The main goal of this study is to investigate stimulus that can be used to increase consumers purchase intentions toward suboptimal food products. Consumers seem to have low preferences to buy fruits and vegetables with unusual appearance, products with damaged package and close to the expiration date, usually called suboptimal food products. However, rejection of suboptimal food is an important contributor to food waste levels. Interventions aimed at encouraging the purchase of suboptimal food are scarce, however needed. This study used the theory of normative influence to test the effect of both descriptive and injunctive norms on a product with an unusual appearance, a product with a reduced expiration date and a product with a damaged package. The first study tested different messages appeals to create a realistic norm in study 2. From this study, it was selected the social message appeal and the frequencies of purchase toward each product, using them in the messages as the prevalent norm The second study analysed the effect of injunctive and descriptive norms of purchase intentions toward suboptimal food and also tested the effect of environmental concern and food waste problem awareness. Results show that both environmental concern and food waste problem awareness impact purchase intentions toward suboptimal food. Additionally, appeals employing social norms proved to affect purchases intentions toward these products. However, this effect only occurred for the vegetable with an unusual appearance and the product with a package damaged. For the product with a reduced expiration date the norms had no effect. Moreover, for the product with an unusual appearance, food waste problem awareness mediated the effect of injunctive norm on purchase intentions. Based on the results, this study contributes to the theory of normative influences by showing that, in a general way, this theory is applied to food waste reduction issues, more specifically, with suboptimal food consumption. However, it is necessary to consider the type of sub-optimally and the context where the influence is applied. Additionally, was discussed how social norms can be used to tackle food waste and the implications for marketing and policy actions.

The main goal of this study is to investigate stimulus that can be used to increase consumers purchase intentions toward suboptimal food products. Consumers seem to have low preferences to buy fruits and vegetables with unusual appearance, products with damaged package and close to the expiration date, usually called suboptimal food products. However, rejection of suboptimal food is an important contributor to food waste levels. Interventions aimed at encouraging the purchase of suboptimal food are scarce, however needed. This study used the theory of normative influence to test the effect of both descriptive and injunctive norms on a product with an unusual appearance, a product with a reduced expiration date and a product with a damaged package. The first study tested different messages appeals to create a realistic norm in study 2. From this study, it was selected the social message appeal and the frequencies of purchase toward each product, using them in the messages as the prevalent norm The second study analysed the effect of injunctive and descriptive norms of purchase intentions toward suboptimal food and also tested the effect of environmental concern and food waste problem awareness. Results show that both environmental concern and food waste problem awareness impact purchase intentions toward suboptimal food. Additionally, appeals employing social norms proved to affect purchases intentions toward these products. However, this effect only occurred for the vegetable with an unusual appearance and the product with a package damaged. For the product with a reduced expiration date the norms had no effect. Moreover, for the product with an unusual appearance, food waste problem awareness mediated the effect of injunctive norm on purchase intentions. Based on the results, this study contributes to the theory of normative influences by showing that, in a general way, this theory is applied to food waste reduction issues, more specifically, with suboptimal food consumption. However, it is necessary to consider the type of sub-optimally and the context where the influence is applied. Additionally, was discussed how social norms can be used to tackle food waste and the implications for marketing and policy actions.

