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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
261

Improving secondary prevention after transient ischaemic attack and minor ischaemic stroke

Paul, Nicola Lisa Marie January 2011 (has links)
Stroke is the second most common cause of death worldwide and the leading cause of long-term neurological disability. In the UK, stroke accounts for approximately 6% of total National Health Service and Social Services expenditure. The burden of stroke is predicted to increase because of the ageing population. Whilst effective primary prevention is important, about 30% of strokes occur in individuals with a previous transient ischaemic attack (TIA) or minor stroke. Recent prospective studies have shown a high early risk of recurrent stroke in the days after TIA or minor stroke. The prompt use of preventative strategies has been shown to be highly effective in reducing this early risk of recurrence and there is now a consensus in favour of rapid access services and urgent secondary prevention after TIA. However, there are several areas where clinical practice still needs to be improved, including delays in seeking medical attention, the reliability of clinical diagnosis of TIA in the acute phase, prediction of stroke recurrence risk and the control of risk factors, particularly blood pressure (BP), in longer-term secondary prevention. My thesis will focus on these clinically important areas. I have used data from a population-based study; the Oxford Vascular Study (OXVASC). OXVASC is a prospective, population-based incidence study of vascular disease in all territories in Oxfordshire, UK, which started in 2002 and is ongoing. The study population comprises approximately 91 000 individuals registered with nine general practices and uses multiple overlapping methods of “hot” and “cold” pursuit to identify all patients with acute vascular events. The research described in this thesis has several clinically useful findings which address areas for improvement during the patient journey after TIA and minor ischaemic stroke. First, I have highlighted that despite public education campaigns, about 70% of patients still fail to correctly recognise TIA or minor stroke symptoms and about 30% delay seeking medical attention for over 24 hours. Second, I have shown that recurrent TIA within 7-days is not associated with a greater stroke risk than after a single TIA, other than in the capsular warning syndrome. Third, in patients with definite posterior circulation TIA or stroke, preceding transient isolated “brainstem” symptoms occur in 26%, which has implications for the current diagnostic criteria for TIA. Fourth, I have shown that the Face Arm and Speech Test does not reliably identify patients at high early risk of recurrent stroke after TIA and minor stroke and has limited potential to improve access to care. Fifth, I have shown that outpatient management of clinic-referred minor stroke is feasible and may be as safe as inpatient care. Sixth, that stroke recurrence risk after minor stroke is delayed compared with TIA, and is high during the subacute phase despite current best medical treatment. Seventh, I have assessed Bluetooth- based home BP monitoring after TIA or minor stroke as a way of achieving better BP control and shown that this method is feasible, irrespective of age, and patient satisfaction is high. Finally, I have studied the late outcomes after TIA and stroke in OXVASC in comparison with a similar cohort from the 1980’s. I have shown that the age and sex specific later risk of recurrent stroke after TIA and stroke in Oxfordshire has fallen. However, the risk of fatal recurrent stroke remains high in contrast with the risk of fatal cardiac events which is low.
262

Improving aetiological classification of transient ischaemic attack and ischaemic stroke

