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1
Kerr, Gillian. "Cerebrovascular diseases, vascular risk factors and socioeconomic status." Thesis, University of Glasgow, 2010. http://theses.gla.ac.uk/1892/.
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Cerebrovascular disease, has an enormous, and increasing, impact on global health. As well as causing clinical stroke, cerebrovascular disease is thought to be a major contributor to cognitive decline and dementia. Socioeconomic status (SES) is associated with risk of stroke. Those in the lowest SES group are estimated to be at twice the risk of stroke compared to those in the highest SES group. Those with low SES may also have a more severe stroke and a poorer outcome. It is imperative that the extent and mechanism of this association is clarified. This thesis aims to determine if the association between SES and stroke is explained by a greater prevalence of traditional vascular risk factors amongst those of low SES. It also explains the link with a novel risk factor, poor oral health. Lastly it addresses the long-term cognitive outcome in older people at risk of vascular disease. A systematic review and meta-analysis was undertaken to establish if vascular risk factors explain the association between SES and stroke incidence / post-stroke mortality. This demonstrated that lower SES was associated with an increased risk of stroke and that a greater burden of vascular risk factors in those with low SES explained about 50% of the additional risk of stroke. However this meta-analysis could not clarify what vascular risk factors are most critical. Low SES was also associated with increased mortality risk in those who have a stroke although study results were heterogeneous and this link was not readily explained by known vascular risk factors. A prospective study of 467 consecutive stroke and transient ischameic attack (TIA) patients from three Scottish hospitals was undertaken with the aim of establishing whether those with low SES carry higher levels of vascular risk factors, have a more severe stroke and have equal access to stroke care services and investigations. Stroke / TIA patients with low SES were younger and more likely to be current smokers but there was no association with other vascular risk factors /co-morbidity. Those who had lower SES had a more severe stroke. The lowest SES group were less likely to have neuroimaging or an electrocardiogram although differences were not significant on multivariate analysis. There was however equal access to stroke unit care. A secondary analysis of a prospective cohort study of 412 stroke patients was conducted. The aim was to explore oral health after acute stroke and assess if poor oral health explains the association between SES and stroke. Dry mouth amongst acute stroke patients was very common, however there was no association between oral health and low SES. There was an association of dry mouth with pre-stroke disability and Urinary Tract Infection. There was also a link with oral Candida glabrata colonisation, although the clinical relevance of this is uncertain. In the acute phase after stroke there was no convincing association of dry mouth with dysphagia or pneumonia. Therefore there was no association between SES and poor oral health as measured in this study but oral health may still be part of the explanation of the association between SES and acute stroke and this needs further investigation. Vascular disease is an important contributor to cognitive decline and dementia. Low SES may be associated with an increased risk of cognitive decline in later life and vascular disease may be a mediating factor. More effective prevention of vascular disease may slow cognitive decline and prevent dementia in later life, particularly in low SES groups. Lipid lowering with statins might be effective in preventing dementia but so far evidence from randomised control trials does not show benefit from statins in preventing cognitive decline and dementia. However the duration of follow-up in these trials was short and there may be benefit in the long-term. My aim was therefore to establish if long-term follow-up of the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) study was feasible. I found that it was feasible to follow-up 300 elderly survivors from the Scottish arm of the PROSPER study and the methods could be extended to the whole group. As expected nearly half of the PROSPER participants were dead. Additionally a large proportion of traceable participants had significant cognitive impairment. Smoking cessation, control of blood pressure and management of other vascular risk factors should be made a priority in areas of low SES. Additionally further research is needed to fully clarify the association between SES and stroke incidence. Avenues for exploration might include the possibilities of poorer access to effective stroke care, reduced uptake of care and poorer oral health in lower SES groups. In addition public health campaigns regarding smoking cessation should be directed at lower SES groups. I have shown that a large scale follow-up of the PROSPER participants is feasible and may determine new and novel risk factors for dementia and assess the long-term effect of a period of treatment with pravastatin.
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Hurtig, Wennlöf Anita. "Cardiovascular risk factors in children /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-179-2/.
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So, Hon-cheong, and 蘇漢昌. "Genetic architecture and risk prediction of complex diseases." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B4452805X.
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Lo, Ling-fun, and 盧玲芬. "Cardiac risk factors in Hong Kong adults." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B25797463.
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Many studies have been conducted in Caucasian populations on the optimal body mass index cut-off for obesity, as well as the relationship between body mass index and percentage body fat and their associations with cardiovascular risk factors. However, few studies of this kind have been conducted in the Hong Kong Chinese population, This research is deemed to be important due to ethnic differences between Asians and Caucasians, Therefore, this dissertation aims to determine any ethnic differences from a sample of the local Hong Kong Chinese population, in order to advance health care policies controlling known cardiovascular risk factors.
A total of 800 subjects were randomly selected from a pool of subjects participated in a Hong Kong Cardiovascular Risk Factor Prevalence study conducted in 1994-1996. These subjects were contacted and 453 disease-free subjects (210 males and 243 females) consented to participate in the current study, Data collected included serum and blood pressure measurements, body mass index, percentage body fat measured by bioelectrical impedance analysis, and a self-completed cardiovascular risk factor questionnaire,
The mean age of the 453 subjects was 51.64 years (SD=12.3). When obesity was defined as percentage body fat ~ 25 and 2: 30 in males and females respectively, 23 kg/m2 was found to be the optimum cut-off value, with 78% correct classification (95% CI = 69%-87%). The corresponding sensitivity and specificity were 88% (95% CI = 81 %-95%) and 67% (95% CI = 57%-77%) respectively. On the other hand, if obesity was defined as percentage body fat ~ 25 and 2: 35 in males and females respectively, then 25 kg/m2 was found to be the best cut-off value with 82% correct classification
(95% CI = 74%-90%). The corresponding sensitivity and specificity were 78% (95% CI = 69%-87%) and 85% (95% Cl = 78%-92%) respectively.
Moreover, body mass index was found to be quadratically body fat. The quadratic relationship did not appear two genders, except that the percentage body fat of of females by 9.97 (SE=0.33).
Finally, except for total cholesterol, high density lipoprotein cholesterol, and fasting glucose, body mass index did not provide any substantial information additional to percentage body fat on serum and blood pressure measurements. was the only measure on which percentage body fat did additional to body mass index. When waist-hip body mass index and percentage body fat,. except for
body mass index did not have additional information on measurements when percentage body fat or/and
[n conclusion, the optimal body mass index cut-off for obesity in Hong Kong Chinese was lower than the 30kg/m2 recommended by the World Health Organization, a clear reflection of ethnic difference between Asians and Caucasians. The quadratic relationship between percentage body fat and body mass index was similar in Hong Kong Chinese as in Caucasians and Blacks. Moreover, percentage body fat together with waist-hip-ratio were found to be better indicators of cardiovascular risk factors in Hong Kong. This was the first time such findings were found in the Hong Kong Chinese population.
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Master of Medical Sciences
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Rantala, A. (Asko). "Risk factors and carotid atherosclerosis in hypertensive and control subjects." Doctoral thesis, University of Oulu, 2001. http://urn.fi/urn:isbn:9514264657.
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Abstract
Different metabolic and environmental factors affect the blood pressure level, constituting a cluster, especially in hypertensives, that leads to an increased risk of cardiovascular diseases. The present research was designed to determine the prevalence and the predictors of the metabolic syndrome and the role of insulin and blood pressure in carotid atherosclerosis in 600 treated male and female hypertensives aged 40-59 years and 600 age- and sex-matched controls.
