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Hekimoglu, Tayfun. "Adolescent pregnancy| Factors and prevention." Thesis, California State University, Long Beach, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1585952.
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In the United States the high rate of adolescent pregnancy is a cause for a concern. Previous research indicates that infants born to adolescent parents have negative social outcomes and are prone to repeat the cycle. For this reason, it is necessary and important to lower the adolescent pregnancy rates. The study examines factors that influence adolescent pregnancy and respondents' age when the first child was born (i.e., teenage pregnancy), consumption of alcohol, and sexually transmitted disease (STD) testing. The 2005 CHIS adult data set was used for the analysis; the sample used included only women less than 20 years of age at the time of interview (N = 390). There were no statistically significant findings, probably due to the small sample size.
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Kamupira, Mercy G. S. "Dyad-related factors in HIV prevention." Doctoral thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/9039.
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Includes bibliographical references (leaves 213-234).[Objectives] Currently, HIV prevention strategies focus on promoting the modification of those individual behaviours that lead to an increase in susceptibility to and transmission of HIV infection. The focus on individuals in HIV voluntary counselling and testing frequently overlooks the fact that communication and collaboration between the sexual partners is required to effect any behavioural change within an intimate partnership. Developing HIV prevention strategies targeting couples is therefore noted to be increasingly relevant for improving HIV/STI risk reduction uptake. Couple HIV counselling and testing (CHCT) is a strategy that aims to bridge this gap by providing a safe environment for partners to be tested and counselled together. In this way, the burden of disclosing one's HIV status to one's partner is eliminated, and the difficulties experienced by the tested individual in negotiating risk reduction uptake are significantly reduced. There is a paucity of data regarding couples' experiences in and perceptions of CHCT within the South African setting. This study explores couples' experiences before, during and after CHCT; determines the socio-behavioural risk factors for HIV status in couples; explores the impact of couple HIV status on fertility desires, and lastly examines the reliability of inter-partner reports on sexual and other behaviours. [Methods] This was a cross-sectional study with baseline and follow-up components; in addition to a qualitative study component. Structured interviewer-administered questionnaires were applied to each member of the couple separately at baseline prior to CHCT (n=600 couples), immediately post CHCT, and at least 1 month post the CHCT process (n= 258 couples). In addition, in-depth qualitative interviews were done with each member of 27 couples at least one month post CHCT. [Results] Overall, the HIV prevalence in the study sample was 30% (24% in male and 35% in the female participants). Of the 600 couples tested for HIV, 354 (59%) were HIV concordant negative, 136 (23%) were HIV serodiscordant and 110 (18%) were HIV concordant positive. Of the HIV serodiscordant, 101(74%) were couples in which the female was the HIV positive partner and 35 (26%) had HIV positive males. Contextual factors such as community perceptions and levels of HIV-related stigma significantly influenced the couples' decision to test for HIV. Couples reported improved risk reduction uptake and improved communication as well as general improvements in other aspects of their lives at follow-up post the CHCT process. Factors such as community and family expectations as well as financial stability seemed to play a more influential role as determinants of fertility desire, compared to the couple HIV status. Comparison of couples' responses to some questions regarding sexual and other behaviours revealed that there was low inter-partner agreement particularly with respect to questions regarding communication behaviours. Key findings indicate that CHCT was acceptable to the couples who attended this process, and yet, making the decision to test was difficult for most couples. Partners devised various strategies to initiate the discussion on the need to test for HIV. However, after CHCT attendance, the process was highly rated, regardless of gender or resultant HIV status. [Conclusion] In order to increase the usefulness and effectiveness of CHCT, the process must be able to address pertinent uncertainties and concerns that couples might have with regard to HIV risk-reduction uptake and fertility desires.
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Zhang, Yi, and 张一. "Identifying risk factors for suicide research and prevention." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hub.hku.hk/bib/B50533782.
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Research on risk factor for suicidal behaviors has been broadly conducted to enhance knowledge of suicide prevention. However, there are still challenges for risk factor research. Four major research gaps have been identified: (1) uncertain effectiveness of the population approach versus the high-risk approach for suicide prevention; (2) lack of a valid and convenient Chinese-version screening tool for the severity of suicidal ideation among adolescents; (3) demand for testing the prospective associations of risk factors with suicidal ideation using a longitudinal designed population-based sample; and (4) necessity of pathway analysis to explore and confirm how risk factors interact with each other and lead to suicidality. This thesis aims to address these gaps through a combination of five studies.
Study 1 introduces an illness and death model to suicide prevention research. Elasticity and sensitivity analyses were performed. The findings revealed that the control of suicide incidence among the healthy population is the most effective prevention strategy whereas treatment of mental illness appears to be the least effective approach to suicide prevention.
Study 2 validates the psychometric properties of the Chinese versions of Reynolds’s Suicidal Ideation Questionnaire (SIQ) and Suicidal Ideation Questionnaire Junior (SIQ-JR, a short version of the SIQ) in a sample of Hong Kong adolescents. A short, four-item version of the SIQ-JR has been suggested as an alternative to the SIQ and the SIQ-JR.
Study 3 identifies the history of psychiatric treatment, depression, anxiety, hopelessness, unstable marital status, poor economic circumstance, and a recent death of a first-degree relative as significant risk factors for the incidence of suicidal ideation. The associations of change in risk factors with the development of suicidal ideation have been tested. There are gender and age differences in the patterns of such associations.
Study 4 focuses on psychological factors associated with the first-ever incidence of suicidal ideation. Psychological factors have been detected generally to differ in their associations with the incidence and persistence of suicidality. The idea that depression partially mediates the effect of average life distress on the persistence of suicidal ideation has clinical value.
Study 5 introduces and tests a stressor and illness model as a theoretical framework reference for future risk factor research. Risk factors are classified into stressor, illness, and pattern factors. Both the simple and complex models are tested. Evidence supported the proposed mediating role of mental disorders between negative life events and severity of suicidal ideation. A gender-specific pattern of associations between stressors, illness, and severity of suicidal ideation has also been detected.
This thesis has made substantial theoretical, psychometric, and empirical contributions to the existing knowledge of suicide research.published_or_final_version
Social Work and Social Administration
Doctoral
Doctor of Philosophy
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Riordan, Paul J. "Dental fluorosis diagnosis, epidemiology, risk factors and prevention /." Perth : Health Dept. of Western Australia, Dental Services, 1994. http://books.google.com/books?id=LO5pAAAAMAAJ.
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Fletcher, Paula C. "Falls among the elderly, risk factors and prevention strategies." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1996. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/nq21346.pdf.
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Jones, Anastasia. "The Homeless Adolescent Population: Complexity, Protective Factors, and Prevention." Scholarship @ Claremont, 2011. http://scholarship.claremont.edu/cmc_theses/230.
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The growing number of people living below the poverty line has made homelessness a topic of interest, once again. This paper focuses on the homeless adolescent population that is often overlooked, and explores the complexity of the homeless situation, and how there is no definite solution to overcome homelessness. At-risk and homeless adolescents are affected by many negative factors that cause them to seek early independence, such as parenting style, finical instability, lack of an education, drugs and alcohol, physical and sexual abuse, all of which are discussed in this paper. Along with the negative factors, there are protective barriers that can potentially help an at-risk adolescent but are ineffective once the adolescent is homeless. This paper also addresses how we as a society can be more proactive in helping this population, and be aware if the warning signs that can lead a youth to decide to run away and eventually end up homeless.
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Hooper, Susan Mary. "Tooth wear associated with dietary factors and its prevention." Thesis, University of Bristol, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.687416.
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Tooth wear is now reported in large numbers of children and young adults, and this is predominantly thought to be related to enamel and dentine erosion. Changes in diet, lifestyle and social behaviour are all considered to contribute to this concerning trend in young dentitions. This dissertation investigates methods for measuring tooth wear in vitro and in situ, studies the effects of erosion and abrasion on enamel and dentine, and explores ways to limit the damaging effects of these processes. The literature review considers the structure of normal dental tissues and the consequences of tooth wear before reviewing enamel and dentine erosion in greater detail, together with ways of addressing this condition for the benefit of future generations. Ten published works are included in this dissertation. Classic methodology for in situ erosion studies was improved and also applied to combine assessment of abrasion and erosion. Results of studies undertaken confirmed the erosive potential of conventional and modified citric and malic acid based fruit juices, acid based fruit drinks, sports drinks and acidic fruit flavoured coatings on chewing gum. The erosive effect of acid based fruit drinks was shown to be reduced by adding calcium [at both room and elevated temperatures], or adding calcium with maltodextrin, or adding calcium with phosphate at room temperature. Further studies showed protection against an erosive challenge in situ, by an experimental fluoride-based toothpaste containing sodium hexametaphosphate, and the benefit of a low RDA [relative dentine abrasivity] paste on dentine. Finally, two studies confirmed the anti-erosive properties of stannous-containing sodium fluoride toothpaste compared with competitor formulations. Conclusions from the work in this dissertation are that acidic based fruit drinks can be beneficially modified to reduce enamel and dentine erosion and that additional protection can be gained from the use of customised anti-erosion toothpastes.
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Brughelli, Matt. "Risk factors, assessments and prevention of muscle strain injuries." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2009. https://ro.ecu.edu.au/theses/1908.
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The relationships between mechanical stiffness, eccentric exercise and muscle strain injury are emerging areas of interest to researchers. For example, asymmetries between lower body limbs during athletic movements (i.e. ground reaction forces or mechanical stiffness) are thought to increase the risk of injury and compromise performance. The first two chapters of this PhD reviewed the literature on the topics of mechanical stiffness, and the effects of eccentric exercise on optimum length for force development. Both chapters included implications for muscle strain injuries. The third chapter reviewed the previous literature that has investigated the effects of eccentric exercise on hamstring injury rates. The interventions used were critiqued, and new eccentric exercises and interventions were introduced. The following four chapters included experimental research on: first) the effects of running velocity on running kinetics (e.g. vertical and leg stiffness) (i.e. chapter 5); second) relationships between hamstring injuries and leg asymmetries during running (i.e. chapter 6); third) the relationships between training background and optimum length, and fascicle length (i.e. chapter 7); forth) a case study on an eccentric exercise intervention for a previously injured athlete (i.e. chapter 8); and, finally) the effects of eccentric exercise on the optimum angle (knee flex ors and extensors) and injury occurrence in professional soccer players (i.e. chapter 9).
The purpose of chapter 5 was to investigate the effects of running velocity of running kinetics and kinematics in Australian Rules football players. Sixteen semiprofessional Australian football players participated in this study. The subjects performed running bouts at 40%, 60%, 80% and 100% of their maximum velocity on a Woodway non-motorized treadmill. The variables of interest included: vertical force (Fv), relative veriical force (RFv), vertical stiffness, leg stiffness, horizontal force (Fb), relative horizontal force (RFb), contact times, impulse, stride frequency and stride length. As running velocity increased from 40% to 60%, RF v and RF h increased by 14.3% ((Effect Size (ES)= 1.0)) and 34.4% (ES= 4.2) respectively. The changes in RFv and RFh from 60% to 80% were 1.0% (ES= 0.05) and 21.0% (ES= 2.9). And finally, the changes in RFv and RFh from 80% to maximum were 2.0% (ES = 0.1) and 24.3% (ES= 3.4) respectively. The total increase in RFh from the slowest running speed (i.e. 40% max) to maximum was 102.0% (ES= 9.3). Vertical stiffness significantly increased between each increasing running velocity (p < 0.05) while leg stiffness remained constant. Both stride frequency and stride length significantly increased with each increasing velocity (p < 0.05). Conversely contact times, impulse and the vertical displacement of the center of mass significantly decreased with running velocity (p < 0.05). A significant positive correlation was found between Fh and maximum running velocity (r = 0.4 7). For the kinematic variables, only stride length was found to have a significant positive correlation with maximum running velocity (r = 0.66). It would seem that increasing maximal sprint velocity may be more dependent on horizontal force prodnction as apposed to vertical force production.