O presente trabalho investiga a relação entre a prática consciente e sua influência na prevenção do desencadeamento e no enfrentamento do processo de prejuízo da performance musical em condições de pressão (choking). Participaram do estudo três estudantes do Curso Superior de Instrumento da Escola de Música e Belas Artes do Paraná – Campus I – UNESPAR, Curitiba, PR. Foram utilizados os Guias de Execução (performance cues) propostos por Chaffin e colaboradores (2002, 2006, 2008) como suporte para o desenvolvimento de habilidades cognitivas. Os procedimentos metodológicos utilizados para coleta de dados consistiram de questionários, relatos verbais obtidos de entrevistas semiestruturadas, relatos de estudo, registro em áudio e vídeo da obra escolhida e relatos de guias de execução assinalados nas partituras como registro de decisões interpretativas deliberadas. O suporte cognitivo fornecido pelo trabalho com os Guias de Execução proporcionou segurança emocional suficiente para o enfrentamento das situações de estresse de exposição e principalmente de avaliação e autoavaliação. A partir da compreensão dos elementos teóricos encontrados na literatura e dos resultados deste trabalho com a abordagem metodológica de Chaffin, proponho um modelo conceitual de performance musical afetada pela ansiedade e centrado nos processos de controle e gerenciamento da informação durante a performance musical. Relacionado à hipótese levantada nos estágios iniciais de elaboração da pesquisa, esse modelo permite explorar a presença e manutenção de afetos e pensamentos negativos durante a prática instrumental individual e sua relação com a ocorrência de eventos de choking, e a suposição de que o desenvolvimento de habilidades cognitivas, relacionadas ao planejamento, monitoração e avaliação da prática instrumental, possa reforçar os processos de controle e gerenciamento do estado ansioso, ao permitir um suporte cognitivo que minimize o sentimento de vulnerabilidade, incontrolabilidade e imprevisibilidade inerentes ao estado ansioso, contribuindo, assim, para a melhoria e prevenção de eventos de déficits cognitivo-motores em performance sob pressão. / This study investigates the relationship between conscious practice, and its influence in prevention and coping with the decrement process in musical performance under pressure (choking under pressure). The study included three students of the bachelor degree of instrument in Escola de Música e Belas Artes do Paraná – Campus I – UNESPAR, Curitiba, PR. Performance Cues proposed by Chaffin and colleagues (2002, 2006, 2008) were used as support for the development of cognitive skills. Methodological procedures used for data collection consisted of questionnaires, verbal reports obtained from semi-structured interviews, practice reports, audio and video records of the chosen work and analysis of performance cues assigned in the scores as records of deliberate interpretative decisions. Cognitive support provided by working with Performance Cues provide enough emotional security for dealing with stress exposure situations and especially with evaluation and self-evaluation. Based on the understanding of theoretical elements found in the literature and the results of this study with the Chaffin methodological approach, I propose a conceptual model of musical performance affected by anxiety focused on process control and information management during the musical performance. Related to the hypothesis in the early stages of the research, this model explores the presence and maintenance of negative feelings and thoughts during the individual instrumental practice and its relation to the occurrence of choking event. The model also explores the assumption that the development of metacognitive skills, related to planning, monitoring and evaluation of instrumental practice can improve the control and management process of the anxious state. This control can be achieved by allowing a cognitive support that minimizes the feeling of vulnerability, uncontrollability and unpredictability, thus contributing to the improvement and prevention of cognitive-motor deficits events in performance under pressure.

Magister Public Health - MPH / Background Nigeria accounted for 2.95 million of the 22 million people globally living with HIV in 2008. In 2010, the HIV prevalence increased to 3.1 million, with 1.5 million people requiring anti-retroviral treatment (ART). ART is effective if patients adhere to treatment (taking 95% or more of drugs as prescribed) over a sustained period. Taking less than 95% of the medication can lead to drug resistance and treatment failure, which have dire individual and public health consequences. This study described adherence to ART and the factors that constrain and motivate adherence among patients on ART at the University of Abuja Teaching Hospital in the Federal Capital Territory (FCT), Nigeria. Methodology An observational, descriptive and analytical, cross-sectional survey of adherence among 502 adult ART patients (254 women and 248 men) from the University of Abuja Teaching Hospital was conducted. I collected sociodemographic and clinical characteristics of participants, and barriers and facilitators to adherence. For the prescription refill data, I utilized the updated pharmacy refill records from the ART dispensary. Bivariate and multivariate analysis was performed to analyse the factors that influence adherence to ART. Results Participants in this study had been on therapy for a mean of 43±27 months. Total optimal self-reported adherence over the previous three days (not missing a dose, taking correct doses in the correct frequency and correct schedule) was 53.6%, compared with 62.5% adherence calculated by prescription refill. However, most (80.3%) participants achieved virologic suppression at a level of <400 copies/μl3. Reported barriers to adherence were: forgot (43%); travelled away from home (21%); ran out of medication (16%); busy at work (13%); lack of food (5%) and medication snatched by armed robbers (2%). Self-reported adherence over the previous three days was positively associated with age and viral load. Younger respondents (under 30 years) were 3 times more likely to adhere to their regimen compared with those older than 30 years (OR = 2.5; 95% CI = 1.26-4.61; p =

In Europe, 45% of vegetables and fruit have been lost before consumption. The main reason for the loss is suboptimal food, which is perfect based on safety and security but imperfect according to appearance or packaging. In this project, I want to find out new possibilities in urban development by suggesting a participative food supply chain.  It aims to inspire a paradigm of urban development and shift people’s attitudes towards suboptimal food. The participative supply chain includes food production, distribution, and retail/consumption. By participating in the food supply, residents and visitors can understand how the food system works, grow their food and help with food processing. With interaction and collaboration workers, they can value more about the food they consume and even change their eating patterns.