The prevalence of the metabolic syndrome in different population-based cohorts varied, depending on the
definition, from 0.8% to 35.3%, being lowest in control men and women and highest in hypertensive men. 73.8%
of a random, middle-aged, urban population showed at least one cardiovascular risk factor, and 91.3% of all
hypertensive subjects showed at least one cardiovascular risk factor in addition to hypertension itself. The
independent predictors of the metabolic syndrome were waist circumference, uric acid, total cholesterol and
gamma-glutamyl transpeptidase. Hypertension had a significant effect on carotid intima-media thickness and the
prevalence of plaques in men, but its effect in women was not significant. A long duration of hypertension
resulted in greater intima-media thickness and a higher prevalence of plaques, particularly in men. There were
significant associations between gamma-glutamyl transpeptidase and the components of the metabolic syndrome
after adjustment for alcohol consumption and also in teetotallers. There were inconsistent associations
between the different insulin measures and the intima-media thickness as a measure of carotid atherosclerosis.
The exclusion of diabetic subjects did not change the results.
In conclusion, a cluster of metabolic abnormalities related to hypertension is frequent among both controls and treated hypertensive subjects. Hypertensive subjects have higher prevalences of carbohydrate and lipoprotein aberrations and structural and functional cardiovascular complications than age- and sex-matched controls.
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Murphy, Georgina Anne Veronica. "Chronic non-communicable diseases and risk factors in rural Uganda." Thesis, University of Cambridge, 2014. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.707995.
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Sjögren, Per. "Cardiovascular risk factors, diet and the metabolic syndrome /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-894-0/.
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Apekey, Tanefa Antoinette. "Weight loss diets : effects on risk factors of diet related diseases." Thesis, University of Lincoln, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.496080.
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Rafnsson, Snorri Björn. "Cardiovascular diseases, risk factors and cognitive decline in the general population." Thesis, University of Edinburgh, 2007. http://hdl.handle.net/1842/30665.
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The principal aim of the present study was to examine the longitudinal change in cognitive test performance in relation to major clinical CVDs and vascular risk factors in a population-based sample of older people. The analysis is based on a cohort of 809 men and 783 women aged 55-74 years which in 1987/8 was randomly selected from the general population of Edinburgh. The findings from the present study further add to those of previous investigations demonstrating a relationship between CVDs, vascular risk factors, and cognitive decline in older people. Specifically, they reveal that, even in the absence of overt stroke, clinical CVDs are associated with a greater cognitive decline in the elderly, independently of potential confounding by a wide range of vascular risk factors. Also, the relationships between several vascular risk factors and cognitive decline proved to be independent of co-existing vascular pathology. Based on these findings, further study is needed to determine the combined effects of CVDs and multiple risk factors on cognitive outcomes in samples of older people. In addition, what the likely pathological mechanisms are underlying cognitive decline associated with atherosclerotic disease and vascular risk factors risk factors needs to be addressed in future studies. From a perspective of preventing or delaying vascular-based cognitive decline and impairment, more research is required to assess the effectiveness of both individual and population-based strategies targeting vascular disease and risk factors in older age groups. Finally, further investigation is needed to address the potential impact of subtle cognitive deficits on indictors of the quality of life and the capability of self-maintenance of elderly vascular patients, on adherence to medical treatment and rehabilitation, and further cognitive decrements and survival.
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Alamian, Arsham. "Multiple Behavioral Risk Factors for Chronic Diseases and Public Health Implications." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/1382.
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Cozens, Russel David. "Insect and disease risk factors in established interior spruce plantations." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/24426.
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Forest insects and diseases active in immature interior spruce stands in the central interior of British Columbia and their possible implications in forest management practices have been surveyed. Collection records, spanning the period 1949 to 1982, from the Forest Insect and Disease Survey of the Canadian Forestry Service were reviewed for the Prince George Timber Supply Area and the pest incidence in immature interior spruce stands summarized.
Twenty-two plantations, established between 1963 and 1973, were surveyed to determine the relative incidence of the major insect and pathogen pests of immature spruce in Supply Block 'G' of the Prince George Timber Supply Area. A bud midge, likely Rhabdophaga swainei Felt (Diptera: Cecidomyiidae), and a terminal weevil, Pissodes strobi Peck (Coleoptera: Curculionidae), were found to consistently infest and damage a significant number of immature interior spruce trees.
A spruce stand stocking profile was developed as a basis for discussion of management practices in plantations and immature stands. The stocking profile can be used in the determination of not only pest management policy decisions but in stand management decisions affecting stand density and, ultimately, merchantable yield at harvest.
The findings confirmed that forest management must be actively practiced throughout the life of a forest stand. To be successful, however, stand management guidelines and merchantable yield projections are required. These guidelines and projections must include the influences of insects and diseases upon the forest crop in their development model. This information is particularly important in the development of complete Timber Supply Area plans and for the flagging of pest hazard periods during the development of spruce forests.Forestry, Faculty of
Graduate
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Tsuro, Urgent. "Modelling the impact of risk factors affecting TB treatment." Thesis, University of Fort Hare, 2013. http://hdl.handle.net/10353/d1019782.
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The Tuberculosis infection rate has been generally escalating due to poor health conditions in the Gweru district of Zimbabwe. The study therefore seeks to identify the risk factors that affect TB treatment in the Gweru district. A cross sectional study was carried out in which a questionnaire was employed for data collection on 113 respondents. A binary logistic regression model was employed for data analysis. A total of 98 TB patients were interviewed: [50 respondents (44.0%) had Multi-drug resistant Tuberculosis and 63 respondents (56.0%) had general Tuberculosis). Before being enrolled into the study, an informed consent form was given to each of the participants. The data was then put into excel and later transferred to SPSS for analysis. Out of the 14 potential risk factors of TB treatment, only 6 variables (side effects, gender, alcohol use, HIV status, smoking during the treatment period and having been pre-exposed to TB drugs) were statistically significant in their association with treatment failure.
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Villar, M. Tracey A. "Risk factors for impaired lung function in the elderly." Thesis, University of Southampton, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.339372.
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Bolinder, Gunilla. "Long-term use of smokeless tobacco : cardiovascular mortality and risk factors /." Stockholm, 1997. http://www.kibic.ki.se/ki/diss/971024boli.html.
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Scott, Andrew. "The influence of walking on risk factors associated with metabolic syndrome." Thesis, Canterbury Christ Church University, 2008. http://create.canterbury.ac.uk/12120/.
