Dissertations / Theses on the topic 'Immediate risk'

While the causes of myriad medical and infectious illnesses have been identified, the etiologies of neuropsychiatric illnesses remain elusive. This is due to two major obstacles. First, the risk for neuropsychiatric disorders, such as schizophrenia, is determined by both genetic and environmental factors. Second, numerous genes influence susceptibility for these illnesses. Genome-wide association studies have identified at least 108 genomic loci for schizophrenia, and more are expected to be published shortly. In addition, numerous biological processes contribute to the neuropathology underlying schizophrenia. These include immune dysfunction, synaptic and myelination deficits, vascular abnormalities, growth factor disruption, and N-methyl-D-aspartate receptor (NMDAR) hypofunction. However, the field of psychiatric genetics lacks a unifying model to explain how environment may interact with numerous genes to influence these various biological processes and cause schizophrenia. Here we describe a biological cascade of proteins that are activated in response to environmental stimuli such as stress, a schizophrenia risk factor. The central proteins in this pathway are critical mediators of memory formation and a particular form of hippocampal synaptic plasticity, long-term depression (LTD). Each of these proteins is also implicated in schizophrenia risk. In fact, the pathway includes four genes that map to the 108 loci associated with schizophrenia: GRIN2A, nuclear factor of activated T-cells (NFATc3), early growth response 1 (EGR1) and NGFI-A Binding Protein 2 (NAB2); each of which contains the "Index single nucleotide polymorphism (SNP)" (most SNP) at its respective locus. Environmental stimuli activate this biological pathway in neurons, resulting in induction of EGR immediate early genes: EGR1, EGR3 and NAB2. We hypothesize that dysfunction in any of the genes in this pathway disrupts the normal activation of Egrs in response to stress. This may result in insufficient electrophysiologic, immunologic, and neuroprotective, processes that these genes normally mediate. Continued adverse environmental experiences, over time, may thereby result in neuropathology that gives rise to the symptoms of schizophrenia. By combining multiple genes associated with schizophrenia susceptibility, in a functional cascade triggered by neuronal activity, the proposed biological pathway provides an explanation for both the polygenic and environmental influences that determine the complex etiology of this mental illness.

The advent of prostate-specific antigen (PSA) testing and increased patient awareness has led to patients being diagnosed with prostate cancer at an earlier stage and a younger age than previously. Adjuvant hormonal therapy to radiotherapy or prostatectomy has been shown to reduce the risk of tumour progression, and in some studies survival benefits have been demonstrated. The non-steroidal antiandrogen bicalutamide (‘Casodex’) has undergone extensive evaluation and is currently undergoing clinical trials as immediate therapy, either alone or as adjuvant to treatment of curative intent in patients with localized or locally advanced disease. Data from the first analysis of one of the studies in the Early Prostate Cancer (EPC) programme involving 3,603 patients have shown that, after a median follow-up of 2.6 years, the risk of prostate cancer progression was significantly reduced (by 43%) in patients receiving bicalutamide 150 mg compared with those receiving standard care alone (HR 0.57; 95% CI 0.48, 0.69; p ≪ 0.0001). The risk of PSA progression was also significantly reduced (by 63%). At this stage the survival data are still immature. Side effects of bicalutamide were mostly gynaecomastia and breast pain, which is consistent with its pharmacology. Overall withdrawal rates were similar in the bicalutamide 150 mg and standard care alone groups. In the bicalutamide 150 mg group, withdrawals were mainly due to side effects, whereas in the group receiving standard care alone, withdrawals were mainly due to disease progression. The programme is ongoing, and survival data are awaited
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich

