Role of a GenoType MTBDRplus line probe assay in early detection of multidrug-resistant tuberculosis at a Brazilian reference center

Resistance to Mycobacterium tuberculosis is a reality worldwide, and its diagnosis continues to be difficult and time consuming. To face this challenge, the World Health Organization has recommended the use of rapid molecular tests. We evaluated the routine use (once a week) of a line probe assay (Genotype MTBDRplus) for early diagnosis of resistance and for assessment of the main related risk factors over 2 years. A total of 170 samples were tested: 15 (8.8%) were resistant, and multidrug resistance was detected in 10 (5.9%). The sensitivity profile took 3 weeks (2 weeks for culture and 1 week for rapid testing). Previous treatment for tuberculosis and the persistence of positive acid-fast smears after 4 months of supervised treatment were the major risk factors observed. The use of molecular tests enabled early diagnosis of drug-resistant bacilli and led to appropriate treatment of the disease. This information has the potential to interrupt the transmission chain of resistant M. tuberculosis.

Sedentary behaviour and health with special reference to obesity and fatty liver in early midlife. The Cardiovascular risk in Young Finns Study

Background: Physical inactivity and positive energy balance pose a risk to health. They increase the risk of obesity and associated non-communicable diseases. Recently, also sedentary behaviour has been associated with obesity and non-communicable diseases. Nevertheless, it has been unclear which type of sedentary behaviour is the most harmful. It is also unknown whether the relationship of sedentary behaviour with obesity is truly independent of other factors, for example physical activity and diet. Longitudinal data are limited, and the direction of causality and the mechanism of action are still unknown. Aims: The aim of this study was 1) to identify the type of sedentary behaviour having the strongest association with obesity, 2) to explore the causal relationship of sedentary behaviour and weight increase, and 3) to additionally, investigate the relationship of sedentary behaviour with fatty liver. These were studied in cross-sectional and/or longitudinal settings using data from the Cardiovascular Risk in Young Finns Study. Special emphasis was put on the evaluation of a wide range of other lifestyle factors and risks for obesity and fatty liver. Subjects: 2,060 subjects (aged 33-50 years in 2011, of which 55 % were female) from the Cardiovascular Risk in Young Finns Study participating in follow-ups in 2001, 2007, and 2011. Measures: Self-reported time spent in various types of sedentary behaviour (I), or TV viewing time (I-III). Measured body weight, height and waist circumference (I-III), and genetic variants for high BMI (I). Fasting plasma concentrations of gamma-glutamyltransferase enzyme and triglyceride, calculated Fatty Liver Index (based on gamma-glutamyltransferase and triglyceride concentration, BMI and waist circumference), and the amount of intrahepatic fat measured with ultrasound (III). Self-reported leisure-time physical activity and active commuting, occupational physical activity, energy intake, diet, alcohol consumption, smoking, socioeconomic status, and sleep duration as possible confounders were considered (I-III). Results: TV viewing is the sedentary behaviour type that has the strongest association with obesity. Sedentary behaviour (TV viewing) precedes weight increase, and not the other way around. Sedentary behaviour (TV viewing) is associated with increased risk of fatty liver. Conclusions: Sedentary behaviour (especially high TV viewing time) is associated with increased risks of obesity and fatty liver. Intervention studies are needed to assess whether reduction of TV time would prevent obesity and fatty liver.

Central auditory processing and the acquisition of phonology in 2-year-old children with recurrent acute otitis media