The purpose of chapter 6 was to quantify the magnitnde of leg asymmetry in kinetic and kinematic variables during running in non-injured and previously injured Australian Rules football (ARF) players. The players included a group of non-injured ARF players (n = II) and a group of previously injured ARF players (n = 11; hamstring injuries only). The players in the injured group had at least one acute hamsh·ing injury in the previous two years. The legs of the non-injured players were classified as dominant and non-dominant whereas the legs of the injured players were classified as injured or non-injured. The players ran on a non-motorized force h·eadmill at approximately 80% of their maximum velocity (Vmax). For the noninjured players, there were no significant differences between dominant and nondominant legs for any of the variables. For the injured players, the only variable that was significantly (p<0.001) different between the injured and non-injured leg was horizontal force production (175 ± 30 vs. 324 ± 44 N). Furthermore, the injured leg (injured group) produced significantly less (30.2% and 33.9%) horizontal force than either legs (dominant and non-dominant legs) of the non-injured group, and the noninjured leg produced significantly more (18.2% and 22.5%) horizontal force than either legs of the non-injured group. In the present study, hamstring injures appeared to have an influence on leg asymmetry in horizontal but not vertical force production during running at sub-maximal velocities.
The purpose of chapter 7 was to investigate differences in optimum angle of peak torque (knee extensors and flexors) and muscle architecture ( vastus lateralis) between nine cyclists and nine Australian Rules Football (ARF) players. The angles of peak torque of the ARF players were significantly (p<0.05) greater during knee extension 70.8 ± 3.5° vs. 66.6 ± 5.9° and smaller during knee flexion 26.2 ± 2.9° vs. 32.3 ± 3.8° compared with the cyclists. The ARF players had significantly (P<0.05) smaller pennation angles 19.3 ± 2.0° vs. 24.9 ± 2.5° and longer fascicle lengths 7.9 ± 0.7 cm vs. 6.2 ± 0.8 cm in comparison with the cyclists. There were no significant differences between groups in regards to muscle thickness or peak torque ratios between the quadriceps and hamstrings (Q/H ratio). Muscle architectural changes associated with resistance strength training need to be investigated so as the effects of training on architecture and functional perfonnance can be detennined.
The purpose of chapter 8 was to present an eccentric exercise intervention, including multi-joint and closed chain exercises, for an Australian Football player with a history of acute hamstring injuries. The athlete was a 24 year old Australian Rules football player with a medical history of three hamstring muscle strain injuries to his right hamstring in the previous four years. After the first three phases of the intervention (i.e. nine weeks), the optimum angle of peak torque during knee flexion decreased from 37.3 to 23.9° in the injured leg, and from 24.3 to 20.3° in the healthy leg. After the first nine weeks, the optimum angles remained constant for another 23 weeks. The optimum angle of peak torque was also shifted in the knee extensors by 3.9° (injured leg) and 3.4° (healthy leg) after nine weeks and remained constant for the remaining 23 weeks. Quadriceps to hamstring peak torque ratio's (Q/H ratios) and peak torque during knee flexion and extension remained constant throughout the intervention. An intervention consisting of multi-joint and closed-chain eccentric exercises can be safe and effective for altering the optimum angle of peak torque (i.e. shifting to longer muscle lengths), after acute hamstring injuries.
The purpose of chapter 9 was to investigate the effects of eccentric exercise on injury occurrence (i.e. hamstrings and rectus femoris) and optimum angle of peak torque (i.e. knee flexors and extensors) in professional soccer players. Twenty three members of a Spanish Professional League soccer team (Division II) were randomly assigned to either an eccentric exercise intervention group (EG) or a control group (CG). Both groups performed regular soccer training during the four week study, which was conducted during the clubs pre-season. After the four weeks, the optimum angles of the knee flexors were significantly (p < 0.05) decreased (i.e. increase in optimum length) by 2.0° in the CG and by 4.0° in the EG. The change in the EG was significantly different to the CG. The optimum angles of the knee extensors were significantly increased (i.e. increase in optimum length) in the EG only by 6.7°. Peak torque levels and ratios of quadriceps to hamstring (Q/H ratios) were not significantly altered throughout the study for either group. There were no injuries reported in the EG, but two rectus femoris muscle strain injuries reported in the CG. It appears that eccentric exercise can shift the optimum length of the knee flexors and extensors and these shifts may have a positive influence in reducing the incidence of injury.
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Nuhu, Assuman. "Factors influencing implementation of soccer injury prevention strategies in Rwanda." Thesis, University of the Western Cape, 2008. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_4867_1271621548.
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Background: Three epidemiological studies conducted in Rwanda have highlighted that many people at different levels in the community of soccer do not implement accepted control measures for reducing the risk of injuries. However, little is known about what soccer community members themselves know about injury prevention. Purpose: The aim of this study was to identify perceptions of factors influencing the implementation of soccer injury prevention strategies in Rwanda.
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Arshad, Syed Hasan. "Allergic disorders in early childhood - prevalence, risk factors and prevention." Thesis, University of Southampton, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.239918.
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Dingli, Kelly M. "Engaging delinquent adolescents in a school-based injury prevention program." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/101513/4/Kelly_Dingli_Thesis.pdf.
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This thesis examined how a universally delivered school-based injury prevention program targeting alcohol-use, violence, and transport- risks was relevant to delinquent year 9 adolescents. The studies examined factors influencing implementation and outcomes. A delinquency classification method was developed and the influence of maturation and the intervention on trajectories of delinquent involvement were examined. Underlying principles that could be applied to other health promotion interventions for delinquents were identified. The program was found to reduce medically-treated injury experience and the transport-risk for delinquents over a six month period. The findings have implications for school-based program design and implementation for delinquent adolescents.
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Lor, Kevin C. "Factors leading Hmong youths to join gangs." Online version, 2003. http://www.uwstout.edu/lib/thesis/2003/2003lorc.pdf.
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Zen, Monica. "Pre-Eclampsia: Prediction, Prevention And Long-Term Sequelae." Thesis, The University of Sydney, 2022. https://hdl.handle.net/2123/29566.
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Preeclampsia is a multi-system disorder that affects approximately 3-5% of all pregnancies and is one of the leading causes of maternal and neonatal morbidity and mortality globally. At present, there remain many facets of preeclampsia lacking data and comprehensive understanding. This thesis presents a number of studies investigating various aspects of prediction, prevention and long-term sequelae of preeclampsia.
Women with pre-existing diabetes mellitus (DM) form a unique cohort of women with significantly increased risk of developing preeclampsia in pregnancy compared to the general population. Despite this, there is minimal data on serum predictive markers and no data on urinary predictive markers for the development of preeclampsia in this cohort. This thesis explored both urinary and serum predictive markers for preeclampsia throughout pregnancy, in women with pre-existing DM. We described urinary protein excretion as pregnancy progresses in women with pre-existing DM. For total protein excretion measured via spot urine protein-to-creatinine ratio (uPCR), results were in keeping with the literature within the general obstetric population, with increments as pregnancy progressed. However, unlike the general population, in our population of women with pre-existing DM, spot urinary albumin-to-creatinine ratio (uACR) remained stable until late trimester 3. We additionally found that for our population, in each trimester of pregnancy, spot uACR outperformed spot uPCR with respect to its association with the outcome of preeclampsia. Additionally, placental growth factor (PlGF) is known to play a key role in placental angiogenesis in pregnancy - we found that preeclampsia is associated with an anti-angiogenic state, with reduced levels of serum PlGF and increased levels of soluble fms-like protein kinase 1 (sFlt1). We demonstrated correlation between urinary and serum levels of PlGF throughout pregnancy and in contrast to the literature within the general obstetric population, we found that for our women with DM, serum PlGF alone performed as a better predictor of preeclampsia than the serum sFlt1-to-PlGF ratio, at all gestations sampled throughout pregnancy.
Due to their increased preeclampsia risk, there is clear consensus that women with pre-existing DM would benefit from aspirin prophylaxis for preeclampsia risk reduction. These recommendations appear to stem from data obtained in the general population. However, there is evidence suggesting potentially reduced aspirin effectiveness in those with pre-existing DM. We reviewed the current literature of preeclampsia risk reduction with aspirin prophylaxis within women with pre-existing DM. Our systematic review is the first published review exploring the available data around the use of antenatal aspirin for the prevention of preeclampsia specifically in women with pre-existing DM. Our findings revealed a great void of available data surrounding aspirin prophylaxis for preeclampsia risk reduction in this cohort, with results suggesting no difference in preeclampsia outcome with aspirin use, a finding likely a consequence of lack of power due to insufficient data available for our cohort of interest.
Preeclampsia not only poses immediate risk to the mother and neonate during the peripartum period, but it is now understood that it has long-term implications for both the mother and offspring. A wealth of evidence now exists demonstrating women with a history of preeclampsia have increased long term risk of cardiovascular morbidity and mortality. It appears that preeclampsia history may be a gender specific cardiovascular risk factor akin to traditional cardiovascular risk factors such as hypertension or obesity. It is known that those with increased cardiovascular risk are also at increased cardiovascular morbidity and mortality post-surgery. However, no data exists regarding postoperative cardiovascular risk in women with a history of preeclampsia. We aimed to explore this association in the PREECLAMPSIA-VISION study, a sub-study including all female participants with a positive pregnancy history from the original Vascular events In noncardiac Surgery patIents cOhort evaluatioN (VISION) study, a large international prospective cohort study of a representative sample of adults aged 45 years and older who underwent non-cardiac surgery. Our primary outcome was Myocardial Injury after Non-cardiac Surgery (MINS) within 30 days after surgery. We found that a positive preeclampsia history was an independent risk factor for MINS, with 26% relative increase in the hazard of MINS in the first 30 post-operative days when compared to women whose previous pregnancies were not complicated by preeclampsia.
In addition to long-term implications for the woman, epidemiological evidence also supports an association between maternal preeclampsia and long-term neurocognitive function in the offspring. However, the available literature is conflicting and there is often incomplete consideration of confounding factors. We explored this association, taking into account important confounding and mediating factors, via a population-based cohort study using record-linkage of New South Wales birth, hospitalization and education data. Our outcome of measure for neurocognitive function was offspring school performance as assessed by the Grade 3 National Assessment Program–Literacy and Numeracy (NAPLAN), a standardised national test, which assesses children in 5 domains: reading, writing, spelling, grammar and punctuation, and numeracy. Our outcome of interest was a score below the national minimal standard (BNMS) in any of the 5 NAPLAN domains. In children exposed to preeclampsia in utero, crude univariate analysis demonstrated an increased risk of scoring BNMS in all 5 NAPLAN domains compared to children of unaffected pregnancies. Interestingly, once perinatal and child factors were accounted for, these differences were completely attenuated. The perinatal factors had a greater mediating effect than child factors, with gestational age at birth being the primary contributor, accounting for up to 21% of the association between preeclampsia and scoring BNMS.