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Metabolic syndrome (MetS) represents a cluster of metabolic abnormalities, characterised by the presence of 3 or more of 1) abdominal obesity, 2) insulin resistance, 3) hypertension, 4) dyslipidaemia, and 5) emerging risk factors, such as pro-thrombotic and pro-inflammatory states, which are each independent cardiovascular disease (CVD) risk factors. This clustering of risk factors is reported to increase the odds ratio for cardiovascular and all-cause mortality above the risk associated with the individual components (Wilson, 2004). The precise aetiology of MetS is currently unknown, however an energy-dense diet, particularly high in carbohydrate, and an inactive lifestyle or low fitness may interact with a genetic susceptibility to contribute to the pathophysiology of MetS (Bouchard, 2007). Therefore the purpose of the studies included in this thesis were to determine whether accumulative brisk walking may improve risk factors associated with MetS and whether one single session of brisk walking at a moderate intensity may improve risk factors associated with MetS in middle-aged men at risk of MetS. Study one recruited 85 males aged 38-73 onto a 24-week randomised controlled trial with participants allocated to control (CON), single 30 minute daily brisk walking (SBW) or accumulative 30 minutes of daily brisk walking (ABW; 3×10 min or 2×15 min) groups. Measures included aerobic fitness (OO2max), body composition and selected blood variables. The main findings were that 24 weeks of accumulating 150 min·wk-1 of brisk walking at ~65% HRmax significantly improved insulin sensitivity, which was associated with decreased abdominal adiposity, assessed by waist circumference, and was at least as effective as a single daily session of equal volume in middle-aged men at risk of MetS. Study two investigated the 24-hour effect of walking for 30 minutes at 50% OO2max (30×50%), 30 minutes at 65% OO2max (30×65%) and 60 minutes at 50% OO2max (60×50%) compared to rest (CON) on cardiovascular control, resting metabolism and selected blood variables. The main findings were that a single 30 minute walking session at 50% OO2max favourably improved cardiovascular control, indicated by decreased heart rate and systolic blood pressure, thus decreasing the workload of the heart, whereas increasing the intensity of the walk to 65% OO2max attenuated this effect, while increasing the duration to 60 minutes had no additional effect compared to 30 minutes at 50% OO2max in men at risk of MetS.
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Hergens, Maria-Pia. "Swedish moist snuff and the risk of cardiovascular diseases /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-372-6/.
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Larsson, Helena. "Premature discharge from military service : risk factors and preventive interventions /." Stockholm : Karolinska institutet, 2009. http://diss.kib.ki.se/2009/978-91-7409-435-0/thesis.pdf.
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Barrett, Sheila C. "Risk factors of type 2 diabetes and cardiovascular diseases among Jamaican adolescents." FIU Digital Commons, 2009. http://digitalcommons.fiu.edu/etd/1413.
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Purpose: The purpose of the study was to examine Jamaican adolescents in a school setting, for risk factors of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs).
Methods: A descriptive epidemiological cross-sectional study of 276 Jamaican adolescents (112 males and 164 females) ages 14-19 years (15.6±1.2), randomly selected from grades 9-12 from ten high schools on the island. Thirteen risk factors were examined. Risk factors were compared with BMI levels and demographics. A sub-study validated finger prick testing of fasting blood glucose, total cholesterol, and HbAlc versus venous testing in 59 subjects.
Results: Prevalence of overweight was 33.0% (n=91) with mean BMI of 23.74±7.74. Approximately 66.7% of subjects reported > 3 risk factors. The number of T2DM and CVDs risk factors increased for subjects with BMI above 25. One third of the overweight subjects were classified with the metabolic syndrome. High BMI was associated with high waist circumference (r =.767, p
(r = .180, p.05). Percentage bias for the methods of blood testing met the reference standards for fasting blood glucose but not for total cholesterol and HbAlc. Bland Altman tests of agreement between the two methods indicated good agreement for all three tests.
Conclusion: Jamaican adolescents are at high risk for T2DM and CVDs as seen in other study populations. Effective programs to prevent T2DM and CVDs are needed. Family history of diseases, anthropometric measures, and gender identified more subjects at risk than did the biochemical measures. Comparison between finger prick and venous blood methods suggested that finger prick is an adequate method to screen for risk factors in children and adolescents.
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Iliadou, Anastasia. "Genetic epidemiological approaches to the study of risk factors for cardiovascular diseases /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-548-4.
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Han, Guangming. "Prevalence of Chronic Diseases and Risk Factors for Death among Elderly Americans." Digital Archive @ GSU, 2011. http://digitalarchive.gsu.edu/math_theses/108.
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The main aim of this study is to explore the effects of risk factors contributing to death in the elderly American population. To achieve this purpose, we constructed Cox proportional hazard regression models and logistic regression models with the complex survey dataset from the national Second Longitudinal Study of Aging (LSOA II) to calculate the hazard ratios (HR)/odds ratios (OR) and confidence interval (CI) of risk factors. Our results show that in addition to chronic disease conditions, many risk factors, such as demographic factors (gender and age), social factors (interaction with friends or relatives), personal health behaviors (smoking and exercise), and biomedical factors (Body mass index and emotional factors) have significant effects on death in the elderly American population. This will provide important information for elderly people to prolong lifespan regardless of whether they have chronic disease/diseases or not.
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Lau, Ming-ho, and 劉明昊. "Risk factors of hand foot mouth diseases outbreaks in kindergartens inHong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B42994901.
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Language, Sarah. "Prevalence and risk factors of chronic diseases of lifestyles in endurance runners." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29796.
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Background: Chronic diseases of lifestyle (CDL) are associated with high rates of morbidity and mortality in South Africa. Although prevalence of CDL has been established in the general population, there is limited research regarding the prevalence and risk factors for CDL in individuals taking part in regular physical activity. Endurance running is a popular sport, with growing levels of participation. Anecdotally, many individuals who participate in endurance running do not undergo formal pre-participation cardiovascular screening. It is also unclear if endurance runners are meeting the World Health Organisation’s recommended weekly moderate to vigorous intensity physical activity hours, or if they have other risk factors for CDL. It is therefore important to establish the prevalence and risk factors of CDL in this active population. Aim and Objectives: The aim of this study was to determine the prevalence of CDL and the associated risk factors in endurance runners in South Africa. The specific objectives of the study were: (a) to determine the presence of risk factors for the development of chronic diseases of lifestyle, including body mass index (BMI), waist circumference, body fat percentage, blood pressure, blood glucose, blood cholesterol, smoking history, dietary intake and weekly physical activity time in South African endurance runners; (b) to determine the presence of non-modifiable risk factors to the development of CDL, namely age and income, in South African endurance runners; (c) to determine whether South African endurance runners are fulfilling the World Health Organization’s recommended weekly moderate to vigorous intensity physical activity hours; and (d) to assess whether there are any relationships between the running characteristics, namely weekly training hours, running speed and level of competition; and the risk factors for chronic diseases of lifestyle. Methods: This study had an analytical, cross-sectional design. Two hundred participants between the ages of 18 to 69 years old, who reported endurance running as their main sport, and ran at least three kilometres twice a week for the past year were included in the study. Participants were excluded if they were pregnant or within six months post-partum, had an injury that required a minimum of two weeks rest or did not complete the questionnaire or physical testing component of the testing process. Participants were recruited through local running clubs and running races in the areas of Nelspruit, Mpumalanga and Cape Town, Western Cape. All participants gave written informed consent, and completed a questionnaire including socio-demographic characteristics, running training characteristics, the International Physical Activity Questionnaire short questionnaire, the modified Borg scale of perceived exertion, and the five-a-day community evaluation tool. Body mass, stature, skin folds and waist circumference were assessed. Blood pressure was measured using an automatic blood pressure monitor. A finger prick test was used to determine random blood glucose and cholesterol concentrations. Participants were requested to fast for three hours prior to testing to standardise the test in a non-fasted state (20). Results: One hundred and twenty four (62%) participants were found to have at least one risk factor for CDL. A high BMI was the most common risk factor for CDL (n=90; 45%). Nineteen participants (9.5%) did not meet the recommended duration of 150 minutes of physical activity per week. Seven percent of female participants (n=7) smoked, which is equivalent to the female population average of South Africa. Multiple risk factors were identified in fifty seven (28.5%) participants, ranging from two risk factors (n=37; 18.5%) to six risk factors (n=1; 0.5%). The majority of participants had no prior medical diagnosis of CDL or risk factors for CDL. The overall self-reported prevalence of a medically diagnosed CDL was 5.5% (n=11). Type 2 diabetes was the most commonly diagnosed CDL (n=6; 3%). Waist circumference, systolic blood pressure and cholesterol were significantly elevated in the older age group. There were no significant differences in risk factors for CDL according to income status. Female runners had significantly higher average sitting times compared to male runners. In addition, participants with a BMI ≥ 25 kg.m-2 had significantly slower 10 km running speeds and lower average weekly training distance, compared to participants with BMI within normal ranges. Conclusion: A high prevalence of risk factors for CDL was identified in South African endurance runners. The majority of endurance runners included in this sample are fulfilling the World Health Organisation’s recommended weekly moderate to vigorous intensity hours. However, the endurance runners in this study remain at risk for developing a CDL due to the presence of other risk factors for CDL. The knowledge and awareness of risk factors for CDL among South African endurance runners needs to be further investigated. Health care professionals are required to improve the prevention and management of risk factors of CDL through education and promotion of healthy lifestyles. A stronger emphasis on the prevention of risk factors for CDL in South African endurance runners is needed.