The advent of prostate-specific antigen (PSA) testing and increased patient awareness has led to patients being diagnosed with prostate cancer at an earlier stage and a younger age than previously. Adjuvant hormonal therapy to radiotherapy or prostatectomy has been shown to reduce the risk of tumour progression, and in some studies survival benefits have been demonstrated. The non-steroidal antiandrogen bicalutamide (‘Casodex’) has undergone extensive evaluation and is currently undergoing clinical trials as immediate therapy, either alone or as adjuvant to treatment of curative intent in patients with localized or locally advanced disease. Data from the first analysis of one of the studies in the Early Prostate Cancer (EPC) programme involving 3,603 patients have shown that, after a median follow-up of 2.6 years, the risk of prostate cancer progression was significantly reduced (by 43%) in patients receiving bicalutamide 150 mg compared with those receiving standard care alone (HR 0.57; 95% CI 0.48, 0.69; p ≪ 0.0001). The risk of PSA progression was also significantly reduced (by 63%). At this stage the survival data are still immature. Side effects of bicalutamide were mostly gynaecomastia and breast pain, which is consistent with its pharmacology. Overall withdrawal rates were similar in the bicalutamide 150 mg and standard care alone groups. In the bicalutamide 150 mg group, withdrawals were mainly due to side effects, whereas in the group receiving standard care alone, withdrawals were mainly due to disease progression. The programme is ongoing, and survival data are awaited.
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

The research investigates those conflicting interests in the future for the Brighton Hippodrome theatre. The building is in a permanent state of disuse since it closed in 2006. It is in poor condition and is adversely affecting its surrounding environment. Though there has not been much happening in regard to the specific building, there have been a lot in relation to it. It has been sold several times, reports being produced, planning applications have been submitted, but its current state remains the same. The stakeholders involved in Brighton Hippodrome has been the subject of a qualitative study conducted through interviews, analysis of documents and articles. The purpose of the survey has been to look at the interests, resources and values of the various stakeholders. As well as when and under what circumstances the stakeholders interact. Through this, different factors and aspects have been identified as presented in text, illustrations and timelines. The result indicates that there are strong forces with sound aspects involved, though they may seem not to, they do share much in common. A major issue is that decisions not being follow through and there is a lack of communication between stakeholders in which ultimately affects the building negatively and prolongs its current derelict state. The current situation might jeopardise what is stated to be of significant value due to the urgency of repair and the rush to find a new use for the building. There is a risk that a future development might leave some stakeholders disappointed if not handled correctly.

Climate change is exacerbating natural disasters, and extreme weather events increase with intensity and frequency. This requires an in-depth evaluation of locations across the various U.S. climates where natural hazards, vulnerabilities, and potentially damaging impacts will vary. At the local building level within the built environment, private residences are crucial shelter systems to protect against natural disasters, and are a central component in the greater effort of creating comprehensive disaster resilient environments. In light of recent disasters such as Superstorm Sandy, there is an increased awareness that residential buildings and communities need to become more resilient for the changing climates they are located in, or will face devastating consequences. There is a great potential for specific high-performance building technologies to play a vital role in achieving disaster resilience on a local scale. The application of these technologies can not only provide immediate protection and reduced risk for buildings and its occupants, but can additionally alleviate disaster recovery stressors to critical infrastructure and livelihoods by absorbing, adapting, and rapidly recovering from extreme weather events, all while simultaneously promoting sustainable building development. However, few have evaluated the link between residential high-performance building technologies and natural disaster resilience in regards to identifying and prioritizing viable technologies to assist decision-makers with effective implementation. This research developed a framework for a process that prioritizes residential building technologies that encompass both high-performance and resilience qualities that can be implemented for a variety of housing contexts to mitigate risks associated with climate induced natural hazards. Decision-makers can utilize this process to evaluate a residential building for natural disaster risks, and communicate strategies to improve building performance and resilience in response to such risks.
Ph. D.

Among preschool-aged children, conduct problems (CP) are the number one reason for referral to mental health professionals. Research has consistently indicated that behavioral parent training (BPT) is the most effective technique for treating children’s disruptive behavior; however, there is a lack of research regarding BPT effects in children below the age of 3. Preventive behavioral parent training (PBPT) can be considered a preventive extension of BPT. The purpose of this study was to determine the degree to which PBPT might yield immediate effects in reducing rates of conduct problems (i.e., noncompliance and tantrums) displayed by typically developing young children. Overall, findings indicated that all four child participants displayed decreased rates of noncompliance and tantrums as predicted.