Middle ear infections (acute otitis media, AOM) are among the most common infectious diseases in childhood, their incidence being greatest at the age of 6–12 months. Approximately 10–30% of children undergo repetitive periods of AOM, referred to as recurrent acute otitis media (RAOM). Middle ear fluid during an AOM episode causes, on average, 20–30 dB of hearing loss lasting from a few days to as much as a couple of months. It is well known that even a mild permanent hearing loss has an effect on language development but so far there is no consensus regarding the consequences of RAOM on childhood language acquisition. The results of studies on middle ear infections and language development have been partly discrepant and the exact effects of RAOM on the developing central auditory nervous system are as yet unknown. This thesis aims to examine central auditory processing and speech production among 2-year-old children with RAOM. Event-related potentials (ERPs) extracted from electroencephalography can be used to objectively investigate the functioning of the central auditory nervous system. For the first time this thesis has utilized auditory ERPs to study sound encoding and preattentive auditory discrimination of speech stimuli, and neural mechanisms of involuntary auditory attention in children with RAOM. Furthermore, the level of phonological development was studied by investigating the number and the quality of consonants produced by these children. Acquisition of consonant phonemes, which are harder to hear than vowels, is a good indicator of the ability to form accurate memory representations of ambient language and has not been studied previously in Finnish-speaking children with RAOM. The results showed that the cortical sound encoding was intact but the preattentive auditory discrimination of multiple speech sound features was atypical in those children with RAOM. Furthermore, their neural mechanisms of auditory attention differed from those of their peers, thus indicating that children with RAOM are atypically sensitive to novel but meaningless sounds. The children with RAOM also produced fewer consonants than their controls. Noticeably, they had a delay in the acquisition of word-medial consonants and the Finnish phoneme /s/, which is acoustically challenging to perceive compared to the other Finnish phonemes. The findings indicate the immaturity of central auditory processing in the children with RAOM, and this might also emerge in speech production. This thesis also showed that the effects of RAOM on central auditory processing are long-lasting because the children had healthy ears at the time of the study. An effective neural network for speech sound processing is a basic requisite of language acquisition, and RAOM in early childhood should be considered as a risk factor for language development.

Solutions to water problems in the bottom of the pyramid market

Solving the water crisis in the developing world is a critical issue. Four billion people in the globe, so called the Base of the Pyramid (BoP) population suffer from inadequate access to safe drinking water, while millions die daily from waterborne diseases and lack of clean water. The BoP people desperately need to obtain a satisfactory access to safe water sources. In order to address the issue, this research has been carried out. To provide holistic consideration to the matter, comprehensive exploration of various causes of the water crisis and its impacts in developing countries were discussed. Then, various viable and relevant solutions to the problem have been thoroughly scrutinized, including scientific, rational, practical and speculative approaches, examination of existing methods, technologies and products at the BoP water market. The role of clean water to the sustainable development was specifically featured. The paper also has studied social and economic factors, actors and circumstances which affect the market development of clean water technologies in the BoP. Possibilities and potentials of successful business between foreign water enterprises and BoP consumers were considered, while primary obstacles are deliberated on, with suggestion of the ways to tackle them. Technologies and products which are needed by the poor must be affordable, sustainable and of an appropriate quality. The crucial question of technology transfer was soundly discussed with pointing out main hindrances on the way of its implementation between the developed and developing world. The means to overcome these barriers were properly observed as well. To explore to some extent the possibility and feasibility of technology transfer from Finland to the BoP sector, 3 case study analyses have been implemented. Personal discussions in form of interviews were conducted at Kemira, Outotec and Fenno Water, Finnish water treatment and supply enterprises. The results of the interviews shed light on the specific practical matters, actual obstacles and potential solutions of the technology transfer from Finland to low-income countries.

Variable-speed-drive-based detection methods for problems in fluid handling systems

Fluid handling systems account for a significant share of the global consumption of electrical energy. They also suffer from problems, which reduce their energy efficiency and increase life-cycle costs. Detecting or predicting these problems in time can make fluid handling systems more environmentally and economically sustainable to operate. In this Master’s Thesis, significant problems in fluid systems were studied and possibilities to develop variable-speed-drive-based detection methods for them was discussed. A literature review was conducted to find significant problems occurring in fluid handling systems containing pumps, fans and compressors. To find case examples for evaluating the feasibility of variable-speed-drive-based methods, queries were sent to industrial companies. As a result of this, the possibility to detect heat exchanger fouling with a variable-speed drive was analysed with data from three industrial cases. It was found that a mass flow rate estimate, which can be generated with a variable speed drive, can be used together with temperature measurements to monitor a heat exchanger’s thermal performance. Secondly, it was found that the fouling-related increase in the pressure drop of a heat exchanger can be monitored with a variable speed drive. Lastly, for systems where the flow device is speed controlled with by a pressure measurement, it was concluded that increasing rotational speed can be interpreted as progressing fouling in the heat exchanger.

