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1
Hoff, David. "L'information et la communication autour des maladies respiratoires. De la recherche d'information du malade à la construction sociale d'un champ." Electronic Thesis or Diss., Université de Lorraine, 2012. http://www.theses.fr/2012LORR0370.
Abstract:
Durant les années 80, la prise en charge des personnes insuffisantes respiratoires a bénéficié d'avancées techniques qui ont permis aux malades, auparavant contraints de rester à l'hôpital, de pouvoir retourner chez eux. Les patients ont alors dû faire face à des problèmes auxquels ils n'étaient pas toujours préparés. Atteints d'une pathologie qu'ils ne connaissaient pas, ces derniers ont dû devenir plus autonomes en matière de recherche d'information, de gestion des crises de la maladie et d'utilisation des traitements. Ils devaient comprendre et construire une représentation de leur maladie, très souvent inconnue par leur entourage et par eux-mêmes. Il leur a fallu également affronter le regard des autres et lutter contre la stigmatisation. Progressivement, les patients se sont réunis et ont créé des associations dans le but de faire face ensemble à ces problématiques. Ces associations départementales ou régionales se sont rapidement fédérées pour former une organisation d'échelle nationale, la Fédération Française des Associations et Amicales de malades Insuffisants ou handicapés Respiratoires (FFAAIR). Progressivement, ce mouvement a permis à des agents d'acquérir la légitimité de représenter les malades et de participer avec les professionnels de santé à la construction d'un nouveau champ social. Ces transformations ont été accompagnées et rendues possibles par l'émergence d'une nouvelle forme d'engagement socio-discursif associatifDuring the 1980's, the management and treatment of people suffering from respiratory failure has been improved by new technical developments enabling patients to return home instead of staying in hospital. These patients were thus confronted by certain issues that they were not necessarily prepared for. Diagnosed with a pathology that they did not know, they had to become more self-reliant in terms of information research, health crisis management and the use of medical treatment. They had to understand and build a representation of their disease, a disease often unknown to their family/social circle as well as themselves. They also had to face the regard of others and to fight against stigmatization. The patients thus joined together and created associations in order to address, together, such problems. These departmental or regional associations soon became an organization on a national scale, the Fédération Française des Associations et Amicales de malades Insuffisants ou handicaps Respiratoires (FFAAIR). Progressively, this movement enabled agents to gain legitimacy in representing patients and, together with health professionals, take part in the construction of a new social field. Such transformations were supported and made possible by the emergence of a new form of socio-discursive associative commitment
2
Edwards, Laura Jane Rhianwen. "Molecular Genetic Associations with Psychological Morbidity in Cancer Patients." Thesis, University of Leeds, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.485238.
3
Hoff, David. "L'information et la communication autour des maladies respiratoires. De la recherche d'information du malade à la construction sociale d'un champ." Thesis, Université de Lorraine, 2012. http://www.theses.fr/2012LORR0370/document.
Abstract:
Durant les années 80, la prise en charge des personnes insuffisantes respiratoires a bénéficié d'avancées techniques qui ont permis aux malades, auparavant contraints de rester à l'hôpital, de pouvoir retourner chez eux. Les patients ont alors dû faire face à des problèmes auxquels ils n'étaient pas toujours préparés. Atteints d'une pathologie qu'ils ne connaissaient pas, ces derniers ont dû devenir plus autonomes en matière de recherche d'information, de gestion des crises de la maladie et d'utilisation des traitements. Ils devaient comprendre et construire une représentation de leur maladie, très souvent inconnue par leur entourage et par eux-mêmes. Il leur a fallu également affronter le regard des autres et lutter contre la stigmatisation. Progressivement, les patients se sont réunis et ont créé des associations dans le but de faire face ensemble à ces problématiques. Ces associations départementales ou régionales se sont rapidement fédérées pour former une organisation d'échelle nationale, la Fédération Française des Associations et Amicales de malades Insuffisants ou handicapés Respiratoires (FFAAIR). Progressivement, ce mouvement a permis à des agents d'acquérir la légitimité de représenter les malades et de participer avec les professionnels de santé à la construction d'un nouveau champ social. Ces transformations ont été accompagnées et rendues possibles par l'émergence d'une nouvelle forme d'engagement socio-discursif associatifDuring the 1980's, the management and treatment of people suffering from respiratory failure has been improved by new technical developments enabling patients to return home instead of staying in hospital. These patients were thus confronted by certain issues that they were not necessarily prepared for. Diagnosed with a pathology that they did not know, they had to become more self-reliant in terms of information research, health crisis management and the use of medical treatment. They had to understand and build a representation of their disease, a disease often unknown to their family/social circle as well as themselves. They also had to face the regard of others and to fight against stigmatization. The patients thus joined together and created associations in order to address, together, such problems. These departmental or regional associations soon became an organization on a national scale, the Fédération Française des Associations et Amicales de malades Insuffisants ou handicaps Respiratoires (FFAAIR). Progressively, this movement enabled agents to gain legitimacy in representing patients and, together with health professionals, take part in the construction of a new social field. Such transformations were supported and made possible by the emergence of a new form of socio-discursive associative commitment
4
Pereira, Filipa Alexandra Antunes Vences de Matos. "Patient associations: raising awareness on chronic diseases." Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/16582.
Abstract:
Mestrado em Biomedicina FarmacêuticaThe patient associations assume a significant role in representing the patients’ rights, sharing information on the diseases, accessing the available resources, maintaining important interactions with other relevant stakeholders and facing challenges. These organizations provide an important support not only to the patients, but also to their families and friends, who are most of the times their direct caregivers. Currently, the patient empowerment has been highly discussed. This project aims to demonstrate in five different clinical disorders what are the motivations, the objectives, the activities, the involvement with other stakeholders and the challenges assumed by the correspondent patient associations. The result of this project allowed to conclude that the significant prevalence of chronic diseases has been introducing changes into the healthcare systems and national disease programmes. Simultaneously, the patients’ ownership has been increasing, contributing to a more participated role near the healthcare professionals and to a more conscious decision regarding the available therapeutics. Patient associations represent these patients and act in critical areas, such as, social, clinical, research, training, education and advocacy.
As associações de doentes assumem um papel fundamental na representação dos direitos dos pacientes, na divulgação de informação acerca das doenças, no acesso aos recursos disponíveis, no relacionamento com os vários intermediários e nos desafios a enfrentar. Estas associações prestam não só um grande apoio aos doentes, como também aos seus familiares e amigos, que são na maior parte das vezes os seus cuidadores diretos. Atualmente, a capacitação de doentes tem vindo a ser bastante discutida. Este projeto pretende demonstrar em cinco quadros clínicos distintos, quais as motivações presentes, os objetivos, as atividades realizadas, o envolvimento com outros stakeholders e os desafios enfrentados pelas respetivas associações de doentes. O resultado deste trabalho permitiu concluir que a prevalência significativa de doenças crónicas tem introduzido alterações nos sistemas de saúde e nos planos nacionais de doenças. Em simultâneo, a responsabilidade dos pacientes tem vindo a aumentar, contribuindo para um posicionamento cada vez mais participativo junto dos profissionais de saúde e para uma tomada de decisão mais consciente em relação às terapêuticas disponíveis. As associações de doentes dão voz a estes pacientes e atuam em áreas críticas, tais como, a área social, emocional, clínica, de investigação, de formação, de educação e de defesa e representatividade de direitos e benefícios.
5
Simonpietri, Caroline. "Acquisition et circulation du savoir « profane » et médical pour la prise en charge des maladies chroniques, en France, à l'essor du numérique et de la « démocratie sanitaire »." Thesis, Sorbonne Paris Cité, 2017. http://www.theses.fr/2017USPCB180/document.
Abstract:
Dans le cadre d'une convention CIFRE, ce travail de thèse porte sur l'acquisition et la circulation d'un savoir "profane" et médical pour la prise en charge des maladies chroniques. Sous la direction de Dominique Desjeux, Professeur émérite, expert en consommation et innovation, nous avons analysé le processus de diffusion de trois "innovations" du système de santé français portées par les institutions depuis le début du 21ème siècle : les associations de patients, l’Éducation Thérapeutique du Patient (ETP), et enfin les NTIC, et plus précisément les serious games. Respectivement sociale, symbolique et matérielle, ces trois solutions ont pour enjeu institutionnel diminuer les coûts de santé en améliorant l'apprentissage de vie des patients avec leur maladie mais également celui des professionnels de santé en formation initiale et continue. Pour chaque solution, dans une démarche qualitative, compréhensive et inductive, nous nous sommes interrogés sur les rugosités pouvant freiner leur réception par l'usager final, des patients ou des médecins. Avec un angle de vue assez original, un regard "socio-anthropologique" au coeur du secteur industriel, nous avons finalement reconstruit une partie du système d'action impliqué dans la circulation de savoirs en santé, profane et médical en cette période de crise sanitaire et d'explosion technologiqueWithin the framework of a "CIFRE convention, this work concerns the acquisition and the circulation of a " lay" and medical knowledge for the care of people who suffer from chronic diseases. Supervised by Dominique Desjeux, emeritus Professor, specialised in consumption and innovation, we have analyzed the diffusion process of three "innovations" of the French health system since the beginning of the 21th century: patients' associations, Therapeutic Education, and finally the ICT, and more exactly the serious games. Respectively social, symbolic and material, these three solutions have, for institutional issues, to decrease the costs of health care and management, by improving the "apprenticeship of life with disease" of patients, but also the professionnals trainning, initial as continuous. For each solution, in a qualitative, comprehensive and inductive approach, we wondered about the roughnesses which can slow down their "reception" by the final user, the patients or the doctors. With a rather original viewpoint, a "socio-anthropological" look at the heart of the branch of occidental industry, we finally reconstructed a part of the "action system" (Crozier, 1963) involved in the circulation of knowledges in health, from patients or medical way, in this transitory period of sanitary crisis and technological explosion
6
Wallis, Lauren Ingrid. "Memory for items and associations in amnesiac patients and controls." Thesis, University of Sheffield, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274958.
