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1
Baker, J. E. "Ethnicity and cardiovascular disease prevention." Thesis, University of Glasgow, 2015. http://theses.gla.ac.uk/6524/.
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Background Public health interventions need to both improve health and reduce health inequalities, whilst using limited health care resources efficiently. Well-established ethnic differences in cardiovascular disease (CVD) raise the possibility that CVD prevention policies may not work equally well across ethnic groups. The aim of this thesis was to explore whether there are ethnic differences in the potential impact of two CVD prevention policy choices – the choice between mass and targeted screening for high cardiovascular risk, including the use of area deprivation measures to target screening, and the choice between population and high-risk approaches. Methods Cross-sectional data from the Health Survey for England 2003 and 2004 were used. Three sets of analyses were carried out – first, calculation of ethnic differences in the utility of area deprivation measures to identify individual socioeconomic deprivation; second, investigation of ethnic differences in the cost-effectiveness of mass and targeted screening for high cardiovascular risk; third, analysis of ethnic differences in the potential impact of population and high-risk approaches to CVD prevention. Results Area deprivation measures worked relatively effectively and efficiently at identifying individual socioeconomic deprivation in ethnic minority groups compared to the white group. In ethnic groups at high risk of CVD, cardiovascular risk screening programmes were a relatively cost-effective option, screening programmes targeted at deprived areas were particularly cost-effective, and population approaches were found to be an effective and equitable way of preventing CVD despite potential underestimation of their impact. Discussion This thesis found that ethnic minority groups in the UK are unlikely to be systematically disadvantaged by a range of CVD prevention policies that have been proposed, or implemented, for the general population. Additional CVD prevention policies, in particular those based on the population approach, should be implemented.
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Tabatabaei, Ali Reza. "Parkinson's disease : etiology, prevention and treatment." Thesis, University of British Columbia, 1991. http://hdl.handle.net/2429/30382.
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This thesis consists of three chapters dealing with different aspects of Parkinson's disease (PD). 3-Acetylpyridine (3-AP), a naturally occurring neurotoxin, was studied for its neurodegenerative properties on the mesostriatal dopaminergic system in rats as a possible environmental cause of idiopathic PD. Chronic administration of this compound to rats caused a moderate but insignificant reduction of striatal dopamine (determined by HPLC measurement of striatal dopamine) and a more substantial degeneration of cerebellar neurons and their neurotransmitters (determined by amino acid analysis of cerebellum). Prophylactic use of a high dose of nicotinamide prevented the reduction of dopamine in the striatum as well as the severe behavioural manifestations induced by 3-AP in rats. The cerebellar damage, however, was not affected. Different mechanisms of damage by 3-AP in these structures were presumed based on the protective effects of nicotinamide in the substantia nigra but not in the cerebellum. Possible protective properties of MK-801 (a noncompetitive NMDA antagonist) and nicotinamide against MPTP neurotoxicity were also examined in mice. MK-801 treatment provided a substantial protection against MPTP-induced reduction of striatal dopamine. Nicotinamide on the other hand provided no such protection. Finally, a new controversial approach to the treatment of parkinsonism was evaluated. Nervous tissue from 13-15 day-old fetuses was transplanted into MPTP-treated mice. The transplanted material was harvested from different areas of the fetal brain and was prepared by various procedures to examine the possible bases of any improvement in the host animal. After two studies, we did not find a biochemical improvement in transplanted mice treated with MPTP regardless of the nature of the transplanted materials.Medicine, Faculty of
Anesthesiology, Pharmacology and Therapeutics, Department of
Graduate
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Raafat, Alaeddin. "Rh disease in Scotland : epidemiology and prevention." Thesis, University of Aberdeen, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.409274.
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The first Chapter in this thesis aims to present an adequate background information on the previous work. Short of introducing routine antepartum prophylaxis programme, the only avenues open to impact on the incidence of RhD alloimmunisation, were efforts to fine-tune the operation of the existing postpartum prophylaxis programme. This included improvement of the accuracy of measuring the volume of transplacental bleeds, in order to ensure that sufficient dose of anti-D is administered to afford protection against sensitisation. Chapter II discusses the results of a Kleihauer Quality Assurance Scheme in Scotland, and demonstrates that, this scheme was effective in bringing about a change in the practice of Kleihauer testing in Scotland, and introduction of greater standardisation and harmonisation of practice with trends towards improved test results. The data presented in Chapter III, provide data on the incidence of RhD alloimmunisation in Scotland and relate this incidence to similar results obtained using different methodologies and denominators. These data show that there had been no significant changes in the alloimmunisation rates over the previous decade. Mortality due to Rh disease had been underestimated, due to reliance on registry data. Combining registry data, information from the case notes of alloimmunised mothers and data from tertiary referral centre in Scotland, as set out in chapter IV demonstrated the true magnitude of fetal / neonatal loss in Scotland between 1987-1991 and provides some information on the long term sequelea of Rh disease. A total of 20 fetal losses occurred over this period, several fold greater than suggested by the registry data. Finally, in collaboration with Health Economic Research Unit in Aberdeen University, the above information was utilised to assess the economic aspects of introducing routine antenatal prophylaxis.
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Sime, Hazel A. "Disease in sheep flocks and its prevention." Thesis, University of Aberdeen, 1988. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU020968.
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To establish the prevalence of diseases in sheep flocks in North-east Scotland responsive to the application of preventative measures which may be incorporated in flock management plans. A survey of a sample of commercial sheep flocks was carried out to ascertain management and marketing practices. A critical assessment was made of the 'Flock Diary' 'Detailed' and 'Daily' Lambing Diaries produced by the Meat and Livestock Commission and their use. A mastitis survey showed an overall incidence for acute severe and chronic mild mastitis of 1.5% and 4.2% respectively. Orf was a particularly important predisposing factor. Antibiotic therapy at weaning resulted in a reduction in the number of ewes culled for chronic mastitis but growth rate of subsequent lambs was unaffected. A survey of trace element status of flocks showed that deficiencies were not always recognised especially selenium. On-farm trials were set up to examine the implications of copper, cobalt and selenium deficiencies and possible methods of control and monitoring. Trials of these procedures in commercial flocks included measurements of blood composition, ewe body condition score, lambing data, lamb birth weight and early growth rate. In lamb based trials blood composition and growth rate were the only parameters measured. Trials over a 4 week period were carried out to test the effectiveness of selenium-cobalt supplemented anthelminthics. The cobalt content of such products was inadequate to maintain pre-existing cobalt/vitamin B12 status in weaned lambs, however, selenium content induced a sustained rise in selenium/GSH-Px. Treatment with oxytetracycline reduced the number of chlamydial abortions in vaccinated gimmers while selenium treatment reduced the stillbirth rate. There was a suggestion that a compliment fixation titre of 1/16 was indicative of infection. Factors limiting implementation of preventive measures in flocks were the absence of performance and health records, accurate diagnosis, effective communication between farmers and external agencies and sources of integrated advice.
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Frauenberg, Sarah. "Aspirin Use for Primary Prevention of Cardiovascular Disease." Diss., North Dakota State University, 2019. https://hdl.handle.net/10365/29207.
