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1
George, Charles Raymond Pax. "Disease Explicated And Disease Defined." Thesis, The University of Sydney, 2005. http://hdl.handle.net/2123/654.
Full textAbstract:
Disease is ubiquitous. Disease afflicts humans. It afflicts animals. It afflicts plants. People refer to disease in their everyday conversation. Newspapers comment upon it. Parliaments enact legislation regarding it. Novelists write about it. Artists depict it. Physicians, veterinary surgeons and agriculturalists seek to combat it. Insurance companies offer reimbursement against it. Anthropologists study it. Philosophers debate its nature, and dictionaries define it. Disease looms large in human consciousness. One might presume that, since disease is so important in daily life, human beings would know exactly what they mean by it. Most people seem to believe instinctively that they understand the nature of disease, and that their ideas about it coincide with other people's ideas. The definition of disease therefore arouses little controversy in everyday conversation. People use the word disease as readily as they use the words spade, or table or nose. They suggest, when they joke that somebody calls a spade a spade, that the nature of the implement used to dig the garden is so obvious that it requires no further definition. Similarly with a table or a nose. They might debate how many legs a table must have, but-regardless of the answer-rarely deny that it is a table; whilst every human must surely know what a nose is. This high level of agreement about so many commonly used terms perhaps creates an assumption that the meaning of disease is equally obvious and requires no further analysis. Is this, however, really the case? Disease is a somewhat less concrete phenomenon than is a spade or a table or a nose. Its existence, most would agree, is incontrovertible, but its nature is less clear. It is something that seems to befall people and animals and plants. It rarely serves any useful purpose. It often carries dire implications. It is something that most of us would prefer not to have, but rarely succeed in avoiding. It commonly comes unannounced and at inconvenient times. It usually causes distress, but not always. It can have a fatal outcome. Some people appear more prone to it that others. It sometimes sweeps through whole populations producing social devastation, but its manifestations vary. Some diseases affect a person's whole body, others merely a part of the body; some affect some parts of the body, others other parts. Some diseases only affect humans, whereas others affect both humans and animals. Some spread from animals to humans, others from humans to humans, and others still do not appear to spread at all. Some diseases affect plants, and few that affect plants seem to affect humans, but some humans can acquire diseases when they come into contact with plants that appear to have no diseases. Any reasonable analysis of the nature of disease must account for all these aspects and many others also. The nature of disease is a topic that has attracted the attention of physicians, scientists and philosophers over millennia. The close association that existed between medicine and philosophy in the classical Egyptian, Palestinian and Greek eras ensured that scholars who flourished in those societies examined the nature of disease. Comparable developments occurred in classical Indian and Chinese civilizations. The natural philosophers of Renaissance and post-Renaissance Europe divided into competing schools of thought over the nature of disease. More recent years have witnessed an enormous flourishing of physicians, pathologists, and agriculturalists who study aspects of disease that relate to their individual disciplines. Most of these researchers have, however, examined ever-narrower aspects of specific diseases-such as manifestations, mechanisms and causes-rather than the generic nature of the phenomenon. Some contemporary philosophers, on the other hand, have become interested in general aspects of the topic. They have proposed a number of novel ideas and reached some stimulating conclusions, although they can hardly yet claim to have reached a consensus. This lack of unanimity presumably implies that the issues involved require closer analysis if a formulation is to emerge that most of them can accept. The object of the present thesis is to undertake such an analysis. It will start by outlining in this introduction the general background to the topic. It will then detail the more noteworthy of previously proposed theories about the nature of this phenomenon, classifying them according to their most prominent components, and assessing their several strengths and weaknesses. It will next discuss the specific philosophical issues of definition, causation, and explication in the biomedical context, before suggesting a comprehensive, but succinct, definition that acknowledges many older views about disease, encompasses current usage, and provides a theoretical base from which to work into the future. It will finally test the strengths and weaknesses of that definition to account for observed phenomena and to accommodate some former definitions.
2
George, Charles Raymond Pax. "Disease Explicated And Disease Defined." University of Sydney. History and Philosophy of Science, 2005. http://hdl.handle.net/2123/654.
Full textAbstract:
Disease is ubiquitous. Disease afflicts humans. It afflicts animals. It afflicts plants. People refer to disease in their everyday conversation. Newspapers comment upon it. Parliaments enact legislation regarding it. Novelists write about it. Artists depict it. Physicians, veterinary surgeons and agriculturalists seek to combat it. Insurance companies offer reimbursement against it. Anthropologists study it. Philosophers debate its nature, and dictionaries define it. Disease looms large in human consciousness. One might presume that, since disease is so important in daily life, human beings would know exactly what they mean by it. Most people seem to believe instinctively that they understand the nature of disease, and that their ideas about it coincide with other people�s ideas. The definition of disease therefore arouses little controversy in everyday conversation. People use the word disease as readily as they use the words spade, or table or nose. They suggest, when they joke that somebody calls a spade a spade, that the nature of the implement used to dig the garden is so obvious that it requires no further definition. Similarly with a table or a nose. They might debate how many legs a table must have, but�regardless of the answer�rarely deny that it is a table; whilst every human must surely know what a nose is. This high level of agreement about so many commonly used terms perhaps creates an assumption that the meaning of disease is equally obvious and requires no further analysis. Is this, however, really the case? Disease is a somewhat less concrete phenomenon than is a spade or a table or a nose. Its existence, most would agree, is incontrovertible, but its nature is less clear. It is something that seems to befall people and animals and plants. It rarely serves any useful purpose. It often carries dire implications. It is something that most of us would prefer not to have, but rarely succeed in avoiding. It commonly comes unannounced and at inconvenient times. It usually causes distress, but not always. It can have a fatal outcome. Some people appear more prone to it that others. It sometimes sweeps through whole populations producing social devastation, but its manifestations vary. Some diseases affect a person�s whole body, others merely a part of the body; some affect some parts of the body, others other parts. Some diseases only affect humans, whereas others affect both humans and animals. Some spread from animals to humans, others from humans to humans, and others still do not appear to spread at all. Some diseases affect plants, and few that affect plants seem to affect humans, but some humans can acquire diseases when they come into contact with plants that appear to have no diseases. Any reasonable analysis of the nature of disease must account for all these aspects and many others also. The nature of disease is a topic that has attracted the attention of physicians, scientists and philosophers over millennia. The close association that existed between medicine and philosophy in the classical Egyptian, Palestinian and Greek eras ensured that scholars who flourished in those societies examined the nature of disease. Comparable developments occurred in classical Indian and Chinese civilizations. The natural philosophers of Renaissance and post-Renaissance Europe divided into competing schools of thought over the nature of disease. More recent years have witnessed an enormous flourishing of physicians, pathologists, and agriculturalists who study aspects of disease that relate to their individual disciplines. Most of these researchers have, however, examined ever-narrower aspects of specific diseases�such as manifestations, mechanisms and causes�rather than the generic nature of the phenomenon. Some contemporary philosophers, on the other hand, have become interested in general aspects of the topic. They have proposed a number of novel ideas and reached some stimulating conclusions, although they can hardly yet claim to have reached a consensus. This lack of unanimity presumably implies that the issues involved require closer analysis if a formulation is to emerge that most of them can accept. The object of the present thesis is to undertake such an analysis. It will start by outlining in this introduction the general background to the topic. It will then detail the more noteworthy of previously proposed theories about the nature of this phenomenon, classifying them according to their most prominent components, and assessing their several strengths and weaknesses. It will next discuss the specific philosophical issues of definition, causation, and explication in the biomedical context, before suggesting a comprehensive, but succinct, definition that acknowledges many older views about disease, encompasses current usage, and provides a theoretical base from which to work into the future. It will finally test the strengths and weaknesses of that definition to account for observed phenomena and to accommodate some former definitions.
3
Pandya, Mital. "Definition of Bovine Leukocyte Antigen Diversity and Peptide Binding Profiles for Epitope Discovery." ScholarWorks @ UVM, 2016. http://scholarworks.uvm.edu/graddis/474.