Li, Linxin January 2014 (has links)
Transient ischaemic attack (TIA) and ischaemic stroke is a heterogeneous disease with more than 150 known causes including different cardiac, arterial, hemodynamic and other systemic abnormalities. TIA and ischaemic stroke of different aetiology have been suggested to have different risk factor profiles, clinical manifestations and prognoses. Therefore categorization of patients into classes congruent with the aetiology is the key to both understanding and managing stroke. Such categorization requires assembling stroke features to create categories based on similarities and is known as aetiological classification. Accurate aetiological classification is indispensable in epidemiological and genetic studies and in clinical trials. However, all current stroke classification systems have limitations. Perhaps the most important limitation of all current stroke classification systems is that about one-third of TIA and ischaemic stroke are of undetermined aetiology despite standard diagnostic work-up, potentially undermining primary and secondary stroke prevention. Therefore, better understanding of stroke aetiology will help to improve the classification of TIA and ischaemic stroke hence ultimately improving the prevention strategy. The aim of my thesis has been to compare characteristics of currently used aetiological classification systems, to explore the underlying causes for TIA and ischaemic stroke of undetermined aetiology, and to study aetiological classification related aspects of TIA and ischaemic stroke, including risk factors, imaging characteristics, plasma biomarkers and prognoses. I have collected, collated and analysed data from the first ten years of the Oxford Vascular study (OXVASC), which is an ongoing prospective, population-based incidence study of vascular disease in all territories in Oxfordshire, UK. The study population comprises approximately 92,728 individuals registered with nine general practices and uses multiple overlapping “hot” and “cold” methods to identify all patients with acute vascular events. There are several clinically relevant findings in this thesis which address areas that could be improved for better aetiological classification of TIA and ischaemic stroke. First, I have validated the aetiological classification of TIA. Second, I have found that compared to the widely used TOAST aetiological classification system, the stringent requirements for adequate investigation in recently developed classification systems do not add subtype-specific information to reliably reduce the assignment to the undetermined subtype. Third, I have shown that neither occult atheroma nor traditional risk factors appear to account for undetermined TIA and ischaemic stroke. However, previous migraine may have a particular role in the aetiology of undetermined TIA and ischaemic stroke. Fourth, I have shown that compared to cases of non-small vessel disease, small vessel disease cases have higher long-term average systolic and diastolic blood pressure but less long-term blood pressure variability. Fifth, I have shown that in contrast to cases of small vessel disease, white matter changes on brain imaging are not independently associated with non-small vessel subtypes. Sixth, I have shown that applying haemostatic and inflammatory markers in stroke aetiological work-up would appear to have little potential to add very limited information regarding the specific underlying cause of different aetiological subtypes. Finally, I have highlighted the large clinical burden of TIA and ischaemic stroke of undetermined aetiology by showing that compared to cases of determined aetiology, undetermined TIA and ischaemic stroke appears to have non-benign short- and long-term prognoses.
263

Evildoing : an attack on morality

Harrosh, Shlomit January 2010 (has links)
This thesis presents a comprehensive theory of evildoing as an attack on morality, grounded in objective morality. It introduces evildoing as a distinct category of immorality, arguing that it is the relationship of evil acts to the core of morality that distinguishes them from ordinary wrongdoing. Two projects are undertaken: to provide an account of morality that can ground a theory of evildoing that is both objective and capable of systematically accommodating the diverse phenomena and definitions of evil acts, and to articulate and defend the attack on morality theory of evildoing. The challenge of the first project is met by a minimalist account of morality, structured by what I call the fundamentals of morality. The thesis defends a particular substantive account of these fundamentals, underpinned by the idea of conatus as the end of morality. Ultimately, it is conatus as the striving to persist in existence and prosper inherent in human beings that justifies the objectivity of the fundamentals of morality and with it the objectivity of the theory of evildoing, for it is these fundamentals that are attacked when we speak of an ‘attack on morality.’ Specifying and defending the conditions necessary for such an attack is the task of the second part of the thesis. An act constitutes evildoing, or an attack on morality, when it is wrong, results in serious harm to others, originates in an intention based on the correct belief that the act will cause or risk such harm, and where the perpetrator’s mental states and/or the act’s consequences are antagonistic to the realization of morality via one or more of its fundamentals.
264