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Cardiovascular disease (CVD) is a major cause of morbidity and mortality in the United States and aspirin is a well-known medication strongly associated with CVD prevention. Aspirin has undeniable benefits in the role of secondary prevention of CVD, however, the benefits are ambiguous when associated with primary prevention. The decision to start aspirin for primary prevention becomes complicated due to aspirin?s effect on coagulation and the risk of gastric ulceration. The United States Preventive Services Task Force (USPSTF) has level B recommendations in place regarding the use of low-dose aspirin (81 mg) for primary prevention of CVD. In addition, the American Heart Association (AHA) and American College of Cardiology (ACC) developed a calculator in 2013 to determine a patient?s 10-year CVD risk. The guideline and CVD calculator offer healthcare providers an easy-to-navigate tool to determine proper patient use of aspirin. However, despite the USPSTF guideline, appropriate aspirin use remains suboptimal. Successful adoption of the 2016 USPSTF guideline on aspirin use for primary prevention of CVD by providers in two rural North Dakota communities was the goal of this practice improvement project. The project began with education to providers and staff at the rural clinics regarding the USPSTF guideline and the ACC/AHA calculator. Following the educational session, implementation of the USPSTF guideline occurred for three months. Evaluation was performed through the use of a post-implementation survey. Results of the project demonstrated increased knowledge and usage of the guideline and a positive viewpoint related to implementation of the guideline with the providers in both of the communities having plans to sustain use in future practice. Data were also collected at a health screening fair in one of the rural communities to validate whether patients were taking aspirin per USPSTF guideline. Data gathered from the fair concluded only 59% of patients (41 out of 70) were taking, or not taking, aspirin appropriately according to the USPSTF guideline. Conclusively, primary care providers would be well served by using the ACC/AHA calculator and 2016 USPSTF guideline with all patients 40-79 years of age to determine appropriate use of aspirin for primary prevention of CVD.
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IJzerman, E. P. F. "Progress in diagnostics and prevention of Legionnaires' disease." [S.l. : [Groningen : s.n.] ; University Library Groningen] [Host], 2009. http://irs.ub.rug.nl/ppn/315954442.
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Basu, Rashmita. "Healthy lifestyle, disease prevention and health care utilization." Pullman, Wash. : Washington State University, 2009. http://www.dissertations.wsu.edu/Dissertations/Fall2009/r_basu_112309.pdf.
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Neubeck, Alicia Helen. "Increasing access to secondary prevention of cardiovascular disease." Thesis, The University of Sydney, 2011. https://hdl.handle.net/2123/27329.
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Background: Access to secondary prevention remains disconcertingly low despite proven
benefits. The objectives of this thesis were: to evaluate telehealth models of secondary
prevention; to determine barriers to participation in secondary prevention; to evaluate the
long-term outcomes of a previously proven telehealth model, CHOICE (Choice of Health
Options In prevention of Cardiovascular Events); to determine the replicability and
generalisability of CHOICE; and to determine future directions for delivery of secondary
prevention.
Methods: Mixed methods were utilised to achieve the objectives of this thesis. To
evaluate telehealth models, a systematic review and meta-analysis process was followed.
To determine the barriers to participation in secondary prevention, a systematic review and
meta-synthesis process was followed; to evaluate the long-term outcomes of CHOICE,
patients who had participated in the original single centre trial had a repeat assessment at
four-years after their baseline assessment; to determine the replicability and generalisability
of CHOICE, a multi-centre replication trial involving 270 participants was conducted; and
to determine future directions for delivery of SP, both quantitative and qualitative methods,
including survey and focus groups, were undertaken.
Results: Telehealth based models of secondary prevention can improve access, reduce risk
factors and improve quality of life in patients who do not participate in facility-based
secondary prevention programs. While there are a number of barriers to participation in
facility-based secondary prevention, some of which are potentially modifiable, it was clear
from our review that a one-size fits all approach will not be suitable and telehealth models
can provide additional options for access to secondary prevention. Results of the long-term
follow-up of the single centre trial demonstrated that at four years participants in CHOICE had maintained the significant improvements that they had made at one year. In the current
replication study results showed that participants were at lower baseline risk than in the
previous single-centre study, but still made improvements in multiple cardiovascular risk
factors. Finally, we determined that an Internet-based model of secondary prevention
would suit some, but not all, patients with cardiovascular disease and may provide an
additional option for patients not accessing facility-based programs
Conclusion: There are multiple barriers to the uptake of secondary prevention and
telehealth models can offer an evidence-based alternative to patients who do not access
facility-based programs. The CHOICE program is a flexible telehealth model that provides
long-term behaviour change and is readily translated into multiple clinical settings. Future
work could focus on utilising new technology to increase uptake to proven secondary
prevention models such as CHOICE.
9
Wahjoepramono, Eka J. "Role of testosterone in prevention of Alzheimer's Disease." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2012. https://ro.ecu.edu.au/theses/518.
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Waitayakul, Chittaya. "Effectiveness of the life skills program for HIV/AIDS prevention in Northern Thai housewives." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2006. https://ro.ecu.edu.au/theses/342.
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This research has applied a Life Skills Program to the health area of HIV/AIDS. The study included both qualitative and quantitative analyses especially designed to establish a strategy to prevent and control HIV/AIDS infection in Thailand. A pseudo-experimental research design was used with pre-test/post-test questionnaires and interviews. The lack of HIV/AIDS knowledge among Thai people and unsafe sexual behaviours place them at risk of acquiring HIV and AIDS. Thus, there is a need to construct a strategy to prevent and reduce the high risk behaviours associated with this infection. The study targeted housewives between the ages of 15 and 60 years living in urban and rural low-income areas in Nakhon Sawan Province in the south of the northern region of Thailand. One hundred housewives participated in the program.
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Zhao, Kun. "Mathematical Methods for Network Analysis, Proteomics and Disease Prevention." Digital Archive @ GSU, 2012. http://digitalarchive.gsu.edu/math_diss/6.
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This dissertation aims at analyzing complex problems arising in the context of dynamical networks, proteomics, and disease prevention. First, a new graph-based method for proving global stability of synchronization in directed dynamical networks is developed. This method utilizes stability and graph theories to clarify the interplay between individual oscillator dynamics and network topology. Secondly, a graph-theoretical algorithm is proposed to predict Ca2+-binding site in proteins. The new algorithm enables us to identify previously-unknown Ca2+-binding sites, and deepens our understanding towards disease-related Ca2+-binding proteins at a molecular level. Finally, an optimization model and algorithm to solve a disease prevention problem are described at the population level. The new resource allocation model is designed to assist clinical managers to make decisions on identifying at-risk population groups, as well as selecting a screening and treatment strategy for chlamydia and gonorrhea patients under a fixed budget. The resource allocation model and algorithm can have a significant impact on real treatment strategy issues.
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Rees, Lois. "The provision of disease prevention services from community pharmacies." Thesis, University College London (University of London), 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.339279.
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Hanzlicek, Gregg Alan. "Epidemiology, diagnosis, and prevention of bovine respiratory disease complex." Diss., Kansas State University, 2010. http://hdl.handle.net/2097/6685.
