Drinking water disinfection by-products, genetic polymorphisms, and birth outcomes in a european mother-child cohort study

International audience

O impacto da urbanização na violência : Contraste urbano e rural

A urbanização mais recente em Portugal caracterizou-se por uma bipolarização concentrada em Lisboa e no Porto acompanhada também pelo crescimento de população ao longo do litoral norte e por fim pelo crescimento de algumas cidades mais pequenas. A construção de habitações sociais para albergar famílias mais carenciadas e com dificuldades económicas veio acompanhada também, ao longo do tempo, por um crescimento da violência urbana. Contudo, pode-se constatar que a criminalidade violenta e grave tem diminuído, pelo menos desde 2010. Este estudo tem o objetivo de descrever as diferenças existentes na criminalidade entre uma área predominantemente urbana e outra área predominantemente rural entre 2010 e 2015 com a finalidade de perceber o que existe nas áreas urbanas que não existe nas áreas rurais, para poder estabelecer uma relação com a criminalidade violenta e grave em ambientes urbanos. Para tal, foi calculada a taxa de criminalidade violenta e grave da área do Subdestacamento Territorial de Alcabideche e do Posto Territorial de Merceana, para perceber a incidência criminal deste fenómeno no período de estudo. Foram também conduzidos inquéritos por entrevista a comandantes e militares responsáveis pela investigação criminal em ambos os locais que exerceram funções entre 2010 e 2015. Chegou-se à conclusão que a criminalidade violenta e grave é bastante mais significativa nas áreas urbanas e a principal causa e fonte da maior parte desta criminalidade poderão ser os bairros de habitação social, no caso de Alcabideche, que albergam algumas pessoas de famílias desestruturadas, onde se concentram muitos indivíduos num mesmo local que poderão praticar crimes, nomeadamente, a crimes violentos e graves.

FLOOD RISK ASSESSMENT UNDER HISTORICAL AND PREDICTED LAND USE CHANGE USING CONTINUOUS HYDROLOGIC MODELING

Current procedures for flood risk estimation assume flood distributions are stationary over time, meaning annual maximum flood (AMF) series are not affected by climatic variation, land use/land cover (LULC) change, or management practices. Thus, changes in LULC and climate are generally not accounted for in policy and design related to flood risk/control, and historical flood events are deemed representative of future flood risk. These assumptions need to be re-evaluated, however, as climate change and anthropogenic activities have been observed to have large impacts on flood risk in many areas. In particular, understanding the effects of LULC change is essential to the study and understanding of global environmental change and the consequent hydrologic responses. The research presented herein provides possible causation for observed nonstationarity in AMF series with respect to changes in LULC, as well as a means to assess the degree to which future LULC change will impact flood risk. Four watersheds in the Midwest, Northeastern, and Central United States were studied to determine flood risk associated with historical and future projected LULC change. Historical single framed aerial images dating back to the mid-1950s were used along with Geographic Information Systems (GIS) and remote sensing models (SPRING and ERDAS) to create historical land use maps. The Forecasting Scenarios of Future Land Use Change (FORE-SCE) model was applied to generate future LULC maps annually from 2006 to 2100 for the conterminous U.S. based on the four IPCC-SRES future emission scenario conditions. These land use maps were input into previously calibrated Soil and Water Assessment Tool (SWAT) models for two case study watersheds. In order to isolate effects of LULC change, the only variable parameter was the Runoff Curve Number associated with the land use layer. All simulations were run with daily climate data from 1978-1999, consistent with the 'base' model which employed the 1992 NLCD to represent 'current' conditions. Output daily maximum flows were converted to instantaneous AMF series and were subsequently modeled using a Log-Pearson Type 3 (LP3) distribution to evaluate flood risk. Analysis of the progression of LULC change over the historic period and associated SWAT outputs revealed that AMF magnitudes tend to increase over time in response to increasing degrees of urbanization. This is consistent with positive trends in the AMF series identified in previous studies, although there are difficulties identifying correlations between LULC change and identified change points due to large time gaps in the generated historical LULC maps, mainly caused by unavailability of sufficient quality historic aerial imagery. Similarly, increases in the mean and median AMF magnitude were observed in response to future LULC change projections, with the tails of the distributions remaining reasonably constant. FORE-SCE scenario A2 was found to have the most dramatic impact on AMF series, consistent with more extreme projections of population growth, demands for growing energy sources, agricultural land, and urban expansion, while AMF outputs based on scenario B2 showed little changes for the future as the focus is on environmental conservation and regional solutions to environmental issues.