7
Koo, Minjoung Monica Koo. "The presenting symptoms of cancer patients and associations with diagnostic timeliness." Thesis, University College London (University of London), 2018. http://discovery.ucl.ac.uk/10053161/.
Abstract:
Diagnosing cancer earlier is an important strand of cancer control. Interventions promoting early diagnosis such as awareness campaigns and fast-track clinical pathways are increasingly commonplace in England and other countries, but their theoretical underpinning is limited. Cancer symptoms are critical components of such interventions, but evidence regarding the presenting symptoms of individuals diagnosed with cancer and measures of diagnostic timeliness remains sparse. I sought to address this evidential gap using data from the first English National Audit of Cancer Diagnosis in Primary Care on a large and representative cohort of cancer patients. Using symptom status (ascertained through the coding of free-text information on presenting symptoms), I identified and described a group of atypically diagnosed cancer patients before proceeding to examine the nature and frequency of presenting symptoms and associated diagnostic timeliness among symptomatic cancer patients. I profiled the broad range of presenting symptoms beyond breast lump among women diagnosed with breast cancer, and found that non-lump symptoms were associated with longer intervals to presentation and referral. I also described variation in diagnostic timeliness among cancer patients who presented with abdominal symptoms, and the case-mix of cancers they were subsequently diagnosed with. The relative length of time to presentation and referral varied by abdominal symptom. A considerable proportion of cancer patients who presented with abdominal symptoms were diagnosed with other solid tumours or haematological cancers, particularly for non-specific abdominal symptoms. Lastly, I examined the association between alarm symptoms and stage at diagnosis among cancer patients who had presented promptly. While most alarm symptoms at presentation were associated with early stage disease, the extent of the association was highly variable compared to patients with other symptomatic presentations. This thesis provides exemplar evidence regarding the epidemiology of presenting symptoms among cancer patients and associated diagnostic timeliness. Together with other evidence, the findings could contribute to the design and evaluation of symptom awareness campaigns and healthcare interventions that expedite the investigation and diagnosis of cancer.
8
Brüggemann, A. Jelmer, and Katarina Swahnberg. "Patients’ silence towards the healthcare system after ethical transgressions by staff : associations with patient characteristics in a cross-sectional study among Swedish female patients." Linköpings universitet, Institutionen för klinisk och experimentell medicin, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-90217.
Abstract:
Objectives To identify which patient characteristics are associated with silence towards the healthcare system after experiences of abusive or ethically wrongful transgressive behaviour by healthcare staff. Design Cross-sectional questionnaire study using the Transgressions of Ethical Principles in Health Care Questionnaire. Setting A women's clinic in the south of Sweden. Participants Selection criteria were: consecutive female patients coming for an outpatient appointment, ≥18-year-old, with the ability to speak and understand the Swedish language, and a known address. Questionnaires were answered by 534 women (60%) who had visited the clinic, of which 293 were included in the present study sample. Primary outcome measure How many times the respondent remained silent towards the healthcare system relative to the number of times the respondent spoke up. Results Associations were found between patients’ silence towards the healthcare system and young age as well as lower self-rated knowledge of patient rights. Both variables showed independent effects on patients’ silence in a multivariate model. No associations were found with social status, country of birth, health or other abuse. Conclusions The results offer opportunities for designing interventions to stimulate patients to speak up and open up the clinical climate, for which the responsibility lies in the hands of staff; but more research is needed.Funding Agencies|Swedish Research Council|2009-2380|Nordic Council of Ministers||
9
Barbot, Janine. "Recherche médicale et mobilisations collectives : le cas des associations de lutte contre le sida." Paris, EHESS, 2000. http://www.theses.fr/2000EHES0039.
10
Burleigh, Karen Sarita. "Associations among plasma homocysteine, amino acids and nutritional status in hemodialysis patients." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/MQ63163.pdf.
11
Charoud, Mary. "Stratégies de communication et évolutions sociales : le cas des associations de patients." Thesis, Grenoble, 2012. http://www.theses.fr/2012GRENL037.
Abstract:
Le développement de la communication des associations de patients dans le secteur de la santé pose la question du positionnement de ces acteurs et de leurs rôles dans un secteur marqué par des acteurs dominants : les acteurs médicaux et politiques. L'analyse des stratégies de communication des acteurs associatifs montre en quoi ces dernières s'inscrivent dans les évolutions récentes qui touchent le secteur de la santé. Des évolutions relatives à la « figure » du patient et à ses rôles potentiels dans les institutions hospitalières et dans la délimitation même de la « santé ». En effet, le « savoir patient » se développe et le type d'informations produites sur les pathologies, par les acteurs associatifs, fournit un exemple de l' « expertise » des personnes malades et de leurs proches. Les associations de patients manifestent leur volonté de diversifier les acteurs de la prise en charge médicale dans le souci d'humaniser l'expérience de la maladie. Autant d'actions qui s'inscrivent dans les revendications politiques des acteurs associatifs qui interviennent dans la «démocratie sanitaire » et les dispositifs qu'elle implique. La réflexion sur les modalités d'action des associations de patients, les modes d'engagement des acteurs associatifs, leurs interventions dans les institutions hospitalières et en lien avec les acteurs médicaux, politiques et administratifs, ainsi que sur les spécificités des stratégies de communication et de mise en visibilité de ces acteurs permettent de poursuivre l'analyse de « l'espace public partiel de la santé » et de ses enjeux sociauxPatients' organizations are now developing communication strategies and are taking a more active role in the healthcare system. However, their functions and responsibilities need to be further defined in the medical sphere dominated by healthcare professionals and policy makers. We analyzed strategies used by patients' groups to communicate. These strategies reflect the recent changes undergone by the healthcare system. Patients can take a more active part into the system and how it is organized. Patients' insightful knowledge is more and more taken into account: patients' groups use their expertise (as well as their relatives') to create informative material for certain pathology. In order to humanize the healthcare, patients‘ groups want more diversity within the people involved in the patient-care (psychiatrists, social workers, sociologists…). These various activities are part of the lobbying strategies patients' organizations want for the “democratie sanitaire”. In order to analyze the notion of “partial healthcare public sphere” and the social issues it raises, we developed different components of this theory: patients ‘groups' involvement, their intervention methods (within the hospital, with policy makers…) as well as their communication strategies to be more present in the media
12
Rundare, Alfeous. "Patterns and associations with immunologic response in patients accessing ART in Khayalitsha." Master's thesis, University of Cape Town, 2007. http://hdl.handle.net/11427/9327.
Abstract:
Includes bibliographical references ( leaves 69-74).[Introduction] This study formed part of an existing prospective cohort study describing the outcomes of treatment of patients accessing ART in Khayelitsha. Despite the reported favorable outcomes in terms of immunologic responses, the actual variations in patterns of and associations with immunologic response over time among adult patients accessing the community based antiretroviral treatment programme in Khayelitsha are largely unknown. [The aim of the study] The aim of this study focused on describing the patterns of and associations with immunologic response, together with some of their subsequent outcomes among adult patients accessing community based antiretroviral treatment programme in Khayelitsha. [Study design and population] The analysis of this study formed part of an existing prospective cohort study describing the outcomes of antiretroviral treatment of patients in Khayelitsha. The study population included patients accessing ART in Khayelitsha, Cape Town, South Africa. A sample size of 400 HIV positive ART naïve patients was sufficiently powered for the analysis. The socio-demographic and clinical information required for the an alysis was already captured, validated and entered in a database. Summary measures, logistic regressions, survival analysis, simple linear regression and population average models were used to make the analysis and report the findings.
13
Balfour, Lindsay E. "Hospital Loneliness and the Patient-Physician Relationship: A Preliminary Analysis of Associations with Recovery in Bone Marrow Transplant Patients." UNF Digital Commons, 2012. http://digitalcommons.unf.edu/etd/336.