All the studies presented within this thesis have either direct clinical implication or translational potential to clinical practice and have laid the foundation for further research. We suggest that women with pre-existing DM form a unique high-risk cohort of women with respect to the outcome of preeclampsia, and screening with uACR instead of the current clinically used uPCR would provide improved risk stratification for this cohort. Our results also suggest that the implementation of current clinically used algorithm-based screening, particularly those that include serum sFlt1-to-PlGF ratio may not be appropriate for women with pre-existing DM and screening within this cohort cannot be based on extrapolation of data obtained from the general obstetric population. Additionally, urinary PlGF holds promise for preeclampsia screening within this cohort and possibly the general obstetric population, however more sensitive commercially available kits are required. Further, we suggest caution before extrapolating currently available data for preeclampsia risk reduction with aspirin prophylaxis to women with pre-existing DM. Our PREECLAMPSIA-VISION study underscores the distinct requirement for enhancement in our overall understanding of gender differences in perioperative cardiovascular outcomes and overall long-term cardiovascular risk and suggests benefit in the incorporation of preeclampsia history into current perioperative risk predictive models for female patients. Lastly, to reduce the risk of poorer long-term offspring educational outcomes associated with preeclampsia, we support the implementation of strategies to safely prolong pregnancy and increase gestational age at birth in women whose pregnancies are complicated by preeclampsia.
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Schultze-Krumbholz, Anja [Verfasser]. "Cyberbullying : Risk and Protective Factors, Consequences and Prevention / Anja Schultze-Krumbholz." Berlin : Freie Universität Berlin, 2015. http://d-nb.info/1076038808/34.
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Schulman, Carl I. "Prevention of Elderly Pedestrian Injury - A Comprehensive Approach and Analysis." Scholarly Repository, 2011. http://scholarlyrepository.miami.edu/oa_dissertations/568.
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The mortality rate for elderly pedestrians struck by vehicles is the highest of any age group, approaching 30% in several large series. Currently, there is a lack of epidemiological studies of the risk factors associated with elderly pedestrian injury; in particular, few prospective studies of elderly pedestrian injuries have been performed. The primary purpose of this project was to identify risk factors that will lead to the development and implementation of effective prevention strategies to reduce the risk of pedestrian injury in this vulnerable population. The project had three phases. In phase 1, pilot studies were performed and identified potential risk factors for elderly pedestrians and confirmed their ability to recall accident details. Risk factors identified included certain walking and street crossing behaviors, as well as the lack of use of assistive devices. In Phase 2, the relatively new case-crossover design was utilized to investigate the association of transient (proximate) triggers or exposures with elderly pedestrian injuries. The relative risk of injury if not obeying the traffic signal is five-fold (odds ratio = 5.2; 95% confidence interval = 1.8 – 15.1). Risk factors such as use of sedating or mood altering medications, or the use of alcohol did not have sufficient discordance for analysis. The behavioral findings suggested that educational programs and behavioral modification might play an important role in designing future interventions. Therefore, in Phase 3, an elderly pedestrian safety program called Safe Crossings was created and evaluated. Over 700 subjects participated in the programs, with 99% reporting they felt it was an important topic and 93% acknowledging they learned something from the program. Focus groups were also utilized to help refine the content and delivery of the program. Posters and brochures were created and distributed in English, Spanish and Creole. The program is now set for wider dissemination and validation.
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Mendoza, Mathison Lilian Cristina. "Risk factors for hyperglycemia in pregnancy, and vitamin D as a prevention strategy in the DALI study." Doctoral thesis, Universitat Autònoma de Barcelona, 2021. http://hdl.handle.net/10803/673323.
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La present tesi doctoral se centra en l’estudi dels factors de risc i l’ús de la vitamina D com a estratègia de prevenció de la diabetis mellitus gestacional (DMG) en una població d’alt risc participants en l’estudi DALI (Intervenció d’estil de vida i vitamina D per a la prevenció de DMG) En el primer article, es descriu l’assaig controlat aleatoritzat DALI de vitamina D per a la prevenció de DMG. L’assaig controlat aleatoritzat DALI va avaluar la suplementació de vitamina D amb 1600 UI / dia, (+/- intervenció combinada d’estil de vida), en una població d’alt risc de DMG, des <20 setmanes de gestació fins al part. Els resultats primaris van ser les mesures subrogades de DMG: glucèmia plasmàtica en dejú (GPA), HOMA-IR i augment de pes intragestación. Hi va haver una petita millora en la GPA (-0,14 mmol / l; IC 95%: -0,28, -0,00) a les 35-37 setmanes de gestació, però no es va observar millora en cap resultat primari a les 24-28 setmanes. Una anàlisi post hoc va identificar com a variables independents per a la suficiència de vitamina D: l’ètnia europea (OR 19,84, CI95 5,87-67,08), l’estació de l’any de l’extracció (OR estiu vs. primavera 17,0 , IC 95 1,84-157,5, ns per altres estacions) i la presa de vitamines (OR 11,1, IC 95 3,01-41,2). En el segon article es descriuen els factors de risc d’hiperglucèmia gestacional (HG) en la població DALI, en diferents períodes de la gestació i punts de la sobrecàrrega oral de glucosa (SOG). Realitzem un sub-anàlisi observacional de l’estudi DALI, que va incloure a 971 dones, que es van sotmetre a una SOG a les <20, 24-28 i 35-37 setmanes (criteris IADPSG / WHO2013). Una regressió logística multivariant va seleccionar variables independents (incloent característiques basals maternes i de la gestació actual) per HG. Les característiques clíniques associades de forma independent amb HG van ser: <20 setmanes, intolerància a la glucosa prèvia (odds ratio (OR): 3,11; IC 95%: 1,41-6,85), DMG prèvia (OR: 2 , 22; IC 95%: 1,20-4,11), circumferència cervical (CC) (OR: 1,58; IC 95%: 1,06-2,36 per al tercil superior), freqüència cardíaca en repòs ( FCR, OR: 1,99; IC 95%: 1,31-3,00 per al tercil superior) i centre de reclutament; a les 24-28 setmanes, mortinat previ (OR: 2,92; IC 95%: 1,18-7,22), FCR (OR: 3,32; IC 95%: 1,70-6,49 per al tercil superior) i centre de reclutament; a les 35-37 setmanes, talla materna (OR: 0,41; IC 95%: 0,20-0,87 per al tercil superior). Les característiques clíniques associades de forma independent amb DMG / diabetis franca, diferien segons el punt de temps de la SOG (per exemple, la CC es va associar amb glucosa alterada en dejú a <20 setmanes, mentre que la FCR es va associar amb la glucosa postsobrecarga a <20 setmanes). En conclusió, en dones amb sobrepès / obesitat participants en l’estudi DALI, la suplementació amb vitamina D no va millorar substancialment les mesures subrogades de DMG definides com a resultats primaris (GPA, HOMA-IR, augment de pes intragestación). Les concentracions mitjana de vitamina D a l’inici de l’estudi van ser més altes del que s’esperava i els principals predictors de la suficiència de vitamina D van ser l’ètnia europea i la ingesta de multivitaminas. En aquesta població, els factors de risc d’HG diferien segons el període de la gestació i el punt de la SOG, i podrien ajudar a definir els criteris per a la detecció selectiva o els participants d’assajos de prevenció.”La presente tesis doctoral se centra en el estudio de los factores de riesgo y el uso de la vitamina D como estrategia de prevención de la diabetes mellitus gestacional (DMG) en una población de alto riesgo participantes en el estudio DALI (Intervención de estilo de vida y vitamina D para la prevención de DMG) En el primer artículo, se describe el ensayo controlado aleatorizado DALI de vitamina D para la prevención de DMG. El ensayo controlado aleatorizado DALI evaluó la suplementación de vitamina D con 1600 UI/día, (+/- intervención combinada de estilo de vida), en una población de alto riesgo de DMG, desde <20 semanas de gestación hasta el parto. Los resultados primarios fueron las medidas subrogadas de DMG: glucemia plasmática en ayunas (GPA), HOMA-IR y aumento de peso intragestación. Hubo una pequeña mejoría en la GPA (-0,14 mmol/l; IC 95%: -0,28, -0,00) a las 35-37 semanas de gestación, pero no se observó mejora en ningún resultado primario a las 24-28 semanas. Un análisis post hoc identificó como variables independientes para la suficiencia de vitamina D: la etnia europea (OR 19,84, CI95 5,87-67,08), la estación del año de la extracción (OR verano vs. primavera 17,0, IC 95 1,84-157,5, ns para otras estaciones) y la toma de vitaminas (OR 11,1, IC 95 3,01-41,2). En el segundo artículo se describen los factores de riesgo de hiperglucemia gestacional (HG) en la población DALI, en diferentes periodos de la gestación y puntos de la sobrecarga oral de glucosa (SOG). Realizamos un sub-análisis observacional del estudio DALI, que incluyó a 971 mujeres, que se sometieron a una SOG a las <20, 24-28 y 35-37 semanas (criterios IADPSG/WHO2013). Una regresión logística multivariante seleccionó variables independientes (incluyendo características basales maternas y de la gestación actual) para HG. Las características clínicas asociadas de forma independiente con HG fueron: <20 semanas, intolerancia a la glucosa previa (odds ratio (OR): 3,11; IC 95%: 1,41-6,85), DMG previa (OR: 2,22; IC 95%: 1,20-4,11), circunferencia cervical (CC) (OR: 1,58; IC 95%: 1,06–2,36 para el tercil superior), frecuencia cardíaca en reposo (FCR, OR: 1,99; IC 95%: 1,31–3,00 para el tercil superior) y centro de reclutamiento; a las 24-28 semanas, mortinato previo (OR: 2,92; IC 95%: 1,18-7,22), FCR (OR: 3,32; IC 95%: 1,70-6,49 para el tercil superior) y centro de reclutamiento; a las 35-37 semanas, talla materna (OR: 0,41; IC 95%: 0,20-0,87 para el tercil superior). Las características clínicas asociadas de forma independiente con DMG/diabetes franca, diferían según el punto de tiempo de la SOG (por ejemplo, la CC se asoció con glucosa alterada en ayunas a <20 semanas, mientras que la FCR se asoció con la glucosa postsobrecarga a <20 semanas). En conclusión, en mujeres con sobrepeso / obesidad participantes en el estudio DALI, la suplementación con vitamina D no mejoró sustancialmente las medidas subrogadas de DMG definidas como resultados primarios (GPA, HOMA-IR, aumento de peso intragestación). Las concentraciones promedio de vitamina D al inicio del estudio fueron más altas de lo esperado y los principales predictores de la suficiencia de vitamina D fueron la etnia europea y la ingesta de multivitaminas. En esta población, los factores de riesgo de HG diferían según el período de la gestación y el punto de la SOG, y podrían ayudar a definir los criterios para la detección selectiva o los participantes de ensayos de prevención.
