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Dissertations / Theses on the topic 'Tribal Population'
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1
Ghosh, Anamika. "Socio-economic condition of tribal population of Dakshin Dinajpur District, West Bengal." Thesis, University of North Bengal, 2019. http://ir.nbu.ac.in/handle/123456789/4370.
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Rajni, Beck Renuca. "Tribal women in the democratic political process: study of tribal women in the Dooars and Terai regions of North Bengal." Thesis, University of North Bengal, 2018. http://hdl.handle.net/123456789/2713.
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Chakraborty, Anindita. "Antileishmanial and Antifungal activities of Ethno-Medicinally important plant extracts used by Tribal populations of North Bengal." Thesis, University of North Bengal, 2022. http://ir.nbu.ac.in/handle/123456789/5163.
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Adkins, Suzanne Craig. "Population Biology and Restoration of Intertidal Cockle Beds." Thesis, University of Canterbury. School of Biological Sciences, 2012. http://hdl.handle.net/10092/7794.
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There is evidence that infaunal bivalves in New Zealand are not as abundant as they once were with overfishing and habitat modification contributing to the decline in density and health of cockles. The population biology and abundance of the bivalve Austrovenus stutchburyi (tuangi) in eight beds in four estuaries was assessed both seasonally (13 seasons) and annually (7 years) as little is known about the cockle beds in the Canterbury region of New Zealand. As with populations of similar species worldwide, there were site specific differences in population structure (density and size ranges) with the highest densities at Takamatua (>1500/m²), and the lowest at Port Levy (<350/m²). Gonad indices varied between male and female cockles. Male reproductive cycles were similar at all sites with male cockles being reproductively active year round, while females were more active in spring and summer. Temporal and spatial site specific differences occurred in cockle condition with high salinity sites having higher condition indices (CI) than low salinity sites. There were spatial and temporal variations in salinity (3-35ppt), sediment structure (fine sand through to predominantly silt), water temperature (6-20°C), nutrient supply (total volatile solids (TVS) 0.002- 0.15mg/L) and contaminant levels. Metal pollution indices (MPI) ranged between 3 and 11.
Three cockle transplant trials were undertaken both within and between estuarine systems. Caged cockles survived well, and cage design needed to allow vertical movement of the bivalves within the substrate to reduce mortality. At the end of the 12 month trial, approximately 45% of the cockles remained in the plots. The condition of transplanted cockles was similar to naturally occurring cockles. Recommendations are made to optimise the success of cockle transplants. Large scale, un-caged placement of 25-30mm length cockles in the mid-low tide region of areas with stable, but not necessarily uncontaminated substrate, moderate salinity and temperature and with a reliable nutrient supply is recommended. The results from the thesis research can be applied to other infaunal bivalves in New Zealand allowing more successful restoration processes leading to increased species diversity and ecosystem functioning.
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Craig, Myrita E. "A Trial to Understand Different Medication Dosing Instructions in Low Literate Populations." University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1378112300.
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Weijer, Charles. "Characterizing the population in clinical trials : barriers, comparability, and implications for review." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23303.
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The definition of the study population for a clinical trial via the criteria for trial eligibility has implications for the validity of the study and its applicability to clinical practice. Though issues of equity regarding the selection of subjects for research have long been a concern of ethicists, issues regarding the impact of subject selection on a trial's generalizability have only recently attracted ethical scrutiny. After a review of the history of the ethics of subject selection, I focus on three empirical questions regarding the generalizability of clinical trials. (1) What proportion of diseased populations are studied in clinical trials? (2) How are subjects selected for clinical trial participation (and what are the main barriers to participation)? (3) Are clinical trial participants comparable to non-participants? Finally, the role of the Institutional Review Board--Research Ethics Board in Canada--in assessing the generalizability of clinical research is discussed.
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Funkhouser, Ellen, Deborah Levine, Joe Gerald, Thomas Houston, Nancy Johnson, Jeroan Allison, and Catarina Kiefe. "Recruitment activities for a nationwide, population-based, group-randomized trial: the VA MI-Plus study." BioMed Central, 2011. http://hdl.handle.net/10150/610161.
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BACKGROUND:The Veterans Health Administration (VHA) oversees the largest integrated healthcare system in the United States. The feasibility of a large-scale, nationwide, group-randomized implementation trial of VHA outpatient practices has not been reported. We describe the recruitment and enrollment of such a trial testing a clinician-directed, Internet-delivered intervention for improving the care of postmyocardial infarction patients with multiple comorbidities.METHODS:With a recruitment goal of 200 eligible community-based outpatient clinics, parent VHA facilities (medical centers) were recruited because they oversee their affiliated clinics and the research conducted there. Eligible facilities had at least four VHA-owned and -operated primary care clinics, an affiliated Institutional Review Board (IRB), and no ongoing, potentially overlapping, quality-improvement study. Between December 2003 and December 2005, in two consecutive phases, we used initial and then intensified recruitment strategies.RESULTS:Overall, 48 of 66 (73%) eligible facilities were recruited. Of the 219 clinics and 957 clinicians associated with the 48 facilities, 168 (78%) clinics and 401 (42%) clinicians participated. The median time from initial facility contact to clinic enrollment was 222 days, which decreased by over one-third from the first to the second recruitment phase (medians: 323 and 195 days, respectivelyp < .001), when more structured recruitment with physician recruiters was implemented and a dedicated IRB manager was added to the coordinating center staff.CONCLUSIONS:Large group-randomized trials benefit from having dedicated physician investigators and IRB personnel involved in recruitment. A large-scale, nationally representative, group-randomized trial of community-based clinics is feasible within the VHA or a similar national healthcare system.
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Zimmerman, Marian Rose. "A Randomized Clinical trial of Cognitive-Behavioral Therapy for Insomnia in a College Student Population." Thesis, University of North Texas, 2011. https://digital.library.unt.edu/ark:/67531/metadc84307/.
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Nearly 10% of college students experience chronic insomnia. Cognitive-behavioral therapy for insomnia (CBTi) is an empirically validated multi-component treatment that has been demonstrated to produce reliable and durable benefits in the general adult population. However, there have been no studies examining the effectiveness of multi-component CBTi in a college student population, even though many studies have examined the efficacy of single treatment modalities. These young adults are different from the general adult population because they are in a unique transitional developmental phase as they are maturing from adolescence into adulthood, they are sleepier than adults, they tend to have irregular sleep schedules, and their living situations are often different from the general adult population. In this study college students with chronic insomnia were randomly assigned to either six sessions of CBTi or a wait list control (WLC) group. All participants completed sleep diaries, sleep measures, and psychosocial measures. The results indicated students who received CBTi showed improvements in sleep efficiency (SE), sleep onset latency (SOL), number of awakenings (NWAK), time awake after sleep onset (WASO), and sleep quality (SQ). They also had decreased insomnia severity (ISI), dysfunctional beliefs about sleep (DBAS), and general fatigue (MFI), as well as increases in global sleep quality (PSQI).
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Derrien, Franck. "Analyse de l'occupation du Sinaï central durant l'holocène." Thesis, Aix-Marseille, 2012. http://www.theses.fr/2012AIXM3026.
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L'analyse critique des différentes prospections archéologiques réalisées dans la péninsule du Sinaï montre clairement que la partie ouest du Sinaï central n'a jamais été explorée totalement avant l'inventaire qui a commencé au milieu des années 1990. Sans étude de cette zone, tout modèle d'occupation ancienne du territoire sinaïtique se révèle insuffisant. L'objectif principal de mon doctorat était de fournir des informations de nature géographique et anthropologique aux archéologues. D'un point de vue méthodologique, l'ensemble des structures archéologiques géoréférencées a été intégré dans un système d'information géographique (SIG). Ces vestiges ont été replacés dans leur contexte environnemental (climat, géologie, géomorphologie, végétation…). Parallèlement, j'ai engagé un travail de documentation anthropologique relatif aux populations bédouines actuellement installées dans la péninsule en général, dans le Sinaï central en particulier. Je me suis particulièrement concentré sur l'étude des structures et des limites tribales, de la gestion des territoires, des pratiques liées au culte des saints et de l'économie. Dans le cadre de cette réflexion ethnoarchéologique, les nouveaux acquis permettent d'établir une analyse comparative de l'occupation ancienne et actuelle du Sinaï central. Mes conclusions sont susceptibles d'être utiles à l'interprétation des vestiges archéologiques du Sinaï central et à l'élaboration d'un modèle de l'occupation ancienne de cette région durant l'HolocèneCritical analysis of the archaeological surveys conducted in the Sinai Peninsula shows that the western central Sinai had never been explored before the beginning of this survey in the mid-1990's. Without a study of this area, models of the ancient occupation of the sinaitic territory were insufficient. The main objective of my PhD was to provide geographical and anthropological information to the archeologists. From a methodological point of view, all georeferenced archaeological structures were integrated into a Geographic Information System (GIS). These remains were placed in their environmental context (climate, geology, geomorphology, vegetation…). In parallel, I initiated an anthropological documentary work on Bedouin currently living in the Peninsula in general, in the central Sinai in particular. I particularly concentrated on the tribal structures and boundaries, the management of territories, the cult of the saints and the economy. As part of this ethnoarchaeological reflection, new learning can establish a comparative analysis of past and current occupation of central Sinai. The conclusions of my studies may help to understand the archeological remains in the central Sinai and to develop a model of the region's occupation during the Holocene
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Rej, Peter H. "Measuring mitochondrial DNA diversity and demographic patterns of tribal and caste populations from the Northeast Indian State of Assam." University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1378113115.
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Grbcic, Stefania M. "A randomised controlled trial of a novel self-help stress reduction manual for the middle management population." Thesis, University of Essex, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.571600.
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Stress and stress-related disorders have been on the increase both in the UK and worldwide. UK Governmental bodies have proposed guidelines for managing stress at work; however most are aimed at reducing and preventing stress in employees. There are also a number of stress management programmes in place (including self-help), but very few have been empirically validated in a middle management population. A novel stress self-help manual based on cognitive behavioural therapy was developed for middle managers and evaluated in this randomised controlled trial (RCT; N = 102). Four outcome measures were used to measure change: Brief Symptom Inventory (BSI; primary outcome measure), Symptom Assessment-45 (SA45), Coping Inventory for Stressful Situations (CISS), and the Job Stress Survey (JSS). Treatment effects were evaluated using analyses of covariance (ANCOVA) with post- treatment scores as dependent variables and pre-treatment scores as covariates. Significant changes were obtained on the BSI (P<0.001) at post-treatment, as well as on the SA45 (P<0.001) indicating intervention effectiveness regardless of the frequency of work stressors and lack of organisational support remaining unchanged. Measures of coping indicated that the intervention increased task, emotion, and distraction-oriented coping styles (P<0.001). The intervention was not found to effect the avoidance- oriented or social diversion coping styles. Regression analyses indicated that discussing the manual with others during the treatment protocol had a significant effect on outcomes, suggesting that future interventions should encourage groups within organisations rather than individual participation, or using the manual as an adjunct to various forms of psychological therapy. Qualitative data was also collated, which revealed that the participants felt more in control and confident after working through the manual. While further evaluation by independent researchers is recommended, including cost effectiveness analysis, the manual has shown initial effectiveness and is considered a potentially useful tool for the development of improvements towards managing and preventing stress.
