Dissertations / Theses on the topic 'Health aspects'
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1
Harrison, Helen E. "In the picture of health, portraits of health, disease and citizenship in Canada's public health advice literature, 1920-1960." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/NQ63424.pdf.
2
Heintz, Emelie. "Health economic aspects of diabetic retinopathy." Doctoral thesis, Linköpings universitet, Utvärdering och hälsoekonomi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-76283.
Abstract:
To ensure that the resources of the health care sector are used effectively, new technologies need to be evaluated before implementation to examine if they generate health outcomes at an acceptable cost. This information can be collected by performing health economic evaluations in which the costs and health outcomes of different technologies are compared. To estimate the effect on health care budgets, there is also a need for information about the prevalence of the specific disease. Health outcomes in health economic evaluations are often measured in quality-adjusted life years (QALYs), which are calculated by multiplying the remaining life years after an intervention by a weight representing the health-related quality of life (HRQoL) during those years. This thesis aims to provide deeper knowledge of the health economic aspects of diabetic retinopathy (DR), an eye complication that affects patients with diabetes and may in the worst case lead to blindness. The focus is on three empirical and two methodological health economic research questions. The empirical research areas cover prevalence, costs, and HRQoL related to patients with DR. The methodological research questions explore the performance of different methods for estimation of QALY weights. This is of interest since it has been argued that the most common methods for estimating QALY weights may not capture all relevant vision-related aspects of quality of life. The analyses comprehend the validity of different methods for estimating QALY weights among patients with DR and if the results of one of the specific methods for estimating QALY weights, the time trade-off (TTO) exercise, are affected by patients’ subjective life expectancy (SLE). The empirical results demonstrate that DR is seen in approximately 40% and 30% of patients with type I and type II diabetes respectively, indicating that the prevalence of DR has decreased in both of these patient groups. Healthcare costs vary considerably between different severity levels of the disease, being estimated at €26, €257, €216, and €433 per patient per year for background retinopathy, proliferative diabetic retinopathy (PDR), diabetic macular oedema (DMO), and PDR combined with DMO respectively. Blindness due to DR is associated with an increased use of transportation services, caregiving services, and assistive technologies as well as productivity losses. This suggests that preventing the progression of DR may lower healthcare costs. Patients with vision impairment due to DR have lowered HRQoL in various dimensions, but the diagnosis of DR in itself has only a limited effect on HRQoL. The results on the methodological research questions show that different methods for estimating QALY weights seem to give different results. In comparison to EQ-5D, the Health Utilities Index Mark 3 (HUI-3) is the most sensitive method for detecting differences in QALY weights due to DR, and if decisions are to be made based on values from the general public, it can be recommended for use in cost-utility analyses of interventions directed at DR. Neither of the direct methods, TTO and the visual analogue scale, seems to be sensitive to differences in visual function, and more research is needed concerning the role of vision in people’s responses to the TTO exercises. In TTO exercises with time frames based on actuarial life expectancy, the patients’ SLE has an effect on their willingness to trade off years for full health. Thus, applying time frames deviating from patients’ SLE may result in biased QALY weights. Such bias may appear stronger within patient populations than within the general public. In conclusion, this thesis offers estimates for prevalence, costs, and QALY weights that can be used in economic evaluations of interventions directed at DR and as benchmarks for future DR research in order to follow up consequences of changes in diabetes care. In addition, it demonstrates that the choice of method for estimating QALY weights may have an impact on whether an intervention is considered cost-effective.
3
Rickayzen, Benjamin David. "Some actuarial aspects of health insurance." Thesis, City University London, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.446443.
4
Reineholm, Cathrine. "Psychosocial Work Conditions and Aspects of Health." Doctoral thesis, Linköpings universitet, HELIX Vinn Excellence Centre, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-95578.
Abstract:
Today’s working life has led to new requirements and conditions at the workplace, and additional factors may be of importance for employees’ health. Most earlier research has taken place in stable organizations, and has not taken changes in organizations into account. The way in which psychosocial work conditions affect employees’ health and well-being has been the topic of several studies but mental ill health is still one of the most common causes of sick leave in Sweden. Little attention is given to the importance of the workplace and organizational context for employees’ health. The overall aim of this thesis is to investigate how different aspects of health are associated with psychosocial work conditions in today’s working life. This thesis comprises two empirical studies. The first study is a longitudinal study, based on questionnaire data from 1010 employees at the Swedish Labour Market Administration. The second study is designed as a prospective cohort study, based on questionnaire data from 8430 employees in ten organizations, participating in the LOHP project. Linear and logistic regressions were performed to investigate associations between psychosocial work conditions and different aspects of health. Multilevel analysis was performed in one paper. The main findings in Paper I are that traditional job stress models are better for predicting ill health than good health. Different psychosocial work conditions may however, be useful for measuring different aspects of health, depending on whether the purpose is to prevent ill health or to promote health. In Paper II, psychosocial work conditions and symptoms of burnout were found to differ between different hierarchical levels, and different psychosocial work conditions were associated with symptoms of burnout at different hieratical levels. Paper III showed that psychosocial work conditions predict voluntary job mobility, and this may be due to two forces for job mobility: job dissatisfaction and career development. In Paper IV, a strong association between high work ability and better performance was found. Clear goals and expectations may result in improved psychosocial work conditions and work ability, which in turn affects employees’ performance. This thesis has provided knowledge regarding different aspects of health and psychosocial work conditions. Conditions at the organizational and workplace level set the prerequisites for if and how employees use their resources and their ability to act. Access to resources and the capacity to use them may vary depending on the employees’ hierarchal position. Occupational health research needs to focus on differences in psychosocial work conditions at different hierarchical levels. Organizations with clear goals and expectations may create more favourable conditions at work, supporting employees’ room for manoeuver, social capital and their ability to cope with working life, hence promoting health. Health promotion has a holistic approach and considers the work environment, the individual and the interplay between them. However, most health interventions at workplaces are directed to employees’ health behaviour rather than improvements in organizational and work conditions. To develop a good work environment it is necessary to identify conditions at work that promote different aspects of health. These conditions need to be tackled at the organizational, workplace and individual level, as good health is shaped by the interplay between the employee and the conditions for work.
5
Hreinsson, Julius, and Yonathan Woldearegay. "Internationalization of health care services : Networking aspects." Thesis, Uppsala universitet, Företagsekonomiska institutionen, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-243306.
Abstract:
Principles of business management are increasingly being used to analyze health care systems. Conceptualizing health care as business networks offers the possibility to apply the ARA model of Actors, Resources and Activities to understand the functioning of the system. We have used this model to study the phenomenon of networking in cross-border care using Uppsala University Hospital as a research case. The aim of the study was to understand actor’s perceptions of networking activities and how these related with international sales of health care services. We collected primary data through five interviews with managers involved in internationalization and a survey study with 26 managers at the hospital. Secondary data on patient flows and research activity was collected from hospital and university records. The main actors identified in the health care networks are doctors with professional identity being an important facilitating factor. Patient´s role as active participators in the system is increasing while researchers, innovators and key opinion leaders are also important. Networking activities consist of knowledge transfer via lecturing, meetings and external consulting activities. Resources in the form of supporting clinics, research centers and administrative services correlate positively with the level of internationalization. The study identifies networking activities as important for internationalization and cross-border sales of health care services. We conclude that the ARA model is a valuable instrument for analyzing cross border activities and internationalization of health care.
6
Robertson, Kevin. "Health-related psychological aspects of playing squash." Thesis, Liverpool John Moores University, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.282785.
7
Leo, Jared. "Capturing temporal aspects of bio-health ontologies." Thesis, University of Manchester, 2016. https://www.research.manchester.ac.uk/portal/en/theses/capturing-temporal-aspects-of-biohealth-ontologies(a2f5868e-94e3-4d4b-bd1e-311358ebf7e0).html.