The present doctoral thesis focuses on the study of risk factors and the use of vitamin D as a prevention strategy for gestational diabetes mellitus (GDM) in a high-risk population (pregnant overweight/obese women) enrolled in the DALI (Vitamin D And Lifestyle Intervention for GDM prevention) study. In the first article, the DALI vitamin D randomized controlled trial for GDM prevention is reported. The DALI vitamin D randomized controlled trial for GDM prevention tested vitamin D supplementation with 1600 IU/day, with or without combined lifestyle intervention in a high-risk population for GDM, starting at <20 weeks’ gestation until delivery. The primary study outcomes were the GDM surrogates, fasting plasma glucose (FPG), HOMA-IR and gestational weight gain (GWG). There was a small improvement in FPG (-0.14 mmol/l; 95%CI -0.28, -0.00) at 35-37 weeks’ gestation, but no improvement in any primary outcome was observed at 24-28 weeks’ gestation, when testing for GDM usually takes place. A post hoc analysis identified as independent variables for vitamin D sufficiency: European ethnicity (OR 19.84, CI95 5.87-67.08), season of measurement (OR summer vs. spring 17.0, CI 95 1.84-157.5, ns for other seasons) and taking vitamins (OR 11.1, CI 95 3.01-41.2). In the second article risk factors for hyperglycemia in pregnancy (HiP) in the DALI population, at different pregnancy periods and oral glucose tolerance test (OGTT) time points are described. We conducted an observational sub-analysis of the DALI study, including 971 women, who underwent an OGTT at <20, 24–28 and 35–37 weeks (IADPSG/WHO2013 criteria). A multivariate logistic regression selected independent variables (including baseline maternal and current pregnancy characteristics) for HiP. Clinical characteristics independently associated with HiP were: at <20 weeks, previous abnormal glucose tolerance (odds ratio (OR): 3.11; 95%CI: 1.41–6.85), previous GDM (OR: 2.22; 95%CI: 1.20–4.11), neck circumference (NC) (OR: 1.58; 95%CI: 1.06–2.36 for the upper tertile), resting heart rate (RHR, OR: 1.99; 95%CI: 1.31–3.00 for the upper tertile) and recruitment site; at 24–28 weeks, previous stillbirth (OR: 2.92; 95%CI: 1.18-7.22), RHR (OR: 3.32; 95%CI: 1.70-6.49 for the upper tertile) and recruitment site; at 35–37 weeks, maternal height (OR: 0.41; 95%CI: 0.20–0.87 for upper tertile). Clinical characteristics independently associated with GDM/overt diabetes differed by OGTT time point (for example, NC was associated with abnormal fasting glucose at <20 weeks, while RHR was associated with post-challenge glucose at <20 weeks and with both, fasting and post-challenge glucose at 24-28 weeks). In conclusion, in overweight/obese women enrolled in the DALI study, vitamin D supplementation did not substantially improve surrogate GDM measurements defined as primary outcomes (FPG, HOMA-IR, GWG) and did not modify secondary outcomes. Average vitamin D concentrations at baseline were higher than expected and major vitamin D sufficiency predictors were European ethnicity and multivitamin intake. In this population, risk factors for HiP differed by pregnancy period and OGTT time point and could assist in defining criteria for selective screening or participants of prevention trials.
Universitat Autònoma de Barcelona. Programa de Doctorat en Medicina
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Nordberg, Petra, and Anna Green. "Riskfaktorer och prevention vid trycksårsamt sjuksköterskans roll i omvårdnaden : En systematisk litteraturstudie." Thesis, Högskolan Dalarna, Omvårdnad, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:du-1819.
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Syftet med denna litteraturstudie var att beskriva riskfaktorer som påverkade uppkomsten av trycksår samt de vanligaste förekommande preventiva åtgärderna. Vidare var syftet att beskriva sjuksköterskans roll vid förebyggandet samt behandlingen av trycksår. De vetenskapliga artiklar (n=21) som ingick i studien söktes manuellt samt datoriserat via databaserna Blackwell Synergy, CHINAL, Elin@Dalarna och Elsiever. Inklusionskriterierna var att de skulle vara vetenskapliga samt av kvalitativ och kvantitativ design. Även litteraturstudier inkluderades. Artiklarna skulle vara publicerade 1990 eller senare och vara svensk eller engelskspråkiga. Resultatet visade att patienter med lågt nutritionsstatus och låga serum albuminvärden riskerade att utveckla trycksår. En annan stor riskgrupp var patienter i peri- och postoperativa skeden där operationstiden kraftigt inverkade på uppkomsten av sår. Även anestesiformen spelade roll. Trycksåren uppkom vanligen på hälarna och korsbenet. I preventativt syfte var evidensbaserade mätskalor viktiga. Även trycksårsreducerande madrasser visade sig vara betydelsefulla. Vidare framkom att hälso- och sjukvårdspersonalen visade ett svalt intresse för trycksår och att kvalitetssäkringen var bristfällig. Sjuksköterskan hade främst en informerande roll inom trycksårspreventionen. Såren rengjordes lämpligast med fysiologisk koksaltlösning och omlades med våt omläggning. Resultatet visade även att smärtanalyser i högre grad borde involveras i trycksårsbehandlingen.
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Dobbs, Suzaane. "Accident and Injury Prevention: The Effects of Job Factors and Employee Behaviors." TopSCHOLAR®, 2004. http://digitalcommons.wku.edu/theses/547.
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Virtually all organizations are concerned about employee safety and the prevention of workplace accidents, but maybe unaware that most accidents are the cause of unsafe employee behaviors. In this study, one company in particular wanted to know where, when, how, and why accidents were occurring in its plant. Accidents of the past three years were content analyzed. The results show that 87.4% of the accidents were due to unsafe behaviors. The highest absolute frequency of accidents occurs in the die cast area, while the highest relative rate of accidents occurs in the furnace room. The type of accident that occurs with the highest frequency is lacerations and the highest rate of accidents occurs during the first shift. The accident analysis can now serve as the basis for the development of a behavioral safety training program. With its implementation, a behavioral safety program has the potential to save thousands of dollars and give the workers a safer environment in which to work.
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Berg, Charlotte C. "Foot-pad dermatitis in broilers and turkeys : prevalence, risk factors and prevention /." Uppsala : Swedish Univ. of Agricultural Sciences (Sveriges lantbruksuniv.), 1998. http://epsilon.slu.se/avh/1998/91-576-5442-5.gif.
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Howard, Dominic Peter James. "Extra-coronary arterial disease : incidence, projected future burden, risk factors and prevention." Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:6ac90d2b-b919-45d4-abfd-2128efb31bc6.
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Vascular disease is the leading cause of death and disability worldwide. Incidence, risk factors, and outcome of coronary artery disease have been extensively studied, but there are fewer data on other forms of arterial disease, including carotid, aortic, visceral, and peripheral arterial disease. Although the burden of these diseases may be increasing due to the ageing population, we lack the most basic epidemiological data on which to base clinical decisions on individual patients (short and long-term prognosis); local service provision (current incidence and projected future burden); public health / screening initiatives (age and sex-specific incidence, risk factors, and outcome); and with which to assess current levels of primary prevention (pre-morbid risk factor control). Indeed, it is this lack of data, rather than a lack of treatments that is the greatest barrier to effective prevention. I have contributed to, cleaned, and analysed data from the Oxford Vascular Study, a prospective, population-based study (n=92,728) of all acute vascular events (2002-2012), and the Oxford Plaque Study, a carotid atherosclerosis biobank of over 1000 carotid plaques, in order to study these conditions. For acute aortic disease, I aimed to assess the risk factors associated with acute abdominal aortic aneurysms (AAA) and the population impact of the current UK AAA screening programme; and the incidence, risk factors, outcome, and projected future burden of acute aortic dissection. For acute peripheral arterial disease, I assessed the risk factors associated with premature onset and poor outcome, together with current levels of primary prevention. For symptomatic carotid artery disease, I studied the timing and benefits of surgical intervention in the current era; and went on to assess whether underlying carotid plaque morphology can be used to improve stroke risk stratification and help explain why ocular and cerebral stroke types have vast differences in future ipsilateral stroke risk. I found that compared with the current UK AAA screening strategy (one-off scan for men aged 65), screening of male smokers at 65 and all men at 75 would prevent nearly four-times as many deaths and three-times as many life-years lost with 21% fewer annual scans. I have also shown that incidence of acute aortic dissection is higher than previous estimates, a third of cases are out-of-hospital deaths, and uncontrolled hypertension is the most significant treatable risk factor for this condition. For acute peripheral arterial disease, the presence of multiple atherosclerotic risk factors are associated with premature onset, and severity of ischaemia, pre-morbid renal dysfunction, cardiac failure, and diabetes mellitus are predictive of future limb loss and survival. A significant proportion of acute peripheral events are AF-related in high risk patients who were not pre-morbidly anticoagulated despite having no contraindications and being at low risk of bleeding. Symptomatic carotid artery disease currently accounts for <10% of incident cerebrovascular events, and only 40% of these patients undergo surgical intervention. Due to improvements in medical therapy and on-going delays to intervention, little benefit is currently obtained from intervening in patients with <70% stenosis. Ipsilateral stroke risk is correlated with several carotid plaque features in a time-dependent manner, confirming the potential utility of plaque morphology in risk stratification. In addition, plaques from patients with cerebral events were significantly more unstable and inflammatory than from those with ocular events, helping explain differences in stroke risk between these groups. My findings advance the understanding of these conditions that form the backbone of modern vascular surgical practice, and I hope will improve prevention, clinical management, and outcome for patients with vascular disease.
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Cruz, Wagener Jackie. "Factors Influencing the Implementation of Substance Use Prevention Programs in Elementary Schools." FIU Digital Commons, 2012. http://digitalcommons.fiu.edu/etd/768.
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Prevention scientists have called for more research on the factors affecting the implementation of substance use prevention programs. Given the lack of literature in this area, coupled with evidence that children as early as elementary school engage in substance use, the purpose of this study was to identify the factors that influence the implementation of substance use prevention programs in elementary schools. This study involved a mixed methods approach comprised of a survey and in-person interviews. Sixty-five guidance counselors and teachers completed the survey, and 9 guidance counselors who completed the survey were interviewed individually. Correlation analyses and hierarchical multiple regression were conducted. Quantitative findings revealed ease of implementation most frequently influenced program implementation, followed by beliefs about the program’s effectiveness. Qualitative findings showed curriculum modification as an important theme, as well as difficulty of program implementation. The in-person interviews also shed light on three interrelated themes influencing program implementation – The Wheel, time, and scheduling. Results indicate the majority of program providers modified the curriculum in some way. Implications for research, policy, and practice are discussed, and areas for future research are suggested.
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Sorinmade, Ibukun. "Refocusing Prevention Practices: From Risk-Based Towards Social Developmental Measures." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23301.
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In exploring current responses to crime, particularly youth involvement in gangs, this thesis examines two approaches: Crime Prevention through Social Development (CPSD) and risk-based prevention. The former is associated with the provision of socially-designed measures to address and eliminate the risk factor associated with persistent offending. The latter, however, refers to the implementation of risk management and statistical assessment to manage the risk factor associated with persistent offending. In light of these two approaches, this thesis examines a debate which purported that crime prevention practices has wholly shifted away from an emphasis on CPSD towards risk-based prevention. This thesis also examines the opposing debate which explains that CPSD and risk-based prevention have emerged into a balanced approach. Taking into account 19 youth gang prevention projects in Canada, the above debates are investigated. Drawing from the analysed project, this thesis concludes that, the crime prevention practices of the analyzed projects significantly rely on risk-based prevention. As a result, the approaches of CPSD still exist in rhetoric and in practice however, its influence on crime prevention initiatives is very limited. Hence, current approaches neither reflect a total shift away from CPSD nor a balanced approach.
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Kancherla, Vijaya. "Epidemiology of choanal atresia - the National Birth Defects Prevention Study." Diss., University of Iowa, 2010. https://ir.uiowa.edu/etd/829.
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Choanal atresia is a well-defined congenital malformation; however, little is known about its prevalence and risk factors. Data from the Iowa Registry for Congenital and Inherited Disorders were used to examine prevalence, infant, and maternal characteristics of choanal artesia. Data from the National Birth Defects Prevention Study (NBDPS) were used to examine selected risk factors for choanal atresia. Overall prevalence was estimated as number of choanal atresia cases per 10,000 live births with 95% confidence intervals (CI)s. Crude and adjusted odds ratios (OR)s and 95% CIs were estimated to investigate selected risk factors. The overall prevalence of choanal atresia among live born deliveries in Iowa from January, 1998 through December, 2005 was 0.46 (95% CI=0.27, 0.78) per 10,000 live births. Using data from the NBDPS, choanal atresia cases were compared to unaffected control infants for births from October 1997 through December 2005. Overall, case infants compared to control infants were more likely to be female, preterm, and a multiple birth. For all choanal atresia cases combined, odds of high maternal zinc (OR=2.1; 95% CI=1.2, 3.9) and vitamin B-12 (OR=2.4; 95% CI=1.4, 4.3) intake in the year prior to pregnancy, and maternal periconceptional (one month before through three months after conception) exposure to anti-infective urinary tract medications (OR=3.3; 95% CI=1.3, 8.4) were significantly elevated among case compared to control mothers. For isolated choanal atresia cases (those with no additional major malformations), odds of maternal periconceptional exposure to passive cigarette smoke (OR=2.3; 95% CI=1.0, 5.3) as well as maternal intake of 3 or more cups of coffee per day one-year prior to pregnancy were increased (OR=2.9; 95% CI=1.3, 6.4) for case compared to control mothers. The reverse was found for low maternal intake of pantothenic acid (OR=0.4; 95% CI=0.2,0.9) and vitamin A (OR=0.3; 95% CI=0.1, 0.8) one-year prior to pregnancy. The current study provided support for potential associations between maternal health behaviors before and during pregnancy and choanal atresia; however, the findings were based on a modest number of cases. The study needs to be replicated in a larger case sample, also examining the role of genetics in choanal atresia.