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Shore, Rob M. "A randomised controlled trial of an online mindfulness-based intervention for paranoia in a non-clinical population." Thesis, University of Surrey, 2015. http://epubs.surrey.ac.uk/808489/.
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Objectives : Paranoia is common in the general population and can impact on health, emotional well-being and social functioning; therefore effective interventions are needed. Brief online mindfulness-based interventions (MBIs) have the potential to be an easily accessible, low cost treatment for non-clinical populations. There is promising evidence for brief online MBIs for anxiety and depression however at present there is no research investigating whether they can benefit people with paranoia in the general population. Therefore the current study explored whether a brief online MBI increased levels of mindfulness and reduced levels of paranoia in a non-clinical population. The mediating effect of mindfulness on any changes in paranoia was also investigated. Method: 110 participants were randomly allocated to either a two week online MBI involving 10 minutes of daily guided mindfulness practice or to a waitlist control condition. Measures of mindfulness and paranoia were administered at baseline, post-intervention and one-week follow-up. Results: Analysis of the data indicated that there were significant group by time interactions for levels of paranoia and mindfulness skills. Participants in the MBI group displayed significantly greater reductions in paranoia and increases in mindfulness when compared to the waitlist control group. Mediation analysis demonstrated that change in mindfulness skills mediated the relationship between intervention type and change in levels of paranoia. Conclusions: This study provides evidence that a brief online MBI can increase mindfulness skills and significantly reduce levels of paranoia in a non-clinical population. Furthermore, increases in mindfulness skills from this brief online MBI can mediate reductions in non-clinical paranoia. The limitations and clinical implications of this study are discussed.
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Chen, Ziyue. "Generalizing Results from Randomized Trials to Target Population via Weighting Methods Using Propensity Score." The Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu1503007759352248.
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Mandal, Pronob. "Educational and employment status of the scheduled tribes population in Malda District, West Bengal." Thesis, University of North Bengal, 2019. http://ir.nbu.ac.in/handle/123456789/4028.
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Chapoullié, Véronique. "Développement durable et populations tribales dans les Nilgiri (Tamil Nadu - Inde du sud) : une approche dynamique de l'interface envrironnement / populations." Bordeaux 3, 2003. http://www.theses.fr/2003BOR30039.
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Au sommet des Nilgiri (Ghâts occidentaux, Inde du Sud) s'isole un haut plateau habité jusqu'au XIXe siècle par des populations tribales, les Toda, Kota et Alu Kurumba, et une communauté provenant de la région de Mysore entre le XIIe et le XVIe siècle, les Badaga. Elles s'organisent et s'articulent par des relations socioéconomiques et un étagement dans l'espace et dans le temps. À partir du début du XIXe siècle, le développement des cultures de plantations et l'installation d'un grand nombre de travailleurs des plaines et de colons britanniques transforment les milieux et bouleversent le développement de ces communautés. Les Toda forment un petit groupe de pasteurs, concentrés principalement dans les Wenlock Downs, entre 2 000 et 2 400 m dans le milieu savane-shola. Les Alu Kurumba, peuple de la forêt subtropicale sempervirente et semi-décidue, sont des agriculteurs itinérants, des cueilleurs-chasseurs, localisés sur les versants abrupts du sud-est au sud-ouest des monts Nilgiri, entre 800 et 1 600 m. Les Kota, communauté d'artisans vivent parsemés dans 7 hameaux sur le plateau des Nilgiri entre 1600 et 2000 m. L'étude de l'interface environnement et communautés tribales est réalisée selon une analyse fonctionnelle et institutionnelle de leurs espaces par l'organisation et la symbolique du territoire et par les déplacements sociaux et culturels. Sous l'angle d'un développement durable, sont étudiés l'impact de l'évolution et des transformations d'une montagne tropicale sur les structures et les fonctions des populations tribales et la question d'une reconnaissance identitaireAt the top of the Nilgiri (Western Ghâts, South of India) stands out a high plateau inhabited until the XIXe century by tribal populations, the Toda, Kota and Alu Kurumba, and a community coming from the area of Mysore between XIIe and XVIe century, the Badaga. They are organised and are based on socio-economic relations and a staging in space and time. Starting from the beginning of the XIXe century, the development of the cultures of plantations and the settlement of a great number of workers from the plains and British colonists transform the milieu and upset the development of these communities. The Toda form a small group of pastors, concentrated mainly in Wenlock Downs, between 2 000 and 2 400 m in the savanna-shola milieu. The Alu Kurumba, people of the subtropical forest, are itinerant farmers, hunter-gatherers, localised on the steep slopes from the south-east to the south-west of the Nilgiri mounts, between 800 and 1 600 m. And the Kota, craftsmen community live in 7 hamlets on the Nilgiri plateau between 1 600 and 2 000 m. The study of the interface environment and tribal communities is carried out according to a functional and institutional analysis of their spaces by the organisation and the symbolic system of the territory and by social and cultural displacements. From the angle of a sustainable development, are studied the impact of the evolution and the transformations of a tropical mountain on the structures and the functions of the tribal populations and the question of a identity's recognition
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Mandrekar, Jayawant Narayan. "Impact of change in level of risk factor(s) and proportion of cured/immune individuals on the population attributable risk : simulation based study /." The Ohio State University, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=osu1486462067843814.
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Tournoux-Facon, Caroline. "Contribuer à l’amélioration du ciblage thérapeutique en oncologie par une nouvelle méthodologie des essais de phase II." Thesis, Paris 11, 2012. http://www.theses.fr/2012PA11T062/document.
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On constate que la majorité des essais de phase III, conduits après des essais de phase II pourtant prometteurs, sont “négatifs”, la nouvelle thérapeutique se révélant finalement trop toxique ou insuffisamment efficace. L’hétérogénéité de la population participant aux différentes phases de développement est une explication. Elle induirait une estimation erronée de la toxicité et, par dilution de l’effet traitement, conduirait à arrêter l’évaluation thérapeutique alors que peut être un sous-ensemble de cette population, définie à partir d’une caractéristique particulière, pourrait en bénéficier.Dans cette thèse, nous proposons dans un premier temps une réflexion sur les aspects méthodologiques des essais de phase II qui permettraient d’améliorer l’identification précoce des thérapeutiques toxiques et des populations les plus sensibles et donc de ne planifier des essais de phase III que sur des populations encore mieux ciblées. Dans un second temps, nous présentons une nouvelle méthodologie d’essai de phase II que nous avons développée pour prendre en compte l’hétérogénéité de la population et son intérêt en pratique clinique courante. Avec cette méthode, qui est une extension du plan de Fleming à deux étapes, le développement des médicaments est moins fréquemment arrêté pour la population entière et moins de patients non sensibles à la nouvelle thérapeutique sont exposés à des molécules potentiellement toxiques, durant l’étape 2 de l’essai de phase II ou plus tard lors de l’essai de phase IIIThe majority of phase III clinical trials, despite being conducted after promising phase II trials, are "negative," with the new therapy determined in the end to be too toxic or insufficiently efficacious. One explanation is the heterogeneity of the populations participating in various phases of development, which results in an erroneous estimation of the toxicity and thus a diluted therapeutic effect. This may lead to termination of evaluation of a therapy, even if a sub-population, defined by a particular characteristic, may stand to benefit from it. In this thesis, we propose a close examination of the methodological aspects of phase II trials which would permit improved early identification of toxic therapies and of responsive populations, so that phase III trials may be designed only with the best targeted populations in mind. We present as well a new phase II clinical trial methodology which we have developed to take into account trial population heterogeneity and its importance in current clinical practice. With this method, drug development is less often stopped for the entire phase II population and less non sensitive patients are exposed to toxic drugs in the second part of phase II trials, and next in phase III trials
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Vong, Camille. "Model-Based Optimization of Clinical Trial Designs." Doctoral thesis, Uppsala universitet, Institutionen för farmaceutisk biovetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-233445.
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General attrition rates in drug development pipeline have been recognized as a necessity to shift gears towards new methodologies that allow earlier and correct decisions, and the optimal use of all information accrued throughout the process. The quantitative science of pharmacometrics using pharmacokinetic-pharmacodynamic models was identified as one of the strategies core to this renaissance. Coupled with Optimal Design (OD), they constitute together an attractive toolkit to usher more rapidly and successfully new agents to marketing approval. The general aim of this thesis was to investigate how the use of novel pharmacometric methodologies can improve the design and analysis of clinical trials within drug development. The implementation of a Monte-Carlo Mapped power method permitted to rapidly generate multiple hypotheses and to adequately compute the corresponding sample size within 1% of the time usually necessary in more traditional model-based power assessment. Allowing statistical inference across all data available and the integration of mechanistic interpretation of the models, the performance of this new methodology in proof-of-concept and dose-finding trials highlighted the possibility to reduce drastically the number of healthy volunteers and patients exposed to experimental drugs. This thesis furthermore addressed the benefits of OD in planning trials with bio analytical limits and toxicity constraints, through the development of novel optimality criteria that foremost pinpoint information and safety aspects. The use of these methodologies showed better estimation properties and robustness for the ensuing data analysis and reduced the number of patients exposed to severe toxicity by 7-fold. Finally, predictive tools for maximum tolerated dose selection in Phase I oncology trials were explored for a combination therapy characterized by main dose-limiting hematological toxicity. In this example, Bayesian and model-based approaches provided the incentive to a paradigm change away from the traditional rule-based “3+3” design algorithm. Throughout this thesis several examples have shown the possibility of streamlining clinical trials with more model-based design and analysis supports. Ultimately, efficient use of the data can elevate the probability of a successful trial and increase paramount ethical conduct.
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Wong, Tak-chuen. "Casting versus percutaneous pinning for extra-articular fracture distal radius in a Chinese elderly population : a prospective randomized controlled trial /." View the Table of Contents & Abstract, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38348251.
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Wong, Tak-chuen, and 王德銓. "Casting versus percutaneous pinning for extra-articular fracture distal radius in a Chinese elderly population: a prospective randomized controlled trial." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B45011539.
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Salamh, Paul A. "Most effective intervention for reducing posterior shoulder tightness acutely in the post-operative population : a single blinded randomized control trial." Diss., NSUWorks, 2015. https://nsuworks.nova.edu/hpd_pt_stuetd/31.
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Lord, Linda K. "Epidemiological study of Ohio animal shelters and lost and found pet population issues." Columbus, Ohio : Ohio State University, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1163187060.