The physiologic and metabolic effects of chronic consumption of energy below recommended levels on constant-load exercise was studied in women age 19-24 years. Ten controls (average caloric intake ~ 35 kcal/kg body weight) and 10 subjects with suboptimal energy intake (average caloric intake - 25 kcal/kg body weight) were matched for age, exercise caloric expenditure and percentage of HB-predicted RMR. Subjects (n=20) completed a maximal incremental cycle ergometer test and a 30-minute cycle ergometer test at 75 % of peak oxygen consumption. Although both groups presented a significant increase in ventilation (VE) over time of exercise, the rate of change in VE and end-exercise VE value was significantly greater, F (1 J 18) = 5.63, P < .05, for the suboptimal energy intake group than for the controls. Although not statistically significant (p = 0.454), heart rate (HR) tended to be continuously higher for the suboptimal energy intake group than the control group during the constant-load cycle test. Peripheral ratings of perceived exertion (RPE-L) also tended to be higher for the suboptimal energy intake group at the end of constant-load exercise, however, not significantly (p = 0.072). Two subjects in the suboptimal energy intake group failed to complete the 30-minute submaximal constant-load cycle test; one completed 15 minutes and the other 20 minutes. All subjects in the control group completed the entire submaximal constant-load test (30 minutes). These results suggest that women with chronic suboptimal energy intake have increased difficulty tolerating moderate intensity exercise for 30 minutes (an intensity and duration that mimics a typical exercise session). / Master of Science

After decades of decrease, maternal mortality rates have shown a slight increase in Europe. Immigrants, especially Africans, have shown to be at higher risk than native women. This could not be explained solely by well-known obstetric and socio-economic risk factors. The aim of this thesis was to study incidence, classification and quality of care of maternal deaths in Sweden, with focus on the foreign-born population. The study population was identified through linkage of the Cause of Death Register, Medical Birth Register, and National Patient Register, and medical records obtained from hospitals. Data from registers, death certificates, and medical records were reviewed. Suboptimal care was studied by structured implicit review of medical records. Differences between foreign- and Swedish-born women were analysed by relative risks, Chi2- and Fisher’s exact test. Underreporting of maternal mortality was shown to be substantial: as compared to the official statistics, 64% more maternal deaths were identified. Women born in low-income countries were identified as being at highest risk of dying during reproductive age in Sweden. The relative risk of dying from diseases related to pregnancy was 6.6 (95% confidence interval 2.6–16.5) for women born in low-income countries, as compared to Swedish-born women. Major and minor suboptimal factors related to care-seeking, accessibility, and quality of care were found to be associated with a majority of maternal deaths and significantly more often to foreign-born women. Suboptimal factors identified included non-compliance, communication barriers, and inadequate care. The rate of suicides during pregnancy or within one year after delivery did not change during the last three decades, and was higher for foreign-born women. A majority of women who committed suicide had been under psychiatric care, but such documentation at antenatal care was inconsistent, and planning for follow-up postpartum was generally lacking. The conclusion of this thesis is that foreign-born women are a high-risk group for maternal death and morbidity that calls for clinical awareness with respect to their somatic and psychiatric history, care-seeking behaviour, and communication barriers. Cross-disciplinary care is necessary, both in obstetric emergencies and in cases of maternal psychiatric illness, to avert maternal death and suicide.

<p>Antibiotic treatment causes an ecological disturbance on the human microflora. Four commensal bacteria: E. coli, enterococci, a-streptococci and coagulase-negative staphylococci, from patients with extensive, high antibiotic usage were investigated with regard to resistance pattern and mutation frequency. Among 193 investigated strains it was found that high antibiotic usage selected for resistant bacteria and enriched for bacteria with a small but significantly increased mutation frequency. </p><p>The relative biological fitness cost of resistance in <i>Staphylococcus epidermidis</i> was assessed in a human in vivo model where the indigenous flora was present. In vitro data of the bacterial growth rate correlated well to in vivo fitness assayed in the competition experiments on skin. </p><p>An in vitro kinetic model was shown to be a useful tool to establish the pharmacokinetic and pharmacodynamic (PK/PD) indices for efficacy of antibiotics. It was confirmed that the time, when the concentration exceeds the minimal inhibitory concentration (MIC), correlates with efficacy for b-lactam antibiotics. To achieve maximal killing for penicillin-resistant pneumococci, with an MIC of 2 mg/L, the peak concentration was also of importance. </p><p>Suboptimal dosing regimen facilitates selection of resistance. Penicillin-resistant pneumococci were easily selected in a mixed population with penicillin-sensitive, -intermediate and -resistant pneumococci in an in vitro kinetic model. The selection of the resistant strain was prevented when the benzylpenicillin concentration exceeded the MIC for approximately 50% of 24 h.</p>