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González, Judith T. "Motivators for Colon Cancer Prevention Among Elderly Mexican Americans." University of Arizona, Mexican American Studies and Research Center, 1990. http://hdl.handle.net/10150/219035.
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This final report documents the theoretical development and preliminary empirical testing of a model that predicts the conditions under which Hispanics will seek preventive health care. Research shows that Hispanics delay preventive care, resulting in higher morbidity and mortality rates for serious diseases such as cancer. Since many serious diseases, such as heart disease, diabetes and cancer can be prevented or treated more effectively if detected early, it is crucial to understand the motivating forces behind Hispanics’ preventive health behavior. The Hispanic model, which is an extension of the Health Behavior in Cancer Prevention Model developed by Atwood, et al. (1986), includes as core variables environmental barriers to access and English-language proficiency, as well as social support, health beliefs, self-efficacy (or perceived skill), health locus of control, and health values.
This correlational descriptive study employed snowballing sampling methods and consisted of 199 Hispanics between 49 and 94 years of age. Measures consist of multi-item scales whose content follows that of the Parent Project. The final instruments showed reliability (Alphas between .69 and .95), although the model testing was limited by the exclusion of some constructs that did not demonstrate reliability. The outcome of predisposition to self-care was predicted by utilization barriers to care, Chance Health Locus of Control, and General Health threat, resulting in an R-square of .07. The findings dealing with dietary preferences and preferred dietary modifications also have great implications for interventions aimed at preventing colon cancer among Hispanics. The practical health policy applications of the model are also discussed.
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Finlayson, Kathleen Joy. "Identification of factors contributing to recurrence of venous leg ulcers." Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/39531/1/Kathleen_Finlayson_Thesis.pdf.
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Background and Significance Venous leg ulcers are a significant cause of chronic ill-health for 1–3% of those aged over 60 years, increasing in incidence with age. The condition is difficult and costly to heal, consuming 1–2.5% of total health budgets in developed countries and up to 50% of community nursing time. Unfortunately after healing, there is a recurrence rate of 60 to 70%, frequently within the first 12 months after heaing. Although some risk factors associated with higher recurrence rates have been identified (e.g. prolonged ulcer duration, deep vein thrombosis), in general there is limited evidence on treatments to effectively prevent recurrence. Patients are generally advised to undertake activities which aim to improve the impaired venous return (e.g. compression therapy, leg elevation, exercise). However, only compression therapy has some evidence to support its effectiveness in prevention and problems with adherence to this strategy are well documented. Aim The aim of this research was to identify factors associated with recurrence by determining relationships between recurrence and demographic factors, health, physical activity, psychosocial factors and self-care activities to prevent recurrence. Methods Two studies were undertaken: a retrospective study of participants diagnosed with a venous leg ulcer which healed 12 to 36 months prior to the study (n=122); and a prospective longitudinal study of participants recruited as their ulcer healed and data collected for 12 months following healing (n=80). Data were collected from medical records on demographics, medical history and ulcer history and treatments; and from self-report questionnaires on physical activity, nutrition, psychosocial measures, ulcer history, compression and other self-care activities. Follow-up data for the prospective study were collected every three months for 12 months after healing. For the retrospective study, a logistic regression model determined the independent influences of variables on recurrence. For the prospective study, median time to recurrence was calculated using the Kaplan-Meier method and a Cox proportional-hazards regression model was used to adjust for potential confounders and determine effects of preventive strategies and psychosocial factors on recurrence. Results In total, 68% of participants in the retrospective study and 44% of participants in the prospective study suffered a recurrence. After mutual adjustment for all variables in multivariable regression models, leg elevation, compression therapy, self efficacy and physical activity were found to be consistently related to recurrence in both studies. In the retrospective study, leg elevation, wearing Class 2 or 3 compression hosiery, the level of physical activity, cardiac disease and self efficacy scores remained significantly associated (p<0.05) with recurrence. The model was significant (p <0.001); with a R2 equivalent of 0.62. Examination of relationships between psychosocial factors and adherence to wearing compression hosiery found wearing compression hosiery was significantly positively associated with participants’ knowledge of the cause of their condition (p=0.002), higher self-efficacy scores (p=0.026) and lower depression scores (p=0.009). Analysis of data from the prospective study found there were 35 recurrences (44%) in the 12 months following healing and median time to recurrence was 27 weeks. After adjustment for potential confounders, a Cox proportional hazards regression model found that at least an hour/day of leg elevation, six or more days/week in Class 2 (20–25mmHg) or 3 (30–40mmHg) compression hosiery, higher social support scale scores and higher General Self-Efficacy scores remained significantly associated (p<0.05) with a lower risk of recurrence, while male gender and a history of DVT remained significant risk factors for recurrence. Overall the model was significant (p <0.001); with an R2 equivalent 0.72. Conclusions The high rates of recurrence found in the studies highlight the urgent need for further information in this area to support development of effective strategies for prevention. Overall, results indicate leg elevation, physical activity, compression hosiery and strategies to improve self-efficacy are likely to prevent recurrence. In addition, optimal management of depression and strategies to improve patient knowledge and self-efficacy may positively influence adherence to compression therapy. This research provides important information for development of strategies to prevent recurrence of venous leg ulcers, with the potential to improve health and decrease health care costs in this population.
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Zolaiha, Jumroon Mikhanorn. "HIV/AIDS prevention behavior among adolescents in high school of Jakarta, Indonesia /." Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd375/4737943.pdf.
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Pedescoll, Albacar Anna. "Clogging in horizontal subsurface flow constructed wetlands: mesures, design factors and prevention strategies." Doctoral thesis, Universitat Politècnica de Catalunya, 2010. http://hdl.handle.net/10803/108721.
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Constructed wetlands are alternative systems to conventional wastewater treatment for small communities
(up to 2000 PE). This is mainly due to that operation and maintenance costs are reduced.
Despite the advantages, the clogging of the bed is the most important trouble encountered by the
managers of subsurface flow wetlands treatment systems. The solids accumulation in the interstitial
spaces of the gravel over time causes the decrease of both, hydraulic conductivity and porosity.
This leads in the development of preferential paths and short-circuiting of the water through the
wetland, which converge in overland flow and contaminant removal efficiency decrease. Therefore,
clogging is the main limiting factor of the life span of a subsurface flow constructed wetland.
The strategies to reverse clogging imply important economic investments. Generally, the most
widespread option is the replacement of gravel. Hence the need to measure realibly the degree of
clogging of a system in order to identify the factors that influence this phenomenon and to search
new configurations and strategies to delay its progress, thus operations needed to reverse it.
Therefore, the aims of this thesis must contribute to establish new design criteria and operation of
horizontal subsurface flow constructed wetlands to minimize clogging processes without reducing
the contaminant removal efficiency. Then, the objectives were to compare a method to measure
hydraulic conductivity in situ, based on falling head permeameter, in order to determine the state of
clogging of wetlands and its horizontal distribution; to determine the most suitable indicator to assess
clogging in horizontal subsurface flow wetlands; to identifie new design and operation parameters
likely to cause or encourage the clogging of the filter medium; and to analyse two new configurations
in a pilot scale system in terms of contaminant removal and clogging development.
Among the different clogging indicators analysed (drenable porosity, hydraulic conductivity, accumulated
solids and effective volume from a tracer test), hydraulic conductivity seems to be the best
one. Firstly, because hydraulic conductivity provides information about the hydraulic behaviour
inside the bed, and linked appropriately with the accumulated solids (a correlation of 74.5% was
found between both indicators). Secondly, because its application in full-scale wetlands is more
straightforward than other techniques.Los humedales construidos son una alternativa al tratamiento convencional de agua residual para pequeños municipios (hasta 2000 hab-eq) ya que son fáciles de operar y mantener y tienen un coste de explotación bajo. El mayor inconveniente a que se enfrentan los explotadores de sistemas de tratamiento con humedales subsuperficiales es la colmatación del lecho. Con el tiempo, la acumulación de sólidos de diversa naturaleza en los espacios intersticiales del medio filtrante, provoca la disminución de la conductividad hidráulica y la porosidad iniciales de la grava. Esto conduce al desarrollo de caminos preferenciales y cortocircuitos en el curso del agua que convergen en la aparición de agua en superficie. A la larga, esto puede comprometer la capacidad depurativa del sistema. Por ello, la colmatación supone el factor limitante de la vida útil de un humedal construido. Las estrategias para solventar la colmatación, una vez se ha producido, son costosas y pasan por realizar inversiones no despreciables. Generalmente la opción más extendida es el cambio del material granular. De ahí la necesidad de medir, de manera fiable, en qué grado un sistema está colmatado, identificar los factores que influyen en el fenómeno e indagar en nuevas configuraciones y estrategias que permitan retrasar el avance de la colmatación y consigo, aplazar las intervenciones necesarias para devolver al sistema un estado óptimo de funcionamiento. Los objetivos de esta tesis doctoral han de contribuir a establecer nuevos criterios de diseño y operación de humedales construidos de flujo subsuperficial horizontal para minimizar, o cuanto menos retrasar, la colmatación de estos sistemas, sin mermar la eficiencia de eliminación de contaminantes del agua residual. Por ello, los objetivos son cuantificar la precisión y exactitud de un método de medición in situ de la conductividad hidráulica, basado en el permeámetro de carga variable, para la determinación del grado de colmatación de un lecho y la distribución horizontal de la misma; estudiar la idoneidad de diferentes indicadores de la colmatación de un humedal de flujo subsuperficial horizontal; evaluar la incidencia de diferentes factores de diseño y operación de humedales de flujo subsuperficial horizontal en el proceso de la colmatación; y caracterizar (en términos de eficiencia de eliminación de contaminantes y de evolución de la colmatación) dos nuevas configuraciones de humedales construidos a escala piloto.
Els aiguamolls construïts són una alternativa al tractament convencional d’aigua residual per a petits municipis (fins 2000 hab-eq) degut, principalment, a la facilitat en llur operació i manteniment y a les reduïdes despeses d’explotació. L’inconvenient més important amb què es troben els explotadors de sistemes de tractament amb aiguamolls subsuperficials és la colmatació del llit. Al llarg del temps, l’acumulació de sòlids de diversa natura en els espais intersticials de la grava, provoca la disminució de la conductivitat hidràulica i la porositat inicials. Això condueix al desenvolupament de camins preferencials i curtcircuits en el curs de l’aigua a través de l’aiguamoll, que convergeixen en l’aparició d’aigua en superfície, i que, a llarg termini pot comprometre la capacitat depurativa del sistema. Per això, la colmatació suposa el factor limitant de la vida útil d’un aiguamoll construït. Les estratègies per a fer front a la colmatació, un cop s’ha produït, passen per realitzar inversions econòmiques gens menyspreables. Generalment, l’opció més extesa és la reposició del material granular. D’aquí neix la necessitat de mesurar, de manera fiable, el grau de colmatació d’un sistema, d’identificar aquells factors que influeixen en el fenomen y qüestionar noves configuracions y estratègies que permetin retardar l’avenç de la colmatació, i per tant ajornar les intervencions necessàries per tornar al sistema a l’estat òptim de funcionament. Per tot això els objectius d’aquesta tesi doctoral han de contribuir a establir nous criteris de disseny i operació d’aiguamolls construïts de flux subsuperficial horitzontal per tal de minimitzar la colmatació d’aquests sistemes, sense minvar l’eficiència d’eliminació de contaminants de l’aigua residual. Els objectius específics són quantificar la precisió i exactitud d’un mètode de mesura in situ de la conductivitat hidràulica, basat en el permeàmetre de càrrega variable, per a la determinació de l’estat de colmatació d’un llit així com la distribució horitzontal d’aquesta; determinar l’indicador més adecuat per avaluar la colmatació d’un aiguamoll construït de flux subsuperficial horitzontal; identificar nous paràmetres de disseny y operación susceptibles de causar o afavorir la colmatación del medi filtrant; i caracteritzar (en termes d’eliminació de contaminants i d’evolució de la colmatación) dues noves configuracions d’aiguamolls construïts a escala pilot.