Restoration Techniques for Northern Bobwhites

Newman, William L. 05 1900 (has links)
Isolated populations of northern bobwhites (Colinus virginianus) have declined causing many quail managers to attempt population restoration by releasing captive-reared bobwhites or translocating wild bobwhites. I evaluated three restoration techniques: (1) release of captive-reared bobwhites, (2) translocation of bobwhites from high densities to low densities, and (3) release of captive-reared and translocated bobwhites acclimated on site prior to release. These results show that captive-reared birds have reduced survival and fewer nesting attempts when compared to translocated birds and that acclimation time was not a factor. I hypothesized that high mortality rates were caused by captive-reared birds exhibiting different predator avoidance behavior than wild birds. Captive-reared and wild-trapped bobwhites were subjected to independent predator simulations and their responses were recorded on high definition video. Threat recognition time, reaction type, and reaction time was recorded for comparative analysis. Pen-reared birds recognized the simulated raptorial and terrestrial predator threats quicker than wild-trapped birds, but reaction times were not different among groups. However, the type of reaction was different among groups where pen-reared birds typically flushed immediately upon recognizing either simulated predator as compared to wild-trapped birds which typically ran or held when subjected to the raptorial threat and showed little to no observable reaction to the terrestrial threat. These results reveal a potential loss of a holding trait in pen-reared birds, resulting in a quicker revealing of their position in the presence of a threat, thereby increasing their risk of predation.
265

The Association Between Periodontal Disease and C-Reactive Protein In Patients With a History Of Heart Attack

Fletcher, Robert Lee, III 01 January 2004 (has links)
The patient population consisted of a maximum of 18,570 subjects who completed the NHANES III questionnaire and examination from 1988 - 1994. The physical examination included such things as body mass index and serum samples, social and medical history. The periodontal examination recorded probing depth, attachment loss and gingival bleeding. Serum samples were analyzed for CRP levels, cholesterol levels etc. Demographic, cardiovascular and oral health variables were compared in subjects with a history of heart attack. Result showed that history of heart attack is associated with increased odds ratio for elevated CRP, diabetes, hypertension, cholesterol, male gender, non-white race and smoking. Of the periodontal indicators of disease, only gingival bleeding had an increased odds ratio for association with heart attack history. The unadjusted odds ratio was 1.25 with 95% CI[0.84-1.87]. The adjusted odds ratio increase to 1.93 with 95% CI [1.02-3.71]. These findings are consistent with previous research indicating that elevated CRP is associated with increased risk of heart attack. The interesting finding of this study is that only gingival bleeding, not probing depth or attachment loss, had an increased odds ratio for an associated with self-reported history of heart attack.
266

Útoky založené na hardwarových chybách / Attacks based on hardware bugs

Válková, Martina January 2011 (has links)
Title: Attacks based on hardware bugs Author: Martina Válková Department: Department of Algebra Supervisor: Mgr. Štěpán Holub, Ph.D. Supervisor's e-mail address: Stepan.Holub@mff.cuni.cz Abstract: The study concerns hardware bugs producing computational errors and cryptanalytic attacks which utilize them. Particularly, the research is focused on attacks presented in the article by Biham E., Carmeli Y., Shamir A.: Bug Attacks [1] and their practical application in the case of schemes RSA and Pohlig-Hellman and various computational circumstances, which points out bigger vulnerability of schemes in the case of using the Right- to-Left modular exponentiation algorithm. The attacks have been tested against the software simulation of a faulty processor, which confirmed that they pose a real security threat in point of that situation. The mathematical part of this work concerns the problem of the finding any roots in Zp. Keywords: hardware bug, attack, RSA, roots modulo p
267

Vliv výkonnosti středového a univerzálního hráče volejbalu na výsledky utkání ve vrcholové soutěži / Influence the performance of the center and versatile volleyball player on the results of matches in the top contest

Mach, Radek January 2013 (has links)
The title of the thesis: Influence the performance of the center and versatile volleyball player on the results of matches in the top contest Place: Charles University Faculty of Physical Education and Sport Department of Sport Games Author: Bc. Radek Mach Branch of Study: Physical Education and Sports honour volleyball Thesis Supervisor: doc. PhDr. Jaroslav Buchtel, CSc. Year of Thesis Defence: 2013 Summary: This thesis focuses on the game of middle blockers and diagonal players in top volleyball competitions. Our research followed all diagonal players and middle blockers in Czech top volleyball competition, organized by the Czech Association of volleyball in the year 2011/2012, in all of their gaming activities that were processed by the statistical program - Data Volley. Goals: The goal is to determine whether game activities and the skills of middle blockers and diagonal players significantly affect the results of matches. Methods: Information for the research part of this thesis, were based on the statistical data of the Czech Volleyball Association. These data are collected every year for the needs of clubs and coaches. The obtained data were statistically analyzed and results were subjects of research using Spearman's correlation. The final correlation coefficients were then subjects of...
268