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Ng, Chun-man, and 吳晉文. "Effect of statins on prevention of cardiovascular diseases in Asian population: a systematic review ofrandomized, controlled trials." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48425060.
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Background
Cardiovascular disease (CVD) is the worldwide leading cause of death among non-communicable diseases and results in a huge burden of mortality and morbidity. China, a rapidly growing East Asian country, has the world largest population and is facing an increasing burden. Incidence of CVD is lower in China than in Western countries. There are more strokes, especially hemorrhagic strokes, but less coronary heart disease (CHD) in China than in Western countries. Statin, a first-choice drug for lowering low-density lipoprotein cholesterol (LDL-C), has been shown to be effective in preventing CVD and is widely used in Western countries. However, it is not known whether the same can be applied to Asian countries, where the incidence of CVD is lower and ischemic events are rarer. The aim of this systematic review is to evaluate the effectiveness of statin for prevention of CVD in East Asian populations.
Methods
A systematic review was conducted by searching for randomized controlled trials from 3 databases (PubMed, MEDLINE and Cochrane Trial) for prevention of CVD comparing statin with usual care or placebo in East Asian population. Data on CVD events (deaths, CHD and cerebrovascular events, rehospitalization and revascularization) and serum lipid levels (total cholesterol (TC), LDL-C, high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG)) were extracted. Risk ratios of CVD events and change in serum lipid level were tabulated. The relationship between change in serum lipid level and mortality and incidence of CVD events were also explored.
Results
Fourteen studies were included, with most of them (9 studies) done in Japan. Overall, statins did not significantly reduce risk of mortality, CHD events, cerebrovascular events, revascularization and rehospitalization due to CHD. However, statins consistently lowered the risk of angina-related rehospitalization by 53% (95% confidence interval (CI) 23% to 71%) and 64% (95% CI 11% to 86%) respectively in 2 studies. There was a consistent reduced risk of composite CVD events by 34% (95% CI 5% to 55%) to 54% (95% CI 6% to 41%) in 4 studies for secondary prevention. In terms of change in lipid levels, TC and LDL-C were significantly reduced by 8% to 31% and 14% to 41% respectively with statin treatment. Change in HDL-C and TG were not consistent across studies. Lowering of TC and LDL-C level was correlated with the reduction in composite CVD and CHD events.
Conclusion
The use of statins in East Asian populations to prevent CVD may not be as effective as in Western countries, because of the lower baseline risk and different patterns of CVD. As the prevalence of CVD risk factors increases, the incidence of CVD will increase and the pattern of CVD may change, so careful monitoring is needed. More importantly, most of the studies included had small sample sizes, short follow-up periods and/or low methodological quality, which might contribute to the inconsistent findings. A further large-scale randomized controlled trial should be done to confirm the benefits of statins among Chinese.published_or_final_version
Public Health
Master
Master of Public Health
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Stinson, Jill D. "Challenges of Sex Offender Risk Management in Rural Community Settings. In: Jill D. Stinson (Chair), Needs of Marginalized Populations: Rural, Tribal, and Deaf Sexual Offenders." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/7916.
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Doyle, Rebecca. "Prohibiting deferred consent can lead to research bias in clinical trials within Paediatric Intensive Care Units." Thesis, Griffith University, 2021. http://hdl.handle.net/10072/406508.
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The conduct of clinical trials under time constraints in the paediatric critical care setting may pose an ethical dilemma for researchers. Many life-saving interventions do not allow adequate time to obtain informed, prospective consent from parents or legal guardians. The rapid decision process in the paediatric critical care environment challenges the ethically accepted gold standard of consent prior to interventional research. In time-critical research, provision is made to obtain consent after the intervention has taken place. This concept is often referred to as deferred consent but may also be referred to as delayed consent, consent to continue, or research without prior consent.
Deferred consent aims to progress critical care research by mitigating the limitations of consent faced by researchers. If the intervention pertains to the treatment of critically ill children, the use of deferred consent may be required to perform the intervention pragmatically and to capture a true representation of the study population. Without deferred consent it is possible that patients requiring an immediate life-saving intervention may be missed. This may result in selection bias thus affecting study outcomes and the generalisability of research findings.
This thesis examined findings from a nested study to investigate whether differences in consent requirements led to significant differences in the study populations and outcomes of an existing multicentre, interventional, clinical trial within Paediatric Intensive Care Units. The parent trial, the Transnasal Humidified Rapid-Insufflation Ventilatory Exchange in children requiring emergent intubation (Kids THRIVE) trial, examines a system of high flow oxygen delivery during the emergency intubation of children. The Kids THRIVE Study sought approval to use deferred consent in circumstances where prospective consent was not possible.
Measures of severity of illness were used to compare participants recruited to the Kids THRIVE trial using deferred consent with those recruited using prospective consent. Severity of illness was measured in ventilator hours, hospital and intensive care length of stay and PIM3 codes.
Results indicate that children recruited to the Kids THRIVE trial using deferred consent differed clinically and statistically to those children recruited using prospective consent. Children in the deferred consent group were more unwell and had less favourable clinical outcomes. They were mechanically ventilated for longer (median [IQR] 70.97 [35.58-122.30]vs 48.85 [27.41-120.91] hours, P=0.001); spent longer in intensive care (median [IQR] 8.84 [4.55-18.38] vs 7.17 [4.25-14.29] days, P= 0.020); and had a longer hospital stay (median [IQR] 27.95 [12.69-63.59] vs 19.77 [10.28-39.96] days, P=0.010) than their counterparts in the prospective consent group. PIM3 scores which predict a percentage probability of death did not show any statistically significant difference between the two groups.
This research provides evidence that the exclusive use of prospective consent in paediatric critical care research can lead to selection bias by recruiting a study population that is not representative of paediatric intensive care patients. Alternatives to prospective informed consent need to be considered to progress research in this patient cohort.Thesis (Masters)
Master of Medical Research (MMedRes)
School of Pharmacy & Med Sci
Griffith Health
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Suzuki, Yuko. "Evolution structurelle d'une société tribale du sud-ouest de l'Iran en conséquence de la modernisation politique : une étude anthropologique de la communauté des Owrīzī de la tribu Došmanziyārī dans le département de Kohgiluye va Boirahmad." Paris, EHESS, 2011. http://www.theses.fr/2011EHES0436.
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Les tribus du département de Kohgiluye va Boirahmad au sud-ouest de l‘Iran ont connu une transformation sociale inédite depuis le siècle dernier. L‘introduction de l‘administration moderne à la place du régime des khāns et la mise en oeuvre des réformes fiscale et foncière depuis les années 1960 amorcèrent des changements dans les ressources économiques : la population tribale, pastorale ou/et agro-pastorale, souvent considérée comme pillarde, se mit à défricher ses propres pâturages et à abandonner le nomadisme en masse. La transformation économique s‘accéléra après la révolution islamique en 1979, à la suite de la mise en place des infrastructures et de divers projets de développement, y compris la progression de l‘Éducation nationale, pour finir par un exode rural massif vers les villes proches où les personnes scolarisées forment les nouvelles classes sociales citadines, comme fonctionnaires, entrepreneurs de société ou commerçants. En espérant contribuer au développement de la région, cette thèse examine le dynamisme des sociétés tribales en Iran, en interrogeant les relations entre leur transformation structurelle et la politique du régime actuel qui vise leur modernisation sociale. Afin de saisir cette mutation sociale de manière à la fois précise et globale, les enquêtes de terrain ont été menées dans deux orientations : d‘abord ethnographique par les enquêtes participatives sur une communauté de 737 personnes qui appartient à la tribu Došmanziyārī; ensuite sociologique, à travers les interviews d‘experts du développement régional et les recherches documentaires du département de Kohgiluye va Boirahmad. En effet, la population de ce département est en majorité tribale, qu‘elle soit composée de Lōrs ou de peuple turcophone comme les QašqāyiThe tribal people in the department of Kohgiluye va Boirahmad in the southwest of Iran have experienced a historical social transformation since the last century. As early as the modern administration substituted the khāns‘ rule in 1964, a new tax system and the land reform made some changes for the people‘s economic resources: the tribal people living by pastoral or agro-pastoral activities began to farm their grazing land, and the most of them settled down in one of their two territories, wintering area or summering one, to end the nomadic life. After the Islamic revolution in 1979, the economic transformation went further on. In the Zagros Mountains, some economic infrastructure was set up and various development programs, including popularization of the national education, were carried out. As a result, a massive demographic movement from the countryside to the urban areas was launched. Then, the persons who profited from the 1960s‘ national education spread, after having graduated from college or university, formed political elite groups in the local cities. Inthe hope of contributing to the regional development, the relations between social structure transformation and the recent political modernization in an Iranian tribe are investigated in this thesis. The field research is realized in two dimensions in order to analyze the social dynamism on the individual level, in the same time to synthesize the general movements in the department of Kohgiluye va Boirahmad, composed of several tribes of the Lōrs and of the Qašqāyi: 1- Ethnographic research with some long-term participation in a tribal community, called the Owrīzī, having 737 inhabitants 2- Sociologic research through numbers of interviews with Iranian development experts, local historians and some big men in the region, as well as documentation of the department
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Björkegren, Karin. "Studies on Vitamin B12 and Folate Deficiency Markers in the Elderly : A Population-based Study." Doctoral thesis, Uppsala University, Department of Public Health and Caring Sciences, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3364.
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The aims of this study were to document the levels of cobalamin, folate, methylmalonic acid (MMA) and total homocysteine (tHcy) in serum and their relations to symptoms, clinical findings, and other factors in order to improve the possibilities of detecting early deficiency of vitamin B12 or folate, and to study the effects of cobalamin and folic acid treatment over a three-year period.
The study population consisted of a 20% random sample of persons 70 years or older living in Älvkarleby in mid-Sweden. They were invited to a survey and 224 (88.4%) persons responded. Data were obtained by questionnaire, laboratory investigations and physical examination for the period 1993 – 1999.
In a multivariate analysis performed at baseline, serum MMA and tHcy were significantly and independently correlated to age, serum cobalamin, and creatinine levels, and tHcy also to sex and serum folate. Neither serum cobalamin, folate, MMA nor tHcy had any significant correlation to haemoglobin or mean red cell volume. Almost half of the study population had signs of low tissue levels of vitamin B12 or folate. Among those who took multivitamin preparations, the proportion was much lower, 25%.
Among traditional symptoms and clinical findings that have been linked to vitamin B12 or folate tissue deficiency, only changes in the tongue mucosa and mouth angle stomatitis were significantly associated with abnormal serum folate and tHcy levels. Traditional symptoms of vitamin deficiency may appear later in the course.