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Turner, Michelle C. "Environmental Risk Factors for Lung Cancer Mortality in the Cancer Prevention Study-II." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/20528.
Full textAbstract:
This thesis examined associations between ecological indicators of residential radon and fine particulate matter air pollution (PM2.5) and lung cancer mortality using data from the American Cancer Society Cancer Prevention Study-II (CPS-II) prospective cohort. Nearly 1.2 million CPS-II participants were recruited in 1982. Mean county-level residential radon concentrations were linked to study participants according to ZIP code information at enrollment (mean (SD) = 53.5 (38.0) Bq/m3). Cox proportional hazards regression models were used to obtain adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for lung cancer mortality associated with radon. After necessary exclusions, a total of 811,961 participants in 2,754 counties were retained for analysis. A significant positive linear trend was observed between categories of radon concentrations and lung cancer mortality (p = 0.02). A 15% (95% CI 1 - 31%) increase in the risk of lung cancer mortality was observed per each 100 Bq/m3 radon. Radon was also positively associated with chronic obstructive pulmonary disease mortality (HR per each 100 Bq/m3 = 1.13, 95% CI 1.05 - 1.21). No clear associations were observed between radon and non-respiratory mortality. In lifelong never smokers (n = 188,699), each 10 µg/m3 increase in mean metropolitan statistical area PM2.5 concentrations was associated with a 15-27% increase in the risk of lung cancer death which strengthened among individuals with a history of asthma or any prevalent chronic lung disease at enrollment (p for interaction < 0.05). There was no association between PM2.5 and mortality from non-malignant respiratory disease. In conclusion, this thesis observed significant positive associations between ecological indicators of residential radon and PM2.5 concentrations and lung cancer mortality. These findings further support efforts to reduce radon concentrations in homes to the lowest possible level and strengthens the evidence that ambient concentrations of PM2.5 measured in recent decades are associated with small but measurable increases in lung cancer mortality. Further research is needed to better understand possible complex inter-relationships between environmental risk factors, chronic lung disease, and lung cancer.
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Bautista, Claire L. "Selected factors associated with non-compliance in HIV prevention in african american women." Honors in the Major Thesis, University of Central Florida, 2000. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/181.
Full textAbstract:
This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Health and Public Affairs
Nursing
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Stewart, Jessica. "School-based primary prevention programmes : outcomes and the factors that affect their success." Thesis, Bangor University, 2018. https://research.bangor.ac.uk/portal/en/theses/schoolbased-primary-prevention-programmes(da7eea0a-1162-4dbd-a697-a39a0e99f2c4).html.
Full textAbstract:
This thesis explores the use of universal, prevention programmes in primary schools. A systematic literature review examined the effectiveness of universally targeted, schoolbased body-image programmes in children under 12. The review highlighted that approximately half of programmes were successful in reducing body dissatisfaction or improving body satisfaction. Improvements in other associated risk factors were also found. Not all results were maintained at follow-up and the longer-term impact of such programmes was not clear. There were also several methodological concerns that must be considered. An empirical study investigated the use of a bullying programme, KiVa, in Welsh primary schools and the school-level factors that predict outcomes. A mixed-methods approach was used with analysis of pupil survey data and interviews with school staff. KiVa was found to have a positive impact on bullying behaviour which continued as years progressed. School level free-school meal percentage as a proxy for socio-economic deprivation and additional learning needs were found to be predictive of KiVa outcome. Teachers also discussed several within school-factors that they felt affected implementation. The final chapter discusses the implication of the findings for future research and clinical application in relation to other research. Recommendations are made for how schoolbased programmes may be successful implemented within primary schools. Finally, a personal reflection of the research process is considered.
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Chornenka, Zh A. "Prevention of non-communicable pathology in students due to lifestyle and risk factors." Thesis, БДМУ, 2021. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/18859.
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Perich, Debra. "Low back pain in schoolgirl rowers: Prevalence, bio-psycho-social factors and prevention." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2010. https://ro.ecu.edu.au/theses/589.
Full textAbstract:
Rowing is one of the largest participant sports on the Independent Girls‟ Schools Sporting Association (IGSSA) in Western Australia with approximately 400 participants competing every year. Rowing is an extra-curricular sport offered to girls 14 years of age and above, with these girls competing and training in both sweep and scull boats. Whilst the benefits of regular physical activity and exercise are well known, musculoskeletal problems have been documented in rowing. In particular, clinical evidence and previous research suggests that low back pain (LBP) is common in rowers. Adolescents who suffer from LBP are at an increased risk of recurrent and chronic LBP during adulthood therefore, this is a critical period to investigate the development of LBP. Therefore, the aim of this doctoral research was to examine LBP amongst the IGSSA rowing population in Western Australia. As the aetiology of LBP is known to be multi-factorial, the problem was investigated from a bio-psycho-social perspective. This thesis contains three studies with data collected over a two year period. These studies are described below.
In the first study, an investigation of the incidence of LBP and the levels of LBP and LBP-related disability for rowers and non-rowers was undertaken. Scoping data on self-reported factors that “bring on” or exacerbate LBP, training hours completed per week and boats most frequently rowed in was also collected in rowers. From this study, it was identified that there was a significantly higher prevalence of LBP in the group of 356 Schoolgirl rowers when compared with 496 non-rowing controls. Further, there was a significant difference evident for pain incidence between Year 9 and Year 10 rowers. Rowers also showed significantly greater pain and disability scores when compared with non-rowers. A number of self-reported rowing-related and habitual factors were associated with LBP in rowers.
The second study of this thesis investigated a sub-sample of Schoolgirl rowers from the first study. Specifically, rowers with LBP (N=30) and without LBP (N=30) participated in a cross-sectional study to determine the physical and psycho-social variables associated with LBP. In addition to measuring the levels of pain and disability in the rowers, this study examined physical factors such as static lumbo-pelvic postures, spinal proprioception, isometric back and lower limb muscle endurance, joint hypermobility, and the psycho-social factors of beliefs about back pain, fear of movement with back pain, as well as the tendency for anxious and depressed behaviour. A secondary aim of the study was to classify the patterns of motor control impairment evident in those with LBP. The majority of the rowers were clinically classified with deficits in flexion or multi-directional segmental spinal control. Factors associated with LBP were reduced lower limb and back muscle endurance, and a general pattern for less accuracy and greater variability in lumbar spine repositioning sense.
In the final study of this thesis a non-randomised controlled trial was conducted to decrease the prevalence of LBP and associated levels of pain and disability in a group of Schoolgirl rowers. In this novel study an intervention group consisting of 90 schoolgirl rowers from one school and a control group consisting of 131 participants from three other schools were recruited. The multi-dimensional intervention strategy consisted of physiotherapy screening, prescription of individualised “specific exercise”, follow up sessions, a back pain education talk and off-water strength and conditioning sessions. Primary outcome variables were collected for both the intervention and control groups at the commencement of rowing training, midway through the rowing season, at the completion of the rowing season and three months after the season had concluded. Primary outcome variables included the incidence of LBP and related levels of pain and disability whilst secondary outcome variables from the bio-psycho-social domain were measured at the start of the season and the end of the season in the intervention group only. From this study it was concluded that rowers have a high incidence of LBP but a multi-dimensional intervention program can be implemented to decrease the LBP incidence and the associated levels of pain and disability. Several secondary outcome variables considered to be of importance in LBP also significantly improved including physical fitness (aerobic conditioning, lower limb and back muscle endurance and sit and reach flexibility) and seated posture (usual and slump sitting). Further, improvements were seen in scores from the Child Behaviour Checklist.
This doctoral thesis has investigated a real world problem and has subsequently been used to formulate policy amongst the IGSSA schools in Western Australia. Further research is needed to determine the respective long-term results with respect to LBP and further randomised controlled studies are required to further validate the findings.
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Wong, Melanie. "Childhood community acquired pneumonia : aetiologic and predisposing factors." Thesis, The University of Sydney, 2004. https://hdl.handle.net/2123/27944.
Full textAbstract:
Conjugate pneumococcal vaccines have been licenced for use in Australia
since Dec 2000, became available around June 2001 and marketed towards the end
of 2001. Its widespread use has however been limited by lack of affordability, not
being part of the routine childhood vaccination schedule. In order to assess the
potential benefits of the widespread use of pneumococcal conjugate vaccines in
Australia, reliable estimates of the incidence of pneumococcal disease are required.
The main manifestations are bacteraemia, pneumonia and otitis media.
Pneumococcal bacteraemia, diagnosed on the basis of positive blood cultures, is
relatively easy to identify and thus it is easy to track changes in incidence over time
with reporting systems similar to those established for other vaccine preventable
diseases such as Haemophilus influenzae type b. On the other hand, definite
diagnosis of otitis media and pneumonia caused by Streptococcus pneumoniae is
problematic. Blood cultures are rarely positive (5 to 10% of pneumonia requiring
hospitalisation in developed countries) and especially in the case of otitis media,
often not performed. In Australian hospitals, culture of affected tissue, usually
entailing lung puncture or tympanocentesis, is rarely performed. Indirect laboratory
tests for pneumococcal infection such as urinary antigen detection and pneumococcal
serum antibodies and immune complexes, are not routinely available. There is also
still considerable debate about the reliability of these latter assays, especially in the
context of pneumococcal carriage in children. Thus the incidence of pneumococcal
pneumonia and otitis media is significantly underestimated. Using a range of
serologic and molecular techniques, it has been estimated that up to a third of all
cases of childhood pneumonia in developed countries may be attributed to
Streptococcus pneumoniae. This figure is supported by an American vaccine efficacy
study demonstrating a 32% reduction in radiograph positive pneumonia in the first
year of life, a 23.4% reduction in the first 2 years but only a 9.1% reduction between
2 and 5 years of age (Black et al, 2002). The issue is further complicated by the lack
of a gold standard for the diagnosis of pneumonia, resulting in variability of case
definition. There are few published data regarding the incidence of childhood
pneumonia in urban Australian children. Such data are essential if conjugate
pneumococcal vaccine efficacy against pneumonia is to be predicted and / or tracked.
There has been recent considerable interest in the role of deficiencies in the
innate immune system in the predisposition to infection and autoimmune disease, as
well as in modification of disease severity. Mannose-binding lectin (MBL) is an
important protein of the innate immune system. It binds to mannose- and N-acetylglucosamine-
rich oligosaccharides present on a wide range of bacteria, viruses, fungi
and parasites. In doing so it interacts with mannose associated serine proteases
(MASP—l and -2), leading to complement activation and resultant opsonization,
phagocytosis and cell lysis. Three structural mutations are primarily responsible for
MBL deficiency, although 3 promoter region polymorphisms also contribute to
variation in serum protein concentrations. Homozygotic individuals have negligible
levels whilst heterozygotic individuals have approximately an eighth of normal
levels. Whilst the majority of these individuals manifest no significant propensity to
increased infection due to other compensating mechanisms within the immune
system, those with impaired primary or acquired immunity fimction, including
young infants whose immune systems are still immature may be at increased risk.