Moderní tréninkové pomůcky pro lední hokej / Modern training equipmens for ice hockey

Křepelka, Jonáš January 2014 (has links)
Title of work: Modern training equipmens for ice hockey Goal of work: Using standardized interviews to determine the frequency of use of modern hockey equipment abroad, then through a questionnaire survey, the frequency and the current status of the use of modern hockey equipment for ice hockey players aged 12-13 years in the Czech Republic. According to the findings recommend examples of training exercises that are suitable for the development of skills for players to prepare for the ice and off the ice. Method: Observation, indirect observation, document analysis, questionnaire survey, data analysis, standardized interview. Results: The results of the thesis we have shown that the frequency and condition using modern training aids for ice hockey in the Czech Republic compared to other countries at a low level. Some tools are used by us all. 40% of those surveyed teams in our equipment in use. On this basis, I recommend examples of training exercises with the use of modern equipment for ice hockey, and I brought a few suggestions on how to properly work with modern tools. Keywords: Ice Hockey, Skating, Stickhandling, Equipmens, Slide Board, Passmaster, Attack triangle, SweetHands
269

Analýza vztahu použitých obranných systémů a charakteristik rychlého útoku u vybraného družstva házené / Analysis of defence systems and attributes of fast attack used for selected handbal team.

Jelínek, Roman January 2017 (has links)
Title: Analysis of defence systems and attributes of fast attack used for selected handbal team. Objectives: The objective of my dissertation was to find out reciprocal relations between defence systems and quantity (quality also) attributes of fast attack used for top handbal team in Czech republic. My next objective was analyzation of recorded values and comparation with available values of national teams from top events like Olympic games, European and World championship. Methods: We used for our dissertation methods of direct observation, indirect observation and analyzation. The results were processed by Microsoft office Excel 2007 and there was used chi-squared distribution of independence. Results: We found out in our dissertation that the observed team was frequently in fast attack during more agresive zone defence system 1:5 than the other defence systems used during games in season 2015/2016. The next detection is that observed team had almost the same quantity of fast attacks in one game like national teams during big international tournaments but there was found a big difference in proportional success of attacks for national teams. The participation of goals from fast attacks and total attacks is bigger for our observed team than for national teams on big international tournaments but...
270

The justice of preventive war

Stephenson, Henry Alan 09 1900 (has links)
Approved for public release; distribution is unlimited / In response to the 9/11 attacks and continuing threats of mass-casualty terrorism, the United States has adopted a new security strategy that emphasizes anticipatory actions including preventive war. Prevention, undertaken in the absence of an act of aggression or an imminent threat, is prohibited by modern conceptions of just war and international law. Many critics of the strategy fear that any legitimization of preventive war would endanger international stability. But an examination of the relevant ethical issues from the perspective of just war doctrine reveals contradictions within a blanket prohibition of preventive war. Preventive "strategic interventions" against illiberal regimes-states that correlate with the threats of terrorism and weapons of mass destruction-parallel humanitarian interventions in that they have an ethical basis in the relationship between human rights and the right of state sovereignty. A widely-accepted minimum standard of human rights, incorporated into new international institutions and/or an explicit revision of the definition of just war, could serve as an ethical boundary for both preventive wars and humanitarian interventions. The formal qualification of prevention and its merger with humanitarian goals could bring enhanced international legitimacy and support to preventive actions by the United States and its allies. / Lieutenant Commander, United States Navy

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