69 persons who had laboratory indications of early or overt tissue deficiency of vitamin B12 or folate and who had no ongoing vitamin treatment were given cobalamin for six months. Those whose MMA or tHcy levels did not normalise were given folic acid in addition to cobalamin. After further treatment for three months, all persons but one had normal levels. The laboratory effect still remained after three years of treatment. There was a tendency towards improvement of vibration sense, especially in the long nerve paths, and improvement of neurological symptoms and oral mucosa findings.
Conclusion: A substantial proportion of elderly persons have laboratory signs of incipient tissue deficiency of vitamin B12 and folate. Treatment normalises lab parameters and some symptoms.
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Cai, Weixing. "Multiple decision rules for equivalence among k populations and their applications in signal processing, clinical trials and classification." Related electronic resource: Current Research at SU : database of SU dissertations, recent titles available full text, 2008. http://wwwlib.umi.com/cr/syr/main.
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Mabweazara, Smart Zivanai. "Physical activity behaviours of persons with HIV and AIDS in low-income populations: The design of a context-sensitive randomised control trial." University of the Western Cape, 2018. http://hdl.handle.net/11394/6593.
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Philosophiae Doctor - PhDThe Human immunodeficiency virus (HIV) and acquired Immunodeficiency syndrome (AIDS) are serious health issues that continue to affect many nations. Specifically, the sub-Saharan African region has the highest prevalence of HIV and AIDS worldwide. Africans living in informal settlements or townships have the highest prevalence of HIV in South Africa. Persons of low socioeconomic status (SES) in general become socialised into unhealthy behaviours and risk factors at early ages, and experience poor health outcomes. Physical activity (PA) is one cost-effective, non-pharmacological approach that has been reported as conjunctive therapy for HIV to effectively address these impairments. Aim: The aim of the study was to develop a contextualized intervention that promotes PA among persons living with HIV and AIDS (PLWHA) of low SES. Methods: A mixed methods approach was used. Studies included (1) a systematic review which assessed (a) specific and useful intervention techniques that were previously used in successful PA interventions (b) relevant behaviour change theories used to develop the intervention content, (2) a narrative review which examined the available literature on PA, social support and SES with a view to inform the design of effective PA interventions for PLWHA of low SES, (3) a cross sectional study which aimed at determining if age, body weight, height, gender, waist-to-hip ratio (WHR), educational attainment, employment status, CD4+ cell count, and body mass index (BMI) could predict overall PA among PLWHA of low SES in Cross roads Township in the Western Cape Province, South Africa (4) a cross-sectional study which (a) examined the PA profile of PLWHA of low SES based on PA domains and intensity and (b) determined whether employment status and level of education can predict PA among PLWHA of low SES in Cross roads Township in the Western Cape Province, South Africa (5) a mixed methods study which investigated the benefits and barriers of PA for HIV-positive women of low SES using the Exercise Benefits/Barriers Scale and focus group discussions, (6) a study which sought to develop a contextualised intervention for promoting PA among PLWHA of low SES and (7) a crossover study conducted at a community centre caring for HIV positive Black African Xhosa-speaking women of low SES in Nyanga Township in the Western Cape Province in South Africa. Results: The systematic literature review showed that the following techniques, namely, ‘provide feedback on performance’, ‘goal setting (behaviour)’, and ‘plan social support/social change’ were the most frequently used behavioural change techniques in interventions focusing on promoting PA for the management of chronic diseases amongst individuals of low SES. The review also showed that the Transtheoretical model of behaviour change and the Social Cognitive theory were the common theoretical frameworks of most study interventions.
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Maku, Vyambwera Sibaliwe. "Mathematical modeling of TB disease dynamics in a crowded population." University of the Western Cape, 2020. http://hdl.handle.net/11394/7357.
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Philosophiae Doctor - PhDTuberculosis is a bacterial infection which is a major cause of death worldwide. TB is a curable disease, however the bacterium can become resistant to the first line treatment against the disease. This leads to a disease called drug resistant TB that is difficult and expensive to treat. It is well-known that TB disease thrives in communities in overcrowded environments with poor ventilation, weak nutrition, inadequate or inaccessible medical care, etc, such as in some prisons or some refugee camps. In particular, the World Health Organization discovered that a number of prisoners come from socio-economic disadvantaged population where the burden of TB disease may be already high and access to medical care may be limited. In this dissertation we propose compartmental models of systems of differential equations to describe the population dynamics of TB disease under conditions of crowding. Such models can be used to make quantitative projections of TB prevalence and to measure the effect of interventions. Indeed we apply these models to specific regions and for specific purposes. The models are more widely applicable, however in this dissertation we calibrate and apply the models to prison populations.
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Lyons, I. "The Medicines Advice Service Evaluation (MASE) : a mixed methods randomised controlled trial of an intervention to improve medication adherence in a mail-order pharmacy population." Thesis, University College London (University of London), 2015. http://discovery.ucl.ac.uk/1471595/.
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Non-adherence to medicines for long-term conditions is a complex and prevalent phenomenon, with significant clinical and economic consequences for patients and health providers worldwide. Simple effective solutions have eluded researchers over many decades. A mixed methods randomised controlled trial was conducted to test the effectiveness of a pharmacist-led intervention to improve adherence, in the context of mail-order pharmacy. 677 patients prescribed at least one oral medication for type 2 diabetes and/or lipid regulation were recruited from a UK pharmacy, and randomised (340 interventions, 337 controls). The intervention was patient-centred, comprising spoken information and advice by phone, and written information by post, delivered by a pharmacist. All elements of the intervention were tailored to the individuals' needs. The primary outcome was self-reported adherence to medication at six-month follow up. Secondary outcomes included prescription refill adherence, lipid and glycaemic control, and patient satisfaction. Patients who received the intervention had 54% increased odds of being adherent (defined as ≥90% of medication taken in the past 7 days), compared to the control group (OR 1.54, 95%CI 1.11-2.15, p=0.01). Analyses of dispensing data also showed that the odds of being classified as adherent (≥90%) were 60% greater for the intervention group compared to the control group (OR 1.60, 95%CI 1.14-2.24, p < 0.01). For patients who provided a blood sample at six-month follow up, 67% vs 31% (16 interventions, 5 controls, p=0.06) and 65% vs 55% (64 interventions, 38 controls, p=0.24) achieved guideline targets for glycaemic and lipid control, respectively. Satisfaction with the Medicines Advice Service was high, with 91.8% (n=245) agreeing that they were satisfied overall. Intervention, led by a pharmacist and tailored to the individuals' needs, can significantly improve medication adherence in patients with long-term conditions. The findings provide further support for the enhanced role of pharmacists in supporting and advising patients, and improving outcomes.
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Uhrig, Lana K. "Feasibility of a long-term food-based prevention trial with black raspberries in a post-surgical oral cancer population: Adherence and modulation of biomarkers of DNA damage." The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1416961549.
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Cabarrou, Bastien. "Prise en compte de l'hétérogénéité de la population âgée dans le schéma des essais cliniques de phase II en oncogériatrie." Thesis, Toulouse 1, 2019. http://www.theses.fr/2019TOU10004.
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Le cancer du sujet âgé est un réel problème de santé publique. L’incidence du cancer augmentant avec l’âge couplée au vieillissement général de la population font que plus de la moitié des tumeurs diagnostiquées aujourd’hui le sont chez des patients de plus de 65 ans. Cependant, cette population hétérogène a longtemps été exclue des essais cliniques et le manque de données prospectives rend difficile la prise en charge de ces patients. Plusieurs publications soulignent l’importance et la complexité de réaliser des essais cliniques dans cette population. Les schémas classiques ne prenant pas en compte l’hétérogénéité, les essais de phase II spécifiques aux sujets âgés sont rares et généralement stratifiés en sous-groupes définis selon un critère gériatrique ce qui augmente le nombre de patients à inclure et donc diminue la faisabilité. L’objectif de cette thèse est de présenter, comparer et développer des schémas de phase II adaptatifs stratifiés permettant de prendre en compte l’hétérogénéité de la population âgée. L’utilisation de ce type d’approche permet de réduire le nombre de patients à inclure tout en maintenant la puissance statistique et en contrôlant le risque d’erreur de type I. Ce qui implique une diminution du coût et de la durée de l’étude et donc une augmentation de la faisabilité. Afin d’améliorer l’efficacité de la recherche clinique en oncogériatrie, il est donc primordial d’utiliser des schémas adaptatifs stratifiés prenant en compte l’hétérogénéité de la population et permettant d’identifier un sous-groupe d’intérêt susceptible de pouvoir bénéficier (ou non) de la nouvelle thérapeutiqueElderly cancer is a real public health problem. With the overall aging population and the increased incidence of cancer, more than half of all tumors diagnosed today are in patients aged 65 years or older. However, this heterogeneous population has long been excluded from clinical trials and the lack from prospective data makes it difficult managing these patients. Many publications highlight the importance and the complexity of conducting clinical trials in this population. As classical phase II designs do not take into account the heterogeneity, elderly specific phase II clinical trials are very uncommon and generally conducted in specific subgroups defined by geriatric criteria which increases the number of patients to be included and thus reduces the feasibility. The objective of this thesis is to present, compare and develop stratified adaptive designs that address the heterogeneity of the elderly population. The use of this methodology can minimize the number of patients to be included while maintaining statistical power and controlling the type I error risk. This implies a reduction in the cost and duration of the study and thus increases the feasibility. In order to improve the efficiency of clinical research in geriatric oncology, it is essential to use stratified adaptive designs that take into account the heterogeneity of the population and make it possible to identify a subgroup of interest that might benefit (or not) from the new therapeutic
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Ujamaa, Dawud A. "Assessing the Effect of Prior Distribution Assumption on the Variance Parameters in Evaluating Bioequivalence Trials." Digital Archive @ GSU, 2006. http://digitalarchive.gsu.edu/math_theses/13.
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Bioequivalence determines if two drugs are alike. The three kinds of bioequivalence are Average, Population, and Individual Bioequivalence. These Bioequivalence criteria can be evaluated using aggregate and disaggregate methods. Considerable work assessing bioequivalence in a frequentist method exists, but the advantages of Bayesian methods for Bioequivalence have been recently explored. Variance parameters are essential to any of theses existing Bayesian Bioequivalence metrics. Usually, the prior distributions for model parameters use either informative priors or vague priors. The Bioequivalence inference may be sensitive to the prior distribution on the variances. Recently, there have been questions about the routine use of inverse gamma priors for variance parameters. In this paper we examine the effect that changing the prior distribution of the variance parameters has on Bayesian models for assessing Bioequivalence and the carry-over effect. We explore our method with some real data sets from the FDA.
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ATWERE, PEARL. "Evaluation of Informed Consent Documents used in Critical Care Trials." Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/33356.