MBL infusions have been successfully used in some deficient individuals with
significant recurrent infections. There have been conflicting data regarding the role
of MBL deficiency in predisposition to respiratory tract infections and pneumococcal
sepsis. This study there provides an excellent opportunity to study the association of
MBL structural mutations with risk of respiratory tract infections, particularly with
respect to age, aetiologic agents and other epidemiologic risk factors.
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Bloodgood, Martha Madden. "High-Risk Sexual Behaviors of Young Adults: AIDS Prevention." Thesis, University of North Texas, 1994. https://digital.library.unt.edu/ark:/67531/metadc277878/.
Full textAbstract:
The Health Belief Model was used to study HIV/AIDS beliefs of 419, 18 to 24 year old, never married, sexually active, heterosexual college students and predict their AIDS preventive behaviors from a larger sample of 662 college students. The structural properties of the scales used were evaluated using confirmatory factor analysis. Recent preventive behaviors were predicted in a LISREL Structural Equation Modeling analysis.
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Tessem, Jeffery Sivert. "Macrophage mediated prevention of islet loss and diabetes during pancreatitis /." Connect to full text via ProQuest. Limited to UCD Anschutz Medical Campus, 2007.
Find full textAbstract:
Thesis (Ph.D. in Molecular Biology) -- University of Colorado Denver, 2007.Typescript. Includes bibliographical references (leaves 162-196). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;
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Crocker, Theresa T. "Physicians as Gatekeepers: Uncovering Barriers and Facilitators to Participation in a Prostate Cancer Prevention Intervention Clinical Trial." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4461.
Full textAbstract:
Clinical trials play an important role in advancing therapeutic and preventive care with many current modalities resulting from prior research. While prior research has described barriers to participation in therapeutic clinical trials, much less in known about barriers related to participation in trials aimed at prevention, prostate cancer prevention in particular. Physicians have been shown to play a critical role in access to trials; however, less is known about the individual and structural factors that influence their participation in prostate cancer prevention trials. This research provides rich ethnographic detail within the context of an ongoing trial. Research participants included physician/investigators who were either directly (serving as a co-investigator) or peripherally (referring patients for participation) involved in prostate cancer prevention intervention clinical trial (PCPICT), as well as those who were considered for participation but declined. Methods included open ended semi-structured interviews, participant-observation and a survey. Participants were recruited via direct inquiry, email and/or letter regarding participation. The results of this study show that individual and structural factors intersect, influencing both the willingness and ability of physician/investigators to participate or refer patients for participation in a prostate cancer prevention intervention clinical trial. Individual factors such as explanatory views on prevention, notions of risk and uncertainty, shared decision-making and duality of roles appear to have a greater influence on the willingness of physicians to participate while structural factors such as staffing, other resources and time are more influential in regards to the ability to participate. This research served as a critical first step towards providing an in-depth understanding of the individual and structural factors that influence a physician's participation in this type of trial. It builds from prior work where a better understanding of barriers and identification of successful strategies to overcome them was a noted void. The researcher identifies areas where additional research would be beneficial and provides applied recommendations for those considering the design of future cancer prevention intervention projects.
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Masoud, Mohamed Abdulsalam. "Validation of a recently proposed equation for the estimation of small, dense LDL particles from routine lipid measures in a population of mixed ancestry South Africans." Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2490.
Full textAbstract:
Thesis (MSc (Biomedical Technology))--Cape Peninsula University of Technology, 2016.Cardiovascular diseases (CVD) are the leading cause of global mortality, of which over 75% occurred in low- and middle-income countries such as South Africa. The lipid profile, specifically decreased levels of high density lipoprotein cholesterol (HDL-C), elevated triglyceride levels and the presence of small-dense low density lipoprotein (sdLDL) has been reported associated with CVD. An increased number of sdLDL is also common in metabolic syndrome (MetS), visceral obesity and diabetes mellitus, the last a known risk factor for CVD. The modification of low density lipoprotein (LDL) size, or number of sdLDL particles, has been reported to significantly reduce CVD risk, but not conclusively so and needs further investigation. In this regard, sdLDL particles are seldom estimated routinely for clinical use because of financial and other limitations. Currently, an alternative approach for estimating sdLDL is to use equations derived from routine lipid measures, as has been proposed by several groups. However, there is a need for extensive evaluation of this equation across different ethnic and disease groups, especially since reports showed an inadequate performance of the equation in a Korean population. The aim of this study was to assess the performance of a recently proposed equation for the estimation of sdLDL in healthy and diabetic mixed ancestry South Africans. Furthermore, we also investigated the role of sdLDL as a cardiometabolic risk factor, as measured against known risk factors such as the glycemic and lipid profiles.
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Whicker, Jennifer L. "Supporting Utah's Parents in Preventing Adolescent Suicide: A Literature Review and Handouts for Utah's Youth Suicide Prevention Manual." BYU ScholarsArchive, 2012. https://scholarsarchive.byu.edu/etd/3275.
Full textAbstract:
Suicide, a public health problem on a global scale, has become the focus in many domains across the United States. With the recent push to provide solutions to the adolescent suicide rate in the U.S., the school setting has become an important venue for prevention and intervention efforts. While there are many risk and protective factors, the majority of suicide completions are concurrent with psychiatric disorders among adolescents; as such, this is an area that warrants further investigation. Additionally, school resources are often overwhelmed by the magnitude of need among the student population; therefore, effective interventions must be identified that can feasibly be implemented in the schools. Research has suggested that parent-adolescent relationships are key in the prevention of suicide, yet minimal research has been conducted towards promoting healthy parent-adolescent relationships for at-risk adolescents. Additionally, some research suggests that school and community interventions are only more effective than parental support when negative parent-adolescent relationships are present. This implies that fostering parental support should be a top priority in school-based suicide prevention efforts. This literature review identifies and summarizes pertinent scholarly research and resources for schools to better support parents of adolescents who struggle with suicidal thoughts and previous attempted suicides. As part of an intervention plan which increases home/school collaboration in adolescent suicide prevention, handouts were developed for parents (found in the appendix), which include information on warning signs of suicide, risk factors for suicide, and methods of responding to suicidality. After adapting these handouts to best meet their students' needs, school-based mental health professionals may consider including these handouts in their school's crisis plan and suicide prevention efforts.
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Jacobsen, Annemette. "Pushes and pulls of radicalisation into violent Islamist extremism and prevention measures targeting these: Comparing men and women." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-24394.
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Recent years’ terrorist attacks in Europe and the flow of foreign fighters joining the terrorist organisation Daesh, has made the understanding of radicalisation evermore crucial. This thesis investigates if push and pull factors leading into violent Islamic extremism differentiate between men and women. Furthermore, it assesses how preventive measures from The United Kingdom, Sweden and Denmark targets push and pull factors and if these are sensitive to sex. To fulfil this objective an exploratory thematic analysis was used to synthesise secondary qualitative research surrounding push and pull factors. The push and pull factor analysis revealed three trends: there were limited variation in the overall categories describing the push and pull factors present for men and women; what caused push and pull factors to manifest differed according to sex; and, there were differences in how much men and women were affected by these factors. The assessment of prevention measures showed that none of the measures explicitly mentioned push and pull factors, yet they all had the potential of targeting these. Sex was included in some aspects of the measures, but was not a consideration in relation to the targeting of push and pull factors. The thesis ends with a discussion of what implications the found results have for practice and offers suggestions to how prevention measures can be improved.
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Tan, Jingwen, and 谭靖雯. "A systematic review of risk factors for Alzheimer's disease and strategies for prevention in China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193815.
Full textAbstract:
Background: Alzheimer’s disease, one type of dementia, is predicted to have great impact on society and economy. This effect increases rapidly especially in developing countries. The number of people with Alzheimer’s disease is huge due to the large population in China where the effects of this disease are amplified by the one-child policy.
Objective: To review the risk factors of Alzheimer’s disease in different countries and offer some suggestions that how to prevent Alzheimer’s Disease in China that has very limited research on Alzheimer’s disease. To make recommendations for potential strategies to be implemented by policy-makers, government or other stakeholders.
Method and results: Relevant studies which identified the risk factors for Alzheimer’s disease and evaluated the interventions and treatments for reducing the risk of getting Alzheimer’s disease, that were published between 1990 and 2012 were searched in PubMed and Google Academic using specific keywords. A total of 1071 studies were found and 62 used. Based on this systematic review, the risk factors of Alzheimer’s disease are age, lifestyle, family history and genetics, vascular, mild cognitive impairment, head injury as well as early-life negative events. There appear to be several important contributions to Alzheimer’s disease prevention including diet, cognitive activity, physical activity, social engagement, smoking cessation, and alcohol ingestion or simply being optimistic.
Conclusion:
This review has included the potential risk factors of Alzheimer's disease and the ways of preventing Alzheimer's disease, as well as to produce some possible strategies of preventing Alzheimer's disease based on the situation in China for the Chinese government and policy makers such as to use media as an important channel to draw people's attention about Alzheimer's disease and to educate about preventive factors. There should be government-funded education and health services in the rural areas and plans to build more leisure and sports centers in China. The government should also subsidize hospitals and medical centers to provide affordable or even free health examinations for people and build a central database for the purpose of recording, analysis and research into Alzheimer's disease for better understanding of the disease. Medical professionals and volunteers can help to enhance this database by the implementation of data collection to look for symptoms of Alzheimer’s disease. If the patients appear to have such symptoms, further data collection should be taking place, such as family history of Alzheimer’s disease, health status, head injuries, family status, characteristics and behavior, income levels, residential areas and other background information of the patients as part of their work whenever and wherever they go, especially in rural areas.published_or_final_version
Public Health
Master
Master of Public Health
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Lundström, Maria. "Delirium in old patients with femoral neck fracture : risk factors, outcome, prevention and treatment /." Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-379.
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Lundström, Maria. "Delirium in old patients with femoral neck fracture : risk factors, outcome, prevention and treatment." Doctoral thesis, Umeå universitet, Geriatrik, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-379.
Full textAbstract:
Delirium is probably the most common presenting symptom of disease in old age. Delirium, as defined in DSM-IV, is a neuropsychiatric syndrome characterized by disturbance in attention and consciousness, which develops over a short period of time and where the symptoms tend to fluctuate during the course of the day. The overall aim was to increase knowledge about the risk factors and outcome of delirium in old patients with femoral neck fracture and to develop and evaluate a multi-factorial intervention program for prevention and treatment of delirium in these patients. In a prospective study of 101 consecutive patients with a femoral neck fracture, 29.7% were delirious before surgery and another 18.8% developed delirium postoperatively. Of those who were delirious preoperatively all but one remained delirious postoperatively. The majority of those delirious before surgery were demented, treated with drugs with anticholinergic properties (mainly neuroleptics), had had previous episodes of delirium and had fallen indoors. Patients who developed postoperative delirium had perioperative falls in blood pressure and seemed to have more postoperative complications, such as infections. Patients with preoperative delirium had a poorer walking ability on discharge compared to patients with postoperative delirium only. In a five-year prospective follow up study 30 out of 78 (38.5%) non-demented patients with a femoral neck fracture developed dementia. Twenty out of 29 (69%) who were delirious postoperatively developed dementia compared to 10 out of 49 (20%) who were not delirious during hospitalization (p<0.001). Twenty-one (72.4%) of those with postoperative delirium died within 5 years compared to 17/49 (34.7%) of those who remained lucid postoperatively (p=0.001). A non-randomized multi-factorial intervention study with the aim of preventing and treating delirium among patients with femoral neck fracture (n=49) showed that the incidence of delirium was significantly lower than reported in previously published studies. The incidence of other postoperative complications was also lower and a larger proportion of the patients regained independent walking ability and could return to their previous living conditions on discharge. A similar multi-factorial intervention program evaluated as a randomized controlled trial including 199 femoral neck fracture patients showed that fewer intervention patients than controls suffered postoperative delirium (56/102, 55% vs. 73/97, 75%, p=0.003). For intervention patients the postoperative delirium was also of shorter duration (5.0±7.1 days vs. 10.2±13.3 days, p=0.009). Eighteen percent in the intervention ward and 52% of controls were delirious after the seventh postoperative day (p<0.001). Intervention patients suffered from significantly fewer in-hospital complications, such as decubital ulcers, urinary tract infections, nutritional complications, sleeping problems and falls, than controls. Total postoperative hospitalization was shorter in the intervention ward (28.0±17.9 days vs. 38.0±40.6 days, p=0.028). In conclusion, pre- and postoperative delirium is common and seems to be associated with various risk factors, which require different strategies for prevention and treatment. Delirium is also associated with the development of dementia and a higher mortality rate. Multifactorial intervention programs can successfully be implemented and result in the reduction of delirium, fewer complications and shorter hospitalization.