Abstract:
The purpose of the present study was to examine general loneliness, hospital loneliness, and the patient-physician relationship in regards to their associations with Bone Marrow Transplant (BMT) recovery outcome variables (days until engraftment and quality of life). Fifteen (66.7% female, 33.3% male; 93.3% white, 6.7% Black/African American; average age 61.73) individuals who had an allogeneic or autologous BMT at The Mayo Clinic of Jacksonville completed the FACT-BMT, UCLA-Loneliness Scale Version 3, the CARE Measure, and provided disease and treatment information at the 6 month posttransplant date (+/- 30 days). Patients recovering from BMT indicated significantly higher scores of hospital loneliness in comparison to their general loneliness scores. This increase is believed to represent the outcome of experiencing hospital isolation during the post-transplant recovery process. Increases in hospital loneliness were marginally significant in predicting decreases in the patients overall quality of life. The patient physician consultational relationship was found to have a significant relationship with the number of days until engraftment, however the direction of the relationship was opposite the hypothesized direction. This may suggest that engraftment influences the quality of the relationship instead of vice versa. These results imply that there is a relationship between hospital isolation and increases in the amount of loneliness experienced during recovery from a BMT. Loneliness has been found to have a negative relationship with a number of physiological and quality of life outcomes. The present study also elucidates possible correlates with the patient-physician relationship.
14
Hansen, Dana M. "Exploring the Associations of Comfort, Relatedness States, and Life-Closure in Hospice Patients." Case Western Reserve University School of Graduate Studies / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=case1354832063.
15
Osler, Meg. "Associations of severe hyperlactataemia and lactic acidosis in HIV-infected patients receiving antiretroviral theraphy." Master's thesis, University of Cape Town, 2007. http://hdl.handle.net/11427/7438.
Abstract:
Includes bibliographical references (leaves 67-70).Severe symptomatic hyperlactataemia and lactic acidosis (SHLA) are life-threatening events that are occurring at increasing incidence levels in South Africa. Globally, the rise in SHLA cases is closely correlated to the increased accessibility of anti retroviral (ARV) medication for human immunodeficiency virus (HIV). Although hyperlactataemia and lactic acidosis were once thought of as rare conditions, they are now being recognized as important concerns when administering antiretroviral therapy. A better understanding of the risk factors for SHLA is important in combating the morbidity and mortality associated with such an adverse event.
16
Harvey, Georgina Ruth. "The significance and clinical associations of autoantibodies in systemic sclerosis patients and their relatives." Thesis, University of Bath, 1998. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.268209.
17
Lucente, Marcella <1992>. "Psychological characterization of hypertensive patients: associations with adherence to pharmacological treatment and self-management." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2022. http://amsdottorato.unibo.it/10213/1/PhD%20Thesis%20-%20Lucente%20Marcella.pdf.
Abstract:
Introduction: The role of psychosocial factors in the onset and progression of essential hypertension has been object of a large body of literature, yet findings appear to be controversial.
Aims: We assessed the predictive role of psychosomatic syndromes, affective symptomatology, psychological reactance, psychological distress, well-being and quality of life on adherence to antihypertensive medications, lifestyle behaviors, hypertension severity and absolute cardiovascular risk grading, as well as their temporal stability at 1-year follow-up, in a sample of hypertensive patients. In addition, we aimed to validate the Italian version of the Hong Psychological Reactance Scale (HPRS).
Methods: Eighty consecutive hypertensive outpatients treated with antihypertensive medications were compared to 80 controls. Psychosocial variables were assessed using clinical interviews and self-rating questionnaires at baseline and at 1-year follow-up. Cardiac parameters were also collected. One-hundred and fifty individuals from general population provided data for the HPRS validation.
Results: Hypertensive patients reported significantly higher levels of psychological distress and lower levels of psychological well-being at baseline compared to controls. Among hypertensive patients, allostatic overload (AO) was the most frequently reported psychosomatic syndrome at baseline. Patients with AO displayed significantly greater levels of psychological distress and lower levels of well-being and quality of life than those without. Further, patients with illness denial were significantly more likely to report poor adherence to pharmacological treatment and, as well as those with higher levels of affective symptomatology, were less likely to follow a balanced diet. At follow-up, patients displayed significantly higher levels of well-being and lower levels of stress, mental pain and quality of life.
Conclusions: Findings suggest the clinical relevance of psychosocial factors and psychosomatic syndromes in the progression of hypertension, with important implications for its management. As to the Italian validation of the HPRS, results support previous findings, even though a confirmatory factor analysis should be carried out.
18
Nechytajlo, O. Yu. "Associations between the neuropathy and diabetic foot syndrome development in patients with type 2 diabetes." Thesis, БДМУ, 2020. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/17813.
19
Mazur, O. O. "The role of microbial associations in chronic purulent rhinosinusitisin patients for type 1 diabetes mellitus." Thesis, БДМУ, 2022. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/19806.
20
Rizvi, Abbas Ali. "Genetic Associations in Acute Leukemia Patients after Matched Unrelated Donor Allogeneic Hematopoietic Stem Cell Transplantation." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1555285409458706.
21
Kilmer, Jared Newman. "Trajectories of Treatment Change among Patients with Major Depressive Disorder: Predictors and Associations with Outcome." Thesis, University of North Texas, 2017. https://digital.library.unt.edu/ark:/67531/metadc1011764/.
Abstract:
Previous research has revealed heterogeneity in outcome trajectories among individuals seeking psychotherapy. However, questions remain as to the number, nature, and predictors of these trajectories. Therefore, the present study had three aims: 1) to identify heterogeneous latent groups among treatment trajectories of 212 clients with major depressive disorder (MDD) seeking psychotherapy at a community mental health training clinic; 2) to identify significant associations between clinical and demographic variables and group membership; and 3) to identify correlations between trajectory shape and positive treatment outcome. Prior to treatment, participants provided demographic information and completed symptom severity ratings. Once in treatment, participants completed a self-report of distress via the Outcome Questionnaire (OQ-45) at every session. Growth mixture modeling was utilized to identify distinct patient subgroups based on outcome trajectories among the sample. Three distinct latent classes of treatment trajectory were identified, providing evidence of heterogeneity in treatment trajectories among individuals with MDD. Baseline distress, pre-treatment work problems, and sleep difficulties were found to be predictive of an individual's membership in a specific trajectory group. Finally, specific shapes of change, namely early response and sudden gains, were associated with positive treatment outcome. Findings from this study can be used to identify patients at risk for treatment failure, allowing clinicians to intervene earlier to enhance mid-treatment feedback and prognosis.
22
Savall, Angélique. "Sociologie d'une cohorte : Naissance et maintenance d’un outil scientifique devenu forme de vie associative." Electronic Thesis or Diss., Lyon, 2021. http://www.theses.fr/2021LYSES019.
Abstract:
En 2001, Marguerite intègre le projet de cohorte Proof et accepte de devenir « sujet » d’une recherche médicale. Comme elle, 1011 séniors stéphanois s’engagent dans l’aventure. Les scientifiques ambitionnent de déterminer la valeur pronostique de la perte d’activité du Système Nerveux Autonome (SNA) sur la mortalité. En 2004, le financement de la recherche devient complexe. Michel, sujet de l’étude, propose un don financier. Les chercheurs l’incitent à créer une association pour tenter de venir en aide à l’équipe : l’association Synapse vient de naître pour sauver l’étude Proof. Cette enquête sociologique propose de réinterroger cette forme sociale qu’est la cohorte, outil humain de la recherche en santé. Ce travail envisage, dans un premier temps, la cohorte comme outil de laboratoire aux mains des scientifiques. L’étude de cohorte va se révéler être un outil opportun pour venir instrumentaliser la mesure de l’activité du SNA puis équiper les relations entre les chercheurs et les sujets. Dans la seconde partie, la cohorte aura basculé aux mains des sujets devenus adhérents. L’association s’inscrit dans une logique du care face à un outil cohorte fragile. Écoute sociale, travail de maintenance technique, moral et relationnel seront alors indispensables. Ce travail a pour ambition d’analyser une transformation ontologique d’une forme – la cohorte – initialement instrument de laboratoire puis groupe d’individus qui s’engage volontairement au service de la recherche. Elle tend à montrer à travers cette transition la spécificité de la cohorte comme objet frontière entre chercheurs experts et sujets profanes, entre recherche médicale scientifique et gens ordinairesIn 2001, Marguerite joined the Proof cohort project and agreed to become a "subject" of medical research. Like her, 1011 seniors from Saint-Etienne joined the adventure. The scientists aim to determine the prognostic value of the loss of activity of the Autonomic Nervous System (ANS) on mortality. In 2004, the financing of the research became complex. Michel, a subject of the study, proposed a financial donation. The researchers encouraged him to create an association to try to help the team: the Synapse association was created to save the Proof study. This sociological investigation proposes to reexamine the social form of the cohort, a human tool for health research. This work first considers the cohort as a laboratory tool in the hands of scientists. The cohort study will prove to be an opportune tool to instrumentalize the measurement of the activity of the ANS and then to equip the relations between researchers and subjects. In the second part, the cohort will be in the hands of the subjects who have become members. The association is part of a logic of care for a fragile cohort tool. Social listening, technical, moral and relational maintenance work will then be indispensable. This work aims at analyzing an ontological transformation of a form - the cohort - initially a laboratory instrument and then a group of individuals who voluntarily commit themselves to the service of research. It tends to show through this transition the specificity of the cohort as a frontier object between expert researchers and lay subjects, between scientific medical research and ordinary people
23
Taber, Samantha Jeanne Stearns [Verfasser]. "Associations between cerebral microbleeds and lipids in first time ischemic stroke patients / Samantha Jeanne Stearns Taber." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2018. http://d-nb.info/1160514852/34.