Effect of the Supplemental Nutrition Assistance Program (SNAP) and Nutrition Education on Nutrition and Health Outcomes of HIV+ Individuals

Factors associated with and barriers to participation in Supplemental Nutrition Assistance Program (SNAP) and the effect participation has on food security, nutrition status, disease status and quality of life was investigated in a cross-sectional study including 175 HIV infected individuals. In addition, the effect of a targeted nutrition education on nutrition knowledge, readiness to dietary behavior change, nutrition status, disease status and quality of life was also investigated among a subset of the population (N = 45) in a randomized clinical control trial. SNAP participation rate was 70.3%, similar to the State of Florida and national participation rates. SNAP participation was positively and independently associated with being born in the US (P < 0.001), having monthly income less than $1000 (P = 0.006), and receiving antiretroviral treatment (P < 0.001). Participation barriers include denial of participation by program, recent incarceration, living in a shelter where participation is not allowed and unawareness of eligibility status. In regression analyses, SNAP participation was not significantly associated with improved food security, nutrition status, disease status and health related quality of life (HRQOL). Over half (56%) of the population experienced food insecurity and had inadequate intakes of half of the nutrients assessed. Illicit drug, alcohol and cigarette use were high in this population (31%, 55% and 63% respectively), and affected food security, nutrients intake, disease status and HRQOL. The nutrition education intervention resulted in a trend towards improvements nutrition knowledge, self-efficacy, and readiness to change without impacting nutrition status, disease state and quality of life. Food insecurity and other nutrition related issues, with implications for treatment, management and cost of HIV disease, continue to plague infected individuals living in poverty. More resources, including food and nutrition programs, specifically targeted towards this population are needed to address these issues.

Cardiorespiratory fitness and cardiometabolic risk factors in schoolchildren from Colombia: The FUPRECOL Study

The objectives of this study are to investigate the association between cardiorespiratory fitness and cardiovascular risk factors in schoolchildren and to evaluate the degree of association between overall and abdominal adiposity and cardiorespiratory fitness. A total of 1,875 children and adolescents attending public schools in Bogota, Colombia (56.2% girls; age range of 9–17.9 years). A cardiovascular risk score (Z-score) was calculated and participants were divided into tertiles according to low and high levels of overall (sum of the skinfold thicknesses) and abdominal adiposity. Schoolchildren with a high level of overall adiposity demonstrated significant differences in seven of the 10 variables analyzed (i.e. systolic and diastolic blood pressure, triglycerides, triglycerides/HDL-c ratio, total cholesterol, glucose and cardiovascular risk score). Schoolchildren with high levels of both overall and abdominal adiposity and low cardiorespiratory fitness had the least favorable cardiovascular risk factors score. These findings may be relevant to health promotion in Colombian youth.

Probiotics for the prevention/treatment of human diseases and ecological study of the intestinal microbiota