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Doctor of PhilosophyDepartment of Diagnostic Medicine/Pathobiology
David G. Renter
Bradley J. White
The objective of my research was to generate novel information concerning the epidemiology, diagnosis and prevention of bovine respiratory disease complex (BRDC), a common pre-weaning and post-weaning beef calf disease. To reach my objective, I conducted three prospective field trials within post-weaned calf populations, and one retrospective study of pre-weaned calves utilizing survey data. I evaluated differences in behavior, health and performance in calves receiving multiple component health programs. Calves in a minimally invasive program, which included primarily non-injectable products, displayed less aversion to initial product administration but experienced higher BRDC morbidity (P = 0.02) and poorer performance (P = 0.04) compared to calves in a more invasive (all injectable products) program. Secondly, in a study of Mannheimia haemolytica inoculated calves, I found that no parameter included in physical examinations, or common blood component evaluations could discern health from disease. However, disease recognition was aided by the measurement of the number of steps taken by a calf in a 24 hour period. None of the parameters that were evaluated predicted the severity of lung pathology. Thirdly, I conducted a study in post-weaned feeder calves that determined prevalence estimates for Mollicutes in general, and Mycoplasma bovis specifically, and their respective associations with health and performance. Nasal Mollicutes prevalence was high on arrival, and differences in calf performance were associated with (P < 0.01) nasal prevalence. More than half of the calves seroconverted to M. bovis; calves not seroconverting gained more weight (0.49 kg/head/day) during the study than those calves that did seroconvert (0.35 kg/head/day). Finally, I conducted a retrospective analysis of national U. S. cow-calf survey data to identify herd level management practices associated with pre-weaned calf BRDC. I found feeding antibiotics to pre-weaned calves, importing cattle, the number of outside visitors, economic purpose of the cow-calf operation, and breeding management of the herd were associated with herd-level pre-weaning BRDC rates. My research projects generated unique information concerning the epidemiology of important pathogens, differences among preventive health programs, objective BRDC diagnostic parameters, and pre-weaning BRDC risk factors. These research studies reinforce the complexity of BRDC and demonstrate the pathogen, animal and management factors affecting BRDC risk in pre- and post-weaned beef calves.
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Irewall, Anna-Lotta. "Recurrent events and secondary prevention after acute cerebrovascular disease." Doctoral thesis, Umeå universitet, Medicin, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-130505.
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Background Patients who experience a stroke or transient ischemic attack (TIA) are at high risk of recurrent stroke, but little is known about temporal trends in unselected populations. Reports of low adherence to recommended treatments indicate a need for enhanced secondary preventive follow-up to achieve the full potential of evidence-based treatments. In addition, socioeconomic factors have been associated with poor health outcomes in a variety of contexts. Therefore, it is important to assess the implementation and results of secondary prevention in different socioeconomic groups. Aims The aims of this thesis were to assess temporal trends in ischemic stroke recurrence and evaluate the implementation and results of a nurse-led, telephone-based follow-up program to improve blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) levels after stroke/TIA. Methods In study I, we collected baseline data for unique patients with an ischemic stroke event between 1998 and 2009 (n=196 765) from the Swedish Stroke Register (Riksstroke). Recurrent ischemic stroke events within 1 year were collected from the Swedish National Inpatient Register (IPR) and the cumulative incidence was compared between four time periods using the Kaplan-Meier survival analysis and the logrank test. Implementation (study II) and 1-year results (study III-IV) for the secondary preventive follow-up were studied in the NAILED (Nurse-based Age-independent Intervention to Limit Evolution of Disease) study. Between 1 Jan 2010 and 31 Dec 2013, the baseline characteristics of consecutive patients admitted to Östersund Hospital for acute stroke or TIA were collected prospectively (n=1776). Consenting patients in a condition permitting telephone-based follow-up were randomized to nurse-led, telephone-based follow-up or follow-up according to usual care. Follow-up was cunducted at 1 and 12 months after discharge and the intervention included BP and LDL-C measurements, titration of medication, and lifestyle counseling. In study II, we analyzed factors associated with non-participation in the randomized phase of the NAILED study, including association with education level. In addition, we compared the 1-year prognosis in terms of cumulative survival between participants and non-participants. In study III, we compared differences in BP and LDL-C levels between the intervention and control groups during the first year of follow-up and, in study IV, in relation to level of education (low, ≤10 years; high, >10 years). Results The cumulative 1-year incidence of recurrent ischemic stroke decreased from 15.0% to 12.0%. Among surviving stroke and TIA patients, 53.1% were included for randomization, 35.7% were excluded mainly due to physical or cognitive disability, and 11.2% declined participation in the randomized phase. A low level of education was independently associated with exclusion, as well as the patient’s decision to abstain from randomization. Excluded patients had a more than 12-times higher risk of death within 1 year than patients who were randomized. After 1 year of follow-up, the mean systolic BP, diastolic BP, and LDL-C levels were 3.3 mmHg (95% CI 0.3 to 6.3), 2.3 mmHg (95% CI 0.5 to 4.2), and 0.3 mmol/L (95% CI 0.1 to 0.4) lower in the intervention group than among controls. Among participants with values above the treatment goal at baseline, the differences in systolic BP and LDL-C levels were more pronounced (8.0 mmHg, 95% CI 4.0 to 12.1; 0.6 mmol/L, 95% CI 0.4 to 0.9). In the intervention group, participants with a low level of education achieved similar or larger improvements in BP and LDL-C than participants with a high level of education. In the control group, BP remained unaltered and the LDL-C levels increased among participants with a low level of education. Conclusion The 1-year risk of ischemic stroke recurrence decreased in Sweden between 1998 and 2010. Nurse-led, telephone-based secondary preventive follow-up is feasible in just over half of the survivors of acute stroke and TIA and achieve better than usual care in terms of BP and LDL-C levels, and equality in BP improvements across groups defined by education level. However, a large proportion of stroke survivors are in a general condition precluding this form of follow-up, and their prognosis in terms of 1-year survival is poor. Patients with a low education level are over-represented within this group and among patients declining randomization for secondary preventive follow-up.
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Collazzo, Yelpo Pablo. "New economic challenges for managing disease prevention and monitoring." Fondazione Gerardo Capriglione Onlus and Regent's University of London, 2017. http://epub.wu.ac.at/6035/1/Collazo_etal_2017_ORBMF_New%2Deconomic.pdf.
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Managing disease prevention and monitoring its progression benefits professionals facing the challenge of acquiring new knowledge and information for fighting the many diseases that negatively affect the life of people in areas such as public health systems, families, economic and business systems. From economic and operational points of view, Cancer Registries as organisations managing information by collecting, storing, reporting and interpreting data to improve cancer monitoring which is needed to plan health policies evaluation and design. Sustaining the role of the Cancer Registry as information system for fighting against cancer relies on paying attention on regulatory and ethical aspects with regard to the protection of confidential data, understanding and meeting the organisational challenges, learning from theory and practice emerging from the comparison of international experiences, bringing together voluntary, private initiatives of associations and public programs for sustaining the relevance of gathering and collecting data, information for knowledge about managing prevention and monitoring of the disease as core competence for driving public health systems towards sustainable development. Regulatory and organizational infrastructures help improve both information and knowledge management and design and implement effective measures and initiatives leading to efficacy in preventing and monitoring cancer disease as support to medical scientific research for cancer cure.