Full textAbstract:
The goal of the work presented herein was to further our understanding of Bovine Leukocyte Antigen (BoLA) class I diversity of Holstein cattle and develop tools to measure class I restricted T cell responses to intracellular pathogens such as foot and mouth disease virus (FMDV) following vaccination. BoLA is a highly polymorphic gene region that allows the bovine immune system to differentiate pathogen-infected cells from healthy cells. Immune surveillance by CD8+ T cells plays an important role in clearing viral infections. These CD8+ T cells recognize BoLA class I molecules bearing epitopes (antigenic peptides) of intracellular origin in their peptide binding groove. Polymorphisms in the peptide binding region of class I molecules determine affinity of peptide binding and stability during antigen presentation. Different antigen peptide motifs are associated with specific genetic sequences of class I molecules. In order to better understand the adaptive immune response mediated by BoLA molecules, technologies from human medicine such as high-throughput sequencing, biochemical affinity and stability assays, tetramers and IFN-γ ELIspot assays could be applied. Therefore, it was hypothesized that we can translate these technologies from the study of human T cell responses to the study of cattle immunity.
The first objective was to establish a comprehensive method for genotyping BoLA of Holstein cattle by using Illumina MiSeq, Sanger sequencing and polymerase chain reaction sequence-specific primers (PCR-SSP) (See Chapter 2). This is an important first step in order to study the BoLA restricted immune responses following FMDV vaccination. The second objective was to define the FMDV capsid protein peptide repertoire bound by BoLA class I molecules using bioinformatics and biochemical affinity and stability assays to facilitate the identification of T cell epitopes (See Chapter 3). The third objective was to demonstrate clonal T cell expansion for specific epitope polypeptides using ex-vivo multi-color flow cytometric MHC-epitope complexes (tetramers), followed by IFN-γ production measured by an ELIspot assay to quantify and define the antigen specific response of Holstein cattle to FMDV vaccination (see Chapter 4). In this, my dissertation studies aimed to improve our understanding of the BoLA class I restricted T-cell responses to candidate FMDV vaccines in Holstein cattle. In this manner, my research will improve animal health through the production of assays for characterizing the bovine immune response to intracellular pathogens and enhance vaccine design leading to improved biologicals to protect cattle from devastating infectious diseases.
4
Jolly, Ann. "Sexually transmitted disease core group membership in Manitoba, strategies for definition, and description of risk markers." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0025/NQ31994.pdf.
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Mengucci, Carlo. "WISDoM: Wishart Distributed Matrices Multiple Order classification. Definition and application to fMRI resting state data." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2018. http://amslaurea.unibo.it/15865/.
Full textAbstract:
In this work we introduce the Wishart Distributed Matrices Multiple Order Classification (WISDoM) method.
The WISDoM Classification method consists of a pipeline for single feature analysis, supervised learning,cross validation and classification for any problems whose elements can be tied to a symmetric positive-definite matrix representation.
The general idea is for informations about properties of a certain system contained in a symmetric positive-definite matrix representation (i.e covariance and correlation matrices) to be extracted by modelling an estimated distribution for the expected classes of a given problem.
The application to fMRI data classification and clustering processing follows naturally: the WISDoM classification method has been tested on the ADNI2 (Alzheimer's Disease Neuroimaging Initiative) database.
The goal was to achieve good classification performances between Alzheimer's Disease diagnosed patients (AD) and Normal Control (NC) subjects, while retaining informations on which features were the most informative decision-wise.
In our work, the informations about topological properties contained in ADNI2 functional correlation matrices are extracted by modelling an estimated Wishart distribution for the expected diagnostical groups AD and NC, and allowed a complete separation between the two groups.
6
Stavropoulos-Kalinoglou, Antonios. "Obesity in chronic inflammation using rheumatoid arthritis as a model : definition, significance, and effects of physical activity & lifestyle." Thesis, University of Wolverhampton, 2009. http://hdl.handle.net/2436/69603.
Full textAbstract:
Background: Inflammation is the natural reaction of the body to an antigen. In some conditions, this reaction continues even after the elimination of the antigen, entering a chronic stage; it targets normal cells of the body and causes extensive damage. Rheumatoid arthritis (RA) is such a condition. It associates with significant metabolic alterations that lead to changes in body composition and especially body fat (BF) increases. In the general population, increased body fat (i.e. obesity) associates with a number of health disorders such as systemic low grade inflammation and a significantly increased risk for cardiovascular disease (CVD). Both effects of obesity could have detrimental effects in RA. Increased inflammation could worsen disease activity while obesity could further increase the already high CVD risk in RA. However, obesity in RA has attracted minimal scientific attention. Aims: The present project aimed to: 1) assess whether the existing measures of adiposity are able to identify the changes in body composition of RA patients, 2) if necessary develop RA-specific measures of adiposity, 3) investigate the association of obesity with disease characteristics and CVD profile of the patients, 4) and identify factors that might affect body weight and composition in these patients. Methods: A total of 1167 volunteers were assessed. Of them 43 suffered from osteoarthritis and 82 were healthy controls. These, together with 516 RA patients were used in the first study. Their body mass index (BMI), BF, and disease characteristics were assessed. In the second, third, fourth and fifth studies a separate set of 400 RA patients was assessed. In addition to the above assessments, their cardiovascular profile and more detailed disease characteristics were obtained. For the final study, 126 RA patients were assessed for all the above and also data on their physical activity levels and their diet were collected. Results: Assessments of adiposity for the general population are not valid for RA patients. Thus, we proposed RA-specific measures of adiposity. These are able to better identify RA patients with increased BF. We were also able to find associations between obesity and disease activity. Both underweight and obese RA patients had more active disease compared to normal-weight patients. Obese patients had significantly worse CVD profile compared to normal-weight. The newly devised measures of adiposity were able to identify those at increased risk. However, not all obese individuals were unhealthy and not all normal-weight healthy. Among our patients we were able to identify subtypes of obesity with distinct phenotypic characteristics that warrant special attention. Finally, we were able to identify factors that influence body weight and composition. Cigarette smoking protected against obesity while its cessation associated with increased adiposity. Physical activity was also found to be protective against obesity while diet or inflammation of the disease failed to produce any significant results. Conclusions: Obesity is a significant threat to the health of RA patients. The measures of adiposity developed herein should be used to identify obese RA patients. Physical activity seems like the sole mode for effective weight management in this population. Health and exercise professionals should actively encourage their patients to exercise as much as they can. This study has created more questions than it answered; further research in the association of obesity and inflammation, as well as in ways to treat it, is essential.
7
Oliver, Elizabeth L. "Vision and disease in the Napoleonic description de l'Egypte (1809-1828) : the constraints of French intellectual imperialism and the roots of Egyptian self-definition." [Tampa, Fla] : University of South Florida, 2006. http://purl.fcla.edu/usf/dc/et/SFE0001658.
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Oliver, Elizabeth L. "Vision and Disease in the Napoleonic Description de l’Egypte (1809-1828): The Constraints of French Intellectual Imperialism and the Roots of Egyptian Self-Definition." Scholar Commons, 2006. http://scholarcommons.usf.edu/etd/3794.
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This study analyzes the travel conventions manifest in the engravings of the
thirty-volume
Description de l’Egypte produced as a result of the Napoleonic campaign
to Egypt in 1798 and published between 1809 and 1828. The first chapter examines the
discourse established on Egypt in travelogues throughout the eighteenth century prior to
the invasion of the country. I argue that the perceptions developed around the country
did not stem from actual experience, but from political and economic motivations that
cast Egypt in a light favorable for occupation.
I examine how this perception was challenged during the collapse of distance
between the French and Egyptians in the process of colonial encounter. Drawing upon
medical records and proclamations of the French medical team in Egypt, I examine a
specific epidemic known as ophthalmia that led to swollen, irritated eyes and eventual
blindness throughout the French army in Egypt. While it is actually caused by
Chlamydia, in every appearance it makes in French medical records throughout the
occupation, the disease was blamed on the climate, sunlight, and air specific to the land
of Egypt. As a result, I argue that the
Description’s hyper-real contrasts of light and dark
and amplified decay in its representations of the monuments residing in Egypt’s ravaging
climate are determined by the manner vision itself was altered by the epidemic of
ophthalmia.
I then contend that there exists a metaphorical parallel between the decaying
pharaonic monuments in the
Description and the perceived decay of modern Egyptian
society that are linked by misconceptions of Egypt’s climate. I conclude that the effect
of Egypt’s climate believed to destroy both physical monuments and physiological
disposition was used as evidence to support the larger agenda of French imperialism that
justified colonization of Egypt.
Lastly, this study examines how Egyptians counteracted the negative discourse of
their race by appropriating symbols of their country used in European representations and
altering them to develop a national identity. Tracing the time period from French
occupation through British colonization, Egyptians were able to galvanize resistance
while still working within the confines of colonial control.