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The literature suggests that informed consent documents (ICDs) are not well understood by research participants. The patient decision aid model may suggest improvements for the informed consent process, particularly in the critical care setting (ICU) because of patient capacity issues. Our goal was to evaluate the extent to which existing ICDs used in ICU research adhere to standards and recommendations for high quality informed consent. Eighteen items from recommendations specific to ICU trials were added to a previously developed ICD evaluation tool. A sample of ICU trials was identified from clinicaltrials.gov database and the investigators contacted for their trial ICD.
Conformity to the recommendations was variable. Some information are found routinely in consent documents for critical care research and some are not. Efforts should aim to establish tools for measuring decision quality in the ICU with the goal of facilitating and helping patients and surrogates work through trial participation decisions.
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Augustin, Alix. "Facteurs épidémiologiques influençant la survie dans le lymphome à cellules du manteau." Thesis, Bourgogne Franche-Comté, 2017. http://www.theses.fr/2017UBFCI020/document.
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Le Lymphome à Cellules du Manteau (LCM) est une entité récemment identifiée qui se caractérise par la translocation génétique t(11 ;14)(q13 ;q32) et compte pour 2 à 10 % de tous les Lymphomes non-Hodgkiniens. Avec une survie médiane entre 3 et 5 ans après le diagnostic, le LCM est une pathologie agressive et malgré les récentes avancées thérapeutiques, peu d’informations sont disponibles concernant ses facteurs pronostiques. Certaines études ont analysé le rôle des caractéristiques clinicopathologiques et des nouvelles stratégies thérapeutiques, mais on connait peut le rôle des facteurs environnementaux et du mode de vie sur le pronostic des patients atteints de LCM. Entre 2008 et 2012, le groupe LYSA a mené en France deux essais cliniques prospectifs multicentriques : LM manteau 2010 SA "RiBVD" (NCI01457144) et Manteau 2007 SJ "LyMa" (NCT00921414). Après une comparaison de ces patients avec les patients de population générale, l’effet de facteurs socioéconomiques et des habitudes de vie sur la survie des patients a été étudié à l’aide d’un questionnaire qualitatif administré à tous les volontaires après le diagnostic. Nos résultats suggèrent qu’un faible niveau d’éducation, un indice de masse corporelle élevé et de la consommation d’alcool sont associés à un risque de décès plus élevé chez les patients atteints de LCM. Toutefois, l’étude de tels facteurs et de leur influence sur un sous-type de LNH aussi rare requiert des échantillons d’étude de taille plus importante. L’élargissement des critères d’inclusion des patients dans les essais cliniques permettrait de sélectionner davantage de patients mais aussi des patients mieux représentatifs de la population générale. Enfin, l’intégration systématique de ce type de questionnaire dans les protocoles d’essais cliniques serait aussi un atout majeurMantle Cell Lymphoma (MCL) is a recently defined entity, typically characterised by the genetic translocation t(11 ;14)(q13 ;q32) and counting for 2 - 10% of all non-Hodgkin Lymphomas. With a median survival between 3 and 5 years after diagnosis, MCL is an agressive disease and despite the recent therapeutic advances little in know about its prognostic factors. Some studies had investigated clinicopathological features and new treatment strategies, but there is a lack of knowledge regarding the impact of lifestyle and environnemental factors on outcome of MCL patients. From 2008 to 2012, the LYSA Group conducted in France two prospective multi center clinical trials on MCL : LM manteau 2010 SA "RiBVD" (NCI01457144) and Manteau 2007 SJ "LyMa" (NCT00921414). After a comparison of these patients with population-based data, socioeconomic factors, lifestyle factors and their influence on survival had been investigated through a qualitative survey administrated to each volunteer after diagnosis. Our findings suggest that low educational attainment, low body body mass index and alcohol consumption are associated with a higher risk of death in MCL. However, to investigate lifestyle factors in this rare NHL subtype, larger studies should be carried out. Clinical trial inclusion criteria must be widen to select more patients and patients more representative of general population. Implementation of these epidemiological studies in clinical practice should be considered
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Pisinthpunth, C. "A Guideline for Environmental Games (GEG) and a randomized controlled evaluation of a game to increase environmental knowledge related to human population growth." Thesis, Coventry University, 2015. http://curve.coventry.ac.uk/open/items/ab227155-e0c9-4389-a76c-33b9f8283fcf/1.
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People often have very little knowledge about the impact of unsustainable human population growth on the environment and social well-being especially in developing countries. Therefore, an efficient method should be explored in order to educate, and if possible, to convince the members of the public to realize the environmental and social problems caused by the unsustainable population growth. Digital Game-Based Learning (DGBL) has been highlighted by some studies as an innovative tool for learning enhancement. While only a handful of studies have scientifically evaluated the impact of DGBL on knowledge outcomes, the approach is an attractive tool to increase knowledge and motivate engagement with environmental issues surrounding population growth because of its potential to improve learners’ motivation and engagement thereby compared to traditional learning approaches. Therefore, the three primary research questions for this study are: 1) "Can a single-player digital game be an appropriate and attractive learning application for the players to gain insight about the relationship between the growing human population and the environmental issues?" 2) "How can we design environmental games for the players to gain insights about the relationship between the growing human population and the environmental issues via playing a game?" and 3) "What are the obstacles preventing the players from adapting environmental knowledge obtained from the learning mediums into the real-life?" To inform the development of an efficacious DGBL game to impact learning outcomes, critical reviews of environmental issues related to population growth as well as critical reviews of commercial and serious environmental games in terms of their educational and motivational values were undertaken in this study. The results of these critical reviews informed the development of a Guideline for Environmental Games (or GEG). The GEG was developed by combining the engaging game technology with environmental learning and persuasion theories. The GEG was then used to inform the development of a prototype game called THE GROWTH; a single-player, quiz-based, city-management game targeting young adolescents and adults. Multiple evaluation methods of the game were used to answer the three key research questions mentioned earlier. These methods included: 1) The Randomized Controlled Trial approach (RCT) where the participants were systematically divided into the experimental and the control group respectively and their knowledge scores (quantitative data) compared and analyzed, 2) The participants’ abilities to recall and describe the environmental and well-being issues were collected and analyzed qualitatively using The Content Analysis method (CA) and, 3) The participants’ overall feedback on the learning mediums was collected and analyzed to evaluate the motivational values of THE GROWTH itself. To this end, THE GROWTH was evaluated with 82 Thai-nationality participants (70 males and 12 females). The results showed that participants assigned to play THE GROWTH demonstrated greater environmental and social-well-being knowledge related to population growth (F(1,40) = 43.86, p = .006) compared to the control group participants assigned to a non-interactive reading activity (consistent with material presented in THE GROWTH). Furthermore, participants who played THE GROWTH recalled on average more content presented in the game when compared to participants who were presented with similar content in the reading material (t (59) = 3.35, p = .001). In terms of level of engagement, the study suggested that participants assigned to the game were more engaging with their learning medium on average when compared to participants assigned to the non-interactive reading activity. This is evidenced by the longer time participants spent on the task, the activity observed from participants’ recorded gameplay, and their positive responses in the survey. The semi-structured interviews used in this study highlighted the participants’ attitudes towards the environmental, social, and technological issues. Although the participants’ perceived behavioural intention towards the environmental commitments were not statistically differed between the two study group, their responses still provide some evidences that leaps may occur from the learning mediums to the real-world context. Furthermore, these responses can be valuable evidences for the policy makers and for the future development of environmental serious games. Overall, the results suggested that digital environmental games such as THE GROWTH might be an effective and motivational tool in promote the learning about sustainable population size, the environment, and the social well-being. The game’s ability to convince the participants to change towards sustainable lifestyles, however, might be subjected to the future research and other real-world circumstances such as the governmental and public supports. In summary, the research in this thesis makes the following contributions to knowledge: • The Guideline for Environmental Games (GEG) contributes to knowledge about making theoretically-based environmental games. It has particular significance because the guideline was validated by demonstrating learning improvements in a systematic randomized controlled trial. • The use of Multi-Strategy Study Design where multiple systematic evaluation methods were used in conjunction to provide conclusive findings about the efficacy of DGBL to impact outcomes. • THE GROWTH itself is a contribution to applied research as an example of an effective DGBL learning tool.
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Magnani, Nathércia Cristina Manzano. "Os direitos humanos e fundamentais dos povos indígenas e os juízes: olhares presentes na jurisprudência da Corte Interamericana de Direitos Humanos e do Supremo Tribunal Federal." Pontifícia Universidade Católica de São Paulo, 2013. https://tede2.pucsp.br/handle/handle/6300.
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Previous issue date: 2013-11-16Conselho Nacional de Desenvolvimento Científico e Tecnológico
This project aims to understand which base(is) of the human and fundamental rights is (are) predominant in the jurisprudence s construction in effect for indigenous communities of Inter-American Court of Human Rights (IACHR) and of the Supreme Federal Court (STF). In order to do so, three theories have been studied aiming to found the human and fundamental rights: universalism, cultural relativism and the critical perspective of the theoretical text present in the literary works of Joaquín Herrera Flores. After that based on collected and analyzed data, it was possible, based on comparison analyzes, to run a quantitative and qualitative study to conclude that the first jurisprudence (IACHR) is more open for the dialogue and confluency universalism. The conclusion was also based in the fact that the first jurisprudence (IACHR) has been interpreting violations committed against indigenous population as well as communal violations therefore highlighting the importance of cultural identity rights of the indigenous population, the right to be consulted and reinforcing their rights to have a dignified life
O trabalho busca compreender qual(is) concepção(ões) de direitos humanos e fundamentais é(são) predominante(s) na construção da jurisprudência sobre povos indígenas da Corte Interamericana de Direitos Humanos (CIDH) e do Supremo Tribunal Federal (STF). Para tanto, foram estudadas três correntes que, de maneira diversa entre si, dedicam-se a fundamentar os direitos humanos: a universalista, o relativismo cultural e a mirada crítica presente nas obras de Joaquín Herrera Flores. Seguidamente, partiu-se para uma análise quantitativa e qualitativa das jurisprudências sobre indígenas da CIDH e do STF e a partir dos dados colhidos, analisados e comparados foi possível ponderar que a primeira é mais aberta para ao diálogo e ao universalismo de confluência do que o segunda, já que vem interpretando as violações cometidas contra as populações ameríndias como violações comunais e dando destaque ao direito à identidade cultural, à consulta prévia, acessível e informada e à vida digna
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Rodrigues, Doriane Picanço. "Diversidade genética e sistema de reprodução progênies elites de Pupunheira Inerme (Bactris gasipaes KUNTH) com marcadores microssatélites: Implicações para o melhoramento do palmito." Universidade Federal do Amazonas, 2006. http://tede.ufam.edu.br/handle/tede/3061.