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Scott, Martha. "The primary prevention of asthma and associated allergic disease." Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/374749/.
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Bingham, Adrienna N. "Controlling Infectious Disease: Prevention and Intervention Through Multiscale Models." W&M ScholarWorks, 2019. https://scholarworks.wm.edu/etd/1582642581.
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Controlling infectious disease spread and preventing disease onset are ongoing challenges, especially in the presence of newly emerging diseases. While vaccines have successfully eradicated smallpox and reduced occurrence of many diseases, there still exists challenges such as fear of vaccination, the cost and difficulty of transporting vaccines, and the ability of attenuated viruses to evolve, leading to instances such as vaccine derived poliovirus. Antibiotic resistance due to mistreatment of antibiotics and quickly evolving bacteria contributes to the difficulty of eradicating diseases such as tuberculosis. Additionally, bacteria and fungi are able to produce an extracellular matrix in biofilms that protects them from antibiotics/antifungals. Mathematical models are an effective way of measuring the success of various control measures, allowing for cost savings and efficient implementation of those measures. While many models exist to investigate the dynamics on a human population scale, it is also beneficial to use models on a microbial scale to further capture the biology behind infectious diseases. In this dissertation, we develop mathematical models at several spatial scales to help improve disease control. At the scale of human populations, we develop differential equation models with quarantine control. We investigate how the distribution of exposed and infectious periods affects the control efficacy and suggest when it is important for models to include realistically narrow distributions. At the microbial scale, we use an agent-based stochastic spatial simulation to model the social interactions between two yeast strains in a biofilm. While cheater strains have been proposed as a control strategy to disrupt the harmful cooperative biofilm, some yeast strains cooperate only with other cooperators via kin recognition. We study under what circumstances kin recognition confers the greatest fitness benefit to a cooperative strain. Finally, we look at a multiscale, two-patch model for the dynamics between wild-type (WT) poliovirus and defective interfering particles (DIPs) as they travel between organs. DIPs are non-viable variants of the WT that lack essential elements needed for reproduction, causing them to steal these elements from the WT. We investigate when DIPs can lower the WT population in the host.
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Chu, Paula N. "Identifying High-Value Lifestyle Interventions for Cardiovascular Disease Prevention." Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:33493540.
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This dissertation evaluates lifestyle strategies for the management of cardiovascular risk factors and prevention of cardiovascular disease (CVD).
In Chapter 1, I systematically review and summarize the evidence of the effect of yoga, a popular mind-body practice, on cardiovascular disease and metabolic syndrome risk factors. I perform a narrative systematic review and a random-effects meta-analysis of randomized controlled trials (RCTs) of posture-based yoga practice. I find that yoga showed significant improvement in a variety of risk factors for CVD and metabolic syndrome, including body mass index, systolic blood pressure, and total cholesterol when compared to no or minimal intervention control groups. When compared to active exercise controls, yoga produced similar risk factor level reduction. Promising evidence supports yoga’s role in improving cardio-metabolic health. Findings are limited, however, by small trial sample sizes, heterogeneity, and moderate RCT quality.
In Chapter 2, I evaluate the comparative effectiveness of four different lifestyle strategies for reducing 10-year CVD risk. I used published literature on risk factor reductions associated with group therapy for smoking cessation, Mediterranean diet, aerobic exercise (walking), and yoga together with the Pooled Cohort risk algorithms to calculate a personalized optimal strategy for risk reduction based on different risk profiles. I find that for smokers, successful smoking cessation is an optimal strategy for reducing risk whereas for non-smokers or for smokers who do not quit successfully, stress reduction through yoga produces the greatest risk reductions.
In Chapter 3, I examine the cost-effectiveness of aerobic exercise and yoga compared to current medical practice for primary prevention of CVD in US adults. I use a subset of RCTs from Chapter 1, along with published literature on utilities, costs, and other parameters as inputs into a validated disease microsimulation model. I calculate the costs per quality-adjusted life year ($/QALY) of aerobic exercise and yoga with an exercise on prescription approach from the societal and healthcare perspective as well as if the activities were reimbursed. Results suggest that both interventions are not cost-effective using a threshold of $100,000/QALY due to high patient time costs in the societal perspective; when the activities are reimbursed and gains in quality of life are taken into account, then the activities can be cost-effective. Future research can explore patient preference and adherence and utility gains from physical activity.Health Policy
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Dolecheck, Karmella A. "DAIRY CATTLE HOOF DISEASE COSTS AND CONSIDERATIONS FOR PREVENTION." UKnowledge, 2018. https://uknowledge.uky.edu/animalsci_etds/84.
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Lameness is considered one of the most important health and welfare issues in the dairy industry. Understanding the total cost per case of disease-specific lameness can help producers select better treatment, prevention, and control strategies for their herds. The first objective of our research was to calculate the costs associated with 3 lameness causing hoof diseases: digital dermatitis, sole ulcer, and white line disease. To accomplish this, a survey of hoof health professionals (hoof trimmers and veterinarians) was conducted to identify treatment related expenditures per case. Data from the hoof trimmer responses to the survey and previously published research were incorporated into a farm-level stochastic simulation model to determine the expected costs per case of each disease and the most influential factors associated with disease costs. The cost per case was calculated by disease type, severity (mild or severe), incidence timing (0 to 60 days in milk, 61 to 120 days in milk, 121 to 240 days in milk, or > 240 days in milk), and parity group (primiparous or multiparous). The second objective of our research was to determine the economic value of investing in different lameness prevention strategies. Two prevention strategies were considered: 1) prevention of infectious hoof diseases and 2) prevention of non-infectious hoof diseases. The total expenditures (therapeutics, outside labor, on-farm labor, and prevention costs) and losses (discarded milk, reduced milk production, extended days open, increased risk of culling, increased risk of death, and recurrence losses) associated with each prevention strategy before and after prevention implementation were calculated and compared to find the breakeven investment cost.
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裴中 and Zhong Pei. "Neuroprotection of melatonin in ischemic stroke models." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31243526.
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Abdullah, Abu Saleh Md. "High risk lifestyles in Hong Kong : implications for the prevention of AIDS /." Thesis, Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B1986792X.
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Fleeton, Marina N. "Genetic vaccination against acute viral disease /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3811-3/.
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Shaw, I., BS Shaw, and GA Brown. "Influence of strength training on cardiac risk prevention in individuals without cardiovascular disease." African Journal for Physical, Health Education, Recreation and Dance, 2009. http://encore.tut.ac.za/iii/cpro/DigitalItemViewPage.external?sp=1001650.