24
Taber, Samantha [Verfasser]. "Associations between cerebral microbleeds and lipids in first time ischemic stroke patients / Samantha Jeanne Stearns Taber." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2018. http://d-nb.info/1160514852/34.
25
Rafatpanah, Baygi Houshang. "Immunogenetic analysis of patients with HTLV-I infection : associations with HLA, cytokine and perforin gene polymorphisms." Thesis, University of Manchester, 2003. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.488453.
Abstract:
Human T lymphotropic virus type (HTLV-I) is associated with HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP) and adult T-cell leukaemia (ATL). Fewer than 2% of HTLV-I-infected individuals develop HAM/TSP. The different outcome of HTLV-I infection may be explained by the existence of viral agents, genetic background or even environmental factors. In the initial part of this study we determined if there was a correlation between cytokine gene polymorphisms, mainly Thl and Th2, in Iranian patients with HAM/TSP, asymptomatic HTLV-I carriers and healthy controls. It was shown that polymorphisms in the TNF-alpha gene promoter at position -308, in TGF-beta1 gene at codons 10_and 25, in IL-10 at positions -1082, -819, -592, in IFN-gamma at position +874, in IL-13 at position +2043 and in IL-4 at position -590 correlates with differential production of these cytokines in vitro. There was a significant difference between HAM/TSP patients and healthy controls in the distribution of IL-10 promoter polymorphisms at position -819 and -592 (p=0.01) and HTLV-I carriers and healthy controls (p=0.02). The frequency of the IL-10 low producer haplotype (ATA) was significantly associated with HAM/TSP compared with healthy controls (p=0.01) and HTLV-I carriers with healthy controls (p=0.02). These data suggest that IL-10 -819 and -592 polymorphisms are associated with HTLV-I infection. However, how this influences HAM/TSP patients and HTLV-I carriers remain unknown. In contrast, we failed to detect any differences in the frequencies of other cytokines between any of the three groups. In this part, we also analysed the influence of HLA class II DRB1 alleles and class I HLA-A2, A-30, CW8 and B54 alleles in all three groups. The frequency of the HLA-DRB1*01 allele was significantly increased in HAM/TSP patients compared with carriers (p=0.03). In contrast, the distribution of HLA-DRB1*014 was higher in HTLV-I carriers compared to HAM/TSP patients (p=0.03). There was also a significant difference in the frequency of HLA-CW8 between HAM/TSP patients and healthy controls (p=0.01). HLA typing suggests that HLA-DRB1*01 and HLA-CW8 are relative risk factors for development to HAM/TSP, whereas possession of the HLA-DRB1*014 allele decreases the risk of HAM/TSP. In this case, the role of other genetic backgrounds should be taken into account. The second part of this study was to define GM-CSF polymorphisms and to seek association between GM-CSF polymorphism and HTLV-I infection. The 5'-flanking region, promoter, exon 1 and 2 and 3'UTR of GM-CSF was screened for detection of polymorphism by SSCP and sequencing. Three novel polymorphisms were found in the 5'-flanking region of GM-CSF at positions -677*A/C, -1440*A/G and -1916*T/C, relative to the translation start site. Mitogenic stimulation of PBMCs from healthy controls showed no correlation between GM-CSF gene polymorphisms and protein level. However, a gel shift assay demonstrated that the -611*A allele binds the transcriptional factor TEF-2 better than the -677*C allele. The frequencies of GM-CSF polymorphisms were the same in all of the HTLV-I groups and controls. In the third part of our study, we screened the promoter and first intron of the perforin gene, as a key factor in elimination of viral-infected cells, to determine novel polymorphisms. A novel polymorphism at position +418 relative to the transcription start site was detected. Results from flow cytometry and Western blotting in non stimulated and stimulated PBMCs showed no association between perforin gene polymorphism and perforin expression. The frequency of the +418*C allele in HAM/TSP patients was significantly increased compared with healthy controls (p=0.015). There was also a difference in the distribution of +418*C allele between HAM/TSP patients and HTLV-I carriers, but this did not reach significant levels (p=0.09). This result suggests that the +418*C allele acts as genetic risk factor for development of HAM/TSP.
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Patalano, Julianne Louise. "A comparison of trial and error learning versus errorless learning of face-name associations in Alzheimer's patients." Scholarly Commons, 2001. https://scholarlycommons.pacific.edu/uop_etds/2697.
Abstract:
The effectiveness of errorless learning, trial-and-error learning (i.e., errorful learning), and a traditional method for recalling face-name associations was compared in early Alzheimer's disease patients. Alternating treatment designs were used to assess method effects for each participant. Face-name associations were learned using pictures from the Rivermead Behavioral Memory Test, six pictures for each of the three learning procedures. The results of the study showed that the errorless learning procedure had a larger number of face-name associations learned in 2 out of the 3 participants, compared to the trial-and-error learning and the traditional method.
27
Henry, Michelle. "Associations between sleep architecture, cortisol concentrations, cognitive performance, and quality of life in patients with Addison's disease." Doctoral thesis, Faculty of Humanities, 2019. http://hdl.handle.net/11427/30377.
Abstract:
Recent literature in the neurosciences suggests that there are mechanistic relations between sleep disruption and cognitive (particularly memory) deficits, and that varying concentrations of the hormone cortisol may play a particularly important role in mediating those relations. Because patients with Addison’s disease (AD) experience consistent and predictable periods of sub- and supra-physiological cortisol concentrations (due to lifelong glucocorticoid replacement therapy), and because they frequently report disrupted sleep and poor memory, those presenting with that endocrinological disorder form an ideal population to use in studies testing hypotheses about the ways in which (a) disrupted sleep is related to impaired consolidation of previously learned material (and, hence, poor performance on tests assessing memory for that material), and (b) cortisol concentrations may mediate this relationship between sleep and memory. This dissertation presents four studies that, together, tested those hypotheses. Study 1 (n = 60 per group) found that patients with AD self-reported significantly more disturbed sleep and poorer cognition and quality of life compared to matched healthy controls. Importantly, our analyses suggested that disrupted sleep, and not AD per se, accounted most strongly for the reported cognitive impairment. Study 2 (n = 35 per group) found that patients had significantly poorer objectively-measured declarative memory performance compared to matched healthy controls, but that other domains of cognition were relatively unimpaired. Study 3 (n = 10 per group) suggested that matched healthy controls retained significantly more declarative information than patients. Importantly, while controls retained significantly more declarative information when a period of sleep, rather than waking, separated learning from recall, patients derived no such benefit. Study 4 (n = 7 per group) suggested that, relative to matched healthy controls, patients had different patterns of night-time cortisol secretion, accompanied by significantly reduced slow-wave sleep. Together, these four studies suggest that, despite being on replacement medication, patients with AD still experience disrupted sleep and memory deficits. These disruptions and deficits may be related to the failure of replacement regimens to restore a normal circadian rhythm of cortisol secretion. This pattern of results provides support for existing theoretical frameworks which posit that (in AD and other neuroendocrine, neurological, or psychiatric disorders) disrupted sleep is an important biological mechanism that underlies, at least partially, the memory impairments that patients frequently report experiencing. With specific regard to patients with AD, the findings presented here suggest that future initiatives aimed at improving patients’ cognitive performance (and, indeed, their overall quality of life) should prioritise optimizing sleep. More generally, this dissertation advances our understanding of sleep as a critical biological process essential for cognitive well-being.
28
Collins, Susan Kay Ransom Palmer Mary H. "Associations between frailty and sex and frailty and race in hospitalized chronic heart failure patients an exploratory study /." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2007. http://dc.lib.unc.edu/u?/etd,1226.
Abstract:
Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2007.Title from electronic title page (viewed Mar. 26, 2008). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the School of Nursing." Discipline: Nursing; Department/School: Nursing.
29
Bishop, Alana. "Patients' preferences for Shared Decision Making: Associations with Demographic Variables, Personality Characteristics and Characteristics of the Health Condition." Thesis, University of Canterbury. Psychology, 2013. http://hdl.handle.net/10092/7679.
Abstract:
Shared Decision Making (SDM) in medical consultations has received significant attention in the literature over the past 10 years. Research indicates that patients’ desire both components of SDM, information sharing and behavioural involvement, to differing degrees (Flynn, Smith, & Vanness, 2006) and that matching medical care to these preferences may be associated with better patient health outcomes (Cvengros, Christensen, Cunningham, Hillis, & Kaboli, 2009). In this thesis, relationships between SDM preferences and patients’ personal characteristics (demographic factors and personality attributes) were investigated (Objective one), as well as associations between patient’s SDM preferences and the features of the health concern that they were seeking care for (Objective two). The current study used 158 Christchurch residents who were part of a longitudinal health and wellbeing study. They completed a questionnaire that measured their general SDM preferences, their demographic and personality characteristics and their preferences for SDM, given four hypothetical health complaints. These complaints varied in duration and perceived seriousness.