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Teel, William Baldwin. "A population-based case-control study risk factors for connective tissue diseases /." Thesis, Connect to this title online; UW restricted, 1997. http://hdl.handle.net/1773/10893.
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Heydon, Emma Elizabeth. "Telomere length and cardiovascular disease risk factors in South Asians." Thesis, University of Cambridge, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.708496.
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De, Wet Cornelia Susanna. "Feline hyperthyroidism in Hong Kong : prevalence and risk factors." Diss., University of Pretoria, 2008. http://hdl.handle.net/2263/30591.
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Feline hyperthyroidism is an important disorder in middle-aged and older cats. The cause and pathogenesis of the disease is still unknown and there are few published incidence rates or prevalence estimates. A descriptive cross-sectional study was conducted to determine the prevalence of and potential risk factors for feline hyperthyroidism in Hong Kong. Serum thyroxine (T4) was measured in 305 cats 10 years and older that presented at various veterinary clinics in Hong Kong between June 2006 and August 2007. The veterinarians taking the samples completed a questionnaire regarding the health of each cat. Each owner completed a questionnaire regarding vaccination history, internal and external parasite control, diet and the environment of their cat. Serum total T4 concentration was determined by use of a commercially available radioimmunoassay kit (Coat-a-count®, DPC®). For total T4 the feline reference interval was 12.8-50.0 nmol/L (1.0-3.9 ug/dL). All cats with a serum total T4 concentration of greater than 50.0 nmol/L were classified as hyperthyroid. Alanine aminotransferase (ALT) and alkaline phosphatase (ALP) activities were measured in all the samples. The prevalence of feline hyperthyroidism in Hong Kong was estimated at 3.93% (95% CI : 2.05-6.77) and there was no significant difference in prevalence between healthy (3.16%) and sick (4.37%) cats. This demonstrates that although this disease is present in Hong Kong, the prevalence is lower than the reported prevalence in other parts of the world. Risk factors that were examined included age, sex, breed, number of cats in household, vaccinations, parasite control, indoor environment, type of diet and type of water. Risk factors for hyperthyroidism identified by multivariate analysis were age and breed. Affected cats were more likely to be older (>15 years) and domestic shorthair cats were less likely to be diagnosed with hyperthyroidism than the other breeds combined. There was no statistically significant relationship between sex, vaccinations, parasite control or indoor environment and the development of hyperthyroidism. There was also no statistically significant relationship between the consumption of a canned food diet by the cats and hyperthyroidism. There were no characteristic clinical features amongst the cats that were hyperthyroid and only one cat exhibited the typical clinical syndrome of ravenous appetite with severe weight loss. The lack of distinctive clinical signs could be due to the presence of a mild or early form of the disease, but can also be due to an atypical form of the disease. This study showed that the disease needs to be considered if any of the following factors are present in an older cat : polyphagia, diarrhoea, and a significant raise in ALT and ALP activities. This study concluded that the prevalence of hyperthyroidism in cats in Hong Kong is less than in most other parts of the world, despite the presence of previously identified risk factors. Comparative epidemiological studies will be necessary to compare the presence of possible risk factors between feline populations in Hong Kong and elsewhere.Dissertation (MSc)--University of Pretoria, 2008.
Companion Animal Clinical Studies
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Geyser, Maria Magdalena. "Risk factors precipitating exacerbations in adult asthma patients presenting at Kalafong Hospital, Pretoria." Diss., Access to E-Thesis, 2006. http://upetd.up.ac.za/thesis/available/etd-08192008-110157/.
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Valencia, Celina I., and Celina I. Valencia. "Modeling social factors of HIV risk in Mexico." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/625554.
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Background: Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) is an urgent public health issue in Mexico. Mexico has witnessed a 122% increase in reported prevalence of HIV since 2001 (Holtz et al., 2014). Country estimates suggest there are between 140,000-230,000 individuals living with HIV in Mexico (CENSIDA, 2014). While approximately 50% of individuals living with HIV in Mexico are unaware that they are living with the virus (CENSIDA, 2014). Despite a federal universal HIV program implemented in 2011, HIV in Mexico has not reached a chronic infectious disease status as seen in other regions of the globe (Deeks, 2013). The mortality rate among individuals with HIV/AIDS in Mexico is 4.2 per 100,000 (CENSIDA, 2014). There is a paucity of findings regarding social and epidemiological data focused on populations outside traditional at risk populations of HIV in Mexico (Martin-Onraët et al., 2016). Analyzing aggregate country level data for Mexico provides necessary insights to better understanding previously unconsidered social factors that are informing sexual and reproductive health trends influencing HIV health patterns.
Methods: Secondary analyses were performed on Mexico's Encuesta Nacional de Salud y Nutrición 2012 (ENSANUT). Mexico’s ENSANUT is a probabilistic aggregate national dataset with a multistage stratified cluster sampling design (Janssen et al., 2013). ENSANUT is Mexico’s equivalent to the National Health and Nutrition Examination Survey (NHANES) in the United States. Data is collected via self-report interviews conducted at the participant's home. A structured questionnaire was administered to individuals 20 years of age and older (≥ 20) where sexual and reproductive data was collected from participants. The ENSANUT adult study sub-sample (n=46,227) is comprised of 42.75% men and 57.25% women. A general linear model (GLM), principal component analysis (PCA), chi-squares (χ²), and logistic regressions were applied to the study adult subsample to disentangle social factors associated with sexually transmitted infections (STIs) in the population. Quantitative analyses were conducted on SAS 9.4.
Findings: Men were more likely to have a STI diagnosis (OR=3.60; 95% CI 3.00, 4.32, p=<0.001). Previous HIV testing was found to be protective for STI diagnosis across both genders (OR=0.82, 95% CI 0.72, 0.94, p=<0.001). Co-infections of HIV/gonorrhea and HIV/syphilis (n=20) were the highest in the study population. The latent variable model indicates mental health and access to health care resources are critical for positive sexual and reproductive health outcomes in Mexico. Mental health was found to be non-protective for STI risk among the study population (OR=1.59, 95% CI 1.41, 1.81, p=<0.0001).