9
Nothnagel, Michael. "The definition of multilocus haplotype blocks and common diseases." [S.l.] : [s.n.], 2004. http://deposit.ddb.de/cgi-bin/dokserv?idn=973611448.
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Nothnagel, Michael. "The definition of multilocus haplotype blocks and common diseases." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2005. http://dx.doi.org/10.18452/15174.
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Bisherige Methoden der Haplotyp-Block-Definition zielen entweder auf abwesende Rekombinationsereignisse oder eine effiziente Beschreibung genomischer Variation. Die vorliegende Arbeit definiert Blöcke von Single Nucleotide Polymorphisms (SNP) als Gebiete erhöhten Kopplungsungleichgewichtes (LD). Für dieses Ziel wird ein neues, entropie-basiertes Maß für LD zwischen multiplen Markern/Loci (Normalized Entropy Difference) entwickelt und als eine Multilocus-Erweiterung des paarweisen Maßes r2 charakterisiert. Ein zugehöriger Algorithmus für die Block-Definition wird vorgeschlagen. Seine Evaluierung an einem Datensatz des menschlichen Chromosoms 12 vom Internationalen Haplotype Map Projekt zeigt die Nützlichkeit der abgeleiteten Blöcke in Hinblick auf verschiedene Eigenschaften, einschließlich ihrer chromosomalen Coverage und der Anzahl sowie des Anteils der häufigen Block-Haplotypen. Der wesentliche Einfluß der SNP-Dichte auf die zu entdeckenden LD- und Blockstrukturen wird demonstriert. Der Erfolg von Assoziationsstudien in komplexen Erkrankungen mit Block-Haplotypen als multiallelischen Markern wird davon abhängen, ob die Common Variants/Common Diseases (CV/CD) Hypothese für solche Erkrankungen erfüllt ist.Current approaches to haplotype block definition target either absent recombination events or the efficient description of genomic variation. This thesis aims to define blocks of single nucleotide polymorphisms (SNP) as areas of elevated linkage disequilibrium (LD). To this end, a new entropy-based measure for LD between multiple markers/loci, the Normalized Entropy Difference, is developed and is characterized as a multilocus extension of the pairwise measure r2. A corresponding algorithm for the block definition is proposed. Its evaluation on a data set of human chromosome 12 from the International Haplotype Map project proves the usefulness of the derived blocks with respect to several features, including their chromosomal coverage and the number and portion of common block haplotypes. The critical role of the SNP density for detectable LD and block structure is demonstrated. The success of association studies in common diseases with block haplotypes serving as multi-allelic markers will depend on whether the Common Variants/Common Diseases (CV/CD) hypothesis holds true for those diseases.
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Molland, Sarah. "Inflammatory bowel disease, health and well-being : definitions, identity and experience." Thesis, University of Plymouth, 2018. http://hdl.handle.net/10026.1/13078.
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In this thesis, I explore the meanings and experience of health and well-being in the lives of individuals with Inflammatory Bowel Disease (IBD). Taking an auto/biographical approach and utilising in-depth qualitative online interviews, I draw on the experience and narratives of seventeen individuals with IBD, including myself. The three main themes addressed are 'Living with IBD', 'Becoming a Patient', and 'Coping and Control'. I explore how IBD influences individuals' experience of personal relationships, and their medical encounters and treatments. I reflect on how and why these factors arise and the effect they may have upon the disease and its management and on individuals' feelings of well-being more generally. I look at the resulting illness narratives and the impact of IBD on the daily life experience and the identity of the individual. I interrogate existing research and add to it from my analysis. Throughout, the research highlights the importance of acknowledging the impact of biographical disruption on the life experience and identity of individuals along with changing illness narratives. There are implications for future research and for policy, including the time taken to reach diagnosis, the use of IBD guidelines in diagnosis and treatment, and patient control and choice as a contributing factor to influence future guidelines and treatment plans.
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Engman, Maria. "Partial vaginismus : definition, symptoms and treatment." Doctoral thesis, Linköping : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-10036.
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Rivera, Victor. "HOW TRADITIONAL DEFINITIONS OF AUTONOMY IMPAIR DECISION-MAKING IN SPINAL MUSCULAR ATROPHY AND ALZHEIMER DISEASE." Master's thesis, Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/553526.
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Urban BioethicsM.A.
Clinical decision making is influenced by available literature, technology, and guidelines, but also by cultural expectations, physician experience, and personal biases. The treatment of various forms of disability is especially vulnerable to these prejudices. Alzheimer Dementia (AD) and Spinal Muscular Atrophy (SMA) represent forms of cognitive and physical disability, respectively. In severe forms of both diseases, patients are often unable to communicate and do not meet traditional definitions of autonomy. However, physicians and consensus guidelines adhere to these very same definitions of autonomy, which subsequently disadvantages patients that cannot verbalize. This bias is reflected in available guidelines for catheter-directed thrombectomy for acute ischemic strokes, which passively discourage physicians from treating patients with baseline AD. Inversely, pediatric definitions of autonomy may expose patients to over-treatment with nusinersen, a medication recently approved for the treatment of SMA. Adapting theories of bodily autonomy will allow physicians to approach the treatment of those who cannot verbalize in a more ethical fashion.
Temple University--Theses
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Haddad, Khristina. "Women, AIDS, and invisibility in the United States : using feminist theory to understand sources and consequences of definitions." Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=68098.
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The practical project of this thesis is to create a critical account of the experiences of women in the AIDS crisis in the United States. The theoretical project is to refine a concept of invisibility of various kinds of problems and obstacles women have been confronted with. The question that both parts of this project seek to answer is roughly the following: "What is it that we can learn about improving the lives of women by looking at the AIDS crisis as a lens into American social conditions at the end of the Twentieth Century?" Feminist theories provide a basis for this inquiry as well as the theoretical work on a concept of invisibility.
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Alamian, Arsham, Liang Wang, Amber M. Hall, Melanie Pitts, and Joseph Ikekwere. "Infant Sleep Problems and Childhood Overweight: Effects of Three Definitions of Sleep Problems." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1375.
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Sleep problems have been defined using a variety of definitions. No study has assessed the longitudinal association between infant sleep problems and childhood overweight or obesity using existing definitions of sleep problems. This study used longitudinal data (n=895) from the multi-site Study of Early Child Care and Youth Development (SECCYD) to investigate the effects of infant sleep problems on childhood weight status in Grade 6. Infants with sleep problems in Phase I (1991) and with complete data through Phase III (2004) of SECCYD were included. Sleep problems were assessed using maternal reports of night wakings and duration of a waking episode. Sleep problems were defined using Richman (1981), Lozoff et al. (1985), and Zuckerman et al. (1987) definitions. Multinomial logistic regression was used to examine the association between sleep problems during infancy and childhood weight status in Grade 6 while controlling for birth weight, race, sex, breastfeeding, maternal poverty, family structure, and maternal education. After adjusting for all covariates, children with a history of sleep problems were found to be overweight in Grade 6 using Zukerman et al. (Odds ratio (OR)=1.68; 95% confidence interval (CI): 1.11–2.55) and Richman (OR=1.76; 95% CI: 1.05–2.97) definitions, but not using Lozoff et al. definition. Infant sleep problems were not found to be associated with being obese. The study found differential effects of infant sleep problems on childhood overweight in Grade 6 per different definitions of sleep problems. Findings highlight the need to construct a single definition of infant sleep problems.
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Hambleton, Ian Richard. "Longitudinal studies in sickle cell disease : using a prospective cohort to examine definitions and clinical course in sickle-cell disease epidemiology : study participants, haematology, clinical events, and health status." Thesis, University of Southampton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399607.
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Trevino, Hugo [Verfasser], and Faik [Akademischer Betreuer] Gelisken. "Intra- and Interobserver agreement in assessment of macular diseases using high-definition spectral-domain optical coherence tomography / Hugo Trevino ; Betreuer: Faik Gelisken." Tübingen : Universitätsbibliothek Tübingen, 2016. http://d-nb.info/1199615587/34.
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Boyd-Flanagan, Sandra L. "A comparative study: Health care providers and student attitudes towards persons with HIV seropositivity or the definitive diagnosis of AIDS." CSUSB ScholarWorks, 1989. https://scholarworks.lib.csusb.edu/etd-project/430.
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Pinto, Elda Garbo [UNESP]. "Acesso vascular definitivo em usuários de hemodiálise: construção e validação de uma escala de conhecimento." Universidade Estadual Paulista (UNESP), 2014. http://hdl.handle.net/11449/108791.