A alergia ao látex representa um importante problema de saúde em pacientes denominados de risco e está relacionada com a ocorrência de diversas manifestações clínicas, inclusive reações potencialmente fatais. O estudo de fatores associados à sensibilização e alergia ao látex é fundamental para o estabelecimento de medidas eficazes quanto à prevenção, tratamento e conhecimento do prognóstico. O principal grupo de risco para a alergia ao látex são os pacientes com defeito de fechamento do tubo neural. O estudo atual teve como objetivo principal identificar fatores clínicos e sorológicos associados à sensibilização e alergia ao látex em pacientes com defeito de fechamento do tubo neural. A pesquisa também analisou concentrações de corte de IgE específica sérica para látex e alérgenos do látex que pudessem identificar pacientes sensibilizados e alérgicos ao látex e avaliou o comportamento da IgG4 específica para látex como fator de proteção associado à ausência de sintomas. Com o intuito de responder estas perguntas, foi realizado um estudo transversal tipo coorte retrospectiva com 400 pacientes com defeito de fechamento do tubo neural, entre 0 e 18 anos, que estavam em seguimento na Associação de Assistência à Criança Deficiente - AACD. Após responderem a questionário específico, os pacientes foram submetidos à coleta de sangue periférico para a detecção dos níveis séricos de IgE total, IgE e IgG4 séricas específicas para látex, IgE sérica específica para rHevb1, 3, 5, 6.01, 6.02, 8, 9 e 11, Dermatophagoides pteronyssinus, Blomia tropicalis, abacate, banana, castanha, mamão, batata, através da metodologia ImmunoCap®. De acordo com a história clínica e o valor da IgE sérica específica para látex, os pacientes foram classificados em quatro grupos: sensibilizados asintomáticos ao látex, alérgicos ao látex, sintomáticos sem sensibilização e controle negativo. A prevalência total de sensibilização ao látex nesta amostra de pacientes foi de 33,2%, sendo 12,2% alérgicos e 21,0% sensibilizados assintomáticos ao látex. Os sintomas cutâneos foram a manifestação clínica mais comum de alergia ao látex (79,6%), sendo a urticária de contato a mais prevalente (67,3%). Houve episódios de anafilaxia associados à exposição ao látex em 21 pacientes (5,2%). Níveis de IgE sérica específica para látex de 0,77 kUA/L foram capazes de diferenciar com boa acurácia os pacientes alérgicos dos demais. Na comparação entre os grupos controle negativo e alérgico, sensibilizado e alérgico, houve diferença entre as variáveis clínicas, cirúrgicas e laboratoriais que estiveram associadas à alergia ao latex. A razão entre IgG4/IgE séricas específicas para látex foi estatisticamente maior no grupo controle negativo. A análise multivariada mostrou na comparação entre o grupo controle negativo e alérgico que a presença de IgE sérica específica para rHevb1 e IgE rHevb5 estão associadas com alergia. Na comparação entre o grupo sensibilizado e alérgico, houve associação de alergia com a presença de IgE sérica específica para rHevb5 e com escore clínico >= 40%. Por outro lado, a IgG4 sérica específica para látex esteve associada à ausência de sintomas no grupo sensibilizado
Latex allergy is an important health problem in patients at risk groups and it is associated with the occurrence of many clinical manifestations, including potentially fatal reactions. The study of factors associated with latex sensitization and allergy is crucial to establish effective measures of prevention, treatment and prognostic. The main risk group for latex allergy is patients with neural tube defects. The objective of this study was to identify the clinical and serologic factors associated with sensitization and allergy to latex. Levels of specific IgE to latex and latex allergens associated with allergy, as well as levels of specific IgG4 associated with clinical tolerance, were established, and its accuracy and cutoff values were calculated. The profile of clinical manifestations, including anaphylaxis, was also characterized. This study was a retrospective cross-sectional cohort of 400 patients with neural tube defects, between 0 and 18 years, who were being followed at the Association for Assistance of Disabled Children - AACD. After answering a specific questionnaire, patients were submitted to blood draw for the detection of total IgE, specific IgG4 to latex, and specific IgE to latex, rHevb (1, 3, 5, 6.01, 6.02, 8, 9, 11), Dermatophagoides pteronyssinus, Blomia tropicalis, avocado, banana, cashew, papaya, and potato, by ImmunoCAP ® methodology. According to the history and value of specific IgE to latex, patients were classified into four groups: sensitized asymptomatic patients, allergic patients, symptomatic patients and negative control. The overall prevalence of latex sensitization in this sample of patients was 33.2%, with 12.2% of allergic and 21.0% of sensitized patients. The skin symptoms were the most common clinical manifestation of latex allergy (79.6%), and contact urticaria was the most prevalent (67.3%). Anaphylaxis after latex exposure was observed in 21 patients (5.2%). Levels of specific IgE to latex of 0.77 kUA/L were able to differentiate allergic patients, with good accuracy. Comparing the negative control and allergic groups, the sensitized and allergic groups they had differents clinical, surgical and laboratory factors associated with allergy to latex. The ratio serum specific IgG4/IgE to latex was statistically higher in the negative control group. Multivariate analysis showed, in the comparison between the negative control and allergic groups, that the presence of serum specific IgE to rHevb1 and rHevb5 were associated with allergy. Comparing the sensitized and allergy groups, allergy was associated with the presence of serum specific IgE to rHevb5 and clinical score >= 40%. Moreover, serum specific IgG4 to latex was associated with lack of symptoms in the sensitized group.