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Abstract
It has widely been shown that exercise, particularly aerobic exercise, has extensive cardioprotective
benefits and is an important tool in the prevention of coronary heart disease (CHD). The present
investigation aimed to determine the multivariate impact of strength training, designed to prevent the
development of CHD, on the Framingham Risk Assessment (FRA) score. Twenty-eight healthy
untrained men with low CHD risk (mean age 28 years and 7 months) participated in an eight-week (3-
d/wk) strength training programme. Self-administered smoking records, resting blood pressures, total
cholesterol (TC), high-density lipoprotein cholesterol (HDLC), FRA scores and absolute 10-year risks
for CHD were determined at the pre-test and post-test. After the eight-week period, no significant (p >
0.05) differences were found in number of cigarettes smoked daily, systolic blood pressure, TC, HDLC,
FRA scores and absolute 10-year risks for CHD in both the strength-trained (n = 13) and non-exercising
control (n = 15) groups. The data indicate that strength training did not reduce the risk of developing
CHD and absolute 10-year risk for CHD as assessed by the FRA score.
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Wahman, Kerstin. "Cardiovascular disease prevention after spinal cord injury : a new challenge /." Stockholm, 2010. http://diss.kib.ki.se/2010/978-91-7409-936-2/.
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Moet, Fake Johannes. "Contacts of leprosy patients: occurance and prevention of the disease." [S.l.] : Rotterdam : [The Author] ; Erasmus University [Host], 2007. http://hdl.handle.net/1765/10513.
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巫志偉 and Chi-wai Mo. "Prevention and therapy of infectious bursal disease by molecular approaches." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B30253329.
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Clasen, Thomas Frank. "Household-based water treatment for the prevention of diarrhoeal disease." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2006. http://researchonline.lshtm.ac.uk/682347/.
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Unsafe drinking water, together with poor hygiene and sanitation, are the main contributors to diarrhoeal disease, a leading cause of mortality and morbidity especially among young children in low-income settings. While the Millennium Development Goals seek to halve the portion of the population without access to safe water by 2015, the high cost of piped-in supplies has led the World Health Organization to call for alternative approaches, including household water treatment. This thesis describes the results of certain research concerning the effectiveness, cost-effectiveness and field implementation of household water treatment for the prevention of diarrhoeal disease. In a systematic review of interventions to improve water quality for the prevention of endemic diarrhoea, 30 studies covering 38 intervention trials were identified and meta- analyzed. The studies varied considerably in design, setting, type of intervention and point of intervention. The evidence suggests that in settings with sufficient water quantity, interventions to improve the microbiological quality of drinking water are effective in preventing diarrhoea, and that household-based interventions are about twice as effective as conventional improvements at the water source. The costs of such water quality interventions was compiled and combined with the effectiveness data from the systematic review to determine the cost-effectiveness of interventions to improve water quality. In most settings, household water treatment meets established criteria for "highly cost effective" health interventions. In a six-month pilot programme in Colombia, household-based water filters were associated with a substantial improvement in microbial water quality and a 60% reduction in the prevalence of diarrhoea (OR = 0.40,95% CI = 0.25,0.63, P<0.0001). In a study to assess the drinking water response to the Indian Ocean tsunami, household water treatment had only a limited role, suggesting the need to consider under what circumstances such interventions can contribute to the delivery of safe drinking water in the immediate aftermath of an emergency. The thesis concludes with some thoughts on the challenge of implementing household water treatment and the need for further research.
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Assimes, Themistocles L., and Robert Roberts. "Genetics: Implications for Prevention and Management of Coronary Artery Disease." ELSEVIER SCIENCE INC, 2016. http://hdl.handle.net/10150/623131.
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An exciting new era has dawned for the prevention and management of CAD utilizing genetic risk variants. The recent identification of over 60 susceptibility loci for coronary artery disease (CAD) confirm not only the importance of established risk factors, but also the existence of many novel causal pathways that are expected to improve our understanding of the genetic basis
of CAD and facilitate the development of new therapeutic agents over time. Concurrently, Mendelian randomization studies have provided intriguing insights on the causal relationship between CAD-related traits, and highlight the potential benefits of long-term modifications of risk factors. Lastly, genetic risk scores of CAD may serve not only as prognostic, but also as
predictive markers and carry the potential to considerably improve the delivery of established prevention strategies. This review will summarize the evolution and discovery of genetic risk variants for CAD and their current and future clinical applications.
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Nuorti, J. Pekka. "Epidemiology of invasive pneumococcal disease in adults : implications for prevention." Helsinki : University of Helsinki, 2000. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/nuorti/.
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Mo, Chi-wai. "Prevention and therapy of infectious bursal disease by molecular approaches /." Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21490156.
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Howse, Eloise. "Public opinion, community attitudes and acceptability of chronic disease prevention." Thesis, The University of Sydney, 2021. https://hdl.handle.net/2123/25377.
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Chronic and noncommunicable diseases such as diabetes, cancer and cardiovascular diseases are a major health problem in Australia and worldwide. Four risk factors contribute to two thirds of the global risk for chronic disease: tobacco use; alcohol use; unhealthy dietary patterns and practices; and physical inactivity. Other risk factors such as obesity (high body mass) also increases risk of chronic disease. Addressing these risk factors is an important strategy to reduce and prevent chronic disease in populations. However, effective prevention of chronic disease is challenging as it requires addressing complex systems that drive these risk factors as well as introducing solutions that are effective, feasible and acceptable to populations. Prevention is particularly challenging when interventions are contested by commercial entities and industry groups.
This thesis focuses on an area of evidence needed for effective prevention: public opinion, community attitudes and acceptability. The views of the public or publics can directly and indirectly influence whether certain preventive interventions are introduced and sustained. The inverse also applies; public support can increase once interventions are implemented, such as in the case of tobacco control. In comparison, for other areas of chronic disease prevention there has been a more mixed picture of policy success, particularly in terms of addressing obesity, improving dietary patterns and food systems, reducing harmful alcohol use, and increasing physical activity. Understanding public opinion and acceptability of prevention that addresses these areas is an important step for implementation and sustainability of effective public health interventions that prevent disease and promote health.
In my thesis, I present original research on public opinion about prevention. I first provide an integrative review and narrative synthesis of the methods used to measure and understand public opinion and acceptability of prevention. I then analyse the opinions and attitudes of different groups or ‘publics’ using four methods. One quantitative method I use is a cross-sectional, nationally representative survey, the AUStralian Perceptions Of Prevention Survey (AUSPOPS). I analyse the 2018 results to ascertain whether age and gender influence Australians’ attitudes to prevention. I also analyse the results of a cross-sectional survey of a university population regarding attitudes about sugar-sweetened beverage regulation, which includes a qualitative analysis component. I use focus groups as a qualitative method to explore young adults’ views about food choices and public health nutrition policies. I also conduct a media analysis of a contested preventive policy to reduce alcohol-related harms in Sydney, Australia.
Through my thesis, I demonstrate that an improved understanding of what communities and groups think about specific policy interventions to prevent chronic disease, as well as more generally what they think are the role of different groups and sectors in responding to poor health, may assist in advancing policy and systems changes in prevention. I also demonstrate the importance of collecting both quantitative and qualitative data on public opinion to inform policy implementation. Furthermore, there is a crucial role for understanding how unhealthy commodity industries may be influencing public opinion and acceptability through strategic use of specific discourses in the public sphere, including news media.