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000769601.pdf: 3033772 bytes, checksum: 836d4d63f7f8df56f8982b5a85eff009 (MD5)Estudo de cunho metodológico de construção e validação de instrumentos de avaliação em saúde, com o objetivo de construir e validar escalas de conhecimento sobre o acesso vascular definitivo em usuários de hemodiálise para os profissionais de enfermagem de nefrologia. As etapas para a elaboração das escalas foram: seleção das práticas envolvendo o acesso vascular definitivo em usuários de hemodiálise, fundamentação teórica das práticas selecionadas e elaboração das escalas pautadas nas diretrizes clínicas (guidelines) Clinical practice guidelines for vascular Access, Guías de Acceso Vascular em Hemodiálisis (Sociedade Espaῆola de Nefrología) e Guía de acceso vascular en hemodiálisis. O produto desse estudo foi a construção de quatro escalas: Escala de conhecimento sobre acesso vascular definitivo em usuários de hemodiálise (ECAVD) – Cuidados universais, Escala de conhecimento sobre acesso vascular definitivo em usuários de hemodiálise (ECAVD) – Cuidados específicos, Escala de conhecimento sobre acesso vascular definitivo em usuários de hemodiálise (ECAVD) – Exame físico e Escala de conhecimento sobre acesso vascular definitivo em usuários de hemodiálise (ECAVD) – Vigilância hemodinâmica. A coleta de dados ocorreu nos meses de fevereiro a agosto de 2013, por meio de um questionário, composto das seguintes partes: julgamento do conteúdo (constructo), dos atributos e dos componentes de cada escala construída. A validação de conteúdo das escalas foi realizada por doze juízes, com ampla experiência na área de nefrologia. Todas as escalas construídas foram validadas pelos profissionais, sob consenso favorável mínimo de 75%. Ressalta-se que após validação as escalas foram aplicadas a 84 profissionais de enfermagem que atuam em terapia de substituição renal em 3 centros no interior do Estado de São Paulo, onde 2,3% dos profissionais demonstraram apresentar pouco conhecimento, 33,3% ...
Methodological nature study of the construction and validation of assessment tools in health, in order to build and validate knowledge scales about the permanent vascular access in hemodialysis users for nephrology nurses. The steps to prepare the scales were: practices selection involving permanent vascular access to hemodialysis users, theoretical basis of selected practices and development of guided scales in clinical guidelines (guidelines) Clinical practice guidelines for vascular Access, “Guías de Acceso Vascular em Hemodiálisis” (Espanish Society of Nephrology) and “Guía de acceso vascular en hemodialysis”. Thus, four scales were built : knowledge Scale of permanent vascular access in hemodialysis users (KSPVA) – Universal Care, knowledge Scale of permanent vascular access in hemodialysis users (KSPVA) – Specific Care, knowledge Scale of permanent vascular access in hemodialysis users (KSPVA) – physical examination and knowledge Scale of permanent vascular access in hemodialysis users (KSPVA) – Hemodynamic Monitoring. Data collection occurred from February to August 2013, using a questionnaire, consisting of the following parts : trial content (constructo), of the attributes and components of each built scale. The scales content validity was performed by twelve judges with extensive experience in the field of nephrology. All built scales were validated by professionals under minimum favorable consensus of 75 %. It is noteworthy that after validation, scales were applied to 84 nurses, working on renal replacement therapy in 3 centers in towns of São Paulo State, where 2.3% of the professionals have demonstrated little knowledge, 33.3 % have demonstrated satisfactory knowledge and 64.2 % of the professionals have demonstrated full knowledge about care and complications with AVF
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Pinto, Elda Garbo. "Acesso vascular definitivo em usuários de hemodiálise : construção e validação de uma escala de conhecimento /." Botucatu, 2014. http://hdl.handle.net/11449/108791.
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Orientador: Wilza Carla SpiriBanca: Carmen Maria Casquel Monti Juliani
Banca: Maria Justina Dalla Bernardina Felipe
Resumo: Estudo de cunho metodológico de construção e validação de instrumentos de avaliação em saúde, com o objetivo de construir e validar escalas de conhecimento sobre o acesso vascular definitivo em usuários de hemodiálise para os profissionais de enfermagem de nefrologia. As etapas para a elaboração das escalas foram: seleção das práticas envolvendo o acesso vascular definitivo em usuários de hemodiálise, fundamentação teórica das práticas selecionadas e elaboração das escalas pautadas nas diretrizes clínicas (guidelines) Clinical practice guidelines for vascular Access, Guías de Acceso Vascular em Hemodiálisis (Sociedade Espaῆola de Nefrología) e Guía de acceso vascular en hemodiálisis. O produto desse estudo foi a construção de quatro escalas: Escala de conhecimento sobre acesso vascular definitivo em usuários de hemodiálise (ECAVD) - Cuidados universais, Escala de conhecimento sobre acesso vascular definitivo em usuários de hemodiálise (ECAVD) - Cuidados específicos, Escala de conhecimento sobre acesso vascular definitivo em usuários de hemodiálise (ECAVD) - Exame físico e Escala de conhecimento sobre acesso vascular definitivo em usuários de hemodiálise (ECAVD) - Vigilância hemodinâmica. A coleta de dados ocorreu nos meses de fevereiro a agosto de 2013, por meio de um questionário, composto das seguintes partes: julgamento do conteúdo (constructo), dos atributos e dos componentes de cada escala construída. A validação de conteúdo das escalas foi realizada por doze juízes, com ampla experiência na área de nefrologia. Todas as escalas construídas foram validadas pelos profissionais, sob consenso favorável mínimo de 75%. Ressalta-se que após validação as escalas foram aplicadas a 84 profissionais de enfermagem que atuam em terapia de substituição renal em 3 centros no interior do Estado de São Paulo, onde 2,3% dos profissionais demonstraram apresentar pouco conhecimento, 33,3% ...
Abstract: Methodological nature study of the construction and validation of assessment tools in health, in order to build and validate knowledge scales about the permanent vascular access in hemodialysis users for nephrology nurses. The steps to prepare the scales were: practices selection involving permanent vascular access to hemodialysis users, theoretical basis of selected practices and development of guided scales in clinical guidelines (guidelines) Clinical practice guidelines for vascular Access, "Guías de Acceso Vascular em Hemodiálisis" (Espanish Society of Nephrology) and "Guía de acceso vascular en hemodialysis". Thus, four scales were built : knowledge Scale of permanent vascular access in hemodialysis users (KSPVA) - Universal Care, knowledge Scale of permanent vascular access in hemodialysis users (KSPVA) - Specific Care, knowledge Scale of permanent vascular access in hemodialysis users (KSPVA) - physical examination and knowledge Scale of permanent vascular access in hemodialysis users (KSPVA) - Hemodynamic Monitoring. Data collection occurred from February to August 2013, using a questionnaire, consisting of the following parts : trial content (constructo), of the attributes and components of each built scale. The scales content validity was performed by twelve judges with extensive experience in the field of nephrology. All built scales were validated by professionals under minimum favorable consensus of 75 %. It is noteworthy that after validation, scales were applied to 84 nurses, working on renal replacement therapy in 3 centers in towns of São Paulo State, where 2.3% of the professionals have demonstrated little knowledge, 33.3 % have demonstrated satisfactory knowledge and 64.2 % of the professionals have demonstrated full knowledge about care and complications with AVF
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Alamian, Arsham, Liang Wang, Melanie Pitts, Joseph Ikekwere, and Amber Hall. "Infant Sleep Problems Increase the Odds of Childhood Overweight at Grade 6: Differential Effects of Commonly used Definitions of Sleep Problems." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/1400.
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Valente, Luiz Eduardo. "Associação do tratamento com alopurinol e desfechos definitivos em portadores de doença renal crônica com hiperuricemia assintomática." Botucatu, 2019. http://hdl.handle.net/11449/183070.