Demographic variables and personality variables accounted for approximately the same amount of variance in participants’ general preferences for SDM, together describing 33% and 42% of the variance in information sharing and behavioural involvement. The strongest contributors were all three Health Locus of Control variables, sex and education level. Big Five personality traits and participant self-rated physical health did not account for a significant amount of variance in SDM preferences, once all variables were controlled for.
In addition, the features of the health concern were marginally associated with participants’ SDM preferences for that specific consultation. Between-subjects analyses found that the duration or perceived seriousness of the health complaint were not associated with SDM preferences reported within the first scenario, once participants’ general SDM preferences were accounted for. Whereas, these two features described a significant amount of variance in participants’ information sharing preferences in the within-subjects analyses, when participants’ general SDM preferences were controlled for. Post-hoc analyses reported that chronic health complaints, that were perceived to be highly serious, elicited significantly greater preferences for information exchange than all other scenarios. No association occurred for participants’ preferences for involvement in final decision making across the four scenarios.
The findings emphasise that differences occur in patients’ preferences for information sharing and behavioural involvement; both in regard to their general preferences and their specific preferences for these components of SDM within a given consultation. They also identify the central role that patients’ personality characteristics may play in determining their collaboration and involvement in healthcare; associations that are often overlooked by the SDM literature. The current findings contribute to our understanding of patient’s preferences for SDM and implications for practice and future research are discussed.
30
Jönsson, Simon. "Leukocyte-derived matrix metalloproteinase-9 in patients with coronary artery disease : Associations with psychological stress and glucocorticoid sensitivity." Doctoral thesis, Linköpings universitet, Avdelningen för kardiovaskulär medicin, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-114328.
Abstract:
Inflammation is closely associated with development of atherosclerosis. The proteolytic enzyme matrix metalloproteinase (MMP)-9 is considered to play a prominent role in this process. MMP-9 has also been introduced as a marker for plaque vulnerability. Still, the possible mechanisms behind altered levels of MMP-9 and its tissue inhibitors (TIMPs) in patients with atherosclerotic disease remain unclear. The general aim of this thesis was to compare leukocyte-derived MMP-9 and TIMPs in patients with coronary artery disease (CAD) and healthy controls and to further relate the findings to psychological stress and glucocorticoid sensitivity. Levels of leukocyte-derived MMP-9 and TIMP-1 showed a significant difference between CAD patients and controls. Neutrophils in CAD patients were more prone to release MMP-9 and furthermore, PBMCs in patients expressed higher levels of MMP-9 and TIMP-1 and -2 mRNA than PBMCs in controls while there were no differences in plasma or serum levels. The increase in leukocyte-derived levels of MMP-9 and TIMPs indicate the presence of preactivated leukocytes in CAD. Inflammation has been proposed as a mechanistic link between cardiovascular risk and depressive symptoms. We investigated whether the overexpression of leukocyte-derived MMP-9 and TIMPs in CAD patients was associated with psychological factors. Patients exhibited sustained elevations in depressive symptoms, however, these symptoms were not related to any MMP-9 or TIMP variables. The findings suggest that overexpression of leukocyte-derived MMP-9 and TIMPs and elevated depressive scores represent two parallel phenomena in CAD. Chronic inflammation may be associated with reduced glucocorticoid sensitivity. We found that PBMCs in CAD patient expressed significantly increased levels of glucocorticoid receptor (GR)-α mRNA, whereas GR-β mRNA levels did not differ between patients and controls. Moreover, in ex vivo assays, dexamethasone efficiently suppressed MMP-9 and TIMPs equally or even more in patients compared to controls. The findings provide evidence for enhanced glucocorticoid sensitivity in CAD patients and also suggest that a state of relative hypocortisolism may contribute to the overexpression of leukocyte-derived MMP-9 and TIMPs. Lastly, we explored the release of MMP-9, TIMPs and cortisol in response to acute mental stress in CAD patients. Patients who exhibited a significant stress-induced increase in serum MMP-9 also exhibited an altered cortisol response. Moreover, the susceptibility to stressinduced increase in serum MMP-9 was associated with shorter leukocyte telomere length and atherosclerotic plaque burden. The findings highlight the existence of a high-risk group which may be in need of improved diagnostic and therapeutic strategies.
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Thwaites, Charlene Louise. "Neural correlates of verbal fluency and associations with demographic, mood, cognitive and tumour factors in brain tumour patients." Thesis, University of Leeds, 2018. http://etheses.whiterose.ac.uk/22711/.
Abstract:
Verbal fluency tests are one of the most commonly used measures of executive functioning in neuropsychological testing and play an important role in the assessment, diagnosis and care planning of patients with a variety of conditions, including brain tumour. There is little conclusive evidence about which factors may influence verbal fluency outcomes. No studies to date have investigated the interactions between a comprehensive range of demographic variables, mood scores, tumour factors and key cognitive skills with the focus of verbal fluency outcomes in brain tumour patients. Similarly, clarification is required across studies assessing the localisation effects of verbal fluency skills. To address these gaps in the evidence base this study used a retrospective cohort design of cross-sectional data from patients with brain tumours, to investigate their performance of both phonemic and semantic verbal fluency. More specifically this study used simple linear and multiple regression calculations to analyse the interactions between these variables and other potentially important factors such as localisation, depression and anxiety (using the HADS), age, gender, education, premorbid functioning (using the TOPF), semantic memory (using the GNT), and tumour type. The results showed that an increase in phonemic fluency performance was significantly correlated with being educated, an increase in semantic memory, and an increase in premorbid functioning. Phonemic fluency was also significantly correlated with localisation. In general, a decrease in phonemic fluency was significantly associated with tumours in the left frontal lobe. An increase in semantic fluency was correlated with an increase in semantic memory. No other factors showed significant associations with phonemic or semantic fluency. The outcomes from the hierarchical multiple regressions indicated that localisation, gender, education, tumour type, depression, semantic memory, and premorbid functioning when combined can predict phonemic fluency variance. Combining localisation effects, semantic memory, depression and education together do not result in a model that predicts semantic fluency, as within this model the only significant relationship was between semantic memory and semantic fluency. These findings show that, for brain tumour patients, it is important to take into consideration tumour localisation, education, semantic memory, and premorbid functioning when assessing and care planning for deteriorations in phonemic fluency. Similar patients with deteriorations in semantic fluency need to have their results considered in light of performance in semantic memory tests.
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Bastos, Daniela Brito. "Plasma catecholamines levels in oral and oropharyngeal cancer patients and their associations with clinicopathological variables and anxiety symptoms /." Araçatuba, 2017. http://hdl.handle.net/11449/151501.
Abstract:
Orientador: Daniel Galera BernabéCoorientador: Glauco Issamu Miyahara
Banca: Dulce Elena Casarini
Banca: Eder Ricardo Biasoli
Resumo: Objetivos: As catecolaminas podem regular diversos efeitos biológicos resultantes do estresse crônico. Estudos demonstram que as catecolaminas podem influenciar a progressão do câncer. No entanto, pouco se sabe sobre o perfil de secreção das catecolaminas em pacientes com câncer de cabeça e pescoço (CCP) e sua associação com as variáveis clinicopatológicas e psicológicas. O presente estudo investigou os níveis plasmáticos pré-tratamento das catecolaminas norepinefrina (NE) e epinefrina (E) em pacientes com câncer de boca e orofaringe e em pacientes com leucoplasia bucal, bem como sua associação com as variáveis clinicopatológicas, biocomportamentais e os sintomas de ansiedade. Pacientes e métodos: Um total de 71 pacientes com carcinoma espinocelular (CEC) de boca, 22 pacientes com CEC de orofaringe e 32 portadores de leucoplasia bucal foram submetidos à coleta de amostras de sangue. Os níveis plasmáticos das catecolaminas NE e E foram mensurados por meio de Cromatografia Líquida de Alta Eficiência com detecção eletroquímica (CLAE-ED) e os níveis psicológicos de ansiedade foram mensurados pelo Inventário de Ansiedade de Beck (IAB). As diferenças nos níveis hormonais entre os grupos foram avaliadas pelo teste ANOVA e análises univariadas e regressões múltiplas foram realizadas para avaliar as associações dos níveis hormonais com as variáveis clinicopatológicas, biocomportamentais e psicológicas. Resultados: As concentrações plasmáticas de NE e E foram significativamente maiores... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Background: Catecholamines may regulate several biological effects resulting from chronic stress. Studies have shown that stress-related catecholamines may affect cancer progression. However, little is known about catecholamines secretion profile in head and neck cancer squamous cell carcinoma (HNSCC) patients and its association with clinicopathological and psychological variables. The present study investigated the pre-treatment plasma levels of catecholamines norepinephrine (NE) and epinephrine (E) in patients with oral and oropharyngeal SCC and patients with oral leukoplakia, as well as their associations with clinicopathological and biobehavior variables and anxiety symptoms. Patients and methods: A total of 71 patients with oral SCC, 22 patients with oropharyngeal SCC and 32 patients with oral leukoplakia were submitted to blood samples. Plasma levels of NE and E were measured by High Performance Liquid Chromatography with electrochemical detection (HPLC-ED) and psychological anxiety levels were measured by the Beck Anxiety Inventory (BAI). Differences in hormone levels among the groups were analyzed by ANOVA test. Univariate and multiple regression analyzes were performed to evaluate the associations of hormonal levels with clinicopathological, biobehavior and psychological variables. Results: Plasma NE and E concentrations were significantly higher in patients with oral and oropharyngeal cancer than oral leukoplakia patients (p<0.05). Oral SCC patients showed NE levels (462.03±47.53 pg/mL) about six times and nine times higher than patients with oropharyngeal SCC (74.46±12.52 pg/mL) and oral leukoplakia (51.69±6.28 pg/mL), respectively. Plasma NE and E levels were positively correlated in patients with oral SCC (p=0.0011), but not in the oropharyngeal SCC and oral leukoplakia groups. Multiple...
