Thesis (Ph. D.)--University of Washington, 2007. / Vita. Includes bibliographical references (p. 511-533).

Thesis (Ph.D.)--Australian National University, 2003.

Thesis (M. Sc.)--University of Hong Kong, 1990. / Xerox of typescript.

Thesis (D. Min.)--Ashland Theological Seminary, 1991. / Abstract. Includes bibliographical references (leaves 203-211).

Thesis (S.T.M.)--Yale University, Divinity School, 1985. / Includes bibliographical references (leaves 54-55).

Thesis (Ph.D.)--University of Texas at Dallas, 2006. / Includes vita. Includes bibliographical references (leaves [212-222])

Introduction: Understanding the life-course determinants of resilience to brain ageing could significantly reduce the burden of cognitive impairment and dementia on individuals, heath care providers, and societies. The focus of this work is the concept of cognitive reserve (CR), which implies that some individuals are able to remain cognitively healthy despite the accumulation of age-related neuropathology. Methods: The determinants of brain structure and function were statistically modelled using three ongoing ageing cohort studies [Aberdeen Birth Cohort of 1936 (ABC1936), Aberdeen Children of the 1950s (ACONF), The Three-City French Cohort (3C)]. First, I performed a systematic literature review to identify life-course determinants of CR. Then, I examined whether other potentially modifiable life-course factors such as birth weight, mid-life occupational profile, and late-life social relationships and technology use provided individuals with greater CR. I modelled data in STATA and SPSS/AMOS. Results: I found that the effects of low birth weight and pre-term delivery on cognitive functions persists into mid-life (ACONF). I showed that childhood intelligence at age 11 has almost twice the protective effect on cognitive ageing than mid-life occupation (ABC1936). The quantity and quality of social relationships (3C), and the aspects of technology use in latelife (ABC1936) did not provide greater CR. Conclusion: Early-life factors contribute to later-life brain health. A major implication of this work is that studies and/or programs should consider a life-course perspective (with a focus on early-life) to accurately assess and to improve the brain health of older adults.

Health and public health services in England are under increasing financial pressure. At the same time, nearly 40% of the total disease burden is potentially amenable to known causes with two of the leading behavioural risk factors being unhealthy diets and physical inactivity. To better inform decision makers and improve health in England, this thesis aims to develop a cost-effectiveness model that can directly compare diet and physical activity interventions. Published public health economic models were reviewed and the strengths and weaknesses of the modelling structures were explored. A pre-existing multistate life table model, PRIMEtime, was developed into PRIMEtime Cost Effectiveness (PRIMEtime CE). Disease specific NHS England costs were derived from NHS England Programme Budgeting Data and unrelated disease costs from NHS cost curves. Social care costs were quantified using a Department of Health tool for estimating wider societal costs. Disease specific utility decrements were adopted from a catalogue of EuroQoL five dimensions questionnaire scores. The cost effectiveness of reformulating food to have less salt and of expanding access to leisure centres in England were modelled from an NHS and social care perspective over a 10 year time horizon, including government and industry costs. Salt reformulation was dominant with an estimated cost per quality adjusted life year (QALY) of -£17,000 (95% uncertainty interval, -£40,000 to £39,000), compared with £727,000 (£514,000 to £1,064,000) for increasing access to leisure centres. Sensitivity analyses and cross validation testing of outcomes demonstrated how cost per QALY estimates were sensitive to the choice of model scope, parameters, and structure. PRIMEtime CE is a tool for decision makers to compare interventions affecting diet and physical activity, enabling them to make better informed choices about how to spend finite resources. Future work will focus on making the model freely available and expanding its risk factors to enable comparisons of other public health interventions.

Over the past 20 years there has been a clear shift in Peru’s mortality profile towards non-communicable diseases. As part of this transition, childhood overweight and obesity (O&O) has become a growing public health concern. In order to address this challenge, context-specific information is needed concerning prevalence, associated factors and culturally appropriate interventions. To this end, I conducted a mixed methods study using a socio-ecological framework to investigate childhood overweight and obesity in Peru. This study found a prevalence of 19.2% overweight and 8.6% obesity among children aged seven to eight in a pro-poor cohort in Peru. Factors associated with being overweight in this cohort included: a high socioeconomic status, living in metropolitan Lima, an O&O mother, being male and being an only child or having only one sibling. The quantitative analysis highlighted the prevalence in O&O in this population and revealed a number of relationships explored in more depth via interviews and focus group discussions. The qualitative component of this research explored these associations amongst a sub-sample of children, parents and teachers in three distinct geographical regions in Peru. My qualitative research showed that parents, teachers and children are aware of the health implications of childhood overweight and obesity and that they have a sophisticated understanding of the many factors that influence its aetiology. Participants also had many suggestions for ways to address this issue in their community. This information was complemented by a systematic review and meta-analysis of the evidence of childhood O&O interventions that took place in Latin America published between 1990 and 2011. A combination of diet, physical activity and pharmaceutical strategies have shown modest effect on BMI reduction in O&O children, but more evidence is needed for effective population-level prevention strategies. The findings highlight the need for comprehensive, multi-level interventions. Notable intervention components include: kiosco reform, junk food taxation, creation of recreational space and enhancement of school-based physical activity programmes. To accomplish this, communities need to be mobilised and work together with school administration, municipal and national government.

Damage to health: comparative study The final thesis deals with the issue of damage to health in the Czech, American and French legislation and case law. The work deals with individual claims arising from injuries and thesis describes the criteria and methods of compensation for these claims. The thesis is divided into three chapters, which are further divided into subsections and subchapters. The first half of the thesis describes the legislation of damage to health and personal injury in the Czech law. This part focuses on the conditions that must be met in order to create an obligation of compensation for personal injury. It also describes the damage to health and its partial claims which may be compensated and it describes the process of determining the amount of damages according to the Methodology of the Supreme Court. Final part of this chapter deals with damages to health caused by medical malpractice. The second half of the thesis is divided into two parts, the first part deals with the US legislation of compensation for damage to health and the second part concentrates on the French legislation which deals with this institute. In the chapter devoted to American law, the work describes the different types of personal injury compensation, which developed in the United States. The thesis...