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Orientador: Luis Cuadrado MartinResumo: Fundamentação: É crescente o número de trabalhos revelando a associação de hiperuricemia assintomática com hipertensão, síndrome metabólica, doenças cardiovasculares e doença renal crônica. Alguns estudos revelam que o tratamento da hiperuricemia assintomática reduz o número de desfechos renais e cardiovasculares. Tal premissa, no entanto, ainda não foi avaliada em uma subpopulação brasileira. Objetivos: Avaliar a associação entre tratamento com alopurinol e ocorrência de desfechos definitivos em portadores de doença renal crônica com hiperuricemia assintomática. Materiais e métodos: Foram avaliados, de forma retrospectiva, pacientes hiperuricêmicos e portadores de doença renal crônica não dialítica, em tratamento no HC-FMB – UNESP, os quais iniciaram acompanhamento no ambulatório de Insuficiência Renal Crônica ou de Nefrologia Geral do HC-UNESP desde janeiro 2002 a dezembro 2017. Com o intuito de avaliar a associação do uso do alopurinol sobre desfechos definitivos (entrada em terapia renal substitutiva, duplicação da creatinina ou morte). Resultados: Foram avaliados 109 pacientes sendo 53 do sexo feminino, cuja média de idade foi de 68 ± 11 anos. Destes, 95 eram brancos, 13 afrodescendentes e um asiático. Vinte e seis pacientes apresentaram o desfecho estudado no período; entre todos os 36 pacientes que iniciaram o uso de alopurinol no primeiro ano seguimento, ocorreram oito desfechos (22%). A proteinúria em 24 h associou-se aos desfechos avaliados Hazzard Ratio de 1,301 (I... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Rationale: There is increasing number of studies revealing an association of hyperuricemia with hypertension, metabolic syndrome, cardiovascular diseases and chronic kidney disease. Some studies have shown that treatment of asymptomatic hyperuricemia reduces the number of renal and cardiovascular outcomes. This premise, however, has not yet been evaluated in a Brazilian subpopulation. Objectives: To evaluate the association between treatment with allopurinol and the occurrence of definitive outcomes in patients with chronic kidney disease with asymptomatic hyperuricemia. Materials and methods: Hyperuricemic patients with chronic non-dialytic kidney disease under treatment at HC-FMB - UNESP who began follow-up at the Chronic Kidney Insufficiency or General Nephrology outpatient clinic at HC-UNESP, were retrospectively evaluated, from January 2002 to December 2017. In order to evaluate the association of the use of allopurinol on definitive outcomes (renal replacement therapy, creatinine doubling or death). Results: A total of 109 patients were evaluated, of which 53 were females, whose mean age was 68 ± 11 years. Of these, 95 were white, 13 Afro-descendants and one Asian. Twenty-six patients presented the outcome studied in the period; among all 36 patients who started using allopurinol in the first year of follow-up, eight outcomes (22%) occurred. Proteinuria at 24 h was associated with the Hazzard Ratio of 1.301 (95% CI: 1.122 -1.508), p: 0.011. In univariate analysis, phosp... (Complete abstract click electronic access below)
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Sandberg, Emma. "Respektfull design: För ökad förståelse och vilja att förändra : FUCK ME, en utställning om den svåra sjukdomen ME/CFS." Thesis, Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-79356.
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In this essay, I go through the different parts that compile my degree project. I have explored the power of graphic design for educational purposes. During my process, I have found a new area of graphic design, respectful design. Something that can be briefly described as design created with the greatest reverence for conveying a difficult subject without diminishing the affected person behind. An approach where one works closely with the involved and frequently checks in, so that nothing is portrayed incorrectly. This along with the constant search for information makes up the basics of respectful design. The disease ME has finally begun to be talked about in society. But the way the disease is portrayed can be argued as incorrect in relation to the bigger picture. As a graphic designer I have analyzed the problem and worked out a possible solution. My conclusion is that strong colors mixed with melancholy and straightforward information can make the subject less heavy and easier to handle. This can open the senses to problem solving and understanding instead of stopping at pity. The aim of the project has been to get away from these dark quilts that the media has placed on us. The goal was to create something that does not hide the awfulness of the disease but informs in a more fun and more inviting way. I strongly believe that graphic design can reduce the social stigma around a topic if done properly. When life is the toughest it has helped me and (after the response of the exhibition) others to learn more about our disease. Above all, if more people know more about the disease, ME- patients will get help. Hopefully society will open it’s arms so that no more people are forced to choose suicide.I denna uppsats går jag igenom de olika delarna som sammanställer mitt examensprojekt. Jag har i grunden utforskat kraften av grafisk design i utbildningssyfte. Under min process har jag kommit fram till ett nytt område inom grafisk design, respektfull design. Detta går kort att beskriva som design utformat med största vördnad inför att förmedla ett svårt ämne utan att förminska den drabbade människan bakom. Respektfull design innebär att man jobbar nära med inblandade, kollar av hela tiden så att inget porträtteras felaktigt och läser på om ämnet så långt det går. Sjukdomen ME har äntligen börjat talas om i samhället. Men sättet sjukdomen porträtteras kan argumenteras som svartvitt och felaktigt gentemot helhetsbilden. Som grafisk designer har jag analyserat problemet och jobbat fram en möjlig lösning. Min slutsats är att starka färger blandat med melankolisk och rak information kan göra ämnet mindre tungt och mer lätthanterligt. Detta kan öppna sinnena för problemlösning och förståelse istället för att stanna vid medlidande. Syftet med projektet har varit att komma ifrån detta mörk täcke som media lagt över oss. Målet var att skapa något som inte döljer det hemska med sjukdomen men informerar på ett roligare och mer inbjudande sätt. Jag tror stark på att grafisk design kan minska det sociala stigmat runt ett ämne om det görs på rätt sätt. När livet är som tuffast har det hjälpt mig och (efter respons av utställningen) också andra med att utbilda och läsa på. Framför allt om fler vet mer om sjukdomen kommer det att gå att få bättre hjälp. Förhoppningvis öppnar samhället sina armar så att inte fler tvingas till att välja självmord.
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Cupido, Ynoma. "Waiting to die: staging of HIV positive people at the first HIV test - Region A, Nelson Mandela Metropole (January 1991-April 2000)." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_8832_1253846190.
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This project suggested tha HIV people in Region A (Nelson Mandela Metropole, formerly Port Elizabeth) health districty of the Eastern Cape, seek HIV testing when they are already in stages three (late disease) and four (AIDS) of HIV infection. Data had been obtained from the AIDS Training Information and Counselling Centre in the Nelson Mandela Metropole in 2000. The consequences of diagnoses onlu in the advanced stages of HIV infection will have a devastating impact on case management. Therefore, this paper yielded important data for South African policy makers to write health and welfare policies that might improve the quality of life of those terminally infected with HIV.
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Eendebak, Robert. "The potential relationships between hormone biomarkers and functional and health outcomes of ageing." Thesis, University of Manchester, 2017. https://www.research.manchester.ac.uk/portal/en/theses/the-potential-relationships-between-hormone-biomarkers-and-functional-and-health-outcomes-of-ageing(e28321cc-703c-44df-99b4-fb0d76f7f429).html.
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Although the female menopause has been extensively characterized as a well-defined symptomatic state of oestrogen deficiency, which responds relatively well to oestrogen replacement therapy, the symptomatic state of androgen deficiency in men is poorly defined and uncertainty exists whether it responds to testosterone replacement. It has been proposed that hypothalamic-pituitary-testicular (HPT)-axis function (responsible for the production of androgens) and regulation could be viewed as a âbarometerâ of health status in older men and that potential alterations in HPT-axis function and regulation reflect subclinical and clinical deficits in function and health, which may result in an aged phenotype of human health and disease in older men. The HPT-axis constitutes a well-defined, tractable, clinically-relevant, biological system, which may permit insight into the mechanisms underlying the expression of ageing-related phenotypes of human health and disease. By using a different lens â such as the genetic background; the compensatory responses within the HPT-axis; the syndromes of androgen deficiency; the ethnic background of an individual or the life course trajectory of function and health from conception into older age â to magnify potential dysregulation in the HPT-axis will it be possible to visualize and understand the phenotypic expression of human male ageing as a gradient of functional and health outcomes. This will allow for a better understanding of the physiological mechanics underlying symptomatic expression of dysregulation in the HPT-axis.
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Anske, Ute. "Chronopsychobiologische Pilotstudie zur objektiven Bestimmung funktioneller Gesundheitszustände." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2003. http://dx.doi.org/10.18452/14965.