The interest in human intestinal microbiota has increased in the last 20 years and significant advances have been achieved with regard to its composition and functions. The gut microbiota contributes to the maintenance of the host health status and, since alterations in the gut microbiota have been involved in the pathogenesis/progression of some diseases, several studies have focused on the manipulation of its composition. Probiotics are a strategy to maintain/restore the correct balance of gut microbial population and to prevent/treat diseases. The aim of this thesis was to explore the possibility of probiotic supplementation for the prevention/treatment of human diseases and the related study of the intestinal microbial environment. After reviewing studies concerning the use of Bifidobacterium breve as probiotic in paediatric diseases, the effectiveness of a probiotic formulation consisting of two strains of B. breve was assessed in paediatric subjects for the prevention or alleviation of gastrointestinal disorders, including coeliac disease and paediatric obesity. As the emerging role of gut microbiota in neurological diseases, the intestinal microbial environment in amyotrophic lateral sclerosis patients compared to healthy controls and the effects of a probiotic administration were examined. Considering the role of viruses in shaping gut microbiota, gut bacteriophages and bacterial community of preterm infants were investigated. The results evidenced differences in gut microbial composition of healthy controls and diseased subjects in coeliac and amyotrophic lateral sclerosis patients. The probiotic approach was effective in restoring the microbial composition in the former, whereas, in the latter, the influence was focused only on some microbial groups. The probiotic intervention was effective in improving the glyco-insulinemic profile in obese children and in preventing gastrointestinal disorders in healthy newborns. The study of the bacterial and phage composition in preterm infants suggested a transkingdom interplay between bacteria and viruses with a reciprocal influence on their composition.

Greening the city: an ecosystem-based framework to support planning towards urban sustainability and resilience

Cities are small-scale complex socio-ecological systems, that host around 60% of world population. Ecosystem Services (ES) provided by urban ecosystems offer multiple benefits necessary to cope with present and future urban challenges. These ES include microclimate regulation, runoff control, as well as opportunities for mental and physical recreation, affecting citizen’s health and wellbeing. Creating a balance between urban development, land take containment, climate adaptation and availability of Urban Green Areas and their related benefits, can improve the quality of the lives of the inhabitants, the economic performance of the city and the social justice and cohesion aspects. This work starts analysing current literature around the topic of Ecosystem Services (ES), Green and Blue Infrastructure (GBI) and Nature-based Solutions (NBS) and their integration within current European and International sustainability policies. Then, the thesis focuses on the role of ES, GBI and NBS towards urban sustainability and resilience setting the basis to build the core methodological and conceptual approach of this work. The developed ES-based conceptual approach provides guidance on how to map and assess ES, to better inform policy making and to give the proper value to ES within urban context. The proposed interdisciplinary approach navigates the topic of mapping and assessing ES benefits in terms of regulatory services, with a focus on climate mitigation and adaptation, and cultural services, to enhance wellbeing and justice in urban areas. Last, this thesis proposes a trans-disciplinary and participatory approach to build resilience over time around all relevant urban ES. The two case studies that will be presented in this dissertation, the city of Bologna and the city of Barcelona, have been used to implement, tailor and test the proposed conceptual framework, raising valuable inputs for planning, policies and science.

Musculoskeletal disorders, research quality, and pelvic floor health in sports: exploring current evidence and new perspectives

Background. Pelvic floor dysfunction (PFD) is an umbrella term that includes a myriad of conditions such as urinary (UI) and anal incontinence, pelvic organ prolapse, pelvic pain, and sexual dysfunction. Literature showed high prevalence rates of PFD among athletes, especially UI, with high-impact sports have been linked with an increased risk of developing symptoms. However, comprehensive research summarising PFD prevalence across sexes, exploring treatment options, and the absence of a standardised referral screening tool are notable gaps. Misinformation is also prevalent in the sports medicine field. Methods. This doctoral project comprises four studies addressing different aspects of pelvic health in athletes. The first two studies were scoping reviews of epidemiological PFD data in male and female athletes, as well as available interventions. Study 3 concerned the development of a new screening tool for PFD in female athletes, aiming to guide sports medicine clinicians in referring patients to PFD specialists through a worldwide Delphi consensus. Study 4 summarised all previous findings, integrating data into an infographic. Results and conclusions. In Study 1, the findings of 100 articles on PFD in both sexes have been collected, highlighting a higher prevalence of studies on female athletes evaluating UI across multiple sports. Other conditions remain rarely investigated. Study 2 found a diverse range of interventions for female PFD, with a notable emphasis on conservative approaches. Recommendations for clinical practice often relied on the transferability of results from the nonathlete population or expert opinions. In Study 3, 41 international experts took part in the consensus development of the Pelvic Floor Dysfunction-ScrEeNing Tool IN fEmale athLetes (PFD-SENTINEL). It incorporates a cluster of PFD symptoms, items (risk factors, clinical, and sports-related characteristics), and a clinical algorithm. Lastly, Study 4 included ten evidence-based information with a relative description concerning pelvic floor health in athletes.