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Monchalin, Lisa A. "Reducing Crime Affecting Urban Aboriginal People: The Potential for Effective Solutions in Winnipeg." Thesis, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/20579.
Full textAbstract:
This study examined the knowledge relevant to reducing crime affecting urban Aboriginal people through a risk-focused approach to prevention and a growing body of knowledge about how it gets implemented. It then examined this knowledge in a case study of its application in Winnipeg.
Interviews were undertaken using a structured questionnaire with program stakeholders and policy planners involved in crime prevention initiatives, programming and policy in Winnipeg. Approximately half of the stakeholders were involved primarily with Aboriginal people and the other half were involved with programs that included both Aboriginal people and non-Aboriginal people. The interviews took place from September to November 2009.
The interviews show that many stakeholders agree with the risk-focused prevention literature on risk factors and that there are prevention programs operating in Winnipeg serving at-risk Aboriginal people. Therefore, there exists the possibility of reducing crime given that they are tackling risk factors in a way which is consistent with crime prevention research.
However, when the interviews turned to issues of implementation, it showed:
• There is no responsibility centre to mobilize different sectors to tackle crime
• Many programs are not implemented comprehensively
• There is a lack of localized coordinated action (including support from the police chief and public engagement)
• There is a lack of political leadership
• There is no city-wide strategic plan, and
• Programs are in constant competition for funding in order to continue operations.
If we are to reduce the disproportionate rates of victimization and offending affecting urban Aboriginal peoples, we need to find more effective ways to implement the strategies that are proven to tackle risk factors. There must be support from the mayor and police chief, training and capacity development, and public engagement which fosters strong use of proven strategies. A responsibility centre with Aboriginal representation must be created. Funding must be expanded to support the community based organizations that are tackling established risk factors. Finally, sustained and adequate funding must be provided to these programs and the responsibility centre.
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Zubair, Nadja, and Jimenez Victoria-Elisabet Lupaca. "Prevention work among youths in Fundación Senda De Libertad in Nicaragua." Thesis, Linnéuniversitetet, Institutionen för pedagogik, psykologi och idrottsvetenskap, PPI, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-18473.
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The purpose of the study is to see how Fundación Senda De Libertad works in a preventive manner with youths who have social difficulties in Dario, Nicaragua. This study has utilised qualitative method, in order to gain adequate and sufficient information. The analysis of data has been gathered through an ethnographic perspective were observations and qualitative interviews have been used. This study shows how youths are affected with different social problems because of the number of risk factors that surround their environment. The organisation’s preventive works is done by going out and teach in schools, society and churches about self-esteem, sex and relationships, drug abuse and so forth. Conclusions show that many youths are unable to affect their own future and will therefore spend their time committing criminal actions, doing drugs and so forth. Fundación Senda De Libertad therefore works to support in order for them to become active participants in society. This will also help them make changes in the future of the general society.
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Nicolaou, Despina Colette Barakat Lamia. "Secondary prevention for HIV-positive adolescents : psychosocial functioning, health promoting factors, and disease control /." Philadelphia, Pa. : Drexel University, 2007. http://hdl.handle.net/1860/1786.
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Hägglund, Hans. "Risk-factors, prevention and treatment of early complications after allogeneic haematopoietic stem cell transplantation /." Stockholm, 1998. http://diss.kib.ki.se/1998/91-628-3034-1/.
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Usman, Ahmad Kabir. "An investigation into the critical success factors for e-banking frauds prevention in Nigeria." Thesis, University of Central Lancashire, 2018. http://clok.uclan.ac.uk/25360/.
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E-Banking frauds is an issue experienced globally and continues to prove costly to both banks and customers. Frauds in e-banking services occur due to various compromises in security, ranging from weak authentication systems to insufficient internal controls. Although some security frameworks to address this issue of fraud have been proposed, the problem of e-banking fraud remains due to the inability of these framework to deal with organisational issues. With limited research in this area, the study sets out to identify the organisational Critical Success Factors (CSF) for E-Banking Frauds Prevention in Nigeria by applying CSF theory. A framework is proposed to help improve security from an organisational perspective. The study adopted a mixture of philosophical paradigms which led to the triangulation of research methods; Literature Review, Survey and Case Studies. The Literature Review involved the synthesis of existing literature and identified potential CSF for frauds prevention in e-banking. A total of 28 factors were identified and a conceptual framework was proposed. A 5-point Likert scale survey questionnaire was sent to retail bank staff in Nigeria to rate the criticality of the factors. A total of 110 useable responses were received at a response rate of 23.9%. Similar interrelated factors were grouped using a Principal Component Analysis. Finally, case studies with 4 banks in Nigeria were carried out to deepen our understanding. The study identified a total of 10 CSF which spanned across strategic, operational and technological factor categories. These included 'Management Commitment', 'Engagement of Subject Matter Experts' and 'Multi-Layer Authentication' amongst others. In addition, new CSF such as 'Risk-Based Transactional Controls', 'People Awareness & Training' and 'Bank Agility via Data Driven Decision Making' were identified. Finally, these CSF were grouped into an e-banking frauds prevention framework. This study is a pioneer study that extends theory to propose a CSF-based frauds prevention framework for banks in Nigeria.
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Blows, Stacey. "Factors associated with substance use among university students in South Africa: Implications for prevention." University of Western Cape, 2020. http://hdl.handle.net/11394/7694.
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Magister Psychologiae - MPsychSubstance use and abuse has been a persistent challenge facing many communities around the world. In more recent times there has been particular focus on the gradual, yet alarming increase in the use and/or abuse of substance use among the students who are currently enrolled in institutions of higher learning. On the strength of such findings, relevant stakeholders and policy makers have since demarcated university students as being one of the most high-risk groups within a society when it comes to substance use and abuse. While substantial research has been done on the issue of alcohol use among adolescents on both a local and global scale, very little is known about the prevalence of substance use among university students in South Africa.
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Lonsdale, Karen anne. "Understanding Contributing Factors and Optimizing Prevention and Management of Flute Playing-Related Musculoskeletal Disorders." Thesis, Griffith University, 2011. http://hdl.handle.net/10072/366404.
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The flute playing position is essentially quite static, with the instrument being held unilaterally, against gravity, often for extended durations. The nature of this position, especially when fatigued, involves unavoidable muscular imbalances. If these are not counterbalanced through stretching, conditioning, or rest, discomfort, tension or pain may result. Major studies have documented the prevalence of playing-related musculoskeletal disorders and a comparison of these has shown that flutists report pain typically in the neck, middle/upper back, shoulders, wrists and hands. Many contributing factors may lead to playing-related musculoskeletal disorders, such as postural flaws, physical and psychological characteristics, incorrect technique, fatigue, intensity and type of practice, discrepancies between instrument size and physical stature, stress, lack of conditioning, and lifestyle choices. Some studies indicate that playing in an asymmetrical position may be more likely to cause more upper body musculoskeletal symptoms, which leads to the question of why the modern flute was initially built as a transverse instrument, rather than a vertically held instrument. Due to limited data specifically on the rate of injuries in the flute community, new research was necessary to help establish areas of concern to the flute community. Central to this research is a study undertaken in 2007 which characterizes these problems more clearly. The survey presented herein is the only large-scale study of musculoskeletal problems facing flutists since some major studies undertaken at National Flute Association Conventions in the United States of America in the 1990s. In the current survey, members of the international flute community were invited to participate in an anonymous online survey entitled Injury Prevention and Management for Flute Players. The survey was specifically designed to “establish the injury concerns of flute players and teachers of all backgrounds, as well as their knowledge and awareness of playing-related injury prevention and management.” The survey provides new insight into how practice habits, education, lifestyle, and playing background impact on the prevalence of musculoskeletal disorders in flutists.Thesis (Professional Doctorate)
Doctor of Musical Arts (DMA)
Queensland Conservatorium
Arts, Education and Law
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Ashton, Emma Louise, and emma ashton@deakin edu au. "Effects of dietary constituents on coronary heart disease risk factors." Deakin University. School of Biological and Chemical Sciences, 2000. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20061207.153511.
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Coronary Heart Disease (CHD) is a major cause of death in Western countries. Mediterranean and Asian populations have a lower risk of death from CHD compared to Westernised population, as do vegetarian versus omnivorous populations. Dietary constituents of traditional diets consumed by these populations are thought to influence both the classical risk factors for CHD, and the more recently identified risk factors, such as oxidative modification of low density lipoprotein (LDL), LDL particle size, arterial compliance and haemostatic factors. The aim of this thesis was to examine the effects of several food components, particularly soybean and monounsaturated fat (MUFA), on CHD risk factors through 3 carefully controlled dietary interventions, and a cross-sectional study.
A randomised crossover dietary intervention study was conducted in 42 healthy males to investigate the effect on CHD risk factors of replacing lean meat with tofu, a soybean product regularly consumed by Asian populations, while controlling all other dietary factors. The tofu diet resulted in significantly lower total cholesterol and triacylglycerol levels compared to the lean meat diet, and LDL particles that were more resistant to in vitro oxidative modification. However, insulin, fibrinogen, factor VII, and lipoprotein (a) were not significantly different on the 2 diets.
A postprandial study was subsequently conducted to investigate any acute effects of a tofu test meal on the oxidative modification of LDL in 16 male subjects. There was no significant difference between the susceptibility of LDL to oxidative modification before and after the tofu meal.
Twenty eight healthy subjects completed a separate randomised crossover dietary intervention comparing a high MUFA fat diet, using an Australian high oleic sunflower oil, with a low fat, high carbohydrate diet on CHD risk factors. The high MUFA oil diet significantly increased high density lipoprotein cholesterol compared to the low fat diet as well as producing LDL that were more resistant to oxidative modification. Neither the size of the LDL particle nor arterial compliance were significantly different on the 2 diets.
Twelve matched pairs of vegetations and omnivores were also studies to compare the habitual diet of a low and higher risk population group, to compare their risk factors and identify dietary constituents that may explain the differences. The vegetarians consumed less saturated fat (SFA) and dietary cholesterol while consuming more polyunsaturated fat, dietary fibre and vitamin E compared to omnivores. The vegetarians had lower total cholesterol, LDL cholesterol and triacylglycerol levels compared to the omnivores and had LDL particles that were more resistant to in vitro oxidation.
These findings contribute to our knowledge about the dietary constituents that can alter some CHD risk factors in healthy subjects, and which could reduce the risk of developing CHD. Investigations in high risk groups might reveal even more benefits.