Youth's experiences of motivation in school physical education and sport

This study's objective was to examine how thirteen year-old females perceive and describe their lived experiences of being physically active in school PE (physical education) and organized youth sport settings through a self-determination theory (Deci & Ryan, 1985) lens. Motivational factors and links between both settings were discussed with five participants using in-depth interviews. Participants discussed factors that facilitated and disrupted their motivation to be active in PE and sport settings. The selfdetermination theory was used as a framework in this qualitative study and results are based on participants' own words and perspectives. Results indicate that participants' positive experiences in school PE and organized sport have the potential to meet their needs of autonomy, competence and relatedness. The autonomy supportive behaviours of social agents, feeling challenged and successful at activities and the strong relationships formed in both settings are all things that motivated young people in this study to continue being physically active throughout high-school and into adulthood.

Investigative links between cognitive function and moderate-to-vigorous physical activity in elementary physical education

Research has noted both physical and psychosocial benefits when children participate in regular physical activity. Recent studies are indicating that there may also be academic benefits and that students may be more efficient learners with participation in physical activity. This study investigated the influence of acute moderate-to-vigorous physical activity on four cognitive functions: planning, attention, simultaneous processing, and successive processing. Three classes (59 students) were each tested twice using a balanced design (intervention, balance, and control groups). It was found that the intervention group had a large increase in planning abiHty (ES = 1.67) when compared to the balance (ES = .80) and control (ES = -.89) groups. On the three remaining cognitive functions, the intervention group showed effect sizes similar to that of the balance and control groups. These results indicate that improved planning after physical activity may playa role in improving student performance.

Zero-sum problems in finite cyclic groups

The purpose of this thesis is to investigate some open problems in the area of combinatorial number theory referred to as zero-sum theory. A zero-sequence in a finite cyclic group G is said to have the basic property if it is equivalent under group automorphism to one which has sum precisely IGI when this sum is viewed as an integer. This thesis investigates two major problems, the first of which is referred to as the basic pair problem. This problem seeks to determine conditions for which every zero-sequence of a given length in a finite abelian group has the basic property. We resolve an open problem regarding basic pairs in cyclic groups by demonstrating that every sequence of length four in Zp has the basic property, and we conjecture on the complete solution of this problem. The second problem is a 1988 conjecture of Kleitman and Lemke, part of which claims that every sequence of length n in Zn has a subsequence with the basic property. If one considers the special case where n is an odd integer we believe this conjecture to hold true. We verify this is the case for all prime integers less than 40, and all odd integers less than 26. In addition, we resolve the Kleitman-Lemke conjecture for general n in the negative. That is, we demonstrate a sequence in any finite abelian group isomorphic to Z2p (for p ~ 11 a prime) containing no subsequence with the basic property. These results, as well as the results found along the way, contribute to many other problems in zero-sum theory.

Toward a grounded theory of trigger events and leadership development in early adulthood

The purpose of this research study was to develop a conceptual model through the use of a grounded theory approach, which explains how trigger events are related to leadership development. Trigger events are experience that cause developmental growth and may result in an increased ability to lead (Luthans and Avolio (2003). In this study, there were two phases of data collection. First participants completed the Washington University Sentence Completion Test (WUSCT), where their respective leadership developmental stage was measured. Second, participants were involved in two in-depth interviews where an understanding was reached as to how various trigger events have impacted their leadership development. From these data, a conceptual model was developed to explain the relationship between trigger events and leadership development. Participants described trigger events as being important developmental periods, during which time they grew as people and became more capable leaders.