Mestre
33
Gandhi, Smita. "Associations among perceived self-efficacy, perceived social support, and well-being in osteoarthritis patients undergoing total hip replacement surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0005/MQ31208.pdf.
34
Delfin, Carl. "The neural basis of aberrant salience attribution in unmedicated patients with schizophrenia spectrum disorders." Thesis, Högskolan Kristianstad, Sektionen för lärande och miljö, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-12152.
Abstract:
Due to abnormal functioning of the brain’s reward and prediction system patients with schizophrenia spectrum disorders are thought to assign salience to non-relevant objects and events and to form context-inappropriate associations. The brain’s ventral striatum is critical in the formation of associations, and aberrant associations are believed to create delusional content during psychosis. The study wanted to examine the neural response, particularly in the ventral striatum, combined with subjective reports as patients learn associations in an aversive Pavlovian conditioning paradigm. The stimuli were randomized and involved circles of different colors. The conditioned stimuli (CS+) was followed by an unconditioned stimuli (US), consisting of an unpleasant sound, in 50% of events. The unconditioned (CS-) stimuli was followed by a low, not unpleasant sound in 50% of events. The degree of striatal activation was thought to be associated with the severity of patient’s illness. Functional magnetic resonance imaging (fMRI) blood-oxygen-level dependent (BOLD) responses were examined in eleven unmedicated non-institutionalized patients with schizophrenia spectrum disorders and 15 matched healthy controls. No significant within group differences in neural or subjective response to the [CS+ > CS-] contrast were found. No significant associations between severity of illness and degree of striatal activation in response to CS+ or CS- were found. Significant differences in neural activation for the [CS+ > CS-] contrast were found in the ventral striatum, the right inferor frontal gyrus, and the right angular gyrus, with patients exhibiting stronger activation compared to controls. The results and implications are discussed along with suggestions for future research.
35
Muda, Piibe. "Homocysteine and hypertension: associations between homocysteine and essential hypertension in treated and untreated hypertensive patients withand without coronary artery disease /." Online version, 2005. http://dspace.utlib.ee/dspace/bitstream/10062/692/5/muda.pdf.
36
Mabry, Jessica Erin. "Obstructive Sleep Apnea Risk in Abdominal Aortic Aneurysm Disease Patients: Associations with Physical Activity Status, Metabolic Syndrome, and Exercise Tolerance." Diss., Virginia Tech, 2013. http://hdl.handle.net/10919/50607.
Abstract:
Obstructive sleep apnea (OSA) is common in older U.S. adults and the prevalence is anticipated to rise in this age group along with obesity, a prominent risk factor for OSA. Recently, OSA was determined to be highly prevalent among patients with abdominal aortic aneurysm (AAA) disease. Objectives: Examine associations between OSA risk and physical activity (PA), metabolic syndrome (MetSyn), and exercise responses to cardiopulmonary exercise testing (CPET) in elderly patients with AAA disease. Methods: Elderly patients (n=326 for Studies 1 and 2; n=114 for Study 3) newly diagnosed with small AAAs (aortic diameter "2.5 and < 5.5 cm) were recruited. Data collection for all participants included: extraction of medical history and drug information from medical records; completion of a physical examination to assess resting vital signs and anthropometrics; fasting blood draw for several biochemical analyses; completion of a cardiopulmonary exercise test (CPET); and completion of interviews and questionnaires for health history, PA, and OSA risk. Results: 57% of subjects were High-risk for OSA and 17% were classified in the highest-risk Berlin Risk Score (BRS) 3 group; these subjects reported fewer blocks walked/day, flights of stairs climbed/day, and expended fewer Calories when engaged in these activities compared to Low-risk counterparts, independent of obesity. Among those at High-risk for OSA, 45% had MetSyn. Subjects with the highest BRS also had the highest prevalence of MetSyn and values for the MetSyn component biomarkers. Exercise capacity and physiological responses at rest, during exercise, and recovery were similar between groups at High- and Low-risk for OSA. Conclusions: Reduced levels of PA among elderly AAA patients at High-risk for OSA could have unfavorable implications for cardiovascular disease (CVD) risk and all-cause and CVD mortality. Subjects demonstrating the most clinical symptoms of OSA showed a significantly higher prevalence for MetSyn and several of the biomarkers that determine MetSyn. In clinical practice, the BRS may be useful for identifying those AAA patients at increased risk for both OSA and MetSyn.Ph. D.
37
Cantrelle, François. "Antibiotherapie preventive systemique chez les patients en aplasie prolongee : etude de 2 associations d'antibiotiques au cours de 61 episodes d'aplasies." Lyon 1, 1989. http://www.theses.fr/1989LYO1M244.
38
Schneider, Harald Jörn, Jens Klotsche, Bernhard Saller, Steffen Böhler, Caroline Sievers, David Pittrow, Günther Ruf, et al. "Associations of age-dependent IGF-I SDS with cardiovascular diseases and risk conditions: cross-sectional study in 6773 primary care patients." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-100953.
Abstract:
Objective: We aimed at investigating the association of age-dependent IGF-I SDS with diabetes, dyslipidemia, hypertension, and heart diseases, in a large patient sample.
Background: IGF-I has been suggested to be associated with several diseases and a prognostic marker for the development of cardiovascular diseases and risk factors. The findings, though, have been inconsistent possibly due to the methodological factors.
Methods: We studied 6773 consecutive primary care patients, aged 18+ years, in a cross-sectional, epidemiological study in primary care, Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment study. All patients underwent a standardized clinical diagnostic and laboratory assessment. IGF-I levels were measured with an automated chemiluminescence assay system. We calculated the odds ratios (OR) for diseases in quintiles of IGF-I, and additionally analyzed the association of age-dependent IGF-I SDS with these conditions.
Results: After multiple adjustments for confounders, we found increased ORs for coronary artery disease in patients with high IGF-I. Women, but not men, with low IGF-I also showed increased ORs for coronary artery disease. Dyslipidemia was positively associated with IGF-I. Type 2 diabetes showed a curvilinear association with IGF-I SDS.
Conclusions: The findings suggest the existence of multiple and complex interactions between IGF-I and several health conditions. The complex nature of disease- and subgroup-specific associations along with the methodological factors can be held responsible for divergent findings in previous studies.
39
Schneider, Harald Jörn, Jens Klotsche, Bernhard Saller, Steffen Böhler, Caroline Sievers, David Pittrow, Günther Ruf, et al. "Associations of age-dependent IGF-I SDS with cardiovascular diseases and risk conditions: cross-sectional study in 6773 primary care patients." BioScientifica, 2008. https://tud.qucosa.de/id/qucosa%3A26326.
Abstract:
Objective: We aimed at investigating the association of age-dependent IGF-I SDS with diabetes, dyslipidemia, hypertension, and heart diseases, in a large patient sample.
Background: IGF-I has been suggested to be associated with several diseases and a prognostic marker for the development of cardiovascular diseases and risk factors. The findings, though, have been inconsistent possibly due to the methodological factors.
Methods: We studied 6773 consecutive primary care patients, aged 18+ years, in a cross-sectional, epidemiological study in primary care, Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment study. All patients underwent a standardized clinical diagnostic and laboratory assessment. IGF-I levels were measured with an automated chemiluminescence assay system. We calculated the odds ratios (OR) for diseases in quintiles of IGF-I, and additionally analyzed the association of age-dependent IGF-I SDS with these conditions.
Results: After multiple adjustments for confounders, we found increased ORs for coronary artery disease in patients with high IGF-I. Women, but not men, with low IGF-I also showed increased ORs for coronary artery disease. Dyslipidemia was positively associated with IGF-I. Type 2 diabetes showed a curvilinear association with IGF-I SDS.
Conclusions: The findings suggest the existence of multiple and complex interactions between IGF-I and several health conditions. The complex nature of disease- and subgroup-specific associations along with the methodological factors can be held responsible for divergent findings in previous studies.
40
Huyard, Caroline. "Rendre le rare commun : expériences de maladies rares et construction d'une action collective." Paris, EHESS, 2007. http://www.theses.fr/2007EHES0018.