Policy recommendations: 1. Increased access and utilization of HIV resources and mental health services would benefit the study population. Further qualitative research is needed to better understand the barriers to health care access and utilization in these two domains; 2. Increase in preventative programs and health initiatives that encourage established strategies for positive sexual and reproductive health outcomes. These strategies include: universal human papillomavirus (HPV) vaccines, wide availability of Pre-Exposure Prophylaxis (PrEP), and routine HIV/STI screenings; 3. Alternative data collection strategies for ENSANUT which are culturally appropriate for sexual and reproductive health constructs.
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Lau, Ming-ho. "Risk factors of hand foot mouth diseases outbreaks in kindergartens in Hong Kong." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42994901.
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Chong, Boon Hor, and 鍾文一. "Risk of ischemic stroke and recurrent hemorrhagic stroke in Chinese population." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B47323450.
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Stroke is a devastating, neurological dysfunction due to brain blood supply disturbance. It is responsible for increasingly high rate of mortality and disability worldwide. This thesis comprises two original studies involving 868 patients at risk of ischemic stroke and/or hemorrhagic stroke.
The first study investigated aspirin’s effect among patients with intracranial hemorrhage. Unlike Caucasians which hemorrhagic strokes account for 10-15% of all strokes; in Chinese, intracranial hemorrhages strike up to 35%. After such, anti-platelet agent like aspirin is often avoided for fear of recurrent intracranial hemorrhages, despite compelling indications. However, clinical data is limited. In this single-centered observational study, we included 440 consecutive Chinese patients with a first spontaneous intracranial hemorrhage surviving the first month performed during 1996-2010. 56 patients (12.7%) of these 440 patients were prescribed aspirin after intracranial hemorrhage (312 patient-aspirin years). After a mean follow-up of 62.2 ± 1.8 months, 47 patients had recurrent intracranial hemorrhage(10.7%, 20.6 per 1,000 patient years). Patients prescribed aspirin did not have higher risk of recurrent intracranial hemorrhage compared with those without (22.7 per 1,000 patient-aspirin years vs. 22.4 per 1,000 patient years, p=0.70). Multivariate analysis identified age > 60 years and hypertension as independent predictors for recurrent intracranial hemorrhage. In a subgroup analysis: the incidence of combined vascular events including recurrent intracranial hemorrhage, ischemic stroke, and acute coronary syndrome was statistically lower in patients prescribed aspirin than without (52.4 per 1,000 patient-aspirin years, vs. 112.8 per 1,000 patient-years, p=0.04). Implications of the results: despite having a substantial risk for recurrent intracranial hemorrhage, post-intracranial hemorrhage ones are at risk for thrombotic vascular events and management goal should thus focus on ameliorating overall cardiovascular risk instead of preventing recurrent intracranial hemorrhage. Hence, thrombo-prophylaxis should still be considered.
The second study investigated the relation between premature atrial complexes and new-onset atrial fibrillation together with other cardiovascular events. Premature atrial complexes though taken as benign phenomenon, are common in patients with underlying conditions such as coronary heart disease, chronic rheumatic heart disease. While prompt management of atrial fibrillation may prevent ischemic stroke, atrial fibrillation is often unfound until ischemic stroke occurs. In this study, 428 patients without atrial fibrillation but complained of palpitations, dizziness or syncope were recruited. 107 patients with >100 premature atrial complexes/day were defined to have frequent premature atrial complexes. After a mean follow-up of 6.1 ±1.3 years, 31 patients (29%) with frequent premature atrial complexes developed atrial fibrillation compared with 29 patients (9%) with premature atrial complexes?100/day (p<0.01). Cox regression analysis revealed: frequent premature atrial complexes, age>75 years and coronary artery disease were independent predictors. In secondary endpoint (ischemic stroke, congestive heart failure, and death), patients with frequent premature atrial complexes were more at risk than those without (34.5% vs. 19.3%) (Hazard ratio: 1.95, 95% confidence interval: 1.37-3.50, p=0.001). Cox regression analysis showed: age> 75 years, coronary artery disease and frequent premature atrial complexes were independent predictors. These permit early identification of high risks patients of new atrial fibrillation and other events, thus promoting appropriate preventive treatment.published_or_final_version
Medicine
Master
Master of Philosophy
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Vlasyk, L. Yu. "The behavioral risk factors of major non-communicable diseases among economically active population." Thesis, БДМУ, 2020. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/18309.
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Angkurawaranon, C. "Urbanization and internal migration as risk factors for non-communicable diseases in Thailand." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2015. http://researchonline.lshtm.ac.uk/2267958/.
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Urbanization, which is driven mainly by the expansion of cities and urban migration, is considered one of the key drivers of non-communicable diseases (NCDs) in developing countries. This research aims to investigate the patterns and associations between different levels of urban exposures and NCD risk factors, NCD morbidity and NCD mortality in Thailand, to better understand the mechanisms underlying the link between urbanization and NCD in Thailand. Using several study designs and analytical techniques, the research described in this thesis found that the process of migration and living in an urban environment were associated with lower social trust and higher levels of emotional problems. Urban environments were also associated with behavioural and physiological risk factors for NCDs, including smoking, heavy alcohol consumption, inadequate physical activity, inadequate fruit/vegetable consumption, high BMI, and high blood pressure. Both early life urban exposure and accumulation of urban exposure throughout life potentially play a role in these increases in behavioural and physiological risk factors for NCDs. Early life urban exposure was also found to be associated with an increased risk of developing obesity in adulthood. Increased psychosocial, behavioural and physiological risk factors associated with living in an urban environment may not translate directly into increased prevalence of biological risk factors for NCDs (such as high cholesterol), the development of NCDs, or into NCD-related mortality. It is likely that biological risk factors for NCDs, as well as NCD incidence and mortality are more amendable to change from the positive influences of urbanization through higher socioeconomic status and potential access to better health care.
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Lu, Yuan. "Impact of Multiple Risk Factors and Preventive Interventions on Cardiovascular Diseases and Disparities." Thesis, Harvard University, 2015. http://nrs.harvard.edu/urn-3:HUL.InstRepos:14117763.
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Major cardiovascular risk factors have changed over the past 3-4 decades throughout the world. While adiposity and diabetes are rising worldwide, blood pressure and cholesterol are declining in high-income and even some middle-income countries, possibly due to improvements in diet or better diagnosis and treatment; the same risk factors have remained unchanged or even increased in low-income countries. To formulate effective prevention and health system policies, there is need to understand the implications of these diverse trends for cardiovascular diseases (CVDs).
This dissertation focuses on quantifying the impact of multiple risk factors and preventive interventions on CVDs and their disparities at the population level. Answering this question requires information on how much of the effects of adiposity on CVDs are mediated through other metabolic risk factors (i.e. high blood pressure, high serum cholesterol and high blood glucose), which themselves have other determinants. The first paper quantifies the direct as well as the mediated effects of excess weight on coronary heart disease (CHD) and stroke through blood pressure, serum cholesterol and blood glucose. The analyses use data of 97 prospective cohorts with more than 1.8 million participants. This allows for assessing whether the extent of mediation is modified by geographical region, study period, and other characteristics of study populations. The second paper revisits the above question using causal inference models and further quantifies the role of inflammatory markers as potential mediators. The analyses use individual-level data from 9 prospective cohort studies that have high-quality measurements of metabolic and inflammatory biomarkers. The third paper uses national data sources in the United States (US) and estimates the distributions of 10-year risk of fatal CHD by race. It also assesses the effects of different population-wide and targeted interventions on CHD risk distributions and their disparities between blacks and whites.