Abstract:
Extending Descriptions Logics (DLs) with a temporal dimension to aid in the ability to model meaningful temporal information is an active and popular research area that has gathered a lot of attention over recent years. DLs underpin the Web Ontology Language (OWL) which offers a way to describe ontologies for the semantic web. Representing temporal information in ontologies plays an important role, specifically for those ontologies where time information is inherently embedded in the information they describe. This is very common for ontologies in the bio-health domain, for example ontologies that describe the development of anatomies of biological entities, stage based development, evolution of diseases and so on. As expressive as DLs are, given that they are fragments of First Order Logic, they are static in nature and are limited in what they can express from a temporal view point, hence the surge in temporal extensions to DLs over recent years. In this thesis we investigate the use of temporal extensions of DLs as suitable representations for the temporal information required for bio-health ontologies. We first set out to find out exactly what types of temporal information need to be modelled, before going on to evaluate current temporal extensions and representations to determine their suitability. We then go on to introduce several new temporal extensions to DLs and evaluate their suitability.
8
Bamford, Margaret. "Aspects of health among an employed population." Thesis, Aston University, 1993. http://publications.aston.ac.uk/10867/.
Abstract:
This survey collected information on aspects of health amongst an employed population, employees in 14 different organisations in the West Midlands Regional Health Authority; and was a stratified sample of senior managers, middle managers and operatives. Nine hundred and sixty questionnaires were distributed asking for both quantitative and qualitative information on 58 questions covering health, work, family, leisure activities and life-style. A response rate of 48% (459 returned questionnaires) came from 290 men (63%), 165 women (36%) and four people (1%) who did not answer the gender question. The initial findings from this study are unique in that there has not been a specific review of the health of people at work. In answer to the main research questions, 92% felt they were healthy. Compared to others of a similar age, 34% felt their health was `above average', 58% `average', and 7&37 `below average'. Thirty two percent of respondents had visited their GP in the past 1-2 months; the highest reason given was disorders of the respiratory system, 20%. People's perceptions on the effects of work on their health were: good effect, 13% fair effect, 20% no effect, 27% poor effect, 27% and bad effect, 7%. The effects of leisure activities on health were thought to be more positive: good effect, 46% fair effect, 20% no effect, 21% poor effect, 3% and bad effect, 2%. The perceptions of effects of life-style on health were considered to be: good effect, 32% fair effect, 32% no effect, 20% poor effect, 9% and bad effect, 1%. In this survey, leisure and life-style were seen by employees to have more beneficial effects on health than work. Future implications include a review of occupational health as a major policy development area within primary care. There is a need to influence the education and training of health care practitioners in order to affect their ability to practise effectively in this new and challenging area of work.
9
Schützhold, Svenja [Verfasser]. "Aspects of oral health in the German Oral Health Studies / Svenja Schützhold." Greifswald : Universitätsbibliothek Greifswald, 2016. http://d-nb.info/1082577367/34.
10
Urassa, David Paradiso. "Quality Aspects of Maternal Health Care in Tanzania." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distrubutör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4221.
11
Slattery, M. "Demographic aspects of resource allocation to Health Services." Thesis, University of Southampton, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.374235.
12
Allin, Sara. "Examining aspects of equality in Canada's health system." Thesis, London School of Economics and Political Science (University of London), 2009. http://etheses.lse.ac.uk/2326/.
Abstract:
Canada's health system is based on the firmly-held belief that the receipt of care should be based on need and not ability to pay. This thesis examines three aspects of this equity goal: provincial variations in equity in the receipt of care; the role of private prescription drug insurance in explaining inequity in the use of physician services; and the equity implications of subjective unmet need. Canada's provinces are responsible for planning and funding most publicly insured health services, hence there is variation in health system characteristics across the country. In the context of such variation, the first empirical analysis examines equity in the use of health services across the provinces. The analysis reveals some evidence of inequity in the likelihood of a GP visit, and the likelihood and number of specialist and dentist visits; some variations can also be found across the provinces. The second empirical analysis investigates the role of complementary insurance for prescription drugs in explaining inequity in the use of publicly-funded physician services. Due to the complementary relationship between prescription drugs and physician services, and the unequal distribution of private insurance coverage across income groups, inequity in physician utilisation partly can be explained by the interaction with insurance. The third empirical analysis assesses the equity implications of subjective unmet need. It finds that there are different utilisation patterns among the different types of unmet need, which raises methodological and conceptual challenges. The concluding chapter positions the three empirical studies within the broader policy context, offers an in-depth discussion of their methodological and policy implications, and proposes areas for future research.
13
Mani, Kevin. "Abdominal aortic aneurysm epidemiological and health economic aspects /." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-110810.
14
Franks, Susan F. (Susan Faye). "Negative Psychological States: Predictors for Immunological Health." Thesis, University of North Texas, 1992. https://digital.library.unt.edu/ark:/67531/metadc332521/.
Abstract:
Relationships of negative psychological conditions with general status of cell-mediated and humoral immune systems were investigated. A unique approach was utilized in that indexes representing multiple aspects of each branch of the immune system were employed to better indicate general immunological status. Differences in emotion-immune interactions between males and females were demonstrated. Results indicated a positive relationship between Trait Anger and Cell-Mediated Immunological Index. Particular criticisms of previous psychoneuroimmunological research were met by addressing sex differences and differences in various conditions of anger and depression, as well as through assessment of cumulative effects of negative emotions on immune system status. Directions for future research in eddressing similar issues are suggested. In general, results provide support for validity of mindbody interactionism and imply the need for revision of standard medical and psychological treatment.
15
Borruso, Laura. "Organizational Aspects of a Public Health Initiative: Inter-Organizational Interactions in the Healthy Ontario Initiative." Scholarship @ Claremont, 2018. http://scholarship.claremont.edu/scripps_theses/1154.
Abstract:
This qualitative study focuses on the intersection of Organizational Studies and Public Health. Through the use of cross-sector work, the Public Health field coordinates work across multiple organizations to diagnose and prevent health issues. Interviewing several administrators from organizations who partake in the Healthy Ontario Initiative allowed me to examine how organizations of different types and sectors interact and connect around this project. This study will predominantly focus on the challenges they face, how they overcome them, and how they are evaluated. Highlighting the intersection of Public Health and Organizational Studies and the way a current Public Health initiative organizes and delivers services may impact the way in which the field evolves in the future.
16
Chamberlin, Christine M. "Workaholism, health, and self-acceptance." Virtual Press, 2001. http://liblink.bsu.edu/uhtbin/catkey/1213153.
Abstract:
The present study was designed to address the issue of the potential harm of workaholism. It specifically examined the relationships between workaholism, self-acceptance, psychological well-being, and physical symptoms. Furthermore, participants completed a form to rate their perceptions of their parents work behaviors, and thus relationships between perceived parental workaholism, physical symptoms, psychological well-being, and self-acceptance, were also explored.Three hundred forty seven students from a Midwestern university completed a survey measuring the above constructs. Of these 347 surveys, 279 were utilized for analysis. It was hypothesized that students' workaholism would correlate negatively with the students' psychological well-being and self-acceptance, and positively with physical health complaints. It was expected that student workaholics would report less psychological well-being, more physical complaints, and less self-acceptance than nonworkaholic students. Furthermore it was hypothesized that there would be no relationship between perceived parental workaholism and students' workaholism. While it was hypothesized that students who perceive their parents as workaholic would report less psychological well-being and self-acceptance than students with perceived nonworkaholic parents, it was not expected that they would report more physical health complaints.Results supported the majority of the hypotheses. A negative relationship was found between students' workaholism and the students' psychological well-being and self-acceptance, while a positive relationship was found between students' workaholism and physical health complaints. Students in the medium to high risk workaholic group were found to have significantly more physical health complaints, and lower self-acceptance and psychological well-being than students scoring in the low risk workaholic group. Furthermore, students with perceptions of parental workaholism falling within the medium to high risk range, had significantly lower levels of psychological well-being and self-acceptance than parents falling within the low risk range. No differences were expected in these two groups in terms of physical health complaints, however students' with perceptions of parental workaholism in the medium to high risk range had significantly more physical symptoms than students' with lower perceptions of parental workaholism. Furthermore, while no correlation was expected between perceived parental workaholism and student workaholism, a significant positive correlation was found.Department of Counseling Psychology and Guidance Services
17
Munro, Catherine A. M. "Developing a dialogue on health : user involvement in health and health services." Thesis, University of Glasgow, 2008. http://theses.gla.ac.uk/291/.