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1. Unterschiedliche Definitionen der Gesundheit mit verschiedenen Betrachtungsweisen (WHO: Der Mensch eine biopsychosoziale Einheit. Schulmedizin: ohne klinischen und paraklinischen Befund mit Orientierung an kritikbedürftigen Referenzmittelwerten) führt bei Fachleuten, Behörden und Laien zu Verwirrungen, wenn es um die Beurteilung gesundheitlicher Schäden geht. 2. Es wurde die Aufgabe gestellt zu prüfen, welche der beiden Definitionen der Realität näher kommt. 3. Mittels der chronopsychobiologischen Regulationsdiagnostik, des Dreiphasenentspannungstests (Hecht und Balzer 2001), wurden unter dem Aspekt der beiden Gesundheitsdefinitionen drei Gruppen untersucht (je 40 Probanden). - klinisch Gesunde (klinisch Gesunde nach Schulmedizin ) - Gesunde nach Definition der WHO - Probanden mit nichtorganische Insomnie (ohne pathologische klinische und paraklinische Befunde) 4. Die mit den verwendeten Methoden gewonnenen Daten wiesen aus, dass zwischen den klinisch Gesunden und den Probanden mit nichtorganischer Insomnie weitgehend größere Ähnlichkeiten bestehen. Beide Gruppen zeigten aber zu der Gruppe der Gesunden nach WHO-Definition, welche die biopsychosoziale Einheit des Menschen berücksichtigt, noch hochsignifikante Unterschiede. Die Gruppe der klinisch Gesunden kann daher auf Grund unserer Ergebnisse nicht den Anspruch erheben, real gesund zu sein. 5. Mit der Bezugnahme auf die Internationale Klassifikation der Krankheiten (ICD 10F) haben die von uns untersuchten klinisch Gesunden und die nichtorganischen Insomniker eine mehr oder weniger stark ausgeprägte Symptomatik von psychischen Störungen. Dies müsste bei der Beurteilung von Schadstoff-, Lärm-, und EMF-Wirkungen auf den Menschen, wie auch bei den klinisch-pharmakoloischen Untersuchungen beachtet werden. Die in der Arbeit erzielten Ergebnisse bedürfen durch weitere Untersuchungen eine Fundierung. Sie signalisieren aber sowohl unter praktischen als auch unter theoretischen Aspekten einen dringenden Forschungsbedarf.1. Differing definitions of health using different criterea (WHO: The human being as a bio- psycho-social unit versus classical medicine: without clinical and paraclinical results based on suspect reference values) bring confusion to experts, authorities and laymen when assessing health damages. 2. The given task was to check which of the two definitions is closer to reality. 3. Using the chrono-psycho-biological diagnostic of regulation, the three-phase-relaxation test (Hecht and Balzer 2001), three groups were examined considering the aspects of the two health definitions (40 test subjects in the study group). - clinically healthy (clinically healthy per classical medicine definition) - healthy per definition of the WHO - test persons with non organic insomnia (i.e. no pathological or paraclinical findings) 4. The data gained from the employed methods revealed bigger similarities between clinically healthy persons and those with non organic insomnia. Both groups still showed highly significant differences to the group which fulfils the definition of the WHO regarding a human as a bio-psycho-social unit. As a result of this study, persons, though classified as "clinically healthy" might nevertheless not absolutely be healthy in reality. 5. In reference to the international classification of illnesses (ICD 10 F) the groups examined, both of clinically healthy and those with non organic insomnia, have more or less severe psychological symptoms. This should be taken into account when assessing the effects of pollution, noise, and EMF as well as clinical pharmacological studies. These present findings still need broader confirmation by further investigations. However, they clearly indicate, for practical and theoretical considerations, an urgent need for further research.
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Ciappuccini, Renaud. "Apport de l'imagerie fonctionnelle par TEMP/TDM et TEP/TDM dans la prise en charge des cancers différenciés de la thyroïde Incremental Value of a Dedicated Head and Neck Acquisition during 18F-FDG PET/CT in Patients with Differentiated Thyroid Cancer Full text links full-text provider logo Actions Favorites Share Page navigation Title & authors Abstract Conflict of interest statement Figures Similar articles Cited by References Related information LinkOut - more resources EJNMMI Res . 2018 Dec 3;8(1):104. doi: 10.1186/s13550-018-0461-x. Optimization of a dedicated protocol using a small-voxel PSF reconstruction for head-and-neck 18 FDG PET/CT imaging in differentiated thyroid cancer 78 Lymph node involvement in head-and-neck and thyroid cancers with digital PET/CT: the impact of ultra-high definition voxels and point-spread function Tumor burden of persistent disease in patients with differentiated thyroid cancer: correlation with postoperative risk-stratification and impact on outcome 133 18F-Fluorocholine PET/CT is a highly sensitive but poorly specific tool for identifying malignancy in thyroid nodules with indeterminate cytology: The Chocolate study PSMA expression in neovasculature of persistent/recurrent differentiated thyroid cancerin the neck: relationship with radioiodine uptake, 18Fluorodeoxyglucose avidity and outcome." Thesis, Normandie, 2020. http://www.theses.fr/2020NORMC424.
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L’imagerie scintigraphique des cancers thyroïdiens différenciés (CTD) présente la particularité d’utiliser deux radiopharmaceutiques, l’iode 131 (131I) et le 18-Fluorodésoxyglucose (18FDG). La fixation de ces traceurs dépend habituellement du degré de différenciation et de l’agressivité de la tumeur. L’objectif de ce travail était d’étudier l’apport de différents aspects techniques et d’instrumentation, à savoir l’imagerie hybride par TEMP/TDM et TEP/TDM, la point-spread function (PSF), la taille des voxels et la technologie TEP digitale, et d’explorer si d’autres traceurs TEP pouvaient présenter un intérêt. Le but de la première partie était d’étudier les performances de la TEP/TDM au 18FDG à l’étage cervical pour la détection de la maladie ganglionnaire. Une acquisition TEP/TDM dédiée a amélioré la détection de la maladie tumorale par rapport à l’acquisition classique. L’utilisation de la PSF a permis de détecter des tailles de lésions plus petites et la durée optimale de cette acquisition a été évaluée. Des reconstructions avec des tailles de voxels ultra-fines ont été réalisées sur TEP digitale pour étudier l’impact de la PSF et des voxels ultra-fins sur les données quantitatives. La seconde partie a porté sur l’imagerie 131I-TEMP/TDM et 18FDG-TEP/TDM, afin de quantifier le volume de la maladie persistante. Il a ainsi été montré que la masse tumorale était corrélée au risque post-opératoire et avait un impact sur la réponse au traitement. L’objectif de la troisième partie était d’étudier un autre traceur TEP, la 18-Fluorocholine (FCH), ainsi qu’un marqueur de la néovascularisation, l’antigène membranaire spécifique de la prostate (PSMA). Nos données suggèrent qu’un examen TEP à la FCH négatif au sein d’un nodule thyroïdien à cytologie indéterminée permettrait d’éliminer la malignité, et pourrait éviter des chirurgies inutiles. Par ailleurs, le marquage au PSMA évalué par immunohistochimie dans les néo-vaisseaux est associé à des facteurs de mauvais pronostic. D’autres études sont nécessaires pour confirmer l’intérêt éventuel des examens TEP à la FCH et au 68Ga-PSMA en oncologie thyroïdienneRadioiodine (131I) and 18-Fluorodeoxyglucose (18FDG) are two radiopharmaceuticals used for scintigraphic imaging in differentiated thyroid cancers (DTC). Tumour uptake of each tracer depends on tumour differentiation and aggressiveness. Our goal was to further assess various technical aspects in DTC imaging workup, such as SPECT/CT and PET/CT, point-spread function (PSF), voxel size, digital PET, and to explore further other PET tracers. The aim of the first part was to assess the performance of 18FDG PET/CT for the detection of neck lymph node involvement. A dedicated PET/CT acquisition improved tumour detection compared to the whole-body acquisition. PSF reconstruction allowed detection of smaller cancer deposits and the optimal acquisition duration time was assessed. Using digital PET acquisitions, ultra-thin voxels reconstructions were performed. The impact of ultra-thin voxels and PSF on quantitative values was evaluated. The second part focused on 131I-SPECT/CT and 18FDG-PET/CT imaging, in an attempt to assess tumour burden of persistent disease. Tumor burden was correlated with the postoperative risk and affected the response to therapy. In the third part, another PET tracer, i.e. 18-Fluorocholine (FCH), and a marker of neovasculature, i.e. prostate-specific membrane antigen (PSMA), were studied. FCH PET/CT offered high negative predictive value to reliably exclude cancer in PET-negative nodules with indeterminate cytology and might prevent unnecessary surgeries. Also, PSMA expression assessed with immunohistochemistry was associated with poor prognosis factors. Further studies are needed to confirm new insights of FCH PET and 68Ga-PSMA PET in DTC
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Mulero, Stephen. "Développement d’outils d’écologie moléculaire pour un suivi intégratif des maladies transmises par les mollusques d’eau douce dans un contexte d’émergences et de changements globaux A Multiplex Rapid Diagnostic PCR (RD-PCR) approach for xenomonitoring of human and animal schistosomiases in a One Health context Genetic diversity and relationships of the liver fluke Fasciola hepatica (Trematoda) with native and introduced definitive and intermediate hosts Simultaneous genotyping of gastropods and their trematode parasites using Amplicon Sequencing Pre-zygotic isolation mechanisms between Schistosoma haematobium and Schistosoma bovis parasites: from mating interactions to differential gene expression." Thesis, Perpignan, 2020. http://www.theses.fr/2020PERP0023.