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Previous issue date: 2006-09-28Fundação de Amparo à Pesquisa do Estado do Amazonas
The peach palm (Bactris gasipaes Kunth var. gasipaes) is a domesticated Neotropical palm that is important as a cultivated source of heart-of-palm. The genetic base for this agribusiness is the Pampa Hermosa landrace, Yurimaguas, Peru, that supplies the absolute majority of the seeds used in the expansion of the agribusiness and the improvement programs in Brazil, because its plants are spineless and more productive than those of other landraces. The use of molecular markers will permit better discrimination among populations and progenies of the landrace, guiding the selection of elite individuals and the search for hybrid vigor via maximization of heterozygosity within the landrace. This study evaluated the genetic diversity, population structure, and genetic relations among progenies and populations in a progeny trial maintained at INPA, Manaus, Amazonas, as well as the mating system of the peach palm using eight microsatellite loci, to support the improvement programs that use these genetic resources. Samples from three populations of the Pampa Hermosa landrace and from the market of Yurimaguas were collected from 12 progenies from the Cuiparillo River (n=140), 12 from the Paranapura River (n=130), nine from the Shanusi River (n=130), and 17 from the market at Yurimaguas (n=168). The sampling concentrated on plants (121) selected for heart length, and included non-selected plants (447). High genetic variability exists in the progeny trail, with a mean of 15.1 alleles per locus and total diversity (HT) equal to 0.82. The eight loci had 12 common alleles and 26 intermediate-frequency alleles found in all the populations and the market, and 83 alleles scattered among populations, with 14 private alleles. The observed heterozygosity (Ho) in the trail was less than the He in the majority of the loci; in locus Bg02-08 Ho was very inferior, suggesting a strong excess of homozygotes in this locus. The Ho was lowest in Shanusi (0.64) and highest in Paranapura (0.74). The inbreeding coefficient f varied among populations and market, and was highest in Shanusi (0.190) and lowest in Paranapura (0.111). Genetic divergence among the populations and the market was low (formula), certainly due to high gene flow (9.8 migrants per generation). The AMOVA detected 82.8% of the total variation within the progenies, 16% among the progenies within the populations and market, and only 1.3% among the populations and the market, describing a weak genetic structure and suggesting that the populations and the market are highly related. This relationship was confirmed by the dendrograms of the DAS genetic distances among the populations, with a greater proximity between the populations of Paranapura and Cuiparillo, and between the Mercado and Shanusi. The dendrogram of the DAS genetic distances showed high genetic affinity among the progenies and the formation of groups independent of their geographic origin. The Ho and He were high for the majority of the progenies, confirming high genetic variability within the progenies. The inbreeding coefficient (f) for the progeny trial was not different from zero, confirming an excess of heterozygotes and confirming the high variability observed from the estimates of heterozygosity. The analysis of the mating system found that the species is predominantly allogamous. The high out-crossing rate demonstrates that the progenies are derived almost exclusively from individuals experiencing out-crossing, probably due to the harvest representing the peak of the flowering season and to the synchronism of flowering associated with the behavior of the pollinator. The estimates of crossing among relatives (tm - ts) were significant (0.101 to 0.202), suggesting some biparental inbreeding, probably due to the farmers practice of planting open-pollinated seeds of only a few seed sources in the same plot. The estimate of paternity correlation was low (varying from 0.051 to 0.112), suggesting a small number of full sibs within the progenies and large number of pollen sources (9 to 20) participating in the crosses. The progenies of the trial are composed mainly of half sibs with great genetic variability, enhanced by the large number of pollen sources, and suggests that selection for heart-of-palm production could be based on the classic models of quantitative genetics applied to exclusively allogamous species. This information will be used to guide the crosses among progenies/populations. Two improvement plans are feasible with this information: population improvement, with crosses among highly divergent plants and progenies; by reciprocal recurrent selection, with the creation of divergent populations based on morphometric and genetic information.
A pupunheira cultivada (Bactris gasipaes Kunth var. gasipaes) é uma palmeira domesticada que vem se destacando como produtora de palmito. A base genética para o agronegócio vem da raça primitiva Pampa Hermosa, Yurimáguas, Peru, que fornece a maioria absoluta das sementes usadas na expansão do agronegócio e nos programas de melhoramento no Brasil, devido a possuir plantas sem espinho que são mais produtivas que as de outras raças. O uso de marcadores moleculares possibilitará discriminar com maior confiabilidade entre populações e progênies, orientando a seleção de matrizes e a busca de vigor híbrido via maximização de heterozigosidade dentro da raça. Este trabalho avaliou a diversidade e a estrutura genética, as relações genéticas entre as progênies e o sistema de reprodução de pupunheira da raça Pampa Hermosa, usando oito loci microsatélites, para apoiar os programas de melhoramento que usam estes recursos genéticos. Foram coletadas amostras de três populações de pupunheira da raça Pampa Hermosa e do mercado de Yurimáguas mantidas no ensaio de progênies do INPA, sendo 12 progênies do rio Cuiparillo (n=140), nove do rio Shanusi (n=130), 12 do rio Paranapura (n=130) e 17 do mercado de Yurimáguas (n=168). A amostragem concentrou-se em plantas selecionadas (121) para comprimento do palmito e não selecionadas (447). Existe alta variabilidade genética nas progênies do ensaio, com média de 15,1 alelos por loci e diversidade total (HT) igual a 0,82. Os oito loci apresentaram 12 alelos comuns e 26 alelos intermediários presentes em todas as populações e o mercado, e 83 alelos raros, sendo 14 privados, 10 esporádicos e 62 difundidos. As heterozigosidades observadas (Ho) no conjunto de plantas foram inferiores a heterozigosidade esperada (He) na maioria dos loci; no lócus Bg02-08 Ho foi muito inferior, sugerindo forte excesso de homozigotos neste lócus. A Ho foi menor em Shanusi (0,64) e maior em Paranapura (0,74). Os coeficientes de endogamia variaram entre populações e mercado, sendo maior em Shanusi (0,190) e menor em Paranapura (0,111). Detectou-se baixa divergência genética entre as populações e o mercado (fórmula), certamente devido ao alto fluxo gênico (9,8 migrantes por geração). A AMOVA detectou 82,8% do total da variação dentro das progênies, 16% entre as progênies dentro das populações e o mercado, e somente 1,3% entre as populações e o mercado, confirmando uma estrutura genética mínima e sugerindo que as populações e o mercado são altamente relacionadas. Este relacionamento foi confirmado pelos dendrogramas de distâncias (DAS) das populações, o qual mostra maior proximidade entre as populações de Paranapura e Cuiparillo, e entre o mercado e Shanusi. O dendrograma das progênies mostra alta afinidade genética e formação de grupos independentes de sua área geográfica de origem. As heterozigosidades observadas (Ho) e esperadas (He) foram altas para a maioria das progênies, evidenciando alta variabilidade genética dentro das progênies. O coeficiente de endogamia (f) para o conjunto de progênies não foi diferente de zero, evidenciando excesso de heterozigotos e confirmando a alta variabilidade observada pelas estimativas de heterozigosidade. A análise do sistema de reprodução revela que a espécie é predominantemente alógama. As altas taxas de cruzamento demonstram que as progênies são oriundas quase que exclusivamente por indivíduos provenientes de exocruzamento, provavelmente devido ao estágio fenológico (pico da safra) e ao sincronismo de floração associado ao comportamento do polinizador. Porém, as estimativas (tm - ts) foram significativas (0,101 a 0,202), evidenciando endogamia biparental, provavelmente decorrente da prática agrícola de plantar sementes de polinização aberta de poucas matrizes na mesma roça. A estimativa da correlação de paternidade foi baixa (variando de 0,051 a 0,112), indicando pequena proporção de irmãos-completos dentro das progênies e grande número de doadores de pólen (9 a 20) participando dos cruzamentos individuais. Portanto, as progênies do ensaio são compostas em sua maioria por meios-irmãos com elevada variabilidade genética, evidenciada pelo alto número de doadores de pólen, e sugere que a seleção para produção de palmito poderá ser baseada nos modelos clássicos de genética quantitativa aplicados para espécies exclusivamente alógamas. Essas informações serão utilizadas para orientar os cruzamentos entre e dentro de progênies/populações. Dois planos de melhoramento são factíveis com essa informação: melhoramento populacional, com cruzamentos entre plantas e acessos altamente divergentes; melhoramento por meio de seleção recorrente recíproca, com a criação de populações divergentes em termos morfométricos e genéticos.
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Stenlund, Therese. "Rehabilitation for patients with burnout." Doctoral thesis, Umeå : Umeå University, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-18434.
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Ndounga, Diakou Lee Aymar. "Essais randomisés conduits en Afrique subsaharienne : épidémiologie, méthodologie et description des interventions." Thesis, Sorbonne Paris Cité, 2017. http://www.theses.fr/2017USPCB064/document.
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L’Afrique sub-saharienne (SSA) se caractérise par une croissance démographique rapide et une pauvreté notoire. Cette région du monde fait face à une charge de morbidité causée à la fois par les maladies infectieuses traditionnelles et par l’émergence des maladies chroniques. Les essais contrôlés randomisés (ECR) prenant en compte le contexte local sont nécessaires pour renforcer les politiques de santé publique et améliorer l’état de santé des populations. Toutefois à cause des capacités limitées de recherche, les ECR conduits en ASS doivent répondre à des questions prioritaires, les biais (erreurs systématiques) doivent être évités dans les méthodes, et les interventions de santé évaluées doivent être décrites de manière pour faciliter leur implémentation dans la pratique clinique courante. Ces mesures permettent d’éviter le « gâchis de la recherche ». Nos objectifs étaient de décrire l’épidémiologie des ECR conduits en ASS, et d’évaluer la qualité méthodologique (risque de biais) ainsi que le « reporting » des interventions évaluées. Nos travaux ont montré d’une part qu’en ASS, les ECR portent fréquemment sur les maladies à forte morbi-mortalité dans cette région ; mais que les financements des recherches effectuées proviennent surtout des pays à haut revenu (Europe occidentale et Amérique du Nord), et que les auteurs correspondants sont majoritairement affiliés aux institutions des pays à haut revenu. D’autre part, nous avons montré que les méthodes à haut risque de biais peuvent être évitées au moyen d’ajustements méthodologiques simples au coût mineur. L’amélioration de la qualité méthodologique des ECR conduits en ASS implique une large diffusion des méthodes à faible risque de biais ainsi que celle des recommandations pour la description complète des interventions. En outre, une compréhension des barrières et des facilitateurs à l’adhérence à ces méthodes et à ces recommandations est également nécessaireSub-saharan Africa (SSA) is characterized by a high population growth and a significant poverty. In addition, this area deals with a burden of disease due to both traditional infection diseases and the emerging chronic diseases. Randomised controlled trials (RCTs) taking into account the local context are needed to strength health policy and to improve the population health. However, because of constraint research capacities, RCTs performed in SSA must investigate relevant research questions, biases must be avoided in methods, and health interventions evaluated must be reported completely for easing implementation in current clinical practice. Such efforts help to avoid waste of research. Our objectives were to describe the epidemiology of SSA RCTs, and then to evaluate the methodological quality as well as the reporting of evaluated interventions. On the one hand, our works highlighted that SSA RCTs mainly focused on diseases of the highest burden in that area, although they were frequently funded by high-income countries, and most of the corresponding authors were affiliated to those countries. In the other hand, we have shown that methods at high risk of bias can be avoided through simple methodological adjustments of minor cost. Improving the methodological quality of SSA RCTs implies a large dissemination of available methods at low risk of bias and guidelines on the complete reporting of interventions. Furthermore, understanding barriers and facilitators to the uptake of those methods and guidelines is equally required
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Heidelk, Tillmann. "Education, labor markets, and natural disasters." Doctoral thesis, Universite Libre de Bruxelles, 2020. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/304527.