An improved understanding of public opinion about prevention, including a demonstration of how public opinion is measured and the many factors that influence people’s opinions and attitudes, will allow for more effective implementation and sustainability of preventive policies and strategies to support wider systems change for improved population health.
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Alabi, Abayomi Olusegun Olanrewaju. "Aspects of bacterial disease prevention and control in penaeid prawns." Thesis, Bangor University, 1997. https://research.bangor.ac.uk/portal/en/theses/aspects-of-bacterial-disease-prevention-and-control-in-penaeid-prawns(303c65c2-1aa8-4510-adb5-b89d90be456a).html.
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Bacterial concentrations in natural sea water were significantly reduced by 5ptm filtration and subsequent treatment with ozone and UV light led to further reductions in total viable counts of bacteria and autoclaving water gave complete sterility. However, with the addition of artificial diets, such treated water was recolonised very rapidly and within 24h, these water samples had significantly higher bacteria counts than the 5pm filtered sea water treatment (f = 21.30; p<0.001). Further treatment of 5ýtrn filtered sea water also led to changes in the bacterial composition of the water. In ozonated and UV light irradiated water samples, the proportions of presumptive Vibrid sp. increased in the 24h following treatment while in 5ýLm filtered and natural sea water samples, the proportions of presumptive Vibrid sp. fell over the same period. When Penaeus indicus PZ1 stage larvae were reared to PI-1 stage in 5lam filtered sea water, good larval survival was obtained irrespective of whether live or microencapsulated artificial diets were fed. In contrast, larvae raised in autoclaved, ozonated and UV light irradiated water exhibited significantly lower survival when raised on live diets and often showed complete mortalities when fed on microencapsulated diets. In periods of poor sea water quality, additions of bacteria from algal cultures to PZ1 stage larvae fed algae had no effect on larval survival to M1 stage for larvae reared in 5gm filtered sea water or autoclaved water. In contrast, additions of these bacteria to larvae reared in 5pm filtered sea water and fed on MED, led to a significant increase in larval survival. This effect was absent when larvae were reared in autoclaved water. Addition of bacteria from algal cultures were found to inhibit counts of presumed viable Vibrid sp. while having no effects on total viable counts. No significant differences were observed in the percentage of soluble protein leached from microencapsulated diets and micro particulate diets when incubated up to 48h in bacterial laden and sterile water indicating that leaching is independent of microbial activity up to 48h. However broken microcapsules gave higher total viable bacterial counts over 48h in 5ýtm filtered sea water when compared with intact microcapsules. Significant levels of protection were conferred on larvae when either fresh or freeze-dried vaccines were administered by Immersion, but not when such vaccines were administered orally. The degree of protection offered was correlated with the virulence of the pathogen from which the vaccine was made. Enhanced protection given by vaccines produced from the more virulent strains was not wholly due to activation of the prophenoloxidase system since such vaccines induced less stimulation of the prophenoloxidase system than less virulent strains. Untreated plasma of Penaeus vannamei significantly enhanced Escherichia coli growth compared with sea water nutrient medium. In contrast, plasma from vaccinated prawns exhibited antibacterial activity detectable up to 7d after vaccination. Exposure to a mixture of fungicides Implicated in the initiation of the taura syndrome disease (TS), had no effects on the immune competence of P. indicus juveniles following live, in vivo pathogenic challenge. In addition, no effects on growth, growth rates, moulting rates or survival of postlarval and early juvenile prawns were observed following exposure to the fungicides. Prawns exhibited no gross or histopathological symptoms characteristic of TS.
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Blackman, Nicole. "Chronic Disease and Injury Prevention Programming for Canada's Indigenous Population." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5165.
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Local public health units in the province of Ontario, Canada, are often the primary source of health promotion and health education resources, but many do not provide programming specific to the Indigenous population. As of January 2018, modernization of the Ontario Public Health Standards requires public health units to work with the Indigenous population in providing culturally appropriate programs and services. The practice question guiding the capstone project was to determine what chronic disease and injury prevention programs exist that are culturally appropriate for the Indigenous population. The purpose of this project was to do an environmental scan and compile an inventory of existing health promotion programming that is culturally appropriate to the Indigenous population. In total, 72 Indigenous-specific programs were identified from the 26 organizations that were included in the environmental scan. Of the 26 organizations, 3 were public health units, 7 were Aboriginal health access centers, 7 were Indigenous friendship centers, 5 were Indigenous health organizations, and 4 were non-Indigenous organizations with an Indigenous component. Results from the capstone project will inform public health units of available, culturally appropriate programs that can be adapted to their local context, thereby addressing a significant gap in the current public health system. This doctoral project aligns with the design of a new model of care in the Ontario public health system and has the potential to address a gap in practice at both the local and provincial level by providing culturally appropriate guidance in the effective delivery of CDIP programming specific to the Indigenous population. This positive social change would impact the health status of this underserved population.
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Wright, Ashley D., and Elizabeth A. Greene. "Rabies in Arizona: Equine Risk and Prevention." College of Agriculture, University of Arizona (Tucson, AZ), 2016. http://hdl.handle.net/10150/608256.
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4 pp.The Informed Arizona Equestrian Horse Health Series was designed to bring up to date information on issues of importance to the horse owners of Arizona and beyond. Rabies has been identified in horses in Arizona (most recently Santa Cruz county in 2016), and is not only fatal for horses, but also can affect the humans handling those horses. It is often overlooked as a possible diagnosis due to the nonspecific early signs of infection. Find out how to protect you and your horses from this devastating disease.
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李雯靜 and Man-ching Anney Lee. "Effects of the disease management programme with nurse-led heart failure clinic." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B40721036.
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Masoud, Mohamed Abdulsalam. "Validation of a recently proposed equation for the estimation of small, dense LDL particles from routine lipid measures in a population of mixed ancestry South Africans." Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2490.
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Thesis (MSc (Biomedical Technology))--Cape Peninsula University of Technology, 2016.Cardiovascular diseases (CVD) are the leading cause of global mortality, of which over 75% occurred in low- and middle-income countries such as South Africa. The lipid profile, specifically decreased levels of high density lipoprotein cholesterol (HDL-C), elevated triglyceride levels and the presence of small-dense low density lipoprotein (sdLDL) has been reported associated with CVD. An increased number of sdLDL is also common in metabolic syndrome (MetS), visceral obesity and diabetes mellitus, the last a known risk factor for CVD. The modification of low density lipoprotein (LDL) size, or number of sdLDL particles, has been reported to significantly reduce CVD risk, but not conclusively so and needs further investigation. In this regard, sdLDL particles are seldom estimated routinely for clinical use because of financial and other limitations. Currently, an alternative approach for estimating sdLDL is to use equations derived from routine lipid measures, as has been proposed by several groups. However, there is a need for extensive evaluation of this equation across different ethnic and disease groups, especially since reports showed an inadequate performance of the equation in a Korean population. The aim of this study was to assess the performance of a recently proposed equation for the estimation of sdLDL in healthy and diabetic mixed ancestry South Africans. Furthermore, we also investigated the role of sdLDL as a cardiometabolic risk factor, as measured against known risk factors such as the glycemic and lipid profiles.