Abstract:
Cette thèse compare six affection afin de donner un cadre unifié à la catégorie de maladie rare. Elle reconstitue les différentes modalités dïntégration des maladies rares dans le monde médical depuis les années 1950. Le problème apparaît aux États-Unis dans les années 1960. Une ambition de restaurer une division du travail plus adaptée se fait jour au début des années 1980 et fixe la catégorie dans des dispositifs réglementaires. L'étude traite ensuite de l'expérience de ces maladies et de l'action collective en situation de rareté. Elle explore ce que représente le fait d'être rare et distingue deux formes de rareté, objective et subjective, cette dernière étant un enjeu de l'action collective. Une enquête dégage un modèle associatif propre aux associations de maladies rares. L'étude de l'action collective inter-associative montre en revanche les difficultés de ces petits groupes à se fédérer dans la duréeThis thesis is a comparative study of six ‘rare disorders’ aiming at providing a coherent frame of analysis for this category. The first part presents the history of connections rare disorders had with medical organisation since 1950. At first well integrated, they became a problem in the United-States during the 1960s. The attempts to reorganise the division of medical labour then framed the regulatory dimension. The second part addresses the experience of these disorders and collective action in a context of rarity. I explore what “being rare” means, which leads me to distinguish two types of rarity, an “objective” and a “subjective” one, the latest being a stake in collective action. The inquiry describes a model of association characteristic for rare disorders. Collective action at the inter-associative level shows how long-term coalitions challenge these small groups
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Masokwane, Patrick Maburu Dintle. "Prevalence of non-AIDS defining conditions and their associations with virologic treatment failure among adult patients on anti-retroviral treatment in Botswana." University of the Western Cape, 2016. http://hdl.handle.net/11394/5247.
Abstract:
Magister Public Health - MPHBackground: The recognition of HIV/AIDS as a chronic life-long condition globally in recent years has demanded a different perception and an alignment to its association with other chronic diseases. Both HIV and other chronic non-communicable diseases are significant causes of morbidity and mortality. Their combined DALY contributions for Botswana would be significant if research and strategies in controlling these conditions are not put in place. Natural aging and specific HIV-related accelerated aging of patients who are on antiretroviral treatment means that age-related diseases will adversely affect this population. Princess Marina Hospital Infectious Diseases Care Clinic has been in operation since 2002. The clinic has initiated over 16 000 patients on anti-retroviral treatment (ART) since 2002. The current study estimated the prevalence of non-AIDS defining conditions (NADCs) in the attendees of the clinic in 2013. The majority of patients that attended the clinic had been on treatment for over three years with some patients more than ten years. These ART experienced patients were more likely to be susceptible to chronic non-communicable diseases, including non-AIDS defining conditions. The nomenclature used in classification of NADCs in the current study was appropriate for resource-limited settings; because the study setting offered HIV treatment under resources constraints. Aim: The current study characterised non-AIDS defining conditions, and determined their associations with virologic treatment failure in a cohort of patients that were enrolled at Princess Marina Hospital antiretroviral clinic in Gaborone, Botswana. Methods: A retrospective cross sectional study of records of patients who attended the Princess Marina Infectious Diseases Care Clinic in 2013. Stratified random sampling of a total of 228 patients’ records was achieved from a total population of 5,781 records. Data was transcribed into a Microsoft Excel Spreadsheet and then exported to Epi-Info statistical software for analysis. Results: Eighty (35%) cases of NADCs were reported/diagnosed in the study sample; with 27% (n=62) of the patients having at least one condition, 6.7% (n=17) two conditions, and 0.4% (n=1) three conditions. The top prevalent conditions were hypertension (n= 40), hyperlipidaemia (n=7) and lipodystrophy (n=7). The prevalence of NADCs on the various categories of patients compared with the total sample population was as follows: active patients (prevalence ratio= 0.70), transferred out patients (prevalence ratio = 1.24), patients who died (prevalence ratio=2.04) and patients who were lost to follow-up (prevalence ratio =2.86). The prevalence of NADCs was significantly associated with increasing age (p<0.001); having social problems (p=0.028); having been on treatment for over three years (p=0.007); an outcome of death (p = 0.03) and being lost to follow-up (p=0.007). The study showed that being controlled on second line or salvage regimen (p=0.014) and the presence of adherence problems in the past was associated with virologic failure (p=0.008). There was no association of presence of NADCs to virologic failure. Conclusions: There was significant morbidity of non-AIDS defining conditions in the Princess Marina Infectious Diseases Care Clinic shown by a prevalence of NADCs in the clinic of 35% in 2013.The significant associations of the presence of NADCs and virologic failure with outcomes of death and loss to follow-up illustrate the adverse effects that NADCs are having, and calls for strategies to address multi-morbidities in HIV patients on antiretroviral treatment.
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Wan, Siu-fung, and 雲小楓. "Understanding the associations of active and passive smoking with HbA1c and diabetes-related complications in type II diabetic patients: a cross-sectional study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B47869872.
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Ewan, Victoria. "Investigating the associations between oral colonisation with respiratory commensal pathogens, oral hygiene and hospital acquired pneumonia in older patients with lower limb fracture." Thesis, University of Newcastle upon Tyne, 2013. http://hdl.handle.net/10443/2198.
Abstract:
Hospital acquired pneumonia (HAP) occurs in 1% of all hospital in-patients, and in around 10% of patients with lower limb fracture, with a mortality of 18- 43%. HAP arises from interactions between three main risk factor groups: resident oral microbiota, aspiration potential (dysphagia, reduced conscious level) and host factors (age, frailty, comorbidity). In this work novel multiplex real time PCR assays were used to study prospectively the oral colonisation dynamics of seven major commensal pathogens over the first fortnight after hospital admission in relation to oral health variables, medical variables and subsequent development of HAP. Of the 93 patients recruited, 10% developed HAP and 60% of in-hospital deaths after lower limb fracture were due to HAP. Persistent oral colonisation with E. coli or S. aureus was significantly associated with HAP or HAP/lower respiratory tract infection in older patients with lower limb fracture. In turn, S. aureus was associated with increased dental plaque at admission and with increased xerostomia indices at 14 days. Other factors such as witnessed aspiration and post-operative cough were also strongly associated with subsequent development of HAP. HAP was associated with increased risk of death and increased length of hospital admission. These findings suggest several potentially modifiable clinical risk factors, and a high risk population for HAP, to whom interventions could be targeted. Given the rise in the older population and the increased costs associated with HAP, early detection and prevention will become increasingly important. Further work is needed to understand the relationships between dental plaque, S. aureus and xerostomia, and also to identify microbial biomarkers which could be used at the start of hospital admission to stratify patients’ risk of HAP.
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Al-Foraih, Meisa. "Dietary, Physical Activity and Other Lifestyle Habits and their Associations with Medication Adherence in a Group of Hypercholesterolemic Patients Prescribed Statin Therapy in Kuwait." Thesis, Griffith University, 2014. http://hdl.handle.net/10072/366088.
Abstract:
The growing epidemic of coronary heart disease (CHD) is evident worldwide, accounting for global mortality rates of approximately 7.2 million per year. Coronary heart disease causes are multi-factorial encompassing both intrinsic and extrinsic factors; including age, gender, genetics, diet, physical activity, obesity, psychology, smoking and alcohol intake. Serum low density lipoprotein (LDL), an underlying consequence mainly of poor dietary habits, is strongly associated with increased risk of developing CHD and therefore a major target for CHD risk reduction strategies. Although intrinsic factors such as age, gender and genetics cannot be controlled or corrected, modifiable factors (extrinsic) can be managed and thus CHD risk may be reduced. Prescription of lipid-lowering drugs such as statins (3-hydroxy-3-methyl-glutaryl-CoA reductase or HMG-CoA inhibitors) has significantly increased due to their LDL-cholesterol lowering properties, where subsequently CHD risk may be reduced. There is little doubt in the efficacy of these drugs; the effectiveness however, is the issue in question. Various studies have reported up to 55% non-adherence to statin medications, after 6 months of treatment. It is important to recognize that once statin adherence subsides in these patients, risk reduction is dependent on the alternative concomitant therapies (diet, physical activity, maintenance of weight and smoking cessation), which may or may not have been implemented by the patient. Therefore the goal of this study was investigate the degree of adherence to statin medication, and alternative concomitant behaviours and examine whether an association exists between these various coronary risk reduction factors and overall CHD risk profile.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Public Health
Griffith Health
Full Text
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Endaltseva, Aleksandra. "Chronic Com-Position Work : Embodying patient organization and patient improvisation within Russian Multiple Sclerosis Society." Thesis, Paris, EHESS, 2020. http://www.theses.fr/2020EHES0071.