Architectural form is both an expression of human desire and built edifice directly related to construction methods. It follows that the responsibilities of the architect seeking new form must extend to the instrumentation of tectonic machines and devices, which are also appropriately new. This thesis proposes a revitalization of the relationship between the architect and machines as a means of restoring intimacy, immediacy, and delight to the act of building. What follows is a presentation of images, photographs, and models related to the design and development of an architecture machine, and related constructions.
Master of Architecture

Les réactions d'hypersensibilité immédiate survenant au cours de l'anesthésie demeurent un sujet de préoccupation majeure pour les anesthésistes. Le médicament le plus fréquemment responsable d'une anaphylaxie sont les curares. Le but de ce travail est de préciser l'épidémiologie actuelle et d'identifier certains facteurs environnementaux susceptibles d'expliquer la fréquence élevée des réactions allergiques aux curares qui peuvent survenir en l'absence de toute exposition préalable. Dans la première partie de la thèse, une enquête nationale décrivant l'épidémiologie des réactions anaphylactiques peranesthésiques entre 2005 et 2007 en France. Elle a confirmé l'intérêt du dosage d'IgE spécifique anti-curare. La survenue de réactions d'hypersensibilité immédiate allergique à l'induction anesthésique lors d'une première exposition aux curares a conduit à évoquer l'existence d'une sensibilisation croisée avec des substances présentes dans l'environnement et possédant un ammonium quaternaire. Différentes hypothèses ont été proposées, notamment une exposition aux produits cosmétiques et/ou désinfectants, une exposition à des antigènes de type phosphorylcholine rencontrés dans les levures, ou certains parasites. Dans la deuxième partie de la thèse, deux populations professionnelles, des apprentis coiffeurs exposés à des agents chimiques contenant des ions ammoniums, et des boulanger-pâtissiers exposés à des allergènes de levures et de parasites, ont été comparées avec la population générale à la recherche de différences concernant la prévalence des anticorps IgE spécifique anti-curare. Au terme de ce travail, l'exposition à des produits cosmétiques chez les coiffeurs apparaît comme un facteur de risque de développer des anticorps IgE spécifique anti-curare, démontrant pour la première fois l'hypothèse du lien entre l'exposition répétée aux produits cosmétiques contenant l'ammonium quaternaire et la sensibilisation croisée aux curares
Immediate hypersensitivity reactions occurring during anesthesia remains a major concern for anesthesiologists. The drugs most frequently responsible for anaphylaxis are neuromuscular blocking agents (NMBAs). The purpose of this study is to determine the current epidemiology and to identify environmental factors that may explain the high frequency of allergic reactions to neuromuscular blocking agents that can occur without any prior exposure. In the first part of the thesis, a national survey describing the epidemiology of anaphylaxis during anesthesia between 2005 and 2007 in France was carried out. The value of testing specific IgE against NMBA was confirmed.The occurrence of immediate allergic hypersensitivity reaction when first exposure to an NMBA during induction led to evoke the existence of cross-sensitization with substances present in environment and having a quaternary ammonium compound. Different hypotheses have been proposed including exposure to cosmetics and / or disinfectants, exposure to antigens encountered in phosphorylcholine yeasts, or parasites, or exposure to a derivative opiate, pholcodine. In the second part of the thesis, two occupational populations, hairdressers apprentice exposed to chemical agents containing ammonium ions, baker and pastry maker exposed to allergens yeast and parasites were compared with the general population to search for differences regarding the prevalence of specific IgE antibody against NMBA. At the end of this work, hairdressers exposed to cosmetics agents appears to be a risk factor for developing specific IgE antibodies against NMBA and we demonstrated for the first time the hypothesis of the ross-sensitization between repeated exposures to cosmetics products containing quaternary ammonium and NMBAs