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Dawson, Jesse. "Prevention of stroke risk stratification and targeted and novel therapies /." Thesis, Connect to e-thesis, 2009. http://theses.gla.ac.uk/851/.
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Thesis (MD.) - University of Glasgow, 2009.MD. thesis submitted to Division of Cardiovascular and Medical Sciences, University of Glasgow, 2009. Includes bibliographical references. Print version also available.
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Greene, Elizabeth A., Ashley Diane Wright, and Nicole Ludwig. "Barn Smarts for Biosecurity: Tips for Keeping Your Horse Safe and Healthy." College of Agriculture, University of Arizona (Tucson, AZ), 2016. http://hdl.handle.net/10150/625413.
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8 pp.By making several simple horse care changes, you can significantly decrease your horse’s risk of exposure to disease. Using the tips below, you may prevent your horse from being exposed to sick horses while away at a show. If your horse were to bring a virus home, proper Biosecurity practices could result in just one sick horse, as opposed to a whole barn full. The intent of this article is to inject a little humor while providing key common sense tips on Biosecurity. Each tip is accompanied by an easy to remember theme and cartoon. These changes seem small but they can make a big difference in protecting the health of your horse. .
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Vedin, Ola. "Prevalence and Prognostic Impact of Periodontal Disease and Conventional Risk Factors in Patients with Stable Coronary Heart Disease." Doctoral thesis, Uppsala universitet, Institutionen för medicinska vetenskaper, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-260564.
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The purpose of this thesis was to assess the prevalence and management of established cardiovascular (CV) risk factors and the prevalence and influence of self-reported markers (number of teeth and frequency of gum bleeding) of periodontal disease (PD), a less explored CV risk factor, in patients with stable chronic coronary heart disease (CHD). We studied patients from the global STabilization of Atherosclerotic plaque By Initiation of darapLadIb TherapY (STABILITY) trial (n=15,828), in which patients with stable chronic CHD were randomized to either darapladib or placebo. Our studies were performed using descriptive statistics and multivariable linear, logistic and Cox regression models. The use of secondary preventive medications was generally high across the whole study population. Despite this, CV risk factors were highly prevalent, including obesity, hypertension and hypercholesterolemia. Achievement of guideline-recommended treatment targets was lacking and little improvement was seen throughout the study duration. Approximately 40% of patients reported having <15 remaining teeth and 25% reported gum bleeding. More tooth loss was associated with a greater CV risk factor burden after adjustment, while the associations for gum bleeding were less evident. After multivariable adjustment for CV risk factors and socioeconomic status, more tooth loss was associated with an increased risk of major adverse CV events (a composite of CV death, myocardial infarction and stroke), CV mortality, all-cause mortality and fatal or non-fatal stroke. We found associations between a higher degree of tooth loss and elevated levels of several prognostic biomarkers known to reflect various pathophysiological mechanisms involved in CV morbidity and mortality. Most biomarkers had little attenuating effect on the relationship between tooth loss and outcomes in a multivariable model. In conclusion, we found an inadequate CV risk factor control despite a high use of evidence-based pharmacological therapies, likely to explain some of the excess risk in CHD patients. Further, we demonstrated a high prevalence of PD markers, tooth loss in particular, that were associated with a wide range of established CV risk factors, prognostic biomarkers and outcomes. Collectively, these findings indicate that tooth loss may be a significant risk factor among patients with stable chronic CHD.
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Slaughter, Geoffrey. "Beyond Disease-Oriented Care for the Uninsured: Increasing Access to Prevention." Thesis, The University of Arizona, 2018. http://hdl.handle.net/10150/626889.
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Bricknell, Martin Charles Marshall. "The prevention of heart illness in the British Army." Thesis, University of Southampton, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.302346.
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Bayoumy, Hassan, and L. O. Averyanova. "Actual problems of stroke disease cure in Egypt." Thesis, Харків, ХНУРЕ, 2019. http://openarchive.nure.ua/handle/document/8375.
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The causes of stroke disease in Egypt are considered. The diagnosis of stroke is explained, and the used diagnostic instruments are studied. The prevention liver cancer is explained. The treatment of each of the causes of liver cancer is analyzed.
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Du, Plooy Frederik Simon. "Perceptions of HIV/AIDS prevention workers in Soshanguve of the role of traditional African beliefs in HIV/AIDS prevention." Diss., Pretoria : [s.n.], 2004. http://upetd.up.ac.za/thesis/available/etd-02172005-103325.
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Barber, Michael. "Mechanisms and prevention of protein aggregation." Thesis, University of Oxford, 2016. https://ora.ox.ac.uk/objects/uuid:924a4f23-a2d3-49af-b201-f29295bdf442.
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The deposition of amyloid in the central nervous system is associated with prevalent neurological disorders such as Alzheimer's and Parkinson's disease. This thesis studies the mechanisms and prevention of amyloid formation in vitro. We specifically focus on Parkinson's disease associated α-synuclein (α-syn). Using novel labeling methods we introduce NMR observable labels onto lysosomal protein glucocerebrosidase (GCase), a leading cause of Parkinson's disease. By introducing NMR active labels we are able to study GCase dynamics and screen potential drug therapeutics (chapter 3). Furthermore, we analyze the three way interaction between GCase, α-syn and lipids. We conclude that GCase is able to effectively chaperone α-syn under lysosomal conditions, both preventing amyloidogenesis and destabilizing mature amyloid fibrils (chapter 4). Additionally, a model chaperone-aggregate system is investigated to gain insight into the mechanisms of small heat shock protein chaperoning, and how such mechanisms prevent aggregation (chapter 5). Finally, a high resolution crystal structure of RNA editing enzyme Cid1 is presented, whilst not directly linked to aggregation, many of the techniques used in this thesis were first developed on Cid1 (chapter 7). Together, we utilize NMR, X-ray crystallography, electron microscopy and native mass spectrometry to elucidate aspects of protein aggregation mechanisms and prevention.
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LeBlanc, Stephen. "Prevention, diagnosis and treatment of postpartum uterine disease in dairy cattle." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/NQ61979.pdf.
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Song, Zhi 1970. "Antibiotic use in secondary prevention of cardiovascular disease : a pharmacoepidemiology study." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=98804.
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Background. Several trials of antibiotic use for the secondary prevention of cardiovascular diseases have been performed but individual studies have produced conflicting and inconclusive results. Therefore, we performed a systematic review of published studies to synthesize the evidence. We also examined a large cohort of previously revascularized patients to assess if a small but meaningful benefit of antibiotic exists.Research question. Whether antibiotic use, compared to non-use, can reduce future cardiovascular events in a population of previously revascularized patients.