Abstract:
Comment est-ce que le mouvement de patients bouge? Le travail de recherche présenté dans cette thèse est motivé par cette curiosité. Les propositions suivantes proviennent de l’étude ethnographique au sein de/avec l’organisation de patients ‘La Société Russe de Sclérose en Plaques’ (RuMSS). En explorant comment la/les vie/s avec la sclérose en plaques (la vie collective organisationnelle et les vies personnelles de ses membres) se composent au sein de la RuMSS, j’introduis la com-position chronique – un concept-en-cours pour faire sens de et sentir le mouvement du patient. Ce concept se concentre à la fois sur la composition – comment on se positionne avec, pour créer et maintenir la solidarité en place –, et sur chronique – comment rester en accord avec les espace-temps multiples en com-posant. Pour cela, j’assiste à comment le mouvement social des patients chroniques s’expérimente à travers les faits, les gestes et les sentiments. Comment est-ce qu’il est vécu avec care (ou pas) avec des ressources limitées (sanitaires, corporelles, financières, d’information ou de technologie, et émotionnelles). J’assiste à comment l’organisation des patients est incarnée dans le corps, sentie et pratiquée par ceux dont le travail fait bouger le mouvement des patients. Comment est-ce que les faits, les gestes et les sentiments qui se manifestent, gèrent et maintiennent une organisation de patients composent les histoires multiples et incohérentes au long du travail de narration et d’écoute. Je propose de commencer à penser le mouvement des patient à partir de la sensibilisation à ses chronotopes multiples- les configurations spatio-temporelles qui suscitent des «genres sociaux» et des récits éthico-politiques spécifiques d'un événement. En commençant avec les chronotopes, ceci me permet de m’attarder sur les détails pratiques de l’entretien de la RuMSS, et le travail fait par ceux dont les ressources sont limitées, en plus d’observer comment le travail est com-posé avec les événements, les accomplissements et les stratégies des organisations Russes de patients plus généralement. En me basant sur des données empiriques issues de pratiques ethnographiques au sein de la RuMSS et en accompagnant la réflexion par le travail féministe sur l'éthique située et non idéalisée ainsi qu’une compréhension du care centrée sur le travail, je spécule comment le travail de com-position chronique peut offrir un potentiel d'émancipation et une pédagogie du careHow does a patient movement move? The research introduced in this dissertation is moved by this curiosity. The propositions which follow are grounded in the ethnographic study with(in) the patient organization “Russian Multiple Sclerosis Society” (RuMSS). Exploring how lives (collective organizational life and personal lives of society’s members) with multiple sclerosis are composed within RuMSS, I introduce chronic com-position - a concept-in-the-making for making sense of and sensing patient movement. This notion has two foci: composition, how to position oneself with, to create and maintain solidarity of place; and chronic, how to stay attuned to the multiple time-and-space scapes when com-posing. For this, I attend to how a social movement of chronic patients is being experienced through doings, makings, and feelings. How it is lived with care (or not) for finite resources - health and body resources, financial resources, information or technological resources, emotional resources. I attend to how patient organization is embodied, sensed, and practised by those whose work moves the patient movement. How doings, makings, and feelings which manifest, manage, and maintain a patient organization make up multiple situated and inconsistent stories throughout the work of storytelling/listening. I propose to start understanding a patient movement by orienting oneself to its multiple chronotopes – time-space configurations which prompt specific ‘social genres’ (ethico-political accounts of a happening). Commencing with chronotopes allows me to stay with the practicalities of RuMSS maintenance performed by those with finite resources. And as well – to observe how maintenance work is being com-posed with the happenings, achievements, and strategies within the Russian patient movement at large. Grounded in empirical material from ethnographic doings within RuMSS and thinking along with feminist work on situated ethics and non-idealized, work-centered understanding of care, I speculate how chronic com-position work may offer a potential emancipation and pedagogy of care
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Oi, Katsuya. "Understanding the Role of Patient Activation in the Association between Patient Socio-Economic Demographics and Patient Experience." PDXScholar, 2012. https://pdxscholar.library.pdx.edu/open_access_etds/467.
Abstract:
This study focuses on the association between patient characteristics, which include both demographic and contextual factors, and patients' experiences with health care. The pre-existing literature provides rich information about patients' various demographics related to patient experience. Despite the abundance of empirical evidence showing that patients' demographics do affect how they perceive their health care. However, there is little to no empirical knowledge explaining the significance of such factors. As the existing literature points out the need for taking into contextual factors such as patient's beliefs, attitudes, skills that are pertinent to dealing with health care, my study proposes patient activation as such a contextual factor that explains the association between patient demographics and patient experience. Findings suggest that patient activation is a strong predictor of two patient experience measures: patients' rating of doctor-patient communication and their self-reported difficulties in getting needed care. However, it is also observed that the mediating effects of patient activation vary by the two dimensions of patient experiences. Though this study demonstrates that promoting patient activation may be able to normalize how patients report the quality of doctor-patient interaction, further research is needed to address access to care issues.
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Schirg, Glenn Richard. "Determining the patient satisfaction factors for hospital room service & the association of room service with the overall satisfaction with the hospital experience." Menomonie, WI : University of Wisconsin--Stout, 2007. http://www.uwstout.edu/lib/thesis/2007/2007schirgg.pdf.
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Jenkins, Valerie Ann. "Novel word association priming in amnesic patients." Thesis, University of Sussex, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.307247.
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Barth, Nathalie. "L'activité physique adaptée pour les personnes atteintes de diabète de type 2 : approche sociologique des "carrières de pratiquant d'APA" dans leurs relations avec la "trajectoire de maladie"." Phd thesis, Université Claude Bernard - Lyon I, 2012. http://tel.archives-ouvertes.fr/tel-00862795.
Abstract:
Outre la prescription d'un traitement médicamenteux, la pratique régulière d'une Activité Physique Adaptée (APA)est recommandée aux personnes atteintes d'un diabète de type 2 (DT2), au même titre qu'un nouvel équilibre alimentaire(HAS, 2006). Cette incitation à opérer des changements concrets dans son " style de vie " rencontre des résistances, qui sontaccentuées pour les malades n'ayant pas préalablement construit de dispositions à la pratique physique. Des dispositifsinnovants ont été imaginés dans certaines organisations de santé (réseau de santé, unité transversale d'éducation) pour rendrepossible cet engagement physique et lui permettre de se développer de manière autonome dans le cadre d'" une carrière depratiquant d'APA " au sens où la définit Becker (1985). L'objectif est d'étudier ce processus d'engagement dans ses relationsavec la " trajectoire de maladie " au sens où l'entend Strauss (1985), en rendant compte des différentes étapes de saconstruction. A l'interface de la sociologie de la santé et de la sociologie du sport, l'approche mobilise ainsi des conceptsinteractionnistes. La méthodologie articule une observation de terrain avec 52 récits d'expériences de personnes atteintes demaladie(s) chronique(s) (dont 39 de DT2) qui ont évolué dans deux dispositifs d'APA différents : l'un proposant des séancesthéoriques d'information/explication (n=17), l'autre mettant en place des séances pratiques dans un cycle éducatif en APA puisune orientation vers une association sportive de patients (n=35). L'analyse des récits utilise un logiciel de traitement dedonnées textuelles (Prospéro).Trois types d'engagement ont ainsi été repérés : Le premier s'inscrit dans la " trajectoire demaladie " mais suppose un rapport au corps renouvelé après une remise en question des représentations de l'AP du patient etde ses capacités. Le second ouvre une " carrière de pratiquant d'APA " et ajoute une sociabilité de l'entre-soi, initiée par lesdispositifs " à et via " l'APA. Le troisième consolide cette " carrière " dans une pratique davantage culturelle que médicale,en l'inscrivant dans une sociabilité plus ouverte. Ces trois formes d'engagement se succèdent selon un continuum au coursduquel s'affirment simultanément une recherche croissante d'autonomie par rapport aux prescriptions médicales, une attentiongrandissante au corps et un développement du réseau relationnel.
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HAO, JULIE-CHRISTINA, and 郝先潔. "ASSOCIATIONS BETWEEN PHYSICAL FITNESS AND COGNITIVE PERFORMANCE IN PATIENTS WITH SCHIZOPHRENIA." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/27574664949816807892.
Abstract:
碩士國立臺灣體育運動大學
運動健康科學系碩士班
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Purpose: There is an increasing prevalence of schizophrenia, which is a mental disorder characterized by cognitive difficulties. This can distress patients severely and persistently making them withdraw, frantic and distractive. It is not only a life-long struggle for the patients themselves but also a burden for their families, and societies. How to maintain the cognitive performance among patients with schizophrenia is critical for clinical therapy. Previous studies have shown that physical fitness is positively associated with cognitive performance for school children and for older adults. Little is known about physical fitness on cognitive performance among patients with schizophrenia. Therefore, this study targeted on patients with schizophrenia, attempting to explore the associations between different dimensions of physical fitness and cognitive performance. Methods: Patients with schizophrenia (n=204) were assessed by several fitness and cognition tests. Physical fitness tests included：body mass index, flexibility, muscular strength, and cardiovascular fitness. Cognition tests included：attention, processing speed, and memory. All analyses were performed using SPSS 22.0 to test the associations between physical fitness and cognitive performance. Results: No significant difference is found between cognitive performance and sex, nor is found between cognitive performance and smoking status. Medication use, metabolic parameters, duration of illness and hospitalization are not associated with cognitive performance. However cardiopulmonary fitness is the strongest factor associated with cognitive performance among the four components of physical fitness in the multivariate regression model. Cardiopulmonary fitness significantly predicts working memory (β= .855，p < .001), processing speed (β= .511，p < .001), and attention (β= .402，p < .001). Attention is also associated with years of education (β= .339，p < .001) as well. Conclusion: The cardiopulmonary fitness is the most significant predictor of cognitive performance among other fitness components. This study increases the sample size and controlled for different components of physical fitness in the statistical analyses filling the gap in the literature. However, this cross-sectional study cannot determine the causal relationship between physical fitness and cognitive performance. Future studies with longitudinal design are suggested.