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Les changements globaux, qu’ils soient d’origine climatique ou anthropique ont diverses conséquences en santé humaine et animale, mais aussi sur les écosystèmes mondiaux. L’une des plus importantes est la modification des aires de répartitions géographiques des espèces et de celle des pathogènes qui leurs sont associés. C’est dans ce contexte que nous assistons ces dernières années à une recrudescence des cas d’émergences et de réémergences de maladies infectieuses dans le monde. Alors que les efforts de recherche menés dans ce domaine se focalisent principalement sur les maladies virales, les maladies transmises par les mollusques d’eau douce, qui affectent plus d’un milliard d’individus dans le monde, sont également sujettes à ces évènements d’émergences devenus fréquents. Cependant, l’étude de la dynamique des parasites associés à ces maladies se focalisent essentiellement sur le diagnostic et le traitement des hôtes définitifs, en particulier l’Homme. Toutefois, une telle approche ne permet pas de prévenir de la transmission de ces parasites à l’Homme et encore moins de prévenir d’un évènement d’émergence, et les outils actuels utilisés pour le suivi de ces parasites dans l’environnement sont difficilement applicables à large échelle. Ce travail de thèse se propose donc d’apporter une vision plus environnementale de la dynamique de ces maladies. Avec l’exemple de l’émergence de bilharziose urogénitale en Corse, nous avons analysé cette émergence en intégrant l’étude des traits d’histoire de vie du parasite tropical en cause, notamment sa thermo tolérance, ainsi que le rôle des hôtes intermédiaires mollusques et des hôtes définitifs sauvages et domestiques dans le maintien local du cycle parasitaire. Dans un second temps nous avons développé des outils de diagnostic par ADN environnemental pour la détection de mollusques hôtes dans l’environnement afin d’identifier les zones à risque d’émergence, ainsi que des outils de détection intramolluscal de schistosomes pour identifier les sites de transmission actif, et donc permettre un suivi environnemental des acteurs de ces maladies. Pour compléter ces approches, nous avons développé un outil plus généraliste de metabarcoding environnemental pour caractériser les communautés de mollusques d’eau douce, et initié le développement d’un outil similaire pour la caractérisation des communautés de trématodes, ceci afin d’étudier les interactions entre ces organismes. Enfin nous discutons de l’intégrations de tous ces éléments dans de nouvelles stratégies de contrôle à l’encontre de maladies transmises par les mollusques d’eau douceGlobal changes, whether climatic or anthropogenic, have various consequences in human and animal health, as well as for worldwide ecosystems. One of the most important is the modification of geographical ranges of species and those of their associated pathogens. It is in this context that in recent years we have witnessed a resurgence in the emergence and re-emergence of infectious diseases around the world. While research efforts in this field are mainly focused on viral diseases, freshwater snail-borne diseases, that affect more than 1 billion peoples around the world, are also subject to these outbreaks, which have become frequent. However, the study of the dynamics of parasites associated with these diseases focuses primarily on the diagnosis and treatment of the definitive hosts, particularly humans. Such an approach does not prevent the transmission of these parasites to humans and even less prevent an emergence event, and the existing tools used to monitor these parasites in the environment are difficult to apply at large scale. This thesis work, therefore aims to provide a more environmental vision of the dynamics of these diseases. With the example of the emergence of urogenital bilharziasis in Corsica, we analysed this emergence by integrating the study of the life history traits of the tropical parasite in question, particularly its thermo tolerance, as well as the role of mollusc intermediate hosts and wild and domestic definitive hosts in the local maintenance of the parasite lifecycle. In a second step, we have developed environmental DNA diagnostic tools for the detection of molluscs hosts in the environment in order to identify areas at risk of emergence, as well as tools for intramolluscal detection of schistosomes to identify active sites of transmission, and thus allow the environmental monitoring of the actors of these diseases. To complete these approaches, we have developed a more generalised environmental metabarcoding tool to characterise freshwater mollusc communities and initiated the development of a similar tool for the characterisation of trematode communities, in order to study the interactions between these organisms. Lastly, we discuss the integration of all these elements into new control strategies against snail-borne diseases
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Hung, Pei-Yuan, and 洪珮媛. "Building a Clinical Guideline for Chronic Kidney Disease using openEHR's Guideline Definition Language." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/14293634069399002910.
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碩士國立陽明大學
生物醫學資訊研究所
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Background Quality of medical care has been gaining more and more attention in the past years. Application of Clinical practice guidelines are a useful way to improve the quality of care. To make it more effective, we need clinical practice guidelines incorporate medical procedures, enabling us to offer a diagnosis of the patient. However, it is not easy to read the paper guidelines, because it is full of obstacles in a clinical setting. Therefore, it would be more useful for integrating medical informatics systems by using the computer-based clinical guidelines. Previous studies have shown that computer-based guidelines can improve clinical outcomes significantly. To make effective use of clinical practice guidelines, principles of computer-based research becomes even more important nowadays. Aim For long, the medical informatics domain has lacked a clinical standard for adequately integrating EHR with the computer-based clinical guideline. openEHR is an open standard specification in health informatics established by the University College London and Ocean Informatics Pty Ltd from UK and Australia corporately. They developed the archetype to represent clinical knowledge and used Guideline Definition Language (GDL) to express clinical guideline. In this way they enhance the interoperability of semantic. Our aim is to build clinical practice guideline using openEHR technology including archetypes and GDL. Method There were three stages in this study. The first stage focused on organizing the clinical guideline as well as identifying the clinical concepts and rules within it. We used Chronic Kidney Disease (CKD) guideline as material. The second stage was to search for the existing archetype and develop the new archetype. The last stage was to model guideline and validation. A focus group discussion was conducted for better understand the feasibility of GDL. Result Ten CKD anemia guidelines were represented by GDL. These computer-based guidelines were based on 11 public archetypes and 12 newly created archetypes. We carried out a focus group study with 16 physicians and 22 IT staffs. After discussion we sorted out two topics. One is about separates the opinion of knowledge from information; another is about feasibility of GDL into information system. Conclusion This study utilized openEHR guideline definition language to build the clinical practice guideline of chronic kidney disease. Using archetype and GDL to represent the guidelines as well as clinical knowledge within it. The result of this study can be a foundation for the integration of EHR and the computer-based clinical guideline.
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Come, Jotamo Jose. "Esophageal cancer in Mozambique. Disease characterization for the definition of a proficient action program." Doctoral thesis, 2021. https://hdl.handle.net/10216/133342.
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Come, Jotamo Jose. "Esophageal cancer in Mozambique. Disease characterization for the definition of a proficient action program." Tese, 2021. https://hdl.handle.net/10216/133342.
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Watkins, Thomas. "High-throughput and high-definition analysis of human T cell repertoires in health and disease." Thesis, 2020. https://researchonline.jcu.edu.au/76793/1/JCU_76793_Watkins_2020_thesis.pdf.
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Thomas Watkins studied a specialised type of white blood cell called a T cell, which are primarily responsible for the defence against foreign microbes. During his PhD, he characterized and defined numerous different T cell populations throughout the human body in both healthy and disease models.
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Li, Meng-Chen, and 李孟臻. "Pulse Wave Analysis of Mechanical Alternans of Small-Breed Dogs with Myxomatous Mitral Valve Disease Using High-Definition Oscillometry." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/10174688096978712080.
