna. Slutsatsen kunde dras att patienter som genomgått akut koronar händelse har en kosthållning som i liten grad överensstämmer med de Nordiska Näringsrekommendationerna. Med ökad kunskap om kostintagets betydelse finns det förbättringspotential för denna grupp patienters kostförändringar och hur personcentrerade kostinterventioner kan bidra till ökad kardiovaskulär hälsa. / Adhering to a healthy diet reduces the risk of cardiovascular disease and contributes to a lower risk of acute coronary syndrome. The Nordic Nutrition Recommendations includes a set of nutritional guidelines aimed at preventing cardiovascular disease and these have been further quantified by the Swedish National Food Agency. Despite the big health improvements that such a diet entails, few Swedes meet the recommended daily intakes. Little is known about how the dietary patterns of the specific subgroup of people who have experienced an acute coronary event compares to the Nordic Nutrition Recommendations. The aim was to investigate to what extent patients whom have been treated for acute coronary syndrome adhere to the latest nutritional guidelines given by the Nordic Nutrition Recommendations 2012. To answer the aim of the study a quantitative method was used through a survey study. Forty-two people were enrolled by consecutive sampling from three different heart polyclinics in southern Sweden. The study had a response rate of 76 percent, which suggests that the study had a high generalisability. Correlations between independent variables were controlled with Student’s t-test and Fisher’s exact test. The results showed that only two percent of the patients reached the guidelines dietary reference level when it comes to fruits and vegetables. The same result was shown when it comes to wholegrain dietary intake among this population, only two percent reached the recommended level. Looking at the dietary intake of red meat the result showed that 88 percent eat according to The Nordic Nutrition Recommendations. Looking at the intake of nuts and seeds, 26 percent of the patients ate as suggested in the guidelines. Sixty-four percent of this studies participants reached the recommended intake of fish per week. Only a low rate of the patients had completely excluded fat dairy products and butter-based products. The conclusion was made that patients who went through an acute coronary event have a dietary consumption that to a low extent correspond to The Nordic Nutrition Recommendations. There are room for improvement in this area. With the help of further studies in this subject would illuminate greater understanding about the dietary patterns among this patient group and how patient participatory dietary interventions could contribute to cardiovascular health.

In times of progressive urbanization and increased environmental awareness, the mobility sector faces the challenge to satisfy an increasing demand, while simultaneously decreasing the negative externalities of transportation. The emerging concept Mobility as a Service (MaaS) claims to resolve this conflict, by offering individualized and seamless mobility through combination of all available modes. This thesis quantifies the tank to wheel (TTW) greenhouse gas (GHG) emissions of a MaaS implementation and simulates effects of potential variations in the service. The pilot under focus is an alteration of MaaS, which is exclusively available to the work force of a specific corporation. This variation is called Corporate Mobility as a Service (CMaaS). The evaluation is based on cross-sectional survey among the employees and operational data from the CMaaS operator. The transport demand model applies a person category approach. The total daily GHG emitted by the work force’s on-site mobility is estimated to 3.735 tCO2. Compared to on-site trips by private cars, trips with CMaaS emit less than half as many GHG emissions per passenger kilometer traveled. This highlights the environmental benefits of MaaS, especially in replacing short trips by private car. Due to the composition of the underlying data sources and the therefore chosen methodology the reactivity to implemented scenarios is very limited. Thus, analysis and interpretation of the results is restricted to largely aggregated levels. Nonetheless, this study offers an initial orientation point for further estimation of TTW GHG emissions by MaaS schemes. Beyond, it highlights the lack in understanding and modelling of corporate mobility in general.

Median Nerve Ultrasonography Examination Correlates for the Diagnosis of Moderate to Severe Carpal Tunnel Syndrome Objective: The aim of the study was to investigate the associations of cross-sectional area (CSA) of the median nerve measured by ultrasonography (US), the median to ulnar nerve ratio (MUR), the median to ulnar nerve difference (MUD) and the ratio of CSA of the median nerve to height squared (MHS) in relation to electrodiagnostic classification of moderate and severe carpal tunnel syndrome (CTS) and thus to identify patients suitable for surgical treatment. Materials and Methods: A prospective study was conducted in patients aged ≥ 18 years who underwent both median and ulnar nerve US and electrodiagnostic studies (EDS). 124 wrists of 62 patients were examined. The patients' characteristics were acquired through a questionnaire. CTS was diagnosed using EDS and classified according to the guidelines of the Czech Republic Association of Electrodiagnostic Medicine. The CSA of the median nerve and of the ulnar nerve were measured at the carpal tunnel inlet, i.e. at the level of the pisiform bone. Results: The median nerve swells at the wrist in CTS. Median nerve CSA at the tunnel inlet ≥ 12mm2 correlates with electrodiagnostic classification of moderate to severe carpal tunnel syndrome. At...