To describe the risk factors associated with burns, to ascertain immediate home and hospital management and to endeavour to establish appropriate recommendations to prevent or reduce the incidence of burns. DESIGN Descriptive, KAP [Knowledge, attitude, practice] study SUBJECTS All burns patients five years and less presenting at Baragwanath Burns Unit from the months o f July to September 1997. RESULTS Hundred andfifty children were seen between the months o f July and September 1997. There were 89 (59.3 %) males and 61 (40.7 %) females. Children less than six months comprised only 4 (2.6%) o f these burns. Of these burns 74.6 % were scalds, 13.3 % were flame and 7.3 % were contact burns. Spillage of hot water and tea were the main causes of scalds. Only 26.7 % of the study population stayed in shack houses and 87.3 % had electricity at home. The mean occupancy rate -was 2.5 people per one room. All children were presented to the health centres within 24 hours o f the injury, except for one who arrived suffering from a burn wound which had become septic. There was only one death from inhalation burns. The vast majority of parents (85.9 %) said they had, learnt something about the prevention of burns from the incident. Only 37.6% of the parents said they were taught health education regarding the immediate home management of burns by the doctors or nursing staff. When the injury occurred, 82.7 % of the children were not alone in the house and 41.7 % o f these were with their mothers in the same room while 26.8 % were with their siblings, none of whom were more than 13 years of age. CONCLUSION Many of the risk factors identified in this study are preventable. Education remains the key factor in the prevention and management of burns. Overcrowding appears to be another reason for burns, however, further studies need to be conducted in order to prove this. The health workers need to be encouraged to help educate the patients and caregivers regarding prevention as well as emergency management of burns. The media, mainly radio stations should also he more extensively utilised for this purpose as it is already successfully done via the Soul City edutainment program on radio and television. Better supervision of children can also be facilitated by older siblings (not pre-teenagers) taking care of the children and by the private sectors together with the government supplying and subsidising daycare centres for their employees. Notification of burns would help to target the appropriate areas which need immediate intervention.

Text in English
The aim of the study was to describe the competencies of midwives during the provision of immediate postnatal care (PNC) with the intention of adapting and linking international best practice guidelines as well as a conceptual framework for the implementation of PNC in Swaziland. A quantitative cross-sectional design study was conducted to investigate the competencies of midwives during the provision of immediate postnatal care services to mothers and their infants. A systematic random sampling technique was used to select eighty-eight (88) midwives and six (6) senior midwives to participate in the study. Data collection was done using structured questionnaires. Quantitative data was complemented by data that was generated from open-ended questions at the end of the questionnaires. Data analysis was conducted using IBM SPSS Statistics version 22.0 software. The study highlighted that all the midwives who participated in this study had the relevant qualification. Of the respondents, 70.5% were state-certified midwives with a second registered certificate, 27.3% had bachelor’s degrees, while 2.3% had an advanced midwifery certificate. The study found no difference between the type of qualification of midwives and the knowledge of PNC interventions to be offered to mothers immediately post-delivery across different qualifications held by the midwives (Kruskal-Wallis test: x2=5.498, df=2, p=0.064). Gaps were identified in their knowledge and practices. There were discrepancies in the level of knowledge and practices regarding maternal vital sign assessment immediately after delivery (within 30 minutes). It was noted that these vital signs, i.e. blood pressure (12.5%), temperature (50.0%), pulse (54.5%), respiration (63.6%) were not taken after delivery. It was also noted that 15.0%, 58.0%, 64.8% of the respondents were not aware of the importance of assessing newborns for APGAR, skin-to-skin contact and drying the neonate. The study found that there were no postnatal care guidelines in Swaziland. The findings of the study led to the adaption and linkage of the latest international evidence-based guidelines and a conceptual framework for the implementation of immediate PNC to mothers and their infants in Swaziland.
Health Studies
D. Litt. et Phil. (Health Studies)