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碩士國立中興大學
獸醫學系暨研究所
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Degenerative myxomatous mitral valve disease (MMVD) is the most common canine heart disease. The prevalence is higher in small-breed dogs. MMVD is characterized by chronic myxomatous mitral valve degeneration resulting in thickening and incomplete apposition of the valve leaflets during systole with secondary mitral regurgitation (MR) and congestive heart failure (CHF) eventually. Mechanical alternans is a phenomenon of alternating strong and weak beats with a constant beat-to-beat interval. The phenomenon has been recognized in patients with CHF. The purpose of the study is to investigate the prevalence and the interaction with CHF of mechanical alternans in small-breed dogs with MMVD using High-Definition Oscillometry (HDO) device (HDO®). In the present study, 22 small-breed dogs diagnosed with MMVD were included which examinations by using HDO device, by which blood pressures and pulse waveforms (via software) can be recorded, were performed at the same visit. The degree of CHF were classified according to the American College of Veterinary Internal Medicine (ACVIM) recommendations for dogs with MMVD. Twelve patients (54.6%) showed mechanical alternans, and there is an increasing trend in the prevalence of mechanical alternans with increasing CHF classes according to Cochran-Armitage trend test (p<0.05). When taking treatment into account, 3 of 8 patients (37.5%) without treatment showed mechanical alternans, and besides the same increasing trend, there is significant difference in CHF classes between groups with and without mechanical alternans according to Fisher’s exact test (p<0.05). In conclusion, the present of mechanical alternans can be detected by using HDO device, and small-breed dogs with mechanical alternans had higher CHF classes.
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Guerreiro, Pedro Emanuel Neves. "Litíase Vesicular: definição de estratégias para tratamento definitivo em tempo ótimo." Master's thesis, 2017. http://hdl.handle.net/10316/82222.
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Trabalho de Projeto do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaBackground: Gallstone Disease (GD) is common in the western countries and when symptomatic or complicated, is associated with high morbidity rates. Laparoscopic cholecystectomy is the gold standard treatment for symptomatic GD. The identification of the individuals that would benefit from early LC as well as defining adequate timing for said treatment it’s becoming increasingly important.Methods: 59 subjects admitted in a surgical ward for symptomatic GD were screened using two methods: interview and consultation of patient file. Were described three concepts of patient admission: (1) major complication; (2) minor complication (biliary colic); (3) programmed. Several clinic and demographic data was collected and the patient was asked about his previous knowledge of his GD (including previous symptomatic episodes)Results: The medium age of participants was 66,5 years with the 80-89 years interval and the male sex showing themselves to be most prevalent. 55,9% were admitted for a major complication and the remaining 44,1% were admitted in a programmed way. 35,6% had suffered from multiple episodes of biliary colic. 21% of the patients admitted for a major complication had suffered from a previous episode of GD complication and two of those had multiple episodes. Biliary colic was the reason for the majority of the programmed admissions with only one patient in this group suffering from multiple major complications. Medical treatment was preferred.Discussion/Conclusion: Was found a group of patients with multiple major complication history of GD, and it is believed that this type of patients may worsen their conditions while waiting for LC. This is associated with high patient morbidity as well as higher healthcare costs. Surgical treatment after a first symptomatic episode seems safe and efficient possibility and should be considered, if conditions and resources are presented.
Introdução: A litíase vesicular (LV) é comum no mundo ocidental e quando sintomática ou complicada, associa-se a altas taxas de morbilidade. A colecistectomia laparoscópica é considerado o tratamento padrão para eliminar definitivamente as complicações da litíase sintomática. Torna-se assim cada vez mais importante identificar os doentes que mais beneficiariam de tratamento cirúrgico precoce, bem como definir os tempos mais adequados para este mesmo tratamento.Métodos: Foram avaliados 59 doentes internados em enfermarias de Cirurgia por LV sintomática através de entrevista e consulta dos processos clínicos. Foram definidos três conceitos para descrever o motivo de internamento do doente: (1) complicação major; (2) complicação minor (cólica biliar); (3) programado. Foram colhidos diversos dados demográficos e clínicos e questionado o conhecimento prévio relativamente ao diagnóstico de LV (incluindo episódios sintomáticos prévios). Resultados: A idade média dos inquiridos foi de 66,5 anos, com o escalão etário dos 80-89 anos e o sexo masculino a serem mais prevalentes. 55,9% dos doentes foram internados por complicação major e os restantes 44,1% foram internados de forma programada. 35,6% dos doentes tinham sofrido de cólica biliar pelo menos uma vez. 21% dos doentes internados por complicação major já tinham tido um espisódio prévio de complicação de LV e dois desses chegaram mesmo a ter episódios múltiplos. A maioria dos doentes internados de forma programada tinham tido apenas episódios de cólica biliar, sendo que apenas um destes doentes teve múltiplas complicações major. Deu-se preferência ao tratamento médico nos doentes internados por complicação major.Discussão/Conclusão: Verificou-se a existência de um grupo de doentes com história de múltiplas complicações de LV, admitindo-se que estes e outros doentes na mesma situação possam agravar a sua condição ao aguadar pelo diferimento de colecistectomia laparoscópica. Tal encontra-se associado a aumento da morbilidade bem como ao aumento dos custos para o serviço de saúde. O tratamento cirúrgico definitivo após um primeiro episódio sintomático torna-se assim uma possibilidade segura e eficaz a ser considerada, desde que existam recursos e condições que o permitam.
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Santos, George F. "Vaccines to combat meningococcal disease - definitive vaccines for elusive pathogens." Thesis, 2016. https://hdl.handle.net/2144/20705.
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Neisseria meningitidis (Nm) disease occurs worldwide. Disease incidence rates can vary from 1 to 1000 cases per 100,000 with the highest incidence found in the sub-Saharan Africa meningitis belt. Nm has evolved a number of mechanisms to evade host immunity. This includes the production of genetic variants through re-combinatorial events, which is thought to have contributed to the evolution of hyper-invasive lineages that are largely responsible for meningococcal disease. Antigenic diversity of Nm surface proteins has been the main limitation in the design of broadly protective vaccines, particularly against capsular serogroup B strains. To overcome this problem, several Nm genomes have been sequenced in an effort to find highly sequence-conserved surface antigens recognized by the human immune system in order to develop a vaccine, which would be broadly protective against disease. Nm genomes contain over 2 million base pairs that contain between 2000 and 2500 open reading frames. Add to this the difficulty of identifying highly conserved recombinant antigens with strong intrinsic immunostimulatory properties, makes vaccine design and development a daunting task. Recent advances in our understanding of the interactions between innate and acquired immunity, and the discovery of pattern recognition receptors, including Toll-like receptors (TLRs), have ushered in a new set of adjuvant compounds, TLR agonists, which invoke strong humoral and cellular responses with nominal toxicity and adverse reactions. These insights have opened up new areas of vaccine research to combat invasive Nm disease.
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Nothnagel, Michael [Verfasser]. "The definition of multilocus haplotype blocks and common diseases / von Michael Nothnagel." 2004. http://d-nb.info/973611448/34.
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Bader, Daniel. "Platonic Craft and Medical Ethics." Thesis, 2010. http://hdl.handle.net/1807/26127.
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Platonic Craft and Medical Ethics examines the Platonic theory of craft and shows its application to different ethical problems in medicine, both ancient and modern. I begin by elucidating the Platonic use of the term “craft” or “technē”, using especially the paradigmatic craft of medicine, and explicate a number of important principles inherent in his use of the term. I then show how Plato’s framework of crafts can be applied to two ancient debates. First, I show how Plato’s understanding of crafts is used in discussing the definition of medicine, and how he deals with the issue of “bivalence”, that medicine seems to be capable of generating disease as well as curing it. I follow this discussion into Aristotle, who, though he has a different interpretation of bivalence, has a solution in many ways similar to Plato’s. Second, I discuss the relevance of knowledge to persuasion and freedom. Rhetors like Gorgias challenge the traditional connections of persuasion to freedom and force to slavery by characterizing persuasion as a type of force. Plato addresses this be dividing persuasion between sorcerous and didactic persuasion, and sets knowledge as the new criterion for freedom. Finally, I discuss three modern issues in medical ethics using a Platonic understanding of crafts: paternalism, conclusions in meta-analyses and therapeutic misconceptions in research ethics. In discussing paternalism, I argue that tools with multiple excellences, like the body, should not be evaluated independently of the uses to which the patient intends to put them. In discussing meta-analyses, I show how the division of crafts into goal-oriented and causal parts in the Phaedrus exposes the confusion inherent in saying that practical conclusions can follow directly from statistical results. Finally, I argue that authors like Franklin G. Miller and Howard Brody fail to recognize the hierarchical relationship between medical research and medicine when they argue that medical research ethics should be autonomous from medical ethics per se.