Antibiotic treatment causes an ecological disturbance on the human microflora. Four commensal bacteria: E. coli, enterococci, a-streptococci and coagulase-negative staphylococci, from patients with extensive, high antibiotic usage were investigated with regard to resistance pattern and mutation frequency. Among 193 investigated strains it was found that high antibiotic usage selected for resistant bacteria and enriched for bacteria with a small but significantly increased mutation frequency. The relative biological fitness cost of resistance in Staphylococcus epidermidis was assessed in a human in vivo model where the indigenous flora was present. In vitro data of the bacterial growth rate correlated well to in vivo fitness assayed in the competition experiments on skin. An in vitro kinetic model was shown to be a useful tool to establish the pharmacokinetic and pharmacodynamic (PK/PD) indices for efficacy of antibiotics. It was confirmed that the time, when the concentration exceeds the minimal inhibitory concentration (MIC), correlates with efficacy for b-lactam antibiotics. To achieve maximal killing for penicillin-resistant pneumococci, with an MIC of 2 mg/L, the peak concentration was also of importance. Suboptimal dosing regimen facilitates selection of resistance. Penicillin-resistant pneumococci were easily selected in a mixed population with penicillin-sensitive, -intermediate and -resistant pneumococci in an in vitro kinetic model. The selection of the resistant strain was prevented when the benzylpenicillin concentration exceeded the MIC for approximately 50% of 24 h.

Submitted by LILIAN HERNÁNDEZ ALVAREZ null (lilianhern@gmail.com) on 2017-10-16T13:40:19Z No. of bitstreams: 1 Lilian_dissertacao_final.pdf: 8133270 bytes, checksum: ea7913c9f03bc3c89f0211896c01cc88 (MD5) / Approved for entry into archive by Monique Sasaki (sayumi_sasaki@hotmail.com) on 2017-10-18T17:58:56Z (GMT) No. of bitstreams: 1 hernandezalvarez_l_me_sjrp.pdf: 8133270 bytes, checksum: ea7913c9f03bc3c89f0211896c01cc88 (MD5) / Made available in DSpace on 2017-10-18T17:58:56Z (GMT). No. of bitstreams: 1 hernandezalvarez_l_me_sjrp.pdf: 8133270 bytes, checksum: ea7913c9f03bc3c89f0211896c01cc88 (MD5) Previous issue date: 2017-09-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Trypanosoma cruzi é o agente causal da doença de Chagas, uma infecção negligenciada que afeta milhões de pessoas nas regiões tropicais. A maioria dos fármacos empregados no tratamento desta doença são altamente tóxicos e geram resistência. Na atualidade, o descobrimento de inibidores alostéricos é um tópico emergente dentro da área de desenho computacional de fármacos, pois promove a acessibilidade a medicamentos mais seletivos e menos tóxicos. Neste trabalho foi desenvolvida uma estratégia para a descoberta computacional de inibidores alostéricos a qual foi aplicada à cruzaína, a principal cisteíno protease do T. cruzi. A caracterização molecular da forma livre e ligada da cruzaína foi investigada através do ancoramento molecular, simulações de dinâmica molecular, cálculos de energia livre de ligação e construção de redes de interações entre resíduos. A partir da análise baseada na geometria das estruturas geradas na dinâmica molecular, foram detectados dois potenciais sítios alostéricos na cruzaína. Os resultados sugerem a existência de diferentes mecanismos de regulação exercidos pela ligação de inibidores diferentes no mesmo sítio alostérico. Além disso, foram identificados os resíduos que estabelecem os caminhos de transmissão de informação entre um dos sítios alostéricos identificado e o sítio ativo da enzima. O presente estudo é a primeira aproximação de desenho de inibidores alostéricos da cruzaína e serve para futuras intervenções farmacológicas. Esses resultados constituem uma base para o desenho de inibidores específicos de cisteíno proteases homólogas da papaína. / Trypanosoma cruzi is the causative agent of Chagas disease, a neglected infection affecting millions of people in tropical regions. There are several chemotherapeutic agents for the treatment of this disease, but most of them are highly toxic and generate resistance. Currently, the development of allosteric inhibitors constitutes a promising research field, since it may improve the accessibility to more selective and less toxic medicines. To date, the allosteric drugs prediction is a state-of-the-art topic in rational structure-based computational design. In this work a simulation strategy was developed for computational discovery of allosteric inhibitors, and it was applied for or cruzain, a promising target and the major cysteine protease of T. cruzi. Molecular dynamics simulations, binding free energy calculations and network-based modelling of residue interactions were combined to characterize and compare molecular distinctive features of the apo form and the cruzain-allosteric inhibitor complexes. By using geometry-based detection on trajectory snapshots we determined the existence of two main allosteric sites suitable for drug targeting. The results suggest dissimilar mechanism exerted by the same allosteric site when binding different potential allosteric inhibitors. Finally, we identified the residues involved in suboptimal paths linking the identified site and the orthosteric site. The present study constitutes the first approximation for designing cruzain allosteric inhibitors and may serve for future pharmacological intervention. These findings are particularly relevant for the design of allosteric modulators of papain-like cysteine proteases. / CAPES: 031/2013