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This thesis explores the entire cycle of education, from initial access to schooling, over degree completion, to returns to education. Despite recent gains in increasing access, an tens of millions of children worldwide are still out of school. Abolishing school fees has increased enrollment rates in several countries where enrollments were low and fees were high. However, such policies may be less effective, or even have negative consequences, when supply-side responses are weak. The first part of the thesis evaluates the impacts of a tuition waiver program in Haiti, which provided public financing to nonpublic schools conditional on not charging tuition. The chapter concludes that school's participation in the program results in more students enrolled, more staff, and slightly higher student-teacher ratios. The program also reduces grade repetition and the share of overage students. While the increase in students does not directly equate to a reduction in the number of children out of school, it does demonstrate strong demand from families for the program and a correspondingly strong supply response from the nonpublic sector.Pertaining degree completion, it is well established that natural disasters can have a negative effect on human capital accumulation. However, a comparison of the differential impacts of distinct disaster classes is missing. Using census data and information from DesInventar and EMDAT, two large disaster databases, the second part of the thesis assesses how geological disasters and climatic shocks affect the upper secondary degree attainment of adolescents. The chapter focuses on Mexico, given its diverse disaster landscape and lack of obligatory upper secondary education over the observed time period. While all disaster types are found to impede attainment, climatic disasters that are not infrastructure-destructive (e.g. droughts) have the strongest negative effect, decreasing educational expansion by over 40%. The effects seem largely driven by demand-side changes such as increases in school dropouts and fertility, especially for young women. The results may also be influenced by deteriorated parental labor market outcomes. Supply-side effects appear to be solely driven by infrastructure-destructive climatic shocks (e.g. floods). These findings thus call for differential public measures according to specific disaster types and an enhanced attention to climatic events given their potentially stronger impact on younger generations.It is also widely appreciated that natural disasters can have negative impacts on local labor market outcomes. However, the study of differential types of negative capital shocks, the underlying labor market mechanisms, and the context of the poorest countries have been neglected. Following testable predictions of economic theory, the third part of the thesis exploits the exogenous variation of destruction of human and physical capital caused by the 2010 Haiti earthquake to disentangle the differential impact on local individual monetary returns to education. Employing individual-level survey data from before and after the earthquake the chapter finds that the returns decreased on average by 37%, especially in equipment-capital intensive industry. Higher educated individuals adjust into low-paying self-employment or agriculture. The returns are particularly shock-sensitive for urban residents, migrants, males, and people over age 25.Doctorat en Sciences économiques et de gestion
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Sallah, Kankoe. "Diffusion spatio-temporelle des épidémies : approche comparée des modélisations mathématiques et biostatistiques, cibles d'intervention et mobilité humaine." Thesis, Aix-Marseille, 2017. http://www.theses.fr/2017AIXM0607.
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Dans la première partie de cette thèse, nous avons mis en place un métamodèle de transmission du paludisme basé sur la modélisation compartimentale susceptible-infecté-résistant (SIR) et prenant en compte les flux de mobilité humaine entre différents villages du Centre Sénégal. Les stratégies d’intervention géographiquement ciblées, s’étaient avérées efficaces pour réduire l’incidence du paludisme aussi bien dans les zones d’intervention qu’à l’extérieur de ces zones. Cependant, des actions combinées ciblant à la fois le vecteur et l’hôte, coordonnées à large échelle sont nécessaires dans les régions et pays visant l’élimination du paludisme à court/moyen terme.Dans la deuxième partie nous avons évalué différentes méthodes d’estimation de la mobilité humaine en l’absence de données individuelles. Ces méthodes incluaient la traçabilité spatio-temporelle des téléphones mobiles ainsi que les modèles mathématiques de gravité et de radiation. Le transport de l’agent pathogène dans l’espace géographique, par la mobilité d’un sujet infecté est un déterminant majeur de la vitesse de propagation d’une épidémie. Nous avons introduit le modèle d’impédance qui minimise l’erreur quadratique moyen sur les estimations de mobilité, en particulier dans les contextes où les ensembles de population sont caractérisés par leurs tailles hétérogènes.Nous avons enfin élargi le cadre des hypothèses sous-jacentes à la calibration des modèles de gravité de la mobilité humaine. L’hypothèse d’une distribution avec excès de zéros a fourni un meilleur ajustement et une meilleure prédictibilité, comparée aux hypothèses classiques n’assumant pas un excès de zéros : Poisson, QuasipoissonIn the first part of this thesis, we have developed a malaria transmission metamodel based on the susceptible-infected-resistant compartmental modeling framework (SIR) and taking into consideration human mobility flows between different villages in the Center of Senegal. Geographically targeted intervention strategies had been shown to be effective in reducing the incidence of malaria both within and outside of intervention areas. However, combined interventions targeting both vector and host, coordinated on a large scale are needed in regions and countries aiming to achieve malaria elimination in the short/medium term.In the second part we have evaluated different methods of estimating human mobility in the absence of real data. These methods included spatio-temporal traceability of mobile phones, mathematical models of gravity and radiation. The transport of the pathogen through the geographical space via the mobility of an infected subject is a major determinant of the spread of an epidemic. We introduced the impedance model that minimized the mean square error on mobility estimates, especially in contexts where population sets are characterized by their heterogeneous sizes.Finally, we have expanded the framework of assumptions underlying the calibration of the gravity models of human mobility. The hypothesis of a zero inflated distribution provided a better fit and a better predictability, compared to the classical approach not assuming an excess of zeros: Poisson, Quasipoisson
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Larabi, Islam Amine. "Nouveaux produits de synthèse : analyse, consommation et métabolisme ; Applications cliniques et médicolégales Rapid and simultaneous screening of new psychoactive substances and conventional drugs of abuse. A comparative study of Biochip Array Technology versus LC-MS/MS in whole blood and urine Development of a sensitive untargeted liquid chromatography– high resolution mass spectrometry screening devoted to hair analysis through a shared MS2 spectra database: A step toward early detection of new psychoactive substances Validation of an UPLC-MS/MS method for the determination of sixteen synthetic cannabinoids in human hair. Application to document chronic use of JWH-122 following a non-fatal overdose Development and validation of liquid chromatography-tandem mass spectrometry targeted screening of 16 fentanyl analogs and U-47700 in hair: Application to 137 authentic samples Prevalence and Surveillance of Synthetic Cathinones Use by Hair Analysis: An Update Review Prevalence of New Psychoactive Substances(NPS) and conventional drugs of abuse (DOA) in high risk populations from Paris(France) and its suburbs A cross sectional study by hair testing(2012–2017) Evaluation of drug abuse by hair analysis and self-reported use among MSM under PrEP: Results from a sub-study of the ANRS-IPERGAY trial. Hair testing for 3‑fluorofentanyl, furanylfentanyl, methoxyacetylfentanyl, carfentanil, acetylfentanyl and fentanyl by LC–MS/MS after unintentional overdose Drug‐facilitated sexual assault (DFSA) involving 4‐methylethcathinone (4‐MEC),3,4‐Methylenedioxypyrovalerone (MDPV), and doxylamine highlighted by hair analysis Metabolic Profiling of Deschloro-N-ethyl-ketamine (O-PCE) and identification of new target metabolites in urine and hair using human liver microsomes and high-resolution accurate mass spectrometry." Thesis, université Paris-Saclay, 2020. http://www.theses.fr/2020UPASL029.
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L’objectif de ce travail a été de développer deux approches analytiques dédiées à l’analyse toxicologique des nouveaux produits de synthèse (NPS) dans différentes matrices biologiques (sang, urine et cheveux). La première est basée sur le criblage non ciblé par chimiluminescence sur biopuces et chromatographie liquide couplée à la spectrométrie de masse haute résolution (LC-HRMS) et la deuxième correspond à un criblage ciblé par spectrométrie de masse en tandem (LC-MS/MS). Ces deux approches ont ensuite été appliquées dans des études observationnelles pour évaluer la consommation de NPS dans des populations à risques de surdosage, de pharmacodépendance ou de soumission chimique dans un contexte clinique ou médico-judiciaire.La dernière partie a été consacrée au développement d’un nouvel outil analytique de traitement des données issues de la LC-HRMS qui a permis d’étudier le métabolisme de 9 NPS in vitro sur des cultures de microsomes du foie humain (HLM) et in vivo sur des échantillons biologiques d’usagers de ces drogues. Cette dernière approche a permis la création d’une bibliothèque de spectres de haute résolution composée de 228 métabolites dont certains ont été proposés comme marqueurs pertinents d’exposition aux NPS dont ils sont issus.Ce travail a été concrétisé par la rédaction de 10 publications scientifiques et a permis d’initier plusieurs collaborations pluridisciplinairesThe aim of the present work was to develop two analytical approaches dedicated to the analysis of new psychoactive substances in different biological matrices (blood, urine and hair). The first approach is based on untargeted screening by both biochip array technology chemiluminescence assay and liquid chromatography coupled to high resolution mass spectrometry (LC-HRMS) and the second corresponds to a targeted screening by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). These two approaches were then applied in observational studies to assess the consumption of NPS in high risk populations (overdose, drug abuse, drug facilitated crimes) in clinical and forensic settings. The last part of the work was devoted to the development of a new analytical tool for LC-HRMS data processing which made it possible to study the metabolism of 9 NPS In vitro on human liver microsomes (HLM) and In vivo in biological samples from drug users. This approach has enabled the creation of HRMS spectral library containing 228 metabolites, some of which have been proposed as relevant markers of NPS exposure.This work has resulted on 10 scientific publications and allowed to initiate many multidisciplinary collaborations
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Prasada, K. L. "Tribal economy and tribal population distribution in Chamarajanagar District :A geographical analysis." Thesis, 2002. http://hdl.handle.net/2009/3157.
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ZHENG, SHENG-HUAI, and 鄭聖懷. "The Correlation between Pain Perception and Quality of Life among the Elderly Population at Tribal Culture Health Stations in Hualien." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/7ukfch.
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Smethurst, Tania. "Well-Being and Ethnic Identity Promotion for Aboriginal Youth: A Community Based Mixed Methods Study of Tribal Journeys." Thesis, 2012. http://hdl.handle.net/1828/4568.