Transcutaneous Tibial Nerve Stimulation In The Treatment Of Lower Urinary Tract Symptoms And Its Impact On Health-related Quality Of Life In Patients With Parkinson Disease: A Randomized Controlled Trial.

A randomized controlled trial study was performed to evaluate the efficacy of transcutaneous tibial nerve stimulation (TTNS) and sham TTNS, in patients with Parkinson disease (PD) with lower urinary tract symptoms (LUTS). Randomized controlled trial. Thirteen patients with a diagnosis of PD and bothersome LUTS were randomly allocated to one of the following groups: Group I: TTNS group (n = 8) and group II: Sham group (n = 5). Both groups attended twice a week during 5 weeks; each session lasted 30 minutes. Eight patients received TTNS treatment and 5 subjects allocated to group II were managed with sham surface electrodes that delivered no electrical stimulation. Assessments were performed before and after the treatment; they included a 3-day bladder diary, Overactive Bladder Questionnaire (OAB-V8), and the International Consultation on Incontinence Quality of Life Questionnaire Short Form (ICIQ-SF), and urodynamic evaluation. Following 5 weeks of treatment, patients allocated to TTNS demonstrated statistically significant reductions in the number of urgency episodes (P = .004) and reductions in nocturia episodes (P < .01). Participants allocated to active treatment also showed better results after treatment in the OAB-V8 and ICIQ-SF scores (P < .01, respectively). Urodynamic testing revealed that patients in the active treatment group showed improvements in intravesical volume at strong desire to void (P < .05) and volume at urgency (P < .01) when compared to subjects in the sham treatment group. These findings suggest that TTNS is effective in the treatment of LUTS in patients with PD, reducing urgency and nocturia episodes and improving urodynamic parameters as well as symptom scores measured by the OAB-V8 and health-related quality-of-life scores measured by the ICIQ-SF.

Interação entre alunos com e sem deficiencia na educação fisica escolar : validação de instrumento

Universidade Estadual de Campinas. Faculdade de Educação Física

A cultura do lazer fisico esportivo como resultado da disciplina da Educação Fisica escolar : o caso do colegio estadual "Culto a Ciencia" de Campinas

Universidade Estadual de Campinas . Faculdade de Educação Física

A resilencia e a imagem corporal de adolescentes e adultos com mielomeningocele

Universidade Estadual de Campinas . Faculdade de Educação Física

Atividade fisica e sintomas musculo-esqueleticos : explorando relações em população de calouros de medicina

Universidade Estadual de Campinas. Faculdade de Educação Física

Conhecendo para intervir, em direção ao empoderamento pela atividade fisica no Complexo São Marcos, Campinas, SP

Universidade Estadual de Campinas . Faculdade de Educação Física

Inquérito de saúde no Município de Campinas, São Paulo, Brasil (ISACamp): comparação de estimativas segundo posse de linha telefônica residencial

O estudo avalia diferenças quanto às características sociodemográficas, de estilo de vida e de condições de saúde entre adultos com e sem linha telefônica residencial, valendo-se de dados de inquérito domiciliar de saúde realizado em Campinas, São Paulo, Brasil (2008/2009). Trata-se de estudo transversal de base populacional com 2.637 adultos (18 anos e mais). Análises descritivas, testes qui-quadrado, prevalências e respectivos intervalos de 95% de confiança foram calculados. Estimaram-se os vícios associados à não cobertura da população sem telefone antes e após o ajuste de pós-estratificação. O impacto do vício nos intervalos de confiança foi avaliado pela razão de vício. Cerca de 76% dos entrevistados possuíam linha telefônica residencial. Exceto para situação conjugal, foram observadas diferenças sociodemográficas segundo posse de telefone. Após o ajuste de pós-estratificação, houve redução do vício das estimativas para as variáveis associadas à posse de linha telefônica, no entanto, exceto para osteoporose, o ajuste de pós-estratificação foi insuficiente para corrigir o vício de não cobertura.