Our findings suggest that nearly half of excess risk for CHD and three-quarters of excess risk for stroke due to excess weight were mediated through three metabolic risk factors: blood pressure, cholesterol, and glucose. Inflammatory biomarkers had much smaller roles than the combination of metabolic risk factors. In the US, the distribution of 10-year CHD risk was shifted to the right among blacks compared to whites and had a heavier tail, leading to a substantially larger proportion of blacks in the high-risk group. A risk-based intervention that identifies and treats these individuals could substantially reduce both the overall risk of CHD and its racial disparities. These results together provide the quantitative evidence on the impact of cardiovascular risk factors and selected interventions on CVDs and their disparities.
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Ljungberg, Liza. "Angiotensin-Converting Enzyme : Effects of Smoking and Other Risk Factors for Cardiovascular Diseases." Licentiate thesis, Linköping : Department of Medical and Health Sciences, Linköping University, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-16704.
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Charbonneau, Guylaine. "Anthropometric correlates and underlying risk factors for type 2 diabetes mellitus among Inuit." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=97924.
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Type 2 diabetes mellitus (DM) is an emerging problem among Inuit of Circumpolar Countries. However, Canadian Inuit health surveillance data are limited. Data from the Nunavik Health Survey were used to evaluate the prevalence of overweight and obesity using the observed body mass index (BMIob) and the standardized BMI adjusted for sitting height (BMIstd). Also, data from Pangnirtung, Nunavut in the Baffin Region pilot health screening were used to evaluate anthropometric correlates of indices of insulin resistance. Obesity among the Nunavik study population (29.8%) is more prevalent than among general Canadians (23.1%), but the prevalence rates are more comparable when using BMIstd (21.5%). In Pangnirtung, anthropometric measures BMIob, BMIstd, waist circumference and percent body fat were associated with indices of insulin resistance/sensitivity (p ≤ 0.05). BMIstd showed similar results to BMIob and does not better predict the indices of insulin resistance/sensitivity.
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Appannah, Geeta. "Dietary patterns, obesity and cardiovascular risk factors in young people." Thesis, University of Cambridge, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648138.
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Phoku, Nkosinathi Terrence. "Cardiovascular risk factors among 15-20 years old rural subjects residing in Dikgale Demographic Surveillance Site (DDSS), Limpopo Province." Thesis, University of Limpopo (Turfloop Campus), 2013. http://hdl.handle.net/10386/1048.
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Thesis (M.Sc. (Chemical Pathology) --University of Limpopo, 2013Cardiovascular diseases (CVDs) are among one of the well documented conditions and pose a significant health burden in the world as they areconsidered to be of adult onset. However, recent studies have shown that in developed countries CVD risk factors are becoming prevalent in young people which isof great concern. Therefore, the aim of this study was to determine if CVD risk factors are present in young subjects aged 15-20 years of age residing in a rural area of a developing country. Methods: Subjects aged between 15-20 years who participated in the “Gene - Environment interaction project” were included in this sub-study. Total cholesterol, triglycerides, HDL-cholesterol, LDLcholesterol, insulin, glucose, creatinine, Lp(a), apoB, apoA-1 and hs-CRPwere determined. Blood pressure, physical activity (number of steps/day), weight, height, waist circumference and hip circumference were obtained from the database. Subjects with CRP levels above 10mg/L and creatinine levels above 130 mmol/L were excluded. Results: The present study showed an overall high prevalence of some CVD risk factors. There was high prevalence of insulin resistance (23.0% in females and 34.7% in males), and high hs-CRP (18.4% in females, 12.9% in males). The prevalence of low HDL-C levels was high (55.2% in females and 16.8 % in males), however, the prevalence of abnormal levels of other lipids such as total cholesterol/HDL-cholesterol ratio was low in both males and females. The prevalence of an increased apoB/apoA ratio was significantly higher in females 26.4% compared to males 7.9%. The prevalence of overweight (12.6%) and obesity (9.2%) was higher in females than in males (overweight 1%, obesity 0 %). The prevalence of hypertension was comparable between the two genders (5.7% in females and 10.9 % in males). Conclusion: The results showed a relatively high prevalence of non-traditional risk factors for cardiovascular diseases in adolescents residing in a rural area, Limpopo Province, while the prevalence of traditional risk factors such as total cholesterol and triglycerides was low.
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Grooten, Wim. "Work and neck/shoulder pain : risk and prognostic factors /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-848-7/.
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Sigvant, Birgitta. "Epidemiological aspects of peripheral arterial disease." Stockholm : Department of Molecular Medicine and Surgery, Karolinska Institutet, 2009. http://diss.kib.ki.se/2009/978-91-7409-670-5/.
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Moore, Vivienne M. "Fetal growth and cardiovascular risk factors in an Australian cohort /." Title page, contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09PH/09phm824.pdf.
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Ng, Kuen-to, and 伍權韜. "The gender difference and association between social position and cardiovascular risk factors in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B45012775.
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Söderberg, Karin. "Risk factors for haemagological malignancies : immune-mediated diseases, body mass index and magnetic fields /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-819-3/.
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Alkhalaf, Majid M. "Nutrition and body composition as risk factors of non-communicable diseases in Saudi Arabia." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8533/.