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There are significant mental health disparities in Aboriginal communities in Canada as a result of historical assimilation policies (Health Canada, 2012). One approach to mitigating these mental health concerns is through prevention programs that include a wilderness component. Wilderness based programs for Aboriginal youth are informed by cultural wisdom and empirical research that connects immersion in nature with psychological well-being. The goal of this study was to collaborate with two community partners (Nala Winds canoe family from the Heiltsuk First Nation, and Victoria Native Friendship Centre) to develop an evaluation tool that will satisfy mainstream funding standards as well as community, cultural standards. This tool-kit was designed to reflect the youth experience and mental health consequences of Tribal Journeys, an annual canoe journey program for Coastal First Nations peoples. The findings were shared with community partners and may be helpful in facilitating the creation, maintenance, and evaluation of other Aboriginal youth programs.Graduate
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"The Effect of Vitamin D Supplementation on Plasma Aβ in an Older Population: A Randomized Control Trial." Master's thesis, 2015. http://hdl.handle.net/2286/R.I.34906.
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abstract: Vitamin D deficiency has been previously associated with a higher Alzheimer’s disease (AD) risk, a condition marked by dependent living and severe cognitive impairment. AD is histologically defined by the presence of brain amyloid beta (Aβ) plaques and neurofibrillary tangles. Ways to enhance Aβ clearance have been examined in order to sustain cognition and delay AD onset. In vitro and in vivo studies suggest that vitamin D might enhance brain Aβ transportation to the periphery by up-regulating P-glycoprotein production. The purpose of this study was to examine the effect of vitamin D supplementation on plasma Aβ in an older population.
This study was a parallel-arm, double-blinded, randomized control trial. Participants consumed either a vitamin D supplement or placebo once a week for eight weeks (n=23). Only vitamin D insufficient (serum total 25-OH, D < 30 ng/mL) people were included in the study, and all participants were considered to be cognitively normal (MMSE scores > 27). Serum total 25-OH, D and plasma Aβ1-40 measurements were recorded before and after the eight-week trial. The plasma Aβ1-40 change was compared between the vitamin D group and control group.
The vitamin D group experienced a 45% greater change in plasma Aβ1-40 than the control group. The effect size was 0.228 when controlling for baseline plasma Aβ1-40 (p=0.045), 0.197 when controlling for baseline plasma Aβ1-40 and baseline physical activity (p=0.085), and 0.179 when controlling for baseline plasma Aβ1-40, baseline physical activity, and age (p=0.116). In conclusion, vitamin D supplementation might increase brain Aβ clearance in humans, but physical activity and age also appear to modulate Aβ metabolism.Dissertation/Thesis
Masters Thesis Nutrition 2015
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Sarakarn, Pongdech, and 沙龐得. "Population-based Randomized Controlled Trial for Colorectal Cancer Screening in Nam Phong District, Khon Kaen Province in Thailand." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/x2wwc4.
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博士國立臺灣大學
流行病學與預防醫學研究所
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Background Colorectal cancer (CRC) is an important health problem and a major cause of morbidity and mortality in worldwide. In Thailand, the trend of CRC incidence during the last two decades has been still slight increase in overall and noticeably increased in men. Although several randomized control trials (RCT) have demonstrated the effectiveness of population-based CRC screening using guaiac fecal occult blood test, there is no RCT to support the implementation of CRC screening using fecal immunochemical test (FIT) as a primary screening tool. It is of great interest to know the sample size and effectiveness while planning a population-based RCT for CRC screening with FIT for countries with intermediate or low incidence of CRC. Aims The objectives of this thesis are; (1) to describe changes in the incidence of CRC among four aged groups which consist of persons who aged under 45 years, aged 45 years and older, and persons who aged under 50 years, aged 50 years and older from 1989 to 2012, (2) to provide some details and the results to date of a colorectal cancer screening trial using FIT, (3) to simulate a hypothetical trial cohort by applying the five-state natural history of CRC model to project effectiveness, and to determine sample size based on primary and surrogate endpoints for the proposed population-based RCT for CRC screening in Kohn Kaen. Methods To describe the trends of CRC incidence rate, we retrieved the data from the Khon Kaen population-based cancer registry to analyze for describing the trend of CRC incidence rate between 1998 and 2012 among four aged groups (persons aged under 45 years, persons aged 45 years and older, persons aged under 50 years, and persons aged 50 years and older and the target population of the trial aged between 45 and 74. Joinpoint regression analysis was employed to detect changes in trends among each line segment and overall lines showing whether increasing or decreasing, using annual percent change (APC) and average annual percent change (AAPC), was statistically significant. The preliminary results of CRC screening of Khon Kaen in Thailand were reported. The projected effectiveness and sample size required for the proposed population-based RCT for colorectal cancer screening with FIT was assessed on the basis of natural progression of colorectal cancer from pre-clinical phase to clinical phase. Results Regarding the trends of CRC incidence rate, the crude and age-standardized incidence rates of CRC between 1989 and 2012 in Khon Kaen for those aged 45 years and older and those aged 50 years or older were found to be gradually increasing over time both when men and women were combined or considered separately. The rates for men were higher than for women through the period from 1989 to 2012, whereas CRC incidence tended to be higher in women than men over the same period. For preliminary results of CRC screening of Khon Kaen in Thailand, 92 people (8.7%) were positive for screening using FIT. This rate was higher than that reported from the previous study in Thailand, which indicated that the incidence of positive FIT cases in the screening programs may be increasing. Our results also showed that f-Hb concentrations vary with sex and age: the f-Hb concentrations were higher in older than in younger participants and higher in males than in females. Given 100% of attendance rate and 100% of colonoscopy compliance rate, biennial screening with FIT was anticipated to reduce 34% mortality of CRC and 52% advanced CRC. The sample sizes for primary and surrogate endpoints based on the projected incidence of 54 per 100,000 were 43,047 and 23,352, respectively. Conclusion The incidence of colorectal cancer in Khon Kaen, Thailand, has shown a gradual increase in both the elder and the young population. Future studies should consider subsite distributions of CRC. The f-Hb concentrations by sex and age from the preliminary results of the randomized controlled trial showed the same trend found in the literatures. Given the results of incidence and the preliminary results of this trial, we projected the effectiveness of screening with FIT and demonstrated the determination of sample size in planning a RCT with disease natural history underpinning by considering the distribution of disease from a specific area.
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Papadakis, Sophia. "Evaluation of two multi-component interventions for integrating smoking cessation treatments into routine primary care practice: a cluster randomized trial." Thesis, 2010. http://hdl.handle.net/10012/5733.
Full textAbstract:
Background and Rationale: There is a well-documented practice gap in the rates at which evidence-based smoking cessation treatments are delivered to patients in primary care settings. Multi-component intervention that combine practice, provider, and patient-level supports have been shown to increase the rates at which primary care providers deliver smoking cessation treatments to patients and increase rates of smoking abstinence amongst patients. The incremental value of adjunct telephone-based smoking cessation counselling when delivered as part of a multi-component intervention has not been examined.
Aim: The primary objective of this study was to determine whether adjunct telephone-based smoking cessation follow-up counselling (FC), when delivered as part of a multi-component intervention program within primary care clinics is associated with increases in (a) the delivery of evidence-based smoking cessation treatments, (b) patient quit attempts, and (c) patient smoking abstinence when compared to the provision of practice and provider supports (PS) alone. The secondary objective of this study was to determine whether the introduction of a multi-component smoking cessation program is associated with increased delivery of evidence-based smoking cessation treatments by primary care providers and patient smoking outcomes, compared to pre-intervention rates. The study also sought to examine the association between patient, provider, clinic and implementation factors, and study outcomes.
Methods: A two-group, pre-post cluster randomized controlled trial was conducted. Eligible clinics were randomly assigned to the PS group or FC group. Both groups were supported with implementing a multi-component intervention program that involved outreach facilitation visits, provider training, real time provider prompts and patient tools, and performance feedback. Clinics assigned to the FC group were also able to refer patients who smoke to a telephone-based follow-up support program for supplemental counselling support. An exit survey was completed with a cross-sectional sample of patients who smoked daily at each study clinic before and after the introduction of the intervention program, and all patients were contacted 4 months later to complete a brief telephone-based interview. Outcome measures included the rate at which evidence-based smoking cessation treatments (5As: ask, advise, assess, assist, arrange) were delivered to patients, the number of patients who made a quit attempt, and patient smoking abstinence at the 4-month follow-up. All data was analyzed using multi-level hierarchical modelling.
Results: Seven family medicine clinics and 115 providers were enrolled in the study. A total of 12,585 patients were screened, and 835 eligible patients (mean age 45.8 SD± 14.6, 41% male) who smoke participated in the study. Contrary to the study hypothesis, a higher and statistically significant 7-day point prevalence abstinence (OR 6.8, 95% CI 2.1-21.7; p=<0.01) and continuous abstinence (OR 13.7, 95% CI 2.1-128.3; p=<0.05) rate was observed in the PS group compared to the FC group at the post-assessment after controlling for differences in smoking cessation rates between intervention groups during the baseline period. The introduction of the multi-component intervention program was associated with higher rates of provider 5As delivery and patient quit attempts compared to baseline, with no differences between groups documented. The odds ratios (OR) and 95% confidence intervals (CI) for 5As delivery between the pre- and post-intervention assessments for both intervention groups combined were: “ask” (OR 1.5; 95% CI 1.1, 2.0); “advise” (OR 2.0; 95% CI 1.5, 2.7); “assess” (OR 2.1; 95% CI 1.6, 2.9); “assist” with cessation (OR 2.30; 95% CI 1.70, 3.12); “arrange” (OR 1.9; 95% CI 1.2, 3.0); and “patient quit attempts” (OR 1.4; 95% CI 1.04, 1.94). Differences in 7-day point prevalence abstinence were not statistically significant between the pre- and post-intervention assessments (OR 1.5; 95% CI 0.94, 2.5). The study documented intra-provider variability in the rates at which evidence-based smoking cessation treatments are delivered to patients. Patient characteristics (readiness to quit, time to first cigarette, previous quit attempt in the last year), and the purpose of the clinic visit being for an annual health exam were associated with higher rates of 5As delivery.
Conclusion: This is the first study to evaluate a multi-component smoking cessation intervention within the primary health care setting in Canada. The study findings demonstrate that the introduction of a multi-component intervention program in primary care settings was associated with significant improvements in the rates at which providers deliver evidence-based smoking cessation treatments, and increase patient quit attempts. The added value of adjunct telephone counselling was not evident at the 4-month follow-up. The conclusions that can be drawn from the present study are limited by the study design and sample size. A larger trial is required to conclusively determine the impact of the program on long-term smoking abstinence and examine the importance of clinic-level variables in explaining observed differences between study clinics.