abstract: Schizophrenia, a debilitating neuropsychiatric disorder, affects 1% of the population. This multifaceted disorder is comprised of positive (hallucinations/psychosis), negative (social withdrawal/anhedonia) and cognitive symptoms. While treatments for schizophrenia have advanced over the past few years, high economic burdens are still conferred to society, totaling more than $34 billion in direct annual costs to the United States of America. Thus, a critical need exists to identify the factors that contribute towards the etiology of schizophrenia. This research aimed to determine the interactions between environmental factors and genetics in the etiology of schizophrenia. Specifically, this research shows that the immediate early gene, early growth response 3 (EGR3), which is upregulated in response to neuronal activity, resides at the center of a biological pathway to confer risk for schizophrenia. While schizophrenia-risk proteins including neuregulin 1 (NRG1) and N-methyl-D-aspartate receptors (NMDAR’s) have been identified upstream of EGR3, the downstream targets of EGR3 remain relatively unknown. This research demonstrates that early growth response 3 regulates the expression of the serotonin 2A-receptor (5HT2AR) in the frontal cortex following the physiologic stimulus, sleep deprivation. This effect is translated to the level of protein as 8 hours of sleep-deprivation results in the upregulation of 5HT2ARs, a target of antipsychotic medications. Additional downstream targets were identified following maximal upregulation of EGR3 through electroconvulsive stimulation (ECS). Both brain-derived neurotrophic factor (BDNF) and its epigenetic regulator, growth arrest DNA-damage-inducible 45 beta (GADD45B) are upregulated one-hour following ECS in the hippocampus and require the presence of EGR3. These proteins play important roles in both cellular proliferation and dendritic structural changes. Next, the effects of ECS on downstream neurobiological processes, hippocampal cellular proliferation and dendritic structural changes were examined. Following ECS, hippocampal cellular proliferationwas increased, and dendritic structural changes were observed in both wild-type and early growth response 3 knock-out (Egr3-/-) mice. Effects in the number of dendritic spines and dendritic complexity following ECS were not found to require EGR3. Collectively, these results demonstrate that neuronal activity leads to the regulation of schizophrenia risk proteins by EGR3 and point to a possible molecular mechanism contributing risk for schizophrenia.
Dissertation/Thesis
Doctoral Dissertation Neuroscience 2020

Motivation This project was of specific importance to the private security industry, victims of residential burglary, community policing forums and the South African Police Service in providing detailed information regarding recommendations of how to manage and combat residential burglary in two selected northern suburbs of Johannesburg. Problem statement Residential burglary is categorised in the top three highest reported crimes according to the official South African Police Service statistics for the 2006/7 financial years. A series of victim interviews, docket analysis, case plotting and residential security audit surveys were conducted to determine the extent (or lack thereof) of security measures at a burgled residence in the selected area. Approach Field data was collected through docket analysis, plotting crime scenes (descriptive mapping), victim interviews and residential security audit surveys. Results The majority of victims of burglary interviewed did not have the minimum security system (integrated measures) in place. Those victims, who had security measures, appeared not to have made or implemented effective use of them. Conclusion Security at a residence extends beyond just the immediate house area and the focus (security risk assessment) should start with the immediate neighbourhood (community) area working inwards towards the property perimeter (boundary), inner perimeter (garden area) and then finally the immediate house area.
CRIMINOLOGY
MTECH: SECURITY RISK MAN