In this study, we examined how hill running affects the Achilles tendon, which is a common location for injuries in runners. Twenty females ran for 10 min on three randomly selected grades (-6%, 0%, +6%). Achilles tendon (AT) cross-sectional area (CSA) was imaged using Doppler ultrasound and peak vertical forces were analyzed using high-speed (240 Hz) videography. A metabolic cart and gas analyzer ensured a similar metabolic cost across grades. Data were analyzed using a forward selection regression. Results showed a decrease in AT CSA from pre-run to post-run (p = .0001). Peak vertical forces were different across grades (p = .0001) with the largest occurring during downhill running and smallest during uphill running. The results suggest that the Achilles tendon is affected by running and a decrease in CSA appears to be a normal response. The AT CSA does not differ between grade conditions when metabolic cost of running is matched, suggesting an adaptive effect of the AT. Coaches and athletes can use this knowledge to develop workout protocols that transition runners to downhill running and allow them to adapt to these greater forces.

PURPOSE: This study examined medication use by individuals with tinnitus who were seeking help for their tinnitus by means of a psychological intervention. METHOD: This study used a cross-sectional survey design and included individuals with tinnitus enrolled in an Internet-based cognitive behavioral therapy trial ( = 439). Study participants provided demographic details, completed various structured questionnaires and provided details about the medications used. The self-reported medications were classified using the United States Pharmacopeial Medicare Model Guidelines v7.0. RESULTS: Current medication use was reported by 67% ( = 293) of the study participants. Those currently using medication were older; had consulted their primary care physician, had greater tinnitus severity, depression, anxiety, and insomnia when compared with those not reporting any current medication use. The top 10 medication used included cardiovascular agents ( = 162; 55.3%), antidepressants ( = 80; 27.3%), electrolytes/minerals/metals/vitamins ( = 70; 23.9%), respiratory tract/pulmonary agents ( = 62; 21.2%), anxiolytics ( = 59; 20.1%), hormonal agents/stimulant/replacement/modifying (thyroid; = 45; 15.4%), gastrointestinal agents ( = 43; 14.7%), analgesics ( = 33; 11.3%), blood glucose regulators ( = 32; 10.9%), and anticonvulsants ( = 26; 8.87%). Some associations between type of medication used and demographic or tinnitus-related variables were noted especially for the cardiovascular agents, electrolytes/minerals/metals/vitamins, and anxiolytics. CONCLUSIONS: This exploratory study indicated a large percentage of patients using medication and a range of medications. Further studies are required to assess the effects of such medications on the tinnitus percept and concurrent medication moderate treatment effects.

Restricting animal-based products from diet may exert beneficial effects on weight status; however, less is known about such a diet and emotional health. Moreover, personality traits, for example high neuroticism, may contribute to restrictive eating habits and potentially confound diet-health associations. We aim to systematically assess if restrictive dietary intake of animal-based products relates to lower weight and higher depressive symptoms, and if differences in personality traits play a significant role. Cross-sectional data from the baseline LIFE-Adult study were collected from 2011–2014 in Leipzig, Germany (n = 8943). Main outcomes of interest were dietary frequency of animal-derived products in the last year measured using a Food Frequency Questionnaire (FFQ), body-mass-index (BMI) (kg/m2), and the Center of Epidemiological Studies Depression Scale (CES-D). Personality traits were assessed in a subsample of n = 7906 using the Five Factor Inventory (NEO-FFI). Higher restriction of animal-based product intake was associated with a lower BMI, but not with depression scores. Personality, i.e., lower extraversion, was related to higher frequency of animal product intake. Moreover, personality traits were significantly associated with depressive symptoms, i.e., higher neuroticism, lower extraversion, lower agreeableness, lower conscientiousness, and with higher BMI. These findings encourage future longitudinal studies to test the efficacy of restricting animal-based products as a preventive and therapeutic strategy for overweight and obesity.