A Psychosocial Approach to Understanding Causality Assessment in Early Phase Oncology Clinical Trials: A Phenomenological Study

Research Question: What are the psychosocial factors that affect causality assessment in early phase oncology clinical trials? Methods: Thirty-two qualitative interviews were explicated with the aid of “Naturalistic Decision Making”. Data explication consisted of phenomenological reduction, delineating and clustering meaning units, forming themes, and creating a composite summary. Participants were members of the National Cancer Institute of Canada’s Clinical Trial Group Investigative New Drug committee. Results: The process of assigning causality is extremely subjective and full of uncertainty. Physicians had no formal training, nor a tool to assist them with this process. Physicians were apprehensive about their decisions and felt pressure from their patients, as well as the pharmaceutical companies sponsoring the trial. Conclusions: There are many problem areas when attributing causality, all of which have serious consequences, but clinicians used a variety of methods to cope with these problem areas.

Early Development of Auditory-Verbal and Visual-Spatial Short-Term Memory: Age and Sex Effects

Memory is a multi-component cognitive ability to retain and retrieve information presented in different modalities. Research on memory development has shown that the memory capacity and the processes improve gradually from early childhood to adolescence. Findings related to the sex-differences in memory abilities in early childhood have been inconsistent. Although previous research has demonstrated the effects of the modality of stimulus presentation (auditory versus verbal) and the type of material to be remembered (visual/spatial versus auditory/verbal) on the memory processes and memory organization, the recent research with children is rather limited. The present study is a secondary analysis of data, originally collected from 530 typically developing Turkish children and adolescents. The purpose of the present study was to examine the age-related developments and sex differences in auditory-verbal and visual-spatial short-term memory (STM) in 177 typically developing male and female children, 5 to 8 years of age. Dot-Locations and Word-Lists from the Children's Memory Scale were used to measure visual-spatial and auditory-verbal STM performances, respectively. The findings of the present study suggest age-related differences in both visual-spatial and auditory-verbal STM. Sex-differences were observed only in one visual-spatial STM subtest performance. Modality comparisons revealed age- and task-related differences between auditory-verbal and visual-spatial STM performances. There were no sex-related effects in terms of modality specific performances. Overall, the results of this study provide evidence of STM development in early childhood, and these effects were mostly independent of sex and the modality of the task.

Exploring Academic (Di)stress and Help-Seeking in Faculty of Education Students

This is a study of education students’ conceptions of and experiences with academic stress and help-seeking. The study explored teacher education and Master of Education students’ academic stress by examining causes of academic stress and how these stressors affect students’ academic and university experiences. Stress-related help-seeking was also a focus of this study, and was explored using inquiries regarding where participants sought stress-related support. Additionally, exploring students’ use of the Internet for stress-related information or support was a goal of this study. These research goals were pursued using a qualitative methodology that applied grounded theory design. Consequently, data were used to develop a theory that would contribute to existing literature. Specifically, participant descriptions related to causes of and responses to academic stress aligned with Maslow’s (1954) theory of human motivation and Alderfer’s (1969) E. R. G. theory, and led to theoretical contributions that took a hierarchy of student needs and motivation into consideration.

A Quantitative and Qualitative Inquiry Into Positive Involvement Trends of Contemporary Fathers and Influence of Parenting Programs

Parent education programs offered by a variety of public health services are effective support and knowledge resources that enhance positive parenting competencies in early childhood and adolescence. However, parenting education programs are less effective and encompass fewer benefits for fathers in comparison to mothers. This study sought to investigate trends of paternal involvement in early childhood and to compare the influence of parenting education programs on paternal involvement and conceptualization of fathers. A sample of 52 fathers, between the ages of 19 to 54, with children 6 years old and younger completed an electronic or hard copy version of a survey questionnaire reporting on their fathering and experiences as a dad. Findings indicate the sample of Canadian fathers self-reported high levels of paternal involvement, including many who favoured play-based interactions with their children. Although no significant difference in levels of involvement was noted between fathers who had versus those who had not previously participated in a parenting education program, half of the Canadian fathers indicated that supports are needed to strengthen their role as fathers. Results suggest that future initiatives to strengthen parent education program services available in Canada should specifically consider the father’s role.