Abstract:
In common with other areas of public services, recent years have seen a shift in the National Health Service (NHS), with increased power and authority transferring from professionals towards the users of services. As a result, user involvement has come to form a central element of government policy on public services, and health in particular, with a series of specific policy commitments to give users a stronger voice and to involve them in the health service having been published by both the Westminster and Scottish parliaments. These seek to increase users’ involvement in making decisions about their own care and treatment, in examining and improving the quality of services and in policy and planning activity. In doing so, this policy aspires to respond to the changing culture of personal and societal expectations of health and the health service; to build democratic participation in the difficult targeting and rationing decisions faced by health agencies and, thus, to help renew public trust and strengthen confidence in the NHS. These are ambitious aims with far-reaching implications as they represent a transformation in the interaction between users, health professionals and health policy makers. This thesis examined how this policy has been understood and implemented in the NHS by exploring the scope, relevance and quality of the user involvement processes available in three health service settings. In order to develop a better understanding of the issues in user involvement it explored the nature of user participation; the character of user representation and the barriers and facilitators to user involvement in maternity, gynaecological oncology and mental health services. The study examined the response to this policy within these three settings; the functioning of existing user involvement mechanisms and their capacity to involve users in determining their individual health care and in shaping health services and policy to their definition of need. From this examination it defined the key features of a model process for user involvement within the professional service culture and organisational ethos of the NHS. The study then drew conclusions on the capacity of these current user involvement processes to deliver on the policy directive to develop both individual treatment and health services in ways that are responsive and accountable to users. Finally, the thesis identified those areas that require further research before proposing the lessons for the further development of this significant and potentially influential policy directive.
18
Wood, Susan. "Mental health literacy and mental health in at-risk populations." Thesis, University of Warwick, 2016. http://wrap.warwick.ac.uk/88088/.
Abstract:
This thesis explores mental health literacy (MHL) and mental health difficulties in at-risk populations. Young people, particularly males, are vulnerable to the onset of mental health difficulties, failing to access support and increased risk of suicide. Supporting people with mental health difficulties and improving prognosis is an important area of public health concern. Chapter one is a systematic review of gender differences in MHL of young people (ages 12-25 years). 14 studies were identified and critically assessed. The nature of gender differences in MHL of young people is complex but most consistently reported in depression. Females tended to have higher levels of MHL than males. The implications for public health interventions and future research are discussed. Methodological components of MHL research, such as the use of case vignettes are also considered. Chapter two is a qualitative research study of male professional footballers’ lived experiences of mental health difficulties and help-seeking using interpretative phenomenological analysis. One superordinate theme emerged from the data; Survival. This is discussed through six subordinate themes and alongside existing literature pertaining to identity, transition, personality and emotional development. The clinical implications of the findings are discussed, as well as suggestions for future research. Chapter three is a reflective paper considering the use of Cognitive Analytic Therapy as a tool for reflexivity in qualitative research. The opportunities and limitations of this approach are considered, alongside reflections on the research process.
19
Warren, Ann Marie. "Partner abuse: Health consequences to women." Thesis, University of North Texas, 2003. https://digital.library.unt.edu/ark:/67531/metadc5534/.
Abstract:
Intimate partner violence is endemic in the United States. According to the American Medical Association (1992), one-fifth to one-third of women will sustain violence from a partner or ex-partner in their lifetime. The relevant literature was organized by ICD-9-CM categories. This study examined the health consequences of partner abuse in a sample of community women using a sample consisting of 564 women in three ethnic groups. Because prior research has failed to account for variations by type of abuse on health consequences, this study assessed psychological abuse, violence and sexual aggression by women's partners. To determine whether or not different types of abuse had an effect on women's health, hierarchical regression analyses were conducted. The regression equations were calculated for women within each ethnic group to facilitate identification of similarities and differences and to control for ethnic differences in risk for specific diseases. The results were consistent with past research on health consequences of abuse and extended the prior literature by showing that psychological abuse had a pervasive effect on health conditions, distress and use of health care resources. Additionally, ethnic differences emerged. As expected, ethnicity appeared to function as a moderator. Clinical implications and recommendations are made for future research, suggesting the development of a new assessment tool for partner abuse screening.
20
Mingotti, Nicola. "Passive environmental design for health." Thesis, University of Cambridge, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.709015.
21
Goulding, Anneli. "Mental health aspects of paranormal and psi related experiences /." Göteborg : Dept. of Psychology, Göteborg University, 2004. http://hdl.handle.net/2077/190.
22
Moore, James W. E. "Aspects of colonic sulphur metabolism in health and disease /." Title page, contents and summary only, 1996. http://web4.library.adelaide.edu.au/theses/09MD/09mdm822.pdf.
23
Poget, Gaël. "Legal aspects of facilitation in civil aviation : health issues." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=81228.
Abstract:
As you probably know, to board the B777-300ERi in Geneva for Anchorage via London, is not just that simple. With your ticket you bought several days before, you come to the airport, check in, pay airport's fees, go through the customs and security checks, walk in the terminal following signs, maybe you stop in the duty free shops, and finally find your gate. By this time, you are ready to board, about one hour after you enter the airport.We will be essentially interested in air law that is why, the purpose of this master's thesis is to consider the legal aspect of facilitation in civil aviation. The term facilitation refers to the process that passengers, crew, luggage, cargo and mail have to go through when they cross borders to fly from a point A to a point B.
Recently, an aspect of facilitation took an outstanding importance: health issues. At the end of last year, the Severe Acute Respiratory Syndrome (SARS) outbreak was a real threat to international civil aviation because passengers (and crews) could have been exposed to an infected person inside the terminal or on board the plane, also, aircrafts were considered a fast vector of this disease through the world. The economic consequences for airlines and airports were very painful.
iBoeing 777-300 Extended Range.
24
Palmer, Keith. "Aspects of human health and occupational exposure to vibration." Thesis, University of Oxford, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.312305.
25
Otter, Robert. "Aspects of environmental public health in Portsmouth, 1764-1864." Thesis, University of Portsmouth, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.387284.
26
Bergman, Julia. "Aspects of Gene Expression Profiling in Disease and Health." Doctoral thesis, Uppsala universitet, Molekylär och morfologisk patologi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-312939.
Abstract:
The aim of this thesis is to in various ways explore protein expression in human normal tissue and in cancer and to apply that knowledge in biomarker discovery. In Paper I the prognostic significance of RNA-binding motif protein 3 (RBM3) is explored in malignant melanoma. To further evaluate the prognostic significance of RBM3 expression was assessed in 226 incident cases of malignant melanoma from the prospective populationbased cohort study Malmö Diet and Cancer Study using tissue microarray technique (TMA). RBM3 was shown to be down regulated in metastatic melanoma and high nuclear expression in the primary tumor was an independent marker of prolonged over all survival. As a tool to facilitate clinical biomarker studies the Human Protein Atlas has created a tissue dictionary as an introduction to human histology and histopathology. In Paper II this work is introduced. A cancer diagnosis can be a complex process with difficulties of establishing tumor type in localized disease or organ of origin in generalized disease. Immunohistochemically assisted diagnosis of cancer is common practice among pathologists where its application combined with known protein expression profiles of different cancer types, can strengthen or help dismiss a suspected diagnosis. In Paper III the diagnostic performance of 27 commonly used antibodies are tested in a predominantly metastatic, multicancer cohort using TMA technique. Overall these 27 diagnostic markers showed a low sensitivity and specificity for its intended use, highlighting the need for novel, more specific markers. Breast, ovarian, endometrial and ovarian cancers affect predominantly women. Differential diagnostics between these cancer types can be challenging. In Paper IV an algorithm, based on six different IHC markers, to differentiate between these cancer types is presented. A new diagnostic marker for breast cancer, namely ZAG is also introduced. In Paper V the transcriptomic landscape of the adrenal gland is explored by combining a transcriptomic approach with a immunohistochemistry based proteomic approach. In the adrenal gland we were able to detect 253 genes with an elevated pattern of expression in the adrenal gland, as compared to 31 other normal human tissue types analyzed. This combination of a transcriptomic and immunohistochemical approach provides a foundation for a deeper understanding of the adrenal glands function and physiology.
27
Pari, Anees Ahmed Abdul. "Health economic aspects in the management of bipolar disorder." Thesis, University of Oxford, 2016. https://ora.ox.ac.uk/objects/uuid:f8ea6eae-9111-4efe-87d1-52276d97e827.
Abstract:
Bipolar disorder (BD) is one of the leading causes of disability worldwide and has a detrimental impact on health-related quality of life (HRQoL), and personal and social functioning. Despite this, there is insufficient knowledge of the costs, HRQoL implications relevant to BD, and the cost-effectiveness of current treatments for BD in the UK. This thesis aims to inform decisions about local and national service provision by applying a variety of health economic tools to build an economic case for BD. First, economic evaluations of BD management strategies are systematically reviewed. A cost-of-illness study is then conducted to estimate the societal burden of BD in the UK and explore the factors that drive variations in these costs. The appropriateness of applying the EQ-5D-3L outcome measure in BD is assessed, and the feasibility of mapping disease-specific measures to the EQ-5D-3L is explored. Finally, a cost-utility analysis (CUA) is conducted to bring together evidence on the costs and outcomes associated with alternative psychological interventions in BD management. This thesis makes critical contributions to multiple research domains, informing the allocation of scarce healthcare resources in this context. There is a sheer dearth of evidence on cost-effectiveness strategies for the long-term management of BD in the UK, especially the evidence for psychological therapies is limited. The annual societal costs associated with BD in the UK are estimated to be £5.14 billion, demonstrating the significant economic burden associated with this disease. The EQ-5D-3L instrument is found to be useful in measuring HRQoL in BD patients who predominantly experience depressive symptoms but is not sensitive enough to detect changes in individuals with mania. More psychometric evidence is therefore required before this instrument can be widely applied in economic evaluations of BD-related interventions. Finally, the CUA indicates that a novel structured psychoeducation intervention in individuals on remote mood monitoring in the UK is not cost-effective.
28
Goulding, Anneli. "Mental health aspects of paranormal and psi related experience /." Göteborg : Göteborg university, 2004. http://catalogue.bnf.fr/ark:/12148/cb402242195.
29
Morandi, Benedetto <1985>. "Epidemiology, Control and Public Health aspects of parasitic diseases." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2019. http://amsdottorato.unibo.it/8939/1/PhD_Thesis_Benedetto_Morandi_Scienze_Veterinarie_Sanita_Animale.pdf.
Abstract:
This elaborate is a three-year route spent on epidemiology, control and surveillance of parasitic diseases both domestic animals and wildlife. It includes eight chapters, where each one, except the prelude and conclusions, concerns different projects regarding to the same topic: Epidemiology and Control of parasitic diseases. It deals with the ancient issue, but still modern, of cystic echinococcosis (CE), one of the costliest diseases to treat and prevent. Its prevalence, in cattle, is still the same 8% compared to the one of fifty years back. This tapeworm is still present and affects exotic animals as ring-tiled lemur (Lemur catta) confined in a zoo. Again, it is stressed the marginal role played by other species, different from sheep and dog, in the Echinococcus granulosus (G1 strain) epidemiology. Additionally, it gives updates on the health status of red fox and wild boar populations and on the plausible interactions between domestic animal and wildlife. Indeed, wild boar population shows a prevalence of the genus Metastrongylus of about 97%, whereas the lungworm Crenosoma vulpis, identified based on size and morphology, is recovered from 28.4% of the fox lungs. Helminth community in Apennine wolf illustrates the attitudes to food in terms of predation and parasitic diseases transmission. The first useful data in a surveillance program is to know and count which aetiological agents are present; the experience, carried out in South African preserves, offers interesting control strategies. Surveillance is aimed at, demostrating the presence/absence of a disease or infection, knowing its epidemiology and spreading in order to detect as early as possible exotic, emerging or re-emerging diseases as well as to cut costs for eradication and avoid exportation restrictions. The present thesis demonstrates the importance of intersectoral cooperation, where each stakeholder puts in the own knowledges in order to stem the spread of transmissible diseases.
30
Shirazi, Farshad 1963. "Metabolic aspects of neonatal rat cardiomyocyte hypertrophy." Diss., The University of Arizona, 1997. http://hdl.handle.net/10150/282447.
Abstract:
The consensus view is that cardiac hypertrophy is an adaptive response to increased work caused by a variety of stimuli. While hypertrophy can be defined as an increase in cell mass without an increase in cell number, not all increases are equivalent in type and amount of protein accumulated. Our goal in this study was to identify the common steps in the process of cardiac hypertrophy. Our working hypothesis was that in all forms of cardiac hypertrophy glucose utilization increases and that the percentage of energy derived from fatty-acid oxidation decreases. The first part of this study entailed the development and characterization of a neonatal rat heart cell model. The model had to provide uniform culture conditions for rapid development of hypertrophy by agents acting at different sites in the cardiomyocytes. The second part of this study was composed of an assessment of hypertrophy caused by four pharmacologically distinct agents: norepinephrine, angiotensin-II, endothelin-I and tetradecylglycidic acid. In this part we compared the quantity of protein accumulation and quality of hypertrophy cause by each agent. This task was accomplished by examining the effect of each agent on selected mRNA messages and alteration in DNA content of cardiomyocytes. Here we also examined the effect of protein kinase-C, endothelin-I and angiotensin-II inhibitors on hypertrophy caused by each agent. In the final part of this study, metabolic alteration in hypertrophy caused by each agent was assessed for a potential common pathway to hypertrophy. As part of this analysis, we examined changes in glucose and palmitate oxidation, glucose uptake and role of pentose pathway in hypertrophy resulting from treatment of cardiomyocyte by each agent.
31
Catena, Rodolfo. "Essays on health care operations management." Thesis, University of Oxford, 2015. http://ora.ox.ac.uk/objects/uuid:3c2035a6-b5d0-43b7-9b12-4883e5db4526.
Abstract:
The aim of operations management in health care is to enhance the provision of services to patients and to decrease costs. Overall worldwide health care expenditures represent around 10.5% of the global GDP and are projected to increase at an annual rate of 5.3% from 2015 to 2017 [74]. In order to investigate how to curb health care costs, I study the English NHS, a health care system that provided universal care to around 54 million people in 2014 [243]. The NHS has launched many initiatives to improve the performance of hospital operations such as the "QIPP" program, which has the objective to save £20 billion of costs by 2015 [98]. Given this framework, this research aims to contribute to the theory that is guiding these operational changes, using data on all admissions to hospitals and focussing on the inguinal hernia, one of the most common surgical procedures [86]. In the next chapters, this research describes inguinal hernia care delivery in the English NHS, examines the impact of spillovers and complementarities on costs, and investigates the effects of length of stay reduction on risk of re-admission and risk of death. The findings of this thesis indicate that one of the possible problems in the delivery of inguinal hernia care in the NHS is the decrease in the number of elective operations performed and the increase in readmission rates. They also clarify how decisions on allocation of resources can affect hospital expenditures by showing that loss in focus can increase health care costs and by pointing out that there is little evidence to support the theory of spillovers and complementarities in the surgical context. Finally, the results of this research can be used to suggest the logic of a policy to decrease length of stay that can inform hospital decisions and can decrease hospital costs.
32
Gordon, Roberta June. "Pregnant women's perception and application of health promotion messages at community health centres." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
Abstract:
Studies have shown that pregnant women do understand and value information of their unborn child. However, those providing health promotion services often focus on medical procedures and health education messages, ignoring the cultural, socio-economic and psychological dimensions that impact on women's health. This research aimed to look at a specific component of health promotion, i.e. health promotion messages shared with pregnant women attending Stellenbosch and Klapmuts Community Health Centre Antenatal Health Promotion Programme and their perceptions of how they apply messages in their daily lives.
33
Fitzwater, Kendra K. "Assessment of environmental and public health hazards of electronic waste." Virtual Press, 2007. http://liblink.bsu.edu/uhtbin/catkey/1380100.
Abstract:
Electronic waste or `e-waste' is a rapidly growing form of solid waste worldwide. The heavy metals present in various electronic components demand attention because such metals may leach and pose significant health and environmental hazards (U.S. EPA, 2007). Knowledge of the potential of heavy metal leaching from e-waste represents an important contribution for developing U.S. standards for classifying e-waste as hazardous waste. Hazardous elements which leach from a variety of electronics wastes were assessed in laboratory batch studies. Electronic components evaluated included PC cathode ray tubes, PC motherboards, PC mice, television remote controls, and cellular phones. Each component was disassembled and digested using the Toxicity Characteristic Leaching Procedure (TCLP), EPA Method 1312, Method EA NEN 7371 (Dutch Environmental Agency), and Method DEV-S4 (Germany). The extracts were analyzed for lead, cadmium, chromium, silver, and cobalt. The TCLP consistently leached the greatest amounts of all metals; TCLP-soluble lead was extracted well beyond federal limits for several electronic devices.Department of Natural Resources and Environmental Management
34
Martin, Susan P. "Young people's sexual health literacy : seeking, understanding, and evaluating online sexual health information." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8528/.
Abstract:
Background: Improving the sexual health of young people is a key policy focus in Scotland. As the influence of the internet has grown within a rapidly changing health information landscape, so have opportunities for both sexual health promotion, and concerns about the challenges faced by young people in navigating this online environment. This study explores young people’s sexual health literacy (SHL), primarily within this online context. Methods: Paired interviews with friendship groups and observational online activities were used to explore young people’s experiences of finding, understanding and evaluating online sexual health information. A purposive sample of 49 participants (aged 16-19), diverse in terms of gender, sexuality and religion, were recruited from across Scotland from areas that varied in terms of deprivation and urban/rural classification. Findings: Participants varied in their confidence and ability to find and identify reliable information, and typically regarded identifying and filtering reliable sources as challenging. Barriers to accessing information on websites included: inaccessible language; inappropriate or non-relatable information; and websites that were difficult to navigate or did not function correctly. Concerns about stigma and ‘being seen’ seeking sexual health information was a key barrier. Stark differences, often mediated by gender, sexuality and educational circumstances, emerged in perspectives towards accessing sexual health information and support online. Findings suggest that different social media platforms present different opportunities and challenges; for example, social content sharing services such as YouTube may be useful venues for developing critical SHL, while social networking sites such as Facebook, may be less suitable to user’s active engagement in identity construction. Dissatisfaction with school-based sexual health education appears to be a catalyst for online information-seeking, but school-based sexual health education did little to equip young people to use the online environment effectively. Conclusions: Gender, sexual identity, stigma, structural factors and social support converge and intersect around young people’s SHL. A broad range of targeted interventions are needed to improve SHL, focusing on overcoming stigma, presenting positive messages and developing interactive and critical skills. Schools could do more to develop SHL skills, including teaching the digital and critical skills to seek and appraise online information. Expanding online sexual health services may effectively complement traditional services and encourage uptake, but it is essential that research establishes a robust, comprehensive conceptualisation of SHL, and develops measurement tools specific to SHL such that interventions can be evaluated and refined.
35
Rabiau, Marjorie Aude. "Balancing temptations and health goals : the role of compensatory health beliefs." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=102154.
Abstract:
Particularly in the health domain, humans thrive to reach an equilibrium between maximizing pleasure and minimizing harm. I propose that a cognitive strategy people employ to reach this equilibrium is the activation of Compensatory Health Beliefs (CHBs). CHBs are beliefs that the negative effects of an unhealthy behavior can be compensated for, or "neutralized," by engaging in another, healthy behavior. "I can eat this piece of cake now because I will exercise this evening" is an example of such beliefs. This thesis presents a theoretical framework which aims at explaining why people create CHBs and how they employ CHBs to regulate their health behaviors. The model extends current health behavior models by explicitly integrating the motivational conflict that emerges from the interplay between affective states (i.e., cravings or desires) and motivation (i.e., health goals). The first study includes a psychometric scale that measures CHBs in the general population and provides data on its reliability and validity. The results showed that scores on the scale were uniquely associated with health-related risk behaviors and symptom reports and could be differentiated from a number of related constructs. Holding CHBs may hinder individuals from acquiring healthier lifestyles, for example lose weight or exercise. The second large-scale study of this thesis aimed at studying CHBs in adolescents with type 1 diabetes. It is proposed that in this population, CHBs might interfere with treatment adherence. If compensatory behaviors fail to compensate for the maladaptive behaviors, poor blood glucose control and related health problems may arise. To investigate this further, I developed and validated a CHB scale specific to type 1 diabetes. The scale was validated in a sample of adolescents with type 1 diabetes. Results showed that holding maladaptive compensatory health beliefs was associated with poorer blood glucose control and poorer adherence to self-care behaviors while adaptive CHBs were associated with better blood glucose control and better adherence to treatment behaviors. Specifically targeting CHBs in an intervention could improve adherence to treatment and therefore the long-term health of this population. Future research as well as the implications for possible interventions are explicitly being discussed.
36
Al, Magrabi Katibah Saad Aldean. "Geographical aspects of health and use of primary health care services in Jeddah, Saudi Arabia." Thesis, University of Strathclyde, 2001. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=21426.
Abstract:
This thesis examines the contribution that geographical analysis can make to the study of the variation in the patterns of human health and subsequently to the discussion on the type and level of use of the public health service in a rapidly developing country. The current study was conducted in Jeddah Governorate, Kingdom of Saudi Arabia during the period 1994 and 2000. One of the main aims was to examine the pattern of health services provided in Saudi Arabia and this aim was achieved by investigating the provision and use of the Public Healthcare services. An attempt was made to clarify the complex web of relations that existed between, on the one hand, the different socioeconomic and geographic factors and on the other, the distribution of common ailments together with the level of utilization of health services. Shortcomings in the nature of the official health statistics regarding socioeconomic conditions of the patients were remedied through the use of a questionnaire. A tot al of 1000 patients from the eight PHCCs were surveyed for their use of the public health service. Data was collected from the same patients on their socio-economic, education and habitation details. This sample was used to supplement the data collected from the official government health statistics. These two data sets permitted an evaluation of the occurrence of different ailments and the variations in geographic distribution among the eight selected PHCCs. Difficulties persisted in the availability of official 1992 census data until publication of census data became available in 1999. In contrast to the problems of the census data, the availability of accurate and up-to-date patient records compiled by Ministry of Health staff was of considerable benefit to this research project. Use was made of Geographic Information Systems software for the analysis of data collected at the level of the PHCC. This allowed visual identification of the spatial variation in the use of the different health services and also allowed the identification of gaps in healthcare provision. The study showed that a density of habitation index used as a prime indicator of socio-economic status could be used as an indicator of the occurrence level for a number of common diseases. A pattern of disease was observed that suggested that the number of visits to PHCCs was substantially higher in low socio-economic districts compared to medium and higher socio-economic districts. It can be shown that the most common ailment was Upper Respiratory Tract Infections followed by Dental and Gingival diseases. Persons aged between 15 and 44 years made most visits to PHCCs although children under 15 years made proportionately greater use of PHCC facilities. No difference could be found between Saudi and Non Saudi as regards the occurrence of the most common ailments and diseases. The lack of difference was probably due to the close integration of the two population groups and the sharing of the same local environment. This similarity occurred despite considerable differences in income levels and socio-economic status. The level of utilisation of health centers in the selected districts showed differences, being higher in those districts categorized as low socio-economic in the south of Jeddah when compared to higher socio-economic districts in the north of the city. It was evident that the difference in socio-economic factors had an impact on the occurrence of some frequently occurring diseases e.g. URI, Dental, Ophthalmic, musculoskeletal and skin diseases. Although not primarily concerned with private health care facilities, for completeness sake some information was collected on the use of private health care in conjunction with public health care facilities. The author was surprised to discover that greatest use of private facilities occurred among women and children patients from Al Nuzla al Yamaneyyah and Al Thaalebah, districts that were characterised by low socio-economic conditions. The use of traditional folk healing was also briefly studied as this form of treatment remains important for some patients. Results showed that there was no difference between the educational standards of patients and their use of traditional folk healers. Again, children and women constituted the majority (86.6%) of users of traditonal healing with Saudi users (18.9%) higher than non Saudi (11.4%). There remains the supposition that alternative medicine may be of far greater importance than the sparse official data suggests. The unquantified illegal immigrant population may be totally reliant on unofficially operating alternative medicine centres. The thesis concludes by recommending a number of improvements to the existing public health care system. Some changes in the policy and practice of PHCC services will inevitably require more financial resources. These include an extension of the opening times of PHCCs and an increase in the number of specialist facilities such as dental surgeries. Other changes may not require more finances. These include a strengthening of communication and co-operation between PHCCs and hospitals to improve the referral of patients. Expansion of the existing computer network connecting PHCCs with hospitals should be given high priority.
37
Danis, Ajau. "Health communication and health literacy : participants perspectives on the PROSTAR Health Promotion Programme." Thesis, Liverpool John Moores University, 2006. http://researchonline.ljmu.ac.uk/5800/.
38
Hu, Qiming, and 胡啟明. "Application of nudge theory for changing diet and physical activity : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206943.
Abstract:
Background: Unhealthy lifestyle are important contributors to chronic illness in Hong Kong and worldwide. Lifestyle modification, particularly improving healthy diet and physical activity, can prevent the development of various chronic illnesses, improve disease conditions, reduce the risk of complications and enhance the quality of life. Many behavioural models have been applied to achieve lifestyle modification, but the major limitation was that they mainly treated human behaviours as individual behaviours that were subsequent to rational thinking. Nudge theory, an advanced behavioral concept, proposed to change individual’s motivation, incentives and decision making through non-direct suggestion and non-forced reinforcement. However, the application of Nudge theory has been challenged on the lack of evidence to prove its effectiveness, and its controversial framework for ethical analysis.
Objectives: This review was to synthesize the empirical findings about the effectiveness of using nudge theory for lifestyle modification including healthy diet and physical activity.
Methodology: Interventional and experimental studies that were conducted based on Nudge theory to change diet or physical activity was identified from the published literature. The studies were divided into two large groups according to outcome measured: healthy diet and physical activity, and they were systematically synthesized. The “nudges” used in these studies were categorized as six types of “nudges” summarized by “nudge unit” as “MINDSPACE” for further discussion. The type of “nudges” that were used in the studies and their effectiveness on changing diet and physical activity was abstracted.
Results: Totally, nine articles that met the inclusion criteria were included. Five nudges were identified from the included studies, including Priming (P), Default (D), Salience & Affect (SA), Incentives (I) and Messenger & Norms (MN). It is found that the strategies and methods applied on the same nudge may have different effectiveness. Seven studies applied Priming (P) as nudge to motivate change in diet, which used two major strategies: “availability” and “accessibility”. The evidence was strong that altering the availability of food presence could be effective to change food selection. The results of studies using accessibility were heterogeneous and contradictive with each other. Another three studies used different nudges including Default, Salience & Affect and Incentive. The effectiveness of Default (D) as nudge seemed to be blurry, and the sustainability remained questionable. The ethical consideration is always the primary pillar for applying nudging theory. As long as the applications are stick to necessary ethical concerns, the nudging model can be beneficial through mild “manipulation” rather than harmful.
Conclusion: It has potential opportunity to carry out “libertarian paternalism” in Hong Kong. However, it is still a long way to take application of nudging model into regulation, legislation and daily practice. The evidences for each type of nudge were not consistent and enough. Besides, the monitoring and evaluation are not available yet. Future research can be focused on transferring these applications into real practice with an effective monitoring and evaluation system.published_or_final_version
Public Health
Master
Master of Public Health
39
Wynchank, Sinclair. "Aspects of paediatric gastro oesophageal scintigraphy." Doctoral thesis, University of Cape Town, 1988. http://hdl.handle.net/11427/27191.
Abstract:
This work is concerned with the application of scintigraphy in studies of foregut motility in paediatric patients; notably oesophageal transit during swallowing, gastro oesophageal reflux (GOR) and stomach emptying as measured by the gastric contents 30 and 120 minutes after deglutition of liquid. Relevant anatomy, physiology, pathophysiology and non-radioisotopic methods of gastro oesophageal examination are outlined. The extremely important question of dose deposited by ionising radiation in paediatric patients is also considered. Because currently available estimations of absorbed dose after swallowing non- absorbable radionuclides are unsatisfactory and often contradictory, a new model was derived. It is based on more physiological principles than previous models, with a continuously varying exponential passage between four compartments in the gastrointestinal tract. From a review of previous work and our experience, a standard method of examination was developed. There is emphasis on normal physiological manoeuvres. The broad extent of useful information available in the study stems from the positions in which the patient is investigated, the quantity of labelled fluid swallowed, its physiological nature and observations of oesophageal transit, GOR, gastric emptying and pulmonary aspiration after two hours. The wide range of paediatric problems amenable to investigation by this means is described, including those of a life-threatening nature. Also, the importance of using this examination to determine the likelihood of successful surgical intervention in the gastro oesophageal region is explained. By using the observations made during swallows in neonates, the closure of the lower oesophageal sphincter (LOS) was observed during a short series of rapid deglutitions. This extends previous knowledge of the function of the neonatal LOS. These findings were very clearly demonstrated by the condensed image technique. A comparison between the abilities of radiology and scintigraphy to detect GOR in paediatric patients, with and without oesophagitis, gives unequivocal results in favour of scintigraphy. Two independent clear correlations between oesophageal transit time and the severity of GOR and age are demonstrated by variance and correlation analysis. The mean duration of GOR, maximum height of a GOR, gastric contents 30 and 120 min after deglutition, the effect of the nature of liquid swallowed and age are also examined and their relations are described. The application of the method to assess drug response is illustrated by the paediatric use of cisapride, an experimental drug which increases acetylcholinesterase release. The deductions from this work include values of the radiation dose deposited in paediatric patients of various ages, after swallowing non- absorbed Tc-99m compounds. Other contributions are a scintigraphic means to allow recognition of the importance of oesophageal dysmotility in paediatrics, especially in the absence of GOR and its relevance to the efficacy of surgery in cases of apparent GOR. Also, this gastro oesophageal scintigraphic study provided information on the paediatric use of cisapride, the relevance of GOR to repeated respiratory problems and the recognition of a new paediatric syndrome analogous to the diffuse oesophageal spasm syndrome of adulthood. It has been demonstrated that a routine, uncomplicated, paediatric scintigraphic examination, useful for investigating a wide range of problems in both a first and third world setting is possible for a nuclear medicine practitioner with normally available radiopharmaceuticals, equipment and radiographical expertise.
40
Au, Yeung Shiu-lun Ryan, and 歐陽兆倫. "Moderate alcohol use and health." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48521668.
Abstract:
Background: Many western observational studies suggest moderate alcohol use is associated with better health including lower risk of cardiovascular diseases, diabetes and cognitive decline. However, the apparent benefit is susceptible to confounding by healthier attributes in moderate users. Randomized controlled trials of moderate alcohol use are infeasible. To assess the validity of these association for causal inference, I examined these associations in a setting (Southern China) with a different social patterning of alcohol use from more commonly studied western populations and using a Mendelian randomization design.
Objectives: This thesis utilized two large Southern Chinese cohorts, the Guangzhou Biobank Cohort Study (GBCS) (n=30,499) and the Elderly Health Centre (EHC) Cohort (n=64,353) to examine sex-specific association of moderate alcohol use with cognitive function using observational designs. I also examined systematic differences between alcohol users and the credibility of alcohol-metabolizing genes as instruments for Mendelian randomization in GBCS. Mendelian randomization was used to examine the effect of alcohol use on cognitive function and cardiovascular risk factors and morbidity among men in GBCS.
Methods: I used multivariable linear regression to examine the adjusted association of alcohol use categories (never, occasional, social weekly (EHC only), moderate, heavy and former) with cognitive function, measured by delayed 10-word recall test (phases 1-3 of GBCS), Mini-Mental State Examination (phase 3 of GBCS) and Abbreviated Mental Test (EHC), stratified by sex and age. I used multinomial logistic regression to examine the sex-specific systematic difference by alcohol category in GBCS. I used multivariable linear regression to examine the genetic association of ALDH2 with different cardiovascular risk factors and morbidities, cognitive outcomes and liver enzymes and to assess if alcohol phenotypes mediated any apparent genetic association in men. I used 2 stage least squares (2SLS) regression to examine the association of alcohol units (10g ethanol/day) with cognitive function and cardiovascular risk factors (blood pressure, lipids and fasting glucose) and morbidities (self reported cardiovascular disease and ischemic heart disease) in men in GBCS.
Results: Occasional alcohol use, rather than moderate alcohol use, was consistently associated with higher cognitive function in both studies. Systematic differences among alcohol users were present. Occasional alcohol users had better health attributes while moderate users had slightly poorer attributes compared to never users. Aldehyde dehydrogenase 2 (ALDH2) was a credible instrument for Mendelian randomization. From Mendelian randomization, low to moderate alcohol use was not associated with cognitive function in men. However, it was positively associated with HDL cholesterol and diastolic blood pressure but not with fasting glucose or cardiovascular morbidity in men.
Conclusions: Moderate alcohol use was not associated with cognitive function, suggesting that previous positive studies could be confounded by better health attributes in moderate users. The lack of association of alcohol use with cardiovascular morbidity despite raising HDL cholesterol is consistent with non-observational studies showing the non-causal role of HDL cholesterol in cardiovascular disease. These may suggest the apparent cardioprotection of alcohol is confounded although it remains possible that cardioprotection is population-specific via pathways other than HDL cholesterol, which require further investigations.published_or_final_version
Community Medicine
Doctoral
Doctor of Philosophy
41
Hedberg, Yolanda. "Environmental and health aspects of corrosion– importance of chemical speciation." Licentiate thesis, KTH, Yt- och korrosionsvetenskap, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-24701.
Abstract:
During the last decades, the interest in corrosion of metals and alloys from an environmental and health perspective has increased rapidly as a consequence of stricter environmental and human exposure legislations, their extensive use as implant materials and an increasing understanding related to occupational and/or daily exposure to airborne particles. Corrosion-induced metal release, however, needs to be understood in detail and to include knowledge related to chemical speciation, i.e. the oxidation state, complexation and chemical form of released metals, parameters of high importance when considering toxicity. In this licentiate work, corrosion-induced metal runoff from roofing materials (copper, zinc, and chromium(III)-, and chromium(VI) surface treated galvanized steel) has been investigated from an environmental perspective with focus on chemical speciation of released metals (Papers I-II). From these papers it was evident that the total concentration measured in the runoff water is not sufficient for any environmental risk assessment. The environmental fate including changes in chemical speciation and hence metal precipitation has to be considered. For example, it was shown that the copper concentration decreased by three orders of magnitude already in the internal drainage system of a shopping centre with a copper roof, to a concentration lower than storm water collected from a nearby parking space (Paper I). Also, speciation measurements can explain corrosion, metal release and surface processes of chromium surface treated galvanized steel at different sites (urban and marine). Any environmental risk assessment has to be done by considering all metal species released, and compared with ecotoxic values. For example, when most chromium(VI) (the most toxic species) was released, significantly less zinc was released at the same time which decreased the overall ecotoxicity of the runoff water significantly (Paper II). When assessing environmental risks by standard laboratory tests, it is important to understand all mechanisms which are possibly influenced by individual experimental parameters and which often are different for different test substances. Some metals released, as seen in the case of iron, may precipitate with time and be pH-, solution- and buffering dependent. This behavior can lead to strongly underestimated measured metal concentrations (Paper III). When particles of metals or alloys are to be investigated (Papers III-VI), it is essential to conduct a thorough particle characterization, since the surface properties cannot be defined. In addition, the surface properties (oxide layer properties) change with varying particle size (Paper VI) and with other experimental parameters such as dispersion (Paper VI). All iron-, and chromium-based particles investigated (Papers III-VI) revealed large differences between alloy particles and pure metals. Particles of pure iron and nickel released significantly more metals compared with particles of the investigated alloys, whereas particles of pure chromium released less metals compared with the alloys. Particles of stainless steel (AISI 316L), ferro-chromium and ferro-silicon-chromium released very low amounts of metals (Papers III-VI). The released quantity increased with increased acidity (Papers III-VI) and also in the presence of complexing agents (ongoing research). The manufacturing process is of high importance, as observed for stainless steel particles when compared with a side product from stainless steel production with similar composition that released significantly more metals (Paper III). Particles of metal oxides, i.e. chromium(III)oxide and iron(II,III)oxide, released very low amounts of metals due to their thermodynamic stability. Ongoing research activities focus on the specific influence of complexing agents and proteins on the metal release process from massive sheet and particles of metals and alloys. The applicability and the possibility to use different analytical tools are investigated and elaborated for small-sized particles. A detailed understanding of the correlation between material and particle characteristics, the metal release process, the chemical speciation in interaction with proteins and/or cells, and the particle/cell interaction is essential to enable any correlation between material/particle characteristics and toxicity. The aim of this licentiate summary is – in contrast to the six included scientific papers – to explain the importance of chemical speciation for corrosion processes from a health and environmental perspective in a popular way to reach a broad non-academic audience. The summary is hence written as a guidance document for stakeholders and the regulatory community working with environmental and health risk assessment.QC 20101006
42
Hope, Judith Dorothy 1969. "Aspects of psychometric assessment of outcomes measurement in mental health." Monash University, Dept. of Psychological Medicine, 2002. http://arrow.monash.edu.au/hdl/1959.1/8119.
43
Adams, Robert John Trenaman. "Health-related quality of life and psychological aspects of asthma /." Title page, contents and introduction only, 1998. http://web4.library.adelaide.edu.au/theses/09MD/09mdt792.pdf.
44
Boodhna, T. "Trends and health economic aspects of service delivery of glaucoma." Thesis, City, University of London, 2017. http://openaccess.city.ac.uk/17931/.
Abstract:
Glaucoma describes a group of optic neuropathies characterised by progressive irreversible loss of visual function. Within this thesis, a health economic model was constructed to map service provision from diagnosis considering two competing strategies: the current practice of annual visual field (VF) monitoring against the proposed guidelines of performing 6 VFs in the first two years. The constructed model found the proposed practice to be cost effective at a willingness to pay ceiling ratio of £30,000 per quality adjusted life year (QALY), identifying an incremental cost effectiveness ratio (ICER) of £21,679. The findings of the model however were potentially sensitive to the modelled infrastructure improvement costs required to undertake the proposed guidelines and a costing study to more accurately ascertain these costs was recommended. Following this study, statistical analysis of 473,252 VFs was undertaken to investigate trends in initial identification and progression rates whilst also narrowing their parameters within the health economic model. Consequently, the average level of glaucomatous vision loss at diagnosis was found to be improving by 0.11 dB per year on average whilst proportions of patients with ‘advanced’ loss at diagnosis fell significantly from 30% to 21%. Average progression rates were found to have fallen from -0.11 dB per year to -0.06 dB per year whilst average rates of loss in older eyes ( > 70 years) were found to progress faster than in younger eyes ( < 60 years). Furthermore, testing frequency was found not to vary by visual impairment risk factors. The constructed health economic model was subsequently updated to incorporate the more narrowly defined parameter distributions whilst also being re-specified to incorporate societal costs of visual impairment to count the true costs of the disease. This resulted in an improved ICER of £11,382. In conclusion, it is likely that implementing the proposed guidelines of 6 VFs in the first two years is more cost-effective than annual monitoring. This argument is further reinforced once societal costs are accounted for however a scoping study to examine the required costs of improving the glaucoma monitoring infrastructure is required.
45
Gerard, Karen M. "Economic aspects of consumer involvement in health care benefit assessment." Thesis, University of Southampton, 2005. https://eprints.soton.ac.uk/57928/.
46
Emery, Maurice George. "Aspects of human CYP 2E1 regulation in health and disease /." Thesis, Connect to this title online; UW restricted, 1999. http://hdl.handle.net/1773/7943.
47
Garcia, Hernandez Jacqueline. "Aspects of ecosystem health in the Colorado River Delta, Mexico." Diss., The University of Arizona, 2001. http://hdl.handle.net/10150/279931.
Abstract:
Two aspects of ecosystem health in the Colorado River delta were investigated as part of the present dissertation. The following is a summary of the most important findings: Contaminants of natural origin (e.g. selenium) and anthropogenic activities (e.g. pesticides) represent a potential threat for humans and wildlife in the Colorado River delta. Fourteen locations were sampled for bottom material and biota from March 1998 to April 2000. Concentrations of selenium in bottom material ranged from 0.6-5.0 μg/g. Concentrations of selenium in biota ranged from 0.5-18.3 μg/g, 23% of these samples exceeded the toxic threshold where reproductive impairment in birds from dietary exposure is reported. Concentrations of DDE exceeded the lower critical dietary level for sensitive species in 30% of biota samples. No clear relationship could be found between the concentration of Se in bottom material and the concentration of Se in fish. Nevertheless, smaller Se concentrations in biota were found at sites that had an outflow and exposure or physical disturbance of the bottom material was uncommon. Greater concentrations of Se in biota were found at sites with strongly reducing conditions, no output, and subsequent periods of drying and flooding or dredging activities, and at sites that received water directly from the Colorado River. The southwestern willow flycatcher (Empidonax traillii extimus ) is an endangered neotropical migrant with only 300-500 breeding pairs. The objective of the second study was to determine the presence/absence of this bird in the Colorado River delta. Surveys were conducted from June to July, 1999 and from May to June, 2000 using an audio tape of this subspecies' songs to elicit responses. We detected a total of 50 willow flycatchers in the Colorado River delta in the months of May to June. None were detected in July, thus, the birds were most likely migrants. Restoration of the intensively used stopover sites of the Colorado River delta appears to be essential for the overall recovery of this subspecies. Additionally, we propose a possible willow flycatcher summer migratory route throughout the series of coastal estuaries found adjacent to the coast of Sonora.
48
Parker, Camilla Harriet. "The legal aspects of the mental health care of adolescents." Thesis, Cardiff University, 2017. http://orca.cf.ac.uk/106484/.
Abstract:
This thesis examines the complex legal framework for admission to hospital and treatment for mental disorder of adolescents. It identifies areas of uncertainty and makes recommendations on how these might be addressed. It does so by mapping the various legal routes for adolescent psychiatric care, including detention under the Mental Health Act 1983, and examining these through a 'human rights lens' which reflects international and European human rights standards, including the European Convention on Human Rights and the United Nations Convention on the Rights of the Child.
49
Gyllensvärd, Harald. "Health Economic Aspects of Injury Prevention at the Municipal Level." Licentiate thesis, Linköpings universitet, Avdelningen för samhällsmedicin, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-106227.
Abstract:
Unintentional injuries are a global health problem, which in 1996 was estimated to cause up to 3 million deaths per year. In Sweden, about 4,600 people die annually due to external causes of morbidity and mortality (injuries and poisoning). Among children 1 to 17 years old, injuries are the leading cause of death in Sweden for both boys and girls. Injuries are also the leading cause of life years lost before age 65 in men and the second most common in women. Injury prevention interventions and programs can be implemented to mitigate the magnitude of this public health problem, the number of injuries in society, and the substantial costs associated with injuries. Society's resources are however limited and therefore it is pivotal that interventions are cost-effective and not only effective: that is, that they provide good value for money. Hence, the aim of this thesis was to develop new knowledge and improve decision making by elaborating on some of the important health economic aspects of injury prevention. Consequently, a critical appraisal of the existing cost-effectiveness studies on injury prevention interventions and estimations of the societal costs for different types of injuries that needed medical attention were conducted. The critical appraisal of studies was limited to those studies that investigated interventions that could be implemented by municipalities. The results shows that injuries are associated with substantial societal costs but differ considerably between different types of injuries. The average cost per injury was estimated at € 2,726 and varied between € 892 and € 15,537. Furthermore, the results indicate that there are injury prevention interventions that offer good use of societal resources. However, there is a general lack of economic evidence surrounding injury prevention interventions. This thesis has expanded the knowledge in some important health economic aspects of injury prevention. The generated knowledge may advantageously be used in future research, including cost-effectiveness analyses of injury prevention interventions, and assist in the targeting of new research. Future research should focus on estimating the cost-effectiveness of different interventions and the reductions in quality of life due to different injuries. Costeffectiveness data help decision-makers make judiciously resource allocation decisions that maximise health gain given limited budgets.
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Bonaga, Giorgia <1979>. "Poverty and Mental Health. Tangible and Intangible Aspects of Microcredit." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2012. http://amsdottorato.unibo.it/4785/1/Bonaga_Giorgia_tesi.pdf.
Abstract:
Microcredit, a small lending system, invests on an individual's creativity by stimulating the development of their own potential. This process leads to the attainment of various objectives which in turn allow individuals to develop their skill awareness. Consequently, this process also increases an individual’s self-esteem and self-confidence. These factors play an important role in the aetiology of a number of mental disorders. Namely, those characterized by a series of psychological conditions which impede the full development of a person’s personal, relational and social sphere.
Furthermore, since Microcredit is thought to produce tangible goods, such as income, and intangible goods, such as self-esteem and mutual trust, it could also represent an innovative socio-economic tool. We therefore also hypothesize that, Microcredit would be valuable in maximizing abilities/skills in those subjects who are financially excluded and rarely perceived as a ‘resource’ for the Community
The longitudinal study set the impact of the Grameen Bank microcredit program on new borrowers women from Noakhali District at the south Bangladesh.
The impact evaluation assessment has been structured to detect individual, family and social changes. Manova Analysis allowed distinguishing from women with positive or negative outcomes related to the loan performance. Data revealed consistent differences in terms of economical outcomes and psychological well being amongst the groups of subject analyzed. The data gathered in relation to the changes arisen in the individuals should be looked into through future, continuous and systematic, monitoring.