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Background: Saudi Arabia is an affluent nation faced with steep population increase (~75% in just over 10 years) and a young population (63% aged under 30) in the context of globalized dietary habits and food supply leading to increase the trend of consumption junk food use. However, there are no national dietary surveys to give more accurate details. With existing high prevalence of obesity, it is foreseeable that Saudi Arabia (SA) will face a significant increase in the burden of non-communicable diseases (NCDs) in a short space of time. Reducing the behavioural and environmental risk factors associated with NCDs (physical activity, alcohol overuse, exposure to tobacco smoke, and low nutritionally balanced diet including high salt and energy intake and low intake of fruit and vegetables) requires cross-community sectors, including health, education, agriculture, and planning. Early detection and intervention also require reliable and cost effective tools. The relationship between chronic high salt intake and CVDs has already been established. This thesis examines the relationship between body composition and nutrition, and NCDs using techniques from the full breadth of Human Nutrition Research. Methods: The first cross-sectional study focused on developing and validating a culture-specific FFQ for salt intake against 24-h urinary outputs and repeated 24-h dietary recall, to identify relationships between salt intake, socio-economic factors and blood pressure (BP); and explore dietary sources of salt intake. In the second study, a secondary analysis of integrated data from five Saudi National Surveys assessed the performance of different anthropometric measures (body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and waist to height ratio (WHtR)) and body composition indices (estimated skeletal muscle mass (SMM), the percentage of skeletal muscle mass to body weight (%SMM) and Skeletal Muscle Mass Index (SMI)) in predicting metabolic diseases. Saudi nationals only were included in the study. ROC analysis was used to explore the best predictor of metabolic diseases and develop new thresholds. To assess the agreement and misclassification of overweight and obesity using BMI and WC measurements, BMI in combination with WC measurements were used to classify participants as [High-Risk Adiposity by BMI and WC], [High-Risk Adiposity by BMI only], and [High Risk Adiposity by WC only] based on the action levels. Each anthropometric and muscle mass indices were categorised to deciles. Additionally calculated were age-adjusted odds ratios by applying logistic regression models of the different metabolic risk factors in case of an increase of one decile of the respective anthropometric and estimated SMM parameter. In the third study, a cross-sectional survey was developed using the Theory of Planned Behaviour to provide a holistic understanding of factors that may influence food choices and behaviours, and in particular, intentions of adopting a nutritionally-balanced diet. External variables including age, gender, socio-economic status, and being aware of health and nutrition policies and others were included into the model as they were potentially related to TPB constructs. Attitude toward behaviour, subjective norms, perceived behavioural control and knowledge as actual barriers to behaviour were assessed. Results: In the first study, the newly developed Saudi FFQ was found to be of moderate validity in ranking people based on their estimated salt intake, and performed as well as other salt FFQ developed for other nations. The Riyadh population used in this survey consumed 8.7 g salt per day (estimate), higher than the recommended level of salt ( > 5 g/d for salt). A minority (18%) met the recommended level. The main sources of salt were, surprisingly, vegetables and un-processed foods, and a positive relationship between income and salt intake was observed. Meanwhile, salt intake, defined by FFQ, was associated with systolic BP only (R=0.089, p=0.036), an association which disappeared when adjusted for age, WC and gender. The second study highlighted that a majority of Saudi adults could be categorized as overweight or obese (72%). Worryingly, short of half of those with a normal BMI (18.5–25) aged over 45 also had a large waist. Combining WC and BMI did not improve their value as predictors of metabolic diseases and WC was the best overall predictor of metabolic diseases while BMI was the poorest. This study suggests new cut-off points for WC in SA, in a context of metabolic diseases, ranging between 90 to 92 cm (women) and 94 to 99 cm (men). The newly developed WC cut-offs are higher than the cut-offs for Asian men and women (90 and 80 cm, respectively). The new WC cut-off for women is higher than the cut-off for Caucasian women (88 cm); and the WC cut-off for men is lower than the cut-offs for Caucasian men (102 cm). The obesity prevalence based on BMI and WC also increased proportionately with both SMM (kg) and SMI (kg/m2) increase while the obesity decreased proportionately with %SMM increase. SMI was a poor predictor of metabolic diseases while %SMM was the best, having the highest AUC levels. New (defined) cut-off points for %SMM for metabolic diseases were defined, ranging from 29 to 32% for men and 26 to 28% for women. The third study highlighted that very few SA adults have been exposed to national nutrition and health guidelines (18%). Awareness of these was the strongest predictor of attitude toward behaviour, social norms and knowledge of nutritionally-balanced diet whilst perceived social pressure to engage in behaviour toward a more nutritionally balanced diet (SN) was the strongest predictor of subjects’ intention. Conclusion: Study 1 added a new and unexpected source of salt intake including vegetables and unprocessed foods. These findings raise a concern regarding the encouragement to increase intake of vegetables without including advice regarding cooking advice, in light of the risk of higher salt intake in SA. It would be worthwhile to consider education strategies towards the use of alternative ingredients or dressings in salad and cooked vegetables. Study 2 added an evidence about the weakness of BMI and SMI in predicting metabolic diseases and misclassifying the population. The study suggests using WC and %SMM as alternative measures and adopting the newly developed cut-offs. Study 3 sheds the light on possible avenues for policies, health promotions and nutrition interventions to focus on Saudi adults, in order motivate the population to adopt nutritionally balanced diet by increasing population knowledge and awareness.
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Khan, Hassan. "Markers of glycaemia and risk of cardiovascular disease." Thesis, University of Cambridge, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648585.
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Black, James Alexander. "Optimising cardiovascular risk management early in the diabetes disease trajectory." Thesis, University of Cambridge, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.709489.
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Young, Seth Allen. "Selected risk factors associated with failure to receive immunizations in an age-appropriate manner /." The Ohio State University, 1985. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487262825075109.
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Gunnbjörnsdóttir, María Ingibjörg. "Asthma and respiratory symptoms in Nordic countries, environmental and personal risk factors /." Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7076.
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Awotedu, Kofoworola Olajire. "Functional changes of the vasculature leading to some cardiovascular risk factors in HIV/AIDS patients." Thesis, Walter Sisulu University, 2013. http://hdl.handle.net/11260/d1015712.
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The present study sought to explore the functional changes that occur in the vasculature of HIV positive participants of African origin in Mthatha district of South africa which might lead to increased risk in their cardiovascular system. Available literature shows that arterial stiffness plays an important role in cardiovascular events such as stroke, vasculitis and myocardial infarction. Measurement of (aortic pulse wave velocity; PWV) provides some of the strongest evidence concerning the prognostic significance of large artery stiffening. This study was aimed at investigating the relationship between anthropometry, age, E-Selectin level, cytokine levels, haemodynamic variables, blood counts and blood lipid profile with pulse wave velocity. Some traditional cardiovascular risk factors such as alcohol, and smoking were also taken into account. This was a cross-sectional study comprising of 169 participants (62 males and 107 females). 63 were HIV negative (group A), 54 HIV positive on treatment (group B), and 52 were HIV positive not on treatment (group C). Pulse wave velocity (PWV) was assessed using the Sphygmocor Vx. Statistically, ANOVA was used for variables with normal distribution and non parametric tests were used for variables with skewed distribution. Notable significant differences were seen in the means of the following variables across all the 3 groups. The mean PWV value for group C (7.21±2.17) was greater than that for group B (6.84± 1.17) which in turn was more than group A (6.38±1.67); P=0.037. In participants who are HIV negative, In univariate analysis PWV correlated significantly with the following: Augmentation index; AIx (75): (r=0.850,p=0.004): Systolic aortic blood pressure; Spa: (r=0.635, p<.000); diastolic blood pressure; dbp: (r=0.436, p<0.000); aortic pulse pressure; Ppa: (r=0.472, p=0.000); Mean arterial pressure; MP: (r=0.446 p=<0.00) and age (r=0.606, p<0.000). In participants who are on HAART the following variables were positively correlated with PWV: Ppa: (r=0.338,p=0.012), MP: (r=0.400,p=0.400), monocytes (r=0.320,p=0.047). Neutrophils: (r=0.341,p=0.034), CD4: (r=-0.446,p=0.009). In participants who are HAART naïve and HIV positive the following correlated with PWV Spa: (r=0.369, p=0.012), MP: (r=0.400, r=0.003) Ppa: (r=0.338,p=0.012), waist to hip ratio: (r=0.319, p=0.037), platelets: (r=0.037, p=0.019), triglycerides: (r=0.490, p=0.002). With multiple linear regression Spa, age and triglycerides as the only independent and significant determinants of PWV among HIV negatives R2= 56.9% (adjusted R2=54.7%), model adjusted for gender, anthropometric parameters, HDL-C, TC, LDL-C, haematologic data, haemodynamic data, cytokines, smoking and alcohol. Only MP and waist circumference were identified as the most important and significant independent determinants of PWV in HIV positive participants not on treatment. Age, MP, HDL-C, and triglycerides were identified as the significant independent determinants of the variations of PWV in HIV positive participants on HAART. R2 =57 %(adjusted R2 =53.5%). Model adjusted for gender, anthropometric data, smoking, alcohol, cytokines, adhesion molecules, total cholesterol, LDL-C. Haematological data, CD4 count, and other haemodynamic parameters. For Aix(75) In HIV negatives the multiple linear regression model identified age (positive correlation), height (negative correlation), CD4 (positive correlation) and MP (positive correlation) as the independent and significant determinants of AIx (75) among HIV negatives. Spa and Age were independently and significantly associated with the variations of Aix(75) among HIV positives not on HAART. On the other hand height was negatively and significantly associated with Aix(75) amongst HIV positives not on HAART. After excluding confounding factors, height (negative correlation) age (positive correlation), MP (positive correlation, HDL-C (negative correlation), platelets (positive correlation) alcohol intake (excessive consummation associated with positive correlation) and TNFα (negative correlation) were identified as the independent and significant variables associated with increase in AIx(75) among HIV positive participants on HAART. Conclusion: This study showed that HIV infected patients with or without antiretroviral therapy have increase arterial stiffness which is associated with an increased cardiovascular risk. The sphygmocor is an accurate, non invassive and useful tool in the evaluation of arterial stiffness and its use in clinical practice should be encouraged. PWV and the augmentation index (AIx) are the two major non-invasive methods of assessing arterial stiffness. Life style modification should be incorporated into the management of HIV patients so as the continuous monitoring of their haematological and lipid profile.