Method. A meta-analysis and a nested case control study were both conducted to answer the research question. In the meta-analysis, PubMed and the Cochrane Central Registry of controlled trials were searched for studies published between January 1 1994 and December 31 2004 using keyword 'antibiotic use' and 'cardiovascular diseases'. 232 published papers were initially identified and 12 randomized trials meet our inclusion criteria. The data were combined using a random effects model. A sensitivity analysis with a fixed effects model was also performed. Our nested case control study was conducted on a cohort of all individuals ≥65 years of age who had a revascularization procedure from 1995 to 2000 and were registered in the Quebec universal health databases. The discharge date of each patient after revascularization was date of cohort entry. The primary endpoint was a composite of death, myocardial infraction and repeat revascularization. For each case, five controls were randomly selected and matched by date of cohort entry and age to the cases. Current users of antibiotics, those whose last prescription overlapped with the index date, were compared to individuals who were not exposed to antibiotics in the year preceding the event. Similarly the risk of recent (1-6 month) and past (6-12 months) antibiotic exposure was estimated. Odds ratios were calculated by using conditional logistic regression and adjusted for potential confounders.
Results. Our meta-analysis identified the 12 studies which randomized 10 231 patients to antibiotic treatment and 10 144 patients to control. The odds ratio for the composite event endpoint of death, myocardial infarction or revascularization was 0.92 (95CI%: 0.84-1.02). A similar result was found using a fixed effect model. No evidence for publication bias was found. Our nested case control study included 6 117 cases and 30 573 controls. The adjusted odds ratios of cardiac events for any current, recent and past antibiotic use were 1.12 [95%CI: 0.98-1.29], 1.21[95%CI: 1.07-1.28] and 1.31 [95%CI: 1.15-1.48], respectively.
Conclusion. No prevention association between antibiotic use and future cardiovascular events was shown either in the meta-analysis or our nested case control study. On the contrary, our nested case control study suggested increased risk long term following antibiotic exposure. One hypothesis to explain these results is that antibiotic exposure is a surrogate marker for a heightened inflammatory status that is associated with later cardiovascular risk.
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Love, Thomas. "trends in the Secondary Prevention of Heart Disease in Primary Care." Thesis, University of Dundee, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.500641.
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Irving, Laura. "IVF based approaches towards the treatment and prevention of mitochondrial disease." Thesis, University of Newcastle upon Tyne, 2014. http://hdl.handle.net/10443/2567.
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Mitochondria are strictly maternally inherited, with all paternal mitochondria being destroyed following fertilisation. Women known to be carriers of pathogenic mtDNA mutations are therefore at increased risk of conceiving affected children. These women are currently offered the following options to aid in genetic counselling: oocyte donation, prenatal genetic diagnosis (PND) or preimplantation genetic diagnosis (PGD). One of the aims of this thesis, was to examine the feasibility of PGD for mtDNA inherited disorders, with specific emphasis on answering the following questions: how accurately does the mutation load observed in the biopsied blastomeres reflect the mutation load in the remaining embryo, are those mutation loads initially observed in the biopsied blastomeres maintained throughout preimplantation embryonic development and do mutation loads observed in the inner cell mass reflect those mutation loads observed in the extra-embryonic trophectoderm cells? In my thesis, I have now been able to provide data towards answering each of these questions through the examination of mutation loads in oocytes, embryos and blastocysts obtained from mitochondrial patients undergoing fertility treatment. Techniques, which have been developed in my current laboratory, have facilitated the characterisation of a nuclear transfer technique known as pronuclear transfer (PNT). This is a method to prevent the transmission of mitochondrial DNA disease from mother to child (Craven et al, 2010). As part of the work for my thesis, I have examined the reproducibility of the PNT technique by assessing whether the procedure could be performed by different operators, whilst maintaining levels of efficiency, survival and developmental outcome. Experiments are now being performed to examine the feasibility of PNT in normally fertilised human zygotes, created from donated oocytes. As it is unlikely that egg collection will be possible from two independent donors on the same day, the final purpose of this study was to examine the potential and feasibility of vitrification of eggs or fertilised embryos at both the pronuclear (PN) and Metaphase II (MII) stage for the purpose of the PNT technique. In summary, my studies has examined the reliability of current methods to reduce the likelihood of having a child affected by a mitochondrial DNA disorder and new techniques currently being developed to prevent the transmission of defective mitochondrial DNA, altogether. I hope this will provide fresh hope for patients with mitochondrial DNA disease.
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Dong, Mia, Masud Husain, David Brooks, Max Wilson, Michael Craven, Frédéric Destrebecq, Jean Georges, and Kim Baden-Kristensen. "Alzheimer’s Disease (AD) Detect & Prevent: presymptomatic AD detection and prevention." TUDpress, 2019. https://tud.qucosa.de/id/qucosa%3A36693.
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Alzheimer’s disease (AD) is a major cause of the rapidly growing and crushing aging challenge that threatens to economically undermine today’s healthcare system. AD prevalence will grow to over 100 million cases in 2050. AD is incurable but can be prevented. Therefore, the most viable solution may be to detect very early signs of AD (presymptomatically) in citizens-at-risk and to intervene in time to reduce AD risk or prevent it entirely. The present project will refine and validate two breakthrough innovations for AD detection and AD prevention and commercialize them as a one-stop digital medical device, named ‘AD Detect & Prevent’. The first innovation is a highly sensitive cognitive assessment method recently pioneered by a group of researchers that has been shown to detect subtle presymptomatic stage cognitive decline specific to AD. This will be integrated with the second innovation – a digital AD prevention programme delivered on an award-winning computerized cognitive training and rehabilitation platform (app + web) that uses high intensity immersive and adaptive ‘neurogames’ and audio-based therapy for behavioural intervention, designed for strengthening core cognitive functions, building cognitive reserve, changing lifestyle and thus reducing the overall AD risk in individuals. The detection and prevention methods will undergo vigorous scientific validation, and the ambition is to create and become the global standard of care for precise presymptomatic detection of AD and effective AD prevention.
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Ruminjo, Irene Nyawira Wahome. "Retired, Unmarried, Male Baby Boomer Attitudes and Behaviors Toward Disease Prevention." Thesis, Walden University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10286199.
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Preventive health care is effective in reducing both infectious diseases and chronic conditions among the elderly. Despite efforts to prevent or decrease the risk of illness, unmarried men are less likely to receive selected preventive services compared to married men. The purpose of this cross-sectional survey was to describe disease prevention attitudes and behaviors of retired, unmarried, male baby boomers residing in Harlingen, Texas. Further, the study examined the effects of socioeconomic status on disease prevention attitudes and behaviors. The health belief theory framed the study. A validated questionnaire collected disease prevention attitudes, behaviors, and sociodemographic characteristics data. Data inquiry included ANOVA, multiple regression and moderation analysis. The findings did not show any differences in disease prevention attitudes and behaviors among retired, unmarried male boomers. Multiple linear regression indicated that the socioeconomic factors explained 24% of the variance in disease prevention behaviors (p = .001). Moderation analysis showed that 29% of the variability in the dependent variable could be explained by the independent variables and interaction terms. The only significant predictor was education, p= .002); none of the interaction terms were significant. Positive social change from the study is the possible increase in disease prevention behavior among the retired, unmarried male baby with a low level of education. The study results may help in developing policies that would target education barriers and raise awareness of disease prevention behavior among the retired, unmarried male baby boomers.