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Viali, Satupaitea Public Health & Community Medicine Faculty of Medicine UNSW. "Trends and development of non-communicable diseases and risk factors in Samoa over 24 years." Awarded By:University of New South Wales. Public Health & Community Medicine, 2009. http://handle.unsw.edu.au/1959.4/40404.
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Abstract inserted as part of Final MPH Thesis: Non-Communicable Diseases like diabetes, cardiovascular diseases, cancers and others, have become the major cause of premature death, morbidity and disability in many Pacific countries including Samoa. These are linked by common preventable risk factors like obesity, hypertension, smoking, unhealthy diets and physical inactivity. OBJECTIVES: To determine the trends and development of Non-Communicable diseases and its risk factors in Samoa over the last 24 years using the recently developed diagnostic criteria. RESEARCH DESIGN AND METHODS: This research thesis combines 3 large surveys that were done in 1978, 1991, and 2002, looking at the trends in the prevalence of diabetes, and the prevalence of the NCD risk factors such as blood pressure, obesity, cholesterol and smoking. The 3 survey samples were selected randomly from around similar regions (Urban Upolu, Rural Upolu, and Rural Savaii) of Samoa in 1978, 1991 and 2002, with a total of 5973 individuals (1978 survey = 1467; 1991 survey = 1778; 2002 survey = 2728) available for the thesis analysis. The 1978 and 1991 data sets were secured from Professor P Zimmet, and the 2002 STEPs survey data set was secured from the Samoa Ministry of Health. The 3 surveys methodologies, survey procedures, questionnaires and anthropometric measurements were similar though the diagnostic criteria used to measure obesity slightly differ between the surveys. The blood pressure measurements were similar though the diastolic blood pressure measure in 1978 was higher. The 1978 and 1991 surveys used fasting venous blood sampling to measure fasting plasma glucose, and cholesterol levels at the laboratory. OGTT was also used in 1978 and 1991, but not 2002. The 2002 survey used capillary sampling to measure fasting glucose using a glucometer, and cholesterol level using a cholesterol meter. The combined data was then cleaned, standardized and matched with each survey, to make analysis easier. The recent diagnostic criteria were then applied to all the surveys to diagnose diabetes (1999 WHO Diabetes Criteria), hypertension (WHO 1999, JNC-VII 2003, NHF 1999 Hypertension Criteria), obesity (BMI ≥30 kg/m??), and hypercholesterolaemia. The prevalences using the recent diagnostic criteria were then mapped out. RESULTS: The overall age-standardized prevalence of type 2 diabetes (known or previously unknown) utilizing the current 1999 WHO diagnostic criteria for men and women ≥20 years of age has increased from 5.4% (males 4.8%, females 5.9%) in 1978, to 12.0% (males 10.9%, females 13.5%) in 1991, and to 20.1% (males 17.2%, females 22.2%) in 2002. Among the individuals with diabetes in the 3 surveys, more than 60% had previously undiagnosed diabetes. Compared with the 1978 survey, the diabetes prevalence in 2002 represents a 4-fold increase over the 24 year period. This has occurred along with increasing obesity, urbanization and modernization, aging, cultural changes, and changes in physical activity. There is a high prevalence of non-communicable disease risk factors. The age-standardized prevalence of hypertension defined by the WHO 1999 and JNC-VII 2003 criteria was 47.2% in 1978, 22.5% in 1991, and 24.0% in 2002. The high prevalence of hypertension in 1978 was due to the method used for recording diastolic blood pressure. Hypertension was more common in the urban regions than rural regions in 1978 and 1991 while in 2002, there was no statistical difference between the rates of hypertension between the different regions due to the rise in the prevalence rate of hypertension in rural regions. There is a high prevalence of overweight and obesity in Samoa. Using the WHO classification for BMI, there was an increase in obesity (BMI ≥ 30kg/m??) prevalence in Samoa in the last decade, increasing steeply from 34.9% in 1978 to 51.3% in 1991, and slowing down to an increase to 57.4% in 2002. The prevalence of obesity is significantly higher in females compared with their male counterparts. The overweight prevalence (BMI 25-29.9kg/m??) was 34% in 1978, 31% in 1991 and 29% in 2002. The prevalence of obesity has increased by 65% from 1978 to 2002 with an increase of 47% from 1978 to 1991, and 12% from 1991 to 2002. Prevalence of obesity is increasing with age and is more of a problem in women than men. It is higher in the urban regions but there has been a faster rise in obesity prevalence in rural regions from 1978 to 2002 as the rural regions become urbanized. The prevalence of hypercholesterolaemia (total cholesterol ≥ 5.2 mmol/l) was 30.5% in 1978, and this increased to 51.1% in 1991. There was a marked decline of hypercholesterolaemia in 2002 (14.4%), which may be due to differences in the method of measurement. Although smoking prevalence remains high in Samoa it declined significantly from 42.4% 1978 to 35.3% 1991 but remained essentially steady at 38% in 2002. There was a significant gender difference in smoking with about 60% of men and 20% of women smoking regularly. CONCLUSION: Samoa is experiencing an increasing problem with Non-Communicable diseases like diabetes and some of its risk factors. Diabetes prevalence has dramatically increased by 4-fold in the last 24 years. The prevalence of hypertension has stabilized around 23% though there was a decrease from 1978. The prevalence of obesity has also increased. Smoking prevalence has slightly increased from 1991 to 2002 with a significant number of the population smoking. Hypercholesterolaemia is more common in 1991 with an apparent decrease in 2002. These findings have important implications for public health efforts and policy developments to contain the epidemic of Non-Communicable diseases in Samoa.
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Alamian, Arsham, and G. Paradis. "Individual and Social Determinants of Multiple Chronic Disease Behavioral Risk Factors Among Youth." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/1381.
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Naumburg, Estelle. "Perinatal Risk Factors for Childhood Leukemia." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2002. http://publications.uu.se/theses